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SEPTEMBER/OCTOBER 2008 VOL.2
IN THIS ISSUE COVER STORY The Autism Story ~ The insight and resources you need to cope with this disorder Page 6
ALSO THIS ISSUE
THE PLAY PROJECT
Activities to help with interaction and communication.
Helping our kids live well
NUTRITION & THE YOUNG ATHLETE Tips for gaining a competative edge
CLASS FIELD TRIPS Volunteering on your kid’s class trip sounds like fun... but are you prepared? Page 28
Get fit tips with laura bender ~ Exercise tips to help kids stay healthy and active. Page 13 Interview with Susanne Bobowiec ~ Autism Services Specialist for MCPS . Page 14 Also Omega 3 ~ The benefits of these essential fatty acids. Page 22 DPHHS ~ Addressing the growing Autism numbers. Page 24 CHIP ~ Health Insurance for kids, peace of mind for parents. Page 26
Health Tip Page 31
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Autism Services Specialist for Missoula County Public Schools By Annalisa Martin Q: What is it that you do for the school district? A: I am a speech-language pathologist, but my current assignment is autism services consultant for preschool through middle school. I work four days a week in that role, and one day a week doing speech-language therapy. I have a counterpart, Sandy Boehmler, who serves the high schools and some middle school students. My job is to help ensure that students with autism or another autism spectrum disorder have their unique needs met. There are four main aspects. The first is educational. I help teachers and staff understand autism spectrum disorders and the students they work with. I present workshops, do individual trainings, provide handouts and books with information, meet with teams, talk to parents, and confer about specific problem issues. The second aspect is to make sure teachers and staff have access to specialized materials they might need, including some teaching techniques specific to autism, such as social stories, visual schedules, and picture communication systems. A third aspect is to assist school assessment teams in their assessments of students who might have an autism spectrum disorder. This usually means meeting with parents, and observing the student in several school settings. Other members also gather information about the student, and the team (family and school professionals) meets to decide if the student needs special education help and which of 13 categories best describes those needs. Autism is one of those categories, and includes students who meet certain criteria representative of autism spectrum disorders. At school, we do not make a formal diagnosis of autism. That is left to a medical or mental health professional. Instead, we use an educational designation to help us focus on the needs specific to the child. Lastly, we problem solve with staff to cover any other needs the students have that we can help withâ€”anything from helping decide what a student on a special diet might be able to eat at school to developing plans for behavior management. Q: Have you seen an increase in the number of children with special needs in the Missoula County Public Schools system? If so, what steps have the schools and staff taken to service those increasing needs? A: We have definitely seen an increase in the number of children with autism in our school system, and I believe other school districts in the region have, as well. The biggest impact is in young children. The Centers for Disease Control has determined that autism occurs in one of every 150 children, but I think we have an even greater proportion in our school district. People tend to move to population centers like Missoula to have more specialized services available. In MCPS, we do not have special classes specific to autism, but students are placed according to their educational needs. Some students are also mentally retarded, and might need 14
livingwell ~ September/October 2008
specialized teaching in a center-based program, with a smaller class with more individualized instruction. Other students have average learning skills, or are even gifted. These students may not need instruction in academics, but still may not be able to perform well in a classroom without extra support. These students might have special help for varying portions of the day, either in the classroom or in a resource room. We have a few students with a diagnosis of an autism spectrum disorder who need no services at all. School staffing generally is based on the total number of students with special needs, and is not tied specifically to autism. I try to alert our special education administrators to any additional services that might be needed so we can plan for the future, and we try to provide the training to make sure our special education staff has the needed skills. Q: What kinds of services are commonly needed for children with Autism Spectrum Disorder? A: To qualify for special education services, the student must demonstrate significant weakness in interpersonal communication and social interaction. Our services are designed to strengthen those weaknesses. Our speech-language pathologists address communication, either through direct speech-language therapy or consultation. Some students do not speak at all, and may need a different communication system, such as choosing from a set of pictures or using an electronic device. Others have varying degrees of difficulty using or understanding language. Older students often have subtle language problems understanding abstract language. Social skills are addressed by resource teachers, speechlanguage pathologists, school counselors or psychologist, parent volunteers, or the classroom teacher. Many students on the autism spectrum have needs for help in organization and getting assignments completed and turned in, even though the work is easy for them. Others have problems dealing with the noises, sights, odors, and ability to touch things that occur in our daily life. Their ability to process this sensory input may interfere with classroom performance. Our occupational and physical therapists can help design accommodations or programs to balance out the sensory difficulties. These therapists might also offer suggestions for PE teachers, since coordination may be poor in students on the autism spectrum. Anxiety and frustration levels are often high in students with autism, and we may need to work out strategies to help the students deal with managing their feelings, or develop special programs to manage problem behaviors. Students with autism often respond well to applied behavior analysis methods, including forms of behavior modification. Teachers use these techniques to teach specific skills and behaviors. Whenever possible, however, we try to use methods like those used in general education to enhance the studentâ€™s success at learning with their peers in their classroom. People with autism often have needs that are different from the typical educational needs of other groups with special needs.
