Thursday, October 22, 2015
Doctor's Perspective
Triggers and kids with autism

By Dr. Anthony Policastro As a developmental pediatrician, I often see patients with autism. One of the more common types of behaviors of autistic patients are meltdowns which look like prolonged temper tantrums. Meltdowns often last 20 to 30 minutes. Parents can get very frustrated by these behaviors. Often, parents do not know what sets their child off and they do not know how to stop the meltdown. Parents often ask me if I can give their child medication to help with meltdowns. Usually, the answer is no. The main issue is that autistic children do not know how to act when they are frustrated. They lash out and react unpredictably. An important part of addressing the problem is to change the way we think. In autism, we often talk about Theory of Mind, which refers to the fact that autistic children have a certain way of thinking. Autistic children feel that everyone must think the same way and they get frustrated when that does not happen. They act out on that frustration so we have to change our approach. In order to prevent the tantrum, we must start thinking like the child. We have to figure out what sets them off. For example, autistic children have rigid routines. They need to do things in a certain order. They like to line their toys up. Any break in these routines will result in a meltdown so we should stick to the routines. If they think that you brush your teeth before you comb your hair, you cannot reverse that order. If you do, a tantrum will result. If you move one of the things that they have lined up, that will also result in a more severe reaction than you would expect. Addressing things like this becomes somewhat obvious. Some autistic children will react to transitioning to a new activity. Advance warnings will sometimes help. We are changing in 15 minutes. We are changing in 10 minutes. We are changing in five minutes. We are changing in one minute. Some autistic children will overreact to sensory stimulation. Loud noises, bright lights, clothing tags, long sleeves and food mixing on a plate might bother them. What this means is that it often takes some detective work to address the causes. For example, an autistic patient of mine was fine while in the exam room but began screaming uncontrollably when we went into the consultation room next door. I asked his mother to bring the patient back to the exam room. Once there he stopped screaming and started playing with the spinning chair in the room. I took him and the spinning chair back into the other room and he was fine. There was no more screaming. All he wanted was the chair. I had changed his rigid thinking. I had to spend time trying to figure out what the trigger was. Working on triggers is the key to dealing with this type of behavior. The more triggers we can avoid the fewer meltdowns we will see. Medication is not the answer.

Safe Sitter Class Nanticoke Memorial Hospital will host a Safe Sitter class from 9 a.m. to 4 p.m. on Saturday, Nov. 14, for children ages 11 to 13 who are interested in learning child care essentials and safety. The course is designed to train teenagers how to be safe baby/child sitters. Components include infant/child development and care, safety, injury prevention, first aid, accident management, rescue breathing and choking management. Cost is $35 per student, which includes the class and all materials. Advance registration is required. To register or for more information, call 629-6611, ext. 2540.

Job Fair at Nanticoke Nanticoke Health Services will host a job fair on Saturday, Oct. 24 from 9 a.m. to 2 p.m. at Nanticoke Memorial Hospital in Seaford. Nanticoke Health Services includes Nanticoke Memorial Hospital (NMH) and the Nanticoke Physician Network (NPN). Nanticoke offers comprehensive full-time and part-time benefits, FSA, PTO, life insurance, tuition assistance, and various community discounts. The job fair will feature information on available clinical, non-clinical, administrative and PRN/Flex Pool positions. On-site interviews may be conducted for some positions for individuals who apply ahead of time and bring their resume. Online application access will be offered on-site for attendees. Sign-on bonuses are available for qualified positions. RSVP is appreciated. For more information, visit To RSVP, contact Nanticoke's Human Resources department at 628-6220 or

Breastfeeding Support Group Breastfeeding is natural, but it doesn't always come naturally. At times, even the most dedicated nursing moms want to give up. On Monday, Oct. 26 at 10 a.m., Nanticoke Memorial Hospital will hold The Mom's Circle, a free breastfeeding support group. Registration is not required. Activities will include: interaction with other moms and babies, opportunities to share advice and information and assistance from an internationally board certified lactation consultant. Each meeting will focus on a new topic such as the first two weeks, night feedings or returning to work. The group will meet monthly with the next two meetings on Monday, Nov. 23 and Monday, Dec. 14 at 10 a.m. For more information, contact Jacalyn Bradley, Nanticoke lactation consultant, at 629-6611, ext. 2234.

Geis named program coordinator The Nanticoke Physician Network welcomes Shelly Geis as bariatric program coordinator.

