Reflux (GERD) & GI Issues	Communication	Education	Hearing
Magazines & On-Line Publications	Medications	Resources	Therapies
Advocacy	Cleft Palate	Feeding & Pre-Speech	Handwriting
Equipment

Reflux (GERD) and GI Issues
What is GERD?	Written by: Jill Kurtzman Student Nurse University of Minnesota
Gastroesophageal reflux (GERD) is characterized by the back flow of stomach contents into the esophagus. The exact cause of GERD is unknown but there are many associated factors. These factors include a delay of the stomach emptying its contents into the intestine and, more commonly, inappropriate relaxation of the lower esophageal sphincter (Ault & Schmidt, 1998). This sphincter is best described in an article by Melinda Berube as "a muscular area at the base of the esophagus that provides a barrier between the stomach and the esophagus" (1997). Other factors contributing to GERD include insufficient swallowing capabilities and increased stomach acid production (Ault & Schmidt, 1998). Symptoms of GERD vary. In nonverbal children symptoms may include spitting up or vomiting after eating, crying that doesn't respond to usual comforting measures, coughing or choking, especially during or after a feeding, refusal to eat, and frequent sleep interruptions. In verbal children, other symptoms may include complaints of abdominal pain or heartburn, chronic cough, vomiting after meals, complaints of chest pain that are NOT related to the heart, and repeated infections, such as pneumonia (Ault & Schmidt, 1998). Many times GERD can be managed through dietary changes (eating thicker foods, avoiding spicy foods and caffeine for example), stress reduction, and/or medication (Berube, 1997). In other situations where GERD does not respond to diet changes or medication after 3 to 6 months or has led to respiratory disease like pneumonia, surgical intervention may be needed. The usual intervention is a Nissen fundoplication. A Nissen is performed under general anesthesia. Its purpose is to restore function to the lower esophageal sphincter. The surgery involves wrapping the upper portion of the stomach (the fundus) around the lower portion of the esophagus. This helps to narrow the opening of the esophagus into the stomach allowing the lower esophageal sphincter to function more appropriately. This surgery has a 95% success rate in managing GERD (Parrish & Berube, 1995). A temporary gastrostomy tube (a tube that enters the stomach from outside of the body, through the abdomen) may be placed to help relieve gas bloating while the stomach is healing from surgery. This tube is usually removed within six weeks after the surgery (Parrish & Berube, 1995). I hope this may have answered some of your questions or was at least a little bit informative. References Ault, D.L., & Schmidt, D. 1998. Diagnosis and management of gastroesophageal reflux in infants and children. The Nurse Practitioner, 23 (6), 78, 81-82, 88-100. Berube, M. 1997. Gastroesophageal reflux. Journal of the Scholarship of Pediatric Nursing, 2 (1), 43-46. Perish, R.S, & Berube, M.C. 1995. Care of the infant with gastroesophageal reflux and respiratory disease: after the Nissen fundoplication. Journal of Pediatric Health Care, 9, 211-217.

The American Pseudo-obstruction and Hirschprung's Disease Society (APHS)

APHS addresses the needs of individuals affected by gastrointestinal motility disorders. They live in all parts of the United States and in many different countries. The needs of families differ markedly, as do the opportunities for individuals to find various kinds of support services when and where needed. APHS is there to offer its services and assistance wherever and whenever possible.

Communication
Beyond Autism - PECS Pictures	Additional PEC pictures made by a parent
EASI - Equal Access to Software and Information	EASI's mission is to serve as a resource to the education community by providing information and guidance in the area of access-to-information technologies by individuals with disabilities. We stay informed about developments and advancements within the adaptive computer technology field and spread that information to colleges, universities, K-12 schools, libraries and into the workplace.

Feeding & Pre-Speech
New Visions	New Visions provides continuing education and therapy services to professionals and parents working with infants and children with feeding, swallowing, oral-motor, and pre-speech problems.

