Autism Teaching Methods

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  • 8/3/2019 Autism Teaching Methods


    Autism Teaching Methods: TEACCH (Treatment and Education of Autistic and Related Communication-Handicapp


    TEACCH was developed by psychologist Eric Schopler at the University of North Carolina in the 1960s; it is usedmany public school systems today. A TEACCH classroom is usually very structured, with separate, defined areas each task, such as individual work, group activities, and play. It relies heavily on visual learning, a strength for machildren with autism and PDD. The children use schedules made up of pictures and/or words to order their day andhelp them move smoothly between activities. Children with autism may find it difficult to make transitions betweeactivities and places without schedules.Young children may sit at a work station and be required to complete certain activities, such as matching pictures

    letters. The finished assignments are then placed in a container. Children may use picture communication symbolssmall laminated squares that contain a symbol and a word to answer questions and request items from their teacThe symbols help relieve frustration for nonverbal children while helping those who are starting to speak to recallsay the words they want.This method of "structured teaching" is often less intensive than Applied Behavior Analysis or Verbal Behaviorprograms in the preschool years.According to its web site, TEACCH respects "the culture of autism" and embraces a philosophy that people with ahave "characteristics that are different, but not necessarily inferior, to the rest of us." It says, "the person is the priorather than any philosophical notion like inclusion, discrete trial training, facilitated communication, etc."Drawbacks to this method: Social interaction and verbal communication may not be heavily stressed because TEAis more focused on accommodating a child's autistic traits than in trying to overcome them. Also, more research isneeded into the effectiveness of TEACCH, especially in comparison to Applied Behavior Analysis and other teachmethods. In contrast to the outcome studies of ABA published by Dr. Ivar Lovaas, TEACCH has not publishedcomprehensive, long-term studies of its effectiveness in treating and educating children. A short-term study in 199found that young children who received four months of a home-based TEACCH program improved more than chiwho received no treatment at all.Parents who want their child completely included in classrooms with nondisabled children may not be happy with TEACCH program.The TEACCH program developed in North Carolina includes an array of services such as evaluations, parent trainand support groups, social and recreation groups, counseling, and supported employment. However, these servicebe missing from public schools in other states that have adopted this method for their autism classroom. You may to learn more about the North Carolina model to see how your school's program measures up.Autism Teaching Methods: DIR/Floortime

    Dr. Stanley Greenspan, a child psychiatrist in the Washington, D.C., area, has developed a form of play therapy thuses interactions and relationships to teach children with developmental delays. This method is called theDevelopmental, Individual-Difference, Relationship-Based model, or "DIR/Floortime" for short. Floortime is baon the theory that autism symptoms are caused by problems with brain processing that affect a child's relationshipsenses, among other things.With Floor Time, the child's actions are assumed to be purposeful. It is the parent's or caregiver's role to follow thechild's lead and help him develop interaction and communication skills.For example, a boy may enjoy tapping a toy car against the floor. During a Floortime session, his mother may imitthe action, or put her car in the way of the child's car. This will prompt the child to interact with her. From there, tmother encourages the child to develop more complex play schemes and incorporate words and language into playFloortime is more child-directed than some teaching methods. Its goal is to increase back-and-forth interaction and

    communication between child and adult.Some school systems are incorporating this strategy into their programs, but usually do not make this their primarmeans of educating preschool-aged children with autism or PDD. With its strong emphasis on social and emotionadevelopment, the Floor Time method may be a natural complement to a behavioral teaching program such asApplied Behavior Analysis or Verbal Behavior or to a TEAACH program. Floortime lacks the controlled, long-research studies of ABA, and it does not focus on specific academic skills. However, it is being used successfully some families who prefer a play-based therapy as a primary or secondary treatment, especially for toddlers andpreschoolers. Floortime advocates say it can be used along with other therapies.The Interdisciplinary Council on Developmental and Learning Disorders (ICDL), which Dr. Greenspan chairs, hapublished Clinical Practice Guidelines that can be requested through its web site. The web site also lists DIR/Floorprofessionals.
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    Floortime DVD Training Series, The Basics: Relating and Communicating by Stanley Greenspan M.D. and Serena WiedPh.D. This two-disk set teaches the basics of using the Floortime Method to teach your child. Floortime DVD TrainSeries. Set 2 Sensory Regulation and Social Interaction for families who've moved beyond the basics. FloortimeDVDTraining Series. Set 3: Symbolic and Logical Thinking completes their training series.Autism Teaching Methods: Sensory Integration Therapy

