Volume 9, Issue 4 - Early Autism Project

Weap:The People
Volume 9, Issue 4
Wisconsin Early Autism Project, Inc.
2015
Can Yoga Help Children with
Autism?
Autism Spectrum Disorder
Fact Sheet
http://www.npr.org
National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov/disorders/autism/detail_autism.htm
What is autism spectrum disorder?
Autism spectrum disorder (ASD) refers to a group of complex
neurodevelopment disorders characterized by repetitive and
characteristic patterns of behavior and difficulties with social
communication and interaction. The symptoms are present
from early childhood and affect daily functioning.
Researchers surveyed teachers at a school in the Bronx
who said a daily yoga program reduced the kids'
aggressive
behavior,
social
withdrawal
and
hyperactivity.
Kristie Patten Koenig, an assistant professor of
occupational therapy at New York University who led the
study, hypothesized that yoga was effective because it
seems to play to the strengths of kids with autism, while
also reducing stress.
Continued on page 5
1 Autism Spectrum Disorder Fact Sheet
12 Tips for the Holidays
7
Groups – Events - Openings
8
WEAP Christmas Party
www.wiautism.com
ASD occurs in every racial and ethnic group, and across all
socioeconomic levels. However, boys are significantly more
likely to develop ASD than girls. The latest analysis from the
Centers for Disease Control and Prevention estimates that 1
in 68 children has ASD.
What are some common signs of ASD?
Even as infants, children with ASD may seem different,
especially when compared to other children their own age.
They may become overly focused on certain objects, rarely
make eye contact, and fail to engage in typical babbling with
their parents. In other cases, children may develop normally
until the second or even third year of life, but then start to
withdraw and become indifferent to social engagement.
INSIDE THIS ISSUE
1 Can Yoga Help Children with Autism?
3
The term “spectrum” refers to the wide range of symptoms,
skills, and levels of disability in functioning that can occur in
people with ASD. Some children and adults with ASD are fully
able to perform all activities of daily living while others require
substantial support to perform basic activities. The Diagnostic
and Statistical Manual of Mental Disorders (DSM-5, published
in 2013) includes Asperger syndrome, childhood disintegrative
disorder, and pervasive developmental disorders not
otherwise specified (PDD-NOS) as part of ASD rather than as
separate disorders. A diagnosis of ASD includes an
assessment of intellectual disability and language impairment.
The severity of ASD can vary greatly and is based on the
degree to which social communication, insistence of
sameness of activities and surroundings, and repetitive
patterns of behavior affect the daily functioning of the
individual.
Continued on next page
1
Social impairment and communication difficulties
depending on the severity of the disorder. Symptoms may even
go unrecognized for young children who have mild ASD or less
Many people with ASD find social interactions difficult. The debilitating handicaps. Very early indicators that require
mutual give-and-take nature of typical communication and evaluation by an expert include:
interaction is often particularly challenging. Children with ASD
may fail to respond to their names, avoid eye contact with other
no babbling or pointing by age 1
people, and only interact with others to achieve specific goals. •
Often children with ASD do not understand how to play or
•
no single words by age 16 months or two-word phrases
engage with other children and may prefer to be alone. People
by age 2
with ASD may find it difficult to understand other people’s feelings
or talk about their own feelings.
•
no response to name
People with ASD may have very different verbal abilities ranging
from no speech at all to speech that is fluent, but awkward and
inappropriate. Some children with ASD may have delayed
speech and language skills, may repeat phrases, and give
unrelated answers to questions. In addition, people with ASD can
have a hard time using and understanding non-verbal cues such
as gestures, body language, or tone of voice. For example,
young children with ASD might not understand what it means to
wave goodbye. People with ASD may also speak in flat, robotlike or a sing-song voice about a narrow range of favorite topics,
with little regard for the interests of the person to whom they are
speaking.
•
loss of language or social skills previously acquired
•
poor eye contact
•
excessive lining up of toys or objects
•
no smiling or social responsiveness
Repetitive and characteristic behaviors
Many children with ASD engage in repetitive movements or
unusual behaviors such as flapping their arms, rocking from side
to side, or twirling. They may become preoccupied with parts of
objects like the wheels on a toy truck. Children may also become
obsessively interested in a particular topic such as airplanes or
memorizing train schedules. Many people with ASD seem to
thrive so much on routine that changes to the daily patterns of life
— like an unexpected stop on the way home from school — can
be very challenging. Some children may even get angry or have
emotional outbursts, especially when placed in a new or overly
stimulating environment.
