Epidemic Answers http://www.epidemicanswers.org Tue, 16 Dec 2014 01:20:10 +0000 en-US hourly 1 Copyright © Epidemic Answers 2013 info@epidemicanswers.org (Epidemic Answers) info@epidemicanswers.org (Epidemic Answers) http://www.epidemicanswers.org/wp-content/plugins/podpress/images/powered_by_podpress.jpg Epidemic Answers http://www.epidemicanswers.org 144 144 Epidemic Answers Epidemic Answers info@epidemicanswers.org no no Nonverbal Learning Disability http://www.epidemicanswers.org/nonverbal-learning-disability/ http://www.epidemicanswers.org/nonverbal-learning-disability/#comments Tue, 09 Dec 2014 02:00:42 +0000 http://www.epidemicanswers.org/?p=7481 by Patricia S. Lemer, M. Ed., Chairman of the Board

Nonverbal Learning DisabilityWhat Is a Nonverbal Learning Disability?

First appearing in the literature in the late sixties, when I was finishing graduate school, non-verbal learning disabilities (NLD or NVLD) are now diagnosed frequently.

A nonverbal learning disability describes a cluster of deficits in motor, visual-spatial, social and sensory arenas combined with strengths in vocabulary, rote memory, and attention to detail. This syndrome causes sensory overload and profound difficulty with cognition, academics, and relationships.

NLD is easily confused with Asperger syndrome and sometimes used synonymously with the dual diagnosis of gifted/learning disabled. While most psychologists agree on the etiology and treatment of language-based learning disability (LD), vision-based LD or NLD is poorly understood.

Compensate or Remediate?

Traditional approaches to NLD focus on diagnosis and compensatory techniques, without addressing the motor, sensory and visual deficits. While teaching strategies can be beneficial, ameliorating deficits makes more sense.

In How to Develop Your Child’s Intelligence, Getman proposes a developmental relationship between the motor and visual systems that offers a structure for remediation in the context of development. At first the motor system dominates, then the motor and visual systems work together. Finally, vision dominates.

Motor First

Children diagnosed with a nonverbal learning disability probably had motor and sensory deficits in the first year of life. Any skipped step in motor development is a red flag to me. Those with NLD may have never crawled, walked early or late, or adopted idiosyncratic movement patterns. They could also overly favor one hand or lack a dominant side. Individualized sensory-motor activities can bring their motor systems up to age level.

The Motor-Visual Team

Binocular vision and depth perception emerge when the body begins to move through space. In the motor-visual stage, movement is primary. Then, as children learn to reach with the eye and the hand at the same time, movement allies with vision. If the two eyes do not work together, the body may show bilateral integration problems.

Deficits at this stage often cause motor clumsiness, lack of interest in motor activities, or extreme shyness due to spatial insecurity. A developmental optometric evaluation and intervention are imperative now, to avoid later visual-spatial and social problems.

Vision Directs Motor

Typically, vision takes precedence over movement sometime before kindergarten. This transition from motor-visual to visual-motor is a huge jump. How many times have pre-school teachers watched a child begin to draw a dog and end up with something else? That child’s hand simply could not produce what the mind told it to.

Many older children with a nonverbal learning disability are still not using their vision purposefully to direct their movements. To draw a dog, a child’s eyes must direct the motor act, as he visualizes the animal in his mind’s eye. The emergence of vision as the dominant sense depends upon a reliable store of touch, movement and muscle “memories” acquired during early development.

Children with a nonverbal learning disability have early histories of tactile defensiveness, vestibular disturbance and low tone, which preclude having well-integrated touch and movement experiences. To cope, they rely more heavily on what they hear than on what they sense, do or see.

Audition and language skills predominate over vision and the more primitive senses early on. As language becomes ever more proficient, the NLD child becomes less able to use vision to focus on and give meaning to what he sees. Avoidance and fear perpetuate the problems.

What Can We Do?

A nonverbal learning disability is REALLY a visual processing disorder that starts early in life with developmental motor, sensory and visual delays. Fortunately, it’s rarely too late to remediate. Epidemic Answers is committed to assisting those with NLD in finding skilled therapists to help close the gaps in their development.

The first priority should be a developmental vision exam. Most people with a nonverbal learning disability have problems with eye teaming, focusing, tracking and perception. Physical and occupational therapists, Brain Gym consultants, psychologists and developmental optometrists can all be part of the team working on sensory, motor, visual-spatial and social skills.

I look forward to the time when books and conferences on NLD include experts from the above disciplines. Individuals with NLD deserve more than palliative intervention. They CAN learn how to use their bodies and minds together. As Carla Hannaford aptly states in the subtitle of Smart Moves: “Learning is not all in your head!”

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Mitochondrial Dysfunction http://www.epidemicanswers.org/mitochondrial-dysfunction/ http://www.epidemicanswers.org/mitochondrial-dysfunction/#comments Mon, 08 Dec 2014 01:53:29 +0000 http://www.epidemicanswers.org/?p=7477 by Kelly Dorfman, MS, LND

Mitochondrial DysfunctionWilliam is a 6 year old with a pervasive developmental delay (PDD) diagnosis. He made encouraging initial gains with extensive intervention until his progress hit a plateau. A developmental specialist reassessed him noting that his muscle tone and stamina were unusually low. She recommended a metabolic specialist to rule out mitochondria disorder.

What are mitochondria?

Each cell contains tiny organelles called mitochondria. The job of the mitochondria is to provide the chemical energy the cell and body needs to operate. The cell cannot use sugar or fats directly. Partially broken down fats and carbohydrates must be converted into adenosine triphosphate (ATP), the cell’s main source of energy.