    All children learn about the world through their senses. A common symptom of Pervasive Developmental Disordeautism is an unusual response to the senses of hearing, sight, touch, smell and/or movement. According to the NatInformation Center for Children and Youth with Disabilities, children with pervasive developmental disorders "mseem under-responsive or over-responsive to sensory stimuli. Thus, they may be suspected of being deaf or visuall

    impaired. It is common for such young children to be referred for hearing and vision tests. Some children avoid gephysical contact, yet react with pleasure to rough-and-tumble games. Some children carry food preferences to extrwith favored foods eaten to excess. Some children limit their diet to a small selection."Is your child extremely sensitive to certain noises, bright lights, food textures or crowds? Does he look out of thecorners of his eyes? Is he afraid of swings or very clumsy? Does he dislike being touched or hugged unless he initit? Is he unusually irritated by tags or seams on his clothes? Does he refuse to wear a coat and make a huge fuss ovsocks and shoes? Does he have an unusually high or low tolerance for pain?These may be signs of Sensory Processing Disorder, also known as Sensory Integration Dysfunction. Sensoryprocessing problems are fairly common among children with autism, PDD and Asperger's Syndrome. Please be awthat sensory problems alone do not mean a child has autism. Some children have a sensory processing disorder onbut no other diagnosis.

    The theory of sensory integration was developed by occupational therapist A. Jean Ayres, Ph.D. in the 1970s. Senintegration occurs when our brains organize the information from our senses for our use.For some people, sensory integration does not develop properly. Sounds, sights and movement may seem more chmore distracting and stronger than they do to others. Balance and coordination may also be a problem.Because of these sensory problems, a child may avoid the playful, sensory-rich experiences that are natural buildinblocks to learning and developing relationships, according to occupational therapist Tara Delaney in her book, 101Games and Activities for Children With Autism, Aspergers and Sensory Processing Disorders.Occupational therapists (OTs) who are trained in sensory techniques will engage a child in playful activities desigto help him process the information he receives from his senses in a more typical manner.The therapist may work with the child in a room with platform swings, large exercise balls and other equipment. "goal of therapy is not to teach skills, but to follow the child's lead and artfully select and modify activities accordin

    the child's responses," according to Marie DiMatties and Jennifer Sammons at The Council for Exceptional ChildrThe therapist can develop a treatment plan for a child that a parent can also follow at home, often using commonhousehold items. The child may need to play with different textures (such as sand, play-dough or shaving cream), swing, or to sit atop a large ball. The activities should be just challenging enough to help the child respond better tsensory information without feeling overwhelmed.Activities to improve focus and to calm the child can be built into his day. "The How Does Your Engine Run? Progra step-by-step method that teaches children simple changes to their daily routine, such as a brisk walk, jumping ontrampoline before doing their homework, and listening to calming music, that will help them self-regulate or keepengine running 'just right.' Through the use of charts, worksheets, and activities, the child is guided in improvingawareness and using self-regulation strategies," according to DiMatties and Sammons.Children with autism, PDD and Asperger's Syndrome may receive free physical and occupational therapy at theirpublic schools or through their state's early intervention program. Parents can ask their school system to evaluate tchild to see if he qualifies for these services, including sensory integration activities.At school, an occupational therapist also may work with the child to improve his fine motor skills (holding a pencusing scissors, handwriting) and self-help skills (using buttons, zippers and silverware). A physical therapist may won gross motor skills such as walking, running, balance and climbing.Sensory Integration Therapy is almost never offered as a sole treatment for autism or PDD; instead, it may be a pia larger program.Some studies show a benefit from Sensory Integration Therapy while other studies do not. A small study released 2008 by Temple University researchers found that children with autism spectrum disorders who had sensory integratherapy had fewer "autistic mannerisms" than children who received fine motor therapy alone.Sensory integration treatment can be expensive if not covered by medical insurance or provided by the school or eintervention office. Some insurance plans will not cover sensory integration therapy, but they may cover therapy tfocuses on motor skills.
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    Remember, a child's "occupation" is play and learning about the world.Autism Teaching Methods: Relationship Development Intervention

