Category Archives: Treatment

Unique Faces of Autism

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Credit: Lisa Feng

People often say, “If you know one person with autism, you know one person with autism.” But what does this mean? Take two boys Geoffrey Ondrich and Waylon Cude, 16 years old and unrelated, who both have the same diagnosis of autism.

Waylon is a very serious person and also very into computers. He spends the majority of his time playing games online and spent his last summer interning at IBM programming websites. He is a perfectionist when it comes to working on computers. Though he speaks politely and answers questions, especially factual ones, he doesn’t engage in too much other conversation.

On the other hand, we have Geoffrey, who loves his iPad where he watches pieces of his favorite movie or finds music to listen to and starts dancing. His other past times include rocking back and forth and slapping his left wrist onto his right hand. His clinician finds it hard to engage him as he picks up a plate and bites it, then rolls a toy car back and forth on the table.

Two boys, both have the same age and diagnosis, yet are living two very different lives. Geneticist David Ledbetter, chief scientific officer at Geisinger Health System in Danville, Pennsylvania says, “What we’ve learned in the last five years about the underlying genetics is that there are hundreds of, if not a thousand or more, different genetic subtypes of autism.” In the same sense, it is just as no two people have the same personality. Researchers are using this information to try to get to the root cause of autism at the genetic level that could create new treatments in the future that go to the root instead of just addressing the symptoms.

To read more about different mutations triggering different types of behaviors, click HERE



Parents Can Be the Best Resource

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When autism was first recognized as a disorder back in the 1940s, people thought that the parents were to blame for their child’s withdrawn behavior. Psychoanalysts thought that cold and detached parenting was the reason behind an autistic child having trouble communicating socially. However, today we know this is not true and there are biological shortcomings of the body and brain development that are responsible for these social deficits.

An important part of helping children on the spectrum with these issues of social interaction is being responsive to the child’s behaviors. This includes making comments or doing things that build on your child’s current interest and actions to support what they are already trying to do. For example, if your child is playing with a ball, you might point to the ball and say, ‘it’s a ball,’ opposed to taking the ball away and asking your child to say ball before giving it back.

Dr. Michael Siller, co-director of the Hunter College Autism Center and Dr. Marian Sigman, co-founder and co-director of the UCLA Center for Autism Research and Treatment (CART), have done research where they show that parents using this responsive method have children who develop better language and social skills. Another study assigned half a group of parents to a one-year long intervention program where they worked one-on-one with a speech therapist to improve their abilities and skills on understanding their child’s subtle social cues. This program was made to help parents interact in a more responsive way to their child. The other half of parents continued receiving their usual community services and, as expected, the parents who went through the program were more responsive and saw more positive results in their children’s social skills as well.

There is a lack of research done on parent-child interaction, since some people are afraid that parents will feel that they are being blamed. However, working on parenting skills and assigning blame are two very different things. This is an important area of research to continue to explore as it can have very promising results for children on the spectrum.



New Therapies for Autistic Children in the Near Future

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Scientists are gathering more and more evidence that autism symptoms can be caused by the bacteria found in the gut or intestines. Research is showing that there is a difference in the trillions of bacteria in a healthy child when compared to the bacteria in an autistic child. The bacteria can differ in quantity or type and these differences can make your child’s stomach more or less susceptible to stomach problems. Scientists are finding that these gut differences may actually have a significant effect on the brain and contribute to the disorder itself.

John Cryan, a professor of anatomy and neuroscience at University Cork College, led a study that showed mice who were fed probiotics were less anxious and produces less stress hormones. He explains, “You have this kilo of microbes in your gut that’s as important as the kilo of nerve cells in your brain. We need to do much more studies on autistic biota.”

When Caltech researcher Elaine Hsiao conducted a study on autistic mice, where they were injected with probiotics, showed results after five weeks of no longer having a “leaky-gut.” The bacteria in their stomach started looking more like a healthy mouse’s, they were less anxious and more vocal, and they also stopped obsessively burying marbles in their cages. Hsiao says, “It’s really impactful, this notion that by changing the bacteria, you could ameliorate what’s often considered an intractable disorder. It’s a really crazy notion and a big advance.”

So what does this all mean for future treatment options? Usually autism is treated with behavioral therapies, but this new research implies that autism may one day be treated in the form of a probiotic, which are “good bacteria” that our bodies need–very similar to the ones found in yogurt. Studies have shown that generally 90 percent of autistic children also suffers from stomach and gut issues, including leaky-gut syndrome, which is when bacteria from the gut trickles into the bloodstream. The CDC reports that there are 3.5 times more likely to experience chronic diarrhea and constipation when compared to their typically developing peers.



