Wednesday, March 13, 2019

Practical Tips from the Perspective of a Psychiatrist

I attended Springbrook's National Converge Autism Conference last week and it was awesome. Here are my notes from one of my sessions. The presenter was Dr. Matthew Fisher, a Child and Adolescent Psychiatrist.

Three pillars of autism
1.     Needs structure
2.     Watch for Sensory overload
3.     Look for Anxiety - panic button; during a panic attack, you can’t do anything.

Pediatrics and Primary Care
4.     Rule out medical
a.     Seizures – 25%
b.     GI disturbances – 25%
c.     Pain
d.     Infection
5.     Rule out dental

Medication Expectations
6.     Strength doesn’t always equal effectiveness – ask about high and low dose ranges
7.     Med washes tend to be ineffective with the ASD population
8.     Anxiety/Depression (SSRIs) – 6-8 weeks to notice a difference
9.     Stimulant medications for ADHD – 3-4 days to notice a difference
10.  Risperdal & Abilify for agitation – 3-4 weeks to notice a difference; lots of side effects; weight gain; treat anxiety which may take care of agitation

Pediatrics and Primary Care
11.  What to ask for:
a.     Early childhood screenings: hearing, speech, vision, developmental
b.     Child behavior checklist
c.     Early childhood screening assessment

What is available?
12.  Occupational therapy
13.  Speech therapy
14.  In school – may be limited by IEP
15.  Outpatient – search for provider specializing in ASD and developmental delays
16.  Speech – alternative methods of communication

How to speak with providers about concerns
17.  Top intervention for developmental delays is early intervention
18.  Keep a log and bring to appointments
a.     Use a calendar or planner
b.     Frequency, duration, intensity
c.     The environment at a time of incident
d.     Potential triggers (internal vs. external)

Clothing and Sensory Concerns
19.  Types of material
20.  How clothing is made – seamless socks, tagless clothing, material
21.  Functional clothing – magnetic shoe closure, Velcro, overalls, leotards, compression clothing

Helping to find happiness
22.  Water: swimming, shower/bath time
23.  Constructing
24.  Deconstructing
25.  Virtual reality as a substitute
26.  Physical activity
a.     Exercise
b.     Social stimulation and opportunity for interactions
c.     Even the simple act of tossing a ball can be a great start

27.  Chewy tube
28.  Noise dampening headphones
29.  A weighted/heavy blanket
30.  Sleeping bag
31.  Trampoline
32.  Swing
33.  Exercise ball
34.  Spinning toys
35.  Pill tray
a.     Reload Sunday
36.  Picky eaters – eating something is better than eating nothing
a.     TV dinners
37.  Snacks
a.     Goldfish
b.     Skittles
c.     Gummies
d.     Sour patch kids
e.     Sour spray
38.  Emotional support for parents
a.     Join a local support group
                                               i.     Ask treatment providers for recommendations
                                             ii.     Find Autism Society near you
b.     Practice self-care
c.     Take a break from the internet
d.     Access respite care


39.  Most elementary classrooms are a sensory nightmare
40.  Be a minimalist when decorating
41.  Visual cueing – show don’t tell
42.  Color coding subject matter
43.  Zoning classrooms – math zone, reading zone, use shapes for zones
44.  Quiet places and escape zones within the classroom – headphones in a tent in classroom
45.  Sensory rooms – before the child is overstimulated.
46.  Allow for physical movement breaks
a.     Wiggle seats
47.  Visual schedule – not too many choices, use real photos when possible
48.  DIY sensory room
a.     Hang pizza pan or cookie sheet – for magnets
b.     PVC tubing to toss a ball into
49.  Social Stories
50.  Reading for the classroom – Kathy Hoopmann
a.     All Cats have Asperger Syndrome
b.     All Dogs have ADHD
c.     All Birds have Anxiety
51.  Recommended Reading and Resources
a.     Thinking in Pictures, My Life with Autism
b.     Temple Grandin, the movie
c.     1001 Great Ideas for Teaching and Raising Children with Autism or Asperger’s

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