What disorders are related to ASD?
Certain known genetic disorders are associated with an
increased risk for autism, including Fragile X syndrome (which
causes intellectual disability) and tuberous sclerosis (which
causes benign tumors to grow in the brain and other vital organs)
— each of which results from a mutation in a single, but different,
gene. Recently, researchers have discovered other genetic
mutations in children diagnosed with autism, including some that
have not yet been designated as named syndromes. While each
of these disorders is rare, in aggregate, they may account for 20
percent or more of all autism cases.
Later indicators include:
•
impaired ability to make friends with peers
•
impaired ability to initiate or sustain a conversation with
others
•
absence or impairment of imaginative and social play
•
repetitive or unusual use of language
•
abnormally intense or focused interest
•
preoccupation with certain objects or subjects
•
inflexible adherence to specific routines or rituals
Health care providers will often use a questionnaire or other
screening instrument to gather information about a child’s
development and behavior. Some screening instruments rely
solely on parent observations, while others rely on a combination
of parent and doctor observations. If screening instruments
indicate the possibility of ASD, a more comprehensive evaluation
is usually indicated.
A comprehensive evaluation requires a multidisciplinary team,
including a psychologist, neurologist, psychiatrist, speech
therapist, and other professionals who diagnose and treat
children with ASD. The team members will conduct a thorough
neurological assessment and in-depth cognitive and language
testing. Because hearing problems can cause behaviors that
could be mistaken for ASD, children with delayed speech
development should also have their hearing tested.
What causes ASD?
People with ASD also have a higher than average risk of having
epilepsy. Children whose language skills regress early in life —
before age 3 — appear to have a risk of developing epilepsy or
seizure-like brain activity. About 20 to 30 percent of children with
ASD develop epilepsy by the time they reach adulthood.
Additionally, people with both ASD and intellectual disability have
the greatest risk of developing seizure disorder.
Scientists believe that both genetics and environment likely play
a role in ASD. There is great concern that rates of autism have
been increasing in recent decades without full explanation as to
why. Researchers have identified a number of genes associated
with the disorder. Imaging studies of people with ASD have found
differences in the development of several regions of the brain.
Studies suggest that ASD could be a result of disruptions in
normal brain growth very early in development. These disruptions
How is ASD diagnosed?
may be the result of defects in genes that control brain
development and regulate how brain cells communicate with
ASD symptoms can vary greatly from person to person each other. Autism is more common in children born prematurely.
Continued on page 5
www.wiautism.com
2
WEAP Classics
Periodically we will republish a previously written article to emphasize an issue of particular importance or value.
Twelve Tips for Helping Individuals with Autism
Have a Happy Holiday Season
http://www.autism-society.org/in-the-news/holiday-tips-families-living-autism/
For example, on the first day, put up the Christmas
tree, then on the next day, decorate the tree and so on.
And again, engage them as much as possible in this
process. It may be helpful to develop a visual schedule
or calendar that shows what will be done on each day.
While many happily anticipate the coming holiday
season, families of people on the autism spectrum
also understand the special challenges that may
occur when schedules are disrupted and routines
broken. Our hope is that by following these few helpful
tips, families may lessen the stress of the holiday
season and make it a more enjoyable experience for
everyone involved. The following tips were developed
with input from the Autism Society, the Indiana
Resource Center for Autism, Easter Seals
Crossroads, the Sonya Ansari Center for Autism at
Logan and the Indiana Autism Leadership Network.
4. If a person with autism begins to obsess about a
particular gift or item they want, it may be helpful
to be specific and direct about the number of times
they can mention the gift.
One suggestion is to give them five chips. They are
allowed to exchange one chip for five minutes of
talking about the desired gift. Also, if you have no
intention of purchasing a specific item, it serves no
purpose to tell them that maybe they will get the gift.
This will only lead to problems in the future. Always
choose to be direct and specific about your intentions.
