Down Syndrome and Obesity

Obesity is a major health concern and is more common in individuals with Down syndrome than the general population. Obesity is defined as excessive fact accumulation that increases health risk. It is an abnormal accumulation of body fact usually 20% of a person’s ideal body weight.

Medical complications of obesity includes sleep apnea, lung disease, pancreatitis, heart disease, cancer, arthritis, inflamed veins and gout. When the body mass increases, so does the risk of having a heart attack or heart failure.

In a study published by the American Association Intellectual and Developmental Disabilities found a difference between studies on children versus adults with Down syndrome. Children with Down syndrome have consistently been found to exhibit a reduced resting metabolic rate meaning children with Down syndrome are at a great risk for weight gain since they will burn fewer calories. at rest during activities.

Children with Down syndrome also tend to have a condition known as hypothyroidism. Approximately 10 percent of children with Down syndrome have hypothyroidism. As children with Down syndrome get older, eating behaviors change leading to obesity (Approximately 30%). These changes may be due to low muscle tone or inactivity due to thyroid problems or heart conditions.

Exercise and recreation are crucial to the well-being of individuals with Down syndrome. The following are strategies for helping to maintain weight control and to live longer and healthier lives:

  1. Develop a regular exercise program. According to Drs. Chicoine and McGuire, authors of The Guide to Good Health for Teens and Adults with Down syndrome, Exercise should be free of risk. Push ups and weightlifting are not appropriate due to many people with Down syndrome who have issues with the upper 2 vertebrates.
  2. Swimming is an effective exercise. Many pool have walking exercises in the pool as well.
  3. Exercise should be fun, socially and realistic.
  4. For older adults with Down syndrome, look for teachable moments to teach portion control, drinking enough fluids, and eating a well-balanced meal.

Reference

Chicoine, B. and McGuire, B. (2010). The Guide to Good Health for Teen and Adults with Down Syndrome. Bethesda, MD

Facts and Statistics- Obsessive Compulsive Disorder (OCD)

Obsessive- Compulsive Disorder (OCD) is defined as a disorder that includes two core symptoms- obsessions and compulsions. According to the Census for Disease Control and Prevention (CDC), obsessions are defined by:

  • Thoughts, impulses, or images that occur over and over again. These thoughts, impulses or images are unwanted. They cause a lot of anxiety and stress.
  • The person who has these thoughts, impulses or images tries to ignore them or tries to make them go away.

Compulsions are defined as:

  • Repeated behaviors or thoughts over and over again or according to certain rules that must be followed exactly in order to make an obsession go away.
  • The person feels that the purpose of the behaviors or thoughts is to prevent or reduce distress or prevent some feared event or situation.

The following are facts and statistics on Obsessive Compulsive Disorder:

  • 1.2% of U.S. adults had OCD in the past year.
  • OCD was higher for females (1.8%) than males (0.5%).
  • Among adults with OCD, approximately one half (50.6%) had serious impairment
  • 34.8% of adults with OCD had moderate impairment
  • 14.6% had mild impairment.
  • OCD affects 2.2 million adults
  • The average onset is 19 with 25% of cases occurring by age 14
  • One-third of affected adults first experience symptoms in childhood
  •  17% of autistic people may specifically have OCD
  • Because of similar characteristics, it is often overlooked
  • It affects people of all races, ethnicities, and socioeconomic backgrounds
  • OCD is one of the top 20 causes of illness-related disability worldwide for individuals between 15 and 44 years of age
  • 1 in 40 adults are affected.
  • 1 in 100 children are affected
  • Other conditions may co-exist with OCD including anxiety, bipolar, ADHD, autism spectrum, Tourette syndrome, and major depressive disorder.
  • Worldwide, OCD is approximately 2% of the general population
  • OCD ranks 10th place among all diseases
  •  1 in every 200 children has the disorder 60 to 70% of OCD children improve significantly with therapy.
  • Many people still hide their OCD behaviors.
Beyond OCD.org
Healthy Place.org
National Institute of Mental Health

Dysgraphia and Workplace Accommodations

Some might be surprised to learn that there are several types of learning disabilities. Dysgraphia is describes as a learning disability that affects writing, spelling and fine motor skills. Dysgraphia is a neurodevelopmental disorder that can occur as a stand alone disorder or part of a co-occurring disorder with other disabilities such as ADHD, Autism, and Dyslexia. Typically it is diagnosed or discovered in the early years when children are beginning to learn how to write. Most adults often remain undiagnosed.

