It’s common for kids on the autism spectrum to have problems with eating. This can make it difficult for some parents to get their kids to eat a healthy range of foods, and can cause a lot of disappointment and conflict at mealtime.

Children with Autism Spectrum Disorder (ASD) may experience a number of issues when it comes to food. Some children may prefer foods that feel a certain way in their mouth, such as crunchy foods or soft foods. Children who only eat soft foods may have weak jaw muscles that make eating chewier food unpleasant. Since many children with ASD are very sensitive to textures, they might sit and not eat at meal times while their peers enjoy a meal without issue because of their texture sensitivity.

Understanding what may be behind children's strict eating habits is the first step toward allowing them to become more comfortable with new meals and making mealtime more enjoyable for everyone.

Finding solutions to mealtime challenges for children with autism is like a game of cards. There are so many things you can do, and the strategies you choose will depend on the person and the problem at hand. As mentioned, autism is a type of spectrum disorder. This means that each person will have different challenges and will respond in different ways to intervention strategies.

The techniques listed below may assist parents in providing better eating experiences for their children:

• Explore new food textures

There are many foods that can go a long way toward relieving the symptoms and discomfort of autism. One of the biggest challenges facing individuals with ASD is in basic sensory processing. The individuals often find that warm or cold foods, crunchy or smooth textures, strong flavors and many other physical qualities of a food make eating hard work for them. 

It is, therefore, usually a good idea to give children with ASD foods that are textured in ways they find easier to eat first while leaving aside textures they don’t like. For example, if fish is one of those tastes an individual with ASD doesn’t like then he/she can instead be given fish burgers by their parents or caregivers.

Slowly introduce new things one at a time. Make sure to set realistic expectations of what they are and be sure you're helping out any way that you can!

• Introduce Children to New Foods Gradually

Introducing one's child to new foods or flavors can be something that expands their palate, but it's up to parents and guardians to get kids involved in finding out which tastes they like best.

Typically, children will take between 10 and 20 attempts to decide whether they like a new food. A child with ASD might find it more difficult because of the new experiences that come with eating something (e.g., new smell, taste, feeling when swallowing).

The best tip to remember when introducing new foods, is to be patient. Sometimes it takes time for our children, or even ourselves to discover what flavors they enjoy the most. When looking at recipes, don’t push them too hard, because children will develop a sense of trust in you over time and that’s when you can begin experimenting with new and exotic flavors. Naming specific children can be helpful in developing their palates further.

• Create a Specific Routine

Children with autism often engage in repetitive behaviours. If parents were to remove these types of behaviours, it could only result in negative repercussions elsewhere, since these children wouldn't be able to express how they are feeling. You should instead establish new practices that are beneficial for the child such as having a specific place for meals -such as a child-sized table or high chair- and having consistent times for meals every day.

Environmental cues help all children – and especially those who have autism – learn what they’re supposed to be doing. For example, an animal’s fresh water bowl is an environmental cue for drinking water. Similarly, the family table needs to be for eating meals.

• Use Positive Reinforcement

Providing positive reinforcement is a sure fire way to encourage and nurture good behavior in your child. Becoming specific about what we liked by explaining exactly why food made us happy allows our children to associate this feed with a positive reaction from us in order to increase the chance of them repeating it again in future.

After they've tried new foods, rewarding them with extra time on things they love, such as playing educational games on a computer or tablet, might inspire them to do it again.

In this article, we discussed some of the challenges that children with autism and their parents typically face when it comes to mealtime. We also outlined strategies and solutions to common mealtime issues. One very key thing mentioned here is to be patient, supportive, open-minded and see if you can give a go at strategies that can help promote a positive experience for both your child with autism as well as yourself.