Hearing
Oticon	Support for families and educators of hearing impaired children and information on Oticon products

Magazines and On-Line Publications
Exceptional Parent

Medications
Rx Drug List - The Internet Drug Index

Resources
The National Information Centre for Youth and Children with Disabilities (NICHCY) - US Based	NICHCY is a national information and referral center that provides information on disabilities and disability-related issues for families, educators, and other professionals. Their special focus is children and youth (birth to age 22).
Kids Together	Information and resources for children and adults with disabilities
disABILITY Information & Resources	Links to a number of information and resource web sites for those with a disAbBILITY
State Resource Sheets (USA)	The NICHCY State Resource Sheet for your state will help you locate organizations and agencies within your state that address disability-related issues. Included on NICHCY state sheets are: state senators, state governors, state agencies serving children and youth with disabilities, state chapters of disability organizations and parent groups, parent training and information projects

Education, Teaching Methods and Home Schooling
Reuven Feuerstein	The Instrumental Enrichment Program The Learning Propensity Assessment Device The International Center for the Enhancement of Learning Potential Hadassah-WIZO-Canada Research Institute in Israel
California Department of Education - Special Education Division	Posts information on current and pending legislature, budget appropriations concerning special education students, and general information on California's responsibilities to students with special needs and how they are complying with the IDEA97
The Special Education Homepage	A comprehensive list of online resources dealing with practically every issue in special education.
TEACCH	Treatment and Education of Austistic and Related Communication Handicapped Children
Kids Together	Information on IEP Planning
Parental Rights in Special Education	From the Iowa Department of Education
The International Journal of Inclusive Education	A quarterly International Research Journal
The Early Childhood Inclusion Network	One community's efforts to promote child care inclusion
Advocates 4Special Kids - Friendship Group/Circle of Friends	Writing goals for social skills in an IEP
A4SK	Advocates 4 Special Kids
Special Education Law	Special Education legal rights and strategies
Wrights Law	Special Education law and advocacy
Wrights Law - Law Library	Copy of IDEA (US)
PACER - Parent Advocacy Coalition for Educational Rights	PACER is a nonprofit that helps parents and families of children with disabilities
FAPE - Family & Advocates Partnership for Education	The Partnership is a project which aims to inform and educate families and advocates about the Individuals with Disabilities Education Act of 1997 and promising practices
LRP Publications - IDEA Regulations	"A User's Guide to the 1999 IDEA Regulations" by the Center for the Study and Advancement of Disability Policy
A Guide to the Individualized Education Program	From the Office of Special Education and Rehabilitation Services U.S. Department of Education

Types of Therapy Interventions
Medek	MEDEK is a therapeutic intervention for the development of gross motor skills in children with movement disorders. MEDEK was developed in Caracas by physical therapist Ramon Cuevas. It was introduced to North America by physical therapist Ester Fink. MEDEK stands for Metodo Dinamico de Estimulacion Kinesica or Dynamic Method for Kinetic Stimulation.

Advocacy
The Council of Parent Attorneys and Advocates (COPAA)	An independent, nonprofit, tax-exempt organization of attorneys, advocates and parents established to improve the quality and quantity of legal assistance for parents of children with disabilities.

Cleft Palate
Wide Smiles	Cleft Lip and Palate Resource

Handwriting
OT Kids, Inc	Handwriting Resources for teachers and parents

Equipment
Achievable Concepts	Adapted recreation and sporting equipment for people with disabilities and the aged
Rock n' Roll Fun Machines	Cycles for all special needs including hand powered, foot powered or both. They have a program where you can earn a bike.
Haverich Adaptive Cycles	One of Europe's manufacturers of tricycles, bicycles and tandems for adults and children with a special focus on mobility products for challenged children and adults.
Special Purpose Vehicles	Special Purpose Vehicles is a company dedicated to custom, human-powered and appropriate technology vehicles.
AmTryke	A therapeutic tricycle for children with a disability. The tricycles are sponsored through AMBUCS (American Business Clubs)
Worksman Cycles	Manufacture and adapt cycles for those with special needs
ASE Tricycles and Electric Tricycles
TriAid	Manufacture children's rehab products including hand and foot powered cycles, gait trainers and toiletting/shower chairs.