Change: Notice it; Adapt to it Anticipate; and Go With It!

Everything changes: winter to spring, summer to fall, youth to adolescence, health to illness. We expect, accept and adapt naturally to the irreversible cycles of the seasons and to aging. Changes from health to illness and illness to health are not so predictable and irreversible. We can benefit from fine tuning our responses to these changes.How people deal with change is the basis for a profound, new, little book, Who Moved My Cheese?, given to me by my dear friend Diana Henry, OTR. Cheese, a metaphor for what we want in life, is elusive. As I read the book, I saw how its wisdom can help us attain our “cheese” — good health and function for our kids.

CHANGE HAPPENS: NOTICE IT

Health changes appear first in those subtle differences in skin, digestion and behavior. Do those little bumps persist? Is elimination less regular? Are sleep patterns disturbed?  In many children these early warning signs are precursors of later developmental delays, including PDD, ADD and autism.

How many of us would love to rewind the clock and return to that first year of life when our babies had eczema, thrush, reflux, colic or croup? Instead of using palliative creams, laxatives or antibiotics, we might have searched for possible causes and responded differently. Could we have prevented yeast infections and asthma?  If health means balance in the body¹s systems, sickness is an imbalance or disharmony among those systems, manifested by bumps, diarrhea and fitful sleep. Let’s inform new mothers about alternatives that could help avoid later developmental, speech/language and learning delays in their children.

THE BODY ADAPTS

Survival depends upon an organism’s capacity to maintain balance or equilibrium. When eczema disappears with the use of a cream, the unaddressed imbalance that caused it goes deeper into the body and effects inner organs. Thrush, a mild fungal infection in the mouth, can become a systemic yeast infection. A case of mild reflux is often followed by chronic constipation or diarrhea; croup, which is mild, by chronic, incapacitating asthma.

…AND SO DO WE

Change occurs not only with our kids.  Without other options, well-intentioned families and schools accommodate children’s out-of-balance behavior. They modify the home and school environment, providing structure, support, special education services and therapies of all kinds. In the meantime our children are getting sicker. The disequilibrium is still there, we’re just handling it better.

What if the parents had also changed their children’s diets by removing dairy and wheat products and started them on vitamins, essential fatty acids and other supplements? These important actions could be steps on the road back to balance.

CHANGE YOUR PHILOSOPHY, CHANGE YOUR LIFE

Changing one’s philosophy about sickness and health can be life-changing. If you believe that a child’s diagnosis is permanent, then you will adapt and adapt, not look for recovery. If, however, you change that philosophy, then you have hope.

“Get over it,” says Karyn Seroussi to those complaining about how hard the GF/CF diet is.  She did, and look at the miraculous results. I know of another entire family that, inspired by her book, did the diet to support their child with autism. Not only did he improve, but so did his brother with asthma and his mother with endometriosis!

WE MUST RE-ADAPT AS CHILDREN CHANGE FOR THE BETTER

Sometimes we forget how much we’ve adapted the environment and our behavior. Then what needs to happen when our children improve? Yes, we must change again! This realization became very clear to me last week, when I evaluated a child with significant oral motor needs. His occupational therapist had provided him with a “chewy” to help him stay organized during the testing. He entered the room gnawing on it with great relish. As the testing progressed, he became increasingly focused and the chewy fell out of his mouth. He was so rapt in attention that he didn¹t even notice. His mother panicked, however, and admonished him to put it back in. The truth was that he didn’t need it. His chewy was a means to an end. It had done its job, and for a few precious moments, this little boy was focused!

Think about some of the changes for the worse you have observed in your children. Reflect on how you adapted. Are you now in a good position to anticipate changes for the better, and readapt as they occur? I hope so. In the meantime, “Be ready…. they keep moving the cheese!”

[New Developments: Executive Director's Column, Winter 2000 - 2001]

Treat Needs not Behavior: Maslow for the Milennium

Mental health professionals and schools often depend on a behavioral model to address  emotional and learning issues. Programs such as 1-2-3 Magic, discrete trial training, time out and even tutoring reward positive behaviors and attempt to extinguish less desirable ones. An alternative way to approach problematic behaviors is to look for the underlying needs that drive them. Let’s visit a third grade class, where I recently observed Emily, a mainstreamed nine year old with PDD.Emily wiggled and squirmed, walked to the water fountain, took a long drink, sharpened her pencil and sat down.  She tucked her foot under her leg, which dangled above the floor, chewed on her pencil, tapped it on the desk, and twirled it in her hair.  She stared hard at the visitor. “Teacher, teacher!” she called.  No answer.  Emily glared again, and then tried to make an arithmetic sentence using 8, 3 and 5. “Ooo…ww,” she wailed suddenly.  Her classmates rolled their eyes.  The teacher stared.  “Ooo…ww,” Emily cried louder. Finally, she jumped from her seat. “OOO…WWW,” she screamed. I couldn’t help thinking of psychologist Abraham Maslow’s hierarchy of human needs. Obviously, Emily’s basic needs for water and recognition were competing with her teacher’s need for her to learn mathematics. Are there any solutions, I wondered, that meet both Emily’s and her teacher’s needs?

