What is it Stool Soiling?

Stool soiling is a condition that occurs after most children have been potty trained and have control of their bowels, typically over the age of 4. Stool soiling is three to six times more common in boys than in girls and affects 1% to 2% of kids under the age of 10. (1) If the soiling is not caused by a physical illness or disability, it is called encopresis. “Children with encopresis may have other problems, such as short attention span, low frustration tolerance, hyperactivity and poor coordination.” (2)

What Causes Stool Soiling?

“Most encopresis cases (90%) are due to functional constipation—that is, constipation that has no medical cause.” (1) This constipation is most likely the result of stool withholding—that it your child isn’t fully emptying his/her rectum when he/she uses the toilet or not emptying at all. There could be different reasons for this including fear of the pain that comes with having a bowel movement, not waiting long enough on the toilet to have a bowel movement, stressful changes in the child’s life, such as the birth of a sibling, separation/divorce of parents, family problems, or a move to a new home or school.

So long as the poop isn’t completely cleaned out, what remains in the rectum becomes harder and it is harder to push the large, dry poop out. The large poop also stretches out the colon, weakening the muscles and affecting the nerves that tell a child when it’s time to go to the bathroom. Eventually, the rectum and lower part of the colon become so full that the sphincter (the muscular valve that controls the passage of feces out of the anus) can no longer hold the poop in resulting in partial BMs and the child soiling his or her pants. Softer poop may also leak out around the large mass of feces and stain the child’s underwear. The child cannot prevent the soiling and is often completely unaware that it’s happening because the nerves that would tell him/her about the need for a bowel movement aren’t working properly. (1)

“Call the doctor if your child shows any of the following symptoms:

• Poop or liquid stool in the underwear when your child isn’t ill
• Hard poop or pain when having a BM
• Toilet-stopping BM
• Abdominal pain
• Loss of appetite” (1)

What is the Treatment for Stool Soiling?

[M]any people mistakenly believe that encopresis is a lack of self-control or laziness issue and punish a child for it, but this will only increase the pooping difficulties, as well as increase the chances for low self-esteem. “Up to 20% of kids with encopresis experience feelings of low self-esteem that require the intervention of a psychologist or counselor.” (1)

“Although most children with soiling do not have a physical condition, they should have a complete physical evaluation by a family physician or pediatrician.” (2)

Treatment is usually carried out in three phases:

1. The first phase involves emptying the rectum and colon of hard, retained poop using mineral oil (stool softener) and/or laxatives or enemas depending on the child’s age and other factors. Never give laxatives or enemas to your child at home without first talking to your doctor.
2. The second phase involves the resetting of your child’s BM schedule once the large intestine is empty. This will usually include the help of stool softeners and daily scheduled potty time, usually after meals when the bowels are naturally stimulated. The goal of this is to the bowels a chance to shrink back to normal size.
3. The third phase will involve a reduction in the use of stool softeners as bowel movements become more regular. (1)

“Keep in mind that relapses are normal, so don’t get discouraged if your child occasionally becomes constipated again or soils his or her pants during treatment….” (1)

“Patience is the key to treating encopresis. It may take anywhere from several months to a year for the stretched-out colon to return to its normal size and for the nerve in the colon to become effective again.” (1)

Darlene Oakley is a freelance writer for Empowher.com

Sources:

1)      Encopresis (Soiling). KidsHealth.org. Web. Mar 25, 2013.

http://kidshealth.org/parent/general/sick/encopresis.html#

2)      Facts for Families: Problems with Soiling and Bowel Control. American Academy of Child and Adolescent Psychiatry. Web. Mar 25, 2013.

http://aacap.org/page.ww?name=Problems+With+Soiling+and+Bowel+Control&section=Facts+for+Families

3)      Fecal Soiling. Silberstein, Warren P. Mindspring.com. Web. Mar 25, 2013.

http://www.mindspring.com/~drwarren/encopres.htm

Am I a Good Mother?

A number of weeks ago, I received a letter from someone who called himself my friend and then proceeded to tell me what a terrible mother I was because I wasn’t doing this or doing that and that my issues with my sons’ behavior would all evaporate if I would just do what he said. And I know there are a bunch of moms out there who also hear words like this.

Now, mind you, his words were completely contradictory to what other mothers have expressed to me. In no way would I hold myself up as the model all moms should aspire to be. But I felt it was highly unfair of this person, who’d only been in my life for a short period of time to render this judgment on my mothering skills. When I expressed that I felt I wasn’t a good mother his response was, basically, “You’re right. You’re not.” Funny how the one negative comment refutes all the good ones I get from other mothers and grandmothers who know what they’re talking about.

We all have our own lives and one of the ways we moms learn best is to chat with other moms. Doesn’t mean there aren’t areas in my mothering life where I need to and can improve, but that doesn’t mean I’m a terrible mother. Doesn’t mean you are either.

Mommy Self-Esteem Issues

My goal as a mother is to provide a safe, welcoming, accepting environment where my kids can de-stress at the end of their school day. I want my kids to see this as a safe place to be, a fun place to be. A home with laughter and jokes, but balanced with the necessary things that they need to learn to be successful in life. It’s also important to me to teach them how to accept others around them, have compassion for those people whose life experience may be different, and to learn to believe in themselves, that they are capable of so much.

