روشهای ارتباطی مکمل و جایگزین (Augmentative and alternative communication system) برای افراد مبتلا به اتیسم عبارتند از :
1-تکمیل یا جایگزینی گفتار یا نوشتار طبیعی با استفاده از وسایل کمکی (مثل استفاده از عکس، تصویر و نمادهای برجسته)
2- تکمیل یا جایگزینی گفتار یا نوشتار طبیعی بدون استفاده از وسایل کمکی (مثل زبان اشاره و هجی با انگشتان)
روش ارتباطی مبادله تصویر:
این روش برای کودکانی که گفتار ندارند یا گفتار آنها بسیار محدود است استفاده می شود و بر مهارتهای تقاضا کردن و ابراز نظر تاکید دارد. این روش شامل شش مرحله است که با مبادله یک تصویر با محرک دلخواه آغاز می شود و به درخواست کردن و اظهارنظر با استفاده از جمله ختم می شود. پیش نیازی که کودک باید داشته باشد نشان دادن موارد دلخواه با اشاره کردن یا به دست گرفتن آنها می باشد.
مرحله1: این برنامه با همکاری سه نفر آغاز می شود. فرد آموزش گیرنده، شریک ارتباطی، درمانگر.
مرحله یک با هدف معرفی تصویر و برقراری ارتباط با محرک غیرشرطی (شی خواسته شده) است. هنگامیکه فرد برای به دست آوردن محرک دلخواه خود تلاش می کند درمانگر فرد را به برداشتن کارت تصویر دلخواه و دادن آن به شریک ارتباطی تحریک می کند. فقط یک کارت تصویر در نزدیک فرد وجود دارد. شریک ارتباطی باید روبه روی فرد نشسته باشد. وقتی فرد کارت را به شریک ارتباطی داد فورا محرک درخواست شده به فرد داده می شود و شریک ارتباطی فقط نام محرک درخواست شده را می گوید مثلا “سیب”. درهرجلسه می توان تا سه تقویت کننده را مورد استفاده قرار داد.
مرحله2: در این مرحله هدف افزایش تقاضای خودانگیخته است. شریک ارتباطی از فرد فاصله بیشتری می گیرد و کم کم این فاصله را بیشتر می کند و فرد برای دادن کارت و گرفتن محرک دلخواه شریک ارتباطی را دنبال می کند.
مرحله3: هدف از این مرحله آموزش تمایز و انتخاب کارت صحیح می باشد. در کنار فرد به جای یک کارت دو کارت وجود دارد. یک کارت تصویر مورد دلخواه فرد و تصویر دیگر که مورد دلخواه فرد نیست مثل یک “سیب” و یک “ملاقه”. اگر فرد کارت اشتباه برداشت و به شریک ارتباطی داد همان محرک اشتباه به او داده می شود. این کار ادامه می یابد تا فرد تمایز تصاویر را یادبگیرد.
مرحله4: این مرحله شروع جمله سازی است که با “می خوام” جمله ساخته می شود. فرد باید کارت دلخواه را کنار کارت “می خوام” قرار دهد تا محرک به او داده شود.
مرحله5: در این مرحله از او می پرسیم که چه می خواهی و فرد باید با استفاده از “می خوام” جمله بسازد. تا به محرک دلخواه به او داده شود (توجه کنید که مهارت های کلامی و بیانی کودک باید مدنظر قرار داده شود)
مرحله6: این مرحله برخلاف مراحل قبل که فقط بر تواناییهای تقاضا کردن تاکید داشتند بر توانایی پاسخ دادن تاکید دارد. مثلاً به فرد آموزش داده می شود جواب سوالهایی از قبیل چه می خواهی؟ چه می بینی؟ و … را بدهد.
در روش ارتباطی مبادله تصویر هم از تصاویر رنگی و هم از تصاویر سیاه و سفید می توان استفاده کرد. اندازه کارتهای تصویری 4*4 سانتیمتر است.
برگرفته از: مشکلات ارتباطی کودکان درخودمانده و اثربخشی روش ارتباطی مبادله تصویر (پکس)
(Communication problems in autistic children and effectiveness of picture exchange communication system (PECS
نوشته: هادی زرافشان (کارشناس ارشد روانشناسی کودکان استثنایی) و دکتر حمید علیزاده (دانشیار دانشگاه علامه طباطبایی) با اندکی تلخیص.
