Ask the Horizons Team: “How do I get my child to eat mac & cheese again?”

May 11, 2012 By Erin Roon, MA CCC-SLP Leave a Comment

Question:

My son used to eat macaroni and cheese on a regular basis, a week ago he refused to eat it and now says he doesn’t like it anymore.  He has a rather limited range of foods and now he won’t eat macaroni and cheese anymore.  How do I get him to eat it?

-Dave in Tulsa, Oklahoma

Answer:

Hi Dave,

What you are describing is a food jag.  Everyone experiences this at one time or another.  When we eat the same food over and over again we get tired of it and decide we don’t want it anymore.  The difference is in the severity of the jag.  For children with feeding disorders (very limited diets) food jags can be more permanent in nature, meaning it takes a great deal of work and typically feeding therapy to regain foods that are lost.  For children who would be termed picky eaters, meaning they have a range of foods in their diet, but a limited amount regaining lost foods can be a bit easier.  Sometimes by not eating the food for a period of time (a few weeks to a few months) can be enough to help your child want the food again.  If your child has a feeding disorder it may be time to contact a feeding therapist to work on expanding their diets and to work on regaining lost foods.  This issue can be a part of treatment for autism as well as other neurodevelopmental disorders.

Take care,
Erin

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The Gut and Nutrition

May 9, 2012 By Erin Roon, MA CCC-SLP 3 Comments

We see many children and young adults in our practice, and find that many of them benefit from a special diet, elimination of certain foods, or use of supplements.  There are many conflicting studies out there that make it difficult to know for sure if there is a connection between nutrition/gut issues and autism; but I can say that in our experience it seems to be true for many.  Like the population as a whole, one rule doesn’t apply to all.  I see some children who do not seem to be affected at all by the things they eat – no gut problems, bowel issues, or behavior that would indicate feeling ill, or high levels of yeast – while others seem to be very affected by all of these things.   It can take a lot of time and effort to sort this all out, but the differences can be remarkable when a child is feeling well and getting proper nutrition.

Special diets are not necessary for every child with an autism spectrum disorder, because every person has their own unique make up and nutritional needs.  There are books, articles, and people out there who promote the gluten/casein free diet for all kids on the autism spectrum.  While this isn’t a bad diet, and it certainly won’t hurt anyone to be on the diet, it isn’t a “cure” for autism; and it doesn’t have the same effect for every person.  Some people see dramatic differences on the diet, while others see no difference.  While the gluten/casein free diet may not be effective for your child, there may be other diets, nutritional changes or supplements that might be.

So, how do you know if your child is suffering from gut issues, or is getting proper nutrition?  This question is a daunting one that can sometimes take days, weeks, months, or even years to answer.  For some children, the answer is quick and easy; for others one answer can lead to more questions.  What works for one child doesn’t necessarily work for another, and often times it is by trial and error that you find just the right fit for your child.

It is our goal to help families find the answers in as quick and efficient a manner as possible.  So, what are some of the ways we gather necessary information?  Below is a list of some of the typical steps we take in determining if your child is experiencing gut issues, has nutritional challenges, or may be suffering from yeast overgrowth.

  • Gather a detailed developmental history.  This includes information on your child’s eating, sleeping, and stool habits, as well as his/her behavior.  The history also looks at what types of diets or supplements your child is currently taking.
  • Gather a three day diet history.  Parents journal for three days on what their child ate and drank.  Included in this are any noticed reactions to the foods.
  • Observation of the child.  We spend time observing and interacting with the child over a few hours or sessions, and note any behaviors or symptoms that may indicate food sensitivities or gut issues.
  • Lab Work.  When necessary lab, work is recommended to test a variety of things including food sensitivities, yeast levels, thyroid levels, and mineral levels.  It may not be necessary for children to have all or any of these tests done; but many times we have clients do some types of tests.
  • Referral to a specialist.  In some cases we find it necessary to refer a client to a medical doctor or other specialist for further testing or treatment.  We may send families to get support for supplementation or diet help if we feel it is outside the scope of our practice.  We may also refer a child to see a gastroenterologist to treat gut issues.  There may be other referrals needed, but these are some examples.

Based on all of the information gathered, a course of action is determined and a trial period is established.  The family monitors the child’s progress, and provides updates as needed.  Often times it is initially necessary to make modifications and changes, especially until the right combination is found.  This can be frustrating for families; but I always tell my clients that I won’t give up on them, and will continue to help them until we find a solution.

