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On FridayDecember 17th,2010 we will be hosting a FREE holiday party for Kids on the Autism Spectrum and their families only at Gator Fred’s. The event will occur from 6-8 pm and will feature a Sensory Friendly Santa as well as FREE open play for the kids. You may take your picture with Santa or just enjoy the evening. Families will be given a number relating to their turn with Santa ( like when you are buying deli meats at the grocery store) and therefore no one has to wait in line. Your child can play until it is their turn and their number is called. We are working on having presents for the kids and there will be raffle type giveaways. The entire event is FREE and is sponsored by Dr Nelson Mane http://www.manecenter.com/, Mane HIT Support Squad http://www.meetup.com/Mane-H-I-T-Autism-Support-Squad/ and Gator Fred’s http://www.gatorfreds.com/ PLEASE TELL YOUR FRIENDS AND HELP GET THE WORD OUT.
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I recently had a patient present to the office for a neurological consultation regarding a learning disability, ADHD or an issue relating to the autism spectrum. It appears that the little girl was spacing out and had difficulty concentrating. In my seminars, I always speak about patients on the autism spectrum not having any hard lesions. That is to say, their MRI is normal in regards to not having any tumors, infections, malformations etc. For example if the child has a tumor, then his diagnosis is not autism but would be whatever type of tumor was found. It is only when all these hard lesions are ruled out that the diagnosis of autism is considered. This type of screening ensures that we are then dealing with a functional lesion. This means that all the structures in the brain are present. It then becomes a question of the function of the brain, its connections and coherence. Another fairly common test that is performed on a child suspected of being on the autism spectrum is an EEG. In this case, we would be looking for seizures. In the case above we would be concerned with absent seizures in which the patient seems to space out or be “absent” consciously even though they are present physically. In my practice ,we have quite a few patients that have both a history of an autism diagnosis as well as a seizure disorder. Please be aware that a patient can have an autism spectrum disorder, a seizure disorder or they may have both. The patient’s treatment will of course be affected by the category into which they fall. for example functional neurologist often use light as a technique to introduce a stimulus into the visual system. If the patient recently had an EEG in which the flashing of lights triggered a seizure, then that information certainly needs to be considered when developing a treatment plan for that particular patient. In any case, many patients being evaluated for these types of conditions will have an MRI and an EEG performed as part of their work up. Those tests should exclude other conditions being a cause of your child’s issues and your child not being part of the autism spectrum. A recent study in the Journal of Brain Development found that 24.6% individuals in the study with infantile autism had at least one epilepsy diagnosis versus 1.5% in the comparison group. The take-home of this article is make sure your basics are covered so that the most appropriate treatment plan can be instituted for your child.
Brain Dev. 2010 Jul 22. [Epub ahead of print]
A longitudinal study of epilepsy and other central nervous system diseases in individuals with and without a history of infantile autism.
Mouridsen SE, Rich B, Isager T.
Centre for Child and Adolescent Psychiatry, Bispebjerg University Hospital, Copenhagen, Denmark.
Abstract
Objective: To compare the prevalence and types of epilepsy and other central nervous system (CNS) diseases in a clinical sample of 118 individuals diagnosed as children with infantile autism (IA) with 336 matched controls from the general population. Methods: All participants were screened through the nationwide Danish National Hospital Register (DNHR). The average observation time was 30.3years (range 27-30years), and mean age at follow-up was 42.7years (range 27-57years). Results: Of the 118 individuals with IA, 29 (24.6%) were registered with at least one epilepsy diagnosis against 5 (1.5%) in the comparison group (p<0.0001; OR=21.6; 95% CI 8.1-57.3). Other CNS diseases occurred with low frequency in both groups and only cerebral palsy, unspecified (p=0.02) was significantly more frequent among participants with a history of IA. Conclusions: Our study lends further support to the notion that epilepsy, but not other CNS diseases, is a common comorbid condition in IA. Low intelligence, but not gender, was a risk factor for epilepsy in IA. Copyright © 2010 Elsevier B.V. All rights reserved.
