Water Park Fun 

with autism 


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water park fun

water park

Before the Water Park Fun

What a beautiful morning for some water park fun! Our mornings typical starts with waking up at 5:30 am to prepare breakfast before Liam gets up. Liam is an early morning kind of boy who does not like to wait too long for breakfast. He adheres to routine and maintains his school morning routines regardless of the day of week. Regardless of whether it is a school morning, weekend, or holiday.

Once he opens his eyes to dawn, he likes to wait in bed for about five to ten minutes before getting up to brush his teeth. He walks to the kitchen to confirm that breakfast is being made. I usually finish the breakfast preparation just in time to join him in the bathroom to monitor his teeth brushing technique and offer help should he need it. Then comes the high five’ as positive reinforcement for brushing his teeth properly. After brushing his teeth, he cleans up after himself. Then comes more high fives. He loves those proud ‘high five’ moment.

 

scrambled eggs

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Before we get into the water park fun, let’s discuss the breakfast of the day. Today’s breakfast is scrambled eggs, bread rolls, with our favorite beverages. That is, a cup of coffee for me and for Liam, Emergen-c mixed with water. On rare days he will enjoy hot chocolate. However, mostly he prefers the Emergen-c mixture with his breakfast. We drink Emergen-c every morning to avoid the common cold. 

Earlier I mentioned his adherence to routine? Guess what? His breakfast must be placed at the left of the breakfast bar. Think of the Sheldon character on the TV show, the Big Bang Theory. Though, unlike the Sheldon character who never changes his spot on his side of the couch, Liam may change his spot at the breakfast bar on a few occasions to have breakfast around the dinner table. 

Encourage to Participate

  • Chooses from a list of breakfast options
  • Participates in breakfast preparations 
  • Helps with cleanup

coffee beans

SUPER SWEET FUN DAY


Liam did not always enjoy variety of foods. In many ways he is still quite picky. For instance, he will not eat any green vegetables unless creatively hidden. Sometimes, he will try lettuce or kale, but that is with a lot of encouragement in the form of high fives. As for fruits, he will only eat bananas. He will try most things except vegetables and fruits. This is much improvement. 

In the past, he would only eat oatmeal and a specific meal replacement drink. His food aversions lasted up until he was five years old. Now he eats most things prepared, excluding unconcealed green vegetables. I usually allow him to have a say in his breakfast choices. Whenever his breakfast of choice involved eggs, he is encouraged to participate in the preparation. 

At the Water Park 


Liam had no idea he was headed for some waterpark fun. All he knew and cared about was that we were heading out somewhere; anywhere for all he cared. He loves the outdoors. We drove to three waterparks only to find that they were closed for maintenance. After calling and driving around, we finally found a park that was open for some waterpark fun. It was a small, cozy waterpark with limited guests. Staff was welcoming and friendly. They were also surprisingly sensory-friendly, a great aspect of the establishment.

We were screened before entering the waterpark. Staff met us at entrance to inform us of the park rules, and to ensure we had proper and adequate equipment for play and safety.

 

Liam had a great day splashing, swimming, and playing at the waterpark. He even met a new friend. Our waterpark fun lasted from 10.30 am until 1:30 pm. He had so much fun that it was nearly impossible to get him to leave. When we initially tried to leave, he protested. With compromise, we were able to leave with the promise of returning for more waterpark 

water park fun

Protect Yourself and Family 

Coronavirus &COVID-19


Coronavirus and you

There is worldwide panic regarding the newest discovered form of coronavirus, a virus that causes respiratory infection. The rapid spread of the virus is causing global pandemic. As a result of public health concerns, government officials, scientists, and healthcare professionals are working nonstop to contain the spread of the virus. Little is known about COVID-19. Still, current research provides support for various treatment interventions to manage severe disease of those affected. Do your part in disease control by following recommendations to protect yourself and family from coronavirus. 

The World Health Organization (WHO) provides the latest and most up to date information about the virus. Find additional information on how to protect yourself and family from coronavirus.

What is Coronavirus?

Coronaviruses, including Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS) have been around for some time. However, the newest form of the virus, COVID-19 was reportedly first detected in December 2019 in Wuhan, China. It is a highly infectious viral infection that is spread through human to human contact. There are few reports of animal infection. However, not enough is known to confirm animal to animal or animal to human transmission. Currently, there is no vaccine against or cure for COVID-19.

Symptoms of COVID-19

COVID-19, a respiratory illness, causes symptoms of fever, cough, and shortness of breath. Symptoms can mimic that of the common cold or flu. These symptoms include body ache, fatigue, sore throat, runny nose, and nasal congestion. COVID-19 can also present with gastrointestinal symptoms of abdominal pain, diarrhea, and changes in smell and taste.

Symptoms usually appear within two to 14 days after exposure. Symptoms can range from mild to severe. It is possible to have an infection without displaying symptoms. Therefore, those at high risk for exposure should self-quarantine for 14 days.

Who Does it Affect?

COVID-19 can affect anyone. However, age, and comorbidities can affect symptom severity. The World Health Organization suggests that individuals with comorbidities such as high blood pressure, heart disease, lung disease, cancer or diabetes are at greatest risk for developing serious illness. Children with an underdeveloped immune system, and individuals with a compromised immune system are also at risk of developing serious disease.