What is mitochondrial dysfucntion?

Children with significant low tone may have mitochondrial dysfunction. Aggressive antibiotic use, heavy metals and pesticides can all injure the mitochondria. The DNA of the mitochondria is separate from and more fragile than the DNA found in the nucleus of the cell. Common environmental toxins can damage the DNA of the mitochondria altering the cell’s future ability to produce energy. The result is loss of muscle tone and stamina.

In mitochondrial dysfunction, muscle tone is low so youngsters need to search for ways to stabilize soft muscles. They may be restless because a comfortable resting position cannot be found. Teachers may complain of poor attention span when in reality the child is chronically distracted by body discomfort.

In rare cases, a child may have one of a limited number of identified mitochondrial defects. The known disorders can only be diagnosed by muscle biopsy and are characterized by serious symptoms (such as an inability to walk). A vast majority of those with low tone suffer from inefficiency, not disease. Because a partial diagnosis does not exist, a painful biopsy is unlikely to provide useful information except in extreme cases.

Disease versus inefficiency

Some mitochondria are more efficient than others because of the influence of different environmental and genetic factors. Well-functioning mitochondria create readily available and sustained energy resulting in toned and well-formed muscles. When these muscles are exercised, they get stronger steadily and predictably.

Whether a child has a known mitochondrial disorder or inefficiency, the only treatment is nutritional. Many nutrients are critical for mitochondrial function but there is a basic cocktail that addresses the most important components.

The Mitochondria cocktail

Vitamin B-1 and/or B-2

Thiamine (vitamin B-1) and riboflavin (vitamin B-2) are both required co-factors for different parts of energy making. The last step of energy making involves converting ADP (adenosine diphosphate) to ATP. This step happens down a chain of five protein complexes named Complex I, II, III, IV and V, respectively. Complex I requires vitamin B-1 to stimulate its enzymes. Both Complex I and II require vitamin B-2.

Some children do well with thiamine but get irritated with riboflavin and vice versa. In other cases, both B-vitamins plus B-3 (as niacinamide) are necessary. Because it is hard to know what to support (without a specific diagnosis), the B-vitamins should be added one at a time. The problem area can be pinpointed by observing the response to intervention. Some children will have a clear response to one B-vitamin or may need them all.

A typical mitochondria formula may contain 50-100mg each of vitamins B-1, B-2 and/or B-3. Keep in close contact with the supervising medical professional and adjust the B-vitamins if the child becomes agitated.

Vitamin E (mixed tocopherols)

The mitochondria must be protected against damage from destructive molecules called free radicals. These volatile substances are a normal by-product of metabolism but a healthy body has the capacity to clean them up. When too many get into the mitochondria, they damage the membrane and disrupt energy production. Vitamin E is an important anti-free radical agent for protecting and healing these membranes.

The dose range used is 100-400IU. Vitamin E is well tolerated and it has no known toxicity. Natural vitamin E is usually derived from wheat or soy. In rare cases, this may cause allergic problems.

Acetyl-L-Carnitine (ALC)

Carnitine is a simple protein made up of the amino acids methionine and lysine. Research suggests that carnitine helps maintain the membranes of the mitochondria. In addition, ALC helps facilitate the transport and utilization of fats so they can be used to make energy.

For mitochondrial disorders, ALC or the prescription version, Carnitor, is dosed at 50 to 100 mg per kg of body weight. It can sometimes cause irritability or stomach distress but is not toxic.

Bottom line

The mitochondria can be more efficient if they are fed properly. Healthy mitochondria provide the sustained energy necessary for optimal growth and development.

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Detoxification for Children http://www.epidemicanswers.org/detoxification-for-children/ http://www.epidemicanswers.org/detoxification-for-children/#comments Fri, 05 Dec 2014 02:37:01 +0000 http://www.epidemicanswers.org/?p=7471 Detoxification for ChildrenThis information comes from Children with Starving Brains, second edition, by Jaquelyn McCandless, MD, and we thank her for her valuable contributions. Kelly Dorfman helped with clarification.

Here are some exciting new choices for detoxification for children, which are presently being used by practitioners concerned about methylation issues.

Please work with a nutritionist or medical professional to integrate them into a whole treatment plan, rather than using them as “treatments du jour.”

Vitamin B12 injections

Chronic gut inflammation, toxicity, and vegetarian diets can be factors in low levels of Vitamin B12. Dr. James Neubrander in Edison, NJ recommends injections of concentrated vitamin B12 in the form of pure methlycobalamin, instead of oral B12, to children with developmental delays. Injections bypass the impaired gut and directly feed the nervous system.

Who is a candidate?

Developmentally delayed children with a history of thimerosal in vaccines, autistic enterocolitis and chronic loose stools. Others have lab values showing anemia, positive myelin basic protein (MBP) antibodies and/or elevated methylmalonate (MMA) on the urinary organic acid test.

What does it do?

Vitamin B12 is tricky to absorb from food, and requires an “usher” molecule in the stomach to lead it to the same part of the small intestine where Andy Wakefield found lymphoid hyperplasia. Together with folate, B12 participates in the complicated detoxification process by facilitating methylation processes important for creating optimum metabolic balance. Then, the body can eventually detoxify itself.

Transdermal thiamine tetrahydrofurfuryl disulfide (TTFD)

TTFD is a synthetic version of allithaimine, a naturally occurring substance found in garlic. Dr. Derrick Lonsdale believes that TTFD has three sulfur-related mechanisms that benefit children with autism spectrum disorders (see below).

