Wednesday, March 27, 2013

Ask the Expert: Ligament Laxity

Q:  My daughter (with Down syndrome) signed up for Special Olympics and we were told she needs an x-ray of her neck. Why does she need this?


A:  As you may be aware, children with Down syndrome have problems with ligament laxity (looseness) and this can occur in the cervical spine (neck), especially at the occiput (back of the head) - C1 vertebra (occipital-atlanto) and C1-C2 vertebrae (atlantoaxial) levels.  Cervical spine x-rays can help determine whether there is ligament laxity and/or instability at these levels of the neck.  If there is evidence of instability of the cervical vertebrae, the child may be at risk for catastrophic neurologic damage with even mild cervical spine injury.  Consequently, they should not participate (and will not be allowed to participate) in Special Olympics. In addition, they may require surgical treatment of their instability (i.e., cervical spine instrumentation and fusion), which we do here at Riley.


Jodi L. Smith, Ph.D., M.D.

Pediatric Neurosurgery

Riley Hospital for Children

Assistant Professor of Surgery

Indiana University School of Medicine


Tuesday, March 26, 2013

Grant from IU Institute helps students gain skills at Indiana Colleges

By:  Joel Fosha, IIDC Communications Manager

BLOOMINGTON, Ind. ‐‐ Ten high school students with intellectual disabilities are working and studying at Vincennes University Jasper Campus (VUJC) this semester, thanks in part to a grant from Indiana University’s Indiana Institute on Disability and Community and its Center on Community Living and Careers.

The institute, a partner in the Indiana Postsecondary Education Coalition, creates programs on Indiana campuses that give students with intellectual disabilities a chance to participate in college life and obtain hands‐on work experience before they begin applying for jobs in their communities.

The Advocacy, Independence and Mastery (AIM) Academy opened this fall for students with special needs who are 1721 and who are typically in their final year at Dubois County high schools. The academy operates at VUJC through a partnership of the Dubois‐Spencer‐Perry Exceptional Children’s Cooperative, Southern Indiana Resource Solutions, VUJC and the Indiana Institute on Disability and Community.

AIM Academy students, like 20‐year‐old Kaci Schwinghamer from Forest Park High School, divide their time between classroom learning and working various jobs on campus. Schwinghamer is now learning to vacuum floors and clean dining trays at the VUJC Bistro. Other students are inflating basketballs in the gym, shredding documents, or cleaning windows.

“Our goal is to get students into off‐campus paid work,” said Mande Keusch, the cooperative’s vocational transition director. Keusch, along with job coaches from Southern Indiana Resource Solutions, is now actively recruiting local businesses that could provide paid work experiences for students in the upcoming semester.

She’s also hoping Indiana school corporations will take an interest in the AIM Academy, not only to ultimately provide jobs to AIM students, but also to mentor students and help with transportation costs, possibly by providing a scholarship for AIM students.


Southern Indiana Resource Solutions program instructors Jennifer Matheis and Jesse Hubert are responsible for job coaching and teaching AIM students skills they will need to be successful employees, such as completing tasks in a timely manner, arriving on time, using a checking account, or just having conversations with friends and co‐workers. The overall purpose of the instruction is to help students gain independence, new skills, and confidence as they encounter new people, situations, and environments.

This is the second Indiana university hoping to build a successful college/work experience program for students with disabilities. The VUJC program is based on a similar one at Indiana University‐Purdue University Indianapolis (IUPUI), which works with students who are transitioning from the Indianapolis Public Schools and other Indianapolis area school systems.

“Having that campus experience for eight months can really improve the outlook and possibilities for a student with disabilities,” said Jean Updike, project coordinator at IU’s Center on Community Living and Careers. Updike has been encouraging other Indiana universities to establish postsecondary programs for students with intellectual and developmental disabilities.

Pointing to the national program ThinkCollege!, at, Updike notes that other states around the nation have very successful programs providing inclusion opportunities to students with disabilities and have found that the programs ultimately benefit not just the students themselves, but also faculty and other students on campus. Building upon that, the Indiana Postsecondary Education Coalition has its own ThinkCollege Indiana website at to provide information and resources to students, families, and professionals.

“Many of the Indianapolis students in the IUPUI program have wonderful success stories to tell,” said Updike. “Several students now have jobs. Some navigate the bus system and travel to the Indy library, their jobs, or to meet friends and attend community events. That’s a tremendous confidence boost for them. To watch the ‘before’ and ‘after’ lives that these students lead is just phenomenal. Were excited that the students at VUJC will now have the chance to tell their own success stories.”

