Expanding our Horizons

Routines are the Foundation for Early Childhood Mental Health

By Maegan Lokteff, PhD

Almost everyone likes to have a routine. Some people have an exercise routine, a morning routine, and a work routine. Routines create structure and help guide activities. They provide predictability and security.

For young children, routines provide the foundation for positive early childhood mental health. Routines ensure relationships. For young children, routines need to be facilitated by the adults in their lives. Routines also ensure repetition. Repetition helps babies and toddlers learn to connect their relationships to their experiences of safety and security. Routines play a major role in helping children develop social and emotional skills by providing safe and predictable experiences which allow them to develop and practice social and emotional understanding.

Routines and Self-Control

Routines help young children learn self-control by providing a sense of safety and security. When children feel safe in their day to day activities, they have more freedom to explore, play, and learn.

Routines Reduce Power Struggles

Mother_Scolding_Aspergers_Son-881x499Because they provide children with information about what will happen next, routines can reduce power struggles. Children feel more in control and have a greater sense of security regarding what’s happening to and around them. When children feel in control, they may be more likely to respond positively to requests.

Routines and Safety

bike-helmet-childWhile routines support young children’s sense of security, they can also support the health and safety of a young child. When health and safety practices like washing hands, sitting in a car seat, or wearing a helmet are expected routines, children are more likely to do them. This in turn supports their health, safety, and sense of responsibility.

Routines and Social Skills

Social interactions are a series of routines. As babies grow into toddlers, they learn how to respond to social cues from routines (they know to say hello when someone arrives and goodbye when someone leaves, for example). Social patterns and routines help young children understand turn taking in conversation and activities as well as problem solving with peers.

Routines and Transitions

toddler-tantrum-1024x682Routines can make transitions easier. Routines around transitions, such as bed time or going to day care, help children know what to expect next. This makes them feel secure and makes the change in activity or environment easier to process.

Routines are the foundation for promoting social and emotional health in young children. They offer opportunities for children to build self-confidence, curiosity, social skills, self-control, regulation, and communication skills.

Maegan Lokteff
Grand Beginnings, Executive Director; 970.725.3391; director@grandbeginnings.org

Maegan has spent almost 20 years working with children and families. After earning a BS in Child Development and Family Relations and a BS in Recreation at the University of Idaho, Maegan spent several years working in early care and education programs, after school programs, and summer day camps as both a teacher and administrator. She spent four years as a coordinator and advocate for families experiencing domestic violence. In 2014, Maegan completed her PhD in Family and Human Development with an emphasis in child development and early care and education at Utah State University.

The mission of Grand Beginnings is to promote a child-centered school readiness system that fosters early learning, facilitates healthy child development and promotes family success in Grand County.

More information can be found at Creating Routines for Love and Learning, Zero to Three, 2010.

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The Daily Vroom App

Parents of kids age five and younger often find themselves juggling work and family, wondering if they’re doing enough of the important stuff kids need to learn and succeed. In our fast paced society, it’s easy to feel rushed, stressed, and overwhelmed. Daily Vroom, a mobile app created to be wherever parents and caregivers are, reminds us that we already have within us what it takes to help kids develop.

Vroom is based on the ideas that brain building moments are all around us and any moment can become a brain building moment. Some parents might benefit from using everyday moments a little differently while others may need new ideas to spark everyday learning.

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In the first five years of life, a child’s brain makes more than 700 neural connections every second. These neural connections form the foundation for future learning. Since each experience and interaction shapes the growing brain, we’re teaching our kids whether we’re trying to or not. Daily Vroom helps parents understand what happens in children’s brains during these experiences and interactions.

Three scientific principles comprise the essence of Vroom. The first principle is that positive relationships with caring adults are essential for brain building. There is no healthy social, emotional, and cognitive development in the absence of relationships.

The second principle is that back and forth interaction between a child and adult—especially pre-language—is the root of relationships. When parents respond to children’s sounds, actions, and expressions, children learn that their sounds, actions, and expressions have meaning. With or without words, kids learn to initiate communication, pay attention, respond, express clarity, and change topics.