Seventeen years ago today, I became a mother and I badger myself about the early years with my son that I wasn’t the mother I am now, and I’m sorry I couldn’t be that mother for him in the beginning. But the thing about life experience is that I’m being that mother now—I think.

The problem is mothers always see things in other mothers that we would like to have or be. Stay-at-home moms look at work-outside-the-home moms and think, “I wish I could do that.” Work-outside-the-home moms look at stay-at-home moms and think, “I wish I could do that.” Breastfeeding moms look at bottle feeding moms and say, “She should be breastfeeding. Why isn’t she breastfeeding? Doesn’t she know it’s better for her baby?” Bottlefeeding moms see breastfeeding moms and say, “I wish I could do that. I know it’s better for my baby. I wish she wouldn’t look at me as a second-class mother because I chose to formula feed. Am I a second-class mother because I couldn’t breastfeed or chose to formula feed?”

All us mothers have something in common besides being mothers–we all tend to be too hard on ourselves for the things we don’t do or wish we could do or should have done and sometimes too hard on other mothers when they don’t appear to have done all the wonderful and better things we have done.

We all need to do the same thing – give ourselves and each other a break. This isn’t a competition. We need to recognize that we are human beings, we cannot and will not be able to do everything we wish or everything our kids wish, and in the end, that’s not what’s important anyway—especially if doing everything we wish or they wish results in damaging the relationship we have with our kids. Where the achievements become the sole focus of our lives rather than the relationship we have with our children. This is something I will be “coaching” myself on leading up to Mother’s Day as I reflect on “Have I been a good mother?”

Repeat after me: “I am a good mother.”

I mean it. Say it out loud to yourself. I’ll wait…. If you need to say it a few more times before you believe it, say it a few more times.

Darlene Oakley is a freelance writer for EmpowHER.com

Sources:

1. Stay-at-home moms have the hardest job. Ryan, Shari. Los Angeles Times. Web. May 6, 2013. http://articles.latimes.com/2011/aug/20/news/la-heb-working-mothers-08202011
2. Why ARE we women so hard on ourselves. Neff, Kristin Professor. DailyMail.co.uk. Web. May 6, 2013. http://www.dailymail.co.uk/femail/article-2009632/Why-ARE-women-hard-ourselves.html
3. 26 Reasons You’re a Great Mom. Dolgoff, Stephanie. Parenting.com. Web. May 6, 2013. http://www.parenting.com/gallery/26-reasons-youre-a-great-mom
4. The Mom Song Sung to William Tell Overture. Renfroe, Anita. Web. May 6, 2013. https://www.youtube.com/watch?v=RxT5NwQUtVM

What is SIDS?

“Sudden unexpected infant death” occurs if a baby under the age of 1 dies unexpectedly. “Sudden infant death syndrome” occurs when no other cause of death can be determined after investigation and autopsy.

“Each year in the United States, more than 4,500 infants die suddenly of no immediately, obvious cause. Half of these Sudden Unexpected Infant Deaths (SUID) are due to Sudden Infant Death Syndrome (SIDS), the leading cause of SUID and of all deaths among infants aged 1-12 months,” says the CDC. Further, “SIDS is the leading cause of death among infants aged 1-12 months, and is the third leading cause overall of infant mortality in the United States. Although the overall rate of SIDS in the United States has declined by more than 50% since 1990, rates for non-Hispanic black and American Indian/Alaska Native infants remain disproportionately higher than the rest of the population.”

Other things you should know about SIDS:

• About 90% of SIDS deaths happen in infant under the age of 6 months. (2)
• SIDS is uncommon within the first 30 days after birth. Risk peaks between 2 and 4 months of age, and then declines. (2)

What is the cause of SIDS?

First of all, SIDS is not (2):

• Caused by sleep apnea (cessation of breathing while asleep).

• Linked to clinical events in which young infants may experience abrupt changes in breathing, color, or muscle tone (apparent life-threatening events or ALTEs).

• Predictable or always preventable

• Caused by immunizations or bad parenting

• Contagious or hereditary

• Anyone’s fault

The exact cause of SIDS is still unknown, and there may not be only one causative factor. To date, there are still only theories based on what scientists and researchers have been able to observe.

1. Certain infants may experience abnormal or delayed development of specific areas of the brain directly affecting the baby’s ability to rouse him/herself. Babies who are unable to rouse themselves may remain in a sleep position that obstructs their nose and mouth, altering the flow of oxygen and carbon dioxide.
2. Lack of laryngeal chemoreflex. Saliva or stomach contents (such as with gastroesophageal reflex) in the airway triggers the body to swallow to clear the airway – the laryngeal chemoreflex. Swallowing and the associated protective arousal response decreases in babies who are laid facedown.
3. Rebreathing asphyxia. In the facedown position, the baby may re-breathe carbon dioxide that he/she has breathed out. Surrounding the baby with soft bedding, blankets, stuffed animals may prevent sufficient air movement around the baby.
4. Hyperthermia: Overdressing, use of excessive coverings and turning the temperature up in baby’s room, can lead to an increased metabolic rate and eventual loss of breathing control. Researchers are still studying whether this has a direct impact on SIDS.

What can I do to Prevent SIDS?