    Relationship Development Intervention (RDI) is a parent-based clinical treatment that seeks to correct the core sproblems of autism, such as friendship skills, empathy and the desire to share personal experiences with others.Psychologist Steven Gutstein developed RDI with his wife, Dr. Rachelle Sheely. In so doing, they took into accouways in which typically-developing children learn how to have emotional relationships from infancy onward.RDI tries to help children interact positively with other people, even without language. When children learn the vaand joy of personal relationships, according to RDI, they will find it easier to learn language and social skills. RDIbased on the idea that children with autism missed some or many of the typical social development milestones as

    infants and toddlers. They can be taught these skills through play and other activities, according to RDI. Here's anexample of RDI in action: "The adult holds a treat in one closed fist, displays both closed fists to the child, and thelooks at the hand that holds the treat. The child is given repeated opportunities to 'find' the treat in the hand the adulooks at," according to the Handbook of Autism and Pervasive Developmental Disorders .Early research of RDI's effectiveness published in 2005 indicates that RDI may be more effective that some othertreatments. When compared to a control group with autism, children whose families participated in RDI showed gimprovement on the Autism Diagnostic Observation Schedule and more independence at school. Dr. Gutsteinacknowledges that more research needs to be done of his method, which is relatively new. It was first publicized i2001.Some families are using RDI in addition to ABA and other teaching methods. About 5,000 families were receivingin 2009, according to RDIconnect. A goal of the family-centered program is "normalization of family life for all

    members."RDI is more often used in homes than schools, though that is changing. RDI-certified consultants can be expensiveWhat is it?The goal ofspeech therapy is to improve all aspects of communication. This includes: comprehension, expression, soproduction, and social use of language (1). Speech therapy may include sign language and the use ofpicture symbols(2

    its best, a specific speech therapy program is tailored to the specific weaknesses and theenvironmentof the individuchild (1,3). Unfortunately, it can be difficult to create a child-specific, evolving, long-term speech therapy plan (1,4).The National Research Council describes four aspects of beneficialspeech therapy.Speech therapy should begin early in a child's life and be frequent.Therapy should be rooted in practical experience in the child's life.Therapy should encourage spontaneous communication.

    Any communication skills learned duringspeech therapy

    should be generalizable to multiple situations


    .Thus, anyspeech therapy program should include practice in many different places with many different people (2). Iorder forspeech therapy to be most successful, caregivers should practice speech exercises during normal daily rouin the home, school, and community (1, 6). Speech therapists can give specific examples of how best to incorporate stherapy throughout a child's day (7).What's it like?Speech therapy sessions will vary greatly depending upon the child. If the child is younger than three years old, thespeech therapist will most likely come into the home for a one-hour session. If the child is older than three, then thsessions will occur at school or in thetherapist's office. If the child is school age, expect that speech therapy will incone-on-one time with the child, classroom-based activities, and consultations between the speech therapist and teacand parents (2).The sessions should be designed to engage the child in communication. Thetherapist will engage the child using gand toys chosen specifically for the child. Several different speech therapy techniques and approaches can be used isingle session or throughout many sessions (see Does it work?).What is the theory behind it?In addition to trouble with communication, children with autism may also have problems behaving. These behavioproblems are believed to be at least partially caused by the frustration associated with the inability to communicateSpeech therapy is intended to improve social communication skills, and teach the ability to use those communicatioskills as an alternative to unacceptable behavior(1).Does it work?
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    Many scientific studies demonstrate that speech therapy is able to improve the communication skills of children witautism(1). The most successful approaches to speech therapy include components of early identification, familyinvolvement, and individualized treatment(7).There are many different approaches to speech therapy and most of them are effective. The table below lists some odifferent approaches. In most cases a speech therapist will use a combination of approaches in a program.