Who is a candidate?

Some children experience a proliferation of “gut-bugs” and yeast as a result of chelation treatments. When gut ecology becomes imbalanced, stop chelation immediately and add necessary nutrients, probiotics, digestive enzymes and dietary restrictions to correct the problem and heal the leaky gut. In some children, TTFD appears to alleviate the negative side effects of yeast die-off.

What does it do?

TTFD allegedly enhances sulphur’s energy metabolism in the central nervous system, functions as a chelating agent, and alleviates intracellular thiamine deficiency. Dr. Lonsdale cautions practitioners to assure that B6, magnesium, vitamin C and taurine are in place before starting TTFD, because TTFD requires a balanced nutritional environment for optimal functioning.

TTFD is a prescription item that you can get at a compounding pharmacy.

Transdermal or intravenous glutathione (GSH)

Glutathione protects the body against toxic agents, such as heavy metals. It is made in the body from the three amino acids, systeine, glycine and glutamine. The level of glutathione (GSH) in the body determines how much toxin is absorbed. If the glutathione levels are low, the body accepts more heavy metals. As glutathione levels rise, the body is better able to excrete poisons.

Adequate levels of GSH are also needed for many aspects of immune function. Low levels impair immune system function, which leads to frequent infection. The body’s poor response to infection causes inflammation and oxidative stress, which, in turn, lowers glutathione.

A vicious cycle perpetuates when there is inadequate glutathione to offset oxidative stress, further reducing immunity, and allowing opportunistic infections (like yeasts and parasites) to proliferate.

Who is a candidate?

Children with suspected immunization damage and heavy metal exposure. Some children with colitis also have impaired GSH function. Bill Walsh found that children with atypical Cu/Zn ratios and thus Metallothionein (MT) errors, have inappropriate GSH.

Children may have MT errors because they have low glutathione, or vice versa. Infants and toddlers with colic, diarrhea or constipation are more likely to have low GSH, and thus be at risk to environmental exposures.

What does it do?

GSH acts as a powerful antioxidant that prevents the formation of free radicals and inhibits cellular damage. Medical professionals prescribe transdermal and IV GSH along with oral glutathione, because the latter is poorly absorbed. To be absorbed the cream must be water soluble, not petroleum-based.

Parents report that combining GSH with TTFD increases the benefit of both. The only negative side effects are the unpleasant odor of the TTFD cream and increased hyperactivity and “stimming” in a small percentage of the children. Adding taurine reduces occasional pale stools and constipation.

The Natural Medicine Guide to AUTISM

“An excellent compiliation of natural, non-drug treatment possibilities,” said Bernie Rimland. Includes nutrition, detox, NAET, homeopathy, cranial osteopathy, metallothionein (MT) promoter, Tomatis, Klinghardt, and others.

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Autism Bike Riding Help http://www.epidemicanswers.org/autism-bike-riding-help/ http://www.epidemicanswers.org/autism-bike-riding-help/#comments Wed, 03 Dec 2014 02:53:06 +0000 http://www.epidemicanswers.org/?p=7464 Autism Bike Riding Helpby Bert Richards, PTA and Gin Utermohlen, PT

“Let’s all go for a bike ride” …a simple suggestion you are not likely to hear in Jesse’s family. Jesse, who has low muscle tone and poor balance, is not yet independent on a bike. He is embarrassed to be seen riding with training wheels, yet a bad experience in previous bike riding attempts makes him afraid to try again without them.

A group called “Spinning Wheels,” developed by The Abilities Center in West Bloomfield, Michigan, helps children like Jesse to become good bikers. The 6-week class is open to children over age 7 who are motivated to ride a two-wheeler. The only prerequisite is that they be able to ride a bike with training wheels.

In the two years since its inception, the group has taught children with diagnoses of Downs Syndrome, low tone, autism, and many who are “clumsy kids” with no diagnosis. Possibly your child or student could learn to ride a bike following this program.

Firm foundation

The unique element in “Spinning Wheels” is the firm foundation of balance it establishes before the children get on their bikes. Our groups spend the first two class sessions in proximal balance activities sitting and standing, without even using a bike.

Focus is on activities which mimic the weight shift and steering components of bike riding. Participants use therapeutic balls to increase tone and stimulate righting reactions. Balance beams from 7″ to 4″ wide, level, inclined and elevated, provide the “just right” challenge to the balance system. Cadence stepping exercises on foam steps promote dissociation of left and right sides, while mimicking the rhythmic up and down of pedaling.

Parents receive weekly hand-outs describing ways to implement the class exercises at home without special equipment. For example, grapevine stepping and single leg stance with eyes closed adapt easily to a home program.

Bonding with the bike

Week three is an exciting session. The children bring their bikes (sans training wheels) to the clinic – not for riding, but for “bonding”. Wearing helmets, they practice mounting, dismounting, walking along beside the bike pushing it, and turning the bike around – all skills which require a “feel.” The children also practice falling off their bikes onto the forgiving surface of soft mats.

The fit of the bike is important too. The child must be able to sit on the bike with both feet flat on the floor, increasing both gravitational security and confidence. This learning bike may be smaller than the one the child ultimately chooses once he or she has become a successful rider.

Taking the bike outside

Weeks four, five and six take place outdoors at a carefully selected community site on a gently sloping grassy area for the first outdoor lesson. Why grass? To alleviate the fear of falling on asphalt or cement. Why a slope? To make pedaling easier. And why an open area? To require less steering so the child can concentrate on balancing.

