Friday, January 25, 2013

Take a Lunch Break for Goodness Sake!

Recent changes at my workplace have lead to a pretty significant change in my daily workflow. Some days are very busy and include one or more trips, by car, to another campus. Change has always been hard for me, and so this has been a bit of a bumpy transition. The most difficult part for me though is that these trips back and forth have affected my precious daily lunch break.

Here is my trusty lunch bag.
Try using real silverware, it's extra nice and fancy.
We live in a culture where business is often thought to be equal to "effectiveness" and maybe even (dare I say) value and worth! Tim Kreider wrote a great Opinion Piece about this in the NY Times last year. I find this to be true in my community and it really shows up at lunchtime. I will often notice my coworkers skip lunch, or I will see them in the cafeteria grabbing a small cup of soup or a granola bar as they scurry to the next thing. This does NOT work for me. My lunches are usually my largest meal. They are usually hot and hearty, often leftovers from dinner I prepped earlier in the week. I try to spend at least 20 minutes chewing and swallowing my food during my lunch meal (and I will get into the importance of chewing more in another post).

So, I will be working with my employer and coworkers to make sure we can all have an opportunity to take a lunch break, sitting in one place, at a consistent time each day, with real food.

Here are the reasons I need to eat lunch:

1. There is a long way to go 'till dinner. Generally Americans eat their largest meal in the evening. Not long before going to bed. I usually need to get a lot accomplished between noon and 7pm. Half my workday, errands, maybe some exercise. And I need fuel for these jobs.

2. Ayurvedic traditions recommend eating three full meals per day to maintain our body's expected cycles of blood sugar boosts and depletion, just in time for the next meal. A skipped or late lunch can be confusing to our bodies and make them go into energy saving (read: fat storing) mode. 

3. I get cranky! Just like a child, because lets face it, I'm just a big version of my child self, my mood is less stable when I have not had a good nutritious lunch full of whole foods. 

4. I need a break. I notice that I am much less effective on the days I go straight through without a "brain break." Sometimes I put on a little Pandora, write a personal email, talk to a coworker about something other than work, or call my mom. Then I can feel refreshed and ready to jump back in to serving the patients and clients I love so well. 

How often do you take a lunch break? What do you eat? Does your lunch break 'feed' you?

Friday, January 18, 2013

My Controversial Opinion on Treatment of Social Skills for Children with Autism

I work with all kinds of patients at my full time job at a small community hospital. From fluency to brain injury, I need to be prepared to support anyone who comes through the door. Every once in a while I get a referral for a child with autism. Usually these individuals are very "high functioning," meaning that their communication and cognitive skills are relatively strong when measured on the autism spectrum. And generally I am providing supplemental therapy for older children (age 10-15) because their parents and teachers feel they need extra support. Most of these kids have access to great treatment in their public school, with therapists who specialize in working with children of their developmental level and often with extra training and experience working with autism.

I'd like to take this opportunity to give a big shout out to the amazing school SLPs out there. They manage big caseloads, lots of budget and policy red tape, and sometimes less than ideal conditions, but boy do they make a difference in these kids academic lives. I will be frank: autism is not an area of specialty for me. However, I feel confident that I can support these kids and their families. I love each of my kiddos and I learn so much from working with them.

A primary area of focus for nearly all of the children with autism that I have worked with is Social Skills. Well, to be fair, it is an area of focus for these children's parents, not for the children themselves per say. Social skills include things like eye contact, topic maintenance in conversations, and "saying nice things to people (and here is the part that gets me most) even if you don't mean it." Though we call them skills in the speech therapy world, these socially acceptable ways of behaving and interacting are really more like "rules." Typically developing kids learn these rules easily, without having to be explicitly taught, because blows to self esteem, fear of being rejected, and being policed and judged by peers are common occurrences in our interactions from a very young age. Children with autism often seem to be immune to these methods of learning. This is sometimes a source of frustration for their families and peers. I hear them say "he doesn't notice when our eyes glaze over because we are ready to talk about something other than scorpions." Or "he doesn't wait for everyone to be ready before he puts away the game."

Here is my dilemma. I have actually spend these first few years of my adult life trying to unlearn many of these rules, or at least free myself from letting them dictate my every interaction. I am trying so hard to learn and internalize the TRUTH which is: the only person I need to take care of is myself, and by doing that I am serving the highest good of all around me. I don't need to manage other people's feelings or make them happy (this is called people pleasing). I don't need to say things I don't mean in order to be liked. I don't need to do anything I don't feel like doing! Of course it's complicated, because some aspects of these unhealthy ways of being have actually skyrocketed me to where I am today. I probably couldn't have scored glowing letters of recommendation, aced the job interviews, and occasionally schmoozed my way out of speeding tickets if I wasn't paying attention and using social skills like those mentioned above. But I just feel so wrong drilling these children to be hypervigilant people pleasers, when I know in my heart of hearts that they are ok just the way they are. In fact I envy them at times. Oh, to be completely free of social anxiety!

I suppose one answer is to show and teach these kiddos about all the different ways we can be in relationship, so they can make the choice about whether and when they want to "play the game." Show them the tools and let them reach for them if they want to. And always to be learning from them as much as they are learning from me.

I welcome your comments, especially those of you who work with people with autism and see the benefits of treating social skills. I trust that we are striving to improve people's quality of life, and not just teach them "the right way." And I encourage you to learn from my friends with autism. If you want to talk about scorpions till the cows come home, do it!

Grounding Shepherd's Pie

I enjoyed this delicious warming and grounding meal on a chilly winter night. It's a bit more labor intensive than some of my other go-to recipes, but soo worth it. I made a lot and packed it for lunch for a few days.

1 lb ground grass fed beef
Olive oil
2-3 carrots, grated, no need to peel!
2-3 red beets, grated
1-2 golden beet, grated
1 medium onion, peeled and grated
2 cloves garlic, minced
1 cup (or so) chicken broth
1 tsp pepper
½ tsp salt
1 tsp rosemary (fresh and minced is best)
fresh parsley, chopped (to taste)

4lbs of potatoes
1/4 cup butter
1/4 cup chicken broth
1 pkg of Boursin cheese
1 – 1 1/2 tsp salt
1 tsp pepper

Chop potatoes into chunks. Boil in a large pot of water until tender.
While potatoes are boiling, combine oil, ground beef, and garlic in a large pan. Cook on medium high heat, stirring and breaking up meat chunks frequently. Once meat is cooked through, add the grated vegetables. Cook till veggies are tender. Add chicken broth. Season with pepper, salt, rosemary, and parsley. Stir. Remove from heat.

Once potatoes are tender, drain and transfer to a large bowl. Use an electric mixer and whip until potatoes are mostly broken down. Add butter, chicken broth, and Boursin cheese. Beat until smooth. Season with salt and pepper.

Preheat broiler to high.
Transfer meat mixture to a large casserole dish. Spread potato mixture evenly over the meat mixture, broil until potatoes are as browned as you would like them.