Hans Asperger Selected Children with Asperger’s Syndrome for Euthanasia

Asperger’s Syndrome (AS), like most syndromes or diseases, is named for the person believed to have first identified it as a distinct condition. But these days, the association is making people a little uneasy. That’s because it’s just been revealed that Hans Asperger, the Austrian pediatrician who discovered Asperger’s Syndrome in 1944, cooperated with the Nazis in its eugenics program. Hans Asperger, in other words, was sending children with AS to die, believing these children inferior beings to be stamped out, eradicated, murdered.

Does this render Hans Asperger’s work on AS irrelevant? Of course not. What it does do is take away our awe and wonderment, our respect of the man Hans Asperger was. No longer is he the haloed entity who helped us finally understand Asperger’s Syndrome, the one who gave the syndrome a name. The one who figured things out so we could get on with the act of educating and parenting children with AS; so that we could get on with mainstreaming those with AS into society.

Now Hans Asperger is as good as a murderer of the very children whose syndrome he identified.

Hitler's letter granting permission to engage in euthanasia of “incurably sick patients.”
Hitler’s letter granting permission for the euthanasia of “incurably sick patients.”

Asperger noted what he called “autistic psychopathy” in four little boys, and wrote about it for the first time in 1944. It wasn’t, however, called “Asperger’s Syndrome” until it was referred to as such in 1981, in a paper published by British researcher Lorna Wing. While Wing was the first to call AS after the man believed to have first noted it as a distinct syndrome, Asperger himself was a prolific writer who published more than 300 research papers and books. The majority of Hans Asperger’s publications are on the subject of autism in children.

It has been said that Asperger may well have had AS, which may be why he so ably noted it in others as a specific set of behaviors, separate from other types of autism. Asperger had difficulty making friends. He was an introvert who spoke of himself in the third person and often quoted his own words. Suspicions that Asperger, a high achiever by any standards, had Asperger’s, makes it even more difficult to understand why he favored sending children with AS to their deaths.

The story that only now sends shockwaves through the general public and in particular, parents of children with AS, is that Asperger “not only collaborated with the Nazis but actively contributed to the Nazi eugenics program by referring profoundly disabled children to the Am Spiegelgrund clinic . . . in Vienna. This was a clinic that he knew participated in the Third Reich’s child euthanasia program, where children were killed as part of the Nazi goal of eugenically engineering a genetically ‘pure’ society through ‘racial hygiene’ and the elimination of lives deemed a ‘burden’ and ‘not worthy of life.’ [1]

Propaganda poster extolling Hitler's eugenics program
Propaganda for Nazi Germany’s T-4 Euthanasia Program: “This person suffering from hereditary defects costs the community 60,000 Reichsmark during his lifetime. Fellow German, that is your money, too.” from the Office of Racial Policy’s Neues Volk.

These revelations came to light through meticulous research by Herwig Czech, a medical historian at the Medical University of Vienna. Can we find a way to be understanding about this information, to look kindly upon these new disclosures? Was Asperger, for instance, cooperating with the Nazis to save his own skin?

Not according to the editors who published Czech’s paper. “We are persuaded by Herwig Czech’s important article that Asperger was not just doing his best to survive in intolerable conditions but was also complicit with his Nazi superiors in targeting society’s most vulnerable people.”

Ouch. To say the least.

Czech isn’t the only researcher to have looked at Asperger’s role in the Nazi Hans Asperger with small childeugenics program. A recent book by Edith Sheffer, Asperger’s Children: The origins of autism in Nazi Vienna, makes the compelling case that Asperger was referring children both directly and indirectly to Am Spiegelgrund, where they would be murdered by starvation or lethal injections.

The cause of death was always recorded as “pneumonia.”

Molecular Autism, the medical journal that published Czech’s work, should be commended for its forthright insistence on telling us the truth about the man who changed everything for those with the subset of autism we know as Asperger’s Syndrome. It is important that we have an honest accounting of medical history in regard to AS; a true accounting of medicine gone wrong. It is also historically necessary to document the twisted path taken by psychiatry and medicine as they were practiced during the Holocaust: that men sworn to the good of mankind by way of the Hippocratic Oath, murdered children on the autism spectrum and any others they deemed undesirable or somehow defective.

One more important fact comes out of this work: that Asperger’s syndrome was discovered before Hans Asperger ever wrote about it. The term “autistic psychopathy” may have originated with Hans Asperger. But Georg Frankl and Anni Weiss had already published on the topic.  Because the two researchers were Jews, however, they were expelled from Austria, leaving for the U.S. (where they soon married). It is Frankl and Weiss who deserve the credit for discovering Asperger’s Syndrome, rather than the man who abetted the murder of those who manifest its symptoms.

Asperger has his apologists. People who say he wasn’t as bad as some of his colleagues. Is one Nazi worse than another? Did he have to administer the lethal injection in order to be called a murderer of children unable to fend for themselves?

And what are the implications of this story for the study of medical ethics? For the self-esteem of those with AS, struggling to be part of society?

Reinventing Hans Asperger, Nazi

In truth, Hans Asperger is no different than any other Nazi reinvented in the imagination, the most famous example being Wernher Von Braun. Von Braun, a Nazi, went on to father the American space program. Hans Asperger, a Nazi, fostered our understanding of Asperger’s Syndrome, even as he failed to understand that people with Asperger’s Syndrome have value and deserve to live and breathe. From now on, Hans Asperger will no longer be thought of as the father of all children with Asperger’s Syndrome. Our awe for the man will be gone, replaced by horror.

The legacy of Hans Asperger, it seems, is not one of honor or respect, but a legacy of evil it is impossible to fathom.

A legacy that is forever changed.

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[1] Simon Baron-Cohen, Ami Klin, Steve Silberman, and Joseph D. Buxbaum, Did Hans Asperger actively assist the Nazi euthanasia program?, (Molecular Autism, 2018), https://molecularautism.biomedcentral.com/articles/10.1186/s13229-018-0209-5


Social Difficulties of Autism Improved with Anti-Cancer Drug

Social difficulties may be the painful behavioral symptom we most associate with autism. But what if there were a drug that could correct this symptom and make it easier for people with autism to socialize? It seems that there may indeed be such a drug, according to the newest autism research published March 12, 2008. Researchers at the University of Buffalo found that brief treatment with very small doses of an anti-cancer drug, romidepsin, not only improved social skills in animals with autism, but that the effects lasted long-term.

Until now, it seemed impossible that such a drug could exist, let alone that a single such drug could be enough to make a difference. Now, however, there is evidence that the behavioral symptoms of autism spectrum disorder (ASD), can be improved by targeting groups of genes known to be involved in the disorder. In this study, mice missing the gene known as Shank 3 (the absence of which is a significant risk factor for ASD), were given a three-day, small-dose treatment with the anti-cancer drug, and the effects lasted a full three weeks.

Why is a three-weeks-long reprieve from social deficits (deficiencies) considered a triumph? Well, we’re talking mice here, not humans. In mice, three weeks is a long time, and spans childhood through late adolescence, a crucial time for developing communication and social skills. Three weeks in mice is the equivalent of several years in a human. Which is why the UB researchers believe that the effects of this brief, low-dose treatment may last many years in people with autism.

“We have discovered a small molecule compound that shows a profound and prolonged effect on autism-like social deficits without obvious side effects, while many currently used compounds for treating a variety of psychiatric diseases have failed to exhibit the therapeutic efficacy for this core symptom of autism,” said Zhen Yan, PhD, a professor in the Department of Physiology and Biophysics at the Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo, and senior author for this study.

