A change is coming...it's a good thing, really!

'Milo has received services since just over 2 years of age; Occupational Therapy (OT), Speech, and Early Intervention. Since starting PreSchool at age 3, he has been provided OT, Speech and Adaptive PE (APE - for gross motor skills) thru LAUSD. All, thankfully, free of cost. Each year at the IEP meetings, his services have always been reviewed an renewed. Today, sitting in the office waiting for the meeting to start with 'Milo's dad, I said to him, do you think 'Milo even needs to continued speech therapy anymore? After talking it over, it was clear to see that he has come a long way, even in the past few years, that we agreed to bring this up at the meeting. Then I said, what about APE? He's been playing soccer and he seems to be much better with the skills as well. And again after discussing, we agreed to also bring this up in the meeting.
So here we are, 'Milo's teacher, his speech teacher, the vice principle, 'Milo's dad and me. We went over the his English, math, writing and so on. Talked about the goals he met (most of which he did!) and some that needed to be adjusted to be more attainable. So when speech came up and the teacher talked about how he's met these goals and how much better he was even since the beginning of this school year and new goal we listened. It was then I said, "we were just talking about this before the meeting started and we're thinking, does he really need to continue with speech? He's come so far in just the last few years; he's aware when he mis-uses a word, and will even correct himself and if clear about that he saying. We feel that he should spend more time on his academics. What are your thoughts?" His teach nearly jumped out of his seat! He said, with a huge smile on his face, "I think this is the first time a parent has asked to remove a service! We have to mark this day down! You guys get it!" He said that parent see progress and they ask for more time on services, but we were asking for just the opposite! This is 1 hour a week, that he is away from class and it just didn't make sense anymore to use that time on a service. He even said, "you should write a book!" I think that was the biggest compliment When the APE services and goals came up, we said the same thing, let's use this time on academics now. I said "he plays soccer now and even wants to try basketball. We think he's ready to transition out of that service as well". They asked how he was doing with soccer, I said he did great, he was even goalie and played defense, blocking shots running up and down the field. They were all supportive of that as well. So now the next step, which is required, is the put in the request for an evaluation in these two areas just to record his progress and make sure these services are no longer needed. I'm sure they will be removed and so next year, he will be able to spend more time in the class on academics. More than likely, the assessment won't be completed until the next school year, but we were able to request that speech be reduced by a half hour a week in the mean time starting the next school year.
All in all it was a great meeting and very happy with the out come. We should start to see some more progress in his academic goals with that extra time in the class. Onward and Upward

IEP: individualized education program - Kids with delayed skills or other disabilities might be eligible for special services that provide individualized education programs in public schools, free of charge to families. Parents work with educators to develop a plan to help kids succeed in school. The IEP describes the goals the team sets for a child during the school year, as well as any special support needed to help achieve them. - Source, http://kidshealth.org/

OT: Occupational Therapy - helps kids who have a physical, sensory, or cognitive disability carry out everyday activities like brushing their teeth or putting on shoes and socks. - Source, http://kidshealth.org/

APE: Adaptive PE - Adapted Physical Education is physical education which has been adapted or modified, so that it is as appropriate for the person with a disability as it is for a person without a disability. Assists in fundamental motor skills and patterns (throwing, catching, walking, running, etc) - Source, http://www.apens.org/

Speech Therapy - With a variety of techniques, speech-language therapy addresses a range of challenges often faced by persons with autism. For instance, some individuals on the autism spectrum do not speak, while others love to talk but have difficulty using conversational speech and/or understanding the nuances of language and nonverbal cues when talking with others. - Source http://www.autismspeaks.org/

Early Intervention - Early attention to improving the core behavioral symptoms of autism will give your child – and the rest of the family – several important benefits that you will not gain if you take a wait-and-see approach until your child enters school at age four or five. A good early intervention program has at least four benefits: It will provide your child with instruction that will build on his or her strengths to teach new skills, improve behaviors, and remediate areas of weakness. - Source http://www.autismspeaks.org/

Diet & Encouraging Picking-Eaters

None of us have this problem, right??  I can tell you, in my personal experience, my son adjusted to food well after being breastfed.  He tried just about anything; fruits, veggies, meats, dairy, the works.  As he got older he stopped eating foods he use to eat.  Now at age 9, he has gotten very picky and specific about food.  He does not like fruit.  In fact, just until a few years ago, he would eat bananas and applesauce, but he refuses those now.  He's actually better at veggies and will eat broccoli, carrots, peas, onion (mixed in foods), string beans and corn.  And forget about breads.  Will not touch or eat and if someone is eating bread near him he has a disgusted look on his face!  So I was excited for this topic.  Here is some information I obtained at a recent support group meeting at CARD.  I feel a disclaiming coming on....

This site does not provide medical advice. The content of the information obtained from CARD and shared here is intended for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding you or your child with Autism. Never disregard professional medical advice or delay seeking it because of something you've read here.

