•
Here is a short article describing the common medications used for attention deficit disorder and attention deficit hyperactive disorder. The article is a nice 101 regarding the medications used, their effects as well as side effects. Remember that autism spectrum disorders is a spectrum with ADD at the beginning of the spectrum and severe autism on the far end of the spectrum. Also recall, that there is much of mixing and matching of signs and symptoms with regard to the various conditions on the spectrum. That is to say, that there are those with Asperger’s syndrome that have attention and hyperactivity issues and those with autism or sensory integration disorder with compulsive issues as an example. Therefore many of those on the spectrum whether they have a primary diagnosis of attention deficit hyperactive disorder or Tourettes Syndrome are many times on medications for hyperactivity and can benefit from the information in this article. This is also a nice website for you to peruse regarding ADD and ADHD. http://adhdadd.org/?p=64
•
We are currently treating a six-year-old child whose chief complaint upon his first visit was lack of muscle tone, poor vision difficulty processing language. He also has some issues with focus and impulse control. Not all, but many of the techniques and treatments used in functional neurology and hemispheric integration therapy require patient cooperation. That is, many times the patient must mimic movements or patterns. Eye movements and exercises are also frequently used. That is to say that some of the techniques can be done to the patient or for the patient while others have to be done by the patient. This mom clearly loves her child and is trying to get the most out of the treatment sessions each and every time. Originally, the child was fascinated with fish. Therefore mom brought it stickers with fish on them and even created colorful fish drawings and cut outs in order to increase the child’s focus on the particular task at hand. After about an month of treatment the child suddenly switched from fish to dogs. The next day, mom came in with dog stickers as well as home made stickers of the child’s pet dog. This has made a great difference with this child attention and focus. The child is happier, I am happier, and mom is happier. I always say that no one knows your child as well as you do. No one knows when to be firm with the child and how firm to be like you do. And no one knows what will motivate the child like you do. These insider tips from mom and this collaborative effort only benefit the child and increase the chances of a better end result. This is something that as a doctor treating children with autism spectrum disorders is tremendously appreciated. From my point of view, nothing is more valuable than an involved and in tune parent.
•
I had written an article regarding how screen time (Internet, television and video games) can be a negative factor regarding those with ADHD. One of the articles that I referenced from the scientific literature dealt with ADHD and Internet addiction. This past Friday happens to have been the 40th anniversary of the Internet. I was fortunate enough to have been contacted by Shannon Mulaire from the local Fox affiliate to comment regarding the Internet and addiction. As the story was about the 40th anniversary of the event and not purely about Internet addiction or ADHD, I only make a brief cameo appearance. Thus, the title of this post 15 seconds of fame. It is still always nice to get some television exposure and I thank Shannon for giving me the call. Here is the link to the video clip as well as the original article. http://www.facebook.com/l.php?u=http%3A%2F%2Fwww.myfoxtampabay.com%2Fdpp%2Fnews%2Fscitech%2Fthe_internet_at_age_40%3A_farmville_rules&h=3a65184086aef55551b2a8d53bfbedf0
http://www.hitautism.com/medical-articles/adhd-treatment-tampa-dr-nelson-mane-says-%e2%80%9cbeware%e2%80%9d-2
•
I found this on this web site http://addhelpsite.com/ the link didn’t quite work for me but I wanted to give them credit. Apparently, this is a free program that is available that can help those with ADHD and LD etc. As always, whenever I find something like this that I thik may help others I try to pass it along. Hope it helps someone. http://theeasyessay.com/
•
Just as with autism where the focus seems to be on children, this also occurs with ADD and ADHD. Approximately 50% of children who have ADHD will grow up to be adults with ADHD. I previously provided a website that had screening for autism. Here is a nice link to a website to tests for adults to check for ADHD type symptoms. This is a nice online test quick and easy for those of you that are wondering about yourselves. http://psychcentral.com/addquiz.htm
•
Children on the autism spectrum have a tendency to be much more sensitive with regard to interaction with their environment. A major part of this interaction is there diet and overall food intake. Here is a link to a blog post in which the author describes a multitude of detrimental effects to having sugar in your diet. One of the things that I like to do is take information not directly related to autism spectrum disorders and adapt them to these conditions and present them to you. At times, this may require you to take a little bit of a leap or move your thinking a step further. Usually, I try to make this a small step. Thus if sugar is detrimental to a normal and healthy body, we can expect it to be even more detrimental to a child on the autism spectrum. This of course is particularly relevant if the child has or is prone to yeast infections. Here is the link to 76 ways sugar can ruin your health
http://www.freeads13.com/blogs/index.php/20090828-793/76-ways-sugar-can-ruin-your-health/
•
The functional neurology and Hemispheric Integration Therapy model for Autism Spectrum Disorders views sensory input as a major factor affecting and influencing those with Autism. I often say that most people are aware of the fact that if you damage the brain you will see changes in the body. We are all familiar with someone that has a stroke and changes in his posture with regard to his arm and his legs when walking. Someone who has had a stroke may also have a drooping of the face. So, we see how the brain can affect the body. Many times people are not aware that the body also affects the brain. That is, we need input and stimulation from the environment in order to drive brain activity. Input comes by way of our senses. The five senses are sight, sound, smell, touch and taste. What is often referred to as the sixth sense is balance. However, balance and vestibular input is a major driving factor to the brain. An animal in the jungle, that cannot balance itself, will not live long. Ask someone who has had vertigo if he would rather be deaf or have vertigo. The answer will be that one can adapt to being deaf although this is limiting. However, if you are continuously out of balance and spinning, you cannot function in any way. Many patients with vertigo cannot get out of bed nor do something as simple as turn their head.