Coincidentally, the same day I discovered the new book, The Irreducible Needs of Children, by Drs. T. Berry Brazelton and Stanley I. Greenspan. Each of the needs they describe applies to Emily and others whom DDR supports. Four needs are analogous to Maslow’s.
Maslow Brazelton & Greenspan
Biological           Experiences tailored to individual differences
Safety                 Physical protection, safety and regulation
Security              Ongoing  nurturing relationships
Knowledge         Developmentally appropriate experiences

Maslow believed that only after children’s most primitive biological needs are met should adults address the higher level needs for safety, security and knowledge. Unfortunately, in today’s schools many teachers put acquisition of knowledge first.  Emily and others have basic biological, safety and security needs that must take precedence.  Her behavior shows us what these needs are.

Biological needs:  Water nourishes the brain; the mouth organizes it. Emily’s brain, like everyone’s, needs water to function. According to Carla Hannaford, author of Smart Moves: Why Learning is not all in Your Head (see booklist), optimal hydration enhances the brain’s ability to process information efficiently. The mouth is also key to a well-organized brain. Both sipping water and chewing on a pencil are calming. Emily unconsciously did both to get focused. Ideas: Provide everyone with a water bottle. String plastic tubing on a cord for chewing. Hydration and oral-motor work will increase focus for all students.

Safety needs: Children struggle to look/listen when underlying senses are inefficient. Feeling “safe” means more than being out of range of gunfire. Emily has sensory processing and regulatory problems that cause her much anxiety. When children fear unexpected movement, touch and sounds, they become hyper-vigilant, as Emily’s staring suggests. Emily simply cannot pay attention to staying seated and do her math problem simultaneously. Ideas: Provide Emily with occupational therapy to normalize her regulatory and sensory processing dysfunction. Put a fidget toy in her pocket to provide appropriate touch and pressure as needed. Do Brain Gym activities before  lessons. Allow movement breaks at least every 20 minutes.

Security needs: Ignored needs don’t go away; they become stronger and undermine nurturing relationships. Being posturally/gravitationally secure helps a child to feel emotionally secure. Emily’s desk and chair are ill-fitting, and her dangling feet, disconcerting. Emily tucks her leg to feel more secure, but the total sensory experience of two ungrounded legs puts her “over the edge.” Her Teacher ignores her, hoping to extinguish her outbursts, but Emily’s need to be heard overtakes her need to learn. Ideas:  Provide Emily with a footstool, a cushion or seat wedge and a chair with arms. Pair her with another student, so that they can work together and Emily has someone who might listen.

Knowledge needs: Children learn and remember lessons when they are developmentally ready.  Emily’s math lesson makes no sense to her. She cannot make number families because she still doesn’t know that eight is more than five. Ideas: Use manipulative materials and story problems to give the mathematics lesson some meaning. Have Emily use the manipulatives while her partner makes the number sentences.

A combination of behavioral therapies and sensory-based, developmentally appropriate activities are best for young children.

[New Developments: Executive Director's Column, Fall 2000]

IYQ

”I wike you, too!”

I bet you are smiling. “A smile is the shortest distance between two people,” says Victor Borge. It takes 17 muscles to smile and 45 to frown. Why waste all that energy? Jogging your insides enhances respiration and circulation, oxygenates the blood, suppresses the stress-related hormones in the brain, and activates the immune system.

I learned these important facts at the 14th annual International Conference on The Positive Power of Humor and Creativity. This hilarious event, sponsored by The HUMOR Project in Saratoga Springs, NY, the brainchild of Joel Goodman, has attracted over 13,000 people from all over the world. Attendees were nurses, doctors, teachers, clergy, mental health professionals, and parents working in hospitals, hospices, rehab centers, schools, prisons, and in home health care. Many have bosses who never say a kind word. Most were stressed out and burned out. All received continuing education credits for laughing until they hurt.