Autism and COVID19

There are some reports that people with autism spectrum disorder are at increased risk of contracting COVID-19. However, little evidence exists to support a direct link between autism and ease of COVID-19 transmission. 

What if I have COVID-19?

Recommendations on responds to presumptive exposure or infection varies. While there are universal recommendations, other recommendations depend on where one resides. A standard recommendation is to self-quarantine.

Health officials are urging those infected with COVID-19 to refrain from visiting the hospital; unless they have severe symptoms that may require immediate medical attention and or hospitalization. Most people infected with COVID-19 do not require hospitalization. Most  recover without treatment. The approach for mild to moderate disease is symptom control. You can  acquire pulse oximetry for home use to monitor oxygenation.

 

 

How Can You Protect Yourself and Family From Coronavirus?

The easiest and most important way to protect yourself and family from coronavirus is proper hand hygiene. Wash your hands throughout the day, for 20 seconds at a time, with soap and water. You can also reduce risk of infection by avoiding touching your face. Other recommendations to protect yourself and family from coronavirus is to practice social distancing. Also avoid or limit social gathering. Wear a mask when in public places or settings. Thoroughly clean common areas and surfaces with approved disinfectants.

So….

COVID-19 pandemic has greatly impacted healthcare infrastructures. The spread of infection and mortality lend to global panic.  To avoid or limit the impact of the disease, you can do your part by following recommendations that promise to reduce the disease spread. Fortunately, recommendations to protect yourself and family from coronavirus are easy to follow.

 

 

 

 

Language Impairment in Autism 

autism crayonsThough autism spectrum disorder (asd) affects children in different ways, many children with autism will demonstrate language impairment. In fact, one of the first signs of autism is failure to develop language (Mody & Belliveau, 2013). Language development in autism may range from being nonverbal, to limited speaking skills, to having an extensive vocabulary.

 

My Son Nonverbal 

My son, Liam, was diagnosed with autism spectrum disorder (ASD) at two and a half years old. Though frightening, his diagnosis did not come as a shock. I recognized that something was different with his development way before deciding to undergo diagnostic assessment. For instance, Liam never went through the different stages of walking. At eight months old, he simply got up and walked. Sure, I was shocked but prouder than anything. And, though no longer a toe walker, he was a toe walker and runner for a long time. There were other signs. Namely, lack of eye contact, social impairment, and language impairment. With language being his biggest deficit.

In addition to Liam’s other challenges, he was considered nonverbal. His deficits with receptive and expressive language was most troubling. It resulted in many fearful questions. How would his language impairment affect him long term? Would he ever be able to communicate his needs? What about his ability to function? How would he be able to comprehend what others are saying? As one can image, I was terrified for him. But once I was done with being afraid, I got to work. After all, he was diagnosed early. And early diagnosis meant he could receive early interventions. And early interventions meant he had the best chance for improved outcomes.

Teaching My Nonverbal Son To Talk

Initially, Liam received aggressive speech, occupational, and Applied Behavioral Analysis therapy. He does not have concerning behavioral issues per se. ABA therapy was to lessen his eloping and problematic and dangerous climbing habits. He was enrolled in ABA therapy and occupational therapy for about a year. Speech therapy he continues. Initially, his speech therapy sessions were three times weekly with each session lasting for an hour. Speech therapy was privately paid and therefore costly. Due to cost, he no longer receives privately paid speech therapy. However, he does receive speech therapy, in the school setting, two times weekly with each session lasting 30 minutes. If you live in Broward County, FL, see the  Broward Connections Guidebook for a list of interventional services. Most resources listed are free!

Interventional services are costly. Especially for a single parent like me. As a result, I invested time to learn speech, occupational, and behavioral techniques for at home use. In other words, the techniques learnt through research and experience of raising my son, are effectively being used in the home setting for his continuous learning. I have also taken on the challenge to become a certified autism specialist. This will provide additional training for in home use and lesson our autism cost.

From Nonverbal to Verbal 

Liam is now seven years old and is no longer considered nonverbal. Though improved, he still has great challenges with receptive and expressive language. Liam has transformed from not saying anything, to repeating whatever he is asked. He has gone from not understanding what is being said or asked, to understanding most of what is being said to or asked of him. For the most part, he responds in action appropriately. We continue to do a lot of modeling, and simple games to build his vocabulary and comprehension. For instance, one game he enjoys is the shoe box word game. He also loves music, so we play a lot of sing along songs. We have even bought a piano to encourage his singing. He still prefers to show his request. So, encouraging him to verbalize his wants is a daily task.

Teaching my son with autism is one of my favorite tasks. However, his short attention and hyperactivity can make lesson time a bit challenging. Accordingly, we schedule regular breaks between lessons. Breaks are usually short and include doing something he enjoys. For instance, he enjoys the shoe box game. The picture cards build his vocabulary. While, placing the card in the slender box hole builds his fine motor skills. I have included simple instructions on how to create the shoe box picture word game.

How to create the shoebox game;

  • Get a shoe box
  • Decorate the shoebox to your liking
  • Create an opening to the top-middle of the decorated box. The opening should be just big enough to fit the card
  • Use flash cards (picture on front with identifying word on back)
  • Ask your child to repeat word, then place card in the box

Due to my son’s short attention, I usually do five to ten picture cards at a time. I also give a reward after every session.

