Autism Q & A with Dr. Kari
Dr. Kari recently answered questions about autism for a HEALTHathon sponsored by Baby Blog Addict.
1. What are 3 myths you hear people say about Autism?
Myth: Autism can be cured by using (fill in the blank).
Cure — “to relieve or rid of something detrimental, as an illness.”
The term “cure” suggests that complete removal of all causing influences can be achieved, and I believe that the autism spectrum behaviors may have complicated mechanisms that produce and sustain them. At this point, I think it is most fruitful to view the behaviors and symptoms associated with the autism spectrum as capable of being improved to some degree.
There are many useful and effective approaches that help to improve the quality of life for individuals on the spectrum. But no one approach will produce improvement for all individuals with autism. Parents must be wary of any approach that claims to “cure” autism, because a cure just hasn’t been discovered.
It’s important to work with a multi-disciplinary team (for example, doctors, occupational therapists, educators, psychologists) to determine the most likely approaches and methods for each person, implement them, and carefully note the changes. Many people on the spectrum benefit from more than one method, and pursuing a balanced, holistic approach to management of symptoms and behaviors, is most likely to produce the best results for your child.
Myth: Repetitive or ritualistic behaviors should always be stopped and restrictive interests should be discouraged.
One of the core characteristics of autism is repetitive and ritualistic behaviors and or limited interests. These behaviors and interests may seem odd to parents, who worry that their child will stand out from peers and be isolated or ridiculed. However, these behaviors can be very grounding and comforting to your child and can provide the foundation of a successful life if nurtured and accepted.
Instead of restricting a child’s interests, I advise parents to help their child investigate the power of their natural interests. Most of us build our careers on our passions and talents. Help your child fully develop his/her talents and interests. Not only will this give your child more opportunities to become self-sufficient, it will give you an ideal opportunity to bond with your child.
Bonding with your child is the platform from which your child will learn social interaction, a sense of belonging and importance, and the self-confidence needed to succeed in life. Pursue your child’s passions with him/her!
At the same time, expose your child to new areas of exploration by eagerly offering to share your own passions and talents. Give your child time to warm up to your interests. Keep providing the opportunity to explore – and to create – new interests and memories with your child!
As children grow, they can discover behaviors (and thoughts) that ground and center them, replacing behaviors that others may see as odd with behaviors that are more “mainstream.” We all use behaviors and thoughts to help ourselves feel safer and more competent, and your child with autism needs to find his/her own coping strategies. I help my students substitute more “mainstream” behaviors and thoughts for those that might unduly set them apart. The key is to accept the necessity of calming behaviors and helping your child find ones that do the job of calming, but seem more “typical” to peers. There is no reason to limit your child’s coping mechanisms; instead work with your child to find coping strategies that do not alienate his/her peers.
Myth: Individuals with autism have mental retardation.
Autism affects each person differently. Although there are three core characteristics of autism: social difficulties, communication issues and repetitive behaviors and/or narrow interests, as well as other frequently encountered problems such as sensory sensitivity, it’s my feeling that many, if not most, individuals on the spectrum have more difficulty revealing their intelligence than we understand.
It is my strong belief that everyone is capable of learning and growing in ways that defy expectations. I always advise parents to expect a tremendous amount of improvement from appropriately focused and sustained interventions. I see great strides made by all students when solid remedial strategies are carried out over a sufficient amount of time. Our kids have locked within them the capacity to amaze us, if we give them the right opportunities!
2. Vaccines, what are your thoughts on them, and what if anything should we be doing?
3. Where does the community stand with vaccines? And what are your beliefs?
Currently, there is not a proven link between vaccines or mercury and autism. We simply don’t know what is triggering the symptoms of autism spectrum disorder.
Any vaccine may be harmful to any given child, but in terms of being a cause of autism, this has not been proven. Some experts speculate that the appearance of autism symptoms may simply coincide with the standard timetable for administering particular vaccines; in other words, it may be a coincidence.
