Clinic Notes: Handwriting and Autism

Many children with autism have fine motor problems and are receiving services from Occupational Therapists (OT's). Buttoning, tying shoes, coloring, puzzles, and stacking blocks can all be issues. A recent study (Schafer Report, November 24, 2010) found that handwriting problems persist into the adolescent years. I think this reinforces what I have been telling parents for years. Do not discontinue OT even if the Ot tells you that your child with autism has met all of the goals unless handwriting is easy for the child. Letters should not only be well formed but completed in a timely manner. I have seen children with autism make bad grades simply because they cannot write fast enough to finish assignments and tests.

Clinic Notes: Desensitizing a Child with Autism to Swallow Pills

About half of the children who come to The Children's Treatment Center are on medication. Many children with autism have issues with swallowing pills so parents have to hide the pills in food or find the medication in liquid form if available. Usually, this is only a short term fix. I use a desensitization procedure similar to a procedure covered in a recent Lovaas Institute Newsletter which works well. Begin by having the child swallow all of the liquid in a spoon in one swallow. Start with just a small amount of liquid and gradually increase the amount until the chills can easily swallow the entire spoon full. Do this with a variety of different liquids. Next add a small amount of juice powder to the liquid and gradually increase the amount by decreasing the amount of liquid. Follow this with a spoon of the child's favorite juice as a reinforcer. Small ice chips can then be placed on the spoon for the child to swallow and gradually increased in size. The transition can then be easily made to small pills.

Clinic Notes: Biomed and Autism

Many parents tell me that raising a child with autism is just more than they can do. Keeping up with all of the ABA programs they are supposed to run in the home, speech therapy, OT, meds, it's just too much. Well, as a clinician I have to agree. Keeping clinical progress notes is often just too much for me too. There's a new app for the iPad called Biomed, which tracks patient care. A patient profile is created--name, birth date, diadnosis, etc. Next a treatment history is entered and quantified if possible. Once all of the information is entered updates are added. Biomed then summarizes everything and you can review all of the information that you have entered on a topic--say ABA-with a tap. We have started using this app at the Children's Treatment Center and we will report in a future blog how it goes.

Clinic Notes: Bad Autism "News"

Last night, after working all day with children with autism in my clinic, I was scanning the autism news, looking for something to blog about. I found the usual scientific studies on genetics, brain function, therapies -- all of great interest, and countless stories about all of the good things that were being done to help children with autism. But what really caught my attention was what a bad day it had been for some children with autism. A substitute teacher was accused of biting a child with autism, a babysitter poured scalding water on a child with autism because of a toileting accident, a student was charged for bullying a child with autism, and a school in Scotland built a cage for a child with autism to "play" in at recess. Maybe tomorrow will be a better day.