In Humor 101, we learned how to take serious things humorously and ourselves lightly. Emulating Patch Adams, M.D., we wore silly hats, blew bubbles and pasted sticker kisses on one another. We learned to use magic tricks to get attention, and light, sound and colors to sustain attention. We practiced Tongue Fu,TM martial arts for the mind and mouth. A nun comically brought the spiritual into “play” with side-splitting stories of her travels abroad.

Although I depend daily on humor, I had forgotten how to be silly. Elizabeth Gerlach reflects in her new book, Just This Side of Normal: Glimpses Into Life with Autism, that play is just as important as everything else in life. Throwing ourselves into work, are we in danger of getting ensnared by a sense of self-importance and power?

The three-day fun fest ended with a mime demonstrating five acts from the circus that are models for keeping humor alive in your life:

1. The Clown – Working and living with children with special needs is serious, and we must take advantage of each day and every therapy session. Visit Mothers From Hell, a group of passionate advocates for their children, who have developed 10 outrageous tips for surviving your IEP meeting. The clown teaches us lightheartedness. Whatever our loss, we need to “get over it.” The funny stuff is there, waiting for those with a sense of humor to seek it. Don’t be afraid to laugh, to lighten up, to enjoy the amusing things people say and do.

2. The Juggler – Juggling schedules, home and work, and the needs of all family members is an enormous job. The juggler teaches us to focus. Only by focusing and keeping our eyes on our mission can we reach our goals. We must screen out daily worries of time and money, the media blitz (blow up the TV!), and other distractions.

3. The Unicyclist – Moving from thought to deed is a huge step. The unicyclist is successful because he knows where his center is. (It’s in the middle… duh!) The unicyclist teaches us to take action and to stay centered. With action comes freedom. Action involves movement, which enhances every part of our being. Keep your actions simple, without complications, and you will stay on track and centered like our circus friend.

4. The Fire Eater – Once we take action, there is no turning back. Putting lit torches in your mouth is analogous to a child taking those first steps without a walker or that first week without milk in the diet. (Why should people drink what comes out of cows’ udders, anyway?) The Fire Eater teaches us to take action in small steps. After that first step, a natural flow begins a series of successes. Feelings of accomplishment add further encouragement. He can now get to the bathroom himself! She actually likes soy milk!

5. The Wire Walker – No tool is as free, available and effective as our imagination. Children learn early to escape reality when it is meaningless and painful, and they go somewhere else. Dr. Stanley Greenspan advises us how to join kids in their worlds during FloorTime. Interacting is how we make emotional connections. The Wire Walker teaches us visualization: the power of the dream. If you can imagine it, you can make it real. This technique is frequently used today in healing, by athletes, and as an amazing tool for children with special needs.

Do you want to become a laughing teacher? I highly recommend The Laughing Classroom by Diane Loomans and Karen Kohlberg.

Looking for props to catch your kids’ attention? Everything from smiles on sticks to happy-face bean bags are in the Sourcebook catalog, free from The Humor Project (800-225-0330) .

[New Developments:  Executive Director's Column, Summer 1999]

Light, Water and Air: Improve their Balance to Enhance Health

Simple improvements can easily be made for those with allergies, asthma and developmental problems in how they partake of nature’s elements: light, water and air. When these are in balance, life flourishes; when balance is upset, so is development. Since ancient times, Eastern philosophy has viewed the healer as a gardener who facilitates nature in making the body days grow. This holistic approach is in marked contrast to that of western doctors who view the body as a machine and themselves as chemists and engineers who replace or repair faulty components. Just as a plant depends on light, water and air, so does the human body.

Both are dynamic, self-regulating systems that transform light and water into tissues. A healthy organism can be resilient against adversity. Plants can withstand drought, storms, and plagues; appropriately growing children can tolerate foods, pollution and animal dander.

Recently, a friend consulted me: “My son is bringing home his girlfriend, and she is allergic to our cat. What can I do?” She thought about offering to pay for a hotel but really didn’t like that idea, since it would mean that they would see less of each other. She had already bought an air purifier and found a homeopathic remedy for animal dander at the local health food store.

I congratulated her on her creative solutions and asked what the girlfriend was doing about her allergies. “Oh,” she said, “she hates the way she feels when she takes allergy medications, so she just stays away from cats,” I told her many techniques could build up her immune system, and that these steps would ameliorate her response to the allergy triggers in the home.

Improving the quality of our indoor air, the water we drink we and bathe or shower in, and the light we use to read or work by can have remarkable effects on our family’s health. Filter or purify the air in your home by using portable machines, cleaning out your ducts, or installing a new ventilation system. If family members have respiratory problems, they can also improve their condition through dietary changes, breathing exercises, herbs, nutritional supplements, homeopathy, acupuncture, and the martial arts.