1. Preparation is crucial for many individuals.
At the same time, it is important to determine how
much preparation a specific person may need. For
example, if your son or daughter has a tendency to
become anxious when anticipating an event that is to
occur in the future, you may want to adjust how many
days in advance you prepare him or her. Preparation
can occur in various ways by using a calendar and
marking the dates of various holiday events, or by
creating a social story that highlights what will happen
at a given event.
2. Decorations around
disruptive for some.
the
house
may
be
It may be helpful to revisit pictures from previous
holidays that show decorations in the house. If such a
photo book does not exist, use this holiday season to
create one. For some it may also be helpful to take
them shopping with you for holiday decorations so
that they are engaged in the process. Or involve them
in the process of decorating the house. And once
holiday decorations have been put up, you may need
to create rules about those that can and cannot be
touched. Be direct, specific and consistent.
5. Teach them how to leave a situation and/or how
to access support when an event becomes
overwhelming.
For example, if you are having visitors, have a space
set aside for the child as his/her safe/calm space. The
individual should be taught ahead of time that they
should go to their space when feeling overwhelmed.
3. If a person with autism has difficulty with
change, you may want to gradually decorate the
house.
Continued on next page
www.wiautism.com
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HOLIDAYS continued from page 3
This self-management tool will serve the individual
into adulthood. For those who are not at that level of
self-management, develop a signal or cue for them to
show when they are getting anxious, and prompt
them to use the space. For individuals with more
significant challenges, practice using this space in a
calm manner at various times prior to your guests’
arrival. Take them into the room and engage them in
calming activities (e.g., play soft music, rub his/her
back, turn down the lights, etc.). Then when you
notice the individual becoming anxious, calmly
remove him/her from the anxiety-provoking setting
immediately and take him/her into the calming
environment.
Talk through this process to avoid embarrassing
moments with family members. You might also
choose to practice certain religious rituals. Work
with a speech language pathologist to construct
pages of vocabulary or topic boards that relate to
the holidays and family traditions.
10. Prepare family members for strategies to
use to minimize anxiety or behavioral
incidents, and to enhance participation.
Help them to understand if the person with autism
prefers to be hugged or not, needs calm
discussions or provide other suggestions that will
facilitate a smoother holiday season. If the
individual becomes upset, it might also be helpful
to coach others to remain calm and neutral in an
effort to minimize behavioral outbursts.
6. If you are traveling for the holidays, make sure
you have their favorite foods, books or toys
available.
Having familiar items readily available can help to
calm stressful situations. Also, prepare them via
social stories or other communication systems for
any unexpected delays in travel. If you are flying for
the first time, it may be helpful to bring the individual
to the airport in advance and help him/her to become
accustomed to airports and planes. Use social stories
and pictures to rehearse what will happen when
boarding and flying.
11. If the person with autism is on special diet,
make sure there is food available that he/she
can eat.
And even if they are not on a special diet, be
cautious of the amount of sugar consumed. And
try to maintain a sleep and meal routine.
12. Above all, know your loved one with
autism.
7. Know your loved one with autism and how
much noise and activity they can tolerate.
Know how much noise and other sensory input
they can take. Know their level of anxiety and the
amount of preparation it may take. Know their
fears and those things that will make the season
more enjoyable for them.
If you detect that a situation may be becoming
overwhelming, help them find a quiet area in which
to regroup. And there may be some situations that
you simply avoid (e.g., crowded shopping malls the
day after Thanksgiving).
Don’t stress. Plan in advance. And most of all
have a wonderful holiday season! ☼
8. Prepare a photo album in advance of the
relatives and other guests who will be visiting
during the holidays.
EMPLOYEE RECOGNITION
Gina Rasmussen October
Becky Knoblauch November
Shawanna Wilson October
Emily Suarez Del Real November
Bryce Bartelt
December
Elizabeth Utesch October
Jillian Freund
November
Nanette Willert
October
Lynn Furlano
November
Allow the person with autism access to these photos
at all times and also go through the photo album with
him/her while talking briefly about each family
member.