The third principle is that children are not born with executive functioning skills, but they are born with the capacity to develop them. Executive functioning skills include working memory, self-control, and mental flexibility. The interactions and experiences children have in early childhood can help them focus, adjust, resist temptations, and manage emotions. These skills are essential in getting along, achieving goals, and becoming part of a civil society.

The Daily Vroom app gives you access to over 1,000 tips appropriate for your child’s age as well as the brainy background (or science) behind the tips. For example, during bath time, give your two year old different size containers to scoop and pour water. Encourage her to explore and compare the containers and talk about what she’s doing. The app will point out that children learn best through hands-on exploration in playful, commonplace ways. When you help your child set up experiments to learn how the world works, she’ll employ math and science concepts and develop critical thinking skills as well.

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You can choose tips related to changing diapers, cleaning up, doing laundry, going to bed, or being in the car, on foot, or at the park. Brushing hair can become math, getting dressed can improve self-control, and eating peas can explain cause and effect. Your child’s development begins and grows with you.

5 Brain Building Basics

  • Look: make eye contact with your child.
  • Chat: talk about things you see, hear, and do. Explain what’s happening around you.
  • Follow: let your child lead. Respond to her sounds and actions. When she starts talking, ask questions like “What do you think caused that?” and “Why do you like that?”
  • Stretch: make interactions last longer by building on your child’s words and actions.
  • Take Turns: use sounds, words, facial expressions, and gestures to go back and forth to create games or conversations.

Limit Toys for Kids

Recent studies have shown that children ages five and under are often overwhelmed with too many toys. Too many options can be over stimulating and make children anxious. Kids can lose the ability to concentrate on one toy long enough to learn from it, and they can feel compelled to play with every toy in sight without fully engaging with each one.

When a nursery school in Germany agreed to remove all of its toys from their classrooms for three months, teachers reported that the children were initially confused but had ultimately begun to concentrate and communicate better and use their imaginations more.

This kind of research was prompted by the prevalent apprehension that parents are too often substituting toys and screens for their children’s development, creating childhoods that are not only defined by prescriptive (or predetermined) play and patterns of consumption but also lacking in meaningful personal interactions.

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With fewer toys in front of them, kids learn to be more creative. They tap into their imaginations and use their surrounding resources to invent games and activities. They also develop longer attention spans by spending more time per toy, letting themselves indulge in the toy and explore its value and possibility. If a particular toy seems too hard to manipulate or solve, kids are less likely to give it up for another toy. They show more patience, perseverance, and determination. And because fewer toys invokes scarcity, kids actually cooperate, share, and get along better.

Toys are an integral part of a child’s development; they shape the child’s character and value system. The kind of toys we give kids and why and how often we give them teach kids about the world, themselves, and our own values. By constantly giving kids more toys, we teach them to rely on material items rather than their own inner resources. We also establish a standard of consumption. Some psychologists argue that everything other than a first transitional object (like a blanket) is a socially generated want.

When toys are removed from the environment, kids will immerse themselves in nature and physical play. They will engage more deeply with their friends and parents, developing better interpersonal relationships. They learn to value what they have and find value in the things around them. They come to understand that happiness is not up to someone or something else to cultivate. Eventually, they might even learn that boredom is a gift.

outdoor-play-nature

Tips to manage toys and play:

  • The optimum number of toys to have out at once is four.
  • Use a “one toy in, one toy out” policy.
  • Keep toys in boxes and rotate them for play.
  • Put old toys out in new combinations.
  • Avoid prescriptive toys that limit fantasy play (“found objects” offer creative potential for free play).
  • Auditory (background noise) and visual clutter can interfere with play.
  • Encourage reading, singing, dancing, coloring, drawing, and painting.
  • Allow children to be bored.

The Five Critical Needs of Children

By Jessica Smolleck, Pyramid Plus Teacher with Grand Beginnings

1) Every person, whether an adult or a child, needs to feel respected.

  • Examine whether you’re treating your children in a positive and respectful way or whether you’re treating them with rudeness by lying to them, demeaning them, or not listening to them. Before you respond to your child, ask yourself: “How would I respond if I was speaking to an adult?”

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2) Children appreciate being made to feel important.

