Autism Therapy: transition

definition of transition: Transition is the activity of moving from one place to another. Transition for people with autism can mean moving from a special ed class to a mainstream class, or it could mean moving from school into a job situation. Transition services are increasingly offered to young adults as they leave the school system and move into the work place and independent living.

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Teaching Exceptional Children, by Roberts, JMA, Keane E., and Clark TR, published in 2008, summarized Nov 11, 2009

A school program in Australia features specialized classes for children with autism within general education schools.

The Autism Spectrum Australia Satellite Class Project provides “small specialist classes” for children with autism. The goal of the program is inclusion of children with autism in general education classrooms. These satellite classes help children with autism transition into general education classes. They provide behavioral therapy for the children. The classes also teach children social and communication skills. The article describes the importance of the individualized education plan (IEP) that tailors the transition plan to the needs of the individual. The program has been successful, and students stay in the general education program long-term.


Journal on Developmental Disabilities, by Levy, A., and Perry A., published in 2008, summarized Nov 5, 2009

Behavioral therapists and special education specialists have differing views about transitions from intensive therapy to the school setting.

Children with autism often get intensive behavioral intervention therapy (IBI) when very young. They then transition to a classroom with typically developing children. The authors asked IBI therapists and special education specialists about how to best transition children from therapy to school. The therapists have a stronger belief in preparing children for transition than the education specialists. Both groups agreed that transition coordinators, parents, and teachers should be involved in the transition process. They recommended that transition start 4 to 6 months before the child starts in the classroom.


Work, by Higgins, KK, Koch LC, Boughfman EM, and Viersta C., published in 2008, summarized Mar 13, 2009

A transition treatment team that looks closely at the weaknesses and strengths of a person with Asperger's Syndrome may be able to help in the school-to-work transition.

Youth with Asperger Syndrome are at great risk of not having jobs. People with Asperger Syndrome are often smart, but they may lack the social skills and language usage skills required to hold a job. These skills may include eye contact, body posture, and gestures. People with Asperger's may come across as loners and not have a network of friends to rely upon to find a job. The authors of this paper look at Asperger Syndrome and issues that people with Asperger Syndrome may have as they move from school to work.


Education and Training in Developmental Disabilities, by Banda, DR, and Grimmet E., published in 2008, summarized Oct 31, 2008

Activity schedules may be able to help teach social, daily living, on-task, and transition behaviors in people with autism.

Activity schedules are easy to make and can be used for different routines and different settings. This review article looked to see if research supported the use of activity schedules for people with autism. The authors reviewed 13 studies and found that all of the studies showed that activity schedules help in the teaching of people with autism. Activity schedules seem to increase desired behaviors and are able to teach skills and behaviors that can be generalized to other settings and people (generalization). Some studies found that activity schedules were able to decrease tantrums and other problem behaviors that may be found during times of transition.


The Monarch School in Houston Texas has broadened its scope for serving kids with autism and other developmental disorders. Monarch serves students from pre-K through high school, but has added a post-graduate program to help older kids find jobs, transition to college, and live more independently in a group home setting. Monarch hopes this will help address the under and unemployment of many young adults with autism. Much of the problem has stemmed from students not being prepared to transition from school. Linda Holloway at the University of North Texas, explained, “We talk about this black hole after graduation. Too many young adults don't know about the resources out there.”

Read original article: Support Beyond School: Faculty Expands Services for People with Autism


Denise Reynolds, a registered dietician, has provided some good suggestions for toilet training your child with autism. She reminds parents that there are milestones that must be reached before a child can be toilet trained, for example, knowing how to dress and undress, understanding the bodily clues needed to use the bathroom, and walking. She explains that sometimes kids with autism have gastrointestinal problems that need to be addressed before successful toilet training. She quotes from an referenced article by Danica Mamlet, Autism and Toilet Training, for motivation cues and potential social integration issues. “A system that uses picture icons with each step identified is recommended as a tool to teaching toilet independence. A consistent routine capitalizes on the autistic’s child need for repetition.” Other tips include a transition object such as a book or a toy and teaching your child words specific to the bathroom so he can communicate. Reynolds’ final reminder is that each child has his own timetable and some children take longer than others to toilet train.