Shank 3 and Social Deficits

This new research trial actually builds on earlier work dating back to 2015. At that time, researchers found that the missing Shank 3 messes up communication between neurons in the brain by affecting the function of a brain receptor known as NMDA (n-methyl-D-aspartate), a crucial factor in the regulation of cognition and emotion. Without Shank 3, the brain has difficulty understanding social cues. This results in the social skills difficulties that are common to those with autism.

In the latest study, UB scientists discovered that a very low dose of romidepsin could reverse these social deficits by restoring gene expression and function. Romidepsin works through epigenetics, which serve as a sort of on/off switch for genes. Dr. Yan notes that human genetics research suggests that epigenetic impairment plays a big role in autism. A number of genetic mutations seen in autism, explains Yan, are due to chromatin remodeling factors, which change the structure of chromatin, gene material contained in the cell nucleus that condenses into chromosomes.

“The extensive overlap in risk genes for autism and cancer, many of which are chromatin remodeling factors, supports the idea of repurposing epigenetic drugs used in cancer treatment as targeted treatments for autism,” said Yan.

Social Deficits/Missing Genes

The researcher and her team knew that chromatin regulators were crucial to treating the social difficulties of ASD, but the problem was how to target many of them at one time. “Autism involves the loss of so many genes,” explained Yan. “To rescue the social deficits, a compound has to affect a number of genes that are involved in neuronal communication.”

Yan and her colleagues decided to look at histone modifiers, a type of chromatin remodeler that modify proteins called histones. Histones help to organize the genetic material in the nucleus so that gene expression can be regulated. The UB reseachers knew that a histone modifier might be effective in targeting the many genes that are altered in autism.

Loosening Up (Those Social Skills)

The scientists focused on histone deacetylase (HDAC), a class of histone modifiers that play a critical role in remodeling chromatin structure regulating transcription in targeted genes. “In the autism model, HDAC2 is abnormally high, which makes the chromatin in the nucleus very tight, preventing genetic material from accessing the transcriptional machinery it needs to be expressed,” said Yan. “Once HDAC2 is upregulated, it diminishes genes that should not be suppressed, and leads to behavioral changes, such as the autism-like social deficits.”

As the researchers found, however, the anti-cancer drug romidepsin, suppresses HDAC, turning down the volume on the HDAC2, which allowed those genes needed for signaling between the neurons, to do their thing. “The HDAC inhibitor loosens up the densely packed chromatin so that the transcriptional machinery gains access to the promoter area of the genes; thus they can be expressed,” said Yan.

Lo and behold, Yan and team found that romidepsin rescued gene expression across the board, targeting all the risk factors/altered genes at once. In fact, when Yan and her co-authors mapped it all out, they saw that romidepsin restored function in most of the more than 200 genes that are suppressed in the autism animal model used by the researchers.

“The advantage of being able to adjust a set of genes identified as key autism risk factors may explain the strong and long-lasting efficacy of this therapeutic agent for autism.” Yan explained.

How Long A Wait??

The scientist and her research team plan to continue looking into autism treatment drugs. Parents of children with autism, meanwhile, can only wonder how long it will be until romidepsin will be authorized as a safe treatment for human beings. The wait is bound to be long and painful.

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Journal Reference:

  1. Luye Qin, Kaijie Ma, Zi-Jun Wang, Zihua Hu, Emmanuel Matas, Jing Wei, Zhen Yan. Social deficits in Shank3-deficient mouse models of autism are rescued by histone deacetylase (HDAC) inhibitionNature Neuroscience, 2018; DOI: 1038/s41593-018-0110-8

University at Buffalo. (2018, March 12). Autism’s social deficits are reversed by an anti-cancer drug: Using an epigenetic mechanism, romidepsin restored gene expression and alleviated social deficits in animal models of autism. ScienceDaily. Retrieved March 20, 2018 from www.sciencedaily.com/releases/2018/03/180312201647.htm

Sensory Play: It’s Summer!

Sensory play is about playing games that stimulate the senses. Children use their senses to understand the world they live in. Sight, smell, hearing, touch, and taste offer different ways for children to experience their surroundings.

Sensory play is also important for developing the senses themselves. As children use their senses, they learn how to make sense of the various stimuli that come at them from different directions. A child who plays sensory games that involve sense of smell, for instance, will develop his sense of smell. The child will learn that some smells are pleasing (flowers, fruit) while other smells may signal danger (cooking gas). The child will also sharpen his senses so that eventually, he can tell the difference between grape and lemon scents.

That’s just sense of smell, but the same is true of all the senses. If you think of a baby who puts everything in her mouth, you understand this immediately. The child must be given things that are safe to put in the mouth, because at that stage, everything is going to end up in her mouth. You wouldn’t, for instance, put a baby of that age in the sandbox, because she’s going to put sand in her mouth. This is how, at this age, she learns about her environment. She learns, for instance, that some things don’t taste very good!

Using the senses, develops the senses. This is true for all children. Some children, however, have issues with sensory integration. These children may have autism or sensory integration dysfunction disorder. The disorders may make it difficult for children to understand and organize the stimuli that come at them by way of the five senses. Think of how some people can’t stand the sensation of a wool sweater against their skin. Children with sensory integration difficulties may need labels cut out of their clothing, and may only be able to tolerate certain fabrics.

Sensory Play Offers Extra Practice

That’s just a single example of a sensory issue relating to sense of touch. A child may find certain sounds too stimulating and may need to wear earphones to block out the background noise in his environment. For these children, too, sensory play offers extra practice in sorting out the senses.

During the summer, children can lose ground in their learning. This is a good time to offer them sensory play time. Sensory play doesn’t feel like learning. It feels like fun. It is fun.

Meantime, sensory play can help build your child’s vocabulary by adding words like sour, salty, bitter, and sweet. Water can be cold, hot, wet, frozen, blue, still, or move in waves. A tree’s bark may be smooth or rough.

Sensory play can also help your child develop fine motor skills. Playing with sand, clay, or a bowl of noodles can help develop these senses as kids pinch clay, pour sand, or pick up a noodle, for instance. This sort of play readies a child for tasks like writing, tying shoes, zipping zippers, and buttoning buttons.

Sensory Play Helps Calm

Sensory play also has a calming effect on children. This is the reason your child is calmer after a bath, or after hard outdoor play, or jumping on his bed. Working the senses is known to help children cope with the discomfort of fatigue, restlessness or boredom, for instance.

Create An Edible Sensory Experience

Here is a recipe for Edible Sensory Playballs, from Emma and Trish over at the Mud Kitchen. These playballs are awesome because they stimulate all five senses: taste, touch, smell, sight, and hearing. Most of all, kids have a blast learning while they play.

Prepare the playballs a day before you plan to use them, as they need time to set.

You’ll need:

  • Jello in assorted flavors
  • Ice ball molds in two different sizes
  • A large tray or tub
  • Bowls (for half spheres)

Mix jello in separate batches to keep colors and flavors separated, and using slightly less water than called for for a firmer consistency. Pour the jello mixture into ice ball molds and/or bowls.

When jello is set, empty the molds and bowls onto a large tray and let the kids at ’em. They are irresistible. In fact, you’ll want to get in on the fun along with them, and so will all the other adults in your home!

There will be all these awesome fruity smells and colors and textures. Kids will dive right in to smash the balls flat or squish them between their fingers. They’ll want to do a taste-test, too, which is all part of the fun.

Note that jello also makes funny, delightful sounds as you mess with it on the tray.

“I Must Have Cried 1000 Tears”

"I must have cried 1000 tears"
“I must have cried 1000 tears.”

“I must have cried 1000 tears,” wrote Amanda Coley of her two year-old son Jack’s loving interaction with Snow White at Walt Disney World, this past November. Jack, you see, has autism and doesn’t speak words. But his love for a beautiful Disney character comes through loud and clear, happily captured on video by dad Chris Coley.