PMID: 20655678 [PubMed - as supplied by publisher]
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Don’t forget about this weekend’s free seminar regarding childhood neurobehavioral disorders in Tampa Florida. Topics under discussion will include hemispheric integration therapy, functional medicine for autism spectrum disorders and learning disabilities, autism assessment and intervention and RDI. The speakers will include Dr. Danielle Sutton and Kathryn Peter as well as myself. Jules Burt from the high heel hike will also be speaking. The seminar will be held at the Hillsborough County children’s board in Ybor city. Check-in is at 830 am with a question and answers starting at three o’clock. For more information go to http://www.hitautism.com/events download the PDF.
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This is a subject that doesn’t seem to get much attention but as I see families come in the office with children on the spectrum who have brothers and sisters, it is apparent that there is a dynamic going on that is often not addressed by the community. As I have said I the past, Autism affects children and therefore the entire family and society in so many ways. This is one aspect that doesn’t seem to get much attention. Here are 2 video clips relating to a sibling of a child with Autism and Asperger’s Syndrome, the interviews address how they feel. http://www.youtube.com/watch?v=oOKAjJDwuBk&feature=related
http://www.youtube.com/watch?v=UEX-5YxUUoA&feature=related
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Most of you know that I am against screen time for those on the autism spectrum. By screen time I mean computer time, video games and television. It is always easier to redirect a child than just outright take something away from him or her. When you redirect the child you are much less likely to get as much resistance. Many times although parents know that video games are not the best for the child , it is the only way that they can get a break. I understand that. He is a nice game that we recommend that is more active and participatory. check it out, I think you will like it. http://www.hasbro.com/games/en_us/bopit/
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Here is a review of some oat cookies made with gluten free oats. There is a raisin cookie and a chocolate chip cookie with some information about where to get the some of the ingredients should you choose to try to make your own. Making the cookies on your own may be a little more work but as unusual doing it yourself may save you some money. Everybody likes cookies and these will make a nice snack or quick treat if you need one. I hope you all enjoy and as always that someone’s day is a little bit easier because of the information. http://www.triumphdining.com/blog/gluten-free/2010/04/review-gluten-free-oatmeal-raisin-cookies/
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One of our patients came in yesterday and was kind enough to show me this site. I thought this was a great site for those with allergies and thought I wanted to share it with you. This site is beneficial because you can put in what your allergies or sensitivities are and the site will give you sample recipes that you can use. Obviously, the recipes do not include anything that your child is allergic to. We will put this site on the resource page for you to refer to in the future. Also recall the switcheroo site which allows you to take a recipe, that perhaps you already have and find a substitute for an ingredient that your child may not be able to have. Here is the link to the allergy recipe site. http://www.cookingallergyfree.com/
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Patients often ask me why other medical disciplines are not looking into these types of concepts such as neuroplasticity. In fact, they are, it will just take a while for these types of approaches to become more mainstream. This link will connect you to a post that is a little bit ” thick ” in that it may be difficult to understand, however it does show how others are using the concepts of neuroplasticity, right and left hemisphere, and primitive brain and Neo cortex. It is not specifically regarding autism and the spectrum or Hemispheric Integration Therapy however I wanted you all to see that others are grabbing these concepts from neuroscience and attemping to apply them.
http://communitywork-schweicks.blogspot.com/2009/11/mindfulness-trauma-and-brain.html
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I have been warned that writing about possible problems with international adoptions might upset some in the international adoption community. Yet, I feel compelled to write this article. One, because this information should be available to those making a decision regarding these types of adoptions. Also, because it is a perfect example of how sensory and motor delays can cause autistic type presentations.