Since the introduction of the Safe to Sleep Public Education Campaign (was the Back to Sleep Campaign started in 1994) by the National Institute of Child Health & Human Development, the overall rate of SIDS has declined by more than 50 percent. (3) You can look at the list of recommendations by the NICHD here, and a SIDS Prevention printable pamphlet here.

Studies over the last 10 years have showed a positive link between the use of pacifiers and the reduction in the risk of SIDS. While the precise effects are still under investigation, researchers speculate that the pacifiers:

• present an “auditory arousal threshold” and keep the baby waking up from time to time
• prevent babies who sleep on their tummies from being able to bury their mouths and noses in soft bedding
• keep the tongue forward, keeping the upper airway open
• soothe infants so that they move less and are less likely to be covered by blankets
• reduce gastroesophageal reflux and apnea
• lead to slight carbon dioxide retention which increases the babies’ need to be breathe. (5)

Also, a review released in 2011 of several research studies shows that “infants who were breastfed were about 60% less likely to die from SIDS than infants who didn’t receive any breast milk. This protective effect increased the longer the baby was breastfed and if the baby was exclusively breastfed.” (6) You can read more about these studies here.

Darlene Oakley is a freelance writer for Empowher.com

Sources:

1)      Sudden Unexpected Infant Death (SUID). Centers for Disease Control and Prevention. Web. Nov 12, 2012.

http://www.cdc.gov/SIDS/

2)      Sudden Infant Death Syndrome (SIDS). eMedicineHealth.com. Web. Nov 12, 2012.

http://www.emedicinehealth.com/sudden_infant_death_syndrome_sids/article_em.htm

3)      SIDSPrevention.com. Web. Nov 12, 2012.

http://www.sidsprevention.com/

4)      Safe to Sleep Public Education Campaign. National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health & Human Development. Web. Nov 12, 2012.

http://www.nichd.nih.gov/sids/

5)      Recommendations for the use of pacifiers. Canadian Pediatric Society. Web. Nov 12, 2012.

http://www.cps.ca/en/documents/position/pacifiers#ref38

6)      Breastfeeding May Cut SIDS Risk. WebMD. Web. Nov 12, 2012.

http://www.webmd.com/parenting/baby/news/20110613/breastfeeding-cuts-sids-risk

Related Links

Breastfeeding Can Help Reduce the Incidence of SIDS. Jones, Dr. Daemon.

http://www.empowher.com/parenting/content/breastfeeding-can-help-reduce-incidence-sids

Serotonin and SIDS – Startling New Research Results. Cody, Susan.

http://www.empowher.com/community/share/serotonin-and-sids-startling-new-research-results

A Sobering Study on SIDS. Mosier, Bailey

http://www.empowher.com/parenting/content/sobering-study-sids

So, you’re one of those couples who wants to put off starting or continuing your family, then you should be aware of the following.

Nothing is 100%

According to Dr. Millicent Comrie, founder and director of the Long Island College Hospital Center for Women’s Health and vice chairman of the college’s Department of Obstetrics and Gynecology, says, “The biggest thing that we know of, that affects the efficacy of the pill, is…patients who do not follow the program as prescribed. (1) To meet the 99% efficacy rate, “women need to take the pill daily, and at nearly the same time of day….” (2)

Aside from abstinence, nothing protects 100% against unexpected pregnancy. It is possible to do everything right in the program and still get pregnant. (3)

Things that interfere with the Pill

Besides not taking the pill as prescribed, or missing a dose, there are other life factors that can affect the pill’s effectiveness. These include (1, 2, 3):

1)      Lack of absorption due to intestinal issues (vomiting or diarrhea)

2)      The pill pack is beyond its expiry date

3)      Taking antibiotics, and anti-seizure or certain migraine medications

4)      Drinking alcohol

5)      Taking cheaper, generic birth control pills which don’t have the same amount of pregnancy-preventing hormones as a name brand.

If you’re ever unsure or uncertain about the efficacy of the pill, use another means of birth control in addition.

If you’re on the pill, and your period doesn’t arrive when it should and/or you experience tingling, sore or heavy breasts, or mild cramping, take a home pregnancy test or contact your doctor. These are usually early signs of pregnancy.

Darlene Oakley is a freelance writer for Empowher.com 

Sources:

1)      Five Reasons Women Get Pregnant While on the Pill. Fiore, Marrecca. FoxNews. Web. Dec 3, 2012.

http://www.foxnews.com/story/0,2933,366741,00.html

2)      Can you get pregnant while on the pill? Answers From Experts & Organizations. Nazario, Brunilda. WebMD. Web. Dec 3, 2012.

http://answers.webmd.com/answers/1189739/can-you-get-pregnant-while-on

3)      Can I get pregnant while on the pill? Smith, Kimberley. ThinkBaby. Web. Dec 3, 2012.

http://www.thinkbaby.co.uk/before-you-try-to-conceive/can-i-get-pregnant-while-on-the-pill/17.html

4)      How likely is it for someone to get pregnant while on the pill? Most Pregnancies occur from Misuse. Pregnancy and Baby. Web. Dec 3, 2012.

http://www.pregnancyandbaby.com/baby/articles/937247/how-likely-is-it-for-someone-to-get-pregnant-while-on-the-pill

Related Links

Bleeding on the Contraceptive Pill: What Causes it? Karpasea-Jones, Joanna.

http://www.empowher.com/sexual-well-being/content/bleeding-contraceptive-pill-what-causes-it

The Birth Control Pill and Antibiotics: Better Use Back-up. Jones, Carrie Dr.

http://www.empowher.com/infertility-fertility/content/birth-control-pill-and-antibiotics-better-use-back

Missed Birth Control Pill Advocacy Sheet.

http://www.empowher.com/birth-control/content/missed-birth-control-pill-advocacy-sheet

What is an Individualized Education Program (IEP)?

