Book Review-by Beth Arch, OTR/L, Raleigh CDSA

 

 

The Reflux Book, written by

Elizabeth Pulsifer Anderson

 

The Reflux Book by Beth Pulsifer-Anderson is a parent friendly guide to navigating what can be a frustrating and stressful experience for the entire family.  With over 17 years experience helping families learn about and cope with children who are diagnosed with gastroesophageal reflux, the author emphasizes the importance of including medical personnel on the treatment team while outlining both basic and more complex concepts in a clear and easily understood fashion.

           

 

The first section of the book discusses basic concepts that are useful to caregivers and professionals alike.  These topics include a chapter titled "Reflux 101" which in layman's terms reviews normal digestion and the causes of reflux and answers common initial questions such as will my child outgrow this condition? Other chapters go on to discuss symptoms, diagnosing reflux, treatment options, feeding techniques and medications.  A particular strength of this fifrst section are the chapters devoted to family support, discussing issues such as intensive care parenting, parenting challenges and sleep issues.  The author does a nice job of incorporating true life stories and parent commentary to support her views and observations.

The second section of the book focuses on more advanced concepts faced while managing reflux, particularly in severe cases or while treating older children.  This section does an especially nice job of explaining complex medical tests in an easily understood manner.  Other topics include surgical and alternative medicine approaches used in the management of reflux. By offering knowledge, caregivers are empowered to advocate for their child as they navigate what can become a complicated medical system.

Finally, at the end of the book is a comprehensive list of resources for professionals and parents including books, websites, and national organizations.  The author herself is executive director of the Pediatric Adolescent Gastroesophageal Reflux Association and welcomes specific questions or concerns through the website she manages, www.reflux.org. As a pediatric occupational therapist, I found the diagrams and parent examples most helpful.  After reading through the medical management options I feel better prepared to answer parent's questions and help guide their search for answers or assistance.  I would recommend this book to parents and professional alike as a nice addition to their "toolbox" of resources.

Bridging the Social  Synapse

Ms. Rintoul's March 7th videoconference session was designed as a follow up  to her presentation delivered on February 15th as part of the Wake AHEC Mental Health Series.  A large number of the videoconference participants were unable to attend her original presentation, so the session began with a brief overview.  This was actually very helpful for all participants, as those who had attended her original presentation benefited from the review.  The discussion revolved around examining attachment from a neurobiological perspective.  She discussed the brain in terms of having three levels, brain stem-controls basic survival skills such as breathing, etc. /limbic system-processes sensory information & is the "seat" of emotions / cortex-controls higher level thinking & problem solving skills.  She suggested we, as humans, communicate with infants & young children on a limbic level.  Because the cortex of infants is not developed they relate to the world through their limbic system by the sensory information they take in.  As adults we interact with babies in ways that are processed through the limbic system-use high pitch speech, rock them, sing to them, use exaggerated facial expressions, etc.  This was a very interesting way of looking at how attachment occurs in the brain. 

One of the fascinating ideas she talked about was new research on something called Mirror Neurons.  This refers to some research done with brain scans where one subject watched another subject perform a task.  It turned out that the parts of the brain used to perform the task were active in the subject who was only watching.  So the brain was being stimulated even though it was not actually performing the task itself.  She stated "some believe this is the biological basis for imitation and empathy".  It certainly makes a compelling argument for using inclusive environments!

Ms. Rintoul then discussed how secure attachments lead to health development.  She laid out the concepts of the "secure base" and "safe haven".  The "secure base" is the caregiver who is tuned into the child's emotions and can act as a "cheerleader" to help the child explore the world around him/her.  The "safe haven" concept refers to the ability for the caregiver to be emotionally available to the child and act as a "comfort zone" when the child is upset.  These two qualities help facilitate secure attachments.

She ended the session by talking about positive emotion and how it can foster "flexibility, creativity, receptiveness to others & learning" in young children (and adults).  However, negative emotion in a child leads to survival behaviors such as withdrawal, aggression, and defiance.  She stated when looking at problem behavior in children it is important to deal with the underlying emotion.  It will be much more effective in trying to solve the behavior problem if you can deal with the emotions the child is experiencing. 

In the end, she quoted Ms. Jeree Pawl-"How you are is as important as what you do."  This was an encouragement to us all to continue to be genuine in our relationship with the children we serve.  This was an excellent topic to discuss.  The format of the videoconference was wonderful in that it was a smaller and more relaxed environment where we could share our thoughts and questions.