Jack finds it difficult to warm up to new people and was not at all getting into the swing of things during that family trip. As it would turn out, Jack would receive his diagnosis just two weeks after the family trip to Disney World. The diagnosis likely came as no surprise to Jack’s parents. Amanda and Chris Coley have three sons and Jack is the second of the three to be diagnosed with autism.

If you’ve been to Disneyland or Disney World, you know that these amusement parks-cum-resorts hire actors to play famous Disney characters and to chat up the visitors. Jack’s brother had been trying to get the boy to interact with the other characters the entire trip but each time, Jack would pull away.

Jack wanted no part of that. Until he saw Snow White.

Then it was love at first sight.

I Must Have Cried 1000 Tears

Amanda wrote,

He was having nothing to do with any of the characters on our Disney vacation in November. You see, he has autism and is non-verbal. He is on the shy side with people he does not know. THEN… he met Snow White. I must have cried 1000 tears watching his interaction with her. He was in love.

It’s pretty amazing to see this clip. There is so much eye contact going on between Jack and “Snow White,” though one of the hallmarks of autism is the difficulty in making prolonged eye contact with others. You have to wonder what sort of magic was going on here: what made this Snow White figure so approachable? Why was it so easy for Jack to make eye contact with her, even as he shied away from the other characters.

It’s not difficult to see why this clip went viral with over  500,000 views as of this writing. Something beautiful unfolds here for the viewer, something magical in the magic kingdom of Disney. What it is, we’re not really sure. But it’s clear the clip has not lost its appeal for Jack Coley, who can watch it all day.

It calms him, and he’ll sign to his mom the word for “more” so she’ll play it for him again.

Does this one minute and fourteen seconds of blissful love and peace signify hope for all those on the autism spectrum and their families? It’s impossible to say. But it’s a good bet that Amanda Coley has raised awareness of autism and of the painful journey Jack’s parents have ahead of them in sharing this clip. Amanda’s pronouncement, “I must have cried 1000 tears,” sums it up in a nutshell.

Here’s wishing the Coley family many more moments of joy in the years to come.

Eye Focus, Getting Emotional, and Autism

Eye focus and especially eye contact is, for most people, a way of connecting with people. It shows we like the person we’re speaking with. Breaking eye contact, on the other hand, may show we’re embarrassed, lying, or feeling guilty about something. Most of us know it’s different for people with autism, who may find it difficult to maintain eye contact for long. In fact, for the layman, this is probably the hallmark symptom of autism: the inability to make eye contact.

Some people have the impression that people with autism are unemotional, and that this is the reason for the avoidance of eye contact in those on the spectrum. But the facts, obtained through research, show something else. There is evidence to suggest that on the contrary, people with autism feel things more intensely than others—so intensely that it overloads their senses. This is part of what is known as the Intense World Theory of Autism.

Eye Focus Moves To The Mouth

A new study from the University of Vermont seems to underscore this idea: that the world is overly intense for those with autism spectrum disorders. Researchers used eye-tracking technology along with Skype to track eye focus in children with autism during conversation. The scientists found something surprising: children with autism focus on the speaker’s eyes until the conversation turns emotional. At that point, eye focus switches to the speaker’s mouth.

This is the first time scientists have used eye-tracking technology to monitor eye movement of children with autism during conversation. Lead author of the study, Tiffany Hutchins, was surprised that no one had done this before. “We were amazed that no one had done this yet,” said Hutchins. “We found only two other studies that used eye-tracking to look at social attention during actual conversations with other people, but none with autism.

“Combining Skype with basic eye-tracking technology feels like low-hanging fruit, and it circumvents a lot of the traditional challenges that we’ve had in the field so when that catches on, I think the implications are that you can do a lot with this technology. I think being first is one of our major contributions,” said Hutchins, an assistant professor of communication sciences and disorders in the College of Nursing and Health Sciences at UV.

The study, which was published in Research in Autism Spectrum Disorders, could make a difference in the way speech therapists work with the approximately 1 in 68 children on the spectrum. These children must struggle daily with a variety of communication, behavioral, and social challenges. In the clip below, you can see the speaker asking a child with autism about what types of jobs people do. This is an unemotional sort of question. The child’s eyes focus on the speaker’s eyes.

When discussion switches to talking about emotions, for instance, what makes the child scared or sad, eye focus moves to the speaker’s mouth. “What you talk about really matters for children with ASD, you just change a few words by talking about what people do versus how they feel and you can have a profound impact on where eyes go for information.”

Hutchins’ team also found that this shifting of the eye focus away from the eyes to the mouth was associated with more severe autism, with impairment seen in verbal skills, intellectual ability, and more limited executive function.

Asked why the eyes switch focus during an emotional turn in conversation, Hutchins suggests that experiencing emotion puts a strain on the child’s executive function, which is about the way we organize ourselves for tasks. Talking about emotions or highly emotional subjects may “place high demand on working memory, which, when a threshold is surpassed, makes rendering information from the eye region particularly difficult,” says, Hutchins.

In other words, kids on the spectrum reach a certain threshold in how much emotion they can process before it begins to affect their ability to think clearly. At that point, the child can no longer process the information coming from the speaker’s eyes. The emotion has become too overwhelming. The child has lost the ability to receive any more information from this source. So the eyes switch their focus to the next best source of information, the mouth, where the child may still be able to get some information.

Driving In A Snowstorm

Hutchins says that for kids with autism, talking about emotions is difficult and draining. “It’s like driving in a snowstorm. Normally, when you drive around in good weather on a familiar route, you go on automatic pilot and sometimes don’t even remember how you got somewhere. But for a child with ASD, having a conversation, especially one about emotions, is more like driving in a snowstorm. In that situation, you are totally focused, every move is tense and effortful, and your executive function drains away. In fact, we found that decreased working memory correlated with decreased eye fixations, so as working memory decreases, then we see fewer fixations on the eyes.”

Hutchins points out that one of the reasons children with autism have a difficult time with social skills is due to this eye focus problem. The mouth is giving fewer social cues than the oh-so-expressive eyes. As a result of focusing on a speaker’s mouth, a child with autism may not get enough information about the underlying social meaning in the speaker’s words. This can cause the child with autism to respond inappropriately to a social situation.

But the whole point of this is that the child cannot look at the eyes of the speaker when things get more emotional. Eye focus on the eyes becomes impossible. It’s overwhelming. It messes up the child’s brain processes, makes it difficult to think and function.

“It’s probably a situation where the poor are getting poorer,” Hutchins says. “If I’m asking you to talk about emotions, and that makes you even less likely to look in my eyes when you really need to go there because I’m more likely to be showing other evidence of an emotion like anger with my eyebrows, you are missing even more. It’s not that there’s no emotional information in the mouth, but during dynamic conversational exchanges they are missing a number of cues that a typically developing child would not.”

This wasn’t the largest study in the word with just 19 neurotypical children and 18 children diagnosed with autism spectrum disorder (ASD), ages 6-12. But it does seem as if Hutchins and her co-author, Ashley Brien, a speech pathologist, have hit on something important. The two of them are now thinking about whether speech pathologists should change the way they work with children on the spectrum. For instance, telling a child to stay focused on the pathologist’s eyes may be a mistake.

“Some social skills programs and many treatment goals for children with autism involve trying to get them to initiate and sustain eye-contact during interaction” says Hutchins.

Brien explains that forcing eye contact may actually work against kids with autism. Insisting that the child’s eye focus remain on the eyes of the speech pathologist may be too taxing for the brain systems of kids with ASD, so they can no longer access working memory or executive function, for instance. Demanding they maintain eye contact may be as bad for the progress of these children as anxiety and stress.