References

https://extensionpublications.unl.edu/assets/html/g2285/build/g2285.htm

https://www.autismspeaks.org/expert-opinion/autism-and-mealtime-therapists-top-ten-tips-success 

Potty training your child can be daunting. As we know, all children are different and thus, when it comes to potty training they will also have distinct differences in comparison to typical children. But have no fear, as you may not need to take the same approach as most parents would typically take in making sure their child is ready for this journey. As you are aware, children diagnosed with autism spectrum disorder (ASD) may need a lot more time than other children when it comes down to mastering every day skills.  As a result, potty training your autistic child can be a different ball game altogether due to how unique these kids are - which means modifications will almost certainly be required from what an average parent might do.

Several factors can affect a child's ability to become toilet trained including the senses in which the child receives too much input, the inability to use motor skills effectively, whether or not they are cognitively able to understand what is expected of them, and even a lack of being able to communicate (verbally or nonverbally) one's needs. It is important that before deciding whether a child is ready for toilet training, these things are taken into consideration.

Toilet training can get challenging — finding the right balance between patience and persistence can be overwhelming, even for the most determined parent. Remember that it’s not just your child who is learning something new here — you are learning it as well. Toilet training does involve more than just knowing how to use the toilet. Sensory issues play an important role in this process for some children. Some kids might have motor skills deficits, while others may just not be cognitively ready to handle toileting independently at this point in time. Another consideration though — it could also be that your child doesn’t recognize the urge to go, which usually leads to accidents.

Successfully toilet training children with spectrum disorders requires a lot of planning and thoughtfulness. It can also be helpful to have pre-arranged procedures in place, in case anything should happen suddenly or unexpectedly. One way to make the experience easier on both parent and child is by dividing the process into smaller phases. Stage one, the planning phase, involves deciding how to accommodate your child. Stage two, an essential part of turning the program into practice, includes the setup stage where you get everything ready for your child's training period.

The best preparation for toilet training is to ensure your little one has all of the proper resources they need. Here's a list of some of the top 8 items you'll want to be sure are present before attempting toilet training!

• Potty chair
• Stepping stool
• Baby wipes
• Mattress protector
• Training pants
• Faucet extender
• Progress chart
• Wet/Dry bag

Once the ideas from the Planning Phase are collected, it is time for Phase 2 - the Setting Up Phase. Pick one bathroom in the house that the child feels most comfortable using and designate it as their Training Bathroom .

The Implementation Phase is the third phase in the potty training process. Successful potty training takes structure and consistency (some more than others), as well as patience! The more consistent one is with children with autism, the more success they will have in achieving this milestone. To begin with, set a date when the potty training process will begin by thinking ahead to make sure everything is ready and any necessary preparation is underway.

Children with an intellectual disability or developmental delay are best toilet-trained by setting them up for success. Reading books about how the body works, practicing sitting on a potty and rewarding simple accomplishments will help your child learn to use the bathroom independently. In order for children to be motivated, separate rewards should not be given for using the potty and washing their hands, but rather one overall reward should be given when successful (for example: “For using the potty you earned a star on our chart” or “You were able to stay dry all day so I will take you out for dinner tonight!”).

Toilet training can be a lengthy process and may require a lot of patience, but the payoff will be huge! Make sure to consult with your behaviorists throughout the way because each child is unique and has different needs.

A good night’s rest isn't always a guarantee for people with autism, but it may be even more difficult to obtain than for those who aren't on the spectrum. Individuals affected by autism often have trouble falling and staying asleep. Additionally, living with autism can also cause certain symptoms themselves - like repetitive motions, social awkwardness and sensitivity to light and sound - all of which may interfere with the person's ability to sleep.

According to one of the largest studies on the incidence of sleep disorders in autism, approximately 80% of autistic toddlers had sleep disruptions. Sleep issues are twice as common in children with autism as they are in children without autism or with other developmental disorders.

Persons with autism are prone to insomnia: falling asleep takes them an average of 11 minutes longer than it does for non-autistic people, and many of them wake up often throughout the night. Some patients with the illness suffer from sleep apnea, which causes them to cease breathing repeatedly during the night.