  • Children need to have a sense of value, control, and usefulness. They need to feel that they are somebody. Find a middle ground between being protective and allowing your child to explore the world. Be willing to listen and let them problem solve or make decisions. Let your children take responsibility for some things.

3) All kids desire and need to be accepted for who they are.

  • Children have a right to their own feelings, desires, and ideas and they deserve to be recognized. This doesn’t mean that you have to agree or disagree with everything, it simply means that you acknowledge them. Avoid overreacting, being overly critical, or encouraging kids to suppress their feelings. Instead, listen to them and praise the things you like.

acceptance of the child

4) Everyone likes to be included, but children especially need to feel included.

  • Children need to be brought in and made to feel a part of things. They need to feel included in family activities and events. Spend time each day sharing what each person in the family is doing, try to make the kids a part of decisions being made, and find activities that the whole family can do together.

5) Most importantly, children must feel secure.

  • Children need to be in an environment and have relationships that are consistent and caring. They need to know they are loved no matter what and that you have their best interests at heart. Keep this in mind with your interaction with your kids, your discipline, and your relationships with others.
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Unconditional Love

Becoming a Student of My Own Behavior

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Self-reflection, self-improvement

  • Which of my action today were positive in regard to my child/children’s 5 critical needs?
  • Which of my actions today were negative in meeting the five critical needs of my child/children?
  • What does this tell me about myself
  • If I were doing today over again, what would I do differently?
  • What will I change or try to do tomorrow?

 

Be a Brain Builder

The first three years of life boast the most rapid and robust brain growth, when 85% of the physical brain develops. At birth, the brain has about all of the neurons it will ever have and can create synapses faster than it will ever be able to. Synapses between neurons are strengthened by use. Rarely used synapses become weak before being eliminated.

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Synapse density over time.

Every day in the United States, one in 1,000 newborns is born profoundly deaf and another two to three out of 1,000 are born with partial hearing loss. Fluctuating hearing loss due to frequent ear infections could mean a young child is missing vital speech information.

dana-suskind

Dr. Dana Suskind

Dr. Dana Suskind specializes in pediatric hearing loss and cochlea implantation at the University of Chicago and is the founder and director of the Thirty Million Words Initiative. With cochlear implant surgery, Dr. Suskind gave children the gift of sound, changing the trajectory of their lives in one day.

Suskind realized that surgery brought children closer to a new world, but the real change happened after surgery. Regarding development, the ability to hear is trivialized without a language rich environment. Hearing is a way for sounds to get into the brain for processing; we hear with our brains, not with our ears. Children’s brains need words to grow.

The Thirty Million Words Initiative refers to a 1990 study citing how many more words children from higher socioeconomic households were exposed to by age three compared to children from lower socioeconomic households. Those who grew up in word poor homes had smaller vocabularies, poorer grades, and lower IQs.

Thirty Million Words promotes baby talk (using rhythm, melodic pitch, and positive tone not fabricated words) and reading to babies. It encourages bilingual families to use mostly their native language and advocates for increased language exposure using the mantra, “Don’t just do it, talk them through it.” It promotes the Three T’s:

  • Tune in: notice what a child is focused on and talk about it. Respond when a child communicates in any way.
  • Talk more: narrate daily routines such as getting dressed and eating meals. Use description, detail, and variety.
  • Take turns: keep the conversation going. Respond to a child’s sounds, gestures, and words and allow plenty of time for the child to respond. Ask questions that compel more than yes or no answers.

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Teri Kite, Teacher of Deaf and Hard of Hearing for Northwest Colorado BOCES and Horizons Specialized Services, says: “Anything we recommend to increase language acquisition for a child with hearing impairment is also good for a child with normal hearing. Enriching language is a universal need in our world that is increasingly electronic.” Teri has seen how making communication fun can ultimately make for families of good communicators. “It’s never too early to begin purposeful communication with your child. Babies’ minds are little sponges.”

In collaboration with Colorado Hands and Voices, Colorado School for the Deaf and the Blind, and The Listen Foundation, Horizons and BOCES are hosting three presentations on March 11th for Early Childhood professionals, families of children with hearing loss, older children with hearing loss, and families and children of all hearing abilities interested in language acquisition (with Thirty Million Words). For more information, contact Susan Mizen (smizen@horizonsnwc.org) or Teri Kite (teri.kite@nwboces.org).