 

Reference:

Mody, M., & Belliveau, J. W. (2013). Speech and language impairments in autism: Insights from behavior and neuroimaging. North American journal of medicine & science, 5(3), 157–161. doi:10.7156/v5i3p157

Lower Your Prescription Medication Cost

It is becoming increasingly difficulty to afford healthcare expenses. This is due to rising healthcare cost. One major factor adding to your healthcare cost is prescription medication cost. For instance, 17 percent of overall healthcare services is attributed to prescription medication cost (Kesselheim, Avorn, & Sarpatwari, 2016).

When compared to other counties, Americans pay higher prices for drug cost. While other industrialized nations average spending for prescription drugs was $400, Americans average spending was $858 in 2013 (Kesselheim, Avorn, & Sarpatwari, 2016). Since then, prescription drug cost has increased. Since drug cost is expected to rise rapidly, learning how you can lower your prescription medication cost can save you big now and even bigger in the future. Learn these 5 ways to lower your prescription medication cost.

prescription cost

Cost Lowering Strategies

Use these five cost saving strategies to lower your prescription medication cost. Save now and even bigger in the future!

01

Choose Generic Drugs

Physician prescribing preference is another key contributor to your drug cost. Despite available comparable alternatives, physicians tend to lean towards prescribing brand name drugs. However, choosing generic drugs over name brand drugs can be effective to lower your prescription medication cost. Generic drugs can cost over 50 percent less the price of name brand drugs. For instance, according to the Agency for Healthcare Research and Quality, Adderall, a name brand drug used to treat attention deficit hyperactivity disorder (ADHD) cost $113 for 5mg dose. While mixed amphetamine salts, the generic form of Adderall, cost $45. Hence, Adderall cost 50 percent more than its generic form.

The cost to manufacture name brand drugs include clinical trials which makes it a more expensive option. Ironically, Americans already contribute $200 billion, through taxation, in research grants from National Institutes of Health to help towards drug development (Jaffe, 2019). What double whammy! In addition to cost to manufacture, name brand drugs undergo little pricing regulation lending to high pricing.

02

Drug Discount Programs

Another strategy to reduce your prescription medication cost is through drug discount programs. Drug discount programs have been proven beneficial to individuals seeking greater drug access and cheaper drug options.  For instance, over the last 8 years, drug discount programs have resulted in savings of nearly $200 million. In other words, when compared to regular drug cost, drug discount programs save $18 per prescription (Munigala et al, 2019). So, if you are interested in additional savings you should consider drug discount programs. Some major companies that offers drug discount programs are Costco, Walmart, Sam’s Club, Walgreens, Publix, and Rite Aid.

 

03

Drug Discount Cards

You may also find additional savings with drug discount cards. These drug discount cards promise to save up to 80 percent off on prescription. Savings is done through drug price comparisons and coupons. Even though drug discount cards may be used with your drug insurance plan, they are especially beneficial for those without insurance drug coverage. Some popular discount cards are GoodRx, SingleCare, WellRx, and US Pharmacy card. If you reside in Florida like I do, a popular prescription drug card is the FloridaRX card. FloridaRX offers free statewide prescription assistance.

04

Choose the Right Pharmacy

There is not much cost difference for prescription medications covered under a drug plan. This is due to the negotiating power of the insurance payer. Cash prices for prescription drugs, however, varies across states. In other words, prescription medication prices can vary by retail pharmacies. Accordingly, one strategy to lower your prescription medication cost is to choose large chair pharmacies instead of small chains or independent pharmacies. Investigators found that small chains and independent chains have higher drug prices when compared to large chain pharmacies (Luo et al, 2019)

 

05

Complementary Alternatives

Complementary medicine should not be used instead of traditional drug therapy. Instead, it can be used to supplement traditional drug therapy. Whereas once tabooed, complementary medicine is becoming increasingly popular among traditional doctors. This is due to more research and positive experiences of complementary medicine. For instance, research supports the benefit of omega 3 fatty acids to reduce hyperactivity in children with autism. Everyone response differently to complementary medicine. So, talk to your doctor to see if this cheaper alternative is right for you.

References:


Jaffe, S. (2019). US lawmakers seek cuts in prescription drug prices. Lancet, 393 North American Edition (10175), 975–976.

Kesselheim, A. S., Avorn, J., & Sarpatwari, A. (2016). The High Cost of Prescription Drugs in the United States: Origins and Prospects for Reform. JAMA: Journal of the American Medical Association, 316(8), 858–871.

Luo, J., Kulldorff, M., Sarpatwari, A., Pawar, A., & Kesselheim, A. S. (2019). Variation in prescription drug prices by retail pharmacy type: A national cross-sectional study. Annals of Internal Medicine, 171(9), 605–611.

Munigala, S., Brandon, M., Goff, Z. D., Sagall, R., & Hauptman, P. J. (2019). Drug discount cards in an era of higher prescription drug prices: A retrospective population-based study. Journal of the American Pharmacists Association: JAPhA, 59(6), 804.

 

 

 

Mindfulness techniques to reduce stress

Reduce Stress with Mindfulness Based Stress Reduction


Stress is a natural part of life. Depending on our everyday responsibilities, some may experience greater stress levels than others. Negative stress can affect our health and well-being. So, it is important to our health that we learn how to reduce stress. We can therefore effectively reduce stress with mindfulness based stress reduction. 