If you feel like your child is experiencing gut or nutritional issues, find a practitioner who is willing to listen and help you sort through the maze of options.  Dietary changes can be an important component of treatment for autism and other neurodevelopmental disorders.

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Ask the Horizons Team: What does “remediation” mean?

May 4, 2012 By Courtney Kowalczyk, M.Ed. Leave a Comment

Question:

This may be a silly question, but what does the word “remediation” mean?  I see you reference it in some of your articles and online, but I’m not sure I know exactly what it means.

Thanks – Jenna in Vermont

Answer:

Hi Jenna,

It’s not a silly question at all!  Remediation means correcting a deficit to the point where it no longer creates a barrier for an individual on their path to obtaining a satisfying quality of life.  The process of developmental remediation allows individuals to have a do-over for the important developmental milestones that may have been missed along the way.  Remediation goes beyond compensations and gets to the root of the problems.  The focus of remediation is to fix the underlying problems the individual is having and not just to make the surface look better.  The reason you see the word remediation come up a lot in our articles and posts is because it is at the heart of what we do.  Our goal is to help resolve the core issues that create challenges – to remediate them so they aren’t obstacles anymore.  It is the core of our approach to treatment for autism, help for ADHD, and support for other neurodevelopmental disorders!

I hope that helps!

Courtney

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Springtime Planning for Transitions

April 30, 2012 By Courtney Kowalczyk, M.Ed. Leave a Comment

The sun is beginning to shine, and the fresh smells of spring are upon us. This time of year is always a favorite of mine, whether I am working with clients or walking through the park with my sons. One thing is for sure, this time of year is always busy in school systems. Special educators, parents, and support staff alike generally meet together for an annual Individualized Education Plan (IEP) for the coming school year. For those of you who are unfamiliar with them, IEPs are usually completed in the spring for students receiving special education services. When preparing for IEPs, it is essential for parents and educators alike to think about the conclusion of the current school year and the beginning of the next, and how they will support the child during this time.

During moments of transition from grade to grade, classroom to classroom, or school to summer, many children with disabilities begin to feel uncertain about what is to come for them in the future. This uncertainty can lead to increased in anxiety, which can be manifested in many different ways. As educators and parents, it is very important to plan not only for the upcoming school year, but also for the transitions in between. Here are several suggestions to make those transitions easier and less stressful for everyone involved:

  • Communicate with the child that the school year is coming to an end, and that summer will be approaching.This is a good time to discuss moving on to a new teacher, saying good-bye to the current teacher, and ways for maintaining friendships over the summer.
  • Include the child in the planning process as it draws near. It is important to ask him/her what he/she would like to learn and from whom in the next school year. For educators, asking for student input is very important. We want our students to feel empowered, that they have an impact on what happens to them in the future.
  • Make decisions as a team. It is important for educators and parents alike to make informed decisions regarding placement for the coming school year. Having received input from the child, parents and educators should discuss the best options for success.
  • Make a plan for the summer. It is very useful for students with disabilities to see a visual of how the transition will take place. You can draw a map for the summer, or write important dates on a calendar (for example when school ends, summer events, meeting the new teacher, when school will begin again, etc.).
  • Guide the child through the transition. It will be important to guide the child in how to say goodbye to this year’s teachers and classmates appropriately. It will also be important, especially for parents, to guide their child through their summer routine whether at home, on vacation, or attending summer school.
  • Gear up for the coming school year. During the several weeks prior to the start of school, it is beneficial to take your child to his or her school, introduce him/her to the new teacher, and allow him/her to familiarize him/herself with the new surroundings. It may also be beneficial to set-up a time to meet with the new teacher(s) to discuss the child’s needs, and what he or she can expect during the first days of school. By doing this, you will be able to help prepare your child for what he/she can expect when school begins again.

In following these steps, transitions from school to summer and then to school again can be less stressful and more enjoyable for everyone involved. Helping children learn to think about and plan ahead for transitions is an important component of treatment for Autism, ADHD, and other Neurodevelopmental Disorders.  As educators and parents, it is important for us to support our children, and guide them in successfully dealing with transitions.