The Touchpoints Approach: Value Disorganization

TBBT. Berry Brazelton, renowned pediatrician and author, developed the Neonatal Behavioral Assessment Scale. The scale assesses newborns’ physical and neurological responses as well as their emotional well-being and individual differences. Brazelton’s greatest achievement, however, has been to raise awareness for the ways that children’s behavior, activity states, and emotional expressions affect their parents, and the ways that parents’ reactions and behaviors, in turn, affect their children.

At birth, babies are ready to build relationships with parents. Their early emotional experiences are powerful enough to become embedded like architecture in their brains. To capitalize on this, Brazelton created the Touchpoints Approach.

Touchpoints are predictable periods of regression and disorganization that occur before bursts in development. What happens between children and their parents at these times? Often, it’s parental frustration and self-doubt, exacerbated by disruption in family relationships. If parents could be warned about these developmental transitions, Brazelton believed they could better understand their children’s behavior, feel more competent, and react positively.

The most critical step in this approach is accepting that development is not linear. The succession of touchpoints in a child’s development is like a map that can be identified and anticipated by parents and providers. Regression, while natural, can cause disorganization. Parents and providers need to embrace the disorganization and value it is a stepping stone—it’s likely a precursor to success. This perspective can change the way parents react to their child, which, in turn, can change the child’s outcome.

Many families of children with delays or disabilities can feel isolated or unsupported. The Touchpoints Approach reinforces providers’ desire to join parents as allies interested in empathetic, not objective, involvement. The approach presents a paradigm shift. It asks us to move from a linear model of development to a multidimensional one. It asks us to focus on parents’ strengths, acknowledging them as the experts on their children. It asks us to see parenting as an ambivalent process built on trial and error. In this way, providers who work with children and families collaborate rather than prescribe, support rather than fix.

quote-T.-Berry-Brazelton

The Touchpoints Approach is an evidenced-based way of understanding and being with families. Providers join the family’s system of care rather than the family joining the providers’ system of care. The child focuses on learning new skills, the parent focuses on developing competencies, and the provider focuses on supporting parents, developing skills, and overcoming assumptions. Goals are optimal child development, healthy and functional families, competent professionals, and strong communities.

While all children develop at their own pace, these Touchpoints typically precede a burst in development and can cause disorganization for the child and family:

  • The Ideal Baby – Pregnancy  TP book
  • The Real Baby – Newborn
  • The Energy Sink – 3 wks
  • The Rewarding Baby – 6-8 wks
  • Looking Outward – 4 mos
  • Up at Night – 7 mos
  • The Pointer – 9 mos
  • The Walker – 12 mos
  • The Clinger – 15 mos
  • Rebel with a Cause – 18 mos
  • Getting to “No!” – 2 yrs
  • “Why?” – 3 yrs
  • What I Do Matters – 4 yrs
  • Who I Am Matters – 5 yrs
  • Entering the Real World – 6 yrs

Excellence: DSPs at Work

All of us

The Capitol Gang: Michael Toothaker, Brittany Smale, Jana Hoffman, Representative Diane Mitsch Bush, Susan Mizen, Heather Gibbon, Yvonne Truelove

At Horizons, we envision a world where people with IDD live community-based lives of their choice supported by highly qualified DSPs. Alliance Colorado celebrated Awareness Day at the Capitol on February 17th, highlighting issues people with IDD face and the work DSPs do. From across the state, 30 DSPs were nominated for the 2016 DSP of the Year Award—all of whom have the knowledge, skills, and values needed to support people with IDD in achieving their life goals.

From Horizons, Jana Hoffman and Brittany Smale were recognized. Jana has worked at Horizons for eight years and Brittany for three. Both Jana and Brittany share a respect for the dignity and completeness of the people in Horizons’ programs.

In the dome

Horizons’ 2016 DSP nominees!

In her worldview, Jana is inherently person centered. She embraces person centered values and employs person centered techniques. When interacting with the people she supports, Jana recognizes their unique attributes and potential. She has exceptional skills and stealth approaches to working with people with IDD, along with the intuitive capacity to understand the person beneath the label.