Read original article: Potty Training Tips for An Autistic Child


Camp Connect is a 5-week summer camp for kids on the autism spectrum. This New Hampshire camp, sponsored by Easter Seals and Works Fitness Centers, is in its 5th year of providing an experience that goes beyond a typical summer school-type environment. Camp Connect, staffed by professionals in the autism field, is focused on language development and increased social skills. Therapies used to enhance the camp experience include picture schedules, social stories, and a social skills-enhancement program called Super Flex. Easter Seals The Family Place, explains "Our approach is always positive when addressing issues that arise relative to transition, anxiety, or overwhelming circumstances. Our purpose is to assist children in learning how to handle all social situations, even those that are overwhelming for them."

Read original article: Camp Connect Helps Teach Art of Friendship


The Socorro Independent School District in El Paso TX has increased the size of their autism resources. Their goal is that when children with autism graduate from high school, they should be able to live and work independently. Elementary school children are eligible for the unit, which provides visual cues to find different classrooms, a sensory area, and a play therapy area. Susan Kelch, the director of special education says of the job training, “They need a lot of structure, and they need a lot of scheduling, and so we really need to teach that very specifically for them.” Skills range from cleaning tables to banking.

Read origingal article: Autism Unit Part of Special Education Expansion



Please comment on this autism topic.

Thank You

Mar 23, 2011 by steveborgman

Thanks for the great information about parents pulling together to advocate for their adult children.  There is so much information out regarding children on the autism spectrum, but not a lot about services and transition processes for adults on the autism spectrum.

Stephen Borgman, Prosper With Aspergers


Responding to visual schedules

Dec 28, 2010 by Anonymous

One of the most important things to remember is that our words disappear, visuals (pictures) do not..  We all use visuals in one form or another, calendars, post it notes, grocery lists, etc.  We all look to visuals for information for instance on the highway for a hospital, gas stations, places to eat and restrooms, divided highway ahead, merge to the right, speed limit 35 and Stop. Visual strategies though, are created with an intended focus of giving particular person information that they are not picking up naturally. If one mentions an abstract word to a group of people, they all may have a different vision of what that word means or looks like.  A picture of the correct definition puts everyone on the same page with regards to comprehending the intended meaning of the word for that purpose. For instance your child may associate “eating” with their favorite cookie so when you say “we are going to eat” they are envisioning getting their favorite cookie, when in fact you are talking about giving them an egg for breakfast.  There is confusion and probably a meltdown because they have a different view of what “eat” means.  Visuals can help take away that confusion for them as well as their expectation of getting the cookie, especially if they are looking at a picture of a plate of eggs, then they are prepared as well for eggs for breakfast, or for what “we are going to eat.”


Visuals can be used to teach so much more than just schedules. I am the mother of a daughter with autism, who is now 16.  I began using visual strategies with her when she was 3.  They were affordable, I could do this myself and I did not need expensive equipment to find success.  My daughter did have speech and occupational therapy and she did have a supportive team at school.  I used visuals to teach routines, behaviors, social and academic rules, academics and the list goes on and on.  I used them mainly to teach comprehension of our very abstract language and to also teach preparation for change.  I created transition tools for moving from one environment to the next.  She had bookmarks for the rules of the library, she had another bookmark with the class rules for doing seatwork as well as a foam cutout of a lunchbox with what to do when the lunchroom gets too noisy rule.  I found the visuals were the bridge or the key to her understanding.  They need to be used consistently, and you must have patience and you cannot give up.  When my daughter looked confused, I would ask myself what it was about the situation she did not understand and then I created a visual to show her. 


My daughter is now 16, a junior in high school, and is taking honors classes and two AP college level classes.  She is fully included and was on the yearbook and school newspaper for two years.  She has a great interest in sports and so her articles involved interviewing coaches and players for the articles.  I believe the early intervention; with the use of visuals throughout the years is a major part of her success. 


