2011年12月31日 星期六

An Independent Consultant's View of Mental Health Disorders and Special Needs

According to the National Center for Children in Poverty, one in five children from birth to 18 has a diagnosable mental disorder. Moreover, one in 10 youths has mental health problems that are serious enough to impair how they function at home, in school, or in the community in which they live. Among the diagnosable mental disorders common in children are anxiety, mood disorder such as depression, and disruptive disorders such as attention deficit and hyperactive disorders.

Special needs, however, are a different concern. Special needs is an umbrella term under which a broad array of diagnosis can be put. Children with special needs may have learning disabilities that range from being mild to profound mental retardation. They may have developmental delays from which they may catch up quickly or some from which they may not catch up at all. Also they may have an occasional panic attack or serious psychiatric problems. Some special needs that can be clearly diagnosed include fetal alcohol spectrum disorder, dysfunction of sensory integration, autism, and dyslexia.

Problems peculiar to children with a mental disorder and special needs are not uncommon. It is not unusual for a child with attention deficit hyperactive disorder to have a learning disability such as a central auditory processing disorder and may struggle with school work regardless of their intellectual abilities.

As a independent mental health consultant, here is the distinction that I make. Mental disorders are essentially psychological problems while special needs are disabilities that affect how a child can effectively function in society. The psychological problems such as mood swings, fits of depression, and feelings of anxiety can be addressed by a competent psychotherapist using one or more approaches such as cognitive-behavioral therapy, social skills training, and parent counseling. Medication may be required, but should never be the sole therapy. It is often most effective when used in combination with a behavioral based treatment. A child will not learn socially acceptable behavior if it is never addressed in therapy. A child with special needs represent a set of different concerns and approaches. They may require specialized learning strategies to help the child to meet his potential and to avoid the loss of the child's self-esteem and reduce behavioral difficulties.

Effective approaches will also involve the school system which is lawfully required to engage the child in an educational program designed to meet his needs. However despite these efforts and time, the child may not respond. Still, you have to continue with love, seek to understand the situation, and have child work towards self-sufficiency.

Keep up to date with timely financial and personal growth tips and strategies. Visit http://www.yourconsultantsite.com and http://www.youcontrol.blogspot.com. You can subscribe to the monthly Financial/Personal Growth newsletter at either site as well as read and download the free articles and e-books. Will Barnes is a financial and personal growth consultant based in Illinois. Mr Barnes has conducted hundreds of workshops on parenting and counseled parents for decades.

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

Disorders of Immune System - AIDS

AIDS is the most typical immunodeficiency disorder worldwide, and HIV infection is one from the best epidemics in human history. AIDS is the consequence of a chronic retroviral virus that produces extreme, life-threatening CD4 helper T-lymphocyte dysfunction, opportunistic infections, and malignancy.

Retroviruses include viral RNA that is transcribed by viral reverse transcriptase into double-stranded DNA, which can be integrated into the host genome. Cellular activation leads to transcription of HIV gene items and viral replication. AIDS is defined by serologic evidence of HIV virus with the presence of a range of indicator diseases related to medical immunodeficiency.

HIV is transmitted by coverage to infected body fluids or sexual or perinatal make contact with. Transmissibility from the HIV virus is related to subtype virulence, viral load, and immunologic host factors. Acute HIV virus may present as an acute, self-limited, febrile viral syndrome characterized by exhaustion, pharyngitis, myalgias, rash, lymphadenopathy, and significant viremia without detectable anti-HIV antibodies.

Following an initial viremic phase, individuals seroconvert along with a period of clinical latency is usually observed. Lymph tissues turn out to be centers for substantial viral replication during a "silent," or asymptomatic, stage of HIV virus despite an absence of detectable trojan in the peripheral blood. Over time, there's a progressive decline in CD4 T lymphocytes, a reversal from the regular CD4:CD8 T-lymphocyte ratio, and numerous other immunologic derangements.

The clinical manifestations are directly related to HIV tissue tropism and defective immune function. Development of neurologic complications, opportunistic infections, or malignancy signal marked immune deficiency. The time course for progression varies, but the median time before appearance of medical illness is about ten many years. Around 10% of individuals infected manifest rapid progression to AIDS within five many years after virus.

A minority of individuals are "long-term nonprogressors." Genetic elements, host cytotoxic immune responses, and viral load and virulence appear to effect susceptibility to virus and the rate of disease progression. Chemokines (chemoattractant cytokines) regulate leukocyte trafficking to sites of inflammation and have been discovered to play a significant role in the pathogenesis of HIV illness.

During the initial stages of virus and viral proliferation, virion entry and cellular infection requires binding to two coreceptors on target T lymphocytes and monocyte/macrophages. All HIV strains express the envelope protein gp120 that binds to CD4 molecules, but different viral strains display tissue "tropism" or specificity on the basis from the coreceptor they recognize. These coreceptors belong towards the chemokine receptor family.