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with the possibility of a lifetime commitment of care. Stressors associated with autism greatly affect families. So much so that when compared to parents of children without autism, parents of children with autism experience greater stress levels. For instance, difficulties of raising a child with autism include limited resources, poor guidance from health professionals, delayed diagnosis, reduced awareness of autism, and stigma for families (Reddy, Fewster, & Gurayah, 2019). As such, limited resources, support, and lack of autism awareness put greater stress on autism families. In addition, unresolved challenges can lead to chronic stress. Fortunately, autism parents can reduce stress with mindfulness based stress reduction. 

Autism parent getting married

Reduce Stress and Fight Caregiver Burden


Parents of children with autism commonly report caregiver burden. Caregiver burden is defined as negative consequences of a caregiver’s inability to cope with and adapt to caregiver duties, as well as manage physical, mental, social and financial demands (Tang et al, 2015). In other words, caregiver burden is the experience of stress by caregivers when they are unable to handle their living situation. Therefore, caregiver burden places autism parents at risk of negative outcomes for themselves and those they care for. Such consequences can lead to poorer physical and mental health. 

Subjective 

Caregiver Burden 

  • Internal Reflections
  • Negative Emotions 
  • Embarrassment 

Objective 

Caregiver Burden 

  • Observable Experience 
  • Increase Duties  
  • Financial strains 

Stress Induced 

Health Issues 

  • Heart Disease 
  • Asthma
  • Diabetes 
  • Obesity
  • Headache
  • Depression Gastrointestinal Problems
  • Premature Death

Black woman taking time to reduce stress

Contributors to Stress 


Unresolved stress can lead to chronic stress.  Stress is a psychological reaction in response to one’s inability to cope. Stress occurs when demands exceed coping resources. Thus, insufficient coping resources greatly affect autism parents. Accordingly, little coping resources can result in everyday problems causing stress that can affect autism parents’ health (Tang, Jang, Lingler, Tamres, & Erlen, 2015). 

Some contributors to autism parents experience of stress are:

  • Child characteristics
  • Family resources
  • Parent coping
  • Type of diagnosis
  • Ability to adapt
  • Child behavior

Reduce Stress with Mindfulness Based Stress Reduction 


Health and well-being are shaped by personal and outside conditions (Wit, et al., 2014). As a result, good health depends on positive physical, social, financial, and environment conditions. Autism parents can reduce stress with mindfulness based stress reduction and  be better able to adapt to stress.

Autism parents are encouraged to use positive thinking to reduce stress. Examples of positive thinking involves focusing on problem, one’s ability to handle stress, and finding other ways to view the problem. Thus, good coping skills can reduce stress and reduce risk of stress related health problems.

Autism parents are very resilient. Many can cope with the tough journey of raising a child or children with autism. However, their resilience depends on several factors, including having a good support system. Therefore, a positive personality, spirituality, resources and support for families affect autism parents’ ability to cope. Mindfulness-Based Programs (MBP) such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) are beneficial to reduce stress.

MBCT is effective at teaching those at risk for depression to adapt and refrain from relapse.

MBSR, an education and training program that teaches individuals with chronic health problems how to cope with life challenges. For instance, it teaches how to cope with the demands of emotional stress (Kabat-Zinn, 2013).

Mindfulness-Based Programs may benefit autism parents and others by strengthening their abilities to manage stressful situations. Therefore, it can also improve their resilience and capacity to recover from stressful events.

 

Leading the Way to Reduce Stress

Take this 100% Free mindfulness-based stress reduction course from the University of Mass medical school. It is an eight-week course that includes guided meditations, articles and videos. All free!

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Boy with autism meditating to reduce stress

Reduce stress with mindefulness based stress reduction

References: 

Crane, R. S., Brewer, J., Feldman, C., Kabat-Zinn, J., Santorelli, S., Williams, J. M. G., & Kuyken, W. (2017). What defines mindfulness-based programs? The warp and the weft. Psychological Medicine, 47(6), 990–999. https://doi-org.ezproxylocal.library.nova.edu/10.1017/S0033291716003317

DobkinPL, Hickman S, Monshat K (2013). Holding theheart of mindfulness-based stress reduction: balancing fidelityand imagination when adapting MBSR. Mindfulness 5, 710 –718.

Tang, F., Jang, H., Lingler, J., Tamres, L. K., & Erlen, J. A. (2015). Stressors and caregivers’ depression: Multiple mediators of self-efficacy, social support, and problem-solving skill. Social Work in Health Care, 54, 651–668. doi:10.1080/00981389.2015.1054058

Wingrove, C., & Rickwood, D. (2019). Parents and carers of young people with mental ill-health: What factors mediate the effect of burden on stress? Counselling Psychology Quarterly, 32(1), 121–134. https://doi-org.ezproxylocal.library.nova.edu/10.1080/09515070.2017.1384362

Witt, C. M., Chiaramonte, D., Berman, S., Chesney, M. A., Kaplan, G. A., Stange, K. C., & …

Minnes, P., Perry, A., & Weiss, J. A. (2015). Predictors of distress and well-being in parents of young children with developmental delays and disabilities: the importance of parent perceptions. Journal of Intellectual Disability Research, 59(6), 551–560. https://doi-org.ezproxylocal.library.nova.edu/10.1111/jir.12160

 

 

 

Autism Spectrum Disorder

So what is Autism? There is growing public awareness on autism spectrum disorder (ASD). Autism is a neurodevelopmental disorder characterized by limitations in communication, unusual social skills, and repetitious behaviors. The American psychiatric association (2013) further adds that autism spectrum disorder (ASD) is typified by stereotyped interests and activities. Hence, autism is considered a spectrum of disorders due to its wide array of characteristics.