An IEP is a legally binding, written plan that lays out the types of special education programing and/or services required by a particular student with an identified learning disability or medical condition that affects how that student functions in a classroom/school setting. (2) The various components that could be included in an IEP are summarized below.

According to the United States Department of Education, each public school child who is eligible to receive special education and related services must have an Individualized Education Program (IEP) which has been designed specifically for that individual student. It cannot be a “copy and paste” document where a child’s name is just inserted into a form letter or previously prepared document. (1)

“The IEP is the cornerstone of a quality education for each child with a disability.” (U.S. Department of Education)

Qualification for an IEP

There are several steps to ensuring that a child qualifies for special educational assistance and, therefore, an IEP (compiled from the U.S. Department of Education).

IEP Qualification Step 1: The child must be identified by parent or school professional as possibly needing special education and related services.

IEP Qualification Step 2: The child is evaluated by the state-run “Child Find” process. If the parents disagree with the evaluation, they can ask for an Independent Educational Evaluation (IEE) for their child, for which they can ask that the school system pay.

IEP Qualification Step 3: If the diagnosis or evaluation places the child within the disability definitions of the Individuals with Disabilities Education Act (IDEA), then he or she is eligible for an IEP and an IEP must be developed within 30 calendar days of the identification. (1) The child will need to be re-evaluated every three years to ensure that he/she continues to fall within the IDEA guidelines, and to re-examine if the child’s educational needs should stay the same or need to be adjusted.

IEP Qualification Step 4: IEP meeting between parents, teachers, principal/vice-principal, teaching or educational assistants to discuss and develop the parameters of the IEP and for the parents to give their consent. No special education services can be given to the child without the parents’ consent. This IEP will be reviewed at least once a year, but parents can request that it be reviewed more often.

What Should an IEP Include?

The original IEP document and reviewed IEPs should clearly state:

• The student’s strengths and needs, which form the basis for the development of the special education program and services. (2)
• A summary of the student’s current level of achievement in each subjects, course, or skill area to which the IEP applies against which the student’s progress will be measured. (2)
• Annual goals describing what the student can reasonably be expected to accomplish by the end of the school year. These annual goals should be developed taking the student’s identified strengths, needs and alternative learning expectations (see below) into account. (2)
• Learning expectations that will provide a focus for learning. These expectations should be based on the student’s strengths, needs, and current level of achievement, and should clearly identify the knowledge and skills that the student is expected to gain through the duration of the course work and school year. (2) The learning expectations should be specific, realistic, observable, and be reviewed “at least once every reporting period and updated as needed in view of the student’s progress.” (2)
• Specific special education strategies, accommodations, and resources that will be used to support the student “in achieving his or her annual goals and learning expectations [such as] teaching strategies and accommodations; human resources; and individualized equipment….” (2)

Darlene Oakley is a freelance writer for Empowher.com

Sources:

1. A Guide to the Individualized Education Program. U.S. Department of Education. Web. Apr 22, 2013. http://www2.ed.gov/parents/needs/speced/iepguide/index.html#top
2. Individual Education Plans: Standards for Development, Program Planning, and Implementation 2000. Government of Ontario (Canada). Web. Apr 22, 2013 http://www.edu.gov.on.ca/eng/general/elemsec/speced/iep/iep.html
3. Individual Education Plans (IEPs): are they useful? TeachingExpertise.com. Web. Apr 22, 2013 http://www.teachingexpertise.com/e-bulletins/individual-education-plans-ieps-are-they-useful-2191
4. Individualized Education Programs (IEPs). KidsHealth.org. Web. Apr 22, 2013. http://kidshealth.org/parent/growth/learning/iep.html#

About Toxemia during Pregnancy

The American Pregnancy Association estimates that 2-6% of healthy, first-time mothers experience toxemia during pregnancy, or preeclampsia. It is also known as pregnancy-induced high blood pressure.

“If preeclampsia is not treated quickly and properly, it can lead to serious complications for the mother such as liver or renal failure, future cardiovascular issues and…other conditions…. Preeclampsia can prevent the placenta from getting enough blood. If the placenta doesn’t get enough blood, you baby gets less oxygen and food. This can result in low birth weight.” (1) It can even lead to placental separation and death of the baby. (2)

The exact cause is still unknown and the presence of, onset and severity of symptoms can vary from patient to patient.