The therapist runs along beside, providing balance assistance at the bike seat as needed, while the child steers independently.   Parents are welcome to be runners if the child invites them, or they can be cheering spectators.

In the final two weeks of class, some children advance to bike trail riding as their steering improves. Independent starting and stopping are refining skills usually gained during these weeks.


We measure biking achievement as follows:

  1. Downhill on grass with assist
  2. Independent downhill on grass
  3. On bike path with assist
  4. On bike path with assist for start/stop only
  5. Independent rider

Thirty-seven children, ages 7 – 14, have been through the “Spinning Wheels” program. Twenty-five students (68%) achieved either a Level 4 or 5 after a single 6-week course. Ten students (27%) achieved Level 2 or 3.

Two significantly impaired students attained only Level 1 rating. One of those with Down’s Syndrome, whose balance was severely compromised, was able to mount and dismount her bike independently after 6 weeks. And the other with cerebral palsy, was able to ride his bike with assistance on grass but was unable to remove his foot from the pedal strap for a controlled stop. Parents report that with continued home practice following the 6-week course many more students advanced to higher levels.

“Spinning Wheels” teaches far more than bike riding. The successful student comes away with improved balance, coordination, and confidence – fundamentals which transfer into the social, physical and emotional arenas. Now, let’s all go for a bike ride.

Bert Richards, PTA and Gin Utermohlen, PT and Physical Therapy Department Supervisor, co-developed and co-teach “Spinning Wheels” at The Abilities Center, a pediatric OT, PT, and Speech clinic in West Bloomfield, Michigan. For more information visit www.abilitiescenter.com.

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Listening Skills http://www.epidemicanswers.org/listening-skills/ http://www.epidemicanswers.org/listening-skills/#comments Wed, 12 Nov 2014 02:18:14 +0000 http://www.epidemicanswers.org/?p=7429 Listening Skillsby Patty Lemer, Chairman of the Board, Epidemic Answers

In her book, Listening with the Whole Body, Sheila Frick asserts that listening is active, voluntary, dynamic and continually adapting.

Hearing and eyesight are passive; listening  skills and vision are active. They require the brain to act upon, perceive, interpret and store information. They are cognitive functions that distinguish human beings.

Although I have lectured and written widely about vision, I have only recently become interested in the dynamics of listening. I am fortunate, however, to have had key professionals in the field of listening share their perspective.

I am indebted to Valerie DeJean at the Spectrum Center as well as Sabra Gelfond Ingall and Sally Brockett for introducing us to Dr. Stephen Edelson, President of the Society for Auditory Integration (SAIT).

Listening develops

It all starts with vibration. The ear of the unborn child responds to heartbeat, respiration, and visceral noises, and most importantly to the mother’s voice. These reactions are crucial to mother-child bonding, and to later development of speech and language. A two month old embryo has everything necessary for full vestibular function. By five months after conception, the fetus can actually process sound, which stimulates muscle tone, balance and equilibrium.

Children with auditory problems, exacerbated by chronic ear infections, need remediation listening to music and participating in auditory therapies can be life-changing.

Listening requires a model

Rhythms and intonations in the womb lay the foundation for listening. A child speaks the “mother tongue” by retaining the ability to hear and form sounds he/she hears, and dropping out those that are missing. Later listening depends not only on the energizing effect of touch, movement and sound, but on modeling, as well.

Maybe many children today are poor listeners because we are “double-tasking” adults, who lack an “in box” for their queries. Children perceive us as not listening and then model that behavior.

Listening and vision are a team

Since sound does not arrive at the two ears simultaneously, the time interval difference contributes to our perception about spatial relationships. Gradually, appreciation of visual and auditory space coincides.

Good listeners can relate vivid images in their mind’s eye… a Technicolor movie for many. Poor listeners have blank screens. Expert listeners communicate involvement with the speaker through gesture, facial expression and affect, as well as voice.

Listening without vision is challenging

Visuals are absent on the telephone, so the listener must depend on voice, intonation and cadence to enhance understanding. Have you ever tried having a phone conversation with someone who is emptying the dishwasher, answering e-mail, or playing a computer game? These distractions interfere with good listening, which requires quiet both internally and externally.

Listening is a gift

The effort and attention we give to enhancing our listening is an invaluable gift to ourselves and our children. Carla Hannaford in Awakening the Child Heart points out that the literal translation of the Chinese symbol for listening is “use the heart to listen.”

Kay Lindahl’s beautiful book, illustrated by Amy Schnapper, details many aspects of listening. Founder of The Listening Center in California, she provides the following guidelines:

  • Listen without judgment. The purpose of dialogue is to understand, not judge right or wrong, good or bad. When you judge, you are conversing with yourself, not another.
  • Listen for understanding. You don’t have to agree or believe… just understand.
  • Ask clarifying questions. These assist understanding.
  • Suspend assumptions. You know you are making an assumption if you are annoyed or upset. Let it be. Resume trying to understand.
  • Make “I” statements. Speak for yourself, not “everyone.” Take ownership of what you say.
  • Suspend status. All are equal in the dialogue process: no seniority or hierarchy.
  • Honor confidentiality. Create a safe space for self-expression.
  • Speak one at a time. When two people are talking at once, neither is listening.
  • Respect silence. Take time to reflect on what you heard and how you want to respond.

Listening takes practice

Practice being present in every conversation.

See these books for activities and ideas on enhancing listening skills.