It’s very important to continue to vaccinate your child against serious diseases. The risk of developing a life-altering or fatal illness is too great when a child is not vaccinated. It’s also important to carefully monitor the frequency of vaccination.
Even though there is no indisputable evidence of the cause, or causes of autism, it is wise to follow a common sense approach to living in a world of chemicals, fast foods, ….etc. and to limit exposure to risk factors.
While the evidence is by no means conclusive, we should limit exposure to lead, household chemicals, chemicals used to treat food or kill pests, and food additives. We simply don’t have enough information about how they affect our children. We need to err on the side of caution and live as green and simple a life as we are capable of living.
4. What are some of the signs of Autism you should be looking for with children?
The following is a red flag list for autism—any child demonstrating these symptoms should be evaluated for ASD:
Speech and Language:
- Does not babble or coo by 12 months
- Does not gesture (i.e., point, wave, grasp, etc.) by 12 months
- Does not say single words by 16 months
- Displays echolalia (i.e., repeating back what someone just said in a meaningless way) in the absence of normal language development
- Does not say two-word phrases spontaneously by 24 months
- Loses previously acquired language or social skills
- Does not respond to own name
- Does not smile when smiled at
- Has poor eye contact
- At times seems to be hearing impaired
- Does not seem interested in other children
- Difficulty initiating conversation
- “Mind blindness” or “theory of mind” limits child’s ability to understand the thoughts and emotions of self and others
- Insistence on routine and sameness
- Does not play imaginatively with toys
- Throws intense or violent temper tantrums
- Reactions seem uncharacteristic of the situation
- Has odd movement patterns
- Move fingers in front or side of eyes
- Taps self on the head, rocks, spins in circles, etc.
- May have restricted diet (may prefer a “white” diet—bread, pasta, fries
- Gets “stuck” on things over and over and cannot move on to other things
- Shows unusual attachments to toys, objects, or schedules (e.g., always holding a string or having to put socks on before pants)
May have Sensory/Motor issues:
- Hypersensitivity to one or more environmental stimuli: lights, sounds, touch, textures
- Auditory processing difficulty
- One sided crawling
- Visual processing issues
- Writing painful or difficult to read
5. Describe to me an average kid with autism
Each individual is unique and there is no way to present a “typical” picture. However, there are three core areas that are affected by autism: social skills, language and communication, and repetitive and/or restricted behaviors. Each child with autism will show some degree of challenge in these areas, but need not show a marked difficulty in all areas. Kids may also have sensory and/or motor problems, to varying degrees.
There are other conditions that may coexist with autism, such as mental retardation, sensory processing disorder, obsessive-compulsive disorder, depression, anxiety, ADHD/ADD, learning disorders, epilepsy, bipolar disorder, Tourette syndrome, and gastrointestinal problems.
6. What can a family do to help an autistic child?
Social development is key:
Opening up a child’s ability to relate to others and initiate and sustain relationships is of paramount importance. Think about it—your child will learn everything he/she will ever know because of interacting in some way with another person. Parents, teachers, friends, even enemies, will be near at hand when learning is occurring, and most often will play a dominant role in the learning.
Helping your child to seek out and maintain solid productive relationships will allow your child to learn valuable tools from others, particularly from successful other people. Focusing on relationships will pay huge dividends for your child in all areas of life.
Play experiences are great excuses to relate to each other. However, many times the activity itself becomes the focus and not the interaction between the parent and child. It is better for your child if you limit play for a specific purpose, such as putting together a puzzle or building with blocks. Play, instead, with “low tech” items you find around the house such as pillows, empty boxes, and buttons. Take the interesting visual objects out of the situation so YOU are the most interesting thing in your child’s life!
Relationship-oriented activities give parent and child a chance to get to know one another, so put more emphasis on things you do together for fun such as hiking, swimming, cooking, singing, building a fort, or making a doll dress. Develop memories together.