People with Autism may spend less time in the REM (Rapid Eye Movement) state of sleep than people who are not autistic. When an individual's body transitions through REM sleep, they enter into a dream-like phase where they can more effectively learn new information and retain old information stored in their memory banks. Most people who are 'non-autistic' spend about 23% of their nightly rest in REM sleep but this is only 15% for those who have autism.

Evidence suggests that not getting enough sleep can make living with Autism more challenging. Kids who do not get enough sleep have greater difficulties in developing social skills and have a harder time making friends than others on the spectrum. Additionally, these children tend to score lower on tests of intelligence, however it is unclear whether these problems arise from poor sleep, contribute to it or both.

Many persons with autism also have anxiety disorders or ADHD, which impair their sleep. For example, they may suffer from constipation and become unable to sleep because of the painful cramps. Sensory sensitivity to light, sound, or touch can all contribute to sleep problems. Sleep issues may also be a sign of depression among autistic persons, though it's unclear whether depression is a cause or a result of sleep issues.

Fortunately, there are several ways parents can improve a child’s sleep. 

• Exercise: Staying fit through exercise helps with sleep. Children who take part in physical activity have proven to get the highest quality of sleep and require less overall sleep. It's best not to allow your child to exercise too close to bedtime as they can become hyperactive, making it harder for them to fall into a deep slumber.

• Sleep Schedule: You should have roughly the same amount of sleep each night, with no more than two hours difference between your weekday and weekend schedule.

• Bedtime routine: It’s important that you make sure your child gets enough sleep during the day so make sure they go to sleep at a reasonable hour. It’s also crucial that you know their bedtime routine as to repeat it every night and this means avoiding technology in their room (like the television, computer or video games) because it could stimulate their brain making it harder for them to fall asleep.

• Sleep hygiene: the bedroom should ideally be dark, quiet and cool. As children with autism may be particularly sensitive to noises and/or have sensory issues, the environment can benefit from the use of soundproofing materials and acoustical panels, which are available cheaply online or in home improvement centers, to enhance a child's sense of security.

It is important to address any medical or emotional issues that might disrupt your child’s health and sleep. Sometimes medications and emotional issues can cause insomnia. If this is the case, counseling, therapy, behavior modification and medication may be required to get your child falling asleep more readily. Some young children have trouble sleeping due to a specific disorder such as sleepwalking or restlessness that may simply require behavioral changes, while others require additional help like testimony from a sleep specialist.

WHAT IS CEREBRAL PALSY?

A congenital disorder of movement, muscle tone or posture. Cerebral palsy is caused due to abnormal brain development, often before birth. Symptoms include exaggerated reflexes, floppy or rigid limbs and involuntary motions. These appear by early childhood. Long-term treatment includes physical and other therapies, drugs and sometimes surgery.
There are several different types of cerebral palsy — spastic, ataxic, athetoid, hypotonic, and mixed cerebral palsy. These conditions are classified based on mobility limitations and affected body parts. Each type can vary in severity, symptoms, and treatment.

Spastic Cerebral Palsy

• 77% of all cases

Spastic cerebral palsy is the most common type and accounts for 77% of all cases. Also referred to as hypertonic cerebral palsy, most individuals with this type experience high muscle tone and exaggerated, jerky movements (spasticity).

It is caused by damage to the brain’s motor cortex, which controls voluntary movement. It is also caused by damage to the pyramidal tracts, which help relay signals to the muscles. For this reason, this type of cerebral palsy is sometimes referred to as “pyramidal.”

The motor cortex is found on both sides of the brain, and the pyramidal tracts connect each side of the motor cortex to one another. Damage to the right side of the motor cortex causes movement problems on the left side of the body, and vice versa.