Early Signs of Dysgraphia

Signs and symptoms of dysgraphia generally begin to show up when children began to lean how to write. Early signs of Dysgraphia include:

  • Inconsistent spacing between letters
  • Poor spatial planning
  • Poor spelling
  • Unable to read own handwriting
  • Poor fine motor skills
  • Omitted words
  • Writes slow
  • Pain in hand from writing
  • Messy unorganized papers
  • Difficulty organizing thoughts on paper
  • Illegible printing and cursive letter formation
  • Slopping handwriting
  • Tight, cramped pencil grip
  • Tires quickly when writing
  • mixes upper and lower case or irregular sizes and shapes of letters.

Download a free dysgraphia checklist

Signs and Symptoms in the Workplace

A early signs that rarely disappears is having a “sloppy” handwriting. The person when writing leaves out letters at the end of a sentence, difficulty reading own handwriting after meetings, trouble with filling out routine forms, displays unorganized papers on the desk, difficulty thinking and writing at the same time and tends to mixes upper and lower case letters when writing. The person will also avoid writing when possible and show a preference to using a computer or texting neatness, line spacing, staying inside margins and capitalization rules.

Strategies to Use in the Workplace
  1. If you have a smart phone, you can use the device to record meetings, interviews or instructions that are given to you.
  2. Assitive technology such as tablets, computers and Apps are also useful in transcribing information
  3. Take the time to organize your desk before you leave work in the evening. Prioritize your workflow and create a plan for the next day.
  4. Pre-write. Before you take on the task of writing, create an outline on paper.

Signs and Symptoms of Fetal Alcohol Spectrum Disorders

Fetal Alcohol Spectrum Disorders (FASD) according to the National Organization on Fetal Alcohol Syndrome describes the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These affects may include physical, mental, behavioral, and/or learning disabilities with lifelong implications.

Fetal Alcohol Spectrum Disorders is not a diagnosed rather, it is a term that is used to describe a wide-range of effects on a person whose mother drank alcohol during her pregnancy. Fetal Alcohol Spectrum Disorders, show in three areas: abnormal facial characteristics, slowed growth and the central nervous system.

Fetal Alcohol Spectrum Disorders affects each person differently. Signs and symptoms include the following:

  • Abnormal facial features including a smooth ridge between the nose and upper lip
  • Small head size
  • Shorter than average height
  • Poor coordination
  • Hyperactive behavior
  • Difficulty with attention
  • Poor memory
  • Difficulty in school
  • Learning disabilities
  • Speech and language delays
  • Intellectual disability or low IQ
  • Poor reasoning and judgement skills
  • Sleep and sucking problem
  • vision and hearing problems
  • Seizures
  • Processing information
  • Problems with the heart and kidneys
  • Poor concept of time
  • Trouble getting along with others
  • Staying on task

Aspiration Precautions

Children and adults with developmental disabilities often face challenges with eating, drinking and swallowing disorders than the general population. It is estimated that adults with intellectual disabilities require support from caregivers during mealtime. It is common among people who have a diagnosis of cerebral palsy, intellectual disability, physical  disability and muscular dystrophy.

Dysphasia is a medical term used to describe any person having difficulty swallowing foods and liquids taking  more energy and time to move food from the mouth to the stomach. Signs of dysphasia may include:

  • Drooling
  • Food or liquid remaining in the oral cavity after swallowing
  • Complaints of pain when swallowing
  • Coughing during or right after eating or drinking
  • Extra time needed to chew or swallow
  • Reflux of food

Dysphasia can lead to aspiration. Aspiration is defined when food, fluid, or other foreign material gets into the trachea or lungs instead of going down the esophagus and into the stomach. when this occurs, the person is able to cough to get the food or fluid out of their lungs, in some cases especially with children and adults with disabilities may not be able to cough. This is known as Silent Aspiration.

A complication of aspiration is Pneumonia which is defined as inhaling food, saliva, and liquids into the lungs

According to the Office of People with Developmental Disabilities Health and safety Alert, factors that place people at risk for aspiration include:

  • Being fed by others
  • Weak or absent coughing, and/or gag reflexes, commonly seen in people with cerebral palsy.
  • food stuffing and rapid eating/drinking
  • Poor chewing or swallowing pills
  • GERD- the return of partially digested food or stomach contents to the esophagus
  • Providing liquids or food consistencies the person is not able to tolerate such as eating whole foods.
  • Seizures that may occur during eating and/or drinking.

