Posts Tagged ‘birth defects’

Autism and Wandering – a constant struggle

Wednesday, August 3rd, 2011

I have written before in this space about special needs children, including children with autism. This week I want to turn my attention to one aspect of autism – wandering – and some of the ways parents and schools are trying to keep kids safe. Wandering is something I really had not heard of before, but I’ve since learned that it is a serious danger to children with autism or other cognitive deficits. It is also a major source of stress to parents who are constantly worried about their child wandering off.

All children have a tendency to wander away from their parents at times. When my daughter was two, I lost her at Sports Authority. I thought she was standing right next to me while I was looking at something, then I looked down and she was gone. After a few frantic minutes – and with the quick help of the store employees – we found her all the way on the opposite side of the store looking at balls. She was perfectly fine, but it was terrifying for me.

For reasons that are not well understood, children with Autism Spectrum Disorder (ASD) tend to wander more than non-autistic children. As reported by the Child Mind Institute and others, a recent study by the Interactive Autism Network has finally tried to quantify what has traditionally been more anecdotal evidence about wandering.

According to the responses from more than 800 parents, roughly 50 percent of children between the ages of 4 and 10 with an ASD wander at some point, four times more than their unaffected siblings. The behavior peaks at 4, almost four times higher than their unaffected siblings, but almost 30 percent of kids with an ASD between the ages of 7 and 10 are still eloping, eight times more than their unaffected brothers and sisters.

Autistic children seem to wander for two basic reasons. One is to find something they like, such as their favorite pond or playground; and one is to get away from something they don’t like such as a stressful school environment. It’s not really running away, at least as that term is usually used to describe a child who decides to leave home because of some real or perceived injustice at home. A majority of parents in the study described their child as happy and focused when they wandered off. It is usually a matter of the child being drawn to something that he or she likes. One child referenced in the Child Mind story had a fascination with exit signs. One day at school, the boy wandered off through the woods toward the highway to find his favorite exit sign. Thankfully, a good Samaritan picked-up the boy and returned him to where he belonged.

The danger for children is very real. While concrete statistics are difficult to come by, drowning seems to be the biggest danger (there are some who believe that autistic children are drawn to water). Children can also wander into traffic. Of course, when any small child wanders alone there is the risk of getting lost or being abducted. To further complicate matters, thirty-five percent of families in the study reported that their child is never or rarely able to communicate basic identifying information such as name, address and phone number. This obviously makes it harder for a wandering child to get back home. Even older or more high-functioning children may – due to their social anxiety – be reluctant to seek out help or cooperate with someone who is trying to intervene.

Wandering represents a challenge to schools because it can be very difficult to monitor a child all day long, especially during class changes and recess. The problem, however, also occurs at home. Wandering occurs not just during the day; night-time wandering is an especially big fear for parents of autistic children. Some children have been known to get up in the middle of the night, undo the deadbolt on the front door, and walk-off into the night. The terror of finding your child gone in the middle of the night is unimaginable. Some parents have installed deadbolts higher up on the doors, some have installed alarms that go off if the door is opened. Some parents have gone so far as to have their children wear tracking devices that send out a signal that can be pin-pointed. While all of these techniques can help, there are no sure-fire methods of preventing wandering. It is a constant worry for parents.

The autism community has taken action by getting the Center for Disease Control’s safety subcommittee to assign a specific medical code for wandering, which will be in conjunction with the diagnosis of ASD. By doing this, it is hoped that doctors will more readily recognize wandering as a legitimate diagnosis that they can address with the parents or other caregivers (the new code applies to adults with ASD as well). The American Academy of Pediatrics is also preparing a fact sheet to educate doctors on the topic so that they can better work with parents to try to reduce the incidence of wandering. The new code may also make it easier for parents to seek reimbursement from their insurance companies for alarms and tracking devices, and it may make it easier for parents to argue to their schools that a one-on-one monitor is needed as part of the child’s Individualized Education Plan (IEP). The new code takes effect in October 2011.

Lori McIlwain, Chairwoman of the National Autism Association, recently discussed how to deal with wandering:

The best overall strategy is a multi-tiered approach, which includes educating the child about safety and dangers using whatever means of communication works, including social stories, language and/or visual prompts. It’s also important that caregivers—and schools—work to understand what is causing, or contributing to, the wandering or bolting behaviors so that any triggers may be addressed or eliminated.

Have any of our readers had any experience with wandering? I’d like to hear your stories as to how you deal with it and how it affects your life.

