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4A Daily News – Tuesday, February 28, 2012 Vitality & health Start with what you can manage You know you should exercise — but you don't do it. Well, here's some advice that's easy to take: "Don't be so hard on yourself." That's the view of Maria Brilaki whose website, fitness- reloaded.com is designed to coax nonexercisers to get mov- ing. "Just stick to what you can do. Forget about what you should do," Brilaki says. "If you beat yourself up, you increase the chance you'll quit." "If you can't do your full workout, just do five minutes. Just do two exercises. This helps keep the momentum up and keeping the momentum up is really important," she says. Brilaki's random survey of 541 people showed that two- thirds of the most committed exercisers (those who have been working out for more than five years) reported that they had quit an exercise program in the past. This shows that even those who have made exercise a habit had a halting start and aren't "natural exercisers," she says. To help get started, Brilaki offers these pointers: "Don't get discouraged." Start with stretches. (I tried the anti-slouch video on her website as I was typing this, and it felt great.) You don't need a gym or special equipment. A backpack with books inside substitutes for dumbbells. A table, sofa and broomstick are all you need to follow her videos. Use daily activities (brushing your teeth, putting on shoes) as triggers that remind you to exercise immediately afterward, even if just for a few minutes of squats, stretches, lunges. Create habits of exercise, no matter how brief, and "sooner or later you'll forget to stop." HARTFORD, Conn. (MCT) — When Caleb Geary was diagnosed with autism at age 3, he had never spoken or eaten solid food. Now 6, the boy speaks and tests at his first-grade level — progress that his parents attribute to insur- ance-based services at home and intensive behavioral intervention at the boy's school in Ham- den, Conn. But they worry what will happen to Caleb's diagnosis — and the ser- vices that have come with it — if the American Psy- chiatry Association's pro- posal to change the defin- ition of autism is adopted. Lori Geary said she has already fought to get her son the help he needs. Tom Zwicker, Caleb's father and the director of an autism center for the Easter Seals of Coastal Fairfield County, Conn., said he believes insurance companies will start requesting annual diag- nostic evaluations if the definition is revised. As a result, his son — and many other children — will lose out on services to treat their conditions. "You have an entire group receiving services that would be left out in the cold," said Zwicker, who lives in Branford, Conn. "We're going to lose a whole generation of children." The autism community has been embroiled in a heated debate for the past few weeks over the pro- posal to dramatically change the criteria for autism diagnosis in the upcoming fifth edition of the Diagnostic and Statis- tical Manual of Mental Disorders. The DSM-5, scheduled to be published in 2013, is the first revi- sion since 1994. The revision would create an umbrella catego- ry known as "autism spec- trum disorder" that would include traditional autism, as well as Asperger's Syn- drome, childhood disinte- grative disorder and per- vasive developmental dis- order not otherwise speci- fied (PDD-NOS) — which currently are con- sidered separate disor- ders. A new category, social communication disorder, would also be created. "What became very apparent is that there aren't clear boundaries, and that they really are all on a spectrum," said Dar- rell Regier, director of research for the APA. The current criteria, he said, is "fuzzy" and as a result some people have been mislabeled as autistic, while others who need treatment can't get it because their symptoms don't match the current criteria. "The thing that we tried to do is be a little more clear about the dif- ferent deficits that these people have," Regier said. But some experts worry that the revision's main effect will be to drastically reduce the number of people who are diagnosed with autism and who now qualify for services to treat it. Fred Volkmar, director of the Child Study Center at Yale School of Medi- cine, is the lead author of a study that found that 44 percent of people previ- ously diagnosed with autism would not meet the proposed new criteria for the diagnosis. The study was based on data collect- ed about individuals in the early 1990s. "We went back and re- analzyed the data and recoded it," said Volkmar, Lassen House Lic. #525002331 Assisted Living & Memory Care Community GRAND OPENING Where our family is committed to yours 705 Luther Road Red Bluff (530) 529-2900 Now Accepting NEW Patients. No referral needed in most cases. ALLERGY Clinic with Diane Kinney, PA-C Kylie Carreras, LVN NOW OPEN! Red Bluff Call NOW to schedule an appointment 528-1220 RED BLUFF 331 Elm Street Timothy Frantz M.D. Board Certified Otolaryngologist 2138 Court Street 222-5115 REDDING www.Emeritus.com redbluff.mercy.org Visit redbluff.mercy.org or scan this code with a QR reader app on your smart phone to learn more information. 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The methodology was "not perfect," Volkmar said, "but I don't think it's horribly bad either." Periodic revisions and refinements of diagnoses are necessary, he said. "Certainly, you could make (the definition of) Asperg- er's better. The problem is, how do you justify change and how do you justify major change? It's an inter- esting discussion." According to Volk- mar's study, to be pub- lished in April in the Jour- nal of the American Academy of Child and Adolescent Psychiatry and online later this month, about one-fourth of those diagnosed with autism would not meet the new criteria and nearly three-fourths of those with Asperger's also would not be diagnosed. Also, 84 percent of those diagnosed with Pervasive Developmental Disorder- Not Otherwise Specified also would no longer meet the criteria. "More and more peo- ple are doing better and better, so we have more people who are out and self-sufficient and inde- pendent," Volkmar said. "And there's a bit of worry that if you take away services, that that's the group that will suffer, not just in terms of losing a label but in terms of los- ing services." "Schools have to do a re-assessment every three years. So in three years' time they say, 'Oh, this kid no longer qualifies.' Is that going to be a ratio- nale for no more ser- vices?" In Caleb's case, Lori Geary said, she and Zwicker spent $600 a week for four hours of daily ABA therapy before insurance started paying for it last year. The out- look for her son before treatment, she believes, was grim: "I fear he'd be in a group home setting for the rest of his life." The boy couldn't speak. Caleb would explode at changes to his routine. If Geary was dri- ving and made a left turn when he expected a right, there would be "hair pulling, shoes flying, kicking the seat," she said. Caleb's work with a therapist involves positive reinforcement to target impulse control, stimming — repetitive movements — and other behaviors. "It's how we got him to talk, how we got him to eat, how we got him to sit on a stool at school," said Geary, a senior project manager at Yale's Center for Outcomes Research and Evaluation, which studies the effects of health care. Caleb now gets at-home therapy for two hours nearly every day for his social skills. With the proposed change to the autism cri- teria, Geary said, "I'm nervous." James W. Tysinger, Jr. M.D. Eye Physician & Surgeon Fellow American Academy of Ophthalmology We accept Medical, Medicare & most Insurances Office Hours: Tues-Wed-Thurs 8am-4:30pm Mon & Fri 1pm-4:30pm For Emergencies, After Hours, Week-ends, Call 530-567-5001 345 Hickory St. Red Bluff Tel: (530) 529-4733 Fax: (530) 529-1114