Anyone who has read or seen “A Civil Action” knows that water contains innumerable toxins. Improving the quality of our H2O is a most important and easy change to make. We must purify or filter not only our drinking water, also that which comes into our shower or bathtub. Chlorine adds to the toxic load and must then be discharged from the body when it enters by mouth or through the skin.

We take light for granted, but if we lived inside the Arctic Circle, we would appreciate it more. Short winters sorely affect many children with behavior and learning problems. They need accessory lighting to simulate sunlight and to reduce visual stress. Sitting all day in schools with poor quality air and fluorescent lights could be enough to put them into a rage. Use a light box, full spectrum lights in a play room or skylights that let in sun. Light is the primary source of energy for the pituitary gland; it is necessary for the body to produce vitamin D, the “sunshine vitamin.” Full-spectrum light nourishes the body, as it contains all the wavelengths of natural sunlight. Fluorescent lights (and TV screens and computer monitors) vibrate and irritate the pituitary gland.

Chinese medicine associates each essential element with one or more organs. Imbalances in an element affect the energy going to those organs. In many children with developmental delays, water is out of balance, and water is associated with the kidneys. At a concrete level, this imbalance diminishes the mineral intake of the body and makes it inefficient at absorbing nutrients. At an energy level, the kidney is the source of intellect and creativity and that regulates growth. It preserves what is essential, the life force. Metal (associated with the lungs and large intestine) vitalizes water with minerals that enhance its life-giving properties. When we give children supplemental nutrients, balance their minerals.

The winter is an opportunity to review the quality of your family’s light, water and air. Making some changes will enhance the immune system of even the most allergic girlfriend. If you are interested in learning more about the Chinese approach to this subject, read Between Heaven and Earth: A Guide to Chinese Medicine. It is very understandable and has chapters on cooking and using herbs, as well.

[New Developments: Executive Director's Column, Winter 1998 - 1999]

The Work of Dr. Leo Galland

Once every few years a book comes along that is destined to become an instant classic. The Four Pillars of Healing by Dr. Leo Galland is such a book. Even before its publication this summer, I was impressed by Dr. Galland who combines common sense with medical science. His previous book, Superimmunity for Kids, has been a best seller for several years. After I heard him speak recently in New Jersey at “Keeping Our Kids Healthy…Naturally,” I felt as if I had known him all my life. Since I am a “diagnostician,” trained in labeling children’s learning problems, I was validated by his approach. I sent him a packet on the DDR, and he offered to speak for us in the Washington D.C. area on September 5, 1997.Dr. Galland is a Harvard-trained physician with impeccable medical credentials that take five pages to enumerate. What makes him stand out is his insistence on putting the patient back into the healing process. As he details the history of medicine in the first chapters of his new book, I savored every word. I was fascinated by his description of how society has moved from treating illness or sickness as a disharmony between the person and his environment in ancient times, to focusing on disease as a separate entity today. For centuries, Greek, Indian, Chinese, Japanese and tribal healers all attempted to regain balance. By the beginning of the 20th century, “the patient had become an object of study, stripped of personal identity, plucked from the context of his life and placed in a hospital bed.” From this time forth “the process of diagnosis and treatment would be directed by the wonders of modern technology as manifested in the laboratory of the X-ray department.”

I could not help but compare this medical scene to the educational one I encounter daily. Although for thirty years I have administered increasingly more sophisticated “tests,” I am depending more and more on interviewing than testing. Finding out about a child’s medical, social, sensory, and familial history often is far more enlightening than giving an IQ test.

Dr. Galland distinguishes between sickness and disease. He believes that sickness is not caused by disease, but by disturbed function, which involves a complex set of phenomena with physiological, psychological, and cultural dimensions. Patient-centered diagnosis combines the biological and behavioral sciences to identify mediators (something that produces symptoms), triggers (anything that activates a, mediator), and antecedents (risk factors that predispose a person) of the illness in a particular individual.

According to Dr. Galland, the first step is to understand that what appears to be a disease is, in fact, no more than a pattern of signs, symptoms, behavior and tissue pathology appearing in unique human beings. These, in turn, are produced by a group of disease mediators, which we call causes, but are, in truth, intermediaries.

Mediators vary from subatomic to societal. For instance, “autism” or “attention deficit disorder” are labels for clusters of symptoms with which most readers are familiar. In some children the mediator is a vaccine, while in others it may be dairy food or a parasite. The antecedents that predispose a child to a trigger are in many cases related to an immature or weak immune system.