 

autism spinner

autism crayons

Autism

Defining Autism

Boy with autism

Today, more Americans are being diagnosed with autism. The Centers for Disease Control and Prevention (CDC, 2019) reports that 1 in 59 children are diagnosed with autism.Also, the CDC reports that boys are four times more likely than girls to develop the disorder. This is a significant rise from the past  As a result of the increase in autism diagnosis, public interest is rising. The increase in public interest is leading to more investigative research on autism, its trend, medical complications and management.

 

What is Autism: Trends 

Toddler with autism

While there is no cause for Autism, research suggests that a combination of genetic and environmental factors increase the risk of developing ASD (Zuckerman, Lindly, & Sinche, 2016). Though genetic and environmental risk factors are major factors of ASD, preterm infants and certain socioeconomic groups are at greater risk.

 

Physical Presentation of Autism 

What is autism and what does it look like? Since autism spectrum disorder (ASD) is a neurodevelopmental disorder it is arbitrary to rely on physical features for a diagnosis. ASD does not carry an absolute physical symptom; however, research have pointed to some common traits shared among children with ASD. Examples of these traits are facial asymmetry, abnormal hair whorls, and infant head lag (Ozgen et al., 2013). Researchers also emphasize an increase in morphological features in children with the disorder.

Nonetheless, the link between facial asymmetry and autism spectrum disorder is weakened by counteracting studies that confirm facial asymmetry in more than half of the populace (Thiesen, Gribel, & Freitas, 2015). Due to limitations in current evidence, further research is needed to investigate the physical expressions of ASD.

 

Clinical Presentation of Autism 

Individuals with autism are among the vulnerable populations. Their various limitations and exceptions place them at increased risk of health inequality. So, to meet the healthcare needs of this vulnerable group, healthcare professionals must learn to recognize the varying clinical presentation of autism.

Proper identification of patients with ASD can promote appropriate treatment interventions.  For instance, a practitioner may notice gaze abnormalities, abnormal motor movement, attention deficit, or hyperactivity disorder in the patient with ASD (Grynszpan et al., 2012).

Children with ASD may be at increased vulnerability to immunologic disorders, seizure disorders, and neuropsychiatric illnesses (Salpekar, 2018). Therefore optimal health outcome depends on parents, caregivers, and healthcare professionals’ collaboration in the immediate recognition of the signs of sickness. Therefore it is recommended that healthcare providers adopt an autism spectrum disorder screening tool routinely in their practice.

 

Psychosocial Presentation of Autism 

Autism spectrum disorder (ASD) is characterized by many behaviors: Fixation on routines, arranging objects, hand/finger flapping, echolalia, inappropriate use of objects, and movement behaviors. In addition, extreme diets and sensitivity to various stimuli are also characteristic of the disorder. Individuals with ASD may avoid eye contact, show disinterest in others, or express limitations in understanding personal boundaries.

Though behaviors are manifested differently by each person with the disorder, the American Psychiatric Association (2013) agrees that restrictive and repetitive conduct is among the principal diagnostic criteria.

*Click below to learn the early signs of autism in toddlers

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Practitioners and Autism Management

It is important to develop individualized treatment interventions when treating patients with autism spectrum disorder. Thus, patient and caregiver training and education should be given in the appropriate form fitting to the patient’s challenges and strengths.

Early intervention is imperative to improved outcomes in patients with ASD. Examples of early interventions include applied behavior analysis (ABA), speech language therapy, occupational therapy and sensory integration. In addition, cognitive behavioral therapy, and social training are also effective early intervention strategies. 

autism spectrum disorder

Autism Management Continued


A

Through early diagnosis and intervention, many patients with ASD learn to function independently. However, for those patients with limited decision-making capacity, the practitioner may collaborate with the patient’s authorized decision maker when creating treatment options.

When dealing with patients with limitation in communication, the practitioner should choose the appropriate language fitting to the patient’s language skill level. Also, effective listening and allowing adequate time for patient response can build patient-health provider rapport and strengthen communication. The use of visual aids can prove effective when communicating with nonverbal patients.

SUBHEADING

 

 

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Blumberg, S. J., Bramlett, M. D., Kogan, M. D., Schieve, L. A., Jones, J. R., & Lu, M. C. (2013). Changes in prevalence of parent-reported autism spectrum disorder in school-aged U.S. children: 2007 to 2011-2012. National Health Statistics Reports, 65, 1- 1.

Center for disease control and prevention (2018). Autism spectrum disorder: Data and statistics. Retreived from: https://www.cdc.gov/ncbddd/autism/data.html

Grynszpan, O., Nadel, J., Martin, J., Simonin, J., Bailleul, P., Wang, Y., & Constant, J. (2012). Self-Monitoring of gaze in high functioning autism. Journal of Autism & Developmental Disorders, 42(8), 1642-1650.

Ozgen, H., Hellemann, G.S., de Jonge, M.V. et al. J Autism Dev Disord (2013). Predictive value of morphological features in patients with autism versus normal controls.  Journal of Autism -and Developmental Disorders. 43(1), 147-155.