Related Nash and Associates Links:

Dogs a Huge Help to Special Needs Kids

The Daily Struggle of Raising a Disabled Child

Many Parents Still Believe Vaccines Cause Autism

 

 

Photo courtesy of: Issueswithautism.com

Birth Defect Updates: Warnings about opioid use before and during pregnancy

Monday, March 21st, 2011

Photo credit: Getty Images

Recently, I wrote about studies concerning the increased risk of birth defects caused by smoking.  A recent press release from the CDC draws attention to a newly discovered link between the use of certainly prescription opioid pain relievers by a woman shortly before conception or in the first trimester of pregnancy to an increase in birth defects.  Similar to the evidence about smoke exposure, the research identifies the period before conception and during early pregnancy as critical.  I think that these findings raise questions about the use of these drugs by woman of child-bearing age as the critical time period may be one when a woman is not aware that she is pregnant or going to become pregnant.

Use of these opioid pain relievers, such as codeine and oxycodone, “was linked to several types of congenital heart defects as well as spina bifida, hydrocephaly, congenital glaucoma and gastroschisis.”  According to the press release, the study, which was published in the American Journal of Obstetrics and Gynecology, “found that women who took prescription opioid medications just before or during early pregnancy had about two times the risk for having a baby with hypoplastic left heart syndrome (one of the most critical heart defects) as women who were not treated with these opioid medications.”   Overall the CDC statement suggests that the risk of these defects is not that large for any individual woman given the rarity of these conditions, but that it is important information nonetheless since the defects are very significant.

Cerebral Palsy rates dropping in U.S.

In happier news, overall rates of cerebral palsy are dropping in the United States.  The cause of the decline is linked to improved care during pregnancy and at birth.  According to Medical News Today, a new “…article published in The Journal of Pediatrics indicates that the rates of cerebral palsy have declined dramatically in the past 15 years.” This is exciting news not just because it means that many fewer children are born with a devastating injury but also because it is an indicator of a general improvement in the care provided to mothers and babies before, during and immediately following birth.

 

 

New BPA Research – Is Your Plastic Water Bottle Toxic?

Saturday, February 20th, 2010

According to an article published in WebMD Health News, two recent studies suggest that the plastic chemical bisphenol A (BPA) is not toxic to the brain and that it does not inhibit the development of the human reproductive system. One of the studies was funded by the plastics industry. Both studies were originally published in Toxicological Sciences.

BPA is an organic chemical compound, which is used as an additive or building block in several plastics. Its primary purpose is to harden plastic. For this reason, BPA is found in a wide variety of consumer products such as plastic bottles, cups, and even baby milk bottles.

“Some experts are concerned that exposure to BPA and its weak estrogen-like effects, especially during critical periods of development, may be linked to a range of health hazards, including behavioral effects, reproductive problems, cancers, heart disease, and diabetes.”

The two studies in question were designed to specifically study the impact of BPA on the brain and the reproductive system. Both studies used animal models.  The study that focused on neurotoxicity found that female rats and their litters did not develop neurological defects from exposure to BPA.  The study that focused on BPA’s impact on the reproductive system found that rats exposed to low doses of BPA in utero and throughout the breastfeeding period maintaind healthy reproductive systems.

Notwithstanding these new findings, many remain concerned about the toxicity of BPA. Even the FDA reversed its position regarding the safety of BPA in January 2010 and called for additional research on the subject. Previous studies appear to suggest that BPA is toxic. For example, in an article published in Reproductive Toxicology in 2007, 38 experts agreed that average levels of BPA in humans are above those that appear to cause harm in animals.  In 2009, an article publushed in Molecular and Cellular Endocrinology, sumarized past BPA research and concluded that:

“The potential for BPA to influence body weight is suggested by in vitro studies demonstrating effects of BPA on adipocyte differentiation, lipid accumulation, glucose transport and adiponectin secretion. Data from in vivo studies have revealed dose-dependent and sex dependent effects on body weight in rodents exposed perinatally to BPA. The mechanisms through which perinatal BPA exposure acts to exert persistent effects on body weight and adiposity remain to be determined.”

Another study published in the Journal of American Medical Association specifically addressed the impact of BPA on humans.  The study concluded that there was a strong positive correlation between the amount of  BPA in a person’s urine and the incidence of heart disease, diabetes, and enzyme abnormalities.  These are just a few of the many research studies suggesting a link between BPA and varous medical complications.

Contributing Author:  Jon Stefanuca