1/22/2010 Autism Spectrum Disorders (ASD) Optometry’s Role: Optometry s Role: AD(H)D LD NLD Asperger’s PDD PDD-NOS Autism ( ) p g …………………………..………………………….. Using a Trans-Disciplinary Approach for Least severe More severe Most severe Patients with Autism Spectrum Disorders ICBO 2010 Patricia S. Lemer, M. Ed., NCC devdelay@mindspring.com Statistics Is There an Autism Epidemic? According to the Autism Society of America: • 1 in 150 children is diagnosed with autism Some Possibilities • 1 in 94 boys is on the autism spectrum • 3 - 5% have attention deficit disorders • More inclusive categories • 5-17% have learning disabilities. Some have both. • 5-17% have learning disabilities Some have both • Changed diagnostic criteria Ch d di i i i • On average, 67 children are diagnosed with autism • Better record keeping per day – nearly one every 20 minutes! • More children will be diagnosed with autism this year than with AIDS, diabetes and cancer combined Question: Where are the adults with • Full blown autism alone costs the nation over $90 autism? billion per year, a figure expected to double in the next decade Thinking Has Changed Causes: Nature? Nuture? • Genetics Loads the Gun • Old Thinking: ASDs are inherited life-long neurological disorders. Interventions can – Parental immune system issues; allergies – Endocrine dysfunction help individuals cope and compensate for – Low thyroid their difficulties. (Kanner, Bettleheim) – Poor ability to detoxify (methylation) Poor ability to detoxify (methylation) • Environment Pulls the Trigger • New Thinking: ASDs result from a – Toxic exposures – pre- & post-natal combination of genetic susceptibility and – Birth trauma environmental causes. The right – Role of vaccines interventions can result in reversal of – Insufficient sensory stimulation symptoms, and even full recovery. – Changes in today’s world – Immune suppressing medications including antibiotics • Autism is Treatable! ( Rimland, www.autism.com/ari) 1
1/22/2010 Use a Trans-Disciplinary Total Load Theory Approach because… • The body is like a bridge, and can • Thinking is a “team sport” and requires handle only a limited number of stressors many types of players • Cumulative effect of stress factors Cumulative effect of stress factors • Restoring health is like restoring a fine Restoring health is like restoring a fine overloads it painting: know and respect its history • Body’s top priority is staying well • It takes time to get well: at least as long as it did to get sick • Degree of overload determines diagnosis Interpret Behaviors as Vision Behaviors in Autism Symptoms of Visual Dysfunction • Squints or closes an eye; pushes or rubs eyes • “Autistic” and “ADD” behaviors are often a • Stares at certain objects or patterns result of poor compensation for integration of • Looks through hands central and peripheral vision • Flaps hands, flicks objects in front of eyes • Visual stims are attempts at jump starting Visual “stims” are attempts at “jump starting” • Looks at objects sideways or with quick glances faulty visual function • Shows sensitivity to light (photophobia) • Fearful of changes in flooring or on stairways • Poor eye contact shows that visual system is • Has difficulty making eye contact over-loaded, and that the brain is not coping • Bumps into objects • Motor clumsiness may be a result of visual • Is fascinated by lights and shadows inefficiency • Holds onto walls or furniture when walking Interventions from The Role of the Optometrist Other Disciplines • Structural therapies • Evaluate and treat underlying visual issues • Reflex integration • Consider possible causes for visual • Biomedical intervention through Defeat problems, such as nutrition, diet, metal Autism Now! physicians Autism Now! physicians toxicity, birth trauma, environment toxicity birth trauma environment – Dietary modification • Take continuing education courses to learn – Nutritional supplementation how to evaluate and treat those areas • Sensory therapies • Develop a referral network for collaborating – Occupational therapy with other professionals expert in those – Sound/Auditory therapies areas • Energy therapies 2