BodyTalk: Helping Our Kids Live Well By Gayle Salisbury, RN, CBP and Natalie Morrow, MS, CBP
livingwell ~ September/October 2008
nfant, child, teenager…worlds apart in how each perceives and fits within the world. The constant as a parent, is that we forever seek that which helps our children, at whatever age, be the best they can be and assure they have the tools to live life to the fullest! We want them to live life to the fullest and yet we want to protect them. Their experiences, both “good” and “bad”, will shape how our kids carry themselves and handle the disappointments and stresses of life whether the stresses are physical, mental, emotional, or spiritual. We all come into this life with certain personal and behavioral traits, predispositions to illnesses and we are also influenced by expectations from those around us. Over time, as children grow, they experience life and all that comes with it each day. These experiences shape them on all levels into the adult they will become. It was not so long ago that you were there…your first day in kindergarten or high school, the fun you had cruising the drag, your parents’ disappointment in your not-so-perfect report card, the missed field goal and the coaches anger, feelings of acceptance or rejection, the bike crash and broken arm, the test that would make or break the “A”, and the flu that kept you from participating in the high school play. Experiences combined with genetics, belief systems and emotions, whether labeled “good” or “bad” shape how children grow physically, mentally, emotionally and spiritually. If these stresses are not processed in a healthy way by the body/mind, they can lead to imbalances in the body. The body/mind complex is an amazing system and can handle a lot, but what might seem minor to one child may be too much for another. If enough stress is applied to the system, these imbalances may lead to disease on one or more levels. The relative level of health,
whether physical, mental, emotional, or spiritual, is often an indicator of how well the systems of the body/mind are interacting and communicating. By the time symptoms appear, the body/mind is already in a state of imbalance. These imbalances may express as something as simple as a cold or flu or as a potentially more serious illness such as asthma. A way to help restore balance and synchronicity within the body/ mind complex is through the BodyTalk System. BodyTalk is a revolutionary health care system that helps to optimize communication within the body/mind complex. This communication helps to relieve system stresses and allows balance to be regained, thereby relieving the symptoms. As Certified BodyTalk Practitioners, we work with children of all ages. We have opportunities to see significant improvement in day-to-day health concerns such as colds, flu, fevers, rashes, and infections as well as more significant concerns like learning problems and anxiety. Studies conducted within school systems where children receive regular BodyTalk have shown significant improvement in overall test scores as well as the behavioral problems which create tension within the classroom. These studies show improvement with some types of learning disorders as well. This improvement translates as increased attention span and ability to better comprehend material presented in the classroom. No matter how old you are, these stresses as a young
person have had some influence over the stresses your body/mind now carries. BodyTalk can help relieve the effects of these stresses to keep your childâ€™s system functioning in better harmony at all levels. When kidsâ€™ systems are functioning optimally, they feel good. When they feel good, they live well. BodyTalk helps kids live well. For more information on how BodyTalk can help your kids live well, visit our website at www.bodytalkmontana.com, www.bodytalksystem.com, or contact one of the practitioners listed in the directory of this publication. Gayle Salisbury, RN, CBP owns Elements in Harmony, LLC with an office in Missoula. She is a Registered Nurse, the mother of 2, aunt of 20 and maintains a practice as a Certified BodyTalk Practitioner. Natalie Morrow, MS, CBP, is a Certified BodyTalk Practitioner in Missoula and owns BodyTalk Works, LLC. She is a Missoula native and 5th generation Montanan. Natalie has a well-rounded scientific background and earned her Bachelor and Master Degrees from the University of Montana, Missoula.