Symptoms of Preeclampsia

Symptoms of mild preeclampsia may include (from the American Pregnancy Association):

• High Blood Pressure
• Water retention
• Protein in the urine

Symptoms of severe preeclampsia may include (from the American Pregnancy Association):

• Headaches
• Blurred vision
• Sensitivity to bright light
• Fatigue
• Nausea/vomiting
• Reduction in urine output
• Upper right abdominal pain
• Shortness of breath
• Tendency to bruise easily

Risk Factors for Preeclampsia

Risk factors for preeclampsia include (from the American Pregnancy Association and Babyzone.com):

• Being African American
• Having an immediate female family member who has had it
• Obesity or BMI greater than 30
• Being pregnant at a young age or older age (teen moms or late-30s)
• Longer intervals between pregnancies
• Women carrying multiples
• Women with a pre-pregnancy history of high blood pressure or kidney disease

Treating and Preventing Preeclampsia

Treating, managing, and preventing preeclampsia really come down to paying attention to what you eat and making good, healthy choices. These include:

• Limiting or eliminating the amount of salt you add to your meals
• Maintain or attain a healthy weight prior to getting pregnant
• Exercise
• Having babies closer together
• Drinking 6-8 glasses of water a day.
• Cut down on your intake of saturated fats, fried food, and sugar.
• Add more veggies and fruit to your diet
• Get at least 10 hugs a day or get massage therapy (touch can lower your blood pressure and enhance your immune response)
• Make sure you’re getting enough rest
• Elevate your feet several times during the day to prevent fluid from pooling there
• Avoid drinking alcohol
• Avoid beverages with caffeine
• Ask your doctor about any medications or additional supplements that could help you maintain good health.

Darlene Oakley is a freelance writer for Empowher.com

Sources

1)      Preeclampsia: Toxemia. American Pregnancy Association. Nov 7, 2012.

http://www.americanpregnancy.org/pregnancycomplications/preeclampsia.html

2)      Toxemia: Causes, treatments, and symptoms of toxemia in pregnancy. Nov 7, 2012.

http://www.babyzone.com/pregnancy/pregnancy-complications/toxemia_71750

3)      Toxemia. Chambers Clark, Carolyn. BellaOnline.com. Nov 7, 2012.

http://www.bellaonline.com/articles/art24833.asp

Related Links:

Preeclampsia of Pregnancy: High Blood Pressure And Protein in the Urine. Smith, Jody.

http://www.empowher.com/preeclampsia/content/preeclampsia-pregnancy-high-blood-pressure-and-protein-urine

Preeclampsia: What Does it Mean for Baby, Me? Faulkner, Dita.

http://www.empowher.com/preeclampsia/content/preeclampsia-what-does-it-mean-baby-me

Preeclampsia and Toxemia: How do they Differ? Mills, Dr. Marlin D. (VIDEO)

http://www.empowher.com/preeclampsia/content/preeclampsia-and-toxemia-how-do-they-differ-dr-mills

Therapy is Best if Started Early

According to the Centers for Disease Control (CDC), 1 in 88 children have been identified with an autism spectrum disorder, and more and more children are being diagnosed at earlier ages, on average at about 4 years of age. (1)

Addressing behavioral and developmental issues associated with autism early can make a huge impact on how children with ASDs can live more independently. “It is important to talk to your child’s doctor as soon as possible if you think your child has an ASD or other developmental problem so that intervention can begin early. (2) Your state has information on early intervention services, including evaluation for an ASD.

While there is no cure for autism, and dietary changes and medication are not always effective for every child, behavioral method training such as ABA or IBI therapy can be of great benefit for children with autism.

ABA – Applied Behavioral Analysis

ABA, or Applied Behavioral Analysis, uses basic scientific principles of behavior (behaviorism) to encourage positive behavior and discourage negative behavior. (2) Strategies include positive reinforcement and other methods to address and curb challenging behavior, encourage a child’s social development and participation, and correct and/or establish daily living skills such as personal hygiene and time management.

ABA methods can be:

·         Used at home

·         Used at school

·         Used in the community

·         Incorporated into regular classroom routines

·         Implemented by parents, grandparents, caregivers, teachers and support workers

·         The basis for on-going skill development. (4)

ABA therapy may include:

Discrete Trial Training (DTT) where “lessons are broken down into their simplest parts and positive reinforcement is used to reward correct answers and behaviors. Incorrect answers are ignored.” (2)

Early Intensive Behavioral Intervention (EIBI) which is similar to IBI defined below, however, EIBI is for children younger than five, and often younger than three. (2)

Pivotal Response Training (PRT) to increase a child’s motivation to learn, monitor his own behavior, and initiate communication with others. (2)

Verbal Behavior Intervention (VBI) which focuses on teaching verbal skills. (2)

Developmental, Individual Differences, Relationship-Based Approach (DIR; also called “Floortime”) which focuses on emotions and relationship development, and is also used to help a child deal with sights, sounds, and smells. (2)

Treatment and Education of Autistic and related Communication-handicapped Children (TEACCH) which uses visual cues, such as picture cards, to teach skills like getting dressed in several small steps. (2)

Occupational Therapy which teaches skills to help a child learn to live as independently as possible such as dressing, eating, bathing, and interpersonal communication. (2)

Sensory Integration Therapy to help a child deal with sights, sounds, and smells, and with being touched. (2)

Speech Therapyto improve a child’s communication skills. This can include actual verbal communication skills or the use of gestures (sign language) or picture boards. (2)

Picture Exchange Communication System (PECS) which teaches communication skills through the use of picture symbols to ask and answer questions and have a conversation. (2)

IBI – Intensive Behavioral Intervention

Intensive Behavioral Intervention (IBI) is “intensive and comprehensive delivery of behavioural treatment for young children with autism [and] is guided by the clinical application of the learning principles and teaching strategies of ABA…” (3) IBI is used for children who are at the moderate to severe end of the autism spectrum. (3) Children with Aspergers usually do not qualify for IBI since, by classification, they’re higher performing.