Pet Therapy And Your Child

Pet Therapy And Your ChildPet Therapy is type of treatment using trained animals to help people cope with a variety of issues, including illness and mental health issues. Pet therapy sessions are guided by the animal’s handler, who is trained in pet therapy. Another name for pet therapy is Animal Assisted Therapy (AAT).

While it is common to use dogs or cats in animal therapy, other types of animals can also serve as pet therapy animals. Some other animals that are used in pet therapy are guinea pigs, fish, and horses. A child who is allergic to animal fur may be able to work with dolphins. The choice of which animal to use in pet therapy has a lot to do with the child and what sort of help he needs.

Some people confuse pet therapy with Animal Assisted Activities, or AAA. Pet therapy is, like most therapies, an ongoing process that takes place over several structured meetings. The patient works toward specific goals. In AAA, the sessions are more casual and about seeking comfort and enjoyment from spending time with animals.

In other types of therapy, a child may feel self-conscious, since all the focus is on the child. This can be hard on the child and may keep him from getting the full benefit of the therapy. In pet therapy, the focus is more on the animals and the cute or funny things they do. With the focus on the animal instead of the child, self-consciousness is greatly reduced and the child is more relaxed.

Maria Glenn specializes in equine therapy, or therapy with horses, and has been in the field since 2005, working in both the UK and in Spain. Glenn says that pet therapy can achieve results faster than some other types of therapy. That’s because it’s easier for a child to build a rapport with an animal than with an (adult) therapist. That rapport comes from having a shared experience, as the child handles or plays with the animal.

Responsibility And Caring

Pet therapy (AAT) also teaches children to have compassion for other beings. Glenn says this is a great lesson for children who have Asperger’s syndrome, for instance, who may have to work hard to find empathy for others. At Glenn’s pet therapy place, caring for the animals is part of the therapy. This helps teach children about taking responsibility for themselves and for others. Glenn creates a verbal contract with each child to accept responsibility for his or her own behavior and safety. That contract is renewed before each pet therapy session.

AAT can also help children build communication skills, both verbal and nonverbal. A child may give a verbal command to a dog, “Jump!” or a nonverbal command, such as a gentle squeeze of the legs to urge on a horse to go faster. Working with an animal is also excellent at teaching children how to “set boundaries for themselves and learn about personal space,” says Glenn.

What Happens in Pediatric Pet Therapy?

The child’s healthcare provider may manage the therapy sessions or refer the child’s parents to an AAT facility. In each session, the animal handler is there to work with animal and child with the provider as guide to achieve therapy goals, determined in advance. Animal handlers may be volunteers who have received training.

Just as there are many types of animals, so too, there are many different types of pet therapy. In general, pet therapy is based on the bond that can be created between humans and animals. In filial pet therapy, for instance, a child may be taught how to use a clicker to teach a dog to jump through a hula hoop. As the child watches the therapy dog progress, the child’s own sense of self-esteem is increased.

The child sees that he has a positive effect on the dog’s behavior. He feels capable and encouraged. The animal handler praises the child for a job well done, and this reinforces these good feelings of self-worth. The sessions are fun and enjoyable. A bond is created between child and animal.

Benefits of Pet Therapy for Children

Pet therapy (AAT) can offer many benefits to children. Pet therapy may, for instance:

  • Build self-confidence
  • Increase self-esteem as the child learns and performs new skills
  • Improve verbal and nonverbal communication skills
  • Teach boundary-setting skills (what is acceptable and unacceptable)
  • Improve organizational and planning skills
  • Teach compassion and empathy for others
  • Demonstrate how to offer and receive unconditional love
  • Teach children to take responsibility for themselves and others
  • Help a child make a connection that is free of judgment—an animal will not laugh at or bully a child
  • Build trust
  • Hone fine motor skills
  • Improve independent or assisted movement
  • Calm anxiety or make a child feel less lonely
  • Help to develop social skills
  • Increase a child’s willingness to join in activities
  • Improve interactions with others
  • Make the child more willing to exercise
  • Help a child get through medical or dental procedures with less anxiety and fear
  • Teach skills that might be useful at school or in the workplace, for instance how to calculate feed rations
  • Reduce pain, anxiety, fatigue, and depression

What Kind of Pet Therapy?

When considering the many types of animals and types of pet therapies, a parent should consider both the child and the goal of therapy: what is the hoped-for outcome. If your child is afraid of dogs, you might not want to choose canine therapy as a way for your child to cope with the stress and fear of chronic illness, as it will be hard for your child to build rapport with a dog. If, on the other hand, your goal is to get your child over her fear of dogs, canine therapy may be just perfect for her.

Maria Glenn offers a true-life example of this in the form of a set of 6 year-old triplets who were sent to her facility for pet therapy. The triplets were homeschooled and their mother wanted them to work on their social skills. “While they were happy to work with huge horses, when they met my tiny Pomeranian dog, they all jumped up on a table and screamed at full volume until the dog was taken away!

“They might have benefited from canine therapy, but the results would have taken a longer time to achieve than it did with the horses.”

Maria Glenn got into the field of equine therapy as the result of having a son with Asperger’s syndrome. Today she describes working with horses and children as an “absolute passion,” and says that, “Horses can be large and scary, but there is no better animal for helping a child build confidence and self-esteem than when he realizes that this giant 600-pound creature is listening to him and will do his bidding when he asks in an appropriate manner.”

Still, equine therapy is not right for every child and Glenn suggests that parents contact local pet therapy facilities in their area, and explain the desired goals and outcomes. An AAT facility should be able to guide parents to the type of pet therapy that is right for the child. Glenn also says that if things don’t work out with one type of animal or therapy, the parents can always try another type.

Pet  Therapy Eligibility

An animal chosen for pet therapy generally has to meet certain standards. First, the animal will need a physical exam by a veterinarian to make sure the animal has all its vaccinations and is healthy. Then the animal will need obedience training so it can be properly controlled by the handler. The animal’s handler must also take lessons in how to interact with patients.

At this point, the animal is evaluated according to its temperament and how it behaves with its handler. Finally, the animal and handler team receives certification.

Many factors come into choosing the animal and handler team for a pet therapy patient. The type of animal, its size, age, behavior, and breed, are all important considerations in figuring out the right team for each child patient. But when all is said and done, pet therapy, properly planned and administered, can bring positive outcomes not just for the child, but for the entire family. In fact, according to the Mayo Clinic, family members who look on during a session of pet therapy tend to feel better, too!

Has your child used pet therapy (AAT) to cope with medical procedures or to improve skills? We’d like to know about it. Write to Varda at Kars4Kids dot org with your child’s pet therapy success story.

Lynette’s Law: Teaching Kids to Be Effective and Kind

Lynette's Law: Teaching Kids to be Effective and KindI have a general rule of thumb that I call Lynette’s Law. It is basically a rule of engagement. I call it “Four Compliments To (every) One Correction!” It teaches you how to be an effective person who is kind.

People like rules, instruction manuals, and systems, so teaching people how to be kinder requires rules just like everything else. Unfortunately, kindness rules are a type of interaction oxymoron because being kind means forgetting the rules, actually throwing out the rulebook and instead taking a good hard look at another person’s actual needs and wants. There IS no law that covers this.

So how can I have a kindness law?

The question is a valid one and initially presents quite a conundrum. After all, rules stand between us and our free will: our ability to go beyond the rules to think with our hearts. This is especially true when rules are followed blindly. That’s why being kind means opening your eyes and thinking about the rules, considering each one and how it applies to your situation.