New Kickboxing Therapy Helps Kids with Autism Spectrum Disorder

Kids part of Fighting for Autism posing with Alex White, UFC and mixed martial arts fighter.

Fighting for Autism is starting a new trial for using kickboxing as a form of therapy for kids on the spectrum. The managing director of US of Fighting for Autism, Brian Higginbotham, who is overseeing their kickboxing therapy program, says “Their first day they couldn’t put a glove on and had no idea how to properly punch. Now they are doing eight strike and ducking under counter punches. It’s pretty cool to see the development and progression of the kids.”

They were able to start this program with the help of Dr. Avi Domnitz-Gebet, a pediatric neurologist at the Pediatric Neurodevelopmental Center in St. Charles and Christina Hannah, owner and inventor of ‘Changeable Chewables.’

So far, with the success they are experiencing, they are hoping to open new kickboxing programs around the world by partnering with other doctors or facilities that would want to host them. Dr. Avi says the program is great for kids and their parents and is a great opportunity to teach self-control, responsibility, and self-esteem. Having the parents involved to interact with their child is a rewarding experience all around.

Joe and Erica Worden, who usually teach MMA training, are also helping kids in the program. Joe explains how “after the first session one kid actually said ‘fun’ to me and his dad said ‘wow, he’s never talked to a stranger before,’ so that’s pretty cool. That is the kind of progress we are seeing, they are focusing more and there is more enjoyment. I would do whatever I needed to do to bring this program out here.”

Kickboxing is a good way for children to really focus on their hand-eye coordination and it puts them in an active environment with other kids and parents they can relate to. Physical exercise is really important for kids with special needs to be healthy and occasionally get out, especially for those on the lower-functioning end of the spectrum.



Tips for Helping Your Child with Social Interaction

Autism can sometimes be characterized by a person’s inability to connect with people, even their own families in a constructive and relationship-building way. The National Center for Learning Disabilities promotes that “guiding your child through various social scripts will enable him or her to navigate such situations with greater ease and less apprehension, especially when he or she is interacting with other children. Research has shown that adolescents with learning disabilities have difficulty in making and keeping friends, spend lots of free-time alone, especially watching television or on their computers.

Here are some activity ideas for helping your child prepare for certain types of social interactions they are likely to face throughout their lives:

– Read storybooks with themes on family and friendship and try to engage your child in storyline to help them understand the interactions between the characters.

– Identify specific social situations that are challenging for your child and role-play how to handle them one-on-one

– Give your child a scenario that he/she can understand and ask them to help you finish the story. Afterward, talk about their ending and other possible endings.

– While watching TV or a movie, point out social cues that may not be so obvious and talk about them with your child

– Make playdates for your child so they can get comfortable with interacting with other children. Supervision is an important part of helping your child along at first.

– If your child seems to have a particular interest, enroll them in an activity that can build on that interest and put them with other kids who have similar interests.

In helping them through these interactions, make sure to be actively listening at all times. For children who have a hard time communicating, you have to also try to understand their emotions, which can be expressed in a variety of ways including but not limited to: outbursts and repetitive behaviors. Also make sure to work with your child’s school and other professionals to make sure your child is having their needs met and that they are receiving appropriate services.

For more resources, click HERE



Earlier Autism Detection Raises Questions About Early Intervention

Autism is a genetic disorder that affects about 20% of younger siblings of those on the spectrum. Researchers are now saying that they often show symptoms as early as 18 months, according to a study published in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP). The study used 719 younger siblings of those with autism, otherwise known as ‘high risk’ siblings, who were assessed at 18 months and then 36 months to identify any social, communications, and repetitive behaviors that could be early symptoms. Warning signs such as poor eye contact and/or repetitive behaviors were observed in 57% of siblings and among those without symptoms at 18 months, for the ones who were later diagnosed, started showing signs by 36 months. Researchers note that about half of the children had poor eye contact combined with limited gestures and imaginative play while other children exhibited repetitive behaviors and lacked nonverbal communication skills.

Although it is important to detect these warning signs or early symptoms of autism, John Elder Robison, author of Raising Cubby, Look Me in the Eye, My Life with Asperger’s and Be Different–adventures of a free range Aspergian, and member of the Interagency Autism Coordinating Committee of the US Dept. of Health and Human Services, expresses his concern over early intervention. According to people on the spectrum who had received early intervention treatments as children, their experiences seemed half positive and half negative.