SYMPTOMS OF SPASTIC CEREBRAL PALSY:

Common symptoms of spastic cerebral palsy include:

1. Abnormal walking
2. Awkward reflexes
3. Contractures (permanently tightened muscles or joints)
4. Stiffness in one part of the body

Athetoid Cerebral Palsy

• 2.6% of all cases

About 2.6% of children with the condition are diagnosed with  (also known as non-spastic or dyskinetic cerebral palsy). This type causes issues with involuntary movement in the face, torso, and limbs. Athetoid cerebral palsy is characterized by a combination of hypotonia (loosened muscles) and hypertonia (stiffened muscles) which causes muscle tone to fluctuate.

This type of cerebral palsy is caused by damage to the brain’s basal ganglia and/or cerebellum. The basal ganglia regulates voluntary motor function and eye movement, and the cerebellum controls balance and coordination.

Athetoid cerebral palsy is considered extrapyramidal. The extrapyramidal tracts in the brain regulate involuntary reflexes and movement signaled by the basal ganglia and cerebellum.

SYMPTOMS OF ATHETOID CEREBRAL PALSY: 

1. Feeding issues
2. Floppiness in the limbs
3. Problems with posture
4. Stiff or rigid body

Ataxic Cerebral Palsy

• 2.4% of all cases

Ataxic cerebral palsy makes up about 2.4% of all cerebral palsy cases. This type of cerebral palsy causes ataxia and issues with balance, coordination, and voluntary movement. It is caused by damage to the cerebellum, which is responsible for coordinating physical movement. Individuals with ataxic cerebral palsy often experience tremors and a reduction in muscle tone.

SYMPTOMS OF ATAXIC CEREBRAL PALSY:

1. Poor coordination
2. Problems with depth perception
3. Shakiness and tremors
4. Speech difficulties
5. Spreading feet apart when walking

Hypotonic Cerebral Palsy

• 2.6% of all cases

It (also known as atonic cerebral palsy) makes up about 2.6% of all cases. This cerebral palsy type is classified by low muscle tone that causes loss of strength and firmness, resulting in floppy muscles. Instability and floppiness in muscles caused by hypotonic cerebral palsy can cause a child to miss developmental milestones such as crawling, standing, or walking.

SYMPTOMS OF HYPOTONIC CEREBRAL PALSY:

1. Flexible joints and ligaments
2. Lack of head control
3. Loose muscles
4. Poor balance and stability

Mixed Type Cerebral Palsy

• 15.4% of all cases

In some cases, damage to the developing brain is not confined to one location. It is possible for a child to develop more than one type of cerebral palsy caused by damage to several areas of the brain. It occurs when a child is showing symptoms of two or more types of cerebral palsy. About 15.4% of all cases are diagnosed as mixed type cerebral palsy.

The most common mixed cerebral palsy diagnosis is a combination of spastic and athetoid cerebral palsy, since both of these types are characterized by issues with involuntary movement.

WHAT IS A DEVELOPMENTAL- BEHAVIORAL PEDIATRICIAN

Developmental-behavioral pediatricians evaluate, counsel, and provide
treatment for children, adolescents, and their families with a wide range of
developmental and behavioral difficulties, including. Learning disorders
including dyslexia, writing difficulties, math disorders, and other school-
related learning problems.

WHAT TRAINING DOES A DEVELOPMENTAL-BEHAVIORAL PEDIATRICIAN
UNDERGO?

Developmental-behavioral pediatricians are medical doctors who have
completed

• Four years of medical school
• M.D in Pediatrics
• Three years of residency training in pediatrics
• Additional subspecialty training in developmental-behavioral pediatrics

WHAT ARE THE CONDITIONS TREATED BY A DEVELOPMENTAL PEDIATRICIAN?

