What is Early Childhood Intervention and Why Is It Needed?

Early intervention (EI) is the process of developing a focused curriculum and treatment plan that is based on a thorough assessment and evaluation that fully encompassed an individual’s physical, mental, social and environmental challenged interspersed with and related to their diagnosis of a mental health disorder. By recognizing the weaknesses or challenges that a child is having with their development and actively trying to treat and change the way the body responds and reacts to the problem, early intervention has been shown to give those individuals affected with ASD the tools and abilities to responds more positively and culturally appropriately in their physical environments and in relationships with others. One reason that has been suggested for early intervention is that by helping and motivating a child to use areas of the brain that are not functioning well, new neurons and connections in the brain can be strengthened and formed. Other thoughts are that, by forcing the brain to have certain experiences, the ‘flexible’ young brain will begin to grow new connections and form new pathways towards more normal processing of information in the affected areas of the brain.

The process of early intervention should be used for all individuals that have been assessed and found to either be at risk of an autism diagnosis or are diagnosed. Another way of looking at it is that EI should be used for any individual found to have a delay in any aspect of the development process that could potentially be corrected with the use of therapy. Research suggests that the sooner… or ‘earlier’… in the child’s life that the intervention is made, the more permanent and positive change can be created in the child. How the intervention is utilized can depend on many factors including, parental or provider choice, what interventions are available, funding or lack thereof for treatment, the individual’s needs, etc… there are more than a dozen programs used for early intervention which include Floortime, Denver, SCERTS, and RDI. While these programs all have differences in how they attempt to facilitate change in the individual, the typical EI priorities usually work on forming spontaneous functional communication techniques, developing coping skills, and learning to interact and play with peers. Programs also tend to try and work on removing the motivations for negative behavior through different avenues and attempting to prevent the behavior from continuing to occur. Other samples of early intervention services that can be offered are speech or occupational therapy, assistive technology or auditory services, as well as counseling, medical or psychological services.

For a newly diagnosed child, one of the first steps is to create and develop an IFSP (Individualized Family Service Plan.) As part of that process, location(s) to begin therapy and what forms of beginning treatment should commence. Several kinds of information are incorporated in the IFSP including a rounded out examination of the child’s current development and needs, family abilities, resources, and desires, how and how much services should be provided and for how long as well as who is responsible for certain aspects of the treatment and also the goals or outcomes that are going to be focused on developing and achieving. For a newly diagnosed two year old child, an IFSP is developed and treatment usually consists of some forms of relationship development, speech or other physical therapies as well as work with interaction and self-soothing. For more newly diagnosed toddlers or babies, intervention treatment is usually performed in the home where the child knows their environment and will feel the most comfortable and open to the treatment.

It has been shown that early childhood intervention with individuals that struggle with developmental delays can create more positive social and future life outcomes. if you or a family member has used early intervention what have your experiences been?

Journey Forth #6 : The Accidental Relationship between Gluten and Casein

When I was first diagnosed with celiac disease and started to research the disorder but also the foods that were available, I ran across many people who started pushing me towards a gluten free-casein free diet not only for myself but for Bug as well- we both have the disease and I think he can thank my genes for that ;) I was skeptical and I am still a bit questioning about some theories behind the diet. This particular diet is recommended for many people with celiac disease and other food allergies and it has become one of the diets of choice for individuals with autism and other developmental disorders and is sometimes recommended for people with mental health disorders such as schizophrenia. So I'll cover the basics of both. (Can I stress that I am wading into territory that is not firmly entrenched in science or statistics yet.)

The basics of this diet are that the individual not only avoids gluten but also all foods that contain the dairy protein. Some need to do this due to a true allergy and some people report that they have reactions that are similar to gluten intolerance when consuming the dairy protein. This protein can be found in butter, cheese, cream and milk, as well as yogurt and countless other products including chocolate, lunch meat or other prepared meat products and other non-dairy products. Symptoms of a true milk allergy are very similar to gluten intolerance as well as wheat allergy and celiac disease so trying to separate out the allergies and sensitivities can be pretty rough and time consuming. The most common symptoms may include; multiple skin reactions, anaphylaxis, multiple digestive complaints (including diarrhea, vomiting, and pain), multiple reactions in the lungs (coughing, sneezing, shortness of breath or wheezing), migraines, irritability, hyperactivity and other personality changes, insomnia, fatigue, depression and anxiety... to start the list. ;) If the challenge of eliminating gluten from the diet seems to be formidable, adding the need for casein removal can make the challenge seem like a herculean task.