1/22/2010 Collaboration with Reflexes “Structural” Professionals • Over 100 involuntary movements that are • Chiropractic controlled by the brain stem • Chiropractic neurology • In infancy protect and assist with survival • Osteopathy Osteopathy • Lead to the development of voluntary Lead to the development of voluntary movement • CranioSacral therapy • As they integrate person gains volitional • Massage control over body • Bioneurofeedback • Result is skilled, intentional behavior • Other “Bodyworks Therapies” • If unintegrated, interfere with development and behavior Consequences Of Immune System Reflex Abnormalities • WHAT GOES WRONG • Aberrant motor development –System becomes exhausted from constant • Poor lateralization assaults from too many load factors, including over-use of antibiotics g • Hyper- or hypotonic muscles Hyper- or hypotonic muscles • SIGNS TO LOOK FOR • Vestibular dysfunction –Allergies, asthma, leaky gut, skin problems • Poor binocularity –Chronic ear/sinus/strep infections –Heavy use of antibiotics • Eye motor difficulties –Dark circles, red ears and cheeks • Perceptual problems Biological Statistics Get Bad Stuff Out - Detoxify • Remove mercury-containing amalgams • 99% - Omega 3 Fatty Acid Deficiencies • Homeopathic detox • 90% - Zinc Deficiencies Assists the body to heal itself from - Copper Excess inside - Immune Disregulation I Di l ti • Antioxidants, foods and nutrients • 80% - Chronic Diarrhea / Constipation • Chelation • 80% - > 5 Ear or strep infections Changing medical protocols • 50-70% - Mercury (Hg) Toxic • Sweat: use a sauna • Hyperbaric oxygen treatments • All require strict medical supervision 3
1/22/2010 Add Back the Good Stuff with Dietary Modification: Nutritional Supplementation Single Most Important Intervention • Many kids with ASD are picky eaters who are addicted to • Closes the gap between what is eaten the very foods that harm them • Removing gluten- and casein-containing products and what the body needs reduces their “total loads” • 1/3 improve dramatically when GF/CF with speech • Helps with poor absorption Helps with poor absorption emerging for the first time emerging for the first time • Another 1/3 show improvement in sleep & general • Detoxifies environmental chemicals behaviors • Heals the leaky gut Reichelt, Ekrem, Scott. Gluten, milk proteins and autism. Dietary intervention effects on behavior and peptide secretion. J. Applied • Repairs the nutritional deficiencies Nutrition 1990; 42:1. Knivsberg, Reichelt, Nodland. Reports on dietary intervention in autistic disorders. Nutritional Neuroscience 2001; 4. • Boosts the immune system Shattock, Whitely. How dietary intervention could ameliorate the symptoms of autism. The Pharmaceutical Journal 2001, 267. Sensory Therapies as “Hybrid” Programs Adjuncts to VT • HANDLE: Judith Bluestone – H olistic A pproach to • Occupational therapy – Works on touch, N euro- D evelopmental and L earning E fficiency – vestibular foundations for vision small, measured doses of simple activities. • Perceptual- motor therapy – Reinforces www.handle.org motor foundations for vision motor foundations for vision • Sensory Learning – Mary Bolles – vestibular, • Sensory Learning Mary Bolles vestibular visual (syntonics), auditory, www.sensorylearning.com • Sound therapies – Lays neurological • S’Cool Moves – Debra M. Wilson- reading pathways for normalizing vestibular readiness www.schoolmoves.com function and for integrating vision and • Interactive Metronome – James Cassily – auditory Computer-based visual, auditory sequencing. Some ODs are being trained to use it in VT. www.interactivementronome.com The Role of Vision in More Interventions Speech-language Development • Speech language pathologist (SLP) is often • Brain Gym the first specialist families turn to • Oral-motor issues related to prematurity • Speech-language therapy • Interaction with feeding/eating problems • Applied Behavioral Analysis pp y • Ideally, co-treatment with OT and OD • Social-Emotional therapies – play • Consider missing links to talking • Homeopathy • Help families and SLP understand the role of movement and vision in language • Klinghardt model for autism development treatment • Relationships between receptive, expressive language, reading and writing 4
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