Jana is respected and admired, quiet and confident, assertive and charismatic. She leads by example and compels others to be their best. Watching her work is like reading a “How To” book—she seamlessly incorporates ideas, strategies, and values to help people achieve their personal goals and greater autonomy. She does this with a gentle spirit and sense of ease: you don’t notice what she’s done until you see the end result. When the people she supports accomplish something you didn’t know they could, that’s when you realize: Jana made this happen.

Jana works well with people who have significant behavioral challenges, people who have extremely high needs, and people who struggle physically or socially. She treats people as individuals without categorizing them, and it works. She makes people feel good about themselves, and it works. Her positivity is contagious, infecting the people she supports and helping them succeed.

Jana with Alliance staff

Jana accepts her nomination as a DSP finalist from Alliance Colorado staff, Ellen Jensby and Josh Rael.

To come up with new ideas to improve people’s lives, Jana taps into her creativity. She discovers new recipes for dinner and unexplored areas of the community for activities. She presents new topics of conversation, unusual games, and unfamiliar faces. In her creativity, Jana is patient and generous. She leads people to new places and waits for them to adapt, accept, decline, or succeed. She wants people to experience life on their own terms, with their own perspective.

Brittany Smale, our other nominee, works weekend shifts at two of our most challenging homes. Residents have high medical and behavioral needs and, at times, Brittany is the only staff for the entire shift. She takes this in stride and no one misses a beat.

Working independently and efficiently, Brittany takes extraordinary care of the people in our programs, paying particular attention to their health. As an LPN, she comes into the office on her time off to talk to her supervisor or agency nurse, following up on health concerns experienced over the weekend. Brittany’s medical knowledge and expertise surpass what’s expected of a DSP and this brings comfort and relief.

Michael, Bob and Brittany

Michael Toothaker, Representative Bob Rankin, Brittany Smale

As a strong natural advocate, Brittany sees people’s strengths rather than their limitations. Her work is predicated on the belief that all people can learn, improve, succeed, and flourish. Her language is person centered and spoken without a trace of negativity, making her a solid support and a consistent leader.

Brittany and Michael

A good team.

Brittany’s actions and words are always a variation on the theme: what can we do to help the people we serve? Her gentle, calm demeanor puts people at ease. Her ability to manage everyone’s needs—the daily details and the big picture—keeps her in high regard among coworkers. She is reliable, dependable, and willing to excel.

When quality is defined at the point of interaction between the DSP and the person with a disability, we feel fortunate to have both Jana and Brittany to fulfill Horizons’ mission.

Real Food: Deciphering Diet Trends

Based on Integrated Health‘s presentation by Cara Marrs, Laura Stout and Charlie Petersen at YVMC.

90% of the cases medical professionals treat in the hospital today are driven by lifestyle diseases—those associated with the way a person lives. That means that while 10% of our health is dictated by genetics, we still have control over the other 90%.

We’ve learned over the years that when we focus on weight, things fall apart. Moving from a definition of diet as a means to lose weight to diet as the kind of food a person continually eats can help us reduce the number and severity of lifestyle diseases.

what causes obesity

Looking back, American diet trends have been intriguing. In the 1930s and 40s, smoking was marketed as a means for weight loss. In the 1950s, there was the cabbage soup diet. It was fast acting and easy to follow: seven days of broth and vegetables. We’ve seen drugs like Fenphedra and Apidren and additives likes Olestra, but these aren’t necessarily safe or sustainable. Diet pills help you lose weight quickly but are intended for short term use only. Diet pills and additives often have undesirable and/or serious medical side effects.

diet-pillszero calories

In the 1980s and 90s, we moved to a low fat trend. Shunning fats, we consumed too many carbs by eating increased amounts of processed fat free foods (which are also high in salt and sugar). The low fat trend gets much of the blame for America’s obesity epidemic.

fat tieIn response, the Atkins Diet removed carbs in favor of high proteins. People lost weight fast, but the Atkins Diet also proved unsustainable. Carbohydrates are essential to our health; along with proteins and fats, they’re one of the macro-nutrients we need to function. Our muscles are fueled by carbs and our brains run on sugar or ketones. A lot of cancers track with a higher consumption of red meat. Those who followed the Atkins Diet experienced higher cholesterol levels and consumed little to no fiber, resulting in a lack of much needed prebiotics. And as soon as they stopped Atkins, their weight returned.