    Type ofSpeech Therapy Definition Does the R

    SupporAugmentative and


    communication (AAC)

    broad term for forms of communication that supplement or

    enhance speech, including electronic devices, picture boards,

    and sign language

    Yes (

    Discrete trial training

    therapythat focuses on behavior and actions Yes(


    communication technique that involves a facilitator who places

    his hand over the patient's hand, arm or wrist, which is placed

    on a board or keyboard with letters, words or pictures

    No (1,


    communication training


    use of positive reinforcement to motivate the child tocommunicate

    Yes (

    Generalized imitation

    child is encouraged to mimic the therapists mouth motions

    before attempting to make the sound

    Yes (

    Mand training

    use ofprompts andreinforcements of independent requests for

    items (referred to as mands)

    Yes (1

    Motivational techniques

    therapytechniques that focus on following the child's lead and

    capitalize on the child's desire to respond

    Yes (

    Peer mentors/circle of


    use of children who are trained to interact with the autistic childthroughout the day

    Yes (

    Picture exchange

    communication system


    method of usingpicture symbolsto communicate (see PECSFact Sheet)

    Yes (




    trademarkedtreatmentprogram that centers on the belief thatindividuals withautism can participate in authentic emotional

    relationships if they are exposed to them in a gradual,systematic way

    Yes (

    Sign language/total


    language of hand shapes, movements, and facial expressions(especially useful for ages 0-3)

    Yes (

    Story scripts/social


    actual stories that can be used or adapted to teach social skills Yes (1
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    V i s u al S c h e d u l e s f o r U s e wA u t i s m

    What is it?

    A visual schedule is a set of pictures that communicates a series of activities or the steps of a specific activity (1,2). Visschedules are meant to help children understand and manage the daily events in their lives (3). Visual schedules may becreated using photographs, pictures, written words, or physical objects. Ideally, they communicate clear expectatiofor the child and decrease the need for constant adult involvement in the activity (4). Mostvisual schedules are introduwith adult guidance that gradually decreases with time (3). They can be used in speech therapy, at school, and at homeWhat's it like?

    The materials used in a visual schedule can vary widely depending upon the child's abilities (6,7). Schedules may be pinto notebooks or on a schedule board, or also presented with the aid or or on computers. The figure below representexample visual schedule for the last portion of a child's school day.When designing a visual schedule, consider the following questions (2): Will the child understand or recognize the pictures or words? Is the activity represented by thevisual schedule obvious to the child? Can the schedule be made clearer by the use of words, more images, or objects? Does the child know and have available the tools required to successfully complete the activity?What is the theory behind it?

    Children with autism frequently have trouble paying attention to, adapting to, and understanding auditory input. Thalso tend to have strengths in rote memory and the ability to understand visual information(8).Visual schedules takeadvantage of these strengths by efficiently communicating information that allows children to better predict and pwithin theirenvironment(2,3,6). Some children withautism benefit from the use of computers to generate and presentvschedules, and may prefer getting visual schedule information directly from a computer rather than from a person (7).Most behavioral problems associated with children with autism seem to stem from poor communication (2). While vschedules can be useful at home, they may be especially useful for children transitioning into a schoolenvironment(4,

    Visual schedules facilitate communication and therefore may minimize behavioral problems (3,4).Does it work?

    Many studies have demonstrated thatvisual schedules are effective in helping developmentally disabled, and specificautistic, children. These studies show visual schedules to be effective in helping children to gain independence andincrease on-taskbehavior at school, at home, and in community settings(1,2, 6,8). In younger children, this can translainto improved play skills, and a decrease in disruptive and aggressive behavior(5,6). Specifically, use ofvisual scheduhas been associated with a decrease in disruptive behavior, aggression, tantrums, and property destruction (1).In older children, use ofvisual schedules can enhance learning and improve a child's ability to perform the skills requfor daily living (1,3,4,6,8). Visual schedules have also been effectively used to improve physical activity in a physicaleducation setting (6). With time, some children are able to independently use visual schedules to achieve on-taskbehavandself-managementwithout supervision(3-6).The most effective way to use visual schedules is to have them readily available and used consistently (6). Most childrseem to enjoy the use of schedules and appear to be excited to see what will be coming next (3,4). This enthusiasm h

    been shown to translate into increased peer-peer interactions (3,4).What is it?