livingwell ~ September/October 2008
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Beneficial Omega By John Young
livingwell ~ September/October 2008
3 Fatty Acids J
ust about everyone has now heard of Omega 3 fatty acids, but not many of us know of the evidence supporting the benefits of these essential fatty acids, or EFA’s, and why they are crucial to our children’s health. Omega 3 fatty acids are considered “essential” since the body cannot manufacture them and they must be supplied in the diet. The typical American diet is very low in Omega 3’s, yet high in Omega 6’s. This imbalance may be the basis for many of our common ailments. Sources of Omega 6’s include the oils from soybean, sunflower, canola and corn which are abundant in prepared and fried food. These oils are also used in everyday cooking. Reducing Omega 6’s and increasing Omega 3’s may help allieviate some conditions. Omega 3 fatty acids can be found in the oil of fish, flax, hemp and some nuts. Fish oil supplies two important components of Omega 3 fatty acids, known as EPA and DHA, that are not present in the other oils. Your body can manufacture EPA and DHA from certain other Omega 3 oils, but obtaining them from fish oil would be a more direct route, which is why fish oil has gained so much popularity. Studies have shown Omega 3’s to be beneficial for autism, depression, hostility, ADD, ADHD, bipolar disorder, memory, coordination, sleep, inflammation, skin disorders, cognition (including IQ), overall intelligence and problem solving. To review studies on these conditions, and many others, go to www.Omega-Research.com. Some of the challenges we face may be the result of this imbalance between Omega 3 and Omega 6 fatty acids. Balancing these fatty acids in favor of Omega 3’s can be simply achieved by reducing the Omega 6’s and increasing the Omega 3’s. Pay close attention to food labels and use olive oil, which contains Omega-9, another beneficial fatty acid, when cooking. Increase fish and nuts (especially walnuts) in your diet. Taking fish oil or flax oil in supplement form is an easy way to tip the scales towards Omega 3. There are differences in the quality of fish and flax oil supplements. Oil that is not fresh or has been oxidized can actually do more harm than good. When purchasing oil, buy from a high quality manufacturer that specializes in that area. This way you can be assured that the oil you are getting is fresh, potent and, when it comes to fish oil, is harvested in an ecologically sound and sustainable manner. John Young opened Back To Nature, a health food store concentrating on supplementation, in Missoula 16 years ago. He moved to Missoula f rom Mobile, Alabama in 1987 and graduated f rom the University of Montana in 1991. He solely credits his brother who owns a health food store in Montgomery, Alabama for his passion in health and wellness.
Missoula Public Library is the place for health information
Health Resouce H
ave you ever left the doctor’s office with more questions than you walked in with? Now you can come into the library, in-person or through our website, and get up-to-the-minute information from reliable journals that you can’t find just on the Internet. Missoula Public Library offers patrons unlimited access to hundreds of health magazines, academic journals, and reference materials – all online:
• CINAHL with Full Text – the world’s most comprehensive source of full text for nursing and allied health journals. • Eldercare – a resource for seasoned citizens, contains news articles on subjects such as Medicare, health care, nursing homes, assisted living, hospice and more. • Health and Wellness Resource Center and Alternative Health Module – provides instant access to carefully compiled and trusted medical reference materials. • Health Reference Center Academic – provides access to the full text of nursing and allied health journals, plus the wide variety of personal health information sources in InfoTrac’s award-winning Health Reference Center.
• InfoTrac Nursing and Allied Health Collection – includes nearly 400 titles of use to both nursing professionals already working in the field as well as students pursuing a nursing-focused curriculum. • InfoTrac Physical Therapy and Sports Medicine Collection – more than 100 titles covering the fields of physical therapy and sports medicine.
These resources are special because they have all been identified as reliable sources – there’s no guesswork and no wrong turns that you might find when you search the Internet at random. When you find an article you like, you can email it, print it or even download it for future reference. Most of this amazing collection can be searched from any Internet connection anywhere you happen to be – all you need to get started is a library card. Our Reference librarians would be happy to show you how to look up information, or to help you over the phone or via our “Ask Our Reference Team” link from our homepage. It’s easy, and free. For more information on Missoula Public Library’s online health resources, visit www.missoulapubliclibrary.org, call 721-2665 or stop by at 301 East Main.
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livingwell ~ September/October 2008
By Jon Ebelt
Addressing the Growing Department of Public Health and Human Autism Numbers The Services allocates $2 million for intervention.
he Department of Public Health and Human Services (DPHHS) will allocate $2 million to launch an early intervention program for children with autism. To address increased autism cases, the Disability Services Division for DPHHS will be working with the Centers for Medicaid and Medicare Services on an Autism Waiver for Children. The waiver clears the way for a combination of DPHHS and federal funds to be used to finance the program. The $2 million allocation includes $600,000 of state funds and the remaining balance is federal.