  • Listening with the Whole Body, Sheila Frick
  • How to Develop Your Child’s Intelligence, G.N. Getman
  • When Listening Comes Alive, Paul Madoule



Contact Vital Links, for workshops incorporating therapeutic listening (www.vitalllinks.net or 608-270-5424)


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Sugar Addiction http://www.epidemicanswers.org/sugar-addiction/ http://www.epidemicanswers.org/sugar-addiction/#comments Fri, 24 Oct 2014 01:05:04 +0000 http://www.epidemicanswers.org/?p=7381 by Kelly Dorfman, MS, LND

Sugar AddictionSam will eat as many cookies as I give him but won’t touch regular meals.” “Erin is such a terrible eater. All she likes are French fries and bagels. If I suggest anything else, she has a fit!” Sound familiar? Are white foods the diet wreckers at your house?

Sugar and white starches like bagels and potatoes, the mainstay of many kids’ diets, are high in simple carbohydrates. These foods cannot sustain energy evenly because the body metabolizes them too quickly. Complex carbohydrates, found in whole grains, beans and vegetables often missing from kids’ diets, are more sustaining because they release energy over a longer period of time.

A recent study has demonstrated what frazzled parents have suspected for years; simple carbohydrates are addicting. Dr. Bartley Hoebel, a professor at Princeton, discovered that when rodents tasted sugar, their brains released opioids just like addictive drugs. Rats showed signs of sugar dependence in just ten days.

Sugar addiction and simple carbohydrate addiction blunts desire for more nutritious food. When children rely on this fast energy, blood sugar levels spike and drop, resulting in moodiness and unfocused behavior. In this state all they want is more sugar. Reasoning with addicts is fruitless, unless they are taken off the blood sugar roller coaster.

Soothing Sugar Addiction

Remove rather than add

You can eliminate all refined sugar from your menu, but you cannot force a child to eat good food. Some parents believe a cookie is better than nothing, but if a cookie is waiting, a carbohydrate addict will wait too. When refined sugar is not available, blood sugar levels will even out after initial withdrawal.

Use treats only as a follow-up to a healthy meal

When your child is eating a healthy, balanced diet and no longer has mood swings, a sweet treat may be OK after a meal. Observe your child’s mood carefully though; for some children sugary foods always disrupt blood sugar balance.

Substitute foods containing healthy sugars

Fresh and dried fruit are the best way to satisfy a sweet craving. Stevia is another possible choice. This natural sweetener is derived from the leaves of a South American shrub and is hundreds of times sweeter than cane sugar. It has been used safely in other countries for decades, but only in small quantities. Studies where rats ingested large amounts found potential problems.

Avoid artificial sugar substitutes completely

Aspartame (NutriSweet) is made up of the amino acids aspartate and phenylalanine. The brain carefully controls the concentration of aspartate because it is extremely excitatory. According to neurosurgeon Russell Blaylock, when aspartame is eaten in large doses, it causes neurons to degenerate and die. They excite themselves to death. For more information, read his book, Excitotoxins: The Taste That Kills.

Once aspartame use peaked, consumer complaints revealed that it caused headaches and lowered seizure thresholds. Children with developmental and cognitive delays are even more prone to these types of neurological stress.

Strengthen breakfast

If children start the day with a weak breakfast, such as waffles with syrup or cereal, it is difficult to get them off the carbohydrate track. A child with sensory issues sometimes skips lunch because noisy cafeterias are distracting. By the time he gets home from school, he is frantic for the fast energy of simple carbohydrates.

Consider serving longer lasting lunch and dinner foods for breakfast. Students need energy at 10 am, not 10 pm.  Chicken and vegetable dumplings, fish sticks, taquitos and soup are breakfast favorites at our house. All can be heated up in minutes.  Food should be concentrated around the time children need energy.

Tie protein to starch

If a child is absolutely stuck on pasta, add some finely ground meat, nuts or even protein powder to the sauce. Offer bread only as part of a sandwich or spread with a seed or nut butter. Put a starchy coat on small pieces of fish or chicken.

Utilize protein supplements

Protein powder goes down easily in a shake mixed with frozen fruit in rice or potato milk. You can also substitute 1/3 of a cup of protein powder for flour in muffin and pancake recipes. There are rice- and pea-based protein powders, as well as a gelatin type for kids who cannot handle the texture of powders (Twin Labs Amino Fuel).

If we recognize over-consumption of sugar as a possible addiction, we can embrace a solution geared to the seriousness of the problem.  Often a child’s carbohydrate compulsion fails to improve because a parent has the same issue.  Addressing eating habits as a family, with all members working together, can benefit everyone.

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Child Not Sleeping Well – What to Do? http://www.epidemicanswers.org/child-not-sleeping-well/ http://www.epidemicanswers.org/child-not-sleeping-well/#comments Tue, 14 Oct 2014 01:00:43 +0000 http://www.epidemicanswers.org/?p=7353 by Anne Buckley Reen, OTR/L

Child Not Sleeping Well - What to Do?Most of us take a good night’s sleep for granted. For many children and adults however, lack of sleep severely inhibits their ability to function and experience positive emotional states and good health. The SANE approach facilitates change through restorative Sleep, Activities to reduce stress, balanced Nutrition, and nurturing Environments for a child not sleeping well.


Sleep is essential. A biologically restorative state of consciousness, sleep replenishes the body on all levels: cellular, endocrine, immune, metabolic, physical and emotional. It repairs and restores major organs and brain chemicals needed for coping, memory and attention.