There are a few reasons put forward for the similarities in symptoms and the immune reactions in the body between ingestion of gluten and casein. All three have been and are currently under study by researchers.

Casein is one of the most common food allergies and some studies suggest that as much as thirty percent of the general population have elevated amounts of the antibodies in their blood.

Casein has a similar molecular structure to gluten and they both create similar metabolic byproducts from their breakdown and digestion.

The enzyme that is needed to digest dairy is found in the brush borders and the tips of the villi in the small intestine... which is the first area that is damaged in gluten consumption for those individuals who are susceptible. With the necessary enzymes being in low numbers or decimated, the digestive process fails until healing and enzyme re-population has commenced... in some cases, a year after a gluten exposure.

For many parents of children with mental health disorders or developmental delays such as autism, this diet is not seen as a “diet” per se, but as a necessity and way of life. The changes in both behavior as well as mentation have been pretty well documented in self reporting and other unofficial forums. From personal experience, I feel a lot more in 'control' of my mind when I haven't had gluten- celiac aside. These experiences as well as watching and learning from friends and parents who have navigated these particular waters, I have found a great deal of confirmation in my mind that there is a great deal of positive evidence for recommendation of this particular diet for people with specific diagnoses or conditions. So even as I stress that the scientific evidence isn't there yet, I feel like I would be remiss if I hadn’t taken the time to discuss it. Whether the problems are due to the body's confusion of the proteins, lack or appropriate digestive enzymes or even another allergy... the problems are very real and need to be dealt with by individual sufferers on a daily basis.

What are your thoughts? Do you personally have experiences with this diet and individuals who use it? Please share if you are willing to...! :)

The Year of the Cat :)

To the reader: One picture is slightly adult and immodest in content. This is your warning. :)

Exactly one year ago, I received a phone call at 6:30 in the morning from a young women in Ellsworth named Jane. Her call was the culmination of six months of advice and was to change my life a little bit more than I expected... because she brought Morianna into my life.

When I lived in Vegas, I used to do a lot of volunteer work for a an animal shelter called the Ark. It was a pretty large shelter and dealt with the majority of strays that were caught in the city limits. I thoroughly enjoyed some of the new skills that I learns and I was soon one of the leaders in training stray cat to become 'smooshable' - a skill that is needed for many people to choose them for a pet. It was a fun place to volunteer, where I saw some awful and sad things, but I also gained great friends, some of the most wonderful companions that I was to know over the last decade or so, and some neat skills that I figured I wouldn't use again after moving to Maine. (I also gained some wonderful rabbits for my grandfather and a few fun hamsters as well.) A few years ago when I had some spare time and my life was beginning its horrible upheaval, the 'local' shelter in Maine started a thrift store in Blue Hill to raise money and I happily joined its volunteer staff. I tagged items, sold them, and tried to help move items quickly to get as much money as I could thinking of the animals that would benefit by my service since the shelter itself was so far away. At one point a woman waked in and told me about some stray cats that lived behind the Riverside cafe and expressed her concern about their future lives and what could be done. I gave her advice on how to catch them- the slow but almost always successful way- and agreed to pick them up and get them to the shelter after she had been successful.

Six months later, I received a call saying she would try the next day and success! She caught a very terrified gray Persian covered with mattes... and eyes the six of dinner plates (maybe about six months old). Twelve hours later, I picked up my trap full with two slightly younger cats of clear mixed heritage... the spitting image of each other in markings though not color. I happily called the local shelter (also called the Ark) and was very distressed to learn a few hard facts. One is that while the Ark in Cherryfield, Maine is a shelter, they are very selective in the animals that they select- only animals that are healthy and appear easily adoptable as accepted with a donation. As I looked through the resources that I had I found that there is no really good funded organization for strays in this state and so the cats only options became clear. I dealt with them or they would be put to sleep. So I realized that all the cats that so many of us as volunteers and as shoppers thought we were supporting were not the lonely hurt strays we imagined. I still love the idea of the Ark and while think it serves a very useful purpose, I think that my energy needs to be more towards the smaller, less known, and less funded organizations that actually help the most needy and vulnerable... the feral population.