6 دیدگاه
Given that nearly all of these research are performed on rats,
it’s tough to confidently say whether it may possibly affect people or not.
Flaxseed is excessive in lignans, which could lower testosterone levels.
The analysis points to the beneficial results of phytoestrogen for girls throughout and after menopause, Rizzo says.
The solely purpose to keep away from meals with phytoestrogen is that if a person is allergic
to it, Rizzo says. The two primary sorts are lignans,
current in excessive concentrations in some seeds;
and isoflavones, primarily found in soybeans and soy
merchandise. Phytoestrogen refers to twenty compounds discovered in several species of plants, says registered dietitian Natalie Rizzo, diet editor for TODAY.
The official name is phytoestrogen, an “estrogen-like substance”
found in some vegetation and plant merchandise that
will have anticancer effects, based on the National Cancer Institute.
Nevertheless, you can nonetheless find some trans fatty acids in processed foods.
It recommends folks get the nutrients by consuming
whole soy meals, not by taking soy supplements, which might
contain much greater quantities of isoflavones.
If you’re eating fruits, greens, legumes and seeds, you’re doubtless
consuming plant estrogen — a bunch of naturally occurring compounds
that can act like a weaker form of the female sex hormone.
Lastly, “vitamin D acts like a hormone within the physique and immediately influences testosterone synthesis,” says
Houman. There aren’t many meals full of vitamin D, but
it can be obtained through direct sun publicity. Men who don’t spend time outdoors or stay in cold climates
could not have the power to meet the beneficial day by day
allowance of vitamin D of 600 IU, so supplementation is useful.
There are so many meals that kill testosterone, including gadgets from a lot of the meals
teams. Some are natural and a few are processed, but they’re all foods that
reduce testosterone in your physique and make it tougher to perform at optimum ranges.
Supporting your overall well being while avoiding lower testosterone levels can be as simple as maintaining a balanced fiber consumption. Incorporating different sources of fiber from fruits, greens,
and complete grains will make positive you get the advantages with out the drawbacks.
Nuts are normally a good source of vitamins however some like walnuts
and almonds which comprise high polyunsaturated fats (PUFAs) could
affect your testosterone levels.
Alternatively, you can use oils with lower levels of polyunsaturated
fatty acids, similar to coconut oil or olive oil.
In all phases of life, males require testosterone, however some
of the substances you eat might decrease these levels. The
following is a comprehensive list of the highest 10 meals that kill testosterone that you
should keep away from. Hold studying to find if your current food plan is inflicting you to have low t.
While sure foods could lower testosterone ranges,
others have the potential to boost it.
In contrast, packaged snacks typically contain refined grains or trans fat linked to decreased testosterone ranges as a result of their effect on insulin sensitivity
or ability to mimic estrogen. anabolic performance research from the National Institute of Well Being means that regular consumption of trans fat from processed foods is linked to having fewer sperm in younger men. The study revealed that
males who consumed the best amounts of trans fats had decrease testosterone levels than these with the
lowest consumption [5].
Likewise, for males with prostate most cancers, lowering the androgen might have positive
results. The ironic factor is a variety of the meals mentioned above are not
inherently ‘bad’ for you. And they, along with flax seeds, are high in fiber and have many different useful nutrients.
No, hot canines aren’t just unhealthy for you because they’re created from the anuses and elbows of
pigs.
Testosterone, a vital hormone in each men and women, has numerous
essential bodily features. In women, it contributes to similar
physiological processes however in lower doses.
Seriously unhealthy options, like processed foods, fried foods, and pastries are
actually ones to be careful with. They all contribute to weight gain, can promote inflammation, and don’t present
many advantages. The best thing you can do is give attention to wholesome meals as much
as attainable and watch your intake of processed
meals and fried foods.
It performs an important role in sustaining bone density,
muscle mass, intercourse drive, and overall
well being, in accordance with the Nationwide Institutes of Well Being (NIH).
Nevertheless, our bodies naturally produce less testosterone as we age, leading to numerous health points,
including obesity, insulin resistance, and diabetes, WebMD explains.