Changes in viral phenotype throughout the course of HIV virus may lead to changes in tropism and cytopathology at different stages of disease. Viral strains isolated in early stages of infection (eg, R5 viruses) demonstrate tropism toward macrophages. X4 strains of HIV are a lot more commonly seen in later stages of illness.

X4 viruses bind to chemokine receptor CXCR4, more broadly expressed on T cells, and are related to syncytium formation. A small percentage of individuals possessing nonfunctional alleles for the polymorphic chemokine receptor CCR5 appear to be highly resistant to HIV virus or display delayed progression of disease. Mathematical models estimate that throughout HIV virus billions of virions are produced and cleared each day.

The reverse transcription step of HIV replication is error prone; mutations occur frequently, and even within an individual patient, HIV heterogeneity develops rapidly. The improvement of antigenically and phenotypically distinct strains contributes to progression of illness, medical drug resistance, and lack of efficacy of early vaccines. Cellular activation is critical for viral infectivity and reactivation of integrated proviral DNA.

Although only 2% of mononuclear cells are found peripherally, lymph nodes from HIV-infected individuals can include large amounts of trojan sequestered among infected follicular dendritic cells within the germinal centers.

The marked decline in CD4 T-lymphocyte counts-characterizing HIV infection-is due to several mechanisms, including the pursuing: (1) direct HIV-mediated destruction of CD4 T lymphocytes, (2) autoimmune destruction of virus-infected T cells, (3) depletion by fusion and development of multinucleated giant cells (syncytium formation), (4) toxicity of viral proteins to CD4 T lymphocytes and hematopoietic precursors, and (five) induction of apoptosis (programmed cell death).

CD8 CTL activity is initially brisk and effective at controlling viremia through elimination of trojan and virus-infected cells. Ultimately, viral proliferation outpaces host responses, and HIV-induced immunosuppression leads to disease development. Loss of viral containment occurs with lack of adequate helper T purpose and decreased IL-2 production leading to diminution of CD8+ T-cell-dependent cytotoxic responses.

Subsequently, there is an accumulation of viral escape mutations with general cytokine dysregulation detrimental to maintenance of lymphatic organs, bone marrow integrity, and effective immune responses. In addition to the cell-mediated immune defects, B-lymphocyte function is altered such that numerous infected individuals have marked hypergammaglobulinemia but impaired specific antibody responses.

Both anamnestic responses and individuals to neoantigens can be impaired. However, the role of humoral immunity in controlling viremia or slowing disease development is unclear. The development of assays to measure viral burden (plasma HIV-RNA quantification) has led to a better understanding of HIV dynamics and has provided a tool for assessing response to therapy.

It is now well recognized that viral replication continues all through the disease, and immune deterioration occurs despite clinical latency. The risk of progression to AIDS appears correlated with an individual's viral load after seroconversion. Data from a number of large clinical cohorts have shown that there's a direct correlation between the CD4 T-lymphocyte count and also the risk of AIDS-defining opportunistic infections.

Thus, the viral load and also the degree of CD4 T-lymphocyte depletion serve as important clinical indicators of immune status in HIV-infected people. Prophylaxis for opportunistic infections such as pneumocystis pneumonia is started when CD4 T-lymphocyte counts reach the 200-250 cells/ L variety.

Similarly, patients with HIV virus with fewer than 50 CD4 T lymphocytes/ L are at significantly increased risk for cytomegalovirus (CMV) retinitis and Mycobacterium avium complex (MAC) infection. Cells other than CD4 T lymphocytes contribute to the pathogenesis of HIV infection.

Monocytes, macrophages, and dendritic cells can be infected with HIV and facilitate transfer of trojan to lymphoid tissues and immunoprivileged sites, such as the CNS. HIV-infected monocytes will also release large quantities from the acute-phase reactant cytokines, including IL-1, IL-6, and TNF, contributing to constitutional symptomatology.

TNF, in particular, has been implicated in the severe wasting syndrome observed in patients with advanced illness. Concomitant infections might serve as cofactors for HIV infection, increasing expression of HIV through enhanced cytokine production, coreceptor surface expression, or increased cellular activation mechanisms.

The medical manifestations of AIDS are the direct consequence from the progressive and severe immunologic deficiency induced by HIV. Patients are susceptible to a wide variety of atypical or opportunistic infections with bacterial, viral, protozoal, and fungal pathogens. Common nonspecific symptoms consist of fever, night sweats, and weight loss. Weight loss and cachexia can be due to nausea, vomiting, anorexia, or diarrhea.

They often portend a poor prognosis. The incidence of infection increases as the CD4 T lymphocyte number declines. Lung virus with Pneumocystis jiroveci is the most common opportunistic infection, affecting 75% of individuals. Patients present clinically with fevers, cough, shortness of breath, and hypoxemia ranging in severity from mild to existence threatening.