How to recognize signs and symptoms of Aspiration:

  • Choking or coughing while eating or just after eating
  • Drooling while eating or just after eating
  • Eyes start to water
  • Shortness of breath
  • Fever 30 minutes after eating
Intervene immediate if there are signs of aspiration:
  • Stop feeding immediately
  • Keep the person in an upright position
  • Call 911 if the person has difficulty or stops breathing and no pulse
  • Start rescue breathing

Minimize aspiration from occurring by serving the appropriate food texture and liquid consistency. If you are not sure of the right consistency, check with your health care provider. The following are pictures of food consistencies.

Courtesy of OPWDD

Courtesy of OPWDD

Whole. Food is served as it is normally prepared; no changes are needed in
preparation or consistency

Courtesy of OPWDD

1 ” Pieces cut to size. Food is served as prepared and cut into 1-inch pieces
(about the width of a fork).

Courtesy of OPWDD

1/4 Pieces Cut to Size. Food is cut with a knife or a pizza cutter or placed in a food
processor and cut into ¼ -inch pieces (about the width of a #2 pencil)

Courtesy of OPWDD

Ground. Food must be prepared using a food processor or comparable equipment
until MOIST, COHESIVE AND NO LARGER THAN A GRAIN OF RICE, or relish
like pieces, similar to pickle relish. Ground food must always be moist. Ground meat
is moistened with a liquid either before or after being prepared in the food processor
and is ALWAYS served with a moistener such as broth, low fat sauce, gravy or
appropriate condiment. Hard, dry ground particles are easy to inhale and must be
avoided.

 

Courtesy of OPWDD

Pureed. Food must be prepared using a food processor or comparable equipment.
All foods are moistened and processed until smooth, achieving an applesauce-like or
pudding consistency. A spoon should NOT stand up in the food, but the consistency
should not be runny. Each food item is to be pureed separately, unless foods are
prepared in a mixture such as a soup, stew, casserole, or salad.

Aspiration Precautions

  • Make sure the person eats slowly and takes small bites of food
  •  Ensure the person takes small sips of liquids
  • Focus on the person’s swallowing
  • Make sure the person remains upright for a minimum of thirty minutes after eating

Data and Statistics- Fetal Alcohol Spectrum Disorders (FASD)

  • Fetal alcohol disorders range from mild intellectual and behavioral problems to extreme disorders that lead to profound disabilities or premature death.
  • FAS are not heredity: they are 100 percent preventable the sole cause is prenatal alcohol exposure.
  • Of the children heavily exposed to alcohol before birth, about 40 percent are estimated to exhibit fetal alcohol disorders, with 4 percent affected by full blown fetal alcohol syndrome.
  • Women who give birth to a child with FAS are 800 times more likely to give birth to subsequent children with the syndrome than are women who have never given birth to a child with the syndrome.
  • Each year, there are four times as many infants born with fetal alcohol disorders as there are infants born with muscular dystrophy, spina bifida and Down syndrome combined.
  • 15 out of 100 women of childbearing age do not know that drinking alcohol during pregnancy is dangerous.
  • FASD affects about 40,000 newborns each year
  • A survey of pediatrician reported in the journal Pediatrics revealed that only 13 percent routinely discussed the risk of drinking during pregnancy with their adolescent patients.

  • According to the Center for Substance Abuse Prevention, 1 in 9 pregnant women binge drink during the first trimester.
  • FASD are 100% incurable
  • 60% of individuals with FASD find themselves in legal trouble at some point in their lives.
  • There is a high prevalence of epilepsy (5.9%) in individuals with FASD compared with individuals who did not have the disorder.
  • 94% of individuals heavily exposed to alcohol in the womb are diagnosed with ADHD
  • It is estimated a lifetime cost for one individual with FASD is 2 million
  • 50% of adults with FASD were clinically depressed

SEPTEMBER IS FETAL ALCOHOL SPECTRUM DISORDER AWARENESS MONTH

School Accomodations for Students Diagnosed with Fetal Alcohol Spectrum Disorders

The Centers for Disease Control and Prevention (CDC) describes Fetal Alcohol Spectrum Disorders as a group of conditions that can occur in a person whose mother drank during pregnancy. The effects of the fetal alcohol disorders includes many learning challenges including hyperactivity, poor attention span, memory issues, coordination challenges, anxiety, speech and language delays, problem-solving issues, difficulty staying on task, behavioral challenges and social interaction.