I co-authored a book with Linda Hodgdon, who is well known internationally in the use of visual strategies for individuals with autism.  Linda has written two great books “Visual Strategies for Improving Communication” and “Solving Behavior Problems in Autism”.  These were my constant companions and you may find them helpful as well.   As a result of using all these visuals with my daughter over the years, I co-authored an e-book with Linda called “Practical Communication Tools for Autism-Visual Strategies for Lifelong Success”.  It is about the journey with visuals and how they worked as well as pictures of many of them with my daughter.  These can be found at www.usevisualstrategies.com


No matter what resource you use, the bottom line is to get started, be patient, consistent and to not give up trying.  You don’t need to be trained in using a “system”, use your gut instinct. I tore apart magazines for pictures and used cereal box tops for cereal choices. This was before the age of the digital camera and film was expensive, but I did take a lot of pictures as well.  I had to teach my daughter how to point and until she could.  I read her facial expressions when I placed her hand on a picture.  We did a lot of detective work and we worked through many obstacles until we got it right, but it was so worth it. Visuals have no side effects and are easy to use and affordable…best of luck


College Living for Students with Learning Disabilities, Executive functioning Deficits, Autism Spectrum Disorders (including Autism, Aspergers, and PDD-NOS)

For students with special needs, life after high school is full of possibilities, including college.

Finding the right college program for students with autism spectrum disorders, Asperger’s, nonverbal learning disorder, ADD/ADHD and other learning disabilities is vital for a college student’s transition into independent adulthood. The right program should provide support for each student’s unique needs and goals.

With the help of New Directions, young adults with learning disabilities are experiencing independence for the first time in their lives. Some of our clients pursue collegiate endeavors and some pursue vocational training/tracks. New Directions helps students attend universities, community colleges, and technical and vocational schools.

For more information, go to http://www.newdirectionsfya.com/ or call 954-571-5102 to contact Dr. Drew Rubin, Ph.D.


Living Gluten Free – Right to Heal

Feb 22, 2010 by karmic health

By Sandi Star, CCN


After struggling for over 40 years with chronic migraines, IBS, Muscle and joint pain, fatigue, brain fog, asthma and a slew of other ailments and frustrations I decided to take a closer look at the cause rather than obsessing on the symptoms. I was tired of relying on doctors to give me answers and tired of the medications that only gave me side affects and little relief.


I had been committed to health and fitness for over 20 years, losing close to 50 pounds and 5 dress sizes, however I still had all the chronic conditions that played havoc in my life. I realized there was a key element missing and soon found out it was my reaction to gluten and dairy. I didn't know enough about food intolerance or allergies or at least put the two together. I never believed food could have such a serious impact on overall health let alone be the direct cause of my diseases. With what I know today I’m surprised my doctor didn’t put the connection together when he diagnosed me with Sjögren’s Syndrome (autoimmune disease). Sjögren’s is one of the symptoms of Celiac along with a long list as you will see below and nutrition plays a critical role in the healing process. By making the appropriate diet changes – (gluten and dairy free), I’ve managed to eliminate my migraines, IBS………etc., etc., and have the Sjögren’s Syndrome under control. Even better, I have eliminated all medications and use food and natural remedies for nutrition and overall health. Now that you know why I became a clinical nutritionist and why I started Karmic Health lets get into the details of why it’s so important to understand gluten and its relation to diseases.


Why the problem with gluten now? A lot has changed in the way we harvest food compared to 50 years ago. Some of the seed companies began engineering wheat kernels that could be more easily ground and produce fluffier flour to make the soft, delicious white bread for example had to have greater yields; it made more money for the farmer and increased sales.


Gluten is a composite of the proteins gliadin and glutenin. These exist, conjoined with starch, in the endosperms of some grass-related grains, notably wheat, rye, and barley.


Understanding what happens in the body and some of the symptoms will help millions of people who go undiagnosed. Celiac is the most common genetic disease of mankind (yet for every person diagnosed, 140 will go undiagnosed).


