Archive for May 2016

Monthly Archive

Ask Dr. Emily- Movement and Sensory Overload

Welcome to the May edition of Ask Dr. Emily! We often receive questions that we want to share with all our readers. To help with this, Dr. Emily Rastall, a clinical psychologist at Seattle Children’s Autism Center, will share insights here, on the last Friday of each month, in a question and answer format. We welcome you to send us your questions and Dr. Rastall will do her best to answer them each month. Send your questions to theautismblog@seattlechildrens.org.

Q: I have two neighbors and a nephew with autism. Something I see all three of them do is walk—A LOT. For example, they might pace or go for walks up and down the driveway, hallway, around the block, etc. Does walking help self-regulate or is it because they are bored?

A: Individuals with autism spectrum disorder (ASD) often have a need to move their bodies. This “need to move” could be explained by a number of things. First, the “autism brain” is often, by nature, an active one. As a result, you might see squirmy, fidgety, and/or restless behaviors. Second, individuals with autism may present with what are called “stereotyped motor patterns,” or more simply put, repetitive body movements. This might look like pacing, rocking, flapping hands, jumping, spinning. Given the “autism brain’s” tendency toward movement, walking or pacing can be soothing to the system. We might think of it as “releasing steam.”

Q: My 3 year old son has autism and he just started school. As soon as we get there he covers his ears and sometimes hums also while covering his ears. He has also started to resist getting his diaper changed. I am wondering why he does these things and if this has anything to do with him starting school about 3 weeks ago.

A: It is not uncommon for kids (typically developing or otherwise) to present with new behaviors (or old behaviors that have disappeared, but come back) when going through significant transitions, such as starting school. They might have a hard time with things that have previously been easy. Kids going through large transitions may also be more tired, so tolerating even the simplest things (like diaper changes) can be challenging. During large transitions, kids can benefit from  sticking to routines at home, getting plenty of rest, and getting extra  child-directed play time with their parents or caretakers.

Specific to kids diagnosed with autism spectrum disorder, new environments can present as overwhelming to the senses. For example, the background noises of the classroom may be loud enough that it prompts kids to cover their ears. Humming may be working to drown out those noises even further. Kids with auditory sensitivities often benefit from noise reducing efforts, such as headphones or a quiet place to rest or recuperate.

Autism and Folic Acid: Another Association Study

Vegetables

 

 

Quiz: Which of the following factors have been identified in association studies as increasing the risk for autism? Mark all that apply.

 

 

Rainy climates

Living near a freeway

Use of flea/tick powder

Older moms

Older dads

Close spacing between birth of children

Vitamin D deficiency

Pesticides

Selective Serotonin Reuptake Inhibitors (SSRI) use in pregnant women

All of the above

If you marked all of the above, you are correct, but get ready to add one more.

If you were anywhere near a computer or television last week, you’re aware of the buzz surrounding a new study that identifies too much folic acid in pregnant women as a risk factor for developing autism.

Folate is the naturally-occurring form of Vitamin B9 found in leafy green vegetables and other foods and folic acid is the synthetic form of this nutrient important in the role of neural tube development in fetuses. In the late 1990’s in an effort to reduce the risk of neural tube defects, folic acid was added to many processed foods such as flour, cereal, and bread and figured prominently in prenatal vitamins.

This recent study was presented at the International Meeting for Autism Research and has not yet been peer-reviewed or published in a professional journal, but it got much attention in the media. Here are links to two of the media reports:

The Atlantic

Concerns About Folate Causing Autism Are Premature

May 12, 2016 By James Hamblin

TIME

Why Fears Over Folic Acid and Autism Need to be Properly Understood

May 12, 2016 By Alexandra Sifferlin

 

Take-Away from this study

The take-away from this (and all association studies) is first to remember that association does not mean causation. This was a small study that has not yet been peer-reviewed so until it has passed through peer review and been published in a scientific journal, we should be curious but cautious. And, even after publication, we want to watch for more rigorous studies to corroborate the findings, before we feel more confident in the finding. If you have any questions about folate/folic acid, ask your health care provider for guidance.

And for more on understanding association studies, we direct you to our own Dr. Gary Stobbe and his blog on the topic.

 

 

Autism and Coping Tools for Parents – Part 1 : Finding Meaning

Tool Time (2)

 

Today we start a series aimed at building your parent coping toolbox, because we know you can’t have too many tools when it comes to the ongoing challenges that autism presents.

We’ll discuss finding meaning in challenges, using humor and humility in the midst of adversity, reframing challenges, surrender, grace, intelligence, courage, patience, and support – and perhaps a few more.

We also invite you to share the tools that work for you. At the end of the series, we hope we all have some new tools at the ready for whatever life hands us.

I’ll start us off with finding meaning in adversity. Keep in mind, this series will be written from each parent-author’s personal perspective and is not intended to reflect or represent any more than just that.

Life isn’t fair!

When bad things happen to us, we have a tendency to feel singled out and a sense of injustice surfaces. “Why me?” or “Why do bad things happen to good people?” we ask, and wonder what we did to deserve such hard luck or bad karma. Even smart people let superstition creep in when trying to make sense of difficulties. It’s curious that our brains don’t seem to put as much effort into wondering why good things happen when they do.

Some call it making lemonade out of lemons or finding the silver lining. Whatever you call it, we do know that whatever the difficulty, being able to find meaning in life’s challenges can help make them a bit easier to deal with, particularly with those things we cannot change.

Ironic, isn’t it?

My family’s story of autism had quite the twist of fate. It was 1981 when I moved to Colorado with a shiny new degree in hand, eager to save the world. I thought I wanted to work with kids.

