Treat autism earlier, more comprehensively/intensively for the best results.

I honestly believe that it can make a difference between an adult living as a resident in a long term health care facility, and an adult that has a career and is married.  http://www.ktvn.com/story/15605586/early-intensive-therapy-better-for-kids-with-autism-study-finds

This is one of my pet peeves in Speech Therapy.  It seems like it doesn't

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matter which of the couple dozen differing diagnostic categories you're in, you get therapy for thirty minutes, once a week.  Or in my case at our nursing home/rehabilitation center, thirty minutes, five times a week.  There are multiple areas that need intensive therapy for the best results. 

In the case of autism, research indicates that kids that get it earlier, get better at a faster rate.  Kids that get more of it, get better at a faster rate.  Kids that get certain kinds of it, get better at a faster rate.  A variable that can't be changed is the non-verbal intelligence of the kids.  Kids with higher non-verbal IQ get better at a faster rate. 

So why do insurance companies and institutional payor sources all say "we'll pay for 30 minutes of therapy per week."  There's no research to indicate that 30 minutes is the most appropriate number.  There's tons of research to indicate that 5 hours per week is much more effective.  I'm certain there is or will be at some point, research that shows that 40 hours per week is even better.  These things make the difference between a productive member of society with positive and meaningful relationships, and the guy that sits in front of the TV all day rocking back and forth. 

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Another pet peeve is not having enough doctors (only certain MDs specialize in this field) to diagnose autism.  As speech therapists, we know who has autism, we know how severe it is, and most of us know what should be done for maximum gains, and yet, if an MD hasn't made the diagnosis official, then the kids 'don't have' autism, and they can miss the most important therapeutic time of their lives. 

Related articles

• Autism in the News - 09.28.11 (autismspeaks.org)
• Promising Drug Treatment for Improving Language, Social Function in People With Autism (cherished79.wordpress.com)

Voice Exercises for the extubated...

Again, thank you University Hospital speech therapists for the English language version of these exercises.  Sometimes people have tubes shoved down their throats to make sure they keep breathing during medical emergencies or surgeries.  These tubes force the vocal folds to remain open, and often cause harm going in or coming out.  If the vocal chords are forced apart for too long or are too damaged, then they don't come together as they should.  They need to come together for airway protection when a person swallows, and they need to come together to vocalize, which is necessary for almost all the sounds in our and every other human language. 

This is mostly for speech therapists, to see what I'm doing, and get ideas.  If you're doing something else, drop me a comment!  These, as well as the swallowing exercises, are used, at least in my case, in the acute setting.  The rehab speechies tend to have a little more detailed and reinforced methods.  Acute tends to be a little more quick and dirty.

Protección de la via respiratoria

1.            Respire profundo y diga “a”.  Repite 10 veces asegurandose de respirar profundo antes de cada repetición.

2.            Haga el mismo ejercício de arriba, pero diciendo “i". 

3.            Cuente de 1 a 5 comenzando con un susurro y aumentando el vólumen de la vóz con cada numero, asi que, cuando llega a 5 está gritando.

4.            Vocalización  sostenida: diga “a” hasta que no aguante más.  Aumente la duración de la nota hasta que lo pueda hacer por 20 segundos sin dificultad. 

Airway Protection

1.            Take a deep breath, say “ah”.  Repeat 10 times making sure to take a big breath before each repetition.

2.      Do the above saying “ee”.

3.      Count from 1-5 starting with a whisper and increasing your voice intensity with each number so that by the time you reach number 5 you are shouting!

4.      Sustained Phonation: say /ah/ for as long as you can.  Increase the time you can hold the note until you can consistently hold for 20 seconds or more. 

Swallowing Exercises for the base of the tongue in English y Espanol.

I apologize for so much speech related stuff all at once, but it's what I've been working on.  Thanks to the speech therapists at University Hospital for the orginal English exercises.  These are mostly for people that have had strokes, tumors, brain injuries, etc. and should be tailored to the individual needs of... an individual by a qualified speech therapist.  If anyone has good pictures for any of these exercises, let me know! 

Base de la Lengua

1.            Presión de la lengua: Abre la boca ámpliamente, presionar la lengua con fuerza contra la parte de atras de los dientes de arriba por tres segundos.  Relaje y repite diez veces.

2.            Sostenido de lengua de Masako: Ponga la punta de la lengua livianamente entre los dientes de al frente.  Haga un tragado con fuerza, pero no permita que la lengua se vaya hacia atras.

3.            Pase de lengua: pase la lengua con fuerza contra el techo de la boca del frente hacia atras diez veces. 

4.            Tragar Supraglotica: Aguante respiración y haga fuerza como si fuera a levantar algo pesado, trague duro, y entonces toza. 

5.            Maniobra Mendelsohn: Moje la boca con una esponja o use un pedazo de hielo si no hay demasiado peligro de aspiración.  Comience a tragar tan duro como pueda.  Siga apretando los músculos de la lengua y la garganta mientras que la manzana de Adán quede alto en la garganta por dos segundos.  Entonces relaje la garganta y complete la acción de tragar. 

6.            Tragar duro/con fuerza: Moje la boca con una esponja o use un pedazo de hielo si no hay demasiado peligro de aspiración.  Baje la quijada hacia abajo, trague duro, toza, y trague duro otra vez. 

Base of Tongue

1.      Tongue press or Penny press:  Keeping mouth open wide, press tongue hard for three sec.  against back of upper teeth.  Relax and repeat 10 times.

2.      Masako Tongue hold:  Hold tongue tip lightly between teeth.  Do not allow your tongue to go back into your mouth; now swallow hard!

3.      Tongue sweep or Peanut butter scraper:  Scrape imaginary peanut butter from roof of mouth by pushing tongue hard from front to back 10 times.

4.      Supraglottic swallow:  Hold breath, bear down, swallow hard, then cough.

5.      Mendelsohn Maneuver:  Swab mouth or use ice chip if safe for ice.   Begin to swallow as hard as you can. Continue to squeeze your tongue and throat muscles while keeping your Adam’s apple up high in your throat for two seconds.  Then relax your throat and complete the swallow.

6.      Hard/forceful swallow: Swab mouth (or use once ice chip if safe).

         Tuck chin down, swallow hard, cough and swallow hard again.