• Learning disorders including dyslexia, writing difficulties, math
  disorders, and other school-related learning problems
• Attention and behavioral disorders including attention-
  deficit/hyperactivity disorder and associated conditions including
  oppositional-defiant behavior, conduct problems, depression, and
  anxiety disorders
• Tics, Tourette syndrome, and other habit disorders
• Regulatory disorders including sleep disorders, feeding problems,
  discipline difficulties, complicated toilet-training issues, enuresis
  (bedwetting), and encopresis (soiling)
• Developmental disabilities including cerebral palsy, spina bifida,
  intellectual disability, autism spectrum disorder, and visual and
  hearing impairments
• Delayed development in speech, language, motor skills, and thinking ability
• Behavioral and developmental problems complicating the full range of pediatric chronic illnesses and disabling conditions (for example, genetic disorders, epilepsy, prematurity, diabetes, asthma, cancer)

HOW DO I SOURCE A DEVELOPMENTAL BEHAVIORAL
PEDIATRICIAN

Developmental-behavioral pediatricians practice in hospitals, major
medical centers, clinics, private practice settings, rehabilitation centers,
schools, and community centers.

Often a developmental-behavioral pediatrician works collaboratively
with a team of professionals. This team may include a psychologist,
speech-language pathologist, occupational therapist, physical therapist,
neurodevelopmental disabilities pediatrician, child psychiatrist, child
neurologist, nurse practitioner, physician's assistant, educational
diagnostician, or clinical social worker.

At Cogniable we have a bright ,experienced team to help any
child with Developmental Challenges.The team consists of

• A Developmental-Behavioral Pediatrician
• Psychologists
• Occupational therapists
• Physiotherapists
• Speech therapists
• Special Educators

For enquiries, feel free to contact us at +91 77109 40821

Inclusive education is a challenging yet rewarding endeavour. It molds children into individuals who can interact not just with their peers but also with people of various ethnicity and socioeconomic backgrounds. This is why it is vital to practice values that advocate for, respect and encourage each child’s individual strengths and limitations regardless of whether they are categorized under a developmental disability or not. An inclusive school setting will not only shape our future workforce but also render them leaders in any field that requires collaboration.

To understand inclusion, it's important to acknowledge that each student is unique in terms of her/his mind and body, so we should be sure to design classroom activities tailored to the interests and abilities of all students. And since people respond differently depending on each individual's personal history, learning styles, and experiences, we have to keep in mind how every child will react when they're given different opportunities at school.

There are three ways of welcoming inclusive education into schools (As discussed by CBSE)

• Integrated Education

Integrated Education means persons with disabilities or special needs, including those identified with special educational needs are being placed in regular classrooms with some adaptations and resources.

Although many educators and parents are starting to understand how beneficial programs for students who have special needs or challenges can be, these types of programs are not ideal for all schools. Good institutions will provide multiple programs so that all children can learn in a way that best fits their unique needs.

• Special Education 

Special Education is the practice of educating students who are experiencing a challenging transition into the educational system or face other barriers to learning due to their special needs. Students with special needs are given personal attention and care, which in turn helps them reach their full potential. 

This can be achieved by learning strategies that focus on strengths rather than weaknesses, which is why adapting teaching strategies and materials are effective ways of supporting students with special needs. This form of pedagogy focuses on regular visits from instructors, adaptive equipment/materials, parents/guardians being partners in the child's education etc

• Mainstreaming

Mainstreaming is a concept that puts students who are "special" into the mainstream in education and society. The focus is on the needs of these individuals, recognizing that they can achieve and contribute to society, like everyone else.

A student may be classified as being in a special education program. Specialized training and/or assistance is needed to help keep that type of student up with the demands of a general education classroom.

Ways of enforcing Inclusivity:

• It is important to keep a balance if we want all our children to receive equal opportunities. This is why, the school should prioritize admissions for disabled students (such as children with autism) and announce this policy openly. By creating customized education programs that have proven their effectiveness, these students can finally find acceptance and an environment they deserve
• Sensitizing people to the importance of safe guarding special needs children and implementing different strategies for education by using workshops or in classrooms.
• Building a culture for inclusion in the school by supporting policies, practices and legislation to provide access to education for all children, including those with special needs.
• Providing a space where students can be the most that they can be by committing to their growth in accordance with the school's policy manuals.
• Various stakeholders need to be involved in the education of their students. This includes professionals, social workers and organizations such as NGOs and parents.

