Re: Hand sucking--Any ideas?

December 7, 2008

I think a no-brainer is to address any inflammation in gut that may be causing

discomfort. I think if everything along these lines was done (pathogen

treatment, strict dietary control, anti-inflammatories, mitochondrial nutrients)

you may be looking at a deeply ingrained habit, and this might be a rare case

(for me) where I would consider a short course of low-dose SSRI along with some

specific behavior-modication work with this behavior. Good luck, it's a tough

one! Dr. JM

Subject: Hand sucking--Any ideas?

To: csb-autism-rx

Date: Sunday, December 7, 2008, 8:44 AM

Hi,

Our son started sucking on his entire hand when he regressed into

autism at age 2. He is 5 now, we have tried everything to decrease

this behavior. He is heavily supplemented and none of this has seemed

to decrease the need. We do chewy tubes--he still prefers the hand.

We tried chewing gum, it helps, but he can't have soy or rice(in most

gums) and the only really safe gum for him--a gum with Xylitol, also

causes diarhea for him. We went to Krigsman this past summer for the

gut problems and while on the 60 days of prednisolone( the first

treatment for Crohn's he used)my son's hand sucking decreased a bit--

so did his posturing behaviors he did to soothe his lower gut. So we

think the sucking may be a way to cope with gut discomfort/pain. Any

ideas on what we might do to decrease this? He hates bandaids and

would peel them right off. We are looking at issues of infection in

his hand as well as a host of dental problems as he gets older. Any

suggestions would be appreciated! Pat

December 7, 2008

Hmm, we are recently dealing with again too with my 8yo (also a patient of

Krigsman) and my 6yo has started tooth tapping (clicking his teeth with his

fingernails) at school (not elsewhere and only during rug time), my 8yo has

also started asking me to cut tags out of clothing again (haven't had to do

that for 2 years). The behavior mod is effective to reduce the behavior for

very short period but it's so constant that it's not effective as we can't

do it all day long and in all environments, he was even doing it almost

constantly today during his AYSO soccer playoff.

What will the SSRI accomplish? Which one? What is a 'short course'?

They are both strict GFCFSF and on Pentasa and LDN as well as all the sups

our DAN! says are needed based on bloodwork.

near LAX

On Sun, Dec 7, 2008 at 2:21 PM, JAQUELYN MCCANDLESS <JMcCandless@...

> wrote:

> I think a no-brainer is to address any inflammation in gut that may be

> causing discomfort. I think if everything along these lines was done

> (pathogen treatment, strict dietary control, anti-inflammatories,

> mitochondrial nutrients) you may be looking at a deeply ingrained habit,

> and this might be a rare case (for me) where I would consider a short course

> of low-dose SSRI along with some specific behavior-modication work with this

> behavior. Good luck, it's a tough one! Dr. JM.

>

December 8, 2008

When you say mitochondrial nutrients--can you explain further? We are not

finished w/Krigsman yet, we are starting flagyl this week. Might this help? I

want to hear your suggestions for SSRI also. Thanks for the ideas. Pat

December 8, 2008

I am still working on my mitochondrial nutrient list - will put it on the list

when finalized. As to SSRI's, I generally do not like or prescribe them, but

have to admit that particularly in families where obsessive-compulsive or

anxiety orders run in the family, that some kids definitely benefit from low

doses of SSRI's. I give this after I have treated for all other causes of

obsessive issues, primarily dietary restriction, gut healing,

anti-inflammatories, and nutrient programs. If all those fail and kids are

still driven by obsessions, I prefer Lexapro, and start with 2.5mg/day (or even