Luckily, a quantity of methods to take care of wholesome testosterone ranges embrace regular train and a balanced food plan.
Join Decide Well Being right now for a proactive
and knowledgeable strategy to health. So, the next time you’re looking for a pure
approach to assist your testosterone health, remember the humble
egg. It might simply be the tiny nutritional powerhouse you’ve been missing.
Sadly, sure dietary habits can dramatically scale back testosterone ranges and finally trigger harm to the physique.
This means each man should pay attention to the highest 10 foods that kill testosterone to allow them
to shield their health. The body regulates testosterone
production by way of a collection of endocrine signals. Both Houman and Azzaro note that consuming trans fat is not
perfect for these who wish to improve their testosterone.
Trans fat are primarily present in partially hydrogenated oils, a
kind of business fat.
As a former employees member at On An Everyday Basis Well Being, she covered a variety
of continual circumstances and ailments. If you’ve low libido, testosterone might help, however it’s important to weigh the
advantages with the risks. Testosterone doses provided
by these formulations typically are much too excessive for females,
so ladies are given a fraction (usually one-tenth) of the dose that
men are prescribed, notes Barbara Schroeder, MD, an assistant professor and ob-gyn with UTHealth Houston. If
you’re new right here, be sure to check out
our Blog Web Page for extra insights and tips about the method
to thrive during perimenopause. Our weblog is full of sensible
advice, success stories, and the newest analysis that can help you in your journey.
“This script was written 20 years ago,” Jill Marie Jones said with a smile.
Take Vitamin C. If you’re low in vitamin C, it may impact your progesterone ranges in a adverse method.
That’s becausevitamin C is a nutrient that actually stimulates the production of
progesterone. So, if you need to get more of it into
your system, take a vitamin C supplement, drink some orange
juice, and/or eatvitamin C-enriched meals like cantaloupe,
parsley, strawberries, papaya, and chili peppers.
Even though alcohol can make you feel sexy for a second, the reality is when you drink an extreme quantity of of it, it may possibly actually trigger your testosterone levels to tank.
Bottom line with this one, pace your self together with your
cocktails — particularly if you already know that your testosterone levels aren’t the place they want to be.
So, what aresome key indications that your estrogen levels are low?
If you’ve tremendous dry pores and skin; your vagina is dry; you’re storing up more belly fat; your durations are irregular; you’re tired a
lot; your sleep patterns are erratic, and/or your libido is low.
Plus, probiotics are recognized for producing the type of “good bacteria” that makes it straightforward in your gut
to release dopamine. That’s as a result of there
are research that say that an excessive quantity of of that sort of fats in your system can mess with how your
brain processes dopamine. For the report, saturated fats include dairy, fried foods, and coconut oil.
Are there also things that you are capable of do to
increase your oxytocin ranges on your own? Phytoestrogens are thought of to be plant-based sources of
estrogen that might assist to get your levels up.
Those foods embrace flaxseeds, peaches, berries, sesame seeds, and cruciferous vegetables (broccoli, cauliflower,
cabbage, and collards).
The lion’s share comes from the ovaries, however small amounts are produced within the
adrenal glands and fats cells. Managed trials of hormone therapies for low libido in postmenopausal girls.
If you’re considering TRT, make sure to seek the guidance of a certified
healthcare provider to discuss your symptoms, get correct testing,
and develop a personalized treatment plan. It’s about discovering the right path to hormonal harmony—so you probably can reclaim your zest for
life, whether or not that’s within the bedroom, the boardroom, or wherever in between. For example,
nervousness can significantly have an effect on the desire for sex –
women are approximately twice as likely as males to endure from anxiety before age 50.
And girls are extra doubtless to report bodily symptoms of
stress that may intrude with sex drive, corresponding to headache or upset abdomen. “The variety of women who truly qualify for it medically is low,” says Jennifer Gunter, an obstetrician and gynecologist within the
San Francisco Bay Space, who was not concerned in the work.
Decreased hormones after menopause might increase
your risk of conditions corresponding to thinning bones (osteoporosis)
and heart problems. If that doesn’t occur, estrogen and progesterone lower once more and the cycle starts throughout.