An education system that welcomes, supports and teaches all children, no matter what ability they have or what their requirements are - This means making sure that the curriculum, school buildings, classrooms, play areas and bathrooms are welcoming to all students (and all of their unique learning needs). Inclusive education means all students join in on the learning process with
one another (no matter if it’s a boy or a girl; special needs kid or not; etc.).
Inclusive education suggests that schools are available to each student, and everyone is welcome as a part of the learning experience.

When it comes to what might be considered a "team approach," the key players could be community members of a diverse group, regular teachers, parents, resource specialists, as well as disabled children who attend schools where inclusion is practiced. Inclusive education helps give special needs kids the same opportunities that other kids get to participate in both school and community life.

UNESCO (1994) states that `All children learn together, whatever possible, regardless of any difficulties or differences they may have. Inclusive schools must recognise and respond to the diverse needs of their students, accommodating both different styles and rates of learning and ensuing quality education to all through appropriate curricula, organisational arrangements, teaching strategies, resource use and partnerships with their communities'. Inclusive education promotes child-to-child learning and participation of parents and community in planning and execution of services for children in general and disabled children in particular.

The community should encourage the education of children with disabilities in their neighborhood. This ensures a higher level of social acceptance in employment, education and social activities. To ensure there are no road blocks to be overcome when educating these children, teachers should adopt a pro-active approach towards their teaching capacity by ensuring that they understand how to handle the different needs of each child.

It is important for them not just to adapt curriculums by including information about children with special needs and learning styles but also learn how to interact with them on an individual basis, as each child reacts differently. By promoting greater awareness amongst society it becomes clear through mutual respect that all people are equal and deserve the right to gain an education and reach their own potential.

Inclusion settings help children with and without disabilities have fun together, even when they are receiving therapeutic services. When a child shows fine motor difficulty, it makes it hard for them to participate in classroom activities such as coloring, cutting or zipping their jackets on their own. Inclusion settings can level the playing field so that both children can fully enjoy every aspect of childhood!

There are positive effects of inclusion on children. It gives the child with special needs exposure to more opportunities like being more independent, making friends, and becoming more confident about themselves. The true test of an inclusive school is that the surrounding community blend well together, both the special needs and regular curricula areas.

• The children are better educated and have a more cheerful
• Teachers' professional abilities are honed
• Special needs children are better equipped for independent
• Parents are more capable of dealing with their
• Inclusive education shows children how some people are different and some When the children grow with this learning the respect among each other is created and there is better understanding.

In India, a country whose government has invested time and resources in making inclusive education a priority, the thrust on this type of education is still rather lacking. Within developing nations, there are many reasons that explain why inclusive education should be better supported financially.

Many reasons can be attributed to this aspect—some might place the blame on lack of special educators and others on mainstream teachers who have difficulty working with students with special needs. Moreover, There is no standard curriculum yet which can help students with disabilities stay in the mainstream education. What we need is an efficient assessment system along with tools and technologies to accommodate special needs children in mainstream education.

For most children, going to school is a time for learning, playing with other kids and enjoying their childhood. But for some children, particularly those with special needs, going to school can be something of an ordeal. While it's important that these children get the types of care they need when at school - individualized programs that help them learn as much as they can while giving attention to their different needs - they also want to be treated like everyone else. This means being able to go to regular school and eventually become independent, successful members of society who can work and contribute productively to the world.

References

• https://www.unicef.org/eca/sites/unicef.oreca/files/IE_summary_accessible_220917_brief.pdf
• https://www.deccanherald.com/opinion/perspective/inclusive-education-learning-693364.html