Common Nutrition & Feeding Concerns:

• “picky” eating behaviors 
• Difficulty with transitioning to age appropriate diet 
• Increased Sensory Sensitivity 
• Short attention span 
• Limited variety in diet 
• Need for routine

Common eating preference:

• Preference to dry, crunchy food
• Refusal of soft, smooth textures
• A dislike for fruits and vegetables
• Preference to finger foods
• Preference to certain brands and preparation methods
• Preference for food of particular color(s)
• -some common foods that are preferred:
• Dry cereal, crackers, chicken nuggets, pizza slices, hot dogs and pasta

Impact on growth and development?

The majority of children with ASD are of average height and weight, according to the Center for Disease and Control (2012)

www.cdc.gov/ncbddd/autism/index.html

Other nutrition concerns that are associated with diet:

-vitamin and mineral deficiencies

-gastrointestinal concerns (reflux, constipation, diarrhea)

-food allergies

-drug nutrient interations

Drug Nutrient Interactions

Medication may increase of decrease appetite and may affect vitamin and mineral absorption.

Examples for interactions:

-Ritalin decreases appetite and stunts growth

-Risperdal or SSRI, may increase appetite

-Seizure medications affect calcium, vitamin D and folate metabolism and may need to be supplemented

What we know about Autism & diet implications

• Studies have shown a difference in nutrient intake with typically developing children (CDC, 2012).

• Additional studies have shown children diagnosed with ASD eat less than the recommended amounts of: vitamin C, D, several B vitamins, iron, and calcium

Gluten-Free, Casein-Free diet

-Leaky gut hypothesis; the gut allow peptide metabolites of Casein & Gluten to cross into the blood stream and then into spinal fluid.

-These peptides act as opiates in the brain and interfere with CNS Function.

The central nervous system (CNS) is the processing center for the nervous system.  The two main organs of the CNS are the brain and spinal cord.  The nervous system consists of the brain, spinal cord and a complex network of neurons. 

Some argument have been made that Autism may be influenced by Gluten and Casein diets

GCFC Diet:  Studies and Implications

-A meta-analysis in 2008 showed no-evidence for efficacy of a GFCF diet.

-2010 study of 15 children with Autism (ages 2-16 years of age), showed no significant results.

--However, Parents and Caregivers reported improvement in Autism related symptoms

--Indicate there is more of a need for investigation and analysis within clinical trials

GFCF diet impact on families

-Extra time needed to buy and prepare foods/meals

-Diet makes child “special” or “different”

-Diet makes peer/social interactions difficult by the introduction of this barrier

-High cost of alternative foods

GFCF Diet: Nutrition Implications

Children on the GFCF diet ten to eat more fruit & vegetables, and less bread and cereals.

Common risks of nutrient deficiencies:

Gluten Free diet: Iron, Zinc, B-vitamins and Folate

Dairy Free diet:  Calcium, vitamin D, Vitamin B2, and Protein

GFCF diet:  What to do?

Weight the Pros and Cons and decide if the diet may be an “option” for your child.

Start slowly.  Start with a CF of GF diet first.  Then make a few changes at a time, and observe your child

Supplement Calcium and Vitamin D

Give a Children’s Multivitamin with Minerals

Most importantly, talk to your pediatrician or consult with a registered dietician.

www.glutino.com/

www.gfco.org

www.gluten.net

www.livingwithout.com

www.allergygrocer.com

www.foodallergynetwork.com

Encouragement: picker eaters

Helpful guidelines

-Important to rule out any medical drivers of food allergies that could be causing a dislike of particular flavors or food groups.  (Consult with pediatrician/dietician)

-Its perfectly natural for a child to be averse to eating a food that caused a bad tummy ache or a bout of food poisoning in the past.  Basic instinct!

-Avoid making food a source of conflict with your family!  Arguing over a food item will not make any situation better—tends to make things worse.

7 Stops to trying new foods: 

1. Simply look at new foods items together 
2. Suggest to smell it and/or touch the food item together 
3. When you feel your child is ready, suggest licking or tasting the food item
4. Sometimes it can help to mix the new food item with a familiar and preferred food for the first taste.  (This gradual approach can decrease anxiety about new foods by increasing familiarity. 
5. Try and give your child choices so they can feel in control of their meals (provide 3 choices:  Peas, carrots or salad  -or- Providing a wide array of foods items, like a buffet. 
6. Make you child’s favorite meal, but add a “mystery ingredient” and make a game out of it 
7.  Include your child in the cooking process, and have him/her choose certain food items (encouraging choice and control can help avoid argument/meltdowns and encourages a more varied diet)
   It’s important to find solution with you child.  The more fun, the better. Make faces on pizza with different vegetables and pepperoni. Paint with pasta sauce. Experiment with how food changes color or consistency when mixed together or cooked. Each of these activities will help a child become more comfortable around new and different foods, create opportunities for trying new tastes and keep food discussion positive.  Make mealtime an opportunity for flexibility, education, choices, and most of all, fun and children will respond favorably, whatever their age.
   
   source:  CARD