A diagnosis of pneumocystis pneumonia could be made by substantiation from the medical and radiographic findings with Wright-Giemsa or silver methenamine staining of induced sputum samples. A negative sputum stain does not rule out disease in patients in whom there's a strong clinical suspicion of disease, and further diagnostic maneuvers such as bronchoalveolar lavage or fiberoptic transbronchial biopsy might be required to establish the diagnosis.

Issues of pneumocystis pneumonia include pneumothoraces, progressive parenchymal disease with severe respiratory insufficiency, and, most commonly, adverse reactions to the medications used for treatment and prophylaxis.

As a consequence of chronic immune dysfunction, HIV-infected individuals are also at high risk for other pulmonary infections, including bacterial infections with S pneumoniae and H influenzae; mycobacterial infections with M tuberculosis or M avium-intracellulare (MAC); and fungal infections with C neoformans, H capsulatum, or C immitis. Medical suspicion followed by early diagnosis of these infections should lead to aggressive treatment.

The improvement of active tuberculosis is significantly accelerated in HIV virus as a result of compromised cellular immunity. The risk of reactivation is estimated to be 5-10% per year in HIV-infected patients compared having a lifetime risk of 10% in those without having HIV. Furthermore, diagnosis may be delayed because of anergic skin responses.

Extrapulmonary manifestations occur in up to 70% of HIV-infected individuals with tuberculosis, and the emergence of multidrug resistance may compound the problem. MAC is really a less virulent pathogen than M tuberculosis, and disseminated infections usually occur only with extreme medical immunodeficiency.

Symptoms are nonspecific and typically consist of fever, weight loss, anemia, and GI distress with diarrhea. The presence on physical examination of oral candidiasis (thrush) and hairy leukoplakia is highly correlated with HIV infection and portends rapid development to AIDS.

Abnormal outgrowth of Candida from normal mouth flora is the cause of persistent oral candidiasis, whereas Epstein-Barr trojan is the cause of hairy leukoplakia. HIV-infected people with oral candidiasis are at much greater risk for esophageal candidiasis, which might existing as substernal pain and dysphagia. This infection and its characteristic medical presentation are so common that most practitioners treat with empiric oral antifungal therapy.

Should the patient not respond rapidly, other explanations for the esophageal symptoms should be explored, including herpes simplex and CMV infections. Persistent diarrhea, especially when accompanied by high fevers and abdominal pain, might signal infectious enterocolitis.

The list of potential pathogens in such cases is lengthy and includes bacteria, MAC, protozoans (cryptosporidium, microsporidia, Isospora belli, Entamoeba histolytica, Giardia lamblia), and even HIV itself. HIV-associated gastropathy and malabsorption are commonly noted in these individuals.

Because of their reduced gastric acid concentrations, individuals have an increased susceptibility to virus with Campylobacter, Salmonella, and Shigella. Co-infection with viral hepatitis (HBV, HCV, CMV) can lead to end-stage liver disease, but fortunately, institution of highly active antiretroviral therapy (HAART) can lead to a reduction in medical HBV illness.

Skin lesions commonly related to HIV virus are typically classified as infectious (viral, bacterial, fungal), neoplastic, or nonspecific. Herpes simplex virus (HSV) and herpes zoster virus (HZV) may cause chronic persistent or progressive lesions in individuals with compromised cellular immunity.

HSV commonly causes oral and perianal lesions but can be an AIDS-defining sickness when involving the lung or esophagus. The risk of disseminated HSV or HZV virus and the presence of molluscum contagiosum appear to be correlated using the extent of immunoincompetence.

Seborrheic dermatitis caused by Pityrosporum ovale and fungal skin infections (Candida albicans, dermatophyte species) are also commonly observed in HIV-infected patients. Staphylococcus including methacillin-resistant S aureus can cause the folliculitis, furunculosis, and bullous impetigo commonly observed in HIV-infected individuals, which require aggressive treatment to prevent dissemination and sepsis.

Bacillary angiomatosis is a potentially fatal dermatologic disorder of tumor-like proliferating vascular endothelial cell lesions, the result of infection by Bartonella quintana or Bartonella henselae. The lesions might resemble those of Kaposi's sarcoma but respond to treatment with erythromycin or tetracycline. CNS manifestations in HIV-infected patients consist of infections and malignancies.

Toxoplasmosis frequently presents with space-occupying lesions, causing headache, altered mental status, seizures, or focal neurologic deficits. Cryptococcal meningitis commonly manifests as headache and fever. Up to 90% of patients with cryptococcal meningitis exhibit a positive serum test for Cryptococcus neoformans antigen.

