http://www.canadianliving.com/health/features/autism2/1.asp

Heartbreak & Joy
By Pam Harrison
 

Some parents are convinced that their children's autism is directly linked to a bowel ailment. Indeed, about one-third of children with ASD suffer from some gastrointestinal problem, such as diarrhea or constipation. The theory is that poorly digested food proteins leak from the gut into the blood, where they produce a chemical effect that alters brain activity and triggers ASD behaviour. Many parents report some success in reducing stomach problems after switching their children to diets free of gluten (primarily in wheat) and casein (in dairy foods). And this diet may also improve behaviour linked to autism. (Other parents have experimented with other diets and met with some success. Coreen Watson of Baldur, Man., was pleased with the results she got when she eliminated red food colouring and preservatives from the diets of her two autistic sons, Willy, 8, and Travis, 6. "It's having a positive impact on their behaviour and attention spans," she reports.)

However, Roberts cautions that, to date, dietary studies on ASD have involved very few subjects and results are not scientifically sound. She stresses that children with ASD can be extremely picky eaters to begin with, and if parents restrict bread and milk, as they would with the gluten-free diet, "the children would be down to nothing." If parents decide to try their kids on this diet, they should do so with professional guidance to ensure that their children receive adequate nutrition.

The challenge in the field of autism is to alter the child's behaviour and provide him with social skills that allow him to function better in the world. Although there have been some positive results in studies of antipsychotic drugs used to treat autism, changing antisocial behaviour isn't easy. Unlike typical children who learn instinctively, youngsters with autism generally have to be taught "everything about social relationships," explains Rebecca Ward, the clinical-research coordinator of autism research programs at Queens University in Kingston, Ont. "Even learning to say 'Mommy'and'Daddy' and being able to accept a hug may have to be taught."
However, there's a growing body of research that suggests that children with autism can learn in different, nonstandard ways. "We think that if you can teach pivotal behaviours to these children - such as imitation skills - they'll be open to learning by observation," she says, "and if you can learn by observation, you have a greater chance of functioning well in the world."

One program that incorporates this philosophy is called Early Intensive Behavioural Intervention (EIBI); this one-on-one program is geared to teaching children with autism appropriate social responses that typical children learn automatically, such as responding to a loving touch. Initiated as early as possible - ideally before the child is 31/2 years old EIBI involves activities with easy-to-follow instructions ("Touch your nose"), interspersed with periods of play. Each instruction is repeated - if necessary, with a physical or verbal prompt - until the child gives the desired response, at which point she is praised and rewarded with a hug or tickle or something fun to play with.

While EIBI won't "cure" ASD, it does seem to be producing tremendous results. Studies show that social and communication skills improve and repetitive behaviours diminish in about 75 per cent of ASD children under six who are exposed to 20 to 40 hours of EIBI a week for two years. A smaller percentage of children who complete the program go on to become independent adults.
The drawback (if there is one) is that it takes a large commitment from family and care workers - at least 30 hours of instruction a week, usually in the home, by a trained specialist for up to two years. And it can be costly - upward of $30,000 per year per child.

Not all parents follow the EIBI route. With a lot of imagination and devotion on the part of parents and care workers, children with ASD can learn using other, highly structured approaches, too. Take Gabriel and Raphael Del Duca of Windsor now 11 and 9, respectively - for example. Like many children with autism, they naturally communicate better with visual rather than auditory signals. "We have Velcro all over the house," says Claudio. He and his wife stick pictures on the fridge of the food inside so their boys can point to pictures to show their parents what they want to eat. Sometimes they can get Raphael to tell them what he wants when they prompt him with "Mommy, I want... and let him finish the sentence.

"The boys have to learn that communication is a two-way street and that it is the only way they're going to get what they want," explains Claudio.

Coreen Watson and her husband, Bob, are struggling to find the best teaching methods for Willy and Travis. After the boys were diagnosed with ASD (on the same day!), the Watsons made up their minds that they would do whatever it takes to teach them social skills. For Willy, learning has to be “show" rather than "tell." "If you say, 'Willy, this is how people fish, he would have no concept of what you're talking about," says Coreen. "But if you show him how to fish, hands on, he will never forget it." Travis, who is still nonverbal, communicates through gestures.
Yet another teaching strategy is the Son-Rise Program. Caregivers "join in" with the child, sort of entering their own private world, with the idea that "joining in" will eventually make children with autism feel comfortable enough that they will learn more social skills. In Vancouver, my sister, Lea Atkinson, volunteers eight hours a week "joining in" with an eight-year-old girl with autism. "If she stares in the mirror, mesmerized, I stare in the mirror, mesmerized," says Lea, adding that this sharing of the autistic child's world helps her make and maintain eye contact, something that Lea believes builds trust, an important stepping stone to socialization.

Not all of these teaching methods have proven track records. Ward suggests parents be skeptical, assess a program "with their eyes wide open" and try it only if a professional can help them evaluate whether a particular approach is truly helping their child.

Parents like the Del Ducas and the Watsons choose to keep their children in the standard school system. With the help of EAs, these children can see how other children interact and perhaps eventually mimic those interactions. These parents feel that this is an invaluable opportunity that has helped their boys make significant progress.

Despite the stress and broken dreams of having perfectly literate social children, many parents of kids with autism say the experience has forced them to become a different type of parent. They now see their children in a different light - one that is much less judgmental. If there's a blessing in all of this, perhaps that's it.

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