livingwell ~ September/October 2008
The program is expected to be in operation later this year. Applicants will be evaluated and diagnosed through a screening process. To be eligible for the program, a child must be between 2 and 5 years of age. The service will include 20-25 hours per week of intensive in-home rehabilitation for three years by a trained provider. “I applaud the hard work by Department staff in developing creative ways to tackle a complex issue,” said Director Joan Miles. “We also appreciate Governor Schweitzer’s concern and support for this issue as we move ahead with this vital project.” “There is no cure for autism, but studies have shown that placing children in intensive services early in life is a proven treatment strategy,” Governor Brian Schweitzer said. “This method has been successful in other states and I’m elated Montana will soon be offering this service.” According to Developmental Disabilities Program director Jeff Sturm the program will cover about 40 children with autism at a cost of $40,000 per year per child. Sturm said at least 100 children in current developmental disability services in Montana need this type of treatment, but there is probably more that have not been identified. “There are more children out there than we can serve, but this is a great start in addressing this escalating problem,” he said. Due to national and state trends showing increased autism cases, Disability Services formed a workgroup last summer to study the issue and to explore what could be done to help in this state. The workgroup included parents of children with autism, advocates, legislators, mental health professionals and others. They looked at current studies and what other states are doing and decided applying for a waiver was the best approach. One of the most difficult tasks the workgroup faced was deciding who among all eligible applicants will be accepted into the program, Sturm said. It was decided a random selection process will be used and those not selected will be put onto a waiting list. The program will be offered to families throughout the state. Parents of the children chosen for the program will
be asked to play a major role in the treatment process, especially after the three years of treatment end. â€œThe goal is to make parents professionals in the treatment of their children and have the expertise to continue and sustain the childâ€™s gains,â€? Sturm added. Currently, there are eight providers covering all 56 counties who have the capability of delivering this service. This announcement comes on the heels of a contract the state recently awarded to A.W.A.R.E., Inc. to open a residential group home in Bozeman that will serve four youth affected by autism between the ages of 10 to 16. A 2007 report from the National Centers for Disease Control and Prevention (CDC) reveals that the incidence of children born with autism is approximately 1 in
150 and that the number of incidents is increasing by an estimated 10 to 17 percent per year with the data collected in 2002. Also, the National Institute of Mental Health reported autism is the fastest growing developmental disorder and affects more children than those with diabetes, cystic fibrosis, Down Syndrome and cancer combined. The cause of autism is unknown. Jon Ebelt is the Public Information Officer at the Montana Department of Public Health and Human Services. He can be reached at 406-444-2695.
livingwell ~ September/October 2008
Montanaâ€™s Childrenâ€™s Health Insurance Plan
Health insurnace for kids, peace of mind for parents.
written by Michael Mahoney 26
livingwell ~ September/October 2008
ontana’s Children’s Health Insurance Plan (CHIP) is a free or low-cost health insurance plan for children and teenagers up to age 19. CHIP provides coverage for families who do not qualify for Medicaid, but cannot afford private insurance for their children. CHIP currently covers over 16,500 Montana children and teenagers. Approximately 15 percent of Montana’s children do not have health insurance. That’s about 34,000 kids. The Department of Health and Human Services estimates that around 20,000 of these uninsured kids may be eligible for CHIP or Medicaid. In state rankings, Montana is fifth in the U.S. with the highest percentage of uninsured children. Only Texas, Florida, New Mexico, and Nevada have higher rates than Montana. In the last year, CHIP enrollment has increased 25 percent, from 13,289 to 16,559. There is no current waiting list, so now is a great time for families to apply for CHIP. CHIP covers a wide array of health services, including medical, dental, vision, mental health services, and prescription drugs. Unlike many private health plans, CHIP covers pre-existing conditions. Children can qualify for CHIP if their household meets income guidelines. (See chart below.) Children may be eligible for CHIP even if family income is more than the amount listed. There are income deductions for employed parents
and dependent care expenses, i.e., day care. Family assets are not considered when determining CHIP eligibility. CHIP families pay no monthly premiums or deductibles. Some families will have small co-pays for certain services like prescription drugs and hospital stays. There are no co-payments for most preventive services like well-child checkups, shots, dental visits, and eyeglasses. No family pays more than $215 per year in co-payments. There are no co-payments for Native American children covered by CHIP. The easiest way to apply for CHIP is to visit www.chip.mt.gov. Applications can be downloaded in two different formats. Both formats allow parents to complete the application on their computer. The application can also be printed out and filled in by hand. Or, parents can call CHIP toll-free at 1-877-KidsNow (1-877-543-7669) and have an application mailed to them. Parents mail the completed application to CHIP at the address printed on the form. Children and teenagers who get regular checkups and treatment for health problems when they are growing up do better in school and are more likely to become healthy adults. Michael Mahoney is the Community Relations Manager for the Children’s Health Insurance Plan (CHIP)
Income guidelines for CHIP* Effective February 1, 2008 Family size Family annual income (including adults)
2 3 4 5 6 7 8
$24,500 $30,800 $37,100 $43,400 $49,700 $56,000 $62,300
Some employment-related and child care deductions apply. Income guidelines may increase in 2009. * If a child qualifies for Medicaid, health insurance will be provided by Medicaid. livingwell ~ September/October 2008
Parents have a lot to learn on class trips. By BETH J. HARPAZ Associated Press Writer
livingwell ~ September/October 2008
ure, volunteering on your kid’s class trip sounds like fun. How hard could it be? Make sure they use the bathroom before leaving school and check the bus for lost backpacks, right? Right. Except that kids always manage to throw adults a few curve balls. What if your tween declares that he is mortified by your presence? What if a kid forgets her lunch? What if you tell a slowpoke to catch up, only to have him run, fall and skin his knee? All these things and more have happened to me while accompanying my sons on class trips over the years. Lessons learned: Keep a low profile once your child’s age hits double digits; bring extra food or cash for that sad little kid with no lunch (there’s one on every trip); and if you tell a child to hurry up, check first that his shoes are tied, then hold his hand to make sure he doesn’t trip. Here are some other tips from classtrip veterans and educators.