Some children with FASD have co-occurring disorders or are often mis-diagnosed.

The following are the most common disorders:

  • Oppositional Defiant Disorders (ODD)
  • Attention Deficit Hyperactive/Inattentive Disorder (ADHD)
  • Learning Disabilities
  • Speech and language delays
  • Anti-Social Personality Disorder

The following are Accommodations that will help students succeed:

  • Use a multi-sensory approach to learning
  • Allow extra time for testing assessments
  • Chunk the test into parts
  • Reduce distractions by using preferential seating
  • Allow the student to take breaks
  • Use oral test
  • Provide oral instructions
  • Use a checklist for the student to use
  • Allow the student to use a timer
  • Use repetition
  • Check in with the students for understanding and provide feedback
  • Teach calming strategies
  • Use assistive technology
  • Use social stories
  • Teach social skills

CDKL5 and Teaching Strategies

CDKL5 is a neurodevelopmental disorder that includes signs of early-onset epilepsy. In fact 90% of children diagnosed with CDKL5 disorder are more likely to develop epilepsy. CDKL5 is derived from a gene and one of the most common causes of genetic epilepsy. Children diagnosed with CDKL5 also face many other developmental challenges as well.

Image by PublicDomainPictures from Pixabay

Click here to download PDF version

Facts

It is a neurodevelopment disease caused by the CDKL5 gene.

It impacts cognitive, motor, speech and visual function

It affects 1 in 40,000-60,000 children each year.

CDKL5 was previously called STK9

The disorder mainly affects females

The cause of CDKL5 deficiency disorder is unknown

Signs of CDKL5 deficiency includes epileptic seizures

Starting within hours of birth to 2 years of life, some children often go for 24 hours or more without sleeping.

Signs and Symptoms of CDKL5
Teaching Strategies

The following are teaching strategies that can used when teaching children with the CDKL5 disorder:

  • Provide frequent breaks
  • Use assistive technology
  • Provide extra time
  • Repeat directions
  • Use concrete items when possible
  • Break task into smaller steps
  • Teach in sequence
  • Use a multisensory approach
  • Use hand-on material

 

Children's Hospital.org
Genetic Home Reference
International Foundation for CDKL5 Research
Rare Diseases.org

 

 

Sensory Eating is not Picky Eating

Published by: Speaking of Autism

I want you to imagine that you are a kid once again, maybe ten or eleven years old. You are sitting down in the evening with your family for dinner. The table is set, and your parents bring out what will be tonight’s entree: a cut of cold, raw chicken breast. It’s slimy pink mass slides onto the plate in front of you, and soon after your whole family is chowing down on the raw cuts of meat. You can’t stand to even watch anyone else eat the raw chicken, let alone fathom yourself choking it down. Yet, despite the very real disgust and aversion you feel towards the raw chicken breast, somehow it’s you who are strange for not wanting to eat it. Maybe you’re called “picky” or told that you simply need to and just learn to enjoy raw chicken like everyone else. Maybe you go hungry every night at dinner because the only thing being served are items as aversive as the cuts of raw chicken. Click here to read the rest of the story.

Free Printable Money WorkSheets

Summer will be here before you know it. If you want your student/ child or individual to continue practicing math skills, I have provided below 4 money sheets that you can printout and make several copies. The money sheets allows the child to work on both IEP and ISP goals including:

  1. Identifying coins
  2. Matching coins
  3. Visual discrimination
  4. Counting
  5. Transition skills
  6. Visual learners

 

Burger King.Worksheet. This is a fun activity especially for children, students and adults that enjoy going to Burger King. The individual will choose the picture and subject the cost of the item from $10.00.  This activity people with dysgraphia, increase money skills, attention skills, task initiation skills and works well as a pre-trip to Burger King. focusing on transition skills.

Matching Dimes Worksheet– The matching dime activity is great for goals on counting and identifying a time. it is useful for children adults that are visual learners and provides hands on materials. The students learning ability will increase with the use of actual dimes.

Circle Nickle Worksheet – This worksheet give the individual an opportunity to work on counting, identify various coins as well as explaining the value of the coin. The worksheet also provides additional support and increases visual discrimination skills.

Dime Counting – helps the child, student or adult with special needs practice counting skills and visual memory.

My plan for the rest of the year is to provide you with more resources that are more functional and allows you to download information.