While many people talk about how wonderful it was to have that support throughout their childhood, “others talk about suppressing behaviors that embarrassed parents…[and] imposing their will where it was not wanted.” Robison argues that this is something to take into serious consideration as we move forward with creating new treatments and therapies for early intervention. He critiques our abilities to deter autism in infants now as young as 6 months old, asking what interventions are actually appropriate at this stage and to what end?

When providing intervention for a four-year-old, we are able to see the progress we make in the child’s behaviors and adjust our plans accordingly. However, with an infant, the issues are not very clear, Robison says, “We may pick up a sign of autism, but what kind of autism? Will the child be verbal or silent? Will the child be lovable, eccentric, unable to care for themselves or talk…it’s too early to know.”

As we continue to move forward with autism diagnoses at earlier stages, we also need to move forward in the methods and treatments we use for early intervention.

To read the original study, click HERE

To read John Elder Robison’s article, click HERE



ABA Therapy Continues Its Success

PHOTO: The Rogersons are happy their sons Tom (L) and Jack (R) are close but don't think Tom should be responsible for Jack as he grows older. (ABC: Australian Story)

Jack Rogerson was diagnosed with autism as a toddler and written off by many medical professionals as low-functioning and limited to special education schooling. He was a hyperactive child who could not express affection and could barely speak but his parents believed that with the right tools and support, their son would eventually be able to live independently and engage in all the same activities as his peers.

After meeting Dr. Elizabeth Watson, a speech pathologist and therapist, Jack’s parents learned about Applied Behavior Analysis (ABA) that is used for early childhood intervention for kids on the spectrum. ABA therapy is essentially “a teaching technique that breaks down every skill that a child needs to learn into very small discrete steps, each of which is taught individually with painstaking repetition and they joined together to complete the task. It is applied to everything from tying shoelaces to social skills and conversation.”

Living in Australia, they found no centers or schools offering ABA therapy and the resources that Jack needed. Wanting to expose Jack to ABA therapy in the hopes that it would help him, Ian and Nicole dedicated themselves to giving Jack the support he needed and turned their house into their own early intervention center. “You’d walk into the house and there’d be labels on things and a big whiteboard and words written on it…and computer screens,” Ian Rogerson explains. “We decided he needed roughly 25 hours a week in that first year of one-on-one therapy,” Nicole said.  

Ian and Jack were determined to mainstream school their son and were eventually able to place him in a public school in Sydney. Jack had an ABA trained helped with him at all times at first to help him adjust to certain routines and behaviors but by the end of his elentary years his ABA helped was only needed for a few hours a week.

Jack went on to the Special Education Inclusion Program where he learned academics as well as domestic life skills. Director of students, Adam Lewis, says, Jack’s help a leadership role this year as a house monitor…He speaks well and politely to the younger guys, he has very high standards himself in terms of how he presents and his own conduct.”

In 2003 Nicole Rogerson decided to team up with Elizabeth Watson to open and establish their own center that specialized in ABA therapy for children on the spectrum. Nicole says she was impressed with Jack’s progress after the therapy. And is now CEO if the non-profit Autism Awareness Australia. She says, “Intensive ABA programs are still the only thing that come out as showing any evidence whatsoever of efficacy, and they’re still not funding it. Unless the government makes a genuine investment in this area, so many children are not going to reach their best outcome and I think that’s a tragedy.”

Shema Kolainu is committed to providing resources for parents and families in all five boroughs and offers a variety of therapies. All of our programs are individualized and based on the science of Applied Behavioral Analysis. To read more about ABA therapy and all the therapies offered by Shema Kolainu, click HERE

HELP MORE CHILDREN RECEIVE ABA SERVICES, CLICK HERE  

To read the original story, click HERE



Nutritional Therapy for Parents

Autism spectrum disorders (ASD) are developmental disorders that affect children by disrupting their ability to communicate and interact socially. To reduce a child’s symptoms of autism and improve social and cognitive behaviors in speech, parents can try nutritional therapy. This is because many children with ASD have reported to have allergies and high sensitivity to foods, especially gluten and casein. Children with autism, according to the theory, process peptides and proteins in foods containing gluten and casein differently than other people do and this difference in processing may exacerbate autistic symptoms.

Identify those food allergies as soon as possible can be vital to the developmental progress of a child with ASD.  Gluten (found in wheat, barley and rye) and casein (found in milk and dairy products), are important in caring for an Autistic child and is worth trying out as many parents have reported changes in speech and behavior after utilizing nutritional therapy.  Parents can seek allergy testing for confirmation or keep a food diary, and remove certain foods from your diet, to determine exactly what your child is allergic to.