Pineda, R., Melchior, K., Oberle, S., Inder, T., & Rogers, C. (2015). Assessment of autism symptoms during the neonatal period: Is there early evidence of autism risk? American Journal of Occupational Therapy, 69(4), 1-11.

Salpekar, J. (2018). Neuropsychiatric effects of epilepsy in developmental disorders. Current Opinion in Psychiatry, 31(2), 109-115.

Thiesen, G., Gribel, B. F., & Freitas, M. P. M. (2015). Facial asymmetry: a current review. Dental Press Journal of Orthodontics, 20(6), 110–125.

Zuckerman, K. E., Lindly, O. J., & Sinche, B. (2016). Parent beliefs about the causes of learning and developmental problems among children with autism spectrum disorder: Results from a national survey. American Journal on Intellectual & Developmental Disabilities, 121(5), 432-447.

 

 

1st Experience with Horseback Riding Girl Horseback riding

When my son was 6 months old, I noticed his love for animals. So we joined a baby and me group for a fun event at an animal farm. The farm’s main attraction was pony and horseback riding which my 6-month-old son seemed to really enjoy. Though he was only 6 months old, he had a distinct connection with the ponies that didn’t go unnoticed by the other moms.  Even the farm attendants remarked that he would grow to love and be good at horseback riding. Soon, the day ended and we went on our merry way with no plans to revisit such adventure.

 

 

 

horse therapyFast forward about 6.5 years later. I decided to surprise Liam (my son) on his 7th birthday to an evening of horseback riding. Since he had only been around horses once, an event I was sure he didn’t remember, I carefully approached the situation. Still, I had high hopes that he would enjoy the experience. Even though I hoped for a fun experience , the real reason behind the visit was to broaden his experience of different live animals. You see, he has challenges with receptive and expressive language, so, modeling the word with a clear picture was effective in improving his language skills. This technique we took from extensive Speech therapy

 

 

 

Horses for horse therapyOur Horseback Riding Story

We got to the ranch and were greeted by the rancher and 3 horses. There were more than 3 horses on the ranch but those 3 were not barned. Those 3 horses had a special interest in Liam. They insisted on following him regardless of how the rancher shielded him. The rancher called her assistant for backup. I overheard her telling the assistant that the 3 horses insisted on meeting Liam.

What did she mean? I thought. 

I am sorry for that. Usually these 3 horses show disinterest in our guests which is why we didn’t care to have them out at your arrival. But, for some reason they want to meet your son,”  she said.

I suggested that the horses might have been attracted to Liam because he has autism spectrum disorder (ASD). This I made up to break the ice. That’s when she uncovered that those 3 horses were used in therapeutic horseback riding for children with autism. Since Liam did not demonstrate any ASD stereotypic behaviors at the initial greeting, the thought of the horses being able to identify him as having autism gave me chills. That was also my first time learning about therapeutic horseback riding.

Therapeutic Horseback Riding Treatment for Autism 

Learning to ride horse So what is therapeutic horseback riding and how does it improve autism associated symptoms? Therapeutic horseback riding (TR) or equine assisted therapy is an activity used with individuals with autism and other special needs. It is used for the purpose of improving physical, emotional, intellectual and social wellness. It is also beneficial in improving balance and coordination, fine and gross motor skills (Anderson et al, 2019), as well as providing positive sensory stimulation.

Researchers investigated the effects of therapeutic horseback riding (TR) or equine assisted therapy on social communication and sensory processing skills of children with autism. They found an increased social interaction, improved sensory processing, and decreased severity of symptoms associated with autism spectrum disorders in those that participated in TR (Ward et al, 2013). TR or equine assisted therapy also influences targeted behaviors in children with autism (Holm et al, 2014). Other studies suggest that therapeutic riding also improves irritability in children with autism.

Liam has since been participating in therapeutic horseback riding.  Not only does he love it, but we have seen tremendous improvements in his emotional and social health. 

 

References:

Anderson, S. K., Loy, D. P., Janke, M. C., & Watts, C. E. (2019). The effects of therapeutic horseback riding on balance. Therapeutic Recreation Journal, 53(4), 307–321.

Holm, M., Baird, J., Kim, Y., Rajora, K., D’Silva, D., Podolinsky, L., … Minshew, N. (2014). Therapeutic horseback riding outcomes of parent-identified goals for children with autism spectrum disorder: An ABA′ multiple case design examining dosing and generalization to the home and community. Journal of Autism & Developmental Disorders, 44(4), 937–947.

Ward, S., Whalon, K., Rusnak, K., Wendell, K., & Paschall, N. (2013). The association between therapeutic horseback riding and the social communication and sensory reactions of children with autism. Journal of Autism & Developmental Disorders, 43(9), 2190–2198.

ABA therapy There are many thoughts on Applied Behavioral Analysis (ABA) therapy in autism. These controversial notions concern whether ABA therapy is abusive to children with autism spectrum disorder (ASD). In addition, there are questions of whether ABA is even effective. Well, the answer depends on one’s understanding of ABA and his/her personal experience with ABA’s procedures. The purpose of this blog is to define ABA therapy use in autism. To examine some evidence. And to provide a personal account with ABA therapy. So, let’s examine ABA therapy in autism.