This relates to Autism Spectrum Disorders in that many children with autism in fact do have sensory integration issues with regard to their vestibular system. So, if we look at the fact that the senses feed the brain and we have sensory integration issues then as is often said in the computer world “garbage in, garbage out.” I have many parents that when asked if the child has any vestibular issues respond “Oh no, he can spin and spin and spin and never get dizzy.” They also tell me how they can go to amusement parks and never get dizzy. But is this a normal response? If I take a neuro typical child or adult and spin him in a chair should he not get dizzy and perhaps nauseous? The answer of course is yes. So, this is an actual weakness and not strength with regard to these children. If vestibular input is a strong input to the brain and these children are not getting any vestibular stimulation then it follows that their brains may not be functioning optimally.
Such is the case with a 10-year-old boy that I’m currently treating. The most obvious issues that the child has upon meeting him is that he scripts (repeats verbiage from movies and video games) as well as toe walks. This child has wonderful parents who are both hard-working and a great support system relating to their grandmother and aunt. My approach to functional neurology with regard to the nervous system is that the lower areas are cleared up first. That is we look at the nervous system from the outside in, for example, we ask the question, “Is it in the receptor, peripheral nerve, spinal cord, brain stem, etc?” So if you look at comparative anatomy between the species, we see that lower life forms have brain stems and vestibular systems while only humans have well developed prefrontal cortex. The vestibular system is really fairly low on the comparative anatomy scale, as I stated previously, all animals need to balance in order to survive. So, in my opinion in this child’s case, his vestibular system was the starting point. In our office, we sometimes have parents tell us that they see changes after one visit. Perhaps after a couple of weeks or a couple of months. This particular child has been very difficult to treat. His response has clearly been slower than expected. This child has been treating for approximately 6 months. He has shown some small vague type signs of improvement, but has not really made the typical improvements that we are accustomed to seeing in the office. We have seen his scripting going from out of context to in context. That is to say, that previously he might have been scripting a happy birthday scene from a movie while we were doing therapy. More recently he has begun to script a scene where a cartoon character is scared of the dark if we shut the lights off in the treatment room. That’s not what I call huge progress.
His mom is amazing with her compassion and dedication to her children. But what she does most well and is helpful to me, is that she knows when her child is just avoiding behavior and when he cannot do something. She has a great sense of how to motivate him to do the activities necessary to make him improve. She also has been very consistent with this treatment even though the progress has been less than expected. Consistency is a major factor with regard to making changes in the brain using the techniques of Hemispheric Integration Therapy.
Within the last few weeks after vestibular stimulation the child has been wanting to lay on the floor. This is a very typical vestibular response. That is, when you feel you are losing your balance or the world is spinning, you tend to want to get closer to the earth. Those that have had vertigo will be able to relate to this statement. But that was still vague in that we weren’t sure if this was a new behavior or that if he was finally feeling the vestibular stimulation. More recently after his last three visits the child did not want any further vestibular stimulation and was nauseous even vomiting on one occasion. For me, this is a sign to celebrate. This signifies that we have finally reached a threshold with regard to his vestibular system and that our stimulation is finally getting through and registering in his brain.
Again, vestibular stimulation, proprioception (joint position sense) and balance are powerful stimulations to one’s brain. And with this system now providing more appropriate stimulation to his brain, we hope to see more positive changes in the future. So yes, I am celebrating the fact that I was able to make a 10-year-old boy vomit. So if you have a child who is on the Autism Spectrum notice if he ever gets dizzy or if you can make him dizzy. If you cannot, this is not a normal response and is an important sign.