In the absence of a good night’s sleep, the body and brain begin a slow deterioration impacting on all areas of health and function. Although the body can survive for a month or more without food, death can occur in a week without sleep. Three nights without restorative sleep can produce a state known as “sleep deprived psychosis,” in which rational thinking is impossible. Epilepsy can occur after 24 hours without sleep.

A child not sleeping well is often cranky and irritable. Some have trouble falling asleep, others staying asleep. Both problems could be caused by poor self-regulatory abilities which result in them seeking something (a thumb or blankie) or someone (a sibling or parent) to help. After a restless night, they are easily stressed, moody, labile and difficult to calm.

Poor sleepers are not happy kids. The reason for this is simple. During restorative sleep, the brain and body produce serotonin, a chemical necessary for mood stabilization, coping, attention and memory. The less serotonin available, the less able one is to deal even with the most mundane day-to-day task. Picky kids get pickier, cranky kids get crankier and spacey kids get further detached.   With insufficient production of brain chemicals necessary for memory and attention, poor sleepers tend to be poor students as well.


Stress depletes our coping chemistry, throwing the entire nervous system out of balance, and thus disrupting sleep. Children who are stressed require strategies and consistent routines to help calm mind and body. Physical and breathing exercises both balance brain chemistry. A 10-minute walk or slow jog, and deep breathing, especially in the morning and mid-day, are powerful regulators and reduce arousal.

A sleep hygiene program, including routines and a set schedule, beginning sleep 30 minutes before lights out, are essential for all children, but especially for children with issues. Following this routine at the same time every night, most parents report significant changes in 1-2 weeks.

  • Establish a set bedtime7:30 pm for preschoolers and 8:30 pm for school-age.
  • Banish TV, computer or video games for at least one hour before bedtime:  These tend to rev up, rather than calm down, young minds.
  • Provide a calming and soothing warm bath for about 15 minutes, followed by a deep towel massage to arms, legs, back, hands and feet:  Add Epsom salts for detox and calming. Speak quietly and soothingly. Put on pajamas and get straight into bed. (This is important because the body temperature drops after coming out of the bath, just as it does in the first stage of sleep- so the body is already “gearing down.”)
  • Read one short story and turn the lights out:  Accept no excuses for more.


In order to fall asleep, stay asleep and sleep restoratively, the body requires certain nutrients. According to Sidney Baker, MD, protein and B vitamins, especially at breakfast and lunch, are key to influencing the brain’s ability to achieve a deep restorative sleep 12 hours later. Diets high in sugar and other stimulants (chocolate, caffeine) will inhibit sleep. Save these treats for special occasions; never eat them after 4 pm. Check also for side effects of medications which very often interfere with sleep cycles.

If necessary, you can use supplements to calm the body and ready it for sleep.


Environmental factors including space, structure, sounds and light can both positively and negatively affect sleep. Adjusting the energy flow in children’s bedrooms according to feng shui principles can help. For children who need lights on to fall asleep, get a dimmer switch and turn lights all the way out, once they are asleep. Any light on in the night will stimulate the pineal gland and inhibit production of sleep hormone.

Music with a 60-beat-per-minute tempo can help to calm to body and mind and regulate the child who is out of balance. Try two great CDs: “Baby Go To Sleep” (birth to 7) and “The Surf” (all ages). Played throughout the night on repeat mode the music enhances regulation of the sleep cycles.

Absence of sleep can produce a variety of disorders and influence behavioral and attention problems. A foundation for all function, sleep is a necessary starting point for getting our children “in balance.”

Good night!

Anne Buckley Reen is a pediatric occupational therapist and President of OT For Kids. She can be reached at 718-318-1180. She lectures nationally with Debra Dickson, PT.

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Strabismus and Amblyopia http://www.epidemicanswers.org/strabismus-and-amblyopia/ http://www.epidemicanswers.org/strabismus-and-amblyopia/#comments Mon, 06 Oct 2014 01:01:24 +0000 http://www.epidemicanswers.org/?p=7307 Strabismus and AmblyopiaThis article is adapted from materials provided by OEP, COVD and Your Child’s Vision by Richard S. Kavner. Dr. Irwin Suchoff, editor of the Journal of Behavioral Optometry (JBO), contributed to this post.

Strabismus and amblyopia are visual conditions that affect the ability of the eyes and the brain to communicate. In a 1999 study by Dr. Melvin Kaplan, 17 of 34 children with autism had a strabismus.

What Happens Normally?

As we scan our environment, not only must our two eyes simultaneously aim at the same object, but our brains must integrate a message from each eye into a single image.

The process of fusion (combining the pictures from each eye into a single picture) enables us to perceive three-dimensional depth and helps us to determine our relationships to objects in our environment. Vision emerges as the primary sense when a typical child integrates it with touch, movement and the other senses.

What Goes Wrong?

In children with developmental delays, signs of incomplete or inefficient eye teaming (binocularity) usually appear around eighteen months, just when expressive language is emerging. However, later onset is not uncommon.

Poor eye teaming can be associated with neurological disturbances related to heavy metal toxicity, high fevers and childhood illnesses such as strep or pneumonia.

Initially, the inability to efficiently and effectively team the eyes may appear only at times of illness, fatigue or intense concentration. However, frequently, the vulnerable binocularity can worsen and strabismus and amblyopia can result.

First, Strabismus…

In strabismus, commonly known as crossed or wall eyes, a person’s eyes are not aligned. One eye accurately aims at the object of regard while the other eye misses it by aiming above, below or to the left or right of it. Double vision (diplopia) then results. The misalignment may be constant or intermittent, and thus not always noticeable. Disorganization and confusion follow as the brain struggles to integrate competing messages.