Understanding ABA Therapy and Autism 

Applied Behavioral Analysis (ABA) is considered a scientific approach to modify behaviors. This is done through manipulating outside factors. ABA therapy looks at the setting in which a behavior occurs. Motivational variables, and events leading to the occurrence of the behavior are then assessed. In addition, ABA therapy examines consequence following the behavior that determines the likely recurrence of the behavior (Vismara & Rogers, 2010). Careful assessment of the individual is needed. Since the results determine interventions designed to alter behaviors.

What Does the Evidence Say?

Research suggests that ABA therapy is effective in autism. However, outcomes depend on several factors. For instance,  diagnosis severity, cognitive functioning, treatment hours, gender, parent education level, or primary language spoken at home (Tiura et al, 2017).

Researchers examined participants, with a mean entry age of 3 years, who received ABA therapy. Then, assessments were conducted at intake and every 6 months thereafter. Results supported therapy effectiveness in communication, social-emotional, and adaptive behavior, with cognitive functioning being the leading predictor of treatment outcomes (Tiura et al, 2017). 

Personal Account of ABA Therapy and Autism 

My son was diagnosed with autism at 3 years old. We did not consider ABA therapy until he was about 5 years old. He is now 7 years old. My interest in ABA sparked one evening after taking my son to speech therapy and observing a behavioral therapist redirecting twin boys (around 7 years old at the time) with ASD with reinforcement techniques. I inquired of their mother of ABA therapy’s effectiveness in managing her son’s undesired behaviors. I wanted her personal experience with ABA therapy and autism. She praised the therapy results and encouraged me to give it a try.

child running

My son, Liam was an eloper. He also enjoyed climbing on or above high objects which was unsafe. He had other ASD characteristic behaviors like hand flapping and squealing. Hand flapping and squealing he did when excited which was perfectly acceptable and nonproblematic. After all, I enjoyed his excitement and wanted him to express it however he could.

We approached ABA to discourage his eloping and inappropriate climbing. I was privy to sit in on a few of his therapy sessions. What I noticed was that he was awarded for his appropriate responses while his undesired behaviors were simply ignored. You see, whenever Liam would elope or climb recklessly, he would look back to see if anyone was watching. When ignored, he stopped. But when given attention, he continued.

Why we stopped ABA Therapy 

My son was involved in ABA therapy for about a year before we withdrew due to our moving further from the therapy center. To be enrolled in ABA therapy, the therapy center required his participation for at least 10 hours per week. 10 hours weekly for ABA therapy was nearly impossible due to his new school hours and after school swimming lessons. ABA therapy proved effective for Liam; his elopement issue is now nonexistent. We have seen a major decline in his inappropriate climbing. Though I am not sure if that’s due to ABA therapy or his backyard jumbo trampoline and doom climber.

ABA Therapy in Autism 

There are numerous arguments on whether ABA therapy exposes children with ASD to abuse. I think that the answer largely depends on the approach used during therapy. Originally, ABA therapy included procedures of reinforcement, shaping, punishment, and prompting to modify behaviors (Leaf et al, 2018). However, when tailored and used appropriately, without punishment procedures, ABA therapy can be effective in autism. A closer look at ABA therapy and autism will help you and your love ones determine if ABA therapy is right for you. 

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References:

Leaf, J. B., Leaf, R., McEachin, J., Cihon, J. H., & Ferguson, J. L. (2018). Advantages and challenges of a home- and clinic-based model of behavioral intervention for individuals diagnosed with autism spectrum disorder. Journal of Autism & Developmental Disorders, 48(6), 2258–2266.

Tiura, M., Kim, J., Detmers, D., & Baldi, H. (2017). Predictors of longitudinal ABA treatment outcomes for children with autism: A growth curve analysis. Research in Developmental Disabilities, 70, 185–197

Vismara LA, & Rogers SJ. (2010). Behavioral treatments in autism spectrum disorder: What do we know? Annual Review of Clinical Psychology, 6, 447–468

toddler with autism

Signs of Autism in Toddlers 

Often, parents and caregivers ignore obvious signs of drawbacks in children. The thought of a child developing differently or even demonstrating traits considered unusual is frightening. Despite fear, it is important to acknowledge early signs of autism in toddlers. Since early identification can lead to better outcomes

The Early Signs 

Four years ago, I was in that same position. My son had normal development until he was three years old, or so I thought. Then I stumbled upon a photo taken a week or so before his second birthday. This seemingly innocent photo compelled me to accept that my son demonstrated signs of autism before I was willing to acknowledge it. In the photo, a close friend of mine three-and-a-half-year old son tried desperately to gain my son’s attention.  At no point did my son acknowledge the other toddler. Instead, he, uninterestedly, gauzed steadily at the floor. Sadly, this was one of many situations where he showed complete disinterest in other children.

In addition to his impaired ability to engage in social relationships with other children, there were other red flags that I ignored. For instance, he played differently with toys. He was obsessed with balls. He could spot a number or letter in any corner of a building. Also, he had strong food preferences and his speech was delayed. Most noticeable, he was a basketball genius. What was most odd though, was that he never crawled. In other words, he skipped crawling and walked at 8 months old. Albeit, he was a toe-walker.

Deciding on Diagnostic Assessment 

Deep down I knew something wasn’t quite right with my son’s development. I shared my concerns with friends and family who reassured me that he was okay and only needed time. Even his pediatrician encouraged me of his normal development.

