Friday, 27 November 2009

• Justin Now Before Biomedical Treatments & Hyperbarics

  Justin experiences melt downs that drain you. His inability to talk makes things difficult for him
  and like anyone who for example was in a foreign country and couldn't get their needs met, -would probably melt down too, he really gets frustrated at just not being able to communicate his needs.
  
  He is a creature of habit. Everything has to be routine, however, he is a ......professional mess- maker. He hates order in his environment with things. He takes his toys when they are neat and in order and walks over to the box, tips it upside down so that everything is everywhere and walks away.
  
  He has a fascination with balls and helicopters. He can fill a ball pit with all the different type and size balls he owns. As for his helicopters, he has his favorites.
  
  He is still in diapers at 5 years old, potty training has been quite......interesting. 
  
  http://maxweber.hunter.cuny.edu/pub/eres/EDSPC715_MCINTYRE/Autism&Toileting.html
  
  [Taken from the above website to better describe why Justin is still in diapers at age 5; but before I continue, Justin was recently evaluated by a child psychologist. He is chronologically 5 y/o but intellectually between 2-3 years old - which is about the age for the average child without autism to learn to potty train, so technically, intellectually he is at the age to learn. However, add on the autism and the following information might explain it better]
  
  Current toilet training methods and practices
  

  "To fully understand the particular difficulties care givers and teachers can have in toilet training autistic children, it is important to review the current and prevailing philosophies in toilet training typically developing children. A review of current journal articles revealed that most practitioners advocate a child-oriented approach to toilet training. This emphasizes child readiness and employing a system of positive reinforcement (Stadtler, Gorski * Brazelton, 1999). Brazelton, et al wrote that achieving bladder and bowel control could contribute to a child's self-esteem. "This model of toilet training comprises three variant forces in child development: physiological maturation (e.g., ability to sit, walk, dress and undress); external feedback (e.g., self esteem and motivation, desire to imitate and identify with mentors, self-determination and independence) (Brazelton, et al., p. 2)." Brazelton et al. stress the delicacy of a child's self-esteem during initial successes in toilet training and emphasize the need for strong parental support during initial and successive toilet training phases. Parents are told to have the child use a potty chair, place stool from the diaper into the potty chair, watch parents go so as to imitate them, let the child sit on the potty fully clothed, and to time when urination and bowel movements are most probable. Parents are encouraged to explain to the child what is expected when they are taken to the potty and to praise and reward any successful eliminations while being careful not to criticize accidents, and to have the child say "bye-bye" to items being flushed so as to diminish anxieties.

  The literature shows that even typically developing children often have difficulty mastering toilet training (Hagopian, Fisher, Paszza & Wiezbicki 1993, Blum, Taubman & Osborne 1997, Buchholz 1999, Issenman, Filmer & Gorski 1999). A common problem among typically developing children is regression, resulting in Encopresis and Enuresis. Authorities highlight targeting self-esteem issues in treatment of these problems. In contrast, autistic children's difficulties in toilet training tend to be less related to self-esteem issues than to problems intrinsic to their disorder."
  
  

  Problems of Autism in toilet training
  "The specific characteristics that impede autistic children's independent use of the toilet are outlined below. Autistic difficulties in understanding social relationships limit the success of a social reward system such as recommended by T. Berry Brazelton, et al. (Stadtler, Gorski, & Brazelton, 1999). This method encourages the typically developing 2-3 year old child to have a sense of pride or accomplishment for success in toilet training. As discussed earlier, autistic children often do not feel pleasure from making their parents and teachers happy. Thus a program based on social motivation would not have great probability for success. Difficulties in comprehending language and logic may inhibit the ability to understand what is expected in regards to the toilet procedure. Autistic children often do not understand an explanation of why they need to eliminate in the toilet and not their diaper.

  Furthermore, autistic children's attachment to routines and resistance to change may make the transition from diapers to the toilet difficult. They may be attached to the sensation of wearing diapers, having used them daily for 2-4 years. They may not like the stimulating environment of the bathroom with its bright lights, echoes, and sounds of running and flushing water and they may be averse to the change in temperature they feel when they take off their clothes (American Psychiatric Association, 1994; Boswell & Gray, 1995.)

  Autistic children's toilet training can be further impeded by their idiosyncratic relationships with their bodies. They may not know how to read bodily cues, and therefore are not aware of the urge to use the toilet. In addition they may not mind the sensation of being soiled. The reasons for this are unclear but some experts have speculated that this may be related to central nervous system abnormalities in children with Autism. (Hagopian, Fisher, Paszza, &Wiezbicki, 1993). All of these factors contribute to the need for adaptation of classic toilet training methods to suit the special needs of autistic children........" (end potty training notes)
  
  {my comments cont....}
  Justin will at times run aimlessly back and forth and start laughing while looking into....nowhere. It's as if he went inward into his own world. He makes all kinds of sounds with his mouth and movements that will tell even a child he is ......different.
  
  He has never really played appropriately with toys and one of our first indicators that something was wrong was with his spinning of things, big wheel....wheels (upside down), helicopter propellers, loved to stare at the ceiling fan whether on or off.
  
  Doesn't recognize sadness, or ill feeling; will laugh when you laugh, but was laughing at mommy for example when I was pregnant with my second child
  and experiencing severe morning sickness and ......hugging the bowl!
  
  Justin has Occupational Therapy, Speech and S.O.S. Feeding therapies weekly. He's had therapy for 4 years with little progress. If anything I see it as a tool to help him learn and experience different things. He does go to Pre-school.
  
  He used to go for Biofeedback until we moved too far and couldn't afford to continue. His therapists at that time agreed with me, that there was an improvement overall with his focus and understanding with biofeedback, however slight. Every child is different. What works for one, might not work for the other, but you educate yourself and find the credible resources to help direct you. No one knows your child better than you, the parent/care taker.
  
  Justin has always suffered and still suffers from Constipation. On top of that he is a great...holder. He is so afraid, (who blames him with all his experience in that department being negative), to have a bowel movement that he goes through great stress when he has the urge because he knows he is getting his weekly liquid suppository which he hates. I am the administrator and I can tell you I hate it. I feel so bad for him but have no choice. He once ended up in the ER with severe cramping and I was told after some very invasive testing that he was full up to his diaphragm with bowel. What he went through that night at the ER I cannot put on one blog only to say when I brought him home I couldn't put him down, I had to try and hug away both our nerves and fell asleep with him in my arms, I cried. He orally takes a laxative and stool softener.....even with that he will not go. So my poor boy is so full of ....junk in his system. 
  
  That surely doesn't help him.
  
  I have heard other moms tell me that they have experience a 360 degree change in their child with constipation issues because of the hyperbaric treatment. I'm looking into that because I don't yet understand fully the science behind that...but I'll keep you posted.

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