Looking past the label or disease to search for the mediators and triggers is the next step in patient-centered diagnosis. No health care practitioner should treat a disease without gathering as much information as possible to clarify the identity of a person. Dr. Galland does not throw out the science, however. He still does a complete physical examination and orders relevant laboratory tests, putting the results into the context of what he finds out during the interview. He then moves on to treatment which is compatible with his ideas about healing, using an integrated, functional approach.

The goal is restoration or enhancement of health, not suppression of disease. The principles that guide him are the improvement of the physiological, emotional, cognitive, and/or physical function of an individual: the very same goals as the mission of the DDR.

This book offers some very interesting and enlightening reading that may change your thinking about health care

[New Developments: Executive Director's Column, Summer 1997]

Milk – the Perfect Food? Maybe for Calves!

Drink your milk so that you will grow up big and strong. How many of us heard those words as young children and still heed them? This wisdom is being renewed by advertisements showing our favorite stars with milk mustaches telling us that they drink their milk. Not only do we insist that our children have their daily allowance, but we as women are using dairy products to strengthen our bones and get our calcium. Because we are obsessed about fat content, we now buy 2% or skim, but it is not the fat that is problematic; it is the additives and the casein, or dairy protein.

What’s wrong with milk? Unfortunately, today’s milk, like much of today’s food, is chemically different than the milk of a generation ago.

This Fish isn’t Sick, the Water’s Dirty

This generation of children is living in a world more riddled with chemicals, toxins, and unnatural substances than any before. Despite massive efforts of individuals and advocacy groups to clear the air, food and water, people are eating, drinking and breathing substances which put enormous stress on their bodies. The end result is immune systems that are working overtime. Add to this mixture a child who may be born with less capacity to deal with poisons (in part because the parents’ immune systems were also overloaded) and drugs to treat frequentillnesses, and what you get is a perfect formula for developmental problems ranging from attention deficits to autism.As a diagnostician by training, I have spent over 25 years testing for educational problems. I evaluate a child’s motor skills, language, perception, reading, writing, and arithmetic. The resulting scores tell me the strengths and weaknesses. Educators use these scores to decide categories of disability in which a child may qualify to receive special education services.

These difficult behaviors and symptoms that mothers and fathers see early in development are then given a label..

So what is the problem? Evaluating a child’s strengths and weaknesses and reaching a diagnosis has become an odyssey that ends there. We can now tell the child that he/she has a mis-wiring of the brain, and that we now know why it is impossible for him to sit through dinner, read a book or answer simple questions. It is more meaningful to do something that will help rather than label and blame the child. To accomplish this, I propose that we look at the child’s environment and its components, and make changes there that will benefit the child.

First and foremost is the chemical environment. If a child’s immune system is processing chemicals, the brain has little energy to deal with sitting still, talking, listening, reading, and writing. Take the chemicals out of your house by using natural alternatives for fleas, termites, head lice and scabies. Eat natural foods without preservatives, additives, colors and flavors. Buy water that is not laced with chemicals. Wear clothes made from natural fabrics such as cotton, linen, silk and wool.

Second is the home environment. It is crucial to provide a structured, organized, consistent daily routine at home. Give children a schedule that is broken only on special occasions. Have a wake-up time with morning rituals including breakfast. Assign everyone a chair at the table with an eye to special needs such as a cushion, footstool or arms to provide comfort and stability. For young children, child-size utensils, plates and cups are essential.

After daycare or school, evening routines are a must. Dinner, parentchild play, and bedtime rituals at consistent times are imperative. Many children with developmental delays are not getting adequate sleep. Eleven hours are essential for children through age twelve.

Providing an individual bed, special toys, books, and sleepwear, as well as darkening the room at bedtime, all encourage children to regulate themselves to fall asleep. Parents sometimes stay with their children or put them in their beds to assist them. Initially this can be helpful, but it does not allow the child’s own nervous system to learn how to regulate itself.

The final environment to look at is school. Many of our schools have lost sight of what is developmentally appropriate. Most kindergartens now have reading groups and journals. Five year olds still need a great deal of movement and are rarely ready to sit for lengthy periods of time and perform abstract tasks such as associating sounds with symbols to use phonics. Parents MUST stop the run-away train of teaching academics prematurely. Educators will listen to you before they will listen to outside experts like me. In addition, look at the food the schools are offering children for snacks and rewards. Help them to offer healthy alternatives to sugar and chemical-laden products.

DDR supports focusing on healthy environments, including structured, nurturing, natural, developmentally appropriate places in which children may grow and learn. Before spending endless hours and dollars looking for the right label for a child, look at the environment.

These fish are not sick, their water is dirty.

[New Developments: Executive Director's Column, Fall 1995]