Rules, you see, are meant to be bent, not so much broken. Shape the rule to fit your circumstance and your family’s circumstance, or the rule will shape you, your family, and your circumstance.

In other words, if you are unwilling to bend the rule the rule will bend you.

When used as a gift that inspires analysis and sophisticated thinking, rules improve your free will rather than impede it. They facilitate cooperative ease and keep the drivers on the appropriate side of the road. Thus, a little rule-based living is needed if we want to build a successful system, even if that system is a system of humans being kind to one another.

So yes, adding rules to guide you in learning how to be an effective person who is kind is a dilemma, but not an unsolvable one. You only need a few rules of engagement to get the job done. You need safety rules, like look both ways before you cross, especially in a foreign country where they may drive on the other side of the street.

Lynette’s Law: Four Compliments to One Correction

Manners, too, on occasion are required, like allowing the lady who looks nine month’s pregnant step ahead of you in the checkout line. And finally, you need Lynette’s Four Compliments to One Correction Law. Insert Lynette’s Law into almost any interaction and you will be an effective teacher, parent, lover, and/or boss, who is kind.

I have read a lot of theories about compliments adding too much responsibility to the person being complimented—theories that imply a good compliment builds fear and resistance. These theories have some basis in reality but are drawn from a misunderstanding of compliments and corrections.

Corrections are simply adjustments, like driving your car and constantly nudging the steering wheel enough to stay between the lines. If the wheel alignment is sound, your car will follow a straight line for ages without needing a correction, but most roads wind and most cars veer a bit, so too here, correcting is a simple adjustment of trajectory. No judgment, no failing. The compliment is a reinforcement of the thing that is going well. Appreciating what comes easy to your child never results in resistance. For example, if a child is learning to walk but loves standing, compliment the standing. Shore her up and make her strong before she ventures forth.Lynette's Law: Compliment the Standing

So, if you have been told not to compliment your child, student, friend, employee, because he or she will grow resistant, you have been misled. There is no such thing as becoming overconfident, though becoming mistakenly confident is a problem. When you offer the wrong compliments, resistance can develop. Specificity solves both issues, avoiding both mistaken confidence and the development of resistance.

For example, let us say I want a child to sit calmly in his chair when in a restaurant. Start by catching him sitting this way and noticing it.

Lynette’s Law: A Correction Surrounded By Compliments

Let’s imagine that, for a minute. You find your child resting on the doorstep, catching his breath for a minute, exhausted from running barefoot. Match his state by sitting down with him. This makes you an ally, a friend; and not a bossy complimenter of sitting, who models the idea that sitting quietly in a restaurant, sucks.

1) Mention how nice it feels to be together in this way andRunning Barefoot

2) How much you enjoy it when he sits with you.

3) Suggest a time in the future when, just like this, you will be happily visiting in a restaurant and everyone will think he is 12 instead of 8. Mention that if he is has dirty bare feet in the restaurant they won’t let him in because they worry about germs and injuries.

4) Then say thanks for the moment, and drop it.

Those were your four compliments (anything positive is a compliment) and your correction (any adjustment to the present behavior).

Later you can suggest he wear shoes to get used to feeling grownup.

Lynette’s Law: Catch Him Being Good

Let’s say that a couple of days later, he’s sitting calmly in a chair eating breakfast. You catch him being good and point it out.

1) Explain how nice it is since his cloths stay clean and he doesn’t have to stress about being messy at school. (Compliments are about what matters to the other person not solely about what matters to us.)

2) Add an extra treat for breakfast and point out that the idea for the treat came to you because his calmness gave you space to think.

3) Thank him for this blessing.

4) Smile and give a thumbs up.

Now show how the cutlery would be used in a restaurant, explaining how using it correctly will signal the waitress when he’s done with his meal. Corrections are about offering information that empowers a person, and not about bringing that person down to size.

So to be clear: Catch children behaving well, explain what’s cool about it and why you love seeing them do it. Add a benefit (real or imagined).Then make the correction matter to their own self-visions, like noticing a daughter’s posture and mentioning how it matches her goal of becoming a fashion model. Extend gratitude for the connection.

Remember that the correction is not about what is bad, or even what they are doing wrong, so much as what is counterproductive to their goals.

While doing this you become a person who smiles, compliments and shares wisdom applicable to your audience, the child. You become happier. It helps you like you. It helps them like you. All because you began by liking them.

As it turns out, all good parenting is primarily self-serving.

Lynette’s Law Equals Happy Parents

This is true of bad parenting too. The difference lies in understanding the methods and the goals.

The goal should always be a happy parent, boss or teacher raising a happy student, child or employee. We are all capable of having this. Unfortunately most of us have been misinformed to believe that unhappiness leads to happiness; that hard work, boundaries, discipline and self-sacrifice lead to happiness. The truth is happiness comes first, and when you’re happy hard work becomes fun work.

Don’t buy into warnings of future danger such as, “If you pay your employees well, they’ll become greedy.”

Generosity breeds generosity. Good breeds good. The end.

Any proof you have to the contrary is a mistaken observation: a mistake that will confuse and disorient you.

When you are happy you think clearly. Remember the child you complimented for standing? We got her standing stronger instead of running in the road. She grew up stable, not wild. If you are parenting like this you are focusing yourself and your people in the present while simultaneously knowing the future skill you mean to build.

But wait, what if your children are special needs? Same deal. Different lessons more steps. More often. Same Lynette’s Law.

I know. I raised six adopted special kiddos.

That is—in part—how I created Lynette’s Law: through parenting the special child. The only difference between my special children and my neurotypical children was that I had to be minutely specific with my compliments and corrections.

And add a little Neurofeedback

To be honest, while I was struggling to teach my special children, I learned that the optimal speed of change in regard to learning happens when people receive feedback on a 4:1 ratio. I read about it in a study (now nowhere to be found!) during a neuroanatomy class.

That study inspired me.

I applied it to behavioral teaching, to loving, and then also to neurofeedback.

Neurofeedback is biofeedback for the brain and it gives its compliments (or Yeses) objectively, no judgment. It allows me to teach the brain before the brain resists the compliment. Then once the brain is feeling cooperative I use real compliments to shape the results. This combo is magical.

Infinite Upward Spiral

It has made everything easier, teaching, parenting, learning, everything, especially my mood. And a happier mood makes me better at parenting, teaching, learning—the infinite upward spiral.

I chose neurofeedback because it worked for every different brain in my differently brained house. It also worked on every different brain around the world. I now travel Abroad and call myself The Brain Broad! Because when you find something this useful, you just want to share it.

Useful breeds useful.

I also chose to focus on neurofeedback because I could have neurofeedback at home. It was handy. Once I knew how to make it work, making it work was always achievable. Neurofeedback became a must-have ingredient for me with my brood.

I think everyone needs to find their own therapy, the kind that fits their thinking and their lifestyle. Some people choose diet, while others may choose vitamins, hyperbaric oxygen, meditation, or chiropractic to name just a few. The important thing is to investigate and choose what type of therapy matches you and yours, with the intention of staying out of the pharmaceutical companies’ pockets and staying in charge of your own health.

For me, and all the people I help, that answer comes in the form of neurofeedback in the home.

Working with the brain has taught me about the brain. Understanding the brain makes me better at knowing if a theory presented to me by any type of expert makes sense for my family. For me, neurofeedback makes sense because it matches my desire to grow more blissful, yet also more powerful, two goals that appear incongruent but really aren’t.

Lynette’s Law: All About The Right Ratio

Neurofeedback helped me design and implement Lynette’s Law. It was congruent in my home by combining corrections and compliments in just the right ratio of 4:1. And because neurofeedback matches my wishes and my style, it didn’t set up a new stressor by adding something counterproductive.