There were just two problems with this plan: unemployment was sky high and it seemed everyone and their grandmother had a PhD plus twenty years experience. This meant I had three part time jobs, none of them with children. In one, I interviewed clients for a video dating club – and that is quite another story!

In another, I was a counselor in a new group home for young adults with autism. A forward-thinking mom of a teen bought a rambling house in the foothills and got it licensed. Six clients ranging in age from 20-40 moved in and we provided 24-7 care for them.

In college I had observed a classroom of children with special needs, including autism. It was fascinating for me to observe the same behavioral traits in adults that I’d seen in the young kids. I recall being perplexed by what, at the time, I’d heard about the cause of autism – these were children of supposed “refrigerator mothers”. This was a time when the “nurture” part of the “nature vs. nurture” debate was given greater weight. Genetics was years away from taking center stage.

As interesting as it was, this was not an easy job. We didn’t get much training in autism or how to handle behavioral challenges, which meant we did a lot of improvising and sometimes got hurt. I was a shy young twenty-something with little experience. Keep in mind, there was no early intervention at that time. These kids didn’t even have the right to go to school and their parents were told at diagnosis to place them in an institution. This is primarily where our clients came from. I left that job thinking very decidedly that this was too hard and that

 Autism is not my life’s work

Fast-forward to 1999, when my nephew was born with Down syndrome. My sister didn’t know prior to his birth so it was a surprise and an adjustment. Well-meaning people gave her lots of unsolicited advice including this from a friend who is a teacher’s aide:

Just be glad it isn’t autism

It was right about this time that I could no longer ignore the subtle but growing red flags that I was seeing in my baby girl. She stopped responding to her name. She stopped playing with toys and instead repetitively tapped kitchen utensils on the floor. I was hesitant to share this with my family. It almost seemed as if I was trying to one-up my sister. And those words kept reverberating in my head: Just be glad it isn’t autism. Autism is not my life’s work.

Well, as they say, you know the rest of the story. She was diagnosed that summer and it was devastating for us.

Finding meaning didn’t happen overnight. It also didn’t happen without effort. It was a conscious choice to move from the place where it was hard for me to share the simple joys of friends who seemed to have so much to celebrate, while we seemed to be hanging on by a thread. There were days when I’d look at people and wonder how they could smile and what they could possibly be happy about. Like a message in a bottle washing ashore from a troubled sea, I realized that staying stuck in strong emotions wasn’t going to help her or me. New thoughts popped up:

Why not me?

 I have what it takes.

I can do this.

How did I find meaning? The easy answer is through curiosity. I began asking myself questions about how and why I arrived at this point in my life. After some uncertainty in young adulthood, wondering what my purpose on the planet was, I felt certain that I wanted to be a mom and work in a helping profession. It would take many years before I would see how these two goals would dovetail. These are some of the questions I asked myself:

What skills do I have that I bring to this challenge?

 What other challenges have I handled well?

Who can I learn from in the areas where I feel unsure of myself?

I looked for parents who were one step ahead of me and gleaned what I could from them. After getting some experience under my belt, I began to volunteer as a mentor for parents new to the diagnosis and signed up for other parent projects. I soon realized that helping others helped me.

As they (once again) say, you know the rest of this story. For nine years now, I’ve had the honor of working alongside the best here at Seattle Children’s Autism Center, doing what we can to make life a bit easier for families. And for at least that long, I have known what my purpose on this planet is:

Be the best mom I can be

Help others

Not so shiny tools

“It’s funny: I always imagined when I was a kid that adults had some kind of inner toolbox full of shiny tools: the saw of discernment, the hammer of wisdom, the sandpaper of patience. But then when I grew up, I found that life handed you these rusty bent old tools – friendships, prayer, conscience, honesty – and said ‘do the best you can with these, they will have to do’. And mostly, against all odds, they do.” 

Anne LamottTraveling Mercies: Some Thoughts on Faith  

Have you found meaning in your challenges? Share your story with us!

Stay tuned for Part 2 of our series on parent coping tools.

Understanding Developmental Disability Administration (DDA) – This Month’s Autism 200 Class

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This month’s Autism 200 Series class “Understanding Developmental Disability Administration (DDA): New Pathways to the Future” will be held Thursday, May 19, 2016, at Seattle Children’s Hospital in Wright Auditorium from 7 to 8:30 p.m. These classes are designed for parents, teachers and caregivers. The topics associated with the majority of classes are applicable to all age ranges and for a wide variety of children diagnosed with autism. This class will be led by Ed Holden, Executive Director, Developmental Disabilities Council.

Mindful Monday- The Pause That Refreshes

The Pause That Refreshes

In our crazy busy lives, we don’t often pause.

Stop. Halt. Cease. Be.

We go. Move. Hurry. Worry. Do.

How do we even begin to slow down?

One small step at a time.

 

 

Mindful Exercise (from Rubin Naiman, PhD in a year of Living Mindfully)

At a time when you feel calm, jot down a few situations that caused moderate to significant reaction – perhaps irritation, anger, anxiety. Could be getting the kids out the door. Or being stuck in traffic. Or feeling burned out at work. Think of ones that tend to recur. 

Select one and for the next week, have the intention of pausing inwardly in the midst of the situation if/when it recurs. For no more than 60 seconds, try to offer a nonjudgmental, neutral appraisal of what’s happening. Take deep breaths. Notice how your body feels. Instead of “I’m going to be late for work again!” try, “Traffic is bad today. I’ll get to work when I get to work”. 

See if you notice any difference between reactivity vs mindful awareness. With practice, you will. 

Quote of the week:

“Life is lived in the pauses, not the events.” – Hugh Prather, Morning Notes: 365 Meditations to Wake You Up