“Nothing is secure but life, transition, the energizing spirit.” (Ralph Waldo Emerson)

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Gut Health and The Importance of Good Nutrition

April 27, 2012 By Nicole Beurkens, PhD Leave a Comment

Question:

Last week your featured article was about gut health and the importance of good nutrition.  I found it very informative, and have been meaning to look at probiotic options for our family.  Do you have any favorite probiotics that you recommend to families?

-Andy in Denver, CO

Answer:

Hi Andy,

I’m so glad you found Erin’s article helpful!  Healthy bodies are essential for healthy brain development, and we all can benefit from improved physical health and wellness.  There are many excellent probiotic products available in the marketplace.  One brand that we like and recommend is Theralac by Master Supplements.  You can get either the capsule form or a children’s powder form.  These are medical-grade products that we have found to work very well for our clients and our own personal families.  You can find Master Supplements online at http://www.master-supplements.com.  Remember that it is a good idea to rotate probiotics periodically so you get the benefits of multiple strains and amounts of various good bacteria.  We have found the Master Supplements company to provide excellent customer service as well, which is always a bonus.  I hope you find a probiotic product that works well for your family, as this can be an important component of treatment for Autism, help for ADHD, and supporting other neurodevelopmental disorders!

Best wishes,
Nicole

(Oh, and I should also mention that this is not medical advice and I am not a medical doctor.  Any questions you have about your child’s/your own medical needs should be directed to your medical providers.)

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It’s the Simple Things!

April 25, 2012 By Erin Roon, MA CCC-SLP 2 Comments

Singing songs, taking a walk, sharing a snack, holding hands, reading a bedtime story – these are the simple things in life. My daughter is really into music, and we spend many hours every day either listening to music, making music, or singing songs. It doesn’t matter to her that her momma can’t carry a tune. As long as I’m signing one of her favorite songs, life is good. One of her other favorite activities is walking around our yard saying, hi and bye to the trees. Sometimes she just wants to walk, and at others she wants to ride in the wagon as we visit each tree. At eighteen months old, she is developing quite the personality and independent mind; but she helps me to remember the simple things.

In our fast paced world, it is important to stop once in a while and take stock of the simple things. Why does life always have to be so complex and full of hustle and bustle? It doesn’t; and we need to remember those times when things were simpler and it was fun just to sing a song or run around the yard. Why is it that as we grow older we forget those things? We’re always hurrying from this activity to that event, and forgetting that faster isn’t always better. At times I find myself thinking, “Slow down” – nothing is that important that it can’t wait a little while.

Slowing down is one of the things I work on with families every day as part of treatment for autism, help for ADHD, and support for other neurodevelopmental disorders; but it can be the hardest thing to implement. I think that if you view slowing down as a way to enjoy the moment and preserve memories it makes it easier. Time goes way too fast that if we don’t slow down once in a while, a whole year passes and we feel like we have nothing to show for it; or it is difficult to pinpoint the progress that has been made. There are many good reasons for slowing down, but I think one of the biggest ones is just to appreciate the moment and build stronger relationships.

Give yourself time to reflect back on those simple things. You will be amazed at all of the things that were discovered in those moments. Sometimes it can be difficult to appreciate the simple things, especially in the midst of a busy day; but trust me, you won’t regret slowing down and taking the time to participate in a simple activity with your child.

Remember it is the simple things that we remember and cherish most later in life. It isn’t the big fancy vacations or the 25 different activities that we were involved in. It is the quiet nights by the campfire, or the family bike rides around the neighborhood, or the favorite book that mom/dad read a thousand times. I challenge you to take 5 minutes and think about the best memories you have from being a kid, and think about the times you spend with your own children. Are you creating those simple moments in your family? If so, good for you! If not, what needs to change to make that happen? Find one simple activity over the next week that you can do with your child, and take some time to reflect on it. Challenge yourself to find more of those moments each week – I promise you won’t regret it. Life is made up of many simple moments, so don’t let them pass you by unnoticed!

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Ask the Horizons Team: Shoe Tying Struggles

April 19, 2012 By Nicole Beurkens, PhD 4 Comments

Question:

We are having an issue with shoe tying in our house!  I have 5 children under the age of 8, and my oldest has significant fine motor and visual processing issues.  It’s been an uphill battle trying to teach him to tie his shoes.  When we need to go somewhere it takes me forever to get everyone’s shoes on and tied.  I’ve tried to go the slip-on shoe route, but my older son really wants “regular” sneakers.  Do you have any ideas for us to try?