You see, the brain targets things, brings them into your focus, depending on your mood. If you are unhappy it shows you problems, and if you are happy it shows you solutions. So be happy. And define yourself.

What is it to be a parent, a teacher, an employer?

It is to be someone who leads the way.

Don’t confuse being a leader with being a tyrant which means to push and force and not care if your people want to follow (or not).

Problems Are the Fuel of Life

True, change requires building a desire for change and then removing obstacles by correcting problems. Understand, though, that problems are not a problem, they are the fuel of life. Problems are part of the equation for learning as long as we don’t add judgment.

Be congruent, complimentary and seek to know about your brain and body. Thus new ideas and solutions will be easier to come by when new problems and hurdles land in your path and that of your children.

Happy complimenting 🙂

Melatonin for Kids: Is it Safe

Melatonin for Kids: Is it Safe?Melatonin is a hormone that helps us know when to sleep and when to be awake. At night, our brains make and release more melatonin and this makes us sleepy. When the sun comes up, the brain slows its production and release of melatonin, so we feel wide awake.

It is light and darkness that tell the brain when to make and release melatonin. The brain produces and releases more melatonin at night in response to darkness, and less of it in the morning, when the sun is high in the sky. As long as there is sunlight or another source of light, such as a computer screen, we feel wakeful. When we stop looking at our computer screens and the sun sets for the day, we begin to get sleepy as our levels of melatonin gradually rise. This is how melatonin teaches us to be sleepy at night and awake during the day. This is called the sleep-wake cycle.

Some children have difficulties in falling asleep. Their parents, looking for a way to help them get the sleep they need, may  think about giving children melatonin pills. After all, melatonin can be found in every drugstore, in some health food stores, and in many supermarkets. You don’t need a prescription to buy melatonin.

Melatonin is thought of as a natural supplement. Since the body produces melatonin, we may see this hormone as both natural and safe. We also know that melatonin plays a role in helping us sleep and that without this hormone, we would toss and turn.

While some parents praise melatonin to the skies as a safe and natural sleep aid, other parents may express concern. Is it really safe to give children melatonin to help them sleep? Isn’t melatonin, used as a sleep aid, just a kind of sleeping pill?

Some parents find melatonin effective in helping their children sleep and continue to use it long term. They feel it is safe to do so, since melatonin is a natural substance created by the body. They see the supplements as giving natural melatonin production a boost.

Melatonin: Sleep Vitamin?

Parents may not even consult their physicians before giving their children melatonin. They reason that it would not be so easy to buy melatonin, if it was a true drug. These parents see melatonin as a sort of vitamin for sleep.

Children given melatonin may have sleep problems that are behavioral. That means that parents may not be strict enough in making kids go to sleep at a certain hour every night. It may be that the children are spending time at the computer, too close to bedtime, so that their brains don’t have time to make and release melatonin before bed. It seems obvious that instead of popping melatonin pills, it would be better to stop looking at a computer screen an hour or so before bed. That way, the body can work as it should.

Other children may have conditions that make it difficult for them to fall asleep at night. ADHD, for instance, can make it difficult for children to wind down and fall asleep at night. It’s even more difficult for kids to fall asleep at night if they are taking medication for ADHD, such as Ritalin, during the day. Autism is also a condition which can make it difficult for children to fall asleep at night. When children have true conditions that make it difficult to fall asleep and stay asleep throughout the night, here is a true reason to look into taking melatonin supplements.

But here too, parents can run into difficulties. Melatonin is not a sleeping pill. It needs to be taken at least an hour before bed. And melatonin is a hormone. Parents should consider whether they want their children taking a hormone supplement on a regular basis, long-term.

Sleep experts at the University of Adelaide, in Australia, are warning parents that melatonin, given to children as sleep aids, may cause serious side effects that show up later. No one knows for certain what melatonin, used for a long time during childhood, will do to the body. There have been no long-term studies.

The author of the Australian study, Professor David Kennaway says that the United States is the only place where melatonin is not regulated. Kennaway talks about lab studies showing all sorts of changes to body systems as a result of taking melatonin. He mentions changes to cardiovascular, immune, and metabolic systems and also says that melatonin affects reproduction in animals.

“Melatonin is also a registered veterinary drug which is used for changing the seasonal patterns of sheep and goats, so they are more productive for industry. If doctors told parents that information before prescribing the drug to their children, I’m sure most would think twice about giving it to their child,” Professor Kennaway says.

“The word ‘safe’ is used very freely and loosely with this drug, but there have been no rigorous, long-term safety studies of the use of melatonin to treat sleep disorders in children and adolescents,” says Professor Kennaway. “There is also the potential for melatonin to interact with other drugs commonly prescribed for children, but it’s difficult to know without clinical trials assessing its safety.”

Kennaway should know. He’s been researching melatonin for 40 years. His concerns, however, are going unnoticed and ignored. “Considering the small advances melatonin provides to the timing of sleep, and considering what we know about how melatonin works in the body, it is not worth the risk to child and adolescent safety,” says Kennaway, but his words are mostly falling on deaf ears.

Canadian physicians, such as Dr. Shelly Weiss, are also cautious about the use of melatonin for sleep problems in children. “Melatonin is not a magic pill. It’s a hormone,” says Weiss.

Still, for children with chronic sleep onset insomnia, which is the failure to fall asleep within 30 minutes after laying down, melatonin can be a godsend. Chronic insomnia is no joke. Lack of sleep can lead to depression, learning difficulties, and poor school performance. If melatonin can help such children, for whom sleep never comes easy, then it is important to consider melatonin as an available option.

How many children suffer from chronic insomnia? Experts believe that some 15%-25% of all children and adolescents find it hard to sleep on a regular basis. Melatonin does work for most of them and with few side effects. But again, there are no long-term studies to prove that melatonin is safe for children.

One National Institutes of Health (NIH) study followed children with ADHD taking melatonin regularly for almost 4 years and  found no terrible long term side effects or issues. Not nearly long enough to be called a long-term study. And even the NIH recommends against melatonin pills for children because they might be unsafe, and because as a hormone, melatonin could affect a child’s development.

The bottom line is that melatonin should not be thought of as some sort of vitamin pill that makes the body work better. If your child is having sleep problems, you shouldn’t be turning to melatonin first. And certainly not without consulting your child’s doctor.

Helpful Sleep Tips

If your child has trouble falling asleep at night, here are some helpful steps to try:

Put Sleep First
If your child is busy with lots of after school activities, this may be the reason he is not getting enough sleep. And sleep isn’t something he can make up in his spare time. Children need a consistent amount of sleep every night. Does your child go to extracurricular classes and then come home to do his homework until quite late? If so, he may end up going to sleep too late to get enough rest. The solution? Cut out those after school activities. Sleep has to come first.

Stick to the Plan

Children should have a regular bedtime and stick to it every night. This helps regulate your child’s sleep-wake cycle: his body clock. Give your child an hour to wind down and do the things that help make him ready for sleep: bath, book, soft lights, and finally, lights out.

No Screens in the Bedroom

Anything that has a bright screen, such as an iPad or tablet, a cell phone, or a television, should be thought of as light sources that keep your child’s brain from making and releasing melatonin.  A no screens in the bedroom rule is a good one.

No Screens Before Bed

Your child’s brain will make and release melatonin to help him get sleepy, as long as he’s not looking at a screen. So put a limit on using electronics. Make a no screens from at least an hour before bedtime rule. Give your child’s body a chance to make its own melatonin. That is how things are supposed to work.

