Physical Problems in People with Autism Spectrum Disorder

Yogesh Thakker
A systematic medical history and physical examination are essential for all patients with ASD. Rates of medical illness are estimated at 10–20%. A number of medical conditions are associated with ASD, including neurological, gastrointestinal, nutritional and sleep disorders. Clinicians should be aware that some individuals with ASD are insensitive to cold and pain, which may lead to a reduction in symptom reporting, while deficits in communication can make diagnosis by clinical interview difficult.

Epilepsy

Epilepsy is the most common neurological condition associated with ASD, and contributes to increased morbidity and mortality. The prevalence of epilepsy in children with autism has been reported to range from 5% to 38%. This childhood epilepsy is particularly persistent into adulthood, with remission in only 16% of cases. The presence of comorbid intellectual disability significantly increases the risk of epilepsy. Magnetic resonance imaging (MRI) and electroencephalography (EEG) remain useful in the assessment of significant neurological comorbidity in the presence of focal neurological signs or seizures.


Gastrointestinal disorder

It has been reported that there is an association between gastrointestinal symptoms such as diarrhoea, constipation, bloating and abdominal pain and ASD. People with ASD who experience abdominal pain may display unusual behaviours such as frequent throat clearing, screaming, grimacing, sleep disturbances or self-injurious behaviour. Additionally, individuals with ASD may display stereotyped behaviours around food and diet. The exclusion of certain foods (for which there is no significant current evidence in the management of ASD) or eating at particular times may risk the development of nutritional deficiencies.

Sleep disorders

Sleep problems, including difficulties with initial and middle insomnia, and shorter duration of sleep, are associated with ASD. The aetiology is likely to be multifactorial, and may include ASD-related alterations to brain structure and function, increased rates of mood and anxiety disorders (which are themselves associated with sleep abnormality), and the avoidance of social interaction. Where psychotropic medication has been prescribed care should be taken to assess for an association between medication side effects and sleep disturbance.

Reference:

Autism spectrum disorder in adults: clinical features and the role of the psychiatrist. Jacqui Garland , Linda O’Rourke , Dene Robertson Advances in Psychiatric Treatment Sep 2013, 19 (5) 378-391; DOI: 10.1192/apt.bp.112.010439 

Autism: A Dad’s Perspective

Bob Schurman, with Jessica Schurman

Autism is a part of my daughter, just like her hair is blonde, and we love that blonde hair, wouldn’t change it for the world.  When Matea was first diagnosed, it was difficult.  I found it really hard to hear words like “global developmental delay” and “self-harm” but the hardest part was watching my wife.  She has more knowledge (don’t let her read this or I will NEVER live that down) and a better understanding of some of the terminology. Every negative word out of the therapists’ mouths, or in an article she had highlighted, was like an arrow to her mom armour, and there was nothing I could do to shield her.  As a man I am what my wife likes to call “a fixer”. I like to survey a situation and fix it, so it has been a difficult transition for me: I can’t fix everything, I can only support.  I have to listen and not just do what I think will work.  We have to work as a team, always.   

As a dad I don’t think I have the chance to get down about my child’s diagnosis.  It would be selfish of me to expect my wife to constantly worry about me, when she is really the one in the “autism trenches”.  I see it as my job to help everyone in our family, and make sure I know what goals we are working towards with Matea (or so help me, my wife would definitely have something to say if I didn’t), and watch to make sure our typical boys aren’t getting lost along the way. But don’t get me wrong – we grieve. My grief may look a little different than my wife’s, but it’s there. When the “Daddy Daughter Dance” flyers start popping up, or my brother showing off his daughter’s latest gymnastics pictures at Christmas time, I am reminded that my girl doesn’t tolerate any fabric but cotton, and following a dance routine is not where we are right now. On some difficult days, my mind always wanders to walking her down the aisle on her wedding, I don’t often allow myself to think about it, because the reality is not something that I want to spend time thinking about. What I do like to spend my time doing is celebrating all our successes – this is so much more powerful and positive (for me) than dwelling on what we aren’t doing yet.  I am thankful that I get to celebrate all the things that come maybe a little easier to a family of a typical child – we celebrate it all. With our daughter’s diagnosis come some unique sensory needs. She loves pressure, which means she loves to hug, and cuddle. While other little girls are starting to become more independent of their parents (and this is our goal for Matea as well), I’m lucky that my daughter wants to jump on the trampoline with me, she wants a piggy back ride, and she loves when we roll her up in a blanket and tell her she is a hot dog.  Most of all she is genuine – she doesn’t give us attention or affection because she wants a toy or thinks she “should”; she is sincere.