    Social stories are used to teach social skills to children with autism(1). A social story is a simple description of an everysocial situation, written from a child's perspective.Social stories can be used in different situations. For example, socstories can help a child prepare for upcoming changes in routine, or learn appropriate social interactions for situatiothat they encounter(2). The idea is that the child rehearses the story ahead of time, with an adult. When the situatioactually happens, the child can then use the story to help guide his or her behavior(1).Each social story uses several different types of sentences:Descriptive sentences (De) give who, what, where, and why details about the situation so the child can recognize whesituation actually occurs.Directive sentences (Di) tell the child the appropriate social responses in that situation.

    Perspective sentences (P) describe one of the child's possible feelings or responses.
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    Affirmative sentences (A) give the child a sense of what others may be thinking or feeling in that situation. What doemean?Cooperative sentences (Co) describe how other people will help out in a given situation.Control sentences (Cn) are created by the child, to help remember strategies that work for him or her. (1,3).For example, a social story using all six sentence types is:When we go to the shoe store,There will be many shoes to choose from. (De)I might not know which shoes I like. (P)

    That is okay with everyone. (A)I can hold onto my string while I decide. (Cn)When I decide about the shoes, I will tell the grown-up. (Di)The grown-up will go get the shoes for me. (Co)It has been suggested that social storiesshould use each of these types of sentences only in specific ratios or amountexample, some researchers suggest that directive sentences should not be used as much as descriptive sentences (1). Howesocial stories can still be effective without following these rules (3). Social storiesare usually written by teachers, speectherapists, and parents, and are individualized for the child with autism(4).What's it like?

    Social stories are written in the first person, in the present tense, and from the child's point of view. The parent, teachtherapist, or counselor should write the story to match the child'svocabulary andcomprehension level. The story is wriand put into booklet format. Once it is ready, an adult should read the story with the child at least twice, even if thchild is capable of reading it. The adult then checks to make sure the child understands the important elements, eitusing a checklist or role-playing the situation ("Let's pretend we're at the shoe store. What happens next?") After ththe child reviews the story each day. For children who cannot read, audio tapes, videotapes, or picture books of thstory can be made for the child to review each day. Finally, the effectiveness of each story should be monitored, wthe story being faded out when the behavior has been learned. (1).Social stories can be enlightening and enjoyable. One child responded "Now I'll know what to do!" after the first reaof a social storyabout lunchtime behavior at school. Later, after using the story for about six weeks, that child rema"I don't even read the story. Now I just remember it." (5).

    What is the theory behind it?Difficulty with reciprocal social interaction is one of the main characteristics ofautism. This impairment might result frunusual activity or functioning of certain areas of the brain that are used for social skills (6).Social stories were developed to help improve social interactions in children with autism by giving simple and cleardescriptions of social cues and appropriate behaviors (1). However, it is not clear whysocial storieswork for childrenautism, when picking up social cues from the everyday environment does not. Some researchers believe that individuwith autism have trouble understanding what others believe, know, or don't know. This difficulty is sometimes calltheory of mind deficit in autism. (7).There are several ways that social storiesmay help improve a child's theory of mind. One is that, by giving examplespecific social cues and behaviors,social stories may improve social problem-solving in general (1). Social storiesmay

    help organize social ides and cues that were previously disorganized


    . Moreover, by using print, audio, video, orpictures to replace in-person teaching, social stories may take away some of the anxietyof social relationships (8). In thway, autistic children can concentrate on what is being said rather than their relationship with the person who is sait.Does it work?