•
Those of you that have seen my presentation on ADHD know that among the other negative factors to be aware of with ADHD medication use is the fact that there is potential for abuse of these medications with these children. This applies not only to themselves but also to the fact that at times the medications are sold to other middle and high school teens. The American Heart Association recommends that children be given a hard exam before being placed on any of the stimulant medications. In my experience, I have rarely found a child that was evaluated in this fashion prior to be giving the medication. Was so there are side effects and abuse which must be taken into consideration when deciding whether or not to medicate your child. Here is a link to an article in a newspaper regarding teen abuse this group of medications .
http://www.nwherald.com/articles/2009/08/28/r_rstmjgs7srim6ljmlf15ig/index.xml
•
Autism is something that affects different children in different ways. Some of the sensory integration issues can be quite unique while others are complaints that seem to weave a common thread for children on the spectrum. This case is about a six-year-old boy who had emergency surgery at three years old for hydrocephalus (water on the brain.) He also had febrile seizures at 13 months. At 15 to 18 months he began to experience speech regression. So the child in addition to being diagnosed with autism also cause the history of hydrocephalus and seizures. Presently his speech is limited to mostly 1 to 2 word phrases. He tends to pull the parents toward what he wants to express himself. It has been determined that his issues are more expressive and receptive. This means that he can understand more than he can say. He is in diapers.
These parents met me at a statewide conference that I spoke at over the summer. They live approximately 2 hours away. Those of you that know me, know that I am not a big fan of distance type treatments. The reason for this is that there is less quality control as more and more of the therapies and exercises are pushed off toward the home. Even parents that treat with me locally and are giving home exercises will tend to make errors in these exercises when we periodically check to see if they were being performed correctly. Fortunately, when someone is treating locally the error only continues for a few days before we catch it not weeks or months. If you understand the concept of plasticity and that we can make changes in the brain, then you understand the changes can be made both in a positive and negative fashion. These children as a group have delicate nervous systems and tend to overreact to various stimuli. So it is important to do the right stimulation at the appropriate time and in the appropriate order for that particular child. The last thing that anyone wants to do is make any of these children worse. For children that are simply doing the functional medicine approach to autism spectrum disorders, the distance treatments are something that can be done in a quality fashion. For those using functional neurology and Hemispheric Integration Therapy the issue of quality becomes more significant. Functional neurology and Hemispheric Integration Therapy also have the risk of over stimulation, as well as doing the wrong stimulation at the wrong time. Therefore, there are many aspects that can be done inappropriately.
However, this family is a great family. Two loving and hard-working parents with two loving and very supportive grandparents desiring to help this child. So I explained to them why I do not like to do a distance programs as I stated above. But I could see the concern, love and dedication that this family showed for this child. I explained to them that with a distance program, progress would probably be slower and they would have to be more patient. The fact that the risk of over stimulation is possible would cause me to give them a slightly watered-down program compared to what we would do in office. This family was disciplined and dedicated and wanted to proceed. They also had not pursued any biomedical options. So we first suggested the basics, a probiotic, a multivitamin and essential fatty acids. I explained to them some of the biomedical aspects such as leaky gut, food sensitivities and the like.
On this child’s first visit he had considerable hyperactivity, he displayed some screaming and patterns. I explained to the parents that with this type of treatment, the more that the child can do with regard to the therapy and stimulations, the more he will progress. That is to say that if we cannot get any cooperation from the child in performing certain types of activities then his progress would be limited. We can always begin with passive activities in which the child does not have to cooperate or participate much; however, even these activities still require some cooperation from the child. I demonstrated a few techniques that they should be trying at home. This was done in the office with myself and supervision. This child’s level of cooperation was not the best and to be quite honest this was going to be something difficult. However, I could see that this family had a wonderful mix of love and discipline. I thought that they would be able to find a way to get the child to perform the activities. After all, nobody knows the child as well of the family. No one knows how to motivate the child as well as the family.
The child recently presented after approximately 6 weeks of treatment. He was not hyperactive in the consultation. He did not scream throughout the entire consultation. He was fairly cooperative. The parents observed he was keeping his clothes on more. One of the child sensory issues is that he does not like to have clothes on. On his last visit, it was reported that the child allowed a family friend to hold him for over five minutes. That is the first time that this has been accomplished. His coordination is improving. His eating habits are improving. He is able to repeat words more appropriately. He is having fewer tantrums. One of the most obvious examples of this is getting a haircut. Apparently, once even approaching the barbershop, he would begin screaming and flailing. His last haircut he went fairly smoothly to the surprise of both his father and the barber. Is it the feeling of the clippers that the child does not like? Is it the sound of the clippers that the child is not like? Is there too much noise in the barbershop? We really don’t know. What we do know is that this child is making improvements with regard to his sensory integration issues and this is affecting his normal daily activities.
How far can we get with this child? Only time will tell, however, he is young, he has a great family and support group, and he is improving. Again, I repeat, the more the child can do, the better chance we have of helping him. So as he becomes more cooperative and is able to follow more instructions, this will put more tools into play that we can use to augment his progress. So, right now I am hopeful. A child getting a haircut, a small thing but a big thing. I am often asked questions such as “ when can a child begin Hemispheric Integration Therapy” or “We don’t live in Tampa can we still do H.I.T or functional medicine interventions at a distance?” I hope this gives everyone a feel for those answers.
•
If you can’t eat out due to the gluten free diet, here is a restaurant review of a nice meal. Hopefully you live near one of these restaurants. http://glutenfreeislife.wordpress.com/
