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.

]]> http://www.hitautism.com/uncategorized/autism-spectrum-disorders-a-child-gets-a-haircut/feed 0 http://www.hitautism.com/uncategorized/adhd-drug-recall http://www.hitautism.com/uncategorized/adhd-drug-recall#comments Sat, 15 Aug 2009 18:18:07 +0000 admin http://www.hitautism.com/?p=411 http://latimesblogs.latimes.com/booster_shots/2009/08/adhd-drug-recalled-for-carrying-toohigh-a-dose.html

My wife had sent one of her friends an email regarding one of our conferences on Hemispheric Integration Therapy for the treatment of Autism Spectrum Disorders. We view the spectrum as starting with A.D.D. and including A.D.H.D. , Sensory Integration Disorder, Processing Disorders, Asperger’s Syndrome, Tourette’s Syndrome, O.C.D. and Autism. An over simplified explanation is that these conditions are termed functional disconnect syndromes meaning that different areas of the brain are under functioning or not communicating with each other properly. This timing issue or desynchronization as it is frequently called causes a loss of the higher functions of humanity.  There are several common suspects in these cases, the cerebellum, basal ganglia and prefrontal cortex, although the functional lesion can be anywhere and clinically only a detailed functional neurological examination will give the answer as to where the patients problem lies.

In this case, we had the benefit of having a SPECT scan available as his parent’s had already taken him to the AMEN Clinic when he was younger. A SPECT Scan, single photon computerized tomography is a type of nuclear imaging test that can show blood flows to your brain to determine what areas of the brain are active.  The scan showed an under active right prefrontal cortex. The right prefrontal cortex is an area of the brain that among other things is responsible for empathy,  judgement and impulse control.

Here is the heart of this story.  The young man apparently drove of in a car leaving his parole officer’s office.  The problem is he no longer had a license.   Therefore he violated his parole and was now looking at five  years in prison for a parole violation. The young man had had an initial consultation with me and had completed one treatment when this occurred.  The report of my initial consultation was presented to the patient’s lawyer and the judge. In the report I explained how a a patient with an under-active right prefrontal cortex will have limited ability to control his impulses as the area of the brain responsible for regulating those impulses is not working adequately. Thus, it may not be that he doesn’t want to listen to the judge’s orders, but that he cannot.  This is something we go over with parents of young children with A.D.D. and A.D.H.D who are treating at the office. I always advise the parent of these children to consider the fact that it may be that the child can’t help it when you are considering punishing him for his actions.  Here a similar situation is occurring with the judge.  Please consider the fact that he can’t help it, yet.

His parents are now talking to the judge regarding putting the young man in a half way home – a much better alternative than prison.  This would allow the patient to come to the office to receive treatment. The patient’s father also said that he would have child rescanned with another SPECT scan after the treatment was completed, in which case further details of this case will be published in a scientific journal. For now, be aware that the children with A.D.D. and A.D.H.D are more likely to get into all sorts of trouble. When punishing them take into account the fact that they may not be capable of controlling their impulses. Realize also that this is a spectrum of disorders that can mix and match. There is much overlap with these neurobehavioral conditions. Your child may have Tourette’s syndrome and A.D.D. or O.C.D. and A.D.H.D. Finally, as these children get older their actions may lead to more serious consequences than be not being allowed to participate in recess because they did into behave in class today.