-Angela in Toledo, Ohio

Answer:

Hi Angela,

I hear you about the hassle of trying to get everyone’s shoes on, tied, and out the door.  That’s one of the things I love about the summer months – crocs and flip-flops for everyone!  You mentioned your son’s fine motor and visual processing issues, and those are definitely challenges when it comes to a complex motor task like shoe tying.  While he may be able to learn to do this independently at some point, he will need to work on underlying developmental milestones in those areas first.  Shoe tying requires a mastery of fine motor control, visual processing, cognitive sequencing, and many other skills we don’t even consciously think about.  Often this type of skill is included in treatment for autism, and can be addressed if a child has a learning disorder .  If he’s not working with a professional who can help you identify the underlying issues he needs to work on, let me know and I’ll give you some additional support in that area.

As for immediate solutions, I’ve got a great one for you!  I recently came across a company called Lock Laces that makes inexpensive laces for regular shoes, but don’t require tying.  They use a patented elastic lacing system that you simply pull tight with a spring-activated locking device.  I’ve used them with many clients with great success.  They will allow your son (and any of your other kids) to independently “tie” his regular sneakers.  Lock Laces cost just a few dollars a pair, and you can get more information at their website here: http://www.locklaces.com.

Give them a try and let me know how they work out for you!

-Nicole

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Ask the Horizons Team: Struggles with wetting and/or soiling behaviors

April 13, 2012 By Nicole Beurkens, PhD Leave a Comment

Question:

Our 10-year-old son has been having wetting and soiling accidents on and off for years.  However, in the past few weeks this has become a daily occurrence and nothing seems to be working.  Every time we ask him about it he lies to us and says he doesn’t need to go or he didn’t just have an accident.  This is causing a major problem and we don’t know what to do about it.  The situation seems hopeless!  Any advice?

-Kathy in Texas

Answer:

Hi Kathy,

I agree that this can be a very challenging problem, and one that creates stress for families.  However, there are a number of highly effective strategies that can alleviate this problem.  I’ll share some of them in general here, but encourage you to seek additional information and guidance for your specific situation.

  1. Recognize that there are often two issues that cause problems with wetting and soiling – physiological issues and emotional issues (generally anxiety).  This behavior is not something that most children enjoy doing or are even very conscious of.  Coming at the situation from a place of understanding and patience is an important first step.
  2. You mentioned that this has become more of a problem in the past few weeks.  The first thought I have is related to the start of the school year, and the increased stress levels that often occur surrounding school.  I frequently see children struggle more with wetting and soiling when they are under significant amounts of stress.  The more stress and anxiety, the more likely kids are to be unaware of their bodies and lose the ability to use effective coping strategies.  Identifying stressors in your child’s life and making attempts to reduce them will likely be an important strategy.
  3. You mentioned that your son “lies” to you when you ask him if he has had an accident.  Again, I’d like to reframe this for you to think about it in a different way.  It is very normal human behavior for us to lie about something when we are confronted with it, especially if we know we have done something inappropriate and wish we hadn’t.  I’m guessing your son doesn’t want to be perceived as a “bad kid” and, therefore, feels it is better to deny he has had an accident than to be honest about it.  There may also be times when he is genuinely unaware he has wet or soiled.  One suggestion I have is to communicate with him using direct statements, rather than questions, when these situations arise.  Instead of saying “Did you have an accident?”; you could instead say, “You had an accident and need to come to the bathroom with me to clean it up.”  That doesn’t leave room for him to respond to your question with a “lie”.  You state the obvious in a calm but firm way, and move on to cleaning it up.  This can avoid adding emotion to an already stressful situation.
  4. If you haven’t already looked into physiological issues related to the wetting and soiling, that would likely be beneficial.  There can be issues related to constipation, urinary tract infections, etc. that can cause an increase in these behaviors.  You can start with your pediatrician, or work with a nutritionist or other holistic health practitioner to identify dietary and other changes that may be helpful.

I hope these ideas provide you some food for thought as you tackle this challenging issue with your son.  There are other strategies that are also beneficial but these at least get you started.  This issue can be a problem especially for children with special needs, and can be an important part of treatment for autism.  If you would like to talk about your situation more specifically, please feel free to contact our office.