HIV-associated cognitive-motor complex, or AIDS dementia complex, is the most frequently diagnosed cause of altered mental status in HIV-infected patients. Patients typically have difficulty with cognitive tasks, poor short-term memory, slowed motor purpose, personality changes, and waxing and waning dementia. Up to 50% of patients with AIDS suffer from this disorder, perhaps caused by glial or macrophage infection by HIV resulting in destructive inflammatory changes within the CNS.

The differential diagnosis can be broad, including metabolic disturbances and toxic encephalopathy resulting from drugs. Other causes of altered mental status consist of neurosyphilis, CMV or herpes simplex encephalitis, lymphoma, and progressive multifocal leukoencephalopathy, a progressive demyelinating disease caused by a JC papovavirus.

Peripheral nervous system manifestations of HIV virus include sensory, motor, and inflammatory polyneuropathies. Almost 33% of individuals with advanced HIV disease develop peripheral tingling, numbness, and pain in their extremities. These symptoms are likely to become due to loss of nerve axons from direct neuronal HIV infection.

Alcoholism, thyroid disease, syphilis, vitamin B12 deficiency, drug toxicity (ddI, ddC), CMV-associated ascending polyradiculopathy, and transverse myelitis also cause peripheral neuropathies. Less commonly, HIV-infected patients can develop an inflammatory demyelinating polyneuropathy similar to Guillain-Barre syndrome; however, unlike the sensory neuropathies, this inflammatory demyelinating polyneuropathy typically presents before the onset of clinically apparent immunodeficiency.

The origin of this condition is not known, although an autoimmune reaction is suspected. Retinitis resulting from CMV virus is the most typical cause of rapidly progressive visual loss in HIV virus. The diagnosis could be difficult to make because Toxoplasma gondii virus, microinfarction, and retinal necrosis can all cause visual loss. HIV-related malignancies commonly seen in AIDS include Kaposi's sarcoma, non-Hodgkin's lymphoma, primary CNS lymphoma, invasive cervical carcinoma, and anal squamous cell carcinoma.

Impairment of immune surveillance and defense and increased coverage to oncogenic viruses appear to contribute towards the development of neoplasms. Kaposi's sarcoma is the most typical HIV-associated cancer. In San Francisco, 15-20% of HIV-infected homosexual men develop this tumor during the progression of their disease.

Kaposi's sarcoma is uncommon in women and children for reasons that are not clear. Unlike classic Kaposi's sarcoma, which affects elderly men within the Mediterranean, the illness in HIV-infected individuals may present with either localized cutaneous lesions or disseminated visceral involvement.

It is often a progressive disease, and pulmonary involvement could be fatal. Histologically, the lesions of Kaposi's sarcoma consist of a mixed cell population that includes vascular endothelial cells and spindle cells within a collagen network.

Human herpesvirus 8 is associated with Kaposi's sarcoma in patients with AIDS. HIV itself appears to induce cytokines and growth factors that stimulate tumor cell proliferation rather than causing malignant cellular transformation. Clinically, cutaneous Kaposi's sarcoma typically presents as a purplish nodular skin lesion or painless oral lesion.

Sites of visceral involvement include the lung, lymph nodes, liver, and GI tract. In the GI tract, Kaposi's sarcoma can produce chronic blood loss or acute hemorrhage. In the lung, it often presents as coarse nodular infiltrates bilaterally, frequently related to pleural effusions.

Non-Hodgkin's lymphoma is particularly aggressive in HIV-infected individuals and usually indicative of substantial immune compromise. The majority of these tumors are high-grade B-cell lymphomas with a predilection for dissemination. The CNS is frequently involved either as a primary site or as an extranodal site of widespread disease.

Anal dysplasia and squamous cell carcinoma are also more commonly found in HIV-infected homosexual men. These tumors appear to become related to concomitant anal or rectal infection with human papillomavirus (HPV). In HIV-infected women, the incidence of HPV-related cervical dysplasia is as high as 40%, and dysplasia can progress rapidly to invasive cervical carcinoma.

Adherence to multidrug regimens remains a challenge, but clearly antiretroviral therapy improves immune purpose. For reasons that are not clear, HIV-infected patients have an unusually high rate of adverse reactions to a wide variety of antibiotics and frequently develop severe debilitating cutaneous reactions.

Drug hypersensitivity and toxicity can be severe, potentially life-threatening, and limiting with certain agents. Immune reconstitution syndrome is really a described reaction occurring days to weeks following initiation of HAART.

Medical relapse or worsening of mycobacterial, pneumocystis, hepatitis, or neurological infections occurs as a result of a resurgence of immune activity, causing paradoxical worsening of inflammation, possibly as residual antigens or subclinical pathogens are attacked.

Other issues of HIV-infection include arthritides, myopathy, GI syndromes, dysfunction of the adrenal and thyroid glands, hematologic cytopