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Parent-Led Autism Therapy (PACT) Shows Lasting Benefits

parent-child-playA therapy that focuses on parents’ communication skills may have lasting benefits for young children with autism, a new clinical trial suggests.

Researchers from the United Kingdom found that preschool children who took part in the program had less-severe autism symptoms six years later, compared to kids who received standard autism services available in their local community.

The study is the first to show such lasting benefits from an early childhood program for autism. Experts not involved in the work were encouraged by the findings.

That’s, in part, because the program is considered “low intensity.” Parents had 18 sessions with a therapist over one year, and then took charge from there.

“This study is important in demonstrating that parent-delivered therapy can be used effectively in low-resource communities where there are few trained professionals,” said Geraldine Dawson. She’s the director of the Duke Center for Autism and Brain Development, in Durham, N.C.

The program, dubbed PACT (for Preschool Autism Communication Trial), focuses on parents’ and children’s “social communication.”

Parents are videotaped during different interactions with their child. Then the parents watch the videos alongside a therapist. Parents learn to better interpret their child’s unique style of communication, and respond to it.

To put that into practice, parents are asked to lead “structured tasks” at home for 30 minutes every day.

The approach makes sense and is “very feasible,” according to Jeff Sigafoos, a professor at Victoria University of Wellington, in New Zealand.

In fact, programs that include similar principles are already available in the “real world,” said Sigafoos. He wrote an editorial published with the study in the Oct. 25 online edition of The Lancet.

“All of these programs tend to share a few common elements — such as being home-based, parent-implemented and focused on supporting parents in engaging their child in more social-communication interactions,” Sigafoos said.

The new findings add to evidence that those approaches can help children and parents alike, according to Rebecca Shalev. She is a clinical assistant professor of child and adolescent psychiatry at NYU Langone’s Child Study Center, in New York City.

It’s not “intuitive” for parents to know how to interact with a child who has autism, Shalev said.

Learning how to play with their child and “have enjoyable experiences” benefits everyone, she said.

An estimated one in 68 U.S. children has been diagnosed with an autism spectrum disorder (ASD), according to the U.S. Centers for Disease Control and Prevention. ASD refers a group of developmental brain disorders that affect children’s behavior and ability to communicate and socialize.

The severity ranges widely from one child to the next: Some kids have relatively mild problems with social interactions, while others speak very little and focus on a limited number of repetitive behaviors.

The PACT study involved 152 British children aged 2 to 4 who had relatively serious issues with social communication and repetitive behaviors. On average, they scored an “8” on a standard scale of 1 to 10 — with 10 signifying the most severe symptoms.

The researchers, led by Jonathan Green of the University of Manchester, randomly assigned the children to either the one-year PACT program or the “usual” autism services available in their local area.

Six years later, the researchers were able to re-test 80 percent of the children.

The researchers found that, compared with kids who’d had standard autism services, children in the PACT group were less likely to have symptoms in the severe range: 46 percent versus 63 percent in the usual care group.

And although the program focused on social communication, it also reduced kids’ repetitive and restrictive behaviors, on average.

That’s an interesting finding, according to Shalev. She said it suggests that enhancing parent/child communication has “collateral benefits.”

Sigafoos said, “One take-home message is that it’s important for parents to be highly responsive to their child’s communication attempts. Try to create the need for your child to communicate and watch for any indication of communication on your child’s part.”

He offered one example: “Your child might lead you to the fridge door to request a drink of milk. When you see this, you can acknowledge that the child is attempting to communicate — ‘Oh, I see you want some milk.’ Then try to get your child to communicate in a more elaborate form, ‘Can you say milk?’ ”

Of course, the study is reporting group averages, and not every child showed the same gains. “Simply put,” Sigafoos said, “some children will respond better than others.”

But, he added, in the real world, therapists can adapt an intervention to better suit a particular child’s needs.

Dawson said that, ideally, children with autism would be seeing a therapist directly, along with any training their parents receive.

But, she added, therapists with that expertise are not always available in a community.

It’s also best for parents to learn at-home techniques from a trained therapist, Dawson said. But, she added, there are also some good books with “useful tips.”

Special thanks to our friends at HealthDay

SOURCES: Jeff Sigafoos, Ph.D., professor, education, Victoria University of Wellington, New Zealand; Geraldine Dawson, Ph.D., director, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, N.C.; Rebecca Shalev, Ph.D., clinical assistant professor, child and adolescent psychiatry, NYU Langone Child Study Center, New York City; Oct. 25, 2016, The Lancet, online

5 Ways to Bully-Proof Your Kid

Talk about it. Talk about bullying with your kids and have other family members share their experiences. If one of your kids opens up about being bullied, praise him or her for being brave enough to discuss it and offer unconditional support. Consult with the school to learn its policies and find out how staff and teachers can address the situation.

Remove the bait. If it’s lunch money or gadgets that the school bully is after, you can help neutralize the situation by encouraging your child to pack a lunch or go to school gadget-free.

Buddy up for safety. Two or more friends standing at their lockers are less likely to be picked on than a child who is all alone. Remind your child to use the buddy system when on the school bus, in the bathroom, or wherever bullies may lurk.

Keep calm and carry on. If a bully strikes, a kid’s best defense may be to remain calm, ignore hurtful remarks, tell the bully to stop, and simply walk away. Bullies thrive on hurting others. A child who isn’t easily ruffled has a better chance of staying off a bully’s radar.

Don’t try to fight the battle yourself. Sometimes talking to a bully’s parents can be constructive, but it’s generally best to do so in a setting where a school official, such as a counselor, can mediate.

More Information

 

January 9th, 2017|School-Age Multiples|

Docs: Infants Should Share Parents’ Room to Help Prevent SIDS

parent-and-infant-handsFrom our friends at HealthDay

Infants should sleep in the same room as their parents — but not in the same bed — to reduce the risk of sudden infant death syndrome (SIDS), new guidelines from the American Academy of Pediatrics advise.

The recommendations call for babies to share their parents’ bedroom for at least the first 6 months of life and, ideally, for the first year.

This could reduce the risk of sudden death by as much as 50 percent, the guideline authors say.

“Room sharing makes a lot of sense,” said Dr. Paul Jarris, deputy medical officer at the March of Dimes.

The rationale is that having the infant within view and reach makes for easier monitoring, comforting and feeding. Because the baby is nearby, parents might notice any potential difficulty, Jarris said.

“If we look at how strong the evidence is, parents will be well advised to adopt room sharing,” Jarris said.

It’s important, however, that infants have their own separate sleep surface, such as a crib or bassinet. They should never sleep on a soft surface like a couch or armchair, the doctors’ group warns.

Nor should babies sleep in the same bed as their mothers, the guidelines say. But, since infants do feed throughout the night, the doctors recommend that mothers feed the baby in bed.

“Babies should be brought to bed for feeding, but following feeding they should be returned to a separate sleep surface,” said report co-author Dr. Lori Feldman-Winter, a professor of pediatrics at Cooper Medical School in Camden, N.J.

“Breast-feeding can reduce SIDS by as much as 70 percent,” added Feldman-Winter.

Because moms may sometimes fall asleep during feeding, the AAP recommends keeping the parents’ bed free of pillows, loose sheets, blankets and other soft bedding that could suffocate the baby, she said.

Each year in the United States, some 3,500 babies die from sleep-related deaths, including SIDS. The number of infant deaths dropped in the 1990s after a national safe-sleep campaign that emphasized placing infants on their back. However, momentum has stalled in recent years, Feldman-Winter said.

Besides room sharing and breast-feeding, the academy’s recommendations to create a safe sleep environment also include the following:

  • Put the baby on his or her back on a firm surface, such as a crib or bassinet, with a tight-fitting sheet.
  • Keep soft bedding, including crib bumpers, blankets, pillows and soft toys, out of the crib. The crib should be bare.
  • Avoid exposing the baby to smoke, alcohol and illicit drugs.
  • Never use home monitors or other devices, such as wedges or positioners, to reduce the risk of SIDS.

Although SIDS risk is greatest from 1 to 4 months of age, evidence shows that soft bedding is still a hazard for older babies.

One pediatric specialist thinks room sharing might be difficult for some parents to accept.

“Room sharing is probably the most controversial recommendation,” said Dr. David Mendez, a neonatologist at Nicklaus Children’s Hospital in Miami.

Parents have strong feelings one way or the other, Mendez said. “Some parents want the baby in the bed right next to them; some parents want the baby to have its own room,” he said.

Mendez said he’s more concerned with other risk factors for SIDS, such as smoking and excess bedding.

“I would rather have the parents put the baby in a separate room if they’re smokers than room share,” he said.

“Having the baby on a firm surface on his back and keeping soft pillows and loose bedding that the baby can get tangled up in out of the bed or crib — those things probably play a much bigger role in preventing SIDS than being in the same room with the baby,” Mendez added.

The new recommendations, published online Oct. 24 in the journal Pediatrics, were to be presented Monday at the academy’s annual meeting, in San Francisco.

SOURCES: Lori Feldman-Winter, M.D., M.P.H., professor, pediatrics, Cooper Medical School, Rowan University, Camden, N.J., David Mendez, M.D., neonatologist, Nicklaus Children’s Hospital, Miami, Fla.; Paul Jarris, M.D., deputy medical officer, March of Dimes; November 2016, Pediatrics

Adopt-a-Family 2016

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Raising Multiples 2016 Adopt-a-Family ListdonatenowWP

Adopt-a-Family List

(click the link above to download the list)

 

Thank you for your interest in helping families in need this holiday season. If you would like to adopt a family, please email us at info@raisingmultiples.org and we will provide shipping information and instructions.

You may mail gift cards or a check (the post office box cannot accept packages) to Raising Multiples, P.O. Box 306, East Islip, NY 11730-0306. Please include the family # you are adopting!

Family #1 – If you’d like to make a general donation to the Adopt-a-Family program, we will do the shopping for you for any families that are not adopted, added to the program late, or that need help during the year. You may mail your contribution to Raising Multiples, PO Box 306, East Islip, NY 11730-0306, or donate online. Be sure to mark the “Please apply this donation to the AAF program” box under Donor Information. Thank you!

 

Family #2 – This military family of 9 is struggling to make ends meet.  Dad has been deployed overseas and won’t be home until next year.  Mom also served in the military and is now home alonefeet in color with the 7 children under the age of 11, including 3-year-old Girl, Girl, Girl, Girl, Boy quintuplets. The quintuplets have a 10-year-old big brother and a 1-year-old little brother.  This family lives near a Walmart.

 

Family #3ADOPTED This family is going through a very tough time.  Dad has cancer and is unable to work right now.  This family has Girl, Boy, Boy triplets who just turned 5 years old.  They struggle every month with the bills and are worried about heating the house this winter.  If we could help them with groceries and warm clothing, they could use the money they do have to pay the mortgage and heat the house.  This family lives near a Target and a ShopRite Supermarket.

 

Family #4ADOPTED This family of 7 survived the Louisiana flood.  They had over 3 feet of water in their house and lost almost everything, but consider themselves lucky.  This family has 6-year-old quadruplets – 2 girls who wear size 4 and 2 boys who wear size 5.  The quadruplets also have a little brother who is 3 years old and wears size 3T.  We’d like to help this family get things back to normal for the kids, who have been having a hard time. This family lives near a Kmart and a Walmart.

 

Family #5ADOPTED This recently single mom of 6 children, including 2-year-old Girl, Boy, Boy, Boy quadruplets is struggling financially. Dad has relinquished his rights to the children and has moved on. The children are having a difficult time. The quadruplets have an 8-year-old big sister and a 4-year-old big sister.  This family is in need of warm clothes – coats, long sleeve shirts, pants and sweatshirts.  The 8-year-old girl wears size 8. The 4-year-old girl wears size 6 and the quadruplets wear size 3T. This family lives near a Meijers.