Next, Amblyopia…

In order to minimize the disorganization and confusion, sometimes the unconscious mind adapts to strabismus by suppressing signals from the faulty aiming eye. Eventually, visual suppression leads to amblyopia or “lazy eye,” in which the nerves that transport and interpret visual information lose some of their ability. The result is poor vision in one eye, due to an interference in the neurological interpretive mechanism.

In many instances the reduced vision cannot be corrected with glasses or surgery. With the eyes functioning at less than 100% efficiency, any sustained visual activity such as reading may require extra effort and strain. As in strabismus, the only obvious sign of amblyopia may be an eye turn. However, some people with amblyopia may turn their heads to see certain things or close one eye when reading.

Strabismus and Amblyopia Affect Spatial Relations and Balance

The cosmetic aspect of misalignment is obvious. Even more important are the effects on function and vision. Strabismus can disrupt the ability to orient oneself in space.  A good number of the eye’s neural fibers bring information to the body’s balance system. If they deliver inaccurate information, the person’s sense of where he is in space can be compromised.

The Psychological Effects of Strabismus

Strabismus and double vision can adversely affect social-emotional development. A child who is disoriented in space experiences himself and his environment as unstable and unpredictable. He may grow increasingly inward, become belligerent or demonstrate sensory defensiveness. Does this sound hauntingly similar to “autism?”

Treatment and Referral

Strabismus and amblyopia always require attention. These conditions rarely go away untreated; nor do children outgrow them. Surgery may cosmetically straighten the eyes but usually does not improve visual function, especially without pre- and post-surgical vision therapy.

Patching the non-amblyopic eye to force the amblyopic eye to see is also of limited value without vision therapy. Effective treatment programs combine usually involve lenses, prisms and motor activity as part of vision therapy to teach the eyes, body and brain to work together.

Research shows that vision therapy can be effective at any age, but more treatment is needed the longer the condition has existed. Proper early childhood examinations are essential since many patients with amblyopia are unaware that their vision is aberrant until they undergo a screening.

Untreated binocular vision problems can pose obstacles to the effective treatment of sensory integration and speech-language disorders and other developmental delays. Professionals treating children with autism, learning and behavioral issues, especially occupational and speech/language therapists, must be alert to signs of poor binocularity so that they can make an appropriate referral.

If you suspect that a child’s eyes don¹t work together, go to www.covd.org to find a qualified eye care practitioner in your area.

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Schizophrenia and Nutrition http://www.epidemicanswers.org/schizophrenia-and-nutrition/ http://www.epidemicanswers.org/schizophrenia-and-nutrition/#comments Sat, 04 Oct 2014 01:43:07 +0000 http://www.epidemicanswers.org/?p=7300 Schizophrenia and Nutritionby Patricia S. Lemer, M.Ed., NCC, M.S. Bus.

A friend in Pittsburgh was astonished when I suggested that Epidemic Answers had something to offer people with schizophrenia. She treats inpatient adults who are so disabled that they cannot work.

In addition to heavy medication, her clinic provides three meals a day, rich in wheat and dairy products. In this and most psychiatric facilities, pharmaceuticals are frequently the first, and sometimes the only option doctors choose to alleviate and mask difficult behaviors.

I reminded my friend that autism was originally labeled “childhood schizophrenia,” and that almost no one today classifies autism spectrum disorders as “mental” illnesses.

Even though The Diagnostic and Statistical Manual (DSM), published by the American Psychiatric Association, still lists that diagnosis, the disease once blamed on refrigerator mothers is now recognized as having other causes.

I first learned about “mental” illness as a child in Pittsburgh. My grandmother “suffered” (a word I cannot stand to this day) from depression. From her forties to her eighties, she went from one “mental” hospital to another, enduring endless talk therapy, experimental drugs, humiliation, and even shock treatments. A kind, gentle woman who loved poetry, music and books, she did not fit in. My family’s efforts to help her were painful for her favorite grand-daughter to watch.

I believe that the injustice I saw as a teen led me to major in psychology in college. What an eye-opener I had my freshman year when my Psych 101 professor introduced me to the work of psychiatrist, Thomas Szasz. His book, The Myth of Mental Illness, was way ahead of its time in suggesting that talk therapy and labeling people’s behavior as aberrant was unethical. I was fascinated by these ideas.

Unfortunately, mainstream thinking still considers schizophrenia a “mental” disease.  Mad in America by Robert Whitaker documents the history of mistreatment of the mentally ill. This extraordinarily well-researched work confirms what many have suspected: that drug companies skewed their studies, employed charlatan scientists to carry them out and hid dangerous side effects from patients…all to make huge profits.

Yet, we are moving forward. TIME Magazine had a cover article entitled “The Link between Mental and Physical Health.” This generation’s psychiatrists were educated during the nineties, or what Whitaker calls the decade of “Mad Medicine” when new “breakthrough” drugs were brought to market. They may not know the long history of successful use of diet and nutrition to treat “mental” illness. Orthomolecular medicine is over 50 years old.

Schizophrenia and Nutrition

The term “orthomolecular” was coined by Linus Pauling in 1952: “ortho” meaning ”right” and “molecular” referring to the cells. Thus,”orthomolecular” means supplying the body’s cells with the right mix of nutrients. Carl Pfeiffer, M.D, Ph.D. was a pioneer in nutritional research, and among the first to recognize the mind-body connection. He recommended a combination of B vitamins, zinc and magnesium to abate anxiety, depression, phobias and schizophrenia. Does that nutrient cocktail sound familiar?