    Recent research studies show that social stories can help reduce problem behaviors, increase social awareness, and/oteach new skills. In some cases, the new behaviors were maintained and generalized to other situations, even afterstory was faded out. Social stories are most useful for children who have basic language skills (2).To date, research studies on social stories have only had very small numbers of children (one to five children per studOne review article found thatsocial stories were shown to be significantly effective on average, but not in every casAnother recent review article found that the limited studies available showed generally positive results, and concluthat the approach is promising (4).
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    Although social storiesin picture-book form are available for children with hearing impairments, there is no researchdate on whethersocial stories have the same effectiveness if communicated with sign language.More research is needed to understand what factors make social stories effective in some cases and not in others (4,9,

    Is it harmful?

    There are no known negative effects ofsocial stories. However, among physicians, there is a belief that social stories mtrain children with autismto learn only one response to a given situation. As a result, some physicians recommendRelationship Development Intervention, which seeks to teach children how to have appropriate responses in any situation

    V i t am i n C T h e r a p y f o r C h iw i t h A

    What is it?

    Vitamin C (ascorbic acid) is an essential water-soluble vitamin that is found naturally in many foods. Vitamin C isimportant for many normally occurringbiological processes including the production ofneurotransmitters. Vitamin C aacts as an anti-oxidant, protecting the body against damage from free radicals. (1).What's it like?

    Vitamin C is found naturally in many foods, particularly citrus fruits such as oranges, tangerines, and grapefruits.VC can be purchased over-the-counter online, or at grocery,drug, or health-food stores. It can be taken every day.

    Unfortunately, it is not clear what the proper dose for children withautismshould be. The only published research ron treatment of children with autism used a dose of 8 grams/70 kg/day (or about 2 grams daily for a 40-pound child)divided into two or three doses (2). If you choose vitamin C as an alternative therapy, ask your child's pediatrician what is appropriate for your child.What is the theory behind it?

    Some children with autism may have a vitamin Cdeficiency. One study demonstrated normal vitamin C levels amongchildren with autism(3), while another reported low levels (4). Some investigators believe, however, that supplementwith vitamin C can be helpful even for children with normal levels ofvitamin C(3).Vitamin C has been shown to have a calming effect on behavior in humans (5). In animals, stereotyped behavior, one of characteristics ofautism(3), was reduced bytreatment withvitamin C(6). Scientists hypothesize that vitamin C has these

    effects because it affects the brain's response to an important neurotransmittercalled dopamine(6).Another explanation for the effectiveness ofvitamin Cis its anti-oxidant properties (1). Some researchers have theorizethat children with autismmay have more trouble managingfree radicals than other children do (7,8). Free radicals arenaturally-occurring chemicals that play important roles in normal functions in the body, but also can cause damagthe brain, immune system, and other tissues or organs in the body. The body has systems to protect tissues from freeradical damage, and anti-oxidants are important for this protection. Because it is ananti-oxidant, vitamin C can protect tbody against the damaging effects offree radicals.

    Does it work?

    So far, only one controlled study has shown that vitamin C can help treat behavioral problems associated with autism(2)

    double-blind experiment showed that high doses ofvitamin C in children with autism had significant positive effects o

    behavior, compared against their own behavior scores when they were taking aplacebo. However, this study was vsmall (only 18 children), and has not been replicated (9).Another research report showed that high doses ofvitamin Cmay help sleep andgastrointestinal problems in childrenautism(4). In this study,vitamin Cwas taken along with other vitamins, so it's not clear which vitamin was responsiblthe positive outcomes.Is it harmful?

    For most people, vitamin C is thought to be harmless. However, tolerance forvitamin C can vary. Therefore, you showatch your child carefully for signs of an upset stomach or diarrhea (1). Check with your child's pediatrician beforestarting treatment.

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    The cost ofvitamin Ctreatment depends on the dosage selected. A bottle of 100 tablets at 1000 mg (1 g) can costanywhere from $5-20, depending on the quality of the ingredients and the store. The study showing positive effectbehavior used vitamin C donated from a pharmaceutical supply company (Hoffman-LaRoche). Vitamin Csupplementscontain sodium, calcium,magnesium, potassium, orzinc ascorbates (salts) of ascorbic acid (4); ask your child's pediatriwhich form is best for your child. Vitamin Csupplements can also be found online, sometimes at a discount.