When you play with your child, relate and reveal your feelings! Use your words to express your personality instead of giving instructions or strictly sharing information. Share your reactions to colors and tastes and odors. Use gestures and facial expressions to convey your meaning as much as possible. Make sure your gestures and words match each other. Make getting to know each other the most important goal rather than talking about factual information. Sure, you can discuss facts, but your reaction to your child’s interests is more important than the facts.
7. Do you think there will ever be a cure for autism and if so when?
The term cure is problematic. Some people on the spectrum do not desire a “cure” and do not view autism as a “disease”, but instead, see it as part of who they are. However, some individuals with autism do experience troubling symptoms, such as extreme sensitivity to environmental stimuli, and may value improvement in the symptoms. Clearly, research will continue and more will be learned about the risk factors, treatment and educational approaches that benefit people with autism—that is certain. If history is any guide, then a great deal will be discovered that we can not even speculate about at this point, and our perspectives and beliefs about autism will undergo significant reorganization through time.
8. Is there any notable research going on as of right now that you are excited about?
If you haven’t heard about “mirror neurons” you can learn more about them in this article.
Mirror neurons are brain cells that fire when a person observes someone else performing movements. These neurons are also thought to be involved in language, imitation of others’ actions, deciphering others’ intentions, and empathy. Some researchers speculate that ASD may be related to dysfunction in the mirror neuron system.
This interesting article discusses research published in Current Medicinal Chemistry proposing that environmental and dietary factors may trigger a devastating cycle of events affecting certain activities of the brain. Specifically, researchers R.L. Blaylock and A. Strunecka propose that increased levels of glutamate, a neurotransmitter involved in more than half of the brain’s neural transmissions, is implicated in ASD.
This review discusses the comprehensive research on treatments released in December of 2009.
9. Do certain types of daily schedules help with kids on the spectrum? If so, what kind?
All kids need structure and routine to feel safe and to thrive. Therefore, setting up supportive structures for meals, sleeping, self-care, social interaction, learning, and recreation are necessary for children to feel comfortable enough to engage in the exploration of their environments that is essential to their growth and development.
I’d like to answer this question by talking about areas that are rarely discussed— how your child’s learning is affected by movement and the body’s natural rhythms.
Movement stimulates the growth of brain cells which are necessary for learning. It gives children the opportunity to explore the world and gather information that develops their intelligence. The brain requires feedback in order to learn and grow, feedback that comes from interaction with the environment. Movements allow children to express their knowledge and begin to tackle the next stage of their learning.
In particular, children who have learning issues benefit from regular movement. Try these activities before beginning homework, and at regular intervals while working.
Encourage your child to engage in cross lateral physical activity for five minutes every hour. Cross lateral movements engage hand and foot on opposite sides of the body. Most of these movements are more effective when done standing. The addition of rhythmic music provides a boost. Some cross lateral movements students enjoy are:
- Karate Cross Crawl: Kick while punching or chopping with alternate hand and foot (right hand chops while left foot kicks).
- Double Doodle. Draw a design with both hands simultaneously. Be sure the designs are mirror images of each other, rather than facing the same direction.
- Brain Gym has a great book, Brain Gym, Teacher’s Revised edition available at their website: braingym.com
Most students remember new information better when they talk, write or draw. For those students who remember information best by writing, provide them with a white board and erasable markers or encourage them to write on paper. Allow your child to act out what has been read, build a model, draw a diagram or chart, sing or dance. Encourage your child to “teach” new information to others in the household.
Movement breaks that help your child focus include: jumping on a trampoline, rolling, pushing against the wall, playing tug of war, standing on a balance board, tossing a bean bag back and forth between hands, squeezing or pulling at soft plastic hand toys.
Some other tips for helping a child be focused for learning include blowing to focus for tasks at a distance such as copying from the board and sucking on something to help near tasks such as reading. Using long, crazy straws to drink think liquids is great.
Body’s Natural Rhythms and Preferences
These areas are important to your child’s learning:
- Sleep effects
- Learning naturally occurs during sleep
- Short bursts of focuses attention
Sleep is essential to survival and to sanity and to improved skills. Interestingly, when a person sleeps, the brain is far from idle! In fact, for only about 20% of the time is the brain actually using less energy than during periods of wakefulness.