In contrast to ABA, IBI:

·         Uses a specific intensive format for each child

·         Is usually delivered at home or in a private space

·         Primarily provided in a one-to-one or small group setting (low ratio) for up to 40 hours per week

·         Is delivered by a trained behavior therapist, supervised by a psychologist

·         Includes ‘learning to learn’ behaviors through imitation, co-operation and attention

·         Is designed to prepare students for school.

Darlene Oakley is a freelance writer for Empowher.com

Sources:

1. Autism Spectrum Disorders (ASDs). Centers for Disease Control and Prevention. Web. April 15, 2013. http://www.cdc.gov/ncbddd/autism/data.html
2. Autism Spectrum Disorders Treatment. Centers for Disease Control and Prevention. Web. Apr 15, 2013. http://www.cdc.gov/ncbddd/autism/treatment.html
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   mso-hansi-theme-font:minor-latin;}What is IBI and is it the same as ABA? Geneva Centre for Autism. Web. April 15, 2013. http://www.autism.net/faqs/595-what-is-ibi-and-is-it-the-same-as-aba.html
5. Applied Behavior Analysis. AutismUnited.org. Web. April 15, 2013. http://www.autismunited.org/blog/applied-behavior-analysis-80435.html

• 63% of children in grades 1 through 10 (ages 6 to 15) report having been bullied;
• 43% of ASD children who attended regular public schools report being bullied; and,
• 61% of children with Asperger’s Syndrome reported being bullied, while 28% of children with autism and 37% of children with other ASDs reported being bullied.

What makes dealing with or addressing the bullying more difficult with children on the autism spectrum is, particularly, their inability to read social cues and to always verbalize what has happened and what they’re feeling inside. Their natural obsessive tendencies also make it extremely hard for them to let go of those feelings and facilitate healing, and can interfere with ignoring or dismissing hurtful comments. Some ASD children will fight back and may be punished for fighting back. Others may just retreat into a protective shell and not react at all, where the feelings build up inside affecting other areas of school and home life.

So, what can parents do to help their ASD child and teachers effectively settle the bullying situation?

The Role of Parents in Bullying

First of all, remember that you are your child’s own best advocate, and that children—regardless of their age—should never be expected or encouraged to settle the issue themselves. ASD children by their very nature don’t have the emotional and life-wisdom resources to deal with this issue by themselves. The fact that they have an ASD makes them even more vulnerable to being bullied and the effects of being bullied than neurotypical children. They need the support of adults.

Adults—parents, teachers, educational assistants, caregivers—need to know how to communicate effectively with children with ASDs, or “speak their language”. Children with ASDs communicate with different words or different frames of reference than neurotypical children, and they need to know you understand what they’re saying and what they’re feeling, even if they don’t come right out and say it. Part of figuring this out is through deduction from what they’re not telling, their behavior or facial expressions, as well as what they say or express through writing or drawing. They can’t always put words to what they’re feeling and it’s a huge relief to them when someone figures it out and explains it to them.

Also remember that what may work with a neurotypical child in terms of talking and resolving and explaining, may not work with a child on the autism spectrum.

What can Parents Do?

1. Talk to your Child: This may happen face-to-face, but may also take the form of journaling or drawing or a question box. Make sure you keep a diary of the incidents, who was involved, how the situation was resolved or is being resolved. (1)
2. Talk to the School: When you talk to your child’s teacher and other educators involved (eg: principle, vice-principle, educational assistants) be as specific as possible and as calm as possible. This whole situation is obviously very emotionally charged and it’s important to be rational and proactive. After the meeting, send everyone involved a letter outlining what was discussed and agreed to. This way everyone can measure how the situation is being handled. (1) Make sure that anti-bullying methods or precautions are included in your child’s individualized education program (IEP). (2)
3. Make a Map: Make “a map of your child’s world and identifying the areas where your child feels most and least vulnerable. This could include…the school as well as the route your child takes to and from school. It can then be used to identify areas that the school needs to be aware of.” (1)
4. Social skills and communication training. Social skills and communication training may help your child learn to recognize when someone is being nice or nasty, again, teaching them how to read social cues or interpret language their peers use. This can take the form of referring to a favorite television program to demonstrate to your child when someone is being nice or nasty. Another way is to have your child sort out pictures and photographs of people into nice and nasty piles. (1)
5. Role Play – Have you and your child act out a bullying scenario so that when he/she encounters that situation again, he/she will know how to react and what to do.

TheBullyProject.com has a list of Parent Resources and a Special Needs Toolkit <a href= http://specialneeds.thebullyproject.com/parents>here</a>.

For a list of state anti-bullying laws and policies, check out <a href= http://www.stopbullying.gov/laws/index.html>www.stopbullying.gov</a>.

