The Autism Society Philippines (ASP) is a national, non-profit organization dedicated to the well-being of persons with autism spectrum disorder. The ASP has been in the forefront of providing services and training to families living with autism.

01 December 2017

Q&A with Autism Experts - December 2017

"It takes a village to raise a child." This African proverb rings louder for children with autism. The Autism Society Philippines believes that parents should build relationships with a professional compassionate support team who can advise and counsel them, in addressing the myriad of questions they have about raising a child on the spectrum.

"If you have met someone with autism, you have met ONE person with autism." There is no substitute for personal consultations with professionals, which consider traits and behaviors unique to the individual with autism.

As ASP continues to receive questions from parents and family members year-round, we have reached out to the following experts to help answer some concerns on health, education and intervention.

Q. My niece has autism and its severe. She is now 14 yo and is very very violent. She will hit her head, face, arms and legs with her fists or bang her head on the walls of the house. If you will try to intervene , she will chase and hit you instead. She will just stop if the swelling and pain is unbearable. After recovering she will again hit herself again and again. Shes under medication but effective only for a few months and then back to her old self again.I would like to ask if theres a home which can help us take care of her temporarily because we can't do anything to prevent her from hurting herself. She might have problem with her vision or worst brain hemorrhage in the future if this will continue.--- C. Ong

A. This must be very stressful for the family. Aside from medications, it might be helpful to investigate possible medical causes of the aggression like ear infections, GI symptoms pointing to a gastrointestinal pathology, headache and seizures to name a few possible causes. Medications should be given continuously and not removed when symptoms abate. Some individuals will need to be hospitalized to address acute aggression. There are private centers that are willing to take in individuals with ASD. --- Dr. Tippy Tanchanco

A. Guanella Center in Tandang Sora is the only place I know which may be willing to take your niece in for respite care. However, it will be most useful to furnish them with information e.g. what triggers the self inflicting behaviors (SIBs), medication she is given, why medications have been stopped, what recommendations her devped has given.

There are also gentle restraints which can be used to restrain her when she has her SIBs. I know how strenuous and dangerous it is to physically restrain one who is having a meltdown but these restraints can keep you niece and the people around her safe. You can improvise one using a spine board (available in medical supply stores) and wide velcro straps. --- Cecilia Sicam

Q. My 4 yr old child with ASD is very picky with food? He only likes rice and fried crunchy food. He doesnt like vegetables and moist food nowadays, even when he loved these kinds of food several months ago. Is this normal? How can we teach him to eat other foods?--- L. Nievera

A. There may be several reasons on why children are picky. Initially, we need to rule out medical conditions including iron and zinc deficiency. Picky eating may be secondary to sensory processing difficultites, making children prefer certain tastes and textures. Another reason is the behavioral preference of children for certain foods. It is recommended that picky eating be addressed to ensure that the child has a healthy diet. We need to treat food like medicine. We need to be able to feed children a healthy, balanced diet. This can be managed by feeding therapists who are usually OTs or speech therapists locally. Depending on the reason of food selectivity, they can craft an intervention plan for the child. An example of a good resource online is: https://www.autismspeaks.org/family-services/health-and-wellness/nutrition/seven-ways-help-picky-eater-autism ---  Dr. Tippy Tanchanco

A. Most PWAs  have sensory processing difficulties which make them sensitive to or seeking of certain textures, tastes, sounds, etc. There are several strategies which can be tried, whatever works:

1. slowly introduce different textures by offering small balls of crunchy food with soft or firm centers. As the child gets used to this and eats it without fuss, make the soft centers slightly bigger in the next round. Continue increasing the soft center as he tolerates it.

2. you can also try reinforcing your child's tolerance for non-crunchy food. Show a very small piece of non-crunchy food (a grain or two of steamed rice, perhaps) and his favorite crunchy food. Make it clear that he will be given the crunchy food only if he will taste and swallow the non-crunchy food. Repeat as often as possible. It should be noted that his access to crunchy food should be limited throughout the training period and he can only eat it if he takes in a bit of non-crunchy food. For some, this may take some time and commitment from his caregivers. As his tolerance for non-crunchy food increases, size of non-crunchy food can also be increased. Later, non-crunchy and crunchy foods can be mixed.

You can also consult your child's OT regarding this. --- Cecilia Sicam

Q. My 27 year old autistic brother has become more aggressive over the years, inflicting self harm whenever he throws tantrums. What can we do? We can't bring him out of the house for consultation.--- L. Jacob

A. A proper work-up would need to be done. Doctors hesitate to recommend medications for the aggression without evaluating the patient, however, in some instances, for compassionate care, parents may have surrogate consults with doctors who can prescribe medications to address the aggression. Home-based assessment and interventions by behavioral therapists may also be helpful. --- Dr. Tippy Tanchanco

Dr. Lourdes Bernadette “Tippy” Sumpaico-Tanchanco, MD, MSc, FPPS, FPSDBP is the clinic director and practicing developmental-behavioral pediatrician at MedMom Child Development Clinic. She is also an Associate Professor at the Ateneo School of Medicine and Public Health. She graduated from the Ateneo de Manila, BS Biology program. She then proceeded to study Medicine at the UERMMMC where she graduated with honors. She took her residency and fellowship in Developmental-Behavioral Pediatrics at the UP-PGH and completed her Master of Science in Epidemiology (Clinical Epidemiology) at the UP-Manila. She has also been invited to numerous conferences, both locally and internationally, to present her research studies and to speak as an expert in her field. Dr. Tippy is certified in using the Griffith’s Mental Development Scale and the Autism Diagnostic Observation Schedule. She was recently certified as a Basic DIRFloortime practitioner after completing her training with the Interdisciplinary Council on Development and Learning.

Ms. Cecilia Sicam is one of the 11 original founders of the Autism Society Philippines. She has served ASP in many capacities, as President from 2000 to 2004; and as its current Vice President. Inspired by her PWA son Likas, Ces has been instrumental in the founding of Professionals for Autism Foundation, Inc., Center for Autism and Related Disorders, the Philippine Association for Behavioral Analysis, and Bridges Foundation where she is currently its Directress. She taught SpEd for three years Santa Clara, California; and came back to serve Filipino children with special needs.

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