My wife and I have talked at great lengths about how autism has affected our family.  Even before Matea was diagnosed, we were never “rat race” people.  I work as a foreman, and Jess was an inclusion teacher at a local middle school. While we were both happy in our careers (Jess perhaps a little more passionate than me) we still always made time for family and our children. After Matea’s diagnosis we decided that we were actually given a gift that most people search their entire lives for.  Ten years into our marriage we already know what is most important!  Money, trips, fancy cars, and a brand new house will not help Matea’s speech delay, fine motor delay, and behavioural issues, but the gift of our time, and building that relationship with our daughter (and our boys) and ALWAYS being present for our children – that is what we believe is most important.

Preparing A New School for Your Child

Candice Bowie

It’s that time of year again where we are starting to look forward to the next school year! For many parents, picking a school and sending your child into kindergarten can be really scary. When you add in all the extra concerns that come with having a child with special needs and how hard transitions can be, it can seem daunting! There are a lot of working pieces to keep our kids happy at school. My son has no functional language and therefore relies on me to make sure that the school will be able to meet his needs.  When you meet with your new school there will be discussions about academics, sensory needs, medical concerns – the list goes on and on! But I have found that making sure the basics are taken care of is often overlooked. I want my child to have a meaningful inclusive education, but I also want to know that he will be able to use the washroom when he needs to. I have built myself a cheat sheet over the past few years and it focuses on the basics, the stuff that will not be constantly changing and the stuff that, as parents, we can plan for and set up ahead of time to ensure our kids feel safe and confident that their needs will be met. I have broken it up into four categories: bathroom needs, eating at school, in the classroom, and outside. 

Bathroom Basics  

I like to talk about the plan during our first school visit.  I bring in all my supplies in the visit that we do before school starts (usually the last week of August), set everything up, make sure it is all labeled and that the person who will be primarily responsible feels confident that they have a plan. You will need to be VERY specific about how your child is changed or taken to the toilet (Do they lay down to get changed? Is it done standing? Do they sit or stand to pee?). If your child needs visuals or a social story, get all the pictures needed during the visit. The following is the list of questions that I bring with me. They will apply to each child differently.  Be prepared to write down their answers, or even let them get back to you. They may need to make a plan.

We have moved three times. My children have transitioned from pre-schools to kindergarten and I have never come across a school that isn’t happy when I bring up these questions and even happier when I get everything all set up.  So here are my go-to questions:

  • Where will my child be changed?
  • On what will they be changed?
  • Do I need to supply a mat?
  • Who will be changing my child? And if they are away, then who? Decide how many people you are comfortable changing your child and tell them. We have said 3 people are allowed, and we know who they are.
  • What do I need to supply?
    • Pull-ups
    • Wipes
    • Gloves
    • Cream
    • Change of clothes
    • Potty reward if applicable
  • Who supplies the potty seat, if needed?
  • How will supplies be transported to school for my child’s privacy?
  • What schedule will you be changing them on or going for bathroom breaks on?
  • How can I help support you in making this easier?

Click here to read more

Bubbles for Autism Across Alberta

Here’s what a couple of communities are doing for April 2, World Autism Awareness Day. There’s still time for your community to organize an event. If you want to get the word out about what you are doing, let us know at AAA@autismsocietyalberta.org!

ASA Hosts Bubbles for Autism in Central Alberta

Autism Society Alberta – Central Alberta Chapter will be joining together with other communities all over Alberta to celebrate Autism Awareness! We would like to welcome all families and friends touched by Autism to come out and blow some bubbles with us and show that they care about people with autism.

Please join us in Red Deer, Alberta this April 2nd 2015 at 5:00 p.m. as we celebrate Autism Awareness Day.
 