 

Family #6ADOPTED This single parent family has 4-year-old Boy, Boy, Girl triplets.  One son is on the autism spectrum and the family struggles every month to pay the bills. We’d like to help this mom give the children a holiday with presents they wouldn’t otherwise be able to afford. This family lives near a Walmart. infant hand in adult hand

 

Family #7 – This family recently lost dad suddenly when he had a heart attack, leaving mom with 13-year-old Girl, Girl, Girl triplets and a big sister who is 17.  The family is struggling emotionally and financially since Dad passed.  The holidays are going to be very hard on everyone.  We’d like to help this mom create new memories this holiday with a little something under the tree for the girls. This family lives near a Walmart.

 

Family #8 – This Louisiana flood victim family needs to start putting the pieces back together. They thought their house was in a safe area, but ended up needing to be rescued. They have 3-year-old Girl, Girl, Girl triplets, a 5-year-old girl, and big brothers ages 7 and 9.  They are grateful to all be safe, but we’d like to help make the holiday ‘normal’ for this family.

 

Family #9 – This family recently lost their dad after a 2-year battle with cancer. This family has 11-year-old Boy, Girl, Girl triplets and is struggling financially. Mom is concerned that the holidays will not only be sad, but with finances the way they are, there will be no gifts.  We’d like to give this family a special holiday season. This family lives near a Walmart.

 

Family #10 – ADOPTED This hard-working family has lost everything in the Louisiana flood, but say they are grateful that they have each other.  This family has 2-year-old Girl, Boy, Boy triplets.  They have reached out to other families, trying to help them find places to stay, while they are staying with family friends in the next town. We’d like to make the holidays special for this selfless fmailyspotlightfamily.

 

Family #11– This family of quintuplets is from Louisiana. The family home was destroyed in the flood.  The quintuplets are older than families we usually ‘adopt’, but a few of the children have special needs and still live at home. They are currently staying with Grandma and we’d like to support this family with a gift card to help them get back on their feet.  This family lives near a Walmart.

November 21st, 2016|Articles|

Hearing Test May Predict Autism Risk Sooner

autism brainA simple hearing test may help identify young children at risk for autism before they’re old enough to speak, a new study suggests.

Researchers from the University of Rochester in Rochester, N.Y., say they’ve identified an inner-ear problem in children with autism that may impair their ability to recognize speech.

“This study identifies a simple, safe and noninvasive method to screen young children for hearing deficits that are associated with autism,” said study co-author Anne Luebke, an associate professor in the departments of biomedical engineering and neuroscience.

“This technique may provide clinicians a new window into the disorder and enable us to intervene earlier and help achieve optimal outcomes,” she said in a university news release.

Autism spectrum disorder is characterized by impaired social-communication skills and restricted and repetitive behaviors. While many signs of autism appear before age 2, most children aren’t diagnosed until after age 4, the researchers said. They suggested that if treatments could start sooner they might have more impact.

For the study, Luebke and her colleagues tested the hearing of children between ages 6 and 17 with and without autism. Those with autism had hearing difficulty in a specific frequency (1-2 kilohertz, or kHz) that is important for processing speech.

The degree of hearing impairment was associated with the severity of autism symptoms, according to the study.

Hearing “impairment has long been associated with developmental delay and other problems, such as language deficits,” said study co-author Loisa Bennetto, an associate professor of clinical and social sciences in psychology.

“While there is no association between hearing problems and autism, difficulty in processing speech may contribute to some of the core symptoms of the disease,” Bennetto said.

If future research confirms the findings, the study authors say the screening could help identify children at risk for autism earlier and perhaps get them services sooner.

“Additionally, these findings can inform the development of approaches to correct auditory impairment with hearing aids or other devices that can improve the range of sounds the ear can process,” Bennetto said.

The hearing test is noninvasive, inexpensive and does not require a child to respond verbally, so it could be adapted to screen infants, the researchers said.

The study was published in the journal Autism Research.

Thanks to HealthDay for covering this topic!