Before going to the grocery store, you can make a list of what your child can have.  You can give pictures of foods the child can eat and have them participate in choosing the foods they would like to eat, that way the child gets a choice but the choice is within a list of acceptable food.

You can have the child with ASD help you cross items off the list while shopping with you. Or you can say the name of the item, point to the item, have the child hold the item or put into the basket so the child starts expanding their vocabulary via sight and sound. You can describe color of the apple, the texture as child holds item, is it a hard or soft object. You can make it a game where she has to help you find what’s next on the list, help you grab it off the shelf, and help you count how many items are left on the list.  Every moment can be a teachable moment that you can do with the child, and even thought at first it seem they aren’t getting it, keep trying, like all children they need lots of repetition and imagery to learn something new.

You can use stickers, stamps, tokens as reward for good behavior. Make sure the rules for earning the tokens are clear and consistent. For example: “Listen to mommy, calm voice, hands to myself.” Stay away from vague rules like “Be good,” and avoid telling her what NOT to do “No crying.” Then when she exhibits the behaviors in the rules, you reward her with a token and praise the good behavior you saw. You might say something like, “Wow, great job listening to mommy/daddy. You earned a happy face!” Once the child with ASD has all the tokens, the child can have a reward. This will help the child with ASD to tolerate the delay in getting what she wants, because she can see that she is working towards it. Here’s a simple example of what it might look like.



States Slow to Move on Mandated ABA Coverage

Months after the federal government passed legislation requiring states to include coverage of therapeutic autism services such as applied behavior analysis (ABA) in their Medicaid programs, progress is slowly being made. 

It was determined in July of this year that Medicaid programs nationwide must cover “medically necessary diagnostic and treatment services” to children with autism spectrum disorders (ASD) including behavioral therapy, occupational and speech therapy, personal care services, and medical equipment. 

California is the first state to comply, issuing a bulletin to plan administrators September 15 explaining that Medi-Cal, California’s Medicaid program, will cover evidence-based behavioral intervention services including ABA for autistic children up to the age of 21. Coverage is available immediately for those who qualify for the program and will be retroactive to July 7, 2014. 

Connecticut and Nevada are expected to be the next states to expand their Medicaid coverage of autism services in compliance with the federal mandate, but no official announcements or timelines have been released. 

Despite warnings from the Centers for Medicare & Medicaid Services (CMS) back in July that it would likely take some time to for states to come into compliance with new regulations, a class action lawsuit has been filed in Hawaii over the state’s failure to provide Medicaid coverage for ABA therapy. We will have to wait and see if this gets the gears of Hawaiian state bureaucracy to move faster and whether similar suits are filed in other states that are slow to comply. 

Navigating Medicaid and obtaining services is complicated and different in every state. Many parents find it much easier to obtain the right services and coverage with the help of local autism advocates and service administrators. Organizations like Shema Kolainu Hear Our Voices School and Center for Children with Autism, serving children in all five boroughs of New York City help parents with Medicaid service coordination, early intervention programs, evaluations, speech therapy, occupational therapy,  physical therapy, and applied behavior analysis.



Video Game Therapy for Autistics

A recent study from Vanderbilt University found that what children with autism hear is often out of sync with what they see. Dr. Mark Wallace, who lead the study, describes it as, “a badly dubbed video.”

By comparing 32 high-functioning children with autism to 32 typically developing children, matched by age, sex, and IQ, researchers found that the children with autism had an enlargement in their temporal binding window (TBW). Simply put, their brains had trouble linking visual and auditory events that happened within a certain period of time.

“Children with autism have difficulty processing simultaneous input from audio and visual channels. That is, they have trouble integrating simultaneous information from their eyes and their ears,” said co-author Stephen Camarata, Ph.D., professor of Hearing and Speech Sciences. “It is like they are watching a foreign movie that was badly dubbed, the auditory and visual signals do not match in their brains.”

The second part of the study found that the autistic children also showed weakness in how strongly they associated audiovisual speech stimuli. Dr. Wallace believes this explains why autistic children often cover their ears or eyes. “We believe that one reason for this may be that they are trying to compensate for their changes in sensory function by simply looking at one sense at a time. This may be a strategy to minimize the confusion between the senses.” 

Building on the findings of this study, researchers are now in the testing phase of an interactive video game that they designed to retrain autistic brains in how they link different sensory input. As Dr. Wallace describes, “It basically takes the tuning of the nervous system and shapes it, so that they get better.”