 
We will be meeting at Bower Ponds (4707 Fountain Drive Red Deer) on the steps of the Cronquist house and then walking to the park and blowing bubbles all the way!

Please invite friends, family, teachers & neighbours!

This event is a fun way to make our communities more aware of autism and the needs of those affected by it.

For more information, contact central@autismsocietyalberta.org

Come Blow Bubbles for Autism in Calgary!

Last year marked Calgary’s first year for a bubble-filled day bringing awareness to autism in a unique way. The festivities included live musical entertainment and dance, food vendor, bouncy house, art displays and much more.

Local autism groups in our city hosted this all ages event at Olympic Plaza downtown Calgary last year on April 2nd.

Click here to view the poster

This event is happening again even bigger and better on April 2nd, 2015 at Olympic Plaza between 11:00am- 2:00pm. We encourage wearing tie-dye clothing and bringing bubbles to blow in support of autism. We will raise awareness and acceptance in our community. Everyone is welcome to come and join the fun!

We Want to Hear From You!

We are looking to publish stories, event notices or news items from all parts of the province. If you’d like to have your items included in the March 2015 issue of Autism Around Alberta, please send your submissions to AAA@autismsocietyalberta.org by the deadline of Monday, March 9.

Creating A Bolt Plan for Your Child with Autism

Candice Bowie

Our son David is amazing – he loves Angry Birds, dictionaries, and reading everything. He makes us laugh each day, and we are so lucky to have been blessed with such a smart, loving little boy. But despite the incredible child that he is, he also terrifies us on an almost daily basis. He likes to run.  He likes to get out of the house, escape our yard, and go to wherever it is that he wants to go without telling us.  David has ASD, no functional language, and is driven to get to what he needs at any given moment.  David’s boltings have become quite predictable – most of the time he is on his way to the library, or when he’s at his aunt’s house he wants to get out to the trampoline. But the time that he got out he was missing for 15 minutes and was found by strangers walking a rural highway in his bare feet. We still don’t know what he was after. We are diligent, we have a security system, we have locks (and I mean A lot of locks). David’s siblings know to call us and try to stop him from leaving the house if we are not in the room.  But still, he tries to run.   If we make a mistake a door gets left unlocked, or a utility person doesn’t lock a gate, David will get out.  So we have a plan at home, we know what we will do if David goes missing.  

When I brought up the idea of a bolt plan to David’s school they had never heard of one before – David is in a regular elementary school in a fully inclusive program with full support. But they were on board, and more than happy to keep the plan ready in a safe place. Hopefully it will never be used.  

The following is our bolt plan. Along with this plan there were 4 pictures of David blown up, a close-up of his face and a couple of him standing.

I made the plan very basic, and I also spoke with our local RCMP to see if there was anything else that they thought I should add.

If you have a child that runs, or hides, or likes to wander, I would recommend making a plan and writing it down. Approach your school or daycare and get them on board. In the terrifying moment that you realize you don’t know where your child is, having a plan will help.

Click here to see David’s bolt plan

Introducing the Occasio Respite Program

OCCASIO (*pronounced: Oh-kay-zee-oh) is a Latin word that refers to a "favorable moment" or an "opportunity".
 
OCCASIO is also a new Social-Recreational Respite program that will be offered by ASEA, starting this spring.

We aim to create a program with easy access for families requiring respite support – but that also allows the participants to build relationships with their peers in a safe and supportive environment.

"Social-Recreational" based respite programming has found success in similar communities (like the Autism Aspergers Friendship Society of Calgary) and ASEA wants to bring these opportunities to the Edmonton region.
 
Social Recreational Respite can address many facets of life and development due to the dynamic nature of the programming.
 
By providing opportunities to meet peers with similar interests, we believe that people are able to build a stronger foundation for social opportunity and personal confidence.

This will help people better understand their own diagnosis, learn and practice social skills, and grow other valuable employment and life skills (such as independence, responsibility and accountability).
 
OCCASIO will be registered for on an activity-by-activity basis. This allows for more accommodative use of respite as it is required by the family, and helps to ensure that individuals are attending activities that most interest them.
 