I had the pleasure of treating a wonderful young girl that was adopted from China. This was actually my introduction into the world of international adoptions and possible complications. The next few sentences highlight some of the issues I have been informed of. Many times the ratio of caretaker to child in some of these orphanages can be as high as 40 to 1. Many times, these children only have their diapers changed once daily. There is the possibility that their hands may be tied as the hands may be considered dirty. Children may never have been taken out of that crib. In fact, they may just have a drip type tube from which to get sustenance. This I was told described the conditions in one of the better orphanages. I was given a copy of a book relating to a term “the dying rooms .” This is a term relating to some of the horrible conditions in the Chinese orphanages during a certain time period. The phrase “Dying room” can be googled and you will be able to find information regarding a book and a television program relating to the same subject. This particular child had not been out of her crib until she was adopted at 18 months old. Therefore, she could not crawl or walk and certainly could not feed herself. When I saw her she was approximately 12 years old.
In the functional neurology model we look at the motor system as being an important driver to brain function. Naturally then development of the motor system is considered paramount development of brain function. Any Situation in which a child did not scoot on time or crawl on time or misses any of their motor milestones becomes a red flag. Primitive reflexes and lower areas of the brain become inhibited as higher areas of the brain develop. If there are inefficiencies in this process, there tends to be inefficiencies in optimal brain function at the highest levels which is what we see in autism spectrum disorders. Therefore, this child was a perfect model for this concept. The fact that she was never out of the crib until she was 18 months old. She had no motor or movement stimulation. She had very little sensory stimulation whatsoever the first 18 months of her life. It is common to see these children stimming and head banging in their cribs looking for some environmental stimulation from the outside world. As I have often said in my presentations to parents and professionals alike, most people realize that if you affect the brain such as in a stroke, you will affect the body. Most, however, do not realize that it is to the receptors from the environment that drives brain activity. Therefore this child’s very limited environmental stimulation had a high probability of presenting with developmental delays, sensory issues and autistic like symptoms.
This child’s functional neurologic examination was exactly as one would expect. She still had primitive reflexes present. She had sensory integration issues mostly related to touch and sound. She had incoordination and a balance disorder. With the appropriate functional neurological examination I was able to localize her functional lesion. Thanks to great cooperation from a dedicated and loving mother, we were able to implement a treatment program to correct her deficits. What is seen most commonly in regard to the application of hemispheric integration therapy with these children is that the ADHD and sensory type symptoms seem to improve first. I then began to get reports from her mom that her cognitive skills were also improving. This child was home schooled and had tutoring. Fairly quickly I began to get reports from mom stating that her reading level had moved up several grade levels. So once again, we got to see the motor cognitive link in action. I recall being in a functional neurology class and hearing the instructor say that “plants don’t have brains, only things that move have brains!” It was something obvious but that had never occurred to me. And so, this wonderful child was an excellent example as to how motor training can drive brain development. Of course, it was not quite as simple as just motor training. We have to incorporate the sensory stimulation and eventually layer her treatment together with cognitive exercises also so as to allow for multi modal processing. However, with the appropriate examination and monitoring of her treatment program allowed us to quickly adapt the program to her rapidly changing findings mostly on a weekly basis but at times on a daily basis.
In my office, we see many boys, as boys tend to be affected by autism spectrum disorders more than girls. However, we have seen quite a few girls and a disproportionate amount of them have been internationally adopted children. So today I got to kill two birds with one stone. I was able to write about functional neurology and hemispheric integration therapy with regard to autism spectrum disorders and inform prospective parents about a not commonly discussed situation with regard to international adoptions.
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This week I was introduced to something I had not heard of yet and so I am sharing it with all of you. I had a parent tell me about a wonderful organization that provides service dogs for autistic children. If you have seen a service dog before it was probably related to a visually impaired person, a seeing eye dog. These dogs undergo extensive training and are specially prepared for those on the autism spectrum. This sounds like a great concept and perhaps after my patient receives his dog I will be able to give you some follow up on ” A boy and his dog.” Here is the link, check it out http://www.4pawsforability.org/dream.html#Hung
