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How to make changes in the routines of children with autism
Children with autism are very resistant to change. Until recently it was considered that they had to live under rigorous and strict routines to improve your quality of life.
Little by little, the intervention models are changing and, above all, reality prevails. Life is change and you have to know how to prepare the child with autism for these changes, so that you know how to deal with them naturally.
Life is full of routines, getting up, having breakfast, brushing teeth, going out of the house, going to school, eating, having a snack, having dinner, bathing, going to bed, etc, ... but at the same time there are also many changes, whether planned or unforeseen .
We explain how to introduce changes in the routines of children with autism.
In general, children with autism unexpected changes They tend to be annoying and cause anxiety in unexpected situations. The loss of predictability of what will happen next often coincides with a bad response. The breaking of known routines added to the inflexibility of the child generates negative responses.
We must not forget that the child does not get angry to annoy us, the child will always have tantrums for a reason, even to get our attention or as a blackmail system. It should not be forgotten that because the child has autism he stops being a child and all children have tantrums and the child with autism is no exception.
Pedro comes and goes to her house every day on the school route, but one day her father goes to pick her up at school because he has a medical appointment.
This incident, a priori so common, can lead to a big tantrum. The doctor's appointment on that specific day requires being very punctual, a fact that will also make us lose our nerves and leave school late, and with a negative emotional charge.
We can extend this problem to countless situations. Clothes, meal times, the food itself, a trip, going out to dinner, going to the supermarket, or any of the everyday situations that can vary unpredictably. We need to work so that the child understands that changes are normal and even fun.
Children with autism usually have small obsessions or hobbies that, added to their inflexibilityThey can cause a small unexpected change in routine to take us to an extreme situation.
We will employ two basic techniques. One is the anticipation of what is going to happen. Anticipation prepares the child for future action reduces the anxiety that an unexpected change may produce. The other is introduce progressive changes in routines. These changes can be made gradually, gradually introducing new changes in the routine, so that you end up receiving the change as one more routine. Flexibility and the elimination of small obsessions are worked on.
Anticipation and participation:
Depending on the child and his abilities, we will use one system or another to anticipate actions. Visual agendas will be very helpful.
Before each change that we want to include in the routine, we will prepare the agenda to notify the child of what is going to happen next.
We can, for example, include an unscheduled visit to the supermarket. We anticipate action and support it visually and verbally. It is also important to establish small prizes or reinforcers. This way we can positively encourage the child's action. If the child participates in the purchase, they will feel a greater attachment to the action itself and it will be easier for us to introduce this new element.
At this point we will have carried out the following actions:
- Active participation in the task and the child's choice of some of the foods to buy. We can make the child choose one and we another.
- Understanding on the part of the child that the action of the purchase entails a small change that is associated with a nice situation. Hence the importance of positive reinforcement in accepting change.
- The child will also accept the anticipation of actions that get out of the strict routine.
Depending on each child, this type of exercise may cost very little, or we will have to arm ourselves with patience. No two children are the same. In turn, the older the child is and the longer he has followed a routine, the more it will cost us to introduce these changes.
Introduce this type of gradual changes It will allow us that in the long term the child is much more flexible when it comes to an unforeseen change.
Work on flexibility It is an important point and it will help us so that the changes that the child is going to face in his life are not so traumatic. There are many situations that will make routines break and preparing the child to face unexpected situations will avoid states of anxiety.
You can read more articles similar to How to make changes in the routines of children with autism, in the category of Conduct on site.
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Spina bifida means that the baby's spinal column is exposed. The most important way to protect your baby from this serious problem is to start using folic acid before pregnancy! Otherwise, a serious health problem, this disease affects the baby for life. Head of Department of Pediatric Neurosurgery at Acıbadem Hospital Dr. Contact memet directly "Spina bifida is the most severe anomaly of the central nervous system," he warns families.
: What is Spina bifida?