The first menstrual period (menarche) occurs about two to
three years after the breasts begin to develop.
Again, it’s completely different for everybody, but most females get their
first period between the ages of 10 and 16.
For extra info read The Global Consensus Place Statement on using testosterone remedy for
women right here.
If you’re someone who likes to take dietary supplements,
do some research on black cohosh. It has a pretty good popularity in phrases of elevating estrogen ranges.
The ruptured follicle closes and the production of progesterone will increase.
Several early researchers anecdotally reported that some ladies handled with excessive
dose testosterone therapies talked about an sudden, but not unappreciated, improve in sexual need (Adair & Hermann, 1946;
Geist et al., 1940; Shorr et al., 1938). Nonetheless, in response to those anecdotal reviews, Salmon and Geist (1943) directly investigated the flexibility
of supraphysiological quantities of testosterone (20–75mg/week) to extend
sexual want in pre- and postmenopausal ladies. They
found that testosterone therapy successfully increased sexual need in all of their female individuals, but
that testosterone together with estradiol was more effective at rising sexual want in postmenopausal women than was
testosterone alone.
In addition to its physiological results, testosterone
also has psychological effects on feminine sexual desire.
Testosterone can contribute to emotions of confidence, assertiveness, and high vanity, all of that are
necessary for a healthy intercourse drive.
Ladies with greater ranges of testosterone may feel extra assured in expressing their needs and
exploring their sexuality. If an individual is experiencing signs of low testosterone, such as decreased libido or sexual performance issues, their
physician could advocate testosterone replacement therapy.
However, testosterone replacement remedy is not applicable for everyone and might include
potential side effects. It’s essential to talk with a physician and weigh the pros and cons of testosterone replacement remedy
before starting remedy. Research have shown that testosterone can impact sexual
attraction, notably in males.
Your guidance for Could is to belief that what’s falling out of your life
or altering for you is doing so in your profit, Aquarius.
Trust that what is occurring is occurring for you and to not you, and don’t doubt that you’ll rebuild from this.
With Pluto going retrograde in your signal from Might four
till October thirteen, you need a break from a variety of the confusion you’ve been feeling in your personal life, and you’re getting a
chance to realize a new perspective this month.
May is about slowing down and allowing your self to find the
answers you have been on the lookout for, Capricorn. This isn’t the time to hurry your progress or doubt where you might
be in life. The Solar is in your 5th home, and this is good for finding more time for fun, pleasure,
self-care, and asking your heart what it wants.
Testosterone continues to be prescribed off-label for the treatment of low libido in ladies (Bolour & Braunstein, 2005),
though the function that androgens play within the modulation of women’s sexual desire remains controversial.
Dennerstein et al. (1994) requested 168 female members to
fill out a every day questionnaire regarding all sexual habits and to supply
a every day urine pattern all through the
research. The authors estimated ovulation as occurring 24-hours prior to the midcycle peak in ranges of urinary estrogen metabolites, and found that participants’ self-reported levels of sexual curiosity considerably elevated simply prior ovulation.
References:
steroid monster (https://chipskills.us/companies/can-testosterone-pellets-cause-anxiety/)
This implies that if the individual’s situation improves or if there are
other remedy options available, Medicare protection for testosterone injections may be
discontinued. However, there are particular requirements that
doctors should meet so as to invoice Medicare for testosterone
injections. Medical Doctors have to be enrolled in the Medicare program as taking
part or non-participating providers. Additionally, they want to ensure that
the injections are administered in accordance with Medicare’s coverage guidelines.
In 2002, prompted by the growing numbers of older males using testosterone to delay or treat a big
selection of signs and signs, the Institute of Medicine shaped a committee to evaluate the
state of knowledge concerning testosterone therapy.
Testosterone substitute remedy (TRT) is a typical remedy for people with low testosterone levels.
Medicare, the federal medical insurance program for people
aged 65 and older, could cowl the value of testosterone injections for eligible beneficiaries.
However, it could be very important understand the reimbursement rates for testosterone injections by way of
Medicare before in search of this remedy. A limitation of our study is that we used knowledge from a single medical well
being examination center in a single area. Moreover, we couldn’t
use the serum estrogen level as a variable because of an absence of information.