9. Practice opening gifts, taking turns and
waiting for others, and giving gifts. Role play
scenarios with your child in preparation for
him/her getting a gift they do not want.
www.wiautism.com
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Green Bay
Green Bay
Milwaukee
Milwaukee
Milwaukee
Madison
Madison
Eau Claire
Eau Claire
YOGA continued from page 1
FACTS continued from page 2
The authors noted that since anxiety fuels a lot of the
negative behavior of children with ASD, the yoga program
may give children a strategy to cope with it. Further, if it is
done every morning with the whole class, it may become
an integral part of the day that sets the status of the
classroom and allows the kids to become calm, focused
and ready to learn.
Environmental factors may also play a role in gene function and
development, but no specific environmental causes have yet
been identified. The theory that parental practices are
responsible for ASD has long been disproved. Multiple studies
have shown that vaccination to prevent childhood infectious
diseases does not increase the risk of autism in the population.
What role do genes play?
According to the researchers, yoga is increasingly being
used in classrooms across the U.S. to get kids to behave
and perform better in school. Early research suggests that
yoga exercises help kids concentrate and focus, and
improves their strength, motor coordination and social
skills.
Twin and family studies strongly suggest that some people have
a genetic predisposition to autism. Identical twin studies show
that if one twin is affected, then the other will be affected
between 36 to 95 percent of the time. There are a number of
studies in progress to determine the specific genetic factors
associated with the development of ASD. In families with one
child with ASD, the risk of having a second child with the
disorder also increases. Many of the genes found to be
associated with autism are involved in the function of the
chemical connections between brain neurons (synapses).
Researchers are looking for clues about which genes contribute
to increased susceptibility. In some cases, parents and other
relatives of a child with ASD show mild impairments in social
communication skills or engage in repetitive behaviors. Evidence
also suggests that emotional disorders such as bipolar disorder
and schizophrenia occur more frequently than average in the
families of people with ASD.
The Bronx school had the kids follow a specific routine
each morning, five days a week, for 17 minutes. The
routine was as follows: mats out, breathe deep, assume
yoga poses, tense and relax muscles, and, finally, sing.
The researchers studied the program for 16 weeks and
compared the kids in the program with a control group of
kids doing a standard morning routine. Their finding?
Teachers said that the kids doing yoga exhibited
significantly fewer problematic behaviors overall.
This yoga program is being implemented in more than 500
classrooms across the city of New York among students
ages 5 through 21 with significant disabilities. The results
of Koenig's study were published in the American Journal
of Occupational Therapy.☼
In addition to genetic variations that are inherited and are
present in nearly all of a person’s cells, recent research has also
shown that de novo, or spontaneous, gene mutations can
influence the risk of developing autism spectrum disorder. De
novo mutations are changes in sequences of deoxyribonucleic
acid or DNA, the hereditary material in humans, which can occur
spontaneously in a parent’s sperm or egg cell or during
fertilization. The mutation then occurs in each cell as the
fertilized egg divides. These mutations may affect single genes
or they may be changes called copy number variations, in which
stretches of DNA containing multiple genes are deleted or
duplicated. Recent studies have shown that people with ASD
tend to have more copy number de novo gene mutations than
those without the disorder, suggesting that for some the risk of
developing ASD is not the result of mutations in individual genes
but rather spontaneous coding mutations across many
genes. De novo mutations may explain genetic disorders in
which an affected child has the mutation in each cell but the
parents do not and there is no family pattern to the disorder.
Autism risk also increases in children born to older parents.
There is still much research to be done to determine the
potential role of environmental factors on spontaneous mutations
and how that influences ASD risk.
NOTE from Dr. Sallows: Unfortunately, the study had a
serious design error, in that the teachers, who rated the
children prior to and after the 16 week period, knew which
children were in the yoga group and the control group.
This is a problem because of a well-documented bias for
raters who are aware of group assignment to rate those in
the treatment group as more improved, whereas data from
“blind” raters may show much less improvement. This is
the reason that current research standards require “blind”
raters and evaluators. It is really not clear then, whether
the yoga group resulted in improvement, or if so, how
much improvement compared to the control group.
http://www.ncbi.nlm.nih.gov/pubmed/22917120
Learn more at the Get Ready To Learn website:
http://home.getreadytolearn.net/
Do symptoms of autism change over time?