Professor Dr. Contact memet directly This disease is a problem that occurs during the first three months of pregnancy when the spinal cord closes and becomes a tube. As a result, the membrane cannot form on the spinal cord because it cannot close and become a tube. Therefore, a certain area on the back of the baby is born in the open. Spina bifida is the most severe anomaly of the central nervous system. It affects the patient all his life. However, it is not difficult to avoid this disease. All you have to do is have a planned pregnancy. By taking folic acid in the 3 months before pregnancy and in the first 3 months of pregnancy, it is possible to protect your baby from a life-long illness.
: How often is seen as spina bifida in Turkey?
Professor Dr. Contact memet directly Spina Bifida is considered a real health problem in our country. One in every 1000 births is Spina Bifida. This is an indication of backwardness. This disease is one of two or three factors to be looked at to measure the backwardness of the health system in a country. The ratio of 1 in 1000 is very high. There are no such cases in Denmark in the last 8 years. However, in the clinical series of Marmara University Faculty of Medicine, more than 500 operations have been performed in the last 7 years. This is a very serious figure. Our main goal as a physician is to take preventive measures to prevent these babies from being born.
: What are the causes of spina bifida?
Professor Dr. Contact memet directly The most important cause of spina bifida is folic acid deficiency. Because of this deficiency, the development of the spinal cord at the end of the first month of pregnancy is lacking. So that part is exposed.
: What is the precaution?
Professor Dr. Contact memet directly This is of course planned pregnancy. A woman notices that she is pregnant in the first month. After that, if folic acid is taken by weight, it is already too late. She should start taking folic acid three months before pregnancy and continue in the first three months of pregnancy. Thus, some degree of guarantee is provided for spina bifida.
: Is it treated surgically?
Professor Dr. Contact memet directly Early intervention is essential in this disease. In the first 36 hours, these babies should definitely be operated on… Because the spinal cord is exposed means that the cerebrospinal fluid is exposed. If the baby gets infected, it causes meningitis. Meningitis means that a baby born with a lot of problems is struggling with a new problem. Problems awaiting these children are divided into early and late periods.
: What are the problems that await early babies?
Professor Dr. Contact memet directly There are two problems that threaten the baby's life for the first month. The first is the accumulation of water in the head called hydrocephalus. The second is a problem called Chiari Type 2. The part of the skull of children with spina bifida that we call the cerebellum is also small. Therefore, the cerebellum does not fit there. Thus, it hangs down and presses on the upper spinal cord region. This causes them to be unable to breathe easily, causing problems with swallowing function. Therefore, close monitoring of the baby with Spina Bifida is essential. These problems are not limited to these children. All the spinal cord functions below the level of the spinal cord is exposed in which region is problematic. For example, if there is a problem in the lumbar region, the patient's foot movements are problematic. Urinary tract problems are also showing. Problems arise with sexual functions whether baby girl or boy.
: What are the problems awaiting late babies?
Professor Dr. Contact memet directly Hydrocephalus, which is the accumulation of fluid in the brain, used in the treatment of problems with the device called shunt arises. In addition, more frequent urinary tract infections, especially in girls, constitute a serious problem. They are more susceptible to this type of disease because they are more easily infected than normal people. For this reason, children with spina bifida should be kept under close monitoring by the pediatric neurosurgery department at least until adolescence.
: Can you give information about postoperative care?
Professor Dr. Contact memet directly The children who are born with spina bifida can survive with the least damage through the first 36 hours of surgery. Early surgical approach to these patients in Turkey, primarily done in the Marmara University Faculty of Medicine, including several university hospitals. In private hospitals, this surgery is performed only at the time of admission to the patient at the hospital. Postoperative care is as important as surgery. The anesthesia that should be applied to these babies during surgery is extremely important.
: Is prenatal diagnosis possible?
Professor Dr. Contact memet directly In prenatal examinations only ultrasonography may not always be sufficient to diagnose this disease. Sometimes the expectant mother goes through the ultrasound repeatedly, but the problem is not noticed. It can be put in by an experienced eye from the 4th month of pregnancy. Amniocentesis should be performed in case of doubt. If the situation is noticed, the decision whether or not to terminate pregnancy belongs to the mother and father. We, as a physician, tell the family about the problems awaiting their babies in the future. However, I would advise families who decide to give birth to the child by cesarean section in the hospital where the child will have surgery.