The Center on Community Living and Careers is part of the Indiana Institute on Disability and Community at Indiana University Bloomington. Both receive support from the Office of the Vice Provost for Research, which is dedicated to supporting ongoing faculty research and creative activity, developing new multidisciplinary initiatives, and maximizing the potential of faculty to accomplish path‐breaking work.

For more information, Joel can be reached at: (812) 855-6508 or


Thursday, March 21, 2013

Wednesday, March 20, 2013

Ask the Expert: Treating Dry Skin

Q: My child has very dry skin.  What are the best and least expensive ways to address this problem?


A: I often get a number of questions about what is a good approach to fight dry skin.  Dry Skin is a problem in Indiana, especially during cold weather because of the decrease in humidity associated with indoor hearing.  Moisturizers actually serve as barriers to evaporation (loss of water from the skin).  The skin should first absorb some water in a short bath or shower (room temperature) using only a mild cleanser.  If the water is too hot, the body will try to cool down by sweating, and this will actually result in more evaporation.  After the skin is hydrated in room temperature water, a moisturizer should be applied to the damp skin to minimize loss of that water from the skin.


Regarding choices for moisturizers, the ones that work best are those that are the thickest (because they are the most effective in the prevention of evaporation).  A specific brand is not essential.  Ointments (like petroleum jelly) are more effective than thick creams which are more effective than thick creams which are more effective than lotions.  Each individual should choose a moisturizer they are comfortable applying and then use it as often as needed.  Avoid moisturizers with additives like fragrances and apply them about 2-3 times daily.  With the more frequent use of hand sanitizers, a need for the use of moisturizers for the hands several times a day has arisen.


The scalp can become dry in a similar manner.  “Gel” type moisturizers can be applied directly to the scalp to address this issue.  OTC (over the counter – non-prescription) ketoconazole shampoo can decrease scale when it is present.  Unfortunately, this particular product can cause dryness of the hair itself.


More information about this topic is available at under the topic “bathing and moisturizing”.  This information may be useful whether your child has eczema or not.


Dr. Patricia Treadwell, M.D.

Professor of Pediatrics

Indiana University School of Medicine

Riley Hospital pediatric dermatologist


Monday, March 11, 2013

Ask the Expert

Q. What is Miralax? Is it safe to use?  I am wondering because I have seen some negative posts about it in the social media…

A. Polyethylene glycol 3350, also known as Miralax, is used to treat constipation. Polyethylene glycol 3350 is in a class of medications called osmotic laxatives. It works by causing water to be retained with the stool. This increases the number of bowel movements and softens the stool so it is easier to pass.

This drug is FDA approved and we’ve used it for many years as pediatric gastroenterologists to treat our patients with constipation, including patients with GI motility issues, such as those seen in Down syndrome. To date I have never encountered any of the mentioned side-effects nor come across any literature about this.

This website is about selling a nutritional supplement and the author is using anti-Miralax tactics to get the attention of potential customers. I have full faith in our rigorous process of FDA approval and have no reservations about using Miralax when indicated.

Shamaila Waseem, MD

Assistant Professor

Pediatric Gastroenterology

Riley Hospital, Indianapolis, Indiana

Friday, March 1, 2013

March is Disability Awareness Month

March 2013 is Disability Awareness Month and Down Syndrome Indiana, along with individuals, businesses and organizations across the state, will be recognizing the abilities of people with disabilities. The Indiana Governor’s Council for People with Disabilities has created a new campaign to help educate Hoosiers about disability-related issues and remind everyone of the importance of access, engagement and relationships in making all our communities better places to live.


The 2013 Disability Awareness Month theme is “Community Connections.” The campaign poster shows civic engagement and neighbors supporting one another, as well as several physical and environmental features that make a community a livable community. The theme reminds us that if our communities are to grow and prosper, they must be fully accessible – with appropriate housing and community services that allow everyone to live independently. This year’s campaign materials are sponsored by Duke Energy.

“We are very excited about the poster and theme of this year’s campaign because creating livable communities across our state is of great importance and this is a wonderful way to get more people involved in spreading the message,” said Suellen Jackson-Boner, Council executive director. “The Council is extremely pleased to learn that Down Syndrome Indiana is joining in this effort.”


As in previous years, Disability Awareness Month 2013 will be celebrated with community-based activities carried out by thousands of advocates and people with disabilities throughout the state. Activities include mayoral proclamations, art contests and awareness campaigns in schools, government agencies and businesses.


For more information about Disability Awareness Month activities and how you can participate, call Lisa Wells at 317-925-7617. If you would like to order free Disability Awareness materials from the Council , visit or contact Kim Dennison at Borshoff, (317) 631-6400 (voice); (317) 631-6499 (fax); or (e-mail).