A wheat allergy is the body’s abnormal autoimmune response to a certain protein component of wheat; it’s exhibited by a severe sudden onset allergic reaction. Usual symptoms are immediate coughing, asthma, breathing difficulties, and/or projectile vomiting. It can cause life-threatening responses in allergic people. A true Wheat allergy affects less than 1/2 % of population. 


Intolerance's are much more common than true food allergies but are harder to diagnose. Food intolerance is an adverse reaction to food that does not involve the body's immune system. Generally food intolerance is an inability to properly digest certain foods. In some cases food passes right through the body before digestion is complete.


Leaky Gut is an increase in permeability of the intestinal mucosa to luminal macromolecules, antigens, and toxins associated with inflammatory degenerative and/ or atrophic mucosa or lining. Put more simply, large spaces develop between the cells of the gut wall allowing bacteria, toxins and food to leak into the bloodstream. Leaky Gut Syndrome has also been linked with many conditions, such as: Celiac Disease, Multiple Sclerosis, Fibromyalgia, Autism, Chronic Fatigue Syndrome, Irritable Bowel Syndrome, Eczema, Dermatitis, and Ulcerative Colitis. 


Celiac disease is an autoimmune disease caused by an inappropriate immune response to dietary proteins found in wheat, rye, and barley (gluten and


gliadin). This response leads to inflammation of the small intestine and to damage and destruction of the villi that line the intestinal wall. These villi are projections (small folds) that increase the surface area of the intestine and allow nutrients, vitamins, minerals, fluids, and electrolytes to be absorbed into the body. When the villi are destroyed, the body is much less capable of absorbing food and begins to develop symptoms associated with malnutrition and malabsorption. When the body is exposed to the gluten and gliadin proteins, it forms antibodies that recognize and act against not only the grain proteins, but also against constituents of the intestinal villi. As long as the patient continues to be exposed to the proteins, he will continue to produce these autoantibodies. Celiac disease is found throughout the world but is most prevalent in those of European descent. It can affect anyone at any age and is more common in women. It is thought to be an inherited tendency that is triggered by an environmental, emotional, or physical event – although the exact mechanism is not fully understood.


According to the National Digestive Diseases Information Clearinghouse, about 5 to 15% of close family members of a celiac disease patient will also have the condition.


Symptoms


There are literally dozens, if not hundreds, of symptoms of gluten intolerance. It all comes down to inflammation in the body! Many people believe the most common symptoms are gastrointestinal in nature - yet the majority of people with gluten intolerance (and celiac disease) have extraintestinal symptoms. 


The most common symptoms of celiac disease include:


Fatigue


• Addison’s disease (hormonal disorder)


Gastrointestinal distress (gas, bloating, diarrhea, constipation, vomiting, reflux)


• Headaches (including migraines)


• Infertility


• Mouth sores


• Weight loss/gain


• Inability to concentrate


• Moodiness/depression


• Amenorrhea/delayed menarche (menstrual cycles)


• Bone/joint/muscle pain


Dental enamel hypoplasia (dental enamel defect)


• Short stature


Seizures


• Tingling numbness in the legs 


The “cure” is a life long gluten free diet.


Making the Transition


1. Have a reality check. Remember this is a choice! If you want to feel lousy for the rest of your life and get worse as time goes on then continue eating gluten. If you want to start on a journey to heal; go gluten free


2. Give it time. It takes time to heal. Take the 45 day challenge.


Within this time frame you will notice the brain fog is gone. Your body will start adjusting to a healthy weight. Yes, you will lose the bloating and weight around the middle. Don’t be discouraged if it takes a little longer to feel 100%. 


3. Look at your current diet and go through your pantry and refrigerator to find the foods and meals you already eat that are gluten-free. You may need to keep a food journal if you haven't already.


Be sure to list condiments, ice creams, produce, snacks, and other foods.


This list will be helpful as you create menus around your new foods and give you encouragement that you're already on the right track!


4. Give yourself permission to eat things that you may have restricted from your diet before your diagnosis. Potato chips or GF cookies may not be appropriate for other people, but they are a treat in a GF diet in small doses of course. You will need to find treats for yourself initially as you adjust to this diet. Count calories after you are comfortable with your new way of eating, manage your portions instead.