Meal replacement systems like Nutrisystem and Jenny Craig offer prepackaged foods delivered to your house. Portions are controlled and meals provide a balance of macro nutrients. Weight Watchers adds the accountability of a group setting. Drawbacks to these systems include their cost and their use of processed ingredients with lots of chemicals. They provide convenience to consumers but don’t establish a relationship between consumers and food. Once the program is finished, people often don’t know how to shop for and prepare their own meals.

Nutrisystem3

Then came the Master Cleanse (or Lemonade Diet). It consists of salt water each morning, water with fresh lemon juice, maple syrup and cayenne pepper throughout the day, and an herbal laxative tea at night. With virtually no calories, weight loss is guaranteed. But you’ll be losing water weight and lean muscle mass—not fat. Fasting can negatively affect your metabolism, increasing the likelihood that you’ll regain weight once you resume a normal diet. Additionally, the Master Cleanse can set you up for nutrient deficiencies, a weakened immune system, and heart and kidney problems.

Juicing is a similar cleanse promoting detoxification and offering more calories (with little to no protein and fat). It can be a good reset for your body but not a healthy, sustainable weight loss program.

More recently, we’ve begun to see lifestyles marketed more so than diets. We hear people identifying themselves as Paleo or Vegan and proclaiming that they “eat clean.” These lifestyles are on the right track, but it’s important to remember that you can take the good parts from each plan to make your own healthy, sustainable lifestyle. We’re more likely to see people focus on real foods and stay away from processed foods. Mainstream messaging informs us about the harmful effects of sugar, a disease-causing “recreational drug.” More people understand the benefits of eating plant-based food rather than man-made food (aka, “the anti-nutrient”).

apple v cookieAmerican diet trends are continuing in their transition from the determination to lose weight to the appreciation for whole body health. People are accepting that food can be functional and medicinal, tasty and fun. Mindfulness is moving into the kitchen with an intent to nurture a healthy relationship between food, eating, mental health and physical health. We’re considering nutrient density instead of counting calories. We even recognize that cultures exist—Blue Zones—where people don’t diet.

Because of their lifestyles, activities, eating habits and values, people in Blue Zones live long lives free of heart disease, obesity, cancer and diabetes. Blue Zone cultures tend to value mindless movement and/or exercise; community, friends and family; plant-based diets (with meat as an accent); sunshine; a sense of purpose or religion; wine; herbal teas; and goat milk. We can look to these cultures and see that food is more than what we eat.

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Real Food: Gut Health

Hippocrates, the Father of Western Medicine, believed that all diseases begin in the gut. The digestive system is directly linked to the immune, nervous and endocrine systems. It’s the avenue through which nutrition is taken in, broken down, absorbed, assimilated and incorporated into our bodies. If your gut is healthy, chances are you’re healthy.

Our modern western lifestyle, however, is far different than Hippocrates’ was in 460 BC. We exist in a culture of stress (which exacerbates digestive issues). We’ve strayed from the daily organic farm to table tradition. And we cohabitate with countless manufactured toxins. From the way we live to the way we feel, our bodies suffer from pervasive threats to our digestive health.

Stress can cause and exacerbate digestive ailments.

Stress can cause and exacerbate digestive ailments.

In their presentation, “Real Food: Gut Health,” Laura Stout, R.D., and Phaedra Fegley, M.D. and Director of Integrated Health, discussed our most common gastrointestinal diseases, their symptoms and some dietary suggestions. Over and over, they extolled the virtues of a plant based diet for keeping the digestive fire strong and healthy. A plant based diet reduces inflammation, increases absorption of nutrients and excretion of toxins, and fuels our bodies for optimal health.

A plant based diet offers lots of fiber. Fiber is what gives plants their structure and is indigestible by humans. Fiber does not add calories to your diet, but it does play a critical role in maintaining gastrointestinal health. The fibrous portion of a vegetable is a prebiotic and can alter the composition of organisms within the gut. Prebiotic food sources include asparagus, garlic, onions, leeks and bananas.

