Clinic Notes: ADHD?

Many parents already have an ADHD diagnosis for their child before they bring them to my clinic. I always separate the parents from their child and then observe the child in our playroom while the child is alone with my assistant and me. If the child appears ADHD, we do not say anything. We let the child run around the playroom as much as he or she wants. Often the child will calm down after a few minutes and play appropriately with the toys and then we will praise the child. Occasionally, we ask the child questions and praise the child if he or she answers the question the first time, but we ignore the child for not answering. Once the child has learned to pay attention to us and played calmly for twenty minutes or so, I ask the parents to come into the playroom. If the child becomes ADHD when the parents come in to the room, and do not settle down, I know the ADHD has been conditioned by the parents’ attention. In other words, the parents ignore the child whenever he or she is not being ADHD, and give the child attention whenever ADHD behaviors occur. This attention is reinforcing for the child and the ADHD behavior increases in its frequency. In cases like this I give the parents an ABA program for staying on task and decreasing other ADHD behaviors. The parents have to learn to reverse their behavior at home and give attention in the form of praise for non-ADHD behaviors and ignore ADHD behaviors. This is hard for the parents to do even with my weekly monitoring and guidance, but when they are successful this simple change in the parent’s behavior can decrease ADHD behavior without having to resort to medications.
Excerpted from Case History # 7. "The Night Life Ain’t No Good Life" Available at: http://www.ABA4Autism.com

Clinic Notes: Autism in the News

Check out the "Autism in the News" link on my website. Ten Things The Student with Autism Wishes You Knew

Ellen Notbohm, author of the book called, Ten Things Every Child With Autism Wished You Knew, has recently expanded her audience to teachers and has written an article, Ten Things The Student With Autism Wishes You Knew.

As a clinician I found this interesting and I think caregivers will too.

Clinic Notes: Selective Mutes

Children who are selective mutes have acquired speech, but never use speech. They point and gesture to get what they want; sometimes tantruming if their needs are not met promptly until caregivers begin to anticipate their needs. When I moved to Tennessee the first case I had in my clinic was a 6 year old girl with a dual diagnosis of autism and mental retardation who had not spoken in years.
In order to change this behavior I instructed everyone to not anticipate the child's needs or respond to pointing and grunting. Now everyone must wait until the child made a sound that approximated a word to get what she wanted. Once this was accomplished, everyone had to wait longer until the approximation more closely resembled a word. After several weeks speech was re-established in this child. Several months later I received a call from the caregivers saying the child was talking too much now and could they bring her back to my clinic.

Clinic Notes: Self-Injurious Behavior

Nothing is more frightening to parents of a child with autism or some other neuropsychological disorder than to see their child engage in self-injurious behaviors such as head banging, biting, or hitting themselves. Self-injurious behavior can occur in children with autism or mental retardation, as well as in children with numerous other neuropsychological disorders, and is the most common reason for institutionalization. Some children injure themselves for attention or to control the people in their environment. (See ABA program number 5 on my ABA4Autism website) With other children, the social environment doesn’t seem to matter. According to Frank Symons, 80 percent of self-injurious behavior is to 5 percent of the body--the hands and face. (The same areas often involved in acupuncture pain reduction.) The hands and face are innervated by areas of the brain, which lie adjacent to each other. Apparently, some autistic children injure themselves to release endorphins (naturally occurring brain opiates). Naltrexone, a drug which blocks opiate receptors, reduces head banging and hand biting in about a third of the kids with self-injurious behavior. Improved eye contact, socialization, and a reduction in self-stimulatory behavior also occurs in some kids with autism if they are receiving Naltrexone, leading to the hypothesis that autism is caused by an excess of endorphins. (North Carolina State Professor James Kalat suggests that in some ways autistic kids act like opium addicts going through withdrawal and then taking more opium.) Excerpted from "Little Bubba's Not Ready for Nashville Yet" available at http://www.ABA44Autism.com

Clinic Notes: ABA4Autism on eBay

This weekend we placed my ABA eBook and Case History eBook for sale on eBay. Both eBooks can be downloaded or we will mail them to you on CD-ROM. We will add individual ABA programs, individual Case Histories, and my online ABA course to eBay if caregivers find eBay a useful outlet. Just type ABA and Autism in eBay's search feature to find us. Of course, all of our ABA materials are still available at http://www.ABA4Autism.com.

Clinic Notes: Autism in Pakistan

A few weeks ago I received an email from Saadia Haseeb, who is the editor of Motherhood, Pakistan's first parenting magazine. She asked me if I would write an article on autism for her magazine. I found the magazine's web site and was amazed. There were articles concerning adopting homeless children who's parents were killed in the recent earthquake and other serious topics, as well as articles and columns on "lighter" topics like health and beauty. With all of the tragedy that Pakistan has endured this magazine wanted an article on autism. I finished the article and sent it in today and the editor was grateful. I'm left wondering how autism in Pakistan ranks with other diasters there?