Darlene Oakley is a freelance writer for Empowher.com

Sources:

1. What you can do. The National Autistic Society. Web. Apr 10, 2013. http://www.autism.org.uk/living-with-autism/education-and-transition/primary-and-secondary-school/your-child-at-school/bullying-a-guide-for-parents/what-you-can-do.aspx
2. Parent Resources. National Bullying Prevention Center. Web. Apr 10, 2013. http://specialneeds.thebullyproject.com/parents
3. Policies & Laws. StopBullying.gov. Web. Apr 10, 2013. http://www.stopbullying.gov/laws/index.html
4. Why Autistic Children are Bullied More – And Bully In Return. Walton, Alice G. Forbes.com. Web. Apr 10, 2013. http://www.forbes.com/sites/alicegwalton/2012/04/24/why-autistic-children-are-bullied-more/
5. Asperger syndrome and bullying. Heinrichs, Rebekah, M.S.N., M.S. Ed. Autism Support Network. Web. Apr 10, 2013. http://www.autismsupportnetwork.com/news/asperger-syndrome-and-bullying-998073
6. IAN Research Report: Bullying and Children with ASD. Anderson, Connie, Ph.D. Interactive Autism Network. Web. Apr 10, 2013. http://www.iancommunity.org/cs/ian_research_reports/ian_research_report_bullying

This article is written in memory of Sam Tobias, who passed away on Friday, April 5 from ALD. He was 8-years-old.

Definition and Symptoms of ALD

ALD, or adrenoleukodystrophy, is a genetic neurological disorder that affects 1 in every 17,900 boys worldwide. Childhood onset ALD, is the most severe of the three forms, with symptoms appearing between the ages of 4 and 10. (2) It is also known as X-ALD since the defect is transmitted through the X-chromosome. Women are carriers of the disease. Boys are affected because they only have one X chromosome. The second X-chromosome in girls protects them against the onset of the disease. (1)

The other two kinds of ALD are adult-onset ALD (adrenomyeloneuropathy or AMN) which appears between the ages of 21 and 35, and neonatal ALD. Neonatal ALD is not genetically inherited and can affect girls and boys. (3) Symptoms for AMN may include progressive stiffness, weakness, loss of coordination or paralysis of the lower limbs and extremities. (1) Adult-onset ALD progresses more slowly than the classic childhood form. “Almost half the women who are carriers of X-ALD will develop a milder form of AMN but almost never develop symptoms seen in boys [with] X-ALD.” (1)

Symptoms of childhood-onset ALD include (1, 4):

• behavioral changes – abnormal withdrawal or aggressive outbursts, poor memory, and poor school performance.
• hyperactivity
• visual loss
• learning disabilities
• seizures
• poor articulated speech
• difficulty swallowing
• deafness
• disturbances of gait and coordination
• fatigue
• intermittent vomiting
• increased skin pigmentation
• progressive dementia

These changes occur due to the breakdown of myelin in the brain—a process called demyelination. Myelin is crucial to the effective transmission of signals between the nerves. While the exact relationship between ALD and myelin is still being studied, researchers believe that the buildup of saturated, very long chain fatty acids (VLCFA) in people with X-ALD provokes an immune response from the body which destroys myelin. When the myelin is destroyed, signals between the body and the brain are impaired, and nerve cells throughout the brain start to die. (1, 2) “The loss of myelin and the progressive dysfunction of the adrenal gland are the primary characteristics of X-ALD.” (1) Demyelination in ALD is similar to other demyelinating disorders such as multiple sclerosis. (3)

“Boys develop normally until the onset of symptoms occurs. Symptoms typically rival those of attention deficit disorder before serious neurological involvement becomes apparent. The symptoms progress rapidly and lead to a vegetative state within two years, and death anytime thereafter.” (2)

Treatment of childhood onset ALD

Treatment includes periodic adrenal function testing and administration of adrenal hormones. Other treatment for symptoms and support as the child deteriorates neurologically may include physical therapy, psychological support, and special education.

“Lorenzo’s Oil” is a mixture of oleic acid and erucic acid, and can be administered to boys with X-ALD prior to the onset of symptoms to prevent or delay the effects of the disease. “Lorenzo’s Oil has no beneficial effect in symptomatic boys with X-ALD.” (1)

A bone marrow transplant is also an option for boys who show early signs of the disease. The transplant procedure itself, however, carries risks and is not recommended for those with severe symptoms or those with neonatal ALD. (1)

ALD News and Research

“Studies are currently underway to identify new biomarkers of disease progression to determine which patients will develop the childhood cerebral form of X-ALD.” (1)

“A recent case study in Europe demonstrated that the combination of gene therapy with bone marrow transplantation, using the patient’s own bone marrow cells, may arrest disease progression in childhood cerebral X-ALD. A therapeutic trial in the United States is currently being discussed with the U.S. Food and Drug Administration.” (As of Oct 2012) (1)

“03 April 2013 – …New York legislature approves Aidan’s law. The law named after Aiden Seeger, who was diagnosed with ALD in 2011, requires ALD to be added to New York’s Newborn Screening Panel.” (5)