Get a Checkup

If these measures don’t help your child fall asleep at night, talk to the doctor. Your child may benefit from seeing a sleep specialist. The specialist may use cognitive behavioral therapy to help your child sleep. And he may end up suggesting melatonin. If so, the expert will tell you how to use it, and will monitor your child’s progress.
Have you used melatonin to help your child sleep? Does it work?  Do you have any concerns about your child using melatonin?

Childhood Apraxia Of Speech, Autism, Or Both?

Childhood apraxia of speech (CAS) is a motor speech disorder which makes it difficult for children to speak sounds, syllables, and words. The difficulty has nothing to do with weak muscles or paralysis. Instead, in childhood apraxia of speech, the brain has a problem with planning out how to move the body parts used for speech, such as the mouth, jaw, tongue, and lips. The child knows what sounds or words  s/he wants to say, but his or her brain can’t figure out how to make all the face parts work together to make the sounds come out.

Signs Of Childhood Apraxia Of Speech

The brain is a complicated place. That means that not every child with childhood apraxia of speech will have the same signs and symptoms. The brain of each child with CAS will have different strengths and weaknesses in planning out sounds and words. One child may have no trouble using her tongue for speech, but her brain may not be able to make her jaw work in tandem with her tongue, for instance.

For this reason, that every child’s brain is different, the signs and symptoms of childhood apraxia of speech will differ from case to case. That is why any child suspected of having CAS must be evaluated by a speech-language pathologist (SLP) who has experience with childhood apraxia of speech. An SLP with experience in CAS will be able to figure out if the child’s problem with speech is childhood apraxia of speech or one of the many other difficulties that can cause speech problems. Knowing the cause of the speech difficulty  goes a long way toward getting your child help.

Here are some general signs you might notice in childhood apraxia of speech:

Childhood Apraxia Of Speech: The Very Young Child

  • Doesn’t coo or babble as a baby
  • First words are late, and may be missing sounds
  • Can only make a few different consonant and vowel sounds
  • Has trouble putting sounds together; there may be long pauses between the sounds
  • Tries to simplify words by switching hard-to-say sounds with easier ones, or by leaving out the trickier sounds (all children do this, but children with childhood apraxia of speech do this more often)
  • May have problems with eating

Childhood Apraxia Of Speech: The Older Child

  • Makes mistakes with speech sounds, but not always the same sounds, and not the sort of speech mistakes young children tend to make
  • Understands what people are saying, better than he can speak
  • Finds it hard to imitate speech, but this is easier than just speaking
  • Looks like he finds it hard to make his lips, tongue, and jaw work together when trying to make sounds or speech
  • Long words and sentences are more difficult, so he may choose shorter words and phrases, instead
  • When he’s anxious, it’s even more difficult to make sounds and words
  • He’s hard to understand, especially when the listener is someone he’s never met before
  • His speech sounds different—he sounds choppy, or his voice doesn’t go up and down, or he may stress the wrong syllables or words

Childhood Apraxia Of Speech:  Other Problems

  • Delayed language development
  • May forget words or put words in the wrong order
  • May have trouble with fine motor movement (coordination)
  • May be oversensitive or under-sensitive in their mouths, for instance, may find brushing his   teeth unpleasant, may not like eating crunchy foods like popcorn, or he may not be able to tell what an object is, when placed in the mouth
  • Children with childhood apraxia of speech may have it hard learning to read, write, and spell

Childhood Apraxia Of Speech: Diagnosis

The first step in diagnosing childhood apraxia of speech or any other speech difficulty is to have your child’s hearing tested by an audiologist. You may need to have your child seen by an ear, nose, and throat specialist, first. You want to make sure that your child doesn’t have a hearing loss, which could make it hard for your child to hear how sounds are supposed to be made. If he can’t hear sounds, he would have trouble speaking. So first check his hearing.

Assuming your child’s hearing is fine, the next step in diagnosing speech difficulties is to have your child evaluated by a certified speech language pathologist. Make sure that the SLP has experience in evaluating children with childhood apraxia of speech. During the evaluation, your child’s oral-motor skills will be tested, along with his melody of speech and his speech sound development. The SLP should be able to diagnose CAS and at the same time, rule out other speech difficulties. Sometimes, however, it’s difficult for the SLP to get a large enough sample of speech from a child to confirm the diagnosis for sure.

Assessing Oral-Motor Skills in CAS:

  • The  SLP will check your child for dysarthria: signs of poor muscle tone or weakness of the lips, tongue, and jaw. Children with childhood apraxia of speech often don’t have muscle weaknesses. This is more about ruling out CAS.
  • The SLP will look to see if the child can coordinate the parts of the mouth when not making sounds. For instance, your child may be asked to smile, frown, or pucker up his lips.
  • The SLP will look at how your child uses his mouth parts, for instance, the order in which the parts of the mouth are used to make a specific sound. Your child may be asked to repeat a long list of sounds as fast as he can, for instance kih, pih, fih, tsih.
  • The SLP will watch to see how your child uses his mouth in real situations and pretend situations. For instance, he may be given a lollypop to lick, and then later be asked to pretend to lick a lollypop. This is the SLP’s way of checking how well your child does when performing tasks by rote or imitation.

Assessing Melody Of Speech (Intonation) In CAS:

  • The SLP listens to the child speaking to see if she knows when to stress syllables and words within sentences.
  • The SLP evaluates whether the child understands how to use pitch and pauses to show the type of sentence, for instance a question versus a statement; and to show the different parts of sentences, for instance to pause after a phrase and not in the middle of a phrase.

Assessing Speech Sound (Sounds In Words) In CAS

  • The SLP listens to how your child says vowels and consonant sounds
  • Your child will be assessed for how he says individual sounds (syllables) and how well he puts certain sounds together (word shapes)
  • The SLP looks to see how well others understand what your child is saying when he speaks words, phrases, or carries on a conversation
  • Some SLP will look to see if the child has problems understanding and expressing himself in words, and how well he writes and understands the written word in order to check for coexisting problems or to rule them out

Childhood Apraxia Of Speech: Treatment

Research finds that children with CAS do better when they have many sessions of treatment a week, for instance 3-5 times a week. It is better for children to have individual treatment rather than be treated in groups. But after there’s some improvement, children with childhood apraxia of speech may not need so many treatments per week, and group therapy sessions may be useful or even preferred to individual treatments.

In treating childhood apraxia of speech, the therapist aims to improve the planning, ordering, and in tandem movement of the muscles used in making sounds and speech. There is no need to work to strengthen the muscles used in sound, as CAS has nothing to do with oral muscle weakness. Childhood apraxia of speech is all about coordination.

The most important thing for improving speech in a child with childhood apraxia of speech is to practice, practice, practice. But it can help to use the different senses to make such practice have more of an impact. A child with CAS might, for instance, watch herself in the mirror as she practices making sounds, to add a visual cue. Or, the child can listen to a recording of someone saying the word the correct way, with pauses for the child to repeat what she hears. This would add an auditory cue, something the child can hear. She can even tap herself on the jaw when that part of the jaw is used to form a word, to add  the sense of touch. Using all the senses is called a multisensory approach and helps makes lessons stick.

Some children with childhood apraxia of speech are taught sign language or may use a device such as an iPad to help them communicate. This can be helpful in the case where the apraxia makes it very hard for the child to speak. Once the treatments begin to help, the child can phase out the use of sign language and devices, but they can really help lower the child’s level of frustration in certain cases.

In addition to treatment sessions, children with childhood apraxia of speech will need to practice speaking at home. The therapist will give homework to the family, at times, designed to help the child get better at speaking in real situations.

Families must be very patient since treating childhood apraxia of speech may take a long time to yield results. It takes lots of time and a commitment by the whole family to help the child with CAS progress. Children with childhood apraxia of speech need to feel they have the full support of their families.