Fibrous, fermented foods optimize gut health.

Fibrous, fermented foods optimize gut health.

The intestinal wall is made up of probiotics, or strains of naturally occurring bacteria which are fed by prebiotics. Probiotics aid digestion, provide nutrients, synthesize vitamins and boost immunity. They rely on prebiotics for nourishment, so buying supplemental probiotics without consuming prebiotics is ineffective. Probiotic food sources include yogurt, kefir, miso, tempeh, kombucha and fermented foods. The pasteurization process kills probiotics.

Understanding and balancing prebiotics and probiotics is essential to cultivating a healthy gut microbiome so that your body can break down your food. But even so, there are foods in our modern western diet that are universally difficult to digest. FODMAP is an acronym of these carbohydrates and their restriction (the FODMAP diet) has been beneficial for people who suffer from gastrointestinal disorders. The carbs are: fructose (fruits with more fructose than glucose, honey, agave nectar); lactose (dairy); fructans (wheat, barley, rye, onion, garlic); galactans (beans, lentils); and polyols (sweeteners such as sorbitol, xylitol).

gut flora

Another seemingly trivial part of our culture that affects our digestive health is drinking cold liquids. Restaurants set tables with plates, utensils, napkins and ice water; it’s how we dine. But, drinking cold water is akin to squelching a fire—you’re literally throwing ice water onto a fire (your digestive system). It’s best to consume liquids that are warm or room temperature, and it’s better to drink liquids between rather than with meals.

The fire of life.

Your gut: the fire of life.

Gastroesophageal Reflux Disease (GERD) is chronic damage caused by stomach acid coming up from the stomach into the esophagus. Symptoms include heartburn, regurgitation, chest pain, feeling like food is stuck in your throat and difficulty or pain when swallowing. Contributing factors can be pregnancy, obesity, alcohol, smoking and certain medications. Lifestyle changes to alleviate the symptoms of GERD include raising the head of your bed 6-8”, not lying down after eating, wearing loose clothing, and drinking liquids between meals rather than with meals. Problematic foods include coffee, tea, cola, citrus, mint flavoring, high fat processed foods, tomato based foods and spicy foods.

A Peptic Ulcer is a break in the lining of the stomach, first part of the small intestine, or lower esophagus. Symptoms include pain (usually worse at night), feelings of fullness, belching, vomiting, poor appetite and weight loss. Treatment options include: antibiotics to get rid of any existing H-pylori bacteria; acid blockers; and stopping the use of NSAIDS and tobacco. Dietary suggestions include limiting the use of alcohol and caffeine as well as fatty, acidic and spicy foods.

Small Intestine Bacterial Overgrowth (SIBO) is a chronic bacterial infection of the small intestine. It’s caused by bacteria that normally live in the gastrointestinal tract that have abnormally overgrown into the small intestine (and are similar to the bacteria found in the colon). The bacteria interfere with the normal digestion and absorption of food that occurs within the small intestine and cause damage to its lining. Common symptoms include abdominal gas, cramps and/or pain as well as constipation and/or diarrhea. Treatment includes antibiotics and probiotics.

Celiac Disease is an immune reaction to eating gluten, a protein found in wheat, barley and rye. Over time, this reaction produces inflammation that damages the small intestine’s lining and prevents absorption of some nutrients (malabsorption). The intestinal damage can cause weight loss, bloating and diarrhea. Eventually, your brain, nervous system, bones, liver and other organs can be deprived of nourishment.

Celiac_disease

The truncating of the villi lining of the small intestine is called villous atrophy.

Irritable Bowel Syndrome (IBS) is the umbrella term used for all of these digestive issues. Stress, diet, medications and hormonal imbalances can play a role.

Inflammatory Bowel Disease (IBD) is an autoimmune disease of the colon and small intestine. Crohn’s Disease and Ulcerative Colitis are the most common types. Currently, there is no medical cure for IBD but prebiotics and probiotics are becoming increasingly effective treatments.

