Monday, February 27, 2012

Sleep and Dental for Autism

Autism Speaks has published two guides that parents will want to download.

The first covers sleep habits and discusses bedtime routine (including sample PEX-style cards), sensory concerns (light, sound, tactile and temperature), the amount of sleep needed (children with autism appear to need less sleep), and strategies for problem sleepers. There is a wealth of good information in 8 pages.  Autism Speaks Sleep Tips

The second guide is a toolkit for dental professionals. It provides practical strategies for doing dental work on children with autism. Included topics are sensory strategies, picture schedules and social stories. There are handouts for dental workers to provide to parents regarding chemicals and procedures. The appendix contains parent medical checklists and parent handouts regarding the nature of amalgams and flouride. Autism Speaks Dental Tool Kit

Wednesday, February 15, 2012

Update on Winter Depression and Melatonin and Lights

Two years ago I wrote about using low dose melatonin to help chase the winter blues. (See that post here.) There is a bit of an art to this method. Someone told me that you are supposed to use the melatonin for a few weeks in the autumn and then stop. I looked for a reference to cite on this, but found none. However, it made sense to me, so I decided to try it this year.

Starting in early November, I took about 3 drops of liquid 25 mg. melatonin in a glass of water (also tried under the tongue, which seemed to be fine, too) once a day for about 3 weeks. Research shows that there are two times of the day it will work. For most people, the dose is to be taken in the early afternoon. For others (that's me), it is taken in the morning. I would get up at 7:00 and take the melatonin at 9:00.

I did nothing else until early January when the light was beginning to increase a tad. At that time, I started getting a bit of brain fog, so I purchased a 10,000 lumen light and began sitting with it for 15 minutes in the morning. It has worked very well. I notice that my brain goes into a bit of hibernation if I miss a few days running, but otherwise, the brain is working well. BYW, I have tried using lights without melatonin in past years, but it didn't seem to be enough. And the article cited below says that melatonin alone may not be enough either.

To get more information, read the short summary on the NIMH website: posted in May 2006 Summary from the National Institute of Mental Health (NIMH):

Ease App on Fox News

A quick note about the EASE listening therapy app from  Fox News did a segment on the product. It can be seen at:

Monday, February 13, 2012

Coaching Cards

Check out the Parent Coach Cards available at There are 20 cards on a ring. Each card has a lively illustration on a topic such as flexibility, reactivity, organization skills, impulsive speech, and other ADHD-related behaviors.

The back side of each card contains text that parents can read to help coach their child on avoiding the problem behavior. The cards are set up for on-the-spot usage. A parent can grab a card, show it to the child and read text such as: "Finding your brakes means using your 'thinking side' to control your energy."

There is also first-person text for the child to read. Within that text are a number of 1-liners such as "I need my 'thinking side' even when I'm having fun", that can be used for quick reminders.

An associated coloring book is also available for sale on the site and on

Saturday, February 4, 2012

Sensory Vs Behavior Approach

There is a bit of unnecessary tension between the fields of applied behavior analysis and sensory therapy. There needn't be. Both approaches have tons of research. Sometimes there is an overlap in the type of therapy one might consider for a given situation. Excellent! Both types of therapists can give a problem a "go". I am grateful to have colleagues to refer difficult cases to and am glad to help their clients, as well.

I've compiled, what I contend, are a list of truisms regarding the scope and overlap of these two types of therapies.

1. Yes, there is such a thing as sensory processing disorder. Yes, there is evidence. Do sensory interventions work? In many cases, yes. See the many, many papers written.

2. No, sensory techniques do not solve all sensory issues. Sometimes a child has developed negative habits and a behaviorist can provide the best therapy. In fact, for truly challenging problems, a behaviorist approach can be a God-send.

3. A behavior approach can be the therapy of choice for feeding problems - even those with textures and tastes. Why? Sometimes the child just needs to get past the weirdness of texture and tastes. There is a rule of 13 tastings. When a child tries a food (that they don't hate) 13 times, they acclimate to it. This is especially important for children who are at risk for failure-to-thrive due to feeding issues.

4. Using one of the BIG sensory therapies such as Therapressure™ (Wilbarger Protocol), sound therapy or a strictly followed sensory diet can change the life of a child with sensitivity (hyper-reactivity) to sensory input. These children suffer - we need to help them

5. "ABA"-based therapies have helped many children with autism to attend to lessons in a regular-education classroom. This can be a life-changer for a child.

6. Movement and other sensory-style breaks throughout the day help all children to attend better in class. This can help all children achieve higher grades.

7. New medical research is uncovering unusual issues in children with autism that affect their behavior. Treating a medical issue with sensory or aba-style therapies can be a waste of time.

That's the short list. What other things might you add?

Wednesday, February 1, 2012

DSM V and Autism

If you want to see what is happening with the DSM V revisions (Psychiatrist's Diagnostic Manual) for autism, check out their website. I was very skeptical prior to looking at the changes because I did not want (and still do not want) to see the Asberger's label go away, but aside from that, I like the way that they have streamlined it to feel like a spectrum. I get a nice visual of its dynamics, seeing severe move to moderate move to high functioning move to off of the label. I see enough children make headway along that path moving slowly but steadily into better space with our therapies, to make that spectrum visual real. As for whether or not it will work, time will tell. There is still time to provide input to the DSM V committee for those of you who want to do so.

By the way, the new language for sensory modulation symptoms for autism is in that definition. They included all three types of modulation problems: hyper-reactive (over-responsive or over sensitive), hypo-reactive (under-responsive or under sensitive) and craving (seeking). This is a huge win and a first step for Dr. Lucy Jane Miller and her colleagues. Sensory modulation does not exist as it's own disorder yet in the DSM. Presumably, that is step two.