“02 April 2013 – …Dr. Scanlan from the Oregon Health & Science University is carrying out a study of sobetirome in X-ALD. He believes: ‘sobetirome may be beneficial to patients with ALD because it will stimulate the production of a gene product called ABCD2 which is very closely related to ABCD1, the defective gene in ALD patients, and ABCD2 can compensate for defective ABCD1. One measure of this compensation is reduction of the elevated VLCFA levels in ALD patients…we also believe that sobetirome may arrest the progression of neurological symptoms in both cerebral ALD and AMN’.” (5)

Darlene Oakley is a freelance writer for Empowher.com

Sources:

1. NINDS Adrenoleukodystrophy Information Page. National Institute of Neurological Disorders and Stroke National Institutes of Health. Web. Apr 8, 2013. http://www.ninds.nih.gov/disorders/adrenoleukodystrophy/adrenoleukodystrophy.htm
2. ALD Information. Aldrenoleukodystrophy Foundation. Web. Apr 8, 2013. http://aldfoundation.org/ald_info.html
3. What is Adrenoleukodystrophy? ALD Foundation Trust. Web. Apr 8, 2013. http://www.ald.org.nz/what_is_adrenoleukodystrophy
4. Introduction. ALDLife. Web. Apr 8, 2013. http://www.aldlife.org/patient-information/introduction/
5. Latest News. ALDLife. Web. Apr 8, 2013. http://www.aldlife.org/news-research/latest-news/

April is Autism Awareness Month.

Definition of Bullying

For years bullying has been dismissed as a normal, school-age, playground experience. We’ve used phrases like ‘Boys will be boys,’ ‘What doesn’t kill you makes you stronger,’ and ‘Kids are cruel’. The reality is that bullying isn’t harmless. “Every day, 160,000 children do not go to school because they are afraid of being bullied.” (2)

The Department for Children, Schools and Families in the UK defines the following actions as bullying:

• Hitting
• Kicking
• Taking belongings
• Name-calling
• Making insulting or offensive remarks
• Spreading nasty stories about someone
• Excluding from social groups
• Making a person the subject of malicious rumors
• Sending malicious emails or text messages (3)

Actions are considered bullying when they’ve been deliberately hurtful, repeated over a period of time, and make it difficult for victims to defend themselves.

Bullying and Autism

The Interactive Autism Network engaged in a survey in the fall of 2011 of families with children on the autism spectrum to investigate the frequency at which children with ASD were bullied because of their disabilities. The preliminary findings of this survey indicate “that children with ASD are bullied at a very high rate, and are also often intentionally ‘triggered’ into meltdowns or aggressive outbursts by ill-intentioned peers.” (1)

To summarize some of the preliminary findings in the IAN survey (1):

• 63% of children aged 6 to 15 with ASD were reported to have been bullied, compared to 12% of their neurotypical siblings.
• 73% of those bullied reported being teased, picked on, or made fun of, 51% reported being ignored or left out of things on purpose, 47% reported being called names.
• Nearly 30% of children who had been bullied had been pushed, shoved, hit, slapped, or kicked.
• 53% had been provoked into fighting back or having a meltdown
• Bullying occurred at every grade level, with the worst time between grade 5 and 8.
• 43% of ASD children who attend regular public schools report being bullied
• 61% of children with Asperger’s syndrome reported being bullied, “compared with 28% of those with autism and 37% of those with Other ASDs.”

It is generally accepted that this 61% is probably higher because there are children who are unable to verbalize that they’re being bullied, or may not even realize they’re being bullied because they are unable recognize when someone’s being mean to them.

Researchers believe—though more investigation into the results needs to be done to confirm this hypothesis—that children with Asperger’s Syndrome (AS), because they’re high performing, are in typical classroom settings in regular public schools. Children with Asperger’s appear more “normal” than children with other ASDs, and classmates perhaps forget that AS children “share the same problems with social understanding as others on the autism spectrum”—this makes them ‘perfect targets.’ (1)

Interestingly, children with more repetitive behaviors, like flapping or spinning, were less likely to be bullied. Perhaps it’s because these children had more severe autism and were more sheltered in terms of school environments, or because these more outward signs made their disability more noticeable and children less likely to pick on them. Behavior traits that were associated with an increased likelihood of being bullied included:

• Clumsiness
• Poor personal and oral hygiene
• Rigid rule keeping
• Continuing to talk about a favorite topic even when others are bored or annoyed
• Frequent meltdowns
• Inflexibility or rigidity (1)

The Effects of Bullying and Getting Involved

“Bullying is not a harmless rite of childhood that everyone experiences. Research shows that bullying can negatively impact a child’s access to education and lead to:

• School avoidance and higher rates of absenteeism
• Decrease in grades
• Inability to concentrate
• Loss of interest in academic achievement
• Increase in dropout rates.” (3)

“Parents, educators, and other adults are the most important advocates that a student with disabilities can have.” (3) It is important that all involved adults learn and know how to communicate effectively with children with autism, and never expect the child to fix the problem. These are children who, by their very nature, cannot read social cues, don’t know the “unwritten rules or hidden curriculum” that govern the classroom, playground, and even bathrooms. So we need to intervene and be aware of the uniqueness of autism, particularly Asperger’s, and how that affects “ordinary” childhood interactions.

Darlene Oakley is a freelance writer for Empowher.com