Hypogonadism is defined as deficient or
absent male gonadal function that leads to inadequate testosterone secretion.
Hypogonadism may be major as a end result of testicular failure,
or secondary because of hypothalamic-pituitary axis dysfunction, resulting
in the production or release of inadequate testosterone to take care of testosterone-dependent capabilities and
techniques. Hypogonadism also can outcome from a mix
of testicular failure and hypothalamic-pituitary axis dysfunction.
You should focus on with your physician the method to monitor for prostate most cancers and other dangers to your prostate.
Males with known or suspected prostate or breast most cancers mustn’t receive testosterone remedy.
It is important for healthcare providers to familiarize themselves
with Medicare’s guidelines and requirements to
make sure accurate billing and reimbursement for testosterone injections and other providers.
When submitting Medicare claims for testosterone injections,
it’s crucial that healthcare suppliers comply with these requirements and provide all essential
documentation. It can be necessary for healthcare providers to remain updated with
Medicare’s guidelines and necessities to ensure compliance and correct billing.
The acceptable use of ICD-10-CM code E29.1 for billing functions involves guaranteeing
that the prognosis of testicular hypofunction is documented by the provider within the evaluation portion of the
observe. This code should be used when the primary purpose
for the patient’s go to or remedy is said to the underproduction of
hormones by the testes. Testosterone deficiency is
quite common among both older males and youthful folks alike.
A disadvantage of the injections is the fluctuation in serum testosterone focus that can cause fluctuating
libido, power degree, and mood. Transdermal types offer
more steady concentrations (13), but they’ll trigger rash in the applied area.
Before initiation of testosterone alternative remedy, an examination of the prostate, together with DRE, PSA assay, and evaluation of prostate signs must be
undertaken, and each the hematocrit and lipid profile must be measured.
There are few absolute contraindications to testosterone alternative remedy other than prostate or breast cancer, a hematocrit of 55%
or higher, or sensitivity to the testosterone formulation.
Understanding the implications of testicular hypofunction on fertility is important for healthcare suppliers
to offer applicable counseling and treatment options
to affected individuals. Once the prognosis of LOH is there a natural
steroid (mianswer.com)
confirmed, testosterone alternative therapy (TRT) must be
thought-about with the goals of bettering secondary sexual traits,
sexual perform, sense of well-being, and bone mineral density.
Throughout the preliminary workup, if a clear treatable
condition that explains androgen deficiency is recognized, it
must be addressed first (11, 14). Hypogonadism affects an estimated 4 to five million men within the United States,
and though it might happen in males at any age, low
testosterone levels are especially common in older males.
More than 60% of males over age 65 have free
testosterone ranges beneath the conventional values of
men aged 30 to 35. Studies suggest that hypogonadism in grownup males is usually
underdiagnosed and under handled. This may be as
a end result of the symptoms are simply attributed to growing older or different medical
causes, or ignored by sufferers and physicians.
Medicare is a federal medical health insurance program that covers individuals who are sixty five years or older, in addition to youthful people with
sure disabilities. Testosterone injections may be prescribed for a selection of situations,
including low testosterone levels, delayed puberty, or transgender hormone therapy.
Good evidence means that testosterone treatment in older
males with low testosterone improves sexual function, anemia, vertebral
and femoral BMD, and possibly strolling distance. In Contrast to placebo, testosterone doesn’t enhance cognitive function, depressive signs, energy,
vitality or physical operate. Testosterone treatment slightly increases non-calcified
and whole plaque volume; while regarding, the clinical significance of this finding isn’t
clear.
Their information help the idea that “the decline in serum T with male ageing is a non-specific impact of the frequent co-morbidities that accumulate during ageing” (5).
Regardless Of this novel examine’s results, the actual fact remains that the majority growing older
males seen in primary care offices are very more doubtless to have at least two continual medical sicknesses (6) and are dissimilar
from the research inhabitants. It would be helpful if
health care professionals could determine men with low serum testosterone levels who
are probably experiencing signs purely from androgen deficiency and
would subsequently benefit from therapy. The clinical utility of CPT code is significant
in the analysis of hormonal well being. The complete testosterone
test is crucial for diagnosing circumstances related to testosterone deficiency or excess.