That didn't change my current situation however. I now had three stray cats in various stages of ill health and not even a real roof over my head. I needed to deal with the difficulties of introducing Brock to them slowly and trying to find them homes. In the end, one year later I still have all three of them and they have been one of the biggest blessings that I have gotten in the last year. The first thing I did was set all three of them up in a large dog crate. Their great fear of me was very apparent and I started in on some of the small things that I used to do to gain trust or at least less fear. I waited for a breakthrough and the breakthroughs can be slow (and usually are.) Stray cats that are older than a few weeks have usually had a few really bad experiences, bad nutrition as well as difficulties in their gestation and early weeks. All of these difficulties can cause brain damage, birth defects, disease, etc...

One of the youngest cracked in two days. She is a beautiful black and white female and around 1am she began to wail. Her fear, sorrow and confusion were very evident and I jumped out of bed and fought past the other two cats to clutch her in my hand. With the recklessness of past experience and the joy of the blessing, I held her softly against my bare skin (yes, I don't wear much to sleep) and crooned a hymn with some clicking and slow notes. For an hour I prayed and held her singing and talking softly and soon I was able to hold her and get dressed without a

great deal of fear from her. By morning, I could sit against the wall, warm and well dressed with a still slightly scared animal, but one who was open to learning about me. She became Morianna, my great companion, who would jump onto the bed for a few pats and would happily act kitteny one minute and feral the next. Over the last year, I have discovered a few things. Her health, while sound has been severely affected. She will never be a full size cat and may always be trapped in a 'teenage' body... slightly small and thin. She is not the sharpest cookie that I have ever had and her enthusiasm for fun and adventure can cause her great trouble as she makes the same mistakes over and over again, not learning the lesson the first time.... or the tenth time. :) Her relationship with Maximilian Robespierre

(my gerbil) has grown over time as he has consistently lured her over to the cage and then bitten her. Over time, Robespierre has gotten tired of biting her (or maybe he feels sorry for her or understands her mental limitations) because he now longer bites her and so he will stand up on his hind feet and throw shavings at her or use his hind feet to kick them in her face. Over the year, she has finally learned to sit close... but not too close! Her fear is almost gone... not quite gone, but has disappeared for the most part. But a few days ago, I walked into the kitchen and she did something that no cat that have ever been feral has done to me before....

Just awesome! She is not the smoochiest cat I have ever had, but the blessings she has given me have become more obvious over time. Caring for her and her 'siblings' has allowed me to use my underused skills and has given me some feelings of success in the rest of the failure in my life. When things have become too much, knowing that these guys depended on me for their very lives would push and motivate me to continue forward. When I get off of work, I am excited to come home and say hello to every one. Her brothers are moving forward much more slowly. The gray Persian I have named Smoke for his ability to appear to dissolve into thin air. He has a few problems. Smoke is also trapped in a stunned body and will probably always look like a teenager. He is thin but with his thick hair, he hides it well... He has problems with digestion, but boy, his reflexes are awesome. Give him a few empty studs with no walls and he can get up, jump, and climb up them in 3 seconds tops.

Egg (or Enigma) is blessed with the perfect kitty size. He is the right adult size now and holds his weight well. The only obvious problem that he has is his eyesight. It is poor and his eyes are a bit infected.... not much I can do about it as I can't hold him down three times a day to put ointment in them. All three look forward to my return every day and have even started to play with my hands or feet when I am supine and haven't moved for a while. I am hopeful in the next few years I will have three great companions. They are truly the blessing I didn't expect at the time. :)

What blessings have you gotten in the form of trouble or difficulty? Anything as 'purry' as mine...? :D