Geis joins Drs. Waked and Palavecino at Nanticoke Physician Network Bariatric and General Surgery located at 121 Front St., Seaford. Geis is certified in health coaching and bariatric support group leadership. She received her associate of science in respiratory therapy from Concorde College in Kansas City, Mo., and her bachelor of arts in accounting from Ashford University in Clinton, Iowa. She is studying for her master's of health care administration at Columbia Southern University in Orange Beach, Ala. Geis previously worked as the bariatric coordinator at Atlantic General Hospital. She has over five years of experience as a bariatric coordinator and over 10 years as an experienced respiratory therapist.

Caregiver Support Group Are you caring for someone with Alzheimer's disease or a related disorder? Join us at Camp Rehoboth located at 37 Baltimore Ave., Rehoboth Beach, for a caregiver support group. Support groups encourage members to share information, give and receive mutual support and exchange coping skills. The groups are a great place to learn how to care for someone who has dementia. Camp Rehoboth Caregiver Support Group will meet the second Wednesday of each month at 1 p.m. The first meeting will be held on Nov. 11, and is open to the public.

Lead poisoning awareness activities To raise awareness of the consequences of lead poisoning among parents and pregnant women who live in homes built before 1978, First State Community Action Agency located at 308 N. Railroad Ave., Georgetown, will participate in National Lead Poisoning Prevention Week (NLPPW) Oct. 25-31. Activities include: De-Lead Open House - On Wednesday, Oct. 28, from 11 a.m to p.m., First State's De-Lead Program will host an Open House. Learn about the harmful effects of lead poisoning and how it can be prevented. Get your children tested for lead at no charge. All are welcome. For more information, contact Sharon McPhatter at 856-7761, ext. 273 or Fritzy Rodriguez at 856-7761, ext. 122.

Diabetes Prevention Class Nanticoke Memorial Hospital will host a Diabetes Prevention Class at 5:30 p.m. on Monday, Nov. 2, in the Medical Staff Conference Room. This two-session course is designed for individuals who have been diagnosed with pre-diabetes, a condition where blood glucose levels are higher than normal, but not high enough to be classified as diabetes. Utilizing resources developed by the National Diabetes Education Program (NDEP), this course provides individuals with basic tools to help them make lifestyle changes and reduce their risk for developing diabetes. Cost is $20 per person and a physician referral is required for registration. For more information and to register, call 629-6611, ext. 2288. Spin-a-Thon for DBCC The Delaware Breast Cancer Coalition (DBCC) is pleased to announce that Midway Fitness & Racquetball is Spinning For Awareness on Saturday, Oct. 24 from 9 a.m. to noon at their fitness center in Rehoboth Beach. In addition to raising awareness for breast cancer during the month of October, the special event will help raise money for the Delaware Breast Cancer Coalition to support local breast cancer programs and services. Classes are $30/bike half hour or supporters can pledge $30 to be a class sponsor. Donations will be collected at Midway Fitness through Oct. 24. To participate, you must RSVP. For more information, contact Kyle Kilgo at or 302-645-0407.

Boo To Do Hollywood Premiere Join Delaware Hospice for the Boo To Do Hollywood Premiere at Nassau Valley Vineyards, Lewes, on Saturday, Oct. 31 from 7-11 p.m. Boo To Do is a sophisticated, fun evening to benefit Delaware Hospice. This Hollywood Premiere themed event will include gourmet food by Nage, live music by The Funsters, photos and a costume contest. Come as your favorite Hollywood Star or in your Sunday best. Limited $75 tickets are still available. For more information, visit or contact Peggy Dolby at 302-746-4666 or To order tickets online, visit

Avoid power lines when trimming With autumn yard cleanup and tree trimming chores in full swing, Delmarva Power urges customers to remember that electricity is a powerful and potentially deadly force and to take appropriate safety measures. Avoid power lines when carrying long or tall items, such as ladders, scaffolding and tree saws. Hold them parallel to the ground and be sure to look up before raising them to check that they're clear of any overhead wires. Touching a power line with any part of your body or most objects can result in serious injury or death. Electricity can move through conductive materials such as water, metal, wood, aluminum, strings and plastics. When trimming branches, check for power lines in or near trees before using a ladder or scaffolding. Certain critical clearances are required by law, and a minimum of 10 feet must be maintained when working below or adjacent to power lines. Find additional information about Delmarva Power by visiting, on Facebook at and on Twitter at A mobile app is available at