Everything seems fine. Boys develop slower than girls. Let’s wait and see,” the pedicatrician said.

Their encouragements did little to alleviate my fears. Then it happened. I received a call from his preschool staff recommending he undergoes screening. Someone else noticed his peculiarity and that was enough to persuade me to take on the difficult challenge of diagnostic assessment. Without doubt, the thought of diagnostic assessment was frightening. I was certainly not ready to confirm what I already knew.

Autism Spectrum Diagnosis 

signs of autism in toddlers My son was screened for autism spectrum disorder by a leading pediatric developmental psychologist in Washington D.C. The session was smooth and informative. I had a clearer understanding of early signs of autism in toddlers. Some early indicators for autism are impaired early language development, impaired social interactions, limited eye contact, unusual response to name and common gestures, etc. (Roberts, 2019).

Facing the truth about my son’s brain function was frightening. Although, not as frightening as not knowing. Evidence suggests that early diagnosis is beneficial, since it promotes early intervention. And early intervention may change the progression of development for children with autism. In other words, children with autism who receive early intervention have better outcomes.

Parents also impact early diagnosis since they are often the first to notice deviation in their children’ growth and development (Warren et a, 2011). Therefore, proper understanding of developmental milestones may be helpful.

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Reference:

Roberts, M. (2019). Seeing ASD signs? Speak up. ASHA Leader, 24(4), 46–55.

Warren, Z., McPheeters, M. L., Sathe, N., Foss-Feig, J. H., Glasser, A., & Veenstra-Vanderweele, J. (2011). A systematic review of early intensive intervention for autism spectrum disorders. Pediatrics, 127, e1303–e1311.

 

 Autism Cost in the U.S

After my son was diagnosed with autism spectrum disorder (ASD), I wondered what came next. From my knowledge, he was the only one in the family to have such diagnosis, so I had no clear sense of direction. How did other single parents cope with having a child or children with ASD? How would the diagnosis affect his future? What therapeutic interventions where available? How would we gain access to them? Most importantly, how would I afford such needed therapies on a single household income? I was not prepared, to say the least, for autism cost in the U.S. Despite my worries, I knew I needed a game plan. For my son to function at his best, early intervention was pivotal regardless of its cost.

Available Options 

Certain public schools offer free interventional services to children with autism spectrum disorder (ASD) and other neurodevelopmental conditions. My son received his initial speech and occupational therapies in the public-school setting. He received speech therapy two times weekly and occupational therapy once weekly with each session lasting for 30 minutes. At the time, he was considered nonverbal and since evidence suggests that nonverbal children with ASD achieve better outcomes in language production with intensive speech sessions (Rogers et al, 2006), I knew that an hour of speech therapy weekly would prove insufficient.

Autism cost in the U.S is challenging for parents with children with autism spectrum disorder. Some insurances cover short term ancillary services base on diagnoses. Our insurance covered speech therapy, occupational therapy, and applied behavioral services with our out-of-pocket costs consisting of coinsurance of 20 percent after deductible is met. In addition to speech therapy offered at school, my son received private speech therapy three times weekly for an hour each session; costing $50 per session. That’s $150 weekly for speech therapy alone. Occupational therapy cost mirrored that of speech therapy. Fortunately, we were able to obtain grants that met the remanding balance for applied behavioral services after insurance payment was applied.  This alleviated much of our autism cost. The typical out of pocket cost for speech therapy in the U.S for those not covered by health insurance can range anywhere from $150-$350 for an initial evaluation. Follow-up speech therapy per hour sessions can cost between $100 to $200. These ranges were priced from different therapy centers that did not accept our insurance. After years of speech therapy my son is no longer considered nonverbal; albeit, he still faces minor challenges with receptive and expressive language. We have reduced outpatient speech therapy with more focus on in-home speech and language techniques.

Applied behavioral analysis (ABA) therapy is another intervention of autism. Some studies suggest that behavioral modification programs like ABA therapy is beneficial to language development and impact core deficits of children with autism (Harrington & Allen, 2014). The per child cost of ABA therapy in the U.S is estimated at $45,000 annually. However, not everyone is a proponent of ABA therapy. See ABA Therapy and Autism: Is ABA Abusive to decide if ABA therapy is right for you and your family.

The annual autism cost in the U.S is $137 billion nationally with residual care, loss of productivity, underemployment, and unemployment in adulthood costing $2.3 million (Shiozawa, 2015). Autism cost in the U.S can be quite challenging with the type and duration of needed interventions determining the overall cost. This article focuses on the typical cost for speech therapy and ABA therapy while neglecting autism cost for occupational therapy, special education schooling, and or expenditures on medical and mental health services.

 

 

Reference:

Rogers SJ, Hayden D, Hepburn S, Charlifue-Smith R, Hall T, & Hayes A. (2006). Teaching young nonverbal children with autism useful speech: A pilot study of the Denver Model and PROMPT interventions. Journal of Autism & Developmental Disorders, 36(8), 1007–1024.

Harrington, J. W., & Allen, K. (2014). The clinician’s guide to autism. Pediatrics in Review, 35(2), 62–78.

Shiozawa, B. (2015). It’s About Time for Autism Reform Legislation in Utah. Journal of Autism & Developmental Disorders, 45(5), 1495–1496.