Sunday, February 16, 2014

Book Review: The Parent's Guide to the Medical World of Autism by Edward Aull, MD

The Parent's Guide to the Medical World of Autism: A Physician Explains Diagnosis, Medications and Treatments by Edward Aull, MD Behavioral Pediatrician.

It was with great trepidation that I approached this book. I knew that it was an important topic but both the title and the cover make it seem like it would be a very tough read. Much to my surprise though, the first half is light and breezy and the second is too informative to put down.

This is essentially two books in one. The first half of the book is about diagnostic procedures while the second is all about medication.

The author, Dr Aull, is a Behavioral Pediatrician with over 30 years of experience treating and diagnosing patients on the autism spectrum. In this book he draws upon his experience to provide many real-world long-term examples of the effects of various medications.

I enjoyed the first half of the book much more than the second because it was much more relatable and because it was far less technical.

Dr Aull talks about the different things that he looks for when patients enter his practice. It was quite interesting to discover that he places such a high emphasis on genetic traits. He talks about observations he makes in a child's parents during the interview and  the questions he asks about the family.

His personal take on Asperger's syndrome is fascinating and he ascribes many of the common symptoms to anxiety, thus increasing the importance of anti-anxiety medications. The book is peppered with stories from his experiences with patients and informed explanations of their "unusual" behavior.

Dr. Aull discusses the importance of fully understanding a diagnosis before prescribing medications and the need to test several medications before settling on one which is most suitable. It was particularly interesting to hear how he uses identical twins to reduce the time required to find the best treatment for a given individual.

The second half of the book is somewhat drier, dealing with medications and specifics. There is no discussion on the issue of whether or not medication is appropriate. The social questions are not part of the book and it is assumed that a parent reading this book is more concerned with choosing the right medication than a debate about whether or not medication is actually required.

The medication chapters discuss different categories of medications and their use in individuals with Asperger's syndrome before moving on to discussions of medications which can assist with ADHD and sleep issues. There is a glossary at the start of the book but it's not really very comprehensive.  It's probably best that when reading this section you draw out a table and put medications into the various categories that he talks about, for easy reference.

Fortunately, he refers to medications by both their class and trade name.  This makes it easier to identify medications you may have tried. There are some amazing insights into medications in this section which include discussions of how often to use them, how long a testing period should take and what changes parents should expect to see.  There is also some discussion on how different medications interact with each other. 

For example; the discussion on Melatonin, a sleep medication, suggests that children should be given 45 minutes of lights out, no object (eg: ipads, books, toys etc) sleep before parents use the drug. Dr Aull also explains that as a "Natural" drug, Melatonin is less rigidly controlled by standards and as a result, different brands will have very different construction and therefore very different effects.  It's all very good information.

A Very Useful Book
The Parent's Guide to the Medical World of Autism is a fascinating read which is presented in a way that makes its complex topic much easier to digest.

If you're considering medications or if your child is already on medication, it's well worth reading. Beyond that, every developmental pediatrician should have copies available in their waiting rooms particularly as the early sections cover many of the questions that are likely to occur to parents only after they have left the doctor's office.

The Parent's Guide to the Medical World of Autism: A Physician Explains Diagnosis, Medications and Treatments by Edward Aull, MD Behavioral Pediatrician is pretty much a one of a kind book that provides some amazing and helpful unbiased insights into medication. It is available from Future Horizons publishing and Amazon.

I was provided with a copy of The Parent's Guide to the Medical World of Autism: A Physician Explains Diagnosis, Medications and Treatments by Edward Aull, MD Behavioral Pediatrician free of charge for review purposes.

Thursday, February 13, 2014

Article: From Fish to Dogs – Selecting a Therapeutic Pet (at Special-ism)

When I was four, my parents got me a border collie cross something (Labrador, I think). It was an inspired decision. Spot became my "everywhere friend" and we had lots of adventures together. In fact, we became inseparable for the next eighteen years.

In the course of those eighteen years, Spot was a comfort, a companion, a friend that I could talk to and a playmate. He acted for my protection against bullies and managed to chase off a few snakes too.  There is no doubt in my mind that my life was much better because of spot.

My next article over at Special-ism all about pets, big and small. Perhaps your special needs child is asking for a pet and you're putting it off because you're not sure whether it would be a good idea?

Did you know that there are service dogs for people with autism? Do you want to know what they do?

Head over to Special-ism to have a read;

From Fish to Dogs – Selecting a Therapeutic Pet

Sunday, February 9, 2014

Aspergers and Bumping into Things.

I'm constantly bumping into things and I often have scrapes and bumps and bruises on my body but can't remember how they got there. It's the same for my kids and it's all to do with spatial awareness.

Spatial awareness, which is often also referred to as motor clumsiness is the ability to think about a figure, usually your own body, in three dimensions. 

Specifically it's about doing the mental calculations required to move your body through spaces without hitting other objects (unless you're hitting them on purpose, as in bat and ball games).  It's not always about your body though because sometimes it's about other moving objects, like catching a ball for instance, or "extended parts" of your body, such as  when moving furniture from one room to another without bumping into walls.

A lack of spacial awareness isn't one on of the defining criteria for autism and indeed I've seen some children on the spectrum with amazing ball control skills.  It is however one of the more common problems I've seen.

Testing for Spacial Awareness Problems
Obviously the easiest of the tests for spacial awareness is to throw a ball to your child and see whether or not he or she can catch it, more than once. In fact, ten times in a row is a good test.  Note that you're throwing the ball to them, not trying to make it difficult to catch.

Ball skills can be learned though, with practice and once your child has mastered these, it doesn't follow that their spacial awareness problems are "fixed", it simply means that they have better ball skills.

Another test is to test your child's ability to make their way through a maze.  Of course, mazes aren't easy to come by (except on paper) so unless you live near one, it's unlikely to be a test you can complete.

There's an online test here which I found very difficult and in which I only scored average. It could account for my poor spatial awareness.  I don't have enough information to say whether it's a good test or not but it is similar to other spatial tests I've seen. I would expect this test to be far too difficult for children.

Improving Spatial Awareness
Your spatial awareness isn't a static skill and even though it's common for people with aspergers to be a little "behind" it's something that can be improved on with a little effort. The best way to improve this skill is to use it. For children, this means getting off the computer and using this skill in real life.

Obstacle courses are a good starting point and you don't have to join the army to use one.  You'll find obstacle courses at scout centers and camp sites and of course, if you're savvy, you can make one yourself. Other things that can help to improve spatial awareness are things like climbing and body awareness sports like Karate.

If nothing else, improving your spatial awareness could save you a few bruises in the future.