    V i t am i n B 6 a n d M a g n e s i u m

    What is it?

    Vitamin B6 (pyridoxine) is an essential vitamin that is necessary for more than 60 biological processes in a healthy hubody. The body converts vitamin B6 into pyroxidal-5-phosphate (PLP), a compound that is used to release energy frocarbohydrates and starches, and to break downproteins. PLP is also used in the production of important chemicals ibrain (1).Magnesium(Mg) is an essential mineral that is necessary for the health of every cell in the body, including the propefunctioning of brain and muscle cells. While,magnesiumdeficiency is rare, some research suggests that children withautism may have too little magnesium(23).Some parents supplement a child's diet with a combination ofvitamin B6 and magnesiumas analternative therapyforauWhat's it like?

    Vitamin B6 and magnesiumsupplements can be purchased online, or fromalmost any grocery,drug, or health-food storeResources).Vitamin B6 is found in many foods; avocados, liver, nuts, chicken, fish, wheat germ, and bananas are good sources vitamin. Vitamin B6 is often included as one of many vitamins in a multivitamin supplement, but check with your cpediatrician before starting a supplement. Vitamin B6supplements can be taken every day, but may be difficult to givchildren, since some children may find thatvitamin B6tastes bitter in tablet or powder form. Liquid B6supplements aalso available and may be better tasting (4). Doses ofvitamin B6 in research studies varied from 0.6 mg/kg/day (abou10.8 mg/day for a 40-pound child) (3), to 30 mg/kg body weight/day (about 545 mg/day for a 40-pound child) (5,6).By comparison, the U.S. recommended daily allowance (RDA) forvitamin B6 is 1.3 mg/day for adults, and 0.5-0.6mg/day for children ages 1-8 years old (Institute of Medicine: Dietary Reference Intakes Tables).Magnesiumis found in many foods, but is especially plentiful in green vegetables, seeds, nuts, and whole grains. Asupplement containing magnesium can be taken every day, but check with your child's pediatrician before starting asupplement. While it is not clear what the proper dose for children with autism should be, research reports used a dthe range of 6-15 mg/kg/day (or about 108-270 mg total daily for a 40-pound child) (3,7).For comparison, the U.S. RDA formagnesium is 400 mg/day for adults, and 80-130 mg/day for children ages 1-8 yeold (Institute of Medicine: Dietary Reference Intakes Tables).

    Some parents supplement magnesium by giving their children Epsom salt (magnesiumsulfate) baths. While magnesiumbe absorbed through the skin, it is hard to say what dose ofmagnesium a child is getting from an Epsom salt bath.If you choose vitamin B6 andmagnesium as an alternative therapy, ask your child's pediatrician about the dose appropriayour child. Vitamin B6 can cause upset stomach when not taken with a meal, so also ask a physician to provide a saschedule for taking B6 and magnesium (see Is it Harmful?).What is the theory behind it?

    The enzyme that is used to break downvitamin B6 into PLP may not work as well in children with autism(4,8). PLP is nfor the production ofdopamine, a brain chemical that is very important for many behaviors (1). If children with autismnot producing enough PLP from thevitamin B6they have in their diets, then supplementing with extra B6 may help the production ofPLP to more normal levels (8).Children with autism can have significantly lower levels ofmagnesium in hair and blood than non-autistic children (2

    There is evidence thatmagnesium supplementation can have a calming effect on some children with attention-deficihyperactivity disorder (ADHD) (10).Aside from the necessity ofmagnesium for the overall physical health as well as the proper functioning of the brainis no specific theory about how magnesiumdeficiency could contribute to autism. The two supplements are often giventogether, as some researchers have reported that the side effects ofvitamin B6treatment are eliminated by magnesium(

    However, studies in which vitamin B6 was used alone did not report any adverse side effects (7,12).