Interventions for autism spectrum disorders.
|Article Type:||Book review|
|Subject:||Books (Book reviews)|
|Publication:||Name: Townsend Letter Publisher: The Townsend Letter Group Audience: General; Professional Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2009 The Townsend Letter Group ISSN: 1940-5464|
|Issue:||Date: Feb-March, 2009 Source Issue: 307-308|
|Topic:||NamedWork: Envisioning A Bright Future: Interventions that Work for Children and Adults with Autism Spectrum Disorders (Nonfiction work)|
|Persons:||Reviewee: Lemer, Patricia S.|
Envisioning a Bright Future: Interventions that Work for Children
and Adults with Autism Spectrum Disorders
edited by Patricia S. Lemer
Optometric Extensions Program Foundation, Inc.
1921 E. Carnegie Avenue, Suite 3-L, Santa Ana, California 92705-5510
Softcover, c, 2008; $35; 414 pp.
We have come a long way from the days when autism was diagnosed as an incurable psychological disorder caused by bad mothers. Now, though, we are faced with an epidemic of children with autism and myriad therapies and treatments. How is a parent to make sense of the many options available? Fortunately, our understanding of autism has matured enough that a parent can formulate an effective regimen with the help of specialists and books. The book Envisioning a Bright Future could prove to be an indispensable resource.
This is a comprehensive book about autism spectrum disorders (ASD), which encompass everything from learning and attention disorders to the most severe forms of autism. Several experts in the field have contributed chapters. Not only is there an outstanding overview of the historical and current understanding of these baffling illnesses, but also discussions of a vast array of treatments. Included in the treatments is one that may be new to most readers: vision therapy.
Lemer came upon the utility of vision therapy in her work as a counseling psychologist. While working with children and with multidisciplinary teams, she observed positive results from special diets and movement therapy, and began to realize the successful therapies were treating the cause of the children's difficulties rather than the symptoms. Then, by chance she observed improvements in adult and child clients who had vision therapy. Her curiosity led her to explore the connection between vision and cognition, achievement and personality. The result has been Lemer's efforts to educate the medical community to include an optometrist in a child's treatment team.
As it is explained in this book, vision is an integral part of the development process in children. The ages of 18 months to four years, when autism is often diagnosed, is an important time in the development of vision, language, and socialization skills. During this time, vision starts to dominate the movement system, and focal vision develops when vision combines with the other senses. When there are failures in this development and the vision system is inefficient, the child must experience his environment through movement and touch. The flapping of arms that we view as aberrant behavior may actually be the child's method of locating herself within space.
Another example of visual dysfunction affecting autistic children can be found in their inability to coordinate their central and peripheral vision, leaving them with preference for one or the other. A child whose vision is primarily focal may stare at an object endlessly. A child who uses peripheral vision will
"The only way to determine possible cause(s) of an individual's autism is to take a complete history of all possible Total Load factors, including genetic, pre-natal, natal, environmental, developmental and medical concerns." be attracted to moving objects, bright colors, and shadows. Poor coordination of the peripheral and focal vision leads to difficulties in focusing, attention, spatial organization, and visual perception.
Though the author refers the reader to other sources for a complete description of how vision develops, she provides an adequate overview to persuade the reader to include vision evaluation and possible therapy in the diagnosis and treatment for a child with ASD. Lemer supplies two very technical chapters to help educate optometrists about proper conduct of a vision evaluation and vision therapy techniques for those in need.
The causes of ASD fall under the umbrella of "total load." Here we find a large list of contributing factors that, when occurring together in a fetus or small child, can cause dysfunction in any number of systems. If there is a traumatic birth, the child may have structural problems that can be treated with chiropractic and craniosacral therapy. There are immune problems in the child with allergies, sensitivities, bacterial and yeast infections, and respiratory conditions. And exposure to toxins, depending upon timing, can lead to developmental abnormalities and later an excessive load of toxic chemicals in the body. One source of toxic exposure has been through vaccines, which the author discusses in depth.
The first step is to reduce the total load, which is done through diet, nutritional supplements, and detoxification. There are several diet options that focus on removing substances known to be problems for children with autism, such as gluten and casein. Another option, the Feingold diet, removes foods that contain artificial additives, because impaired detoxification systems are often found in children with autism. Supplements found to be beneficial, such as essential fatty acids and magnesium, are added to the regimen. Finally, detoxification is recommended, because children with autism have been found to have high levels of toxic chemicals and low levels of antioxidants in their bodies. Detoxification methods include chelation through various agents, infrared sauna, and hyperbaric oxygen.
The other chapters of the book examine the possible causes, and detail many of the successful therapies used for treatment of ASD. At first glance the therapies may seem disparate, but tucked away in this book is a gem that unfies these diverse approaches. Judith Bluestone of the HANDLE Institute informs us that what we view as aberrant behavior in these children should instead be viewed as communication, not symptoms that need to be controlled or masked. This and the fact that each child is unique underlie the usefulness of the many therapies discussed.
The modalities offered cover a wide range that includes treating retained primitive reflexes that are impeding the child's motor development and sound-based therapies to help the child perceive through sound and overcome aural sensitivities. And what may be the most urgent for parents is a chapter concerning the often missing interaction between child and parent. Here the parent will learn of several methods to engage the child through play. This slow process requires the parent to meet the child at her level of comprehension and perception, with the goal of bringing her into the larger world.
These and many other therapies are discussed in enough detail that the reader will come away with a good understanding of why the intervention works and what dysfunction the child is exhibiting to warrant that treatment. In fact there is so much information in this book that it could leave parents overwhelmed, but Lemer closes the book with a step-by-step guide for establishing priorities in treatment.
Envisioning a Bright Future may turn out to be, a milestone book for people who want to learn more about autism. Lemer succeeds in integrating the consideration of vision in diagnosis and therapy. She also succeeds in altering our perceptions of children with these disorders. Through her able descriptions of the therapies, we come to understand that the behavior we find so puzzling is in fact an expression of sensory and developmental dysfunction in these children. In a way, they are behaving appropriately according to certain limitations. The job, then, for parents and specialists is to help them overcome the dysfunctions rather than force them into altered behaviors. This realization offers hope and a deeper compassion for the child facing these challenges.
|Gale Copyright:||Copyright 2009 Gale, Cengage Learning. All rights reserved.|