Actually, it’s hard to determine a generalization for how much sleep is optimal. The best way to determine how much sleep is generally good for your child is to observe and keep careful logs of the amount of sleep, any unusual circumstances, and your child’s functioning the next day.
Too much sleep can be just as devastating to your child’s academic success as too little sleep. Both cause the brain to be less efficient, mood to be effected, processing of the environment to be inefficient, and produces less control of anxiety and frustration. Naturally, you want to figure out how much sleep your child needs on average, and set up routines that allow for this much sleep each night.
Don’t be concerned if your child seems to need more or less sleep than others, as long as he or she is doing well. The amount of sleep a person needs fluctuates depending upon circumstances such as their age—they need more sleep when younger, less as they mature, and more as they enter older age. There are differences due to entering puberty, a person’s gender, a person’s nutrition, and a host of factors unique to each individual. Some people function better if they have a nap during the day, others do not. There is research and theory to suggest that many people respond best to a long sleep at night and a nap in the middle of the day.
Each person has a unique internal clock of sleep and wakefulness. Help your child learn his rhythms and do his best to tackle the most challenging subjects during his most alert time of day.
During sleep, the brain engages in rhythmical activity and mountains of research have documented that individuals who “sleep on it”, in other words, who are taught something and then are asked to perform it after an interval of sleep, perform better than they did at the end of the training session. This is even truer of learning motor sequences and performing procedures.
How can parents use this interval of sleep to help their child learn? If your child has noticeably more learning after “sleeping on it”, ask her teacher to let you preview the next day’s material one or two days before. Ask to have the reading material and comprehension questions in advance. Ask for the social studies assignment so it can be read before class discussions. In the areas in which your child has the greatest learning challenges, try to get advance notice of the material and give your child the opportunity to work with it before hand and to “sleep on it.” Naturally, this can also help to allay any anxiety your child may have about the next day. Children who are feel inadequate in a particular class or with a particular subject will have some of that tension eased when they can work with the material beforehand, and the principle of “sleeping on it” will give an added boost to their learning. And also, a child who is less tense will sleep better, and that will boost his performance as well!
The human mind is made for short bursts of focused attention. Therefore, frequent changes of pace are crucial to learning. The mind needs to reorganize and consolidate new information during non-learning periods.
The brain responds to novelty in order to learn, so let your child change aspects of his study environment when they no longer stimulate him. Naturally, you need to be sensitive to your child’s need of comfort and security. But the brain learns best in response to new, different and interesting stimuli, so find ways to help your child make small modifications that increase alertness. These modifications will actually work to your child’s advantage in many ways. For example, his brain will take greater note of the changes and become more available for other stimuli, such as concepts and skills.
Small, manageable changes that your child finds pleasing and interesting form a great platform for building a sense of safety, security and control in the environment, because they are chosen by the child and expand his awareness and knowledge. For example, use different colored paper or pens, put up a poster or picture in the work area, and change it every month or so, or change the screen saver on her computer.
A child’s storehouse of background knowledge is the support system for new learning. Bolster your child’s supply of knowledge by taking trips, answering the relentless “why” questions, and having meaningful discussions about the nature of the world!
10. Talk about your thoughts on the diet aspect of helping your child with autism. Do you believe it helps? If so what diet helps?
Many anecdotal reports attest to the positive effects of dietary changes in the behavior of individuals on the spectrum. Some diets that have helped people include:
- eliminating gluten, the protein in wheat,
- eliminating casein, the protein in dairy products,
- limiting sugar
- limiting refined and highly processed foods
- increasing Omega 3 fatty acids
- increasing Vitamin B6, taken with magnesium (which makes the vitamin effective)
But there is no support for the claim that any dietary change can ease symptoms of autism for ALL people. Therefore, only try dietary changes with caution, under the supervision of a registered dietician and/or physician, and keep careful records of the changes in your child’s behavior and learning.