For many children, symptoms improve with age and behavioral
treatment. During adolescence, some children with ASD may
become depressed or experience behavioral problems, and their
treatment may need some modification as they transition to
adulthood. People with ASD usually continue to need services
and supports as they get older, but depending on severity of the
disorder, people with ASD may be able to work successfully and
live independently or within a supportive environment.
Continued on next page
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5
How is autism treated?
There is no cure for ASD. Therapies and behavioral
interventions are designed to remedy specific symptoms and
can substantially improve those symptoms. The ideal treatment
plan coordinates therapies and interventions that meet the
specific needs of the individual. Most health care professionals
agree that the earlier the intervention, the better.
Educational/behavioral interventions:
Early behavioral/educational interventions have been very
successful in many children with ASD. In these interventions
therapists use highly structured and intensive skill-oriented
training sessions to help children develop social and language
skills, such as applied behavioral analysis, which encourages
positive behaviors and discourages negative ones. In addition,
family counseling for the parents and siblings of children with
ASD often helps families cope with the particular challenges of
living with a child with ASD.
Medications:
While medication can’t cure ASD or even treat its main
symptoms, there are some that can help with related symptoms
such as anxiety, depression, and obsessive-compulsive
disorder. Antipsychotic medications are used to treat severe
behavioral problems. Seizures can be treated with one or more
anticonvulsant drugs. Medication used to treat people with
attention deficit disorder can be used effectively to help
decrease impulsivity and hyperactivity in people with ASD.
Parents, caregivers, and people with autism should use caution
before adopting any unproven treatments.
What research is being done?
The mission of the National Institute of Neurological Disorders
and Stroke (NINDS) is to seek fundamental knowledge about the
brain and nervous system and to use that knowledge to reduce
the burden of neurological disease. The NINDS is a component
of the National Institutes of Health (NIH), the leading supporter
of biomedical research in the world. NINDS and several other
NIH Institutes and Centers support research on autism spectrum
disorder.
Nearly 20 years ago the NIH formed the Autism Coordinating
Committee (NIH/ACC) to enhance the quality, pace, and
coordination of efforts at the NIH to find a cure for autism
(http://www.nids.nih.gov/autism_coordinating_committee).
The
NIH/ACC has been instrumental in promoting research to
understand and advance ASD. The NIH/ACC also participates in
the broader Federal Interagency Autism Coordinating Committee
(IACC), composed of representatives from various U.S.
Department of Health and Human Services agencies, the
Department of Education, and other governmental organizations,
as well as public members, including individuals with ASD and
representatives of patient advocacy organizations. One
responsibility of the IACC is to develop a strategic plan for ASD
research, which guides research programs supported by NIH
and other participating organizations.
NINDS and several other NIH institutes support autism research
www.wiautism.com
6
through the Autism Centers of Excellence (ACE), a trans-NIH
initiative that supports large-scale multidisciplinary studies on
ASD, with the goal of determining the causes of autism and
finding new treatments. NINDS currently supports an ACE
network focused on ASD and tuberous sclerosis complex (TSC).
ASD occurs in approximately half of TSC patients. In particular,
the ACE investigators are studying whether certain brain imaging
and activity measures in infants diagnosed with TSC can predict
the development of ASD. Such biomarkers could aid in
understanding how and why ASD occurs in some children but
not others, and help to identify patients who might benefit from
early intervention. Other ACE centers and networks are
investigating early brain development and functioning; genetic
and non-genetic risk factors, including neurological, physical,
behavioral, and environmental factors present in the prenatal
period and early infancy; and potential therapies.
NINDS funds additional research aimed at better understanding
the factors that lead to ASD, including other studies on genetic
disorders associated with ASD, such as TSC, Fragile X
Syndrome, Phelan-McDermid syndrome (which features such
autism-like symptoms as intellectual disability, developmental
delays, and problems with developing functional language), and
Rett syndrome (a disorder that almost exclusively affects girls
and is characterized by slowing development, intellectual
disability, and loss of functional use of the hands). Many of these
studies use animal models to determine how specific known
mutations affect cellular and developmental processes in the
brain, yielding insights relevant to understanding ASD due to
other causes and discovering new targets for treatments.