Take Care,
Nicole

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Go With Your Gut: Five Tips for Parents Making School-Related Decisions

April 11, 2012 By Nicole Beurkens, PhD 6 Comments

School-related decisions seem to be an ever-present issue for all families, but especially for families with a child with unique learning needs. Here are some tips I find myself frequently providing parents in regards to their child’s education:

  • Do not buy into the idea that there is a certain place out there that is a perfect fit and if you just keep searching long enough you will find it. No setting is perfect and there will be flaws and problems that crop up wherever you go. What is important is finding the right people who are willing to customize things to work for the best interest of each child – people who will bring you as parents in as part of the team and will work with you to ensure progress.
  • Don’t hem and haw over the next 15 years of your child’s school career when you only need to be making a decision about what to do for right now. I have met with too many parents who are paralyzed at the thought of pursuing something different from the status quo because they wonder what the ramifications will be 10 years down the road. Schools make decisions about placement and services one year at a time based on the current needs of the child and parents should do the same. You may feel that something is important for your child right now, and feel completely different about it a year from now. None of us can predict the future with certainty – no matter how hard we try! What is important is making the right decision for this point in time, and re-evaluating as you go along.
  • Find out what is available and choose what you feel is most appropriate for your child. Just because a service or option is available doesn’t mean you have to take it. If you don’t think the speech sessions are helping then stop them. If you don’t want the weekly home visit from the early intervention specialist then don’t do them. If you think your child needs to be home with you rather than at school for some of all of the day, then do it. Do not allow what “other people” say or do to steer you in the wrong direction with your child, or professionals to over-ride your own good judgment about what your child needs.  Don’t be afraid to go against the grain or make a different choice in the best interest of your child and family.
  • Don’t get hung up on labels! It really does not matter what a certain classroom is called as long as the people are invested in setting high standards and helping each child reach his or her potential. Very often programs are given specific names for the purpose of paperwork and reporting – nothing more. Visit lots of places – meet the staff and watch them in action; get a feel for the environment; watch the other students. Those are the critical elements in determining whether a classroom is a good fit for your child; not whether the name of the classroom matches the label of the child.
  • Finally, keep the developmental level of your child and the amount in mind when making educational decisions. There is tremendous pressure to put children, particularly those with autism, into formal educational settings earlier and earlier, but that may not be the best decision for your child. If you know your child is not ready for a classroom-based program then don’t send them. There is much to be gained from allowing children to benefit from the guidance of their parents during the early stages of development – and that process can take longer in children with unique learning needs. The same goes for children who experience significant amounts of stress in school. Parents must carefully weigh the potential benefits of a school environment against the amount of stress that is caused and the detrimental impact of that stress over time. Each of us as parents needs to take a good hard look at our child and decide if they are ready to enter a school setting for some or all of the day, or if they need more time to be truly successful and derive benefit from that environment. Again, don’t be afraid to make a different choice; to say “thanks, but not now” to school-based options if your child is not ready.

Maybe some of these things touch on issues you have been thinking about in relation to your child’s education. Choosing the best educational environment is essential in treatment for Autism, ADHD, or another type learning disorder.  Don’t be afraid to think outside the box and do what is right for your child at this point in time. You are your child’s best advocate and are in the best position to make decisions regarding your child’s education – don’t let anyone tell you otherwise!

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Ask the Horizons Team: Writing & Typing Computer Programs

April 5, 2012 By Nicole Beurkens, PhD Leave a Comment

Question:

I’m looking for a computer program to help my son learn typing and writing skills. He’s 7 years old and is interested in using the computer, but struggles with typing and getting his thoughts down in writing. Do you have any programs you recommend?

-Donna in Michigan

Answer:

Hi Donna,

While I’m not typically a fan of very many computer programs (I think kids spend too much time in front of screens!), I do have a program I use and recommend for typing. It’s called the Read, Write, & Type! Learning System, and it’s designed to teach phonics, spelling, keyboarding, and word processing. The program is entertaining and includes enough repetition that kids can grasp the skills with practice. It can be very successful for students with autism in the classroom. I’ve used this program with a number of students very successfully, so hopefully your son will benefit as well. Let me know what you think if you decide to us it. The link to the program is here:http://www.readwritetype.com/readwritetype/RWT-learning-system.html

Best Wishes,
Nicole

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