Leaky Gut Syndrome is the condition of increased intestinal permeability which allows food and toxins to leave the intestines and enter the bloodstream. Because these particles aren’t supposed to be in the bloodstream, the immune system identifies them as dangerous and creates an immune response, attacking them along with other healthy cells. Leaky Gut can cause allergies, fatigue, skin conditions, depression, anxiety, insomnia, migraines, and more. It’s important to remember that intestinal impermeability is not fixed—we all have it to some degree and it can change over time.

leakyGut_largeIntegrated Health’s mission is to promote self-healing through interaction of mind, body and spirit and enhance traditional medicine practices.

Horizons Annual Plan Update: Executive Summary, April 2015

When I look back on 2014, I will think of it as a year of growth. We opened a new, seven person apartment building in the spring. By the end of the calendar year, 17 additional people were offered Supported Living (SLS) resources. By March 2015, eleven new people were enrolled in our SLS program with three more in process. In the Children’s Extensive Support Waiver, we have enrolled two new children for a total of four. While these numbers are relatively small, they represent significant growth in our program.

We have achieved many important things:

  1. Seventy-two employees have been trained in Person Centered Thinking.
  2. We are maintaining financial sustainability by limiting growth in agency expenses and increasing revenue.
  3. We developed systems to maximize our use of the funding hierarchy for Early Intervention services.
  4. Individuals are being served in an SLS model using Routt County mill levy funds.
  5. Three individuals were enrolled in our Medicaid comprehensive services program.
  6. Four individuals are enrolled in CES. Three more are approved and one in process. This represents 300% growth for us.
  7. We have 20 one to one mentors for the adults in our programs. These partnerships do a variety of things: attend fundraisers for other non-profits, go skiing, go out for coffee, go for walks, go out for meals, attend social media classes, play billiards, attend local sporting events, go to community concerts, and go to local restaurants for Happy Hour.
  8. We held our third annual Pick a Dish event in Moffat County in April. Interested individuals in Horizons’ adult programs were paired with chefs from local restaurants. Together they prepared a dish to share at the event. About 200 people attended and voted on their favorites. The primary goal of the event was to develop relationships between our chefs and the restaurant chefs that would result in employment. No job offers yet…
  9. Tommy Larson and Sylvia McFeaters were two of the five finalists for the Direct Support Professional of the Year award by Alliance at Awareness Day at the Capitol.
  10. All Adult Service Coordinators have been trained by the Labor Relations Board to conduct investigations.
Jamie Ogden and Ashleigh Santistevan partner with Castle Ranch at this year's Pick a Dish fundraiser in Craig.

Jamie Ogden and Ashleigh Santistevan partner with chefs from Castle Ranch at this year’s Pick a Dish fundraiser in Craig.

Sylvia McFeaters and Tommy Larson were finalists for the 2015 Alliance DSP award. Matt Troeger led the pledge on the House floor on Disability Awareness Day at the Capitol.

Sylvia McFeaters and Tommy Larson were finalists for the 2015 Alliance DSP award. Matt Troeger led the pledge on the House floor on Disability Awareness Day at the Capitol.

We have maintained many important things:

  1. The president of the board of directors is a liaison between the Grand County Advisory Board and Horizons’ board.
  2. We are maintaining our collaborations with Aging Well, the Northwest Colorado Center for Independence, the Yampa Valley Autism Program, Steamboat Adaptive Recreation Services (STARS), and the Council on Aging.
  3. We work closely with Behavior Services of the Rockies and with Mindsprings Health.
  4. We have maintained a high level of supported employment in Routt County.

Our priorities for 2015 include:

  1. Identifying needed growth in infrastructure in response to an additional 15 SLS resources, and growth in CES and comprehensive programs.
  2. Identifying staff to become Person Centered thinking trainers.
  3. Upgrading our vehicles with $81,400 in funding from the Colorado Department of Transportation.
  4. Updating and/or creating policies and procedures.
  5. Improving our system for monitoring agency performance.
  6. Defining our relationship with the local autism program.
  7. Continuing to monitor our budget to ensure that we are limiting growth in expenses and maximizing revenue.
  8. Advocating for choice in Case Management to include Horizons CMs.
  9. Advocating for a solution to CFCM that preserves our mill levy.
  10. Celebrating our 40th anniversary! We are planning 1970’s dance parties in Steamboat and in Craig.

Susan Mizen, Executive Director