In the 80’s, I read the story of Pfeiffer’s patient, Rickie. The daughter of a psychiatrist Frederic Flach, she was diagnosed with schizophrenia as a teen. After years seeking help in the wrong places, her father finally found Pfeiffer at the Princeton Bio Center in New Jersey. He and optometrist Melvin Kaplan helped Rickie get well. While Pfeiffer worked on her bio-chemistry with diet and nutrition, Kaplan taught her eyes to work together using lenses, prisms and vision therapy. Today, Rickie is counseling people like herself, and Mel Kaplan primarily sees children with autism.

Pfeiffer’s legacy is the Pfeiffer Treatment Center, a branch of the Health Research Institute in Warrenville, IL.   Dr. Pfeiffer became interested in the research conducted at HRI, and worked with the HRI team to correct chemical imbalances until his death in 1988. William Walsh, PhD who discovered the importance of MT promoters in autism named the treatment facility in his honor.

That “mental” illness is biological should be no surprise to those of you who have successfully pursued special diets and nutritional support. My friend’s inability to connect “mental” illness to Epidemic Answers’ mission helped me realize that what I take for granted is still not generally accepted.

What saddens me is that Pittsburgh has seen so little change of attitude toward “mental” illness in over 40 years. How can we expand to reach those working with “mentally” ill or “emotionally” disturbed? If you have access to psychiatric clinics or schools, please share our information.

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Improving Picky Eating by Changing Adult Behavior http://www.epidemicanswers.org/improving-picky-eating-changing-adult-behavior/ http://www.epidemicanswers.org/improving-picky-eating-changing-adult-behavior/#comments Tue, 30 Sep 2014 00:43:36 +0000 http://www.epidemicanswers.org/?p=7281 Improving Picky Eating by Changing Adult Behaviorby Kelly Dorfman, MS, LND

Parenting a child who refuses to eat is distressing. Hours can be wasted on creative dishes that are spit out. Help is on the way!

Treating underlying biomedical and sensory problems is always the top priority when trying to improve the diet. Ruling out digestive and oral motor issues are important first steps.

Positive change also occurs when parents take charge of their own behavior. Psychotherapists insist that you cannot change another person but you can affect the dynamics of the relationship by changing yourself. This article looks at how adult behavior can contribute to picky eating, and devising a workable plan that encourages a wider choice of foods without resistance.

Accidental Negative Reinforcement

Frustration with a child’s rigidity often leads to fruitless negotiations and bribes. When inducements fail, yelling is next. Yet this inordinate amount of focused attention “accidentally” reinforces the very conduct that needs changing. Children need attention and they will accept it whether it is positive or negative. Eventually, youngsters learn to get attention by cooperating.

To encourage children to eat better, stick to your goals without forcing. Eating behavior is tricky to address because even a child with severe developmental delays can refuse food. People like to have power over their environment. Children with sensory issues have a stronger need to control their surroundings in order to lessen their anxiety. In the hopes of avoiding angry scenes, sympathetic parents give up.

Don’t Force, Don’t Give in

Giving in reinforces the stuck behavior by enabling poor eating. Because the child is closely linked to the parent, he must shift in response.

Make Your Plan

Step 1:  Work on one food at a time.

A new food every day can be overwhelming. Pick one item that would improve the diet. If a child already eats ice cream and milk, pudding is not qualitatively better. Consider fruits, vegetables or protein foods (like small pieces of chicken). These foods are often missing in the diets of fussy eaters.

Choose a version of the food close in texture to other foods the child eats. Kids preferring soft creamy foods might handle applesauce or pureed chicken soup. For those drawn to crunch try peeled cucumbers or thinly sliced apple. Also consider foods the child liked in the past but no longer eats.

Step 2:  Give your child a small “job”.

Learning to eat well is a job. The child should be told ahead of time that their job is to learn to eat healthy foods like Elmo, Thomas the Tank Engine or some other figure they like. Their “job” is a doable task, such as taking one bite or in extreme cases, picking up the food. Encourage them to help you select the food by giving them several choices. Keep discussion about the “job” to a minimum.

If the job is unfinished, become unavailable for anything else the child wants until it is. Sadly, the TV and computer cannot be turned on. You would love to go to the park, as soon as job is done.

Step 3:  Acknowledge only positive behavior.

Most fussy eaters will say, “no”, when asked whether they want pears or baby carrots. If this happens say, “I see you need help choosing, so I will pick this time. You can choose next time.” The child can then see that lack of cooperation changes nothing.

Food appearing at dinner (a better time than the morning) is another opportunity for the child to see if resistance works. If the task is accomplished, stay warm and connected. Act like you knew he could do it all along. If the child refuses or throws a fit, briefly make sure he is safe and walk away. Say you will return when he calms down.

Do not threaten, “If only you would eat…..”. Instead utilize when; then. “When you are finished eating, then we can read a story.” If the child wanders around all evening without eating the food, simply comment that tomorrow you will be working on the job again.

Step 4:  If you are losing your temper; take a time out.

We want to teach children that cooperating works. This means staying calm, when they are frustrated and misbehaving. After a long day, this can be challenging. When you reach your limit, give yourself a time out. Forcing the child into time-out rewards bad conduct with increased interaction. Your child needs you to stay calm, so he can get calm.

You CAN Do This!

When adults focus on positive attempts at eating, even the most finicky eaters can expand their palates. How about some Brussel sprouts with that hamburger?

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