Once you are comfortable with the switch start cutting back on refined grains, crackers, breads, etc., to help the gut heal quicker. In all honesty, bread will not be that important. It's all about taking baby steps! 


5. Look at your current menus and meals and find ways to eliminate gluten from your diet. Replace bread in sandwiches with GF bread or green leaf lettuce and add your favorite fixings and condiments. Have breakfast burritos with rice tortillas instead of toast and eggs. Look for GF hot and cold cereals (must not have barley malt) and have those handy for a snack or meal. Replace bread and crackers with tortilla or corn chips, brown rice cakes or popcorn. For example, chicken or tuna salad on rice cakes or scooped onto corn chips is delicious. Popcorn is a filling side dish with soup. Be on the lookout for meals on your current menus or the menus of friends and family that are naturally gluten-free (roasted chicken, baked sweet potatoes and steamed veggies, for example) and make them a staple on your new menus. Surf the internet, watch cooking shows and browse magazines for ideas and adapt them as you see fit.


6. Clear out any and all foods that have gluten, wheat, wheat flour, oats, oat flour, rye, semolina, or modified food starch from your pantry. This will allow you to see how close you are to living gluten-free already. If you have family members living with you who are not gluten free, you might consider giving the "offending edibles" to them to be put in another part of the house while you learn to live and think gluten-free. As time goes on you can cook for the entire family without gluten.


7. Plan and prepare your meals ahead of time. Being caught hungry without a plan is not a good idea! Keep a few GF soups on hand in case of extreme hunger. Keep a small cooler in your car with snacks such as nuts, dried fruit and water. It helps to outline and pack any meals you're eating at home and away from home, including snacks. An example could be -


o Breakfast: scrambled eggs and mixed vegetables rolled in a rice tortilla, sliced apples, and coffee.


o Lunch: Lettuce with turkey, avocado slices, tomato, and mustard, 1 oz. chips, and 2 organic dark chocolate pieces.


o Dinner: Grilled fish or chicken with mixed vegetables, wild rice, and fruit.


o Snacks: 1 oz. almonds and popcorn.


o Desert: Coconut Ice Cream or fruit. 


Tips


1. Be patient with yourself. You'll have days when being gluten-free is really depressing (maybe even "fall off the wagon"). This is normal.


Relax – it’s a process.


2. Carry snacks with you wherever you go. It's often difficult to find an appropriate snack when the hunger strikes. GF bars are great! 


3. Arrange with the hosts of gatherings you may attend to bring your own sides or complete meals. Most people are very supportive of restricted diets.


4. Carry a small cooler in your car with small cold packs to store fruit, snacks and water


5. Consider avoiding restaurants during your transition phase as you learn how to eat and think gluten-free. Grilled meats (over a flame), baked potatoes and salads without croutons are usually safe bets. But keep a log of places you eat, what you ate and how you felt afterward. Gluten is insidious and can turn up in the oddest places (french fries, for example which can be dusted with flour).


6. Get your hands on cookbooks or start collecting your own recipes in a binder. 


7. Carry digestive aids (enzyme and bioflavonoid) with you in case of accidental ingestion. There are ones specifically for gluten such as GlutenFlam by Apex Energetics; available from your healthcare practitioner.


8. Consider taking a multi-vitamin to make up for vitamins and minerals you may lack with your new diet (ask your doctor or nutritionist if necessary).


9. Find a mentor or support system.


10. Breathe


About the author: Sandi Star, CCN


Sandi is the founder of Karmic Health, specializing in nutrition related to disease where a gluten and casein (dairy) free lifestyle is crucial; working with celiac, autism and all auto immune disorders. Sandi graduated from The Natural Healing Institute with a degree in Clinical Nutrition and is continuing her studies in Clinical Herbology. She has hands on understanding of many health issues and has dedicated her life in helping others reach their optimal health.


For more information related to this article please visit www.karmic-health.com or contact Sandi Star at 760.685.3154


© Copyright Karmic Health 2010



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