STAY NEUTRAL: “Don’t try to resolve issues between children,” Eckmann said. “Go to the teacher and tell them what you saw, unless a child is in immediate danger.” I once tried to make peace between a crying girl and a group of second-graders who decided en route to a museum that they didn’t like her. “But she was your friend five minutes ago!” I said, to no avail. Finally I invited the scorned child to be my partner for the rest of the trip, and she cheered up. What I learned: Do offer comfort, but don’t try to sort out the complicated social lives of 8-year-olds. BEWARE THE EMBARRASSMENT FACTOR: “Don’t become the loud screaming mother. That’s a quick way to draw attention to yourself and embarrass the heck out of your child,” advised Jen Singer, who writes a blog at MommaSaid.net and has accompanied her two pre-teen boys on class trips to the Bronx Zoo and the Liberty Science Center in New Jersey Eckmann suggests talking to your child beforehand about what he or she would like you to do on the trip. “If they are embarrassed or shy about you being there, take a back seat and stay out of the way as much as possible,” she said. Instead, “take the ‘happy to help’ mentality.”
“A chaperone’s most basic tasks are not unlike a border collie’s.”
MODEL GOOD BEHAVIOR: Don’t smoke in front of students, pay attention, be on time, follow directions, stay positive, don’t interrupt the teacher or guides, and compliment kids for doing a good job, said Catherine Holecko, mother of two and editor of the Parents Channel for Scholastic.com. Also, “avoid discussing your child’s progress or other irrelevant topics with the teacher during the trip,” she added. Do ask how you can help. “Teachers usually have in their mind exactly what the roles of the parents should be, and by asking the teacher you will gain their trust that you will be helpful,” said Helen Eckmann, co-author of “Simple Principles to Raise a Successful Child” and “Simple Principles to Excel at School” (WS Publishing Group). Treat the children with respect and try not to raise your voice. If you need to remind a child of the rules, “say something about it in a gentle way,” said Kathy Riccardelli, a teacher at Wanaque (N.J.) Elementary School who recently took her class to the Museum of Modern Art in Manhattan, accompanied by three mothers and an aunt. ASK BEFORE FEEDING: Don’t bring or buy a treat for your own child unless you’re willing to shell out for the class. And if you want to provide snacks for everyone, check with the teacher first. “Today many kids have allergies,” said Robin Ryan, a career counselor and mother of a fifth grader in Washington state. “My son and two others in his class are allergic to nuts and peanuts. One child has diabetes. The school is liable for these kids and has a strict policy because of these children’s school medical plans.”
FOCUS ON CROWD CONTROL: A chaperone’s most basic tasks are not unlike a border collie’s. Keep the line together, cross the street safely, don’t fall behind the larger group. Patrol against spills and litter, make sure seat belts are buckled, advertise bathrooms whenever you have the opportunity, bring Band-Aids and tissues. And when your group leaves a room, building, bus or bench, make sure no bags or coats were left behind. Above all, count heads early and often. Also, try to anticipate trouble. “You’re usually assigned to a certain number of kids,” Singer said. “You have to identify which kid is going to be the one most likely to wander off, break something, hurt someone else or come home covered in mud. You can shadow that kid a little bit more than the other ones. Hopefully you can intervene before things get bad, and hopefully you only have one like that.” One technique for dealing with problems: “Get up close to the face of the offending child and calmly but firmly tell them they should not be sticking gum on someone’s hair,” Singer said. “It’s not so public. But it’s effective.”
livingwell ~ September/October 2008
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