Childhood Apraxia Of Speech: Helpful Organizations

Here are some organizations that can be helpful to children with childhood apraxia of speech and their families:

Childhood Apraxia Of Speech:  Causes

Most of the time, we don’t know why a child develops childhood apraxia of speech. Some of the known causes of this motor speech disorder are:

  • Genetic disorders or syndromes
  • Stroke or brain injury

Sometimes, experts refer to childhood apraxia of speech as “developmental apraxia.” This term can lead parents to think that CAS is something a child can outgrow, which is not the case. Some children with developmental speech disorders outgrow them.  But CAS is not outgrown and there is no cure.  Children with childhood apraxia of speech can, however, make great progress with  lots of hard work and support. Getting a diagnosis as early as possible, and getting the right kind of treatment, is really important.

Childhood Apraxia Of Speech: Is It Common?

Actually, there’s not a lot of data on the topic, so we just don’t know how many children have childhood apraxia of speech. It does seem like more children than ever are being diagnosed with CAS. But that may be because we’re getting better at spotting  speech difficulties and diagnosing them.

Research shows, on the other hand, that a full seventy-five percent of cases of childhood apraxia of speech are misdiagnosed. And then you have the cases of CAS that get confused with autism. Finally, as it turns out, sixty-four percent of children diagnosed with autism, turn out to have childhood apraxia of speech in addition to autism. This is why it is so important to get an expert evaluation of your child by different specialists, as soon as you possibly can. And if you’re not satisfied with your child’s progress, consider having her evaluated by another expert in the field.

It’s hard watching a child struggle with childhood apraxia of speech, but your love and support will serve her well!

Immunization Debate: Do You Say Yes to Vaccines?

Immunization Awareness Month: Do You Say Yes to Vaccines?
(credit: ChameleonsEye / Shutterstock.com)

Immunization Awareness Month is upon us which means we wake up the sleeping beast: the debate for and against vaccination. There’s a lot of hot feeling on either side of the debate which is only natural. These are our children we’re talking about and their lives are in our hands. As parents, it’s our duty to protect them.

But just try and read through all the medical mumbo jumbo on the web. Most parents are not doctors. We just want to understand what it is we need to know about immunization to make the right decision, for or against.

And then of course there’s the problem of whose “facts” to believe. How can you, as a parent without medical training, know which facts about immunization are true? Is the decision to vaccinate your child going to come down to a crapshoot, or perhaps, a leap of faith (to one side or the other)?

Let’s take a look at the facts, and the pros and cons of immunization, dumbed down:

Fact: Immunization Recommended/Not A Law

The Centers for Disease Control (CDC) says children up to age six should be getting 28 doses of 10 vaccines. But that’s only a recommendation. There is no federal law that says children must be vaccinated. In other words, the medical establishment says you should vaccinate your child, but you won’t go to jail if you don’t.

Fact: Immunization A Must For Public School Kids With Few Exceptions

All 50 states require some vaccinations for children going to public school. Almost every state offers exemptions on the grounds of medical or religious issues while some state allow exemptions for philosophical reasons. In other words, if your religion forbids vaccination or your child has a medical problem which means he can’t be vaccinated, you can get out of vaccinating your child. If you are against immunization for other reasons, you may be able to get out of vaccinating your child, depending on where you live. You can check what laws apply in your state HERE.

Pro: Immunization Is Safe/Reactions Rare

Bad reactions to vaccines are very rare. Experts don’t have an exact statistic, but agree that the odds are very small of having a severe allergic reaction (anaphylaxis) to a vaccine. Some say the number is one severe allergic reaction per every several hundred thousand vaccinations, while other experts say the chance of a bad reaction is one in one million vaccinations.

Con: Immunization Is Risky/Dangerous

Some kids do actually die as a result of getting vaccinated. While reactions to vaccines are rare, they do happen to an unfortunate few. Bad reactions to vaccines include seizures, paralysis, and even death.

Pro: Immunization Prevents Illness, Saves Lives

Those in favor of immunization say that vaccination is the greatest medical advancement of our time. Thanks to vaccination, smallpox, polio, diphtheria, rubella (German measles), and whooping cough have been wiped out, at least for now. These are diseases that have killed children in the past. Pro-immunization medical experts estimate that vaccines have saved millions of children’s lives.

Con: Immunization Unnecessary/Risk Not Worth Taking

Those against immunization say that a child’s immune system can fight against most diseases without any help from vaccines. They say that putting the substances of a vaccine into a child’s body can not only cause serious side effects but may be the trigger for a lot of the health problems and learning disabilities we see in children today, such as autism, diabetes, and ADHD.

Pro: Link Between Immunization And Autism Not Proven

Andrew Wakefield had a study published in 1998 in the Lancet, an important medical journal. The study showed a link between the Measles Mumps Rubella (MMR) vaccine and autism. As a result of the study, many parents stopped vaccinating their children. They feared their children would develop autism as the result of immunization.

Wakefield’s study was small. There were only 12 children studied. Eight of them supposedly developed symptoms of what Wakefield called “regressive autism” within days of receiving the shot. The problem was that no one could replicate Wakefield’s results, though they tried again and again.

The results of a study are accepted only after others repeat the study and gets the same results. That just didn’t happen with Wakefield’s study. By 2004, people were getting suspicious and a reporter began investigating. Finally, Wakefield was called before a review board and in 2010, was exposed as a complete fraud. The Lancet withdrew the paper saying their experts been deceived, and Wakefield lost his medical license.

Even though Wakefield was proven a fraud, parents continue to claim their children developed autism as a result of immunization. Other parents may not have heard that Wakefield was a phony. They continue to believe that the MMR vaccine causes autism. You will see plenty of web pages that continue to insist there is a link between autism and the MMR shot.

The Wakefield study is believed to be the reason for the Disneyland measles outbreak in California. Parents stopped vaccinating their kids after Wakefield’s study was published. They were scared  their children would develop autism.

While most parents in American vaccinated their children (at least until the Wakefield report), parents in poorer countries may not have had good medical care for their children. Children in those countries may be vulnerable to diseases like the measles, because they were not immunized. If a child with measles should come to visit Disneyland in America, and spends time with children who were not vaccinated, those children can get and spread the measles.

Some parents who stopped vaccinating their children because of the Wakefield report thought their children were safe from the measles, because vaccination had for the most part wiped out the disease in America. They thought: “Why vaccinate our children when there is no measles in America? Why risk autism or worse, when the disease has been mostly wiped out?”

The problem is, so many parents had this thought, that many American children ended up getting the measles as a result of contact with a tourist at Disneyland. The Disneyland outbreak brought more hot debate about immunization, both for and against. The media scrambled to cover it all.

One media story did a lot to explain how immunization works. The father of six year-old boy, Rhett Krawitt, asked school officials not to let kids come to school who were not vaccinated because of their families’ religious or personal beliefs. Rhett is getting over leukemia and it would be dangerous for him to get the measles vaccine. His system is too weak and the vaccine could make him actually get the measles. Because he is so weak, measles could be especially dangerous to him and might even kill him.

Since Rhett cannot be immunized, his parents feel it is dangerous for him to be around healthy children who have not been vaccinated. They fear that with the all the measles outbreaks, Rhett could be exposed to the measles from these children. It seems unfair to them that their child has to stay home from school because of parents who refuse to vaccinate their healthy children.

There are many other issues around the immunization debate. For instance, some people say that vaccines are unethical because some of the ingredients of the vaccines are animal byproducts, while other ingredients may cause cancer. Part of the debate on immunization has to do with government: should the government force people to get vaccinated or would that take away peoples’ basic freedoms.

A good website for reading more about the pros and cons of vaccination is the webpage on vaccination at ProCon.org.