NINDS researchers are studying aspects of brain function and
development that are altered in people with ASD. For example,
NINDS-funded researchers are investigating the formation and
function of neuronal synapses, the sites of communication
between neurons, which may not properly operate in ASD and
neurodevelopmental disorders. Other studies use brain imaging
in people with and without ASD to identify differences in brain
connectivity and activity patterns associated with features of
ASD. Researchers hope that understanding these alterations can
help identify new opportunities for therapeutic interventions.
Additional NINDS researchers are studying the relationship
between epilepsy and autism.
Through the National Center for Advancing Translational
Sciences (NCATS) Rare Disease Clinical Research Network
(RDCRN), NINDS and other NIH Institutes and Centers support
a research consortium focused on three rare genetic syndromes
associated with ASD and intellectual disability, including TSC
and
syndromes
involving
mutations
in
the
genesSHANK3 (Phelan-McDermid syndrome) and PTEN. The
goals of the consortium are to understand shared mechanisms
across these syndromes, which may suggest common
approaches to their treatment.
NINDS supports autism spectrum disorder research through
clinical trials at medical centers across the United States to
better our knowledge about ASD treatment and care. Information
about participating in clinical studies can be found at the “NIH
Clinical
Trials
and
You”
website
at
www.nih.gov/health/clinicaltrials . Additional studies can be found
at www.clinicaltrials.gov . People should talk to their doctor
before enrolling in a clinical trial.☼
Groups and Classes
Location
Group
Age/Level
Facilitator
Fee
Days
Time
Start Date
Madison
Kangaroo Troop
Ages 3-4
Amy G.
$30/class
Wednesdays
10:00AM-11:00AM
1/27-5/11
Madison
Dolphin Pod
Ages 5-6
Susha S.
$30/class
Wednesdays
4:00PM-5:30PM
1/27-5/11
Madison
Lion Pride
Ages 7-9
Chelsea D.
$30/class
Mondays
4:00PM-5:30PM
1/25-5/9
Madison
Teen Groups
Ages 13-17
Matt S./Jevin L.
$30/class
Thursdays
4:00PM-5:30PM
1/28-5/12
Madison
Wolf Pack
Ages 10-12 Lindsay B./Kayla R.
$30/class
Tuesdays
4:00PM-5:30PM
1/26-5/10
Madison
Ft. Atkinson Group
Ages 5-6
JoAnn Donny
$30/class
Thursdays
4:00PM-5:30PM
1/28-5/12
Milwaukee
The Eagles
Ages 14-18
Eric A.
$30/class
Thursdays
4:30-6:00PM
1/21- 5/26
MIlwaukee
The Hawks
Ages 11-14
Nicole L.
$30/class
Thursdays
4:30 -6:00pm
1/21- 5/26
MIlwaukee
The Falcons
Ages 7-10
Jess M.
$30/class
Tuesdays
4:30-6:00pm
1/19- 5/24
Upcoming Events
Family Movie Day
WHERE:
TIMES:
WHEN:
RSVP:
Everybody Plays - Spectrum Saturday
WhenSat, December 19, 8:30am – 10:00am
WhereThe Building for Kids Children's Museum, West
College Avenue, Appleton, WI, United States (map)
WEAP 1210 Fourier Drive, Madison
10:00-12:30 5 years old and under
1:00-3:30
6+ Years old
December 30th, 2015
By Dec. 28th by calling 608-662-9327
Opens early at 8:30 AM. Enjoy a lower sensory
experience until 10:00 AM, but stay as late as you
like. Meet other families and resource professionals
from the area.
Suggested donation of $2.00 for:
• Popcorn
• Drinks
• Ice Cream at intermission
For more information
visit http://www.buildingforkids.org/events-programs/autism-spectrum-saturdays
Facilitated conversations after the movie
Quiet rooms available for breaks
Current Openings
EAU CLAIRE
715-832-2233
MADISON
608-662-9327
GREEN BAY
920-338-1610
Clark County
Wisconsin
Rapids
Wausau
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Door county
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Fond du lac
Fox Cities
Green Bay
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Lyndon Station
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7
MILWAUKEE
262-432-5660
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