Program activities will include things like: board games or video games nights, visits to Edmonton attractions like the Valley Zoo, West Edmonton Mall or Telus World of Science, attending local festivals, sporting events or concerts… and everything inbetween.
 
The name "Occasio" was the result of a Canada-wide naming contest, with a cash prize sponsored by Insight Psychological in Edmonton. Thanks to our winning contributors, Kevin Payne and Leona Sudom, and to everyone else for their creative and inspiring submissions!
 
Registration will be open to ASEA members in the coming weeks. For more information please visit ASEA’s website www.autismedmonton.org

Free Webinar: To Disclose or Not to Disclose?

Should you tell your employer about your disability? Who should you tell? How much should you tell? For individuals with disabilities, disclosing a disability to an employer can be a difficult decision. It takes thought and planning.

In this interactive session, our panel will share their experiences, discuss current research on disclosing disabilities at work, and present a series of questions that can help you decide whether to disclose or not. They will also take your questions.

AGENDA:
Date: March 4, 2015
Time: 1:30 p.m. – 2:30 p.m.
Register: http://EFdisclosure.eventbrite.ca
Cost: FREE! Please share with your networks
Format: Live webinar presentations with Q & A
Q & A: You can pose questions to the panelists through the live chat functionality
 

FEBRUARY WEBCAST NOW ONLINE!
 
The February webcast self-employment is now online, featuring self-employed management consultant Bill Brandon and Deborah Barrett of Anthony At Your Service. You can watch the full video on the Alberta Employment First Strategy Webcast webpage.

Building Your Transition Team

When it comes to planning for the transition to adulthood, building your transition team is one of the first steps in fulfilling your future vision. Who makes up your transition team will depend your youth’s needs and goals and may include:

  • Your Family Support for Children with Disabilities (FSCD) Worker
  • Representatives from Human Services adult programs:
    • Persons with Developmental Disabilities (PDD)
    • Assured Income for the Severely Handicapped (AISH)
    • Office of the Public Guardian and Trustee (OPGT)
    • Alberta Works
  • Representatives from other government or community programs
  • Education and/or Alberta Health Services
  • Service providers, teachers and other natural supports you identify as being important in you or your youth’s life

Your transition team should consider what services and supports may be available to support your goals. When thinking about this, your son or daughter should consider the following five questions:

  1. What are my goals?
  2. What skills do I need to learn to reach my goals?
  3. What local programs, services and supports are available to support me in reaching my goals?
  4. What responsibilities must school, government, cultural and community agencies, my family and I assume in order for me to reach my goals?
  5. Are there gaps or barriers to address in order to reach my goals?

Visit the Human Services Transition Planning webpage to learn more about the integrated approach to transition planning and proactive supports that are available.  If you have any questions about your role in transition planning, please contact your local FSCD office.

ASEA and ARC 2015 Graduate Student Pilot Grants



This year, ASEA and ARC are once again offering Graduate Student Pilot Grants
to support individuals conducting graduate research in any field related to Autism Spectrum Disorders (to begin May 2015). These Scholarships are jointly funded by the Autism Society of Edmonton Area and the Autism Research Centre at the Glenrose Rehabilitation Hospital (affiliated with Alberta Health Services and the University of Alberta). Each pilot grant (maximum $5,000.00) is to be applied towards the operating costs of the successful applicants’ graduate research project. Applications will be judged on the quality and originality of the proposed project, and on the potential of the research to contribute to the well‐being of persons with ASD and their families.
 
Please see the attached announcement for details of the grant and application process. Deadline to apply is March 1, 2015.

Are You The Parent of a Child with Autism?

Parents needed for research study on personal growth of parents of children with autism spectrum disorder (ASD)

Are you the parent of a child who has been diagnosed with autism? We are investigating the coping strategies used by parents and the personal growth experiences they have in raising children with ASD.

Click here to learn more

Relevant Research: Vocational Support Approaches in Autism Spectrum Disorder

In coming issues of Autism Around Alberta, we’ll be bringing you cutting-edge research featuring the latest insights into the world of ASD. This month, Dr. David Nicholas, researcher and parent of two children with ASD, looks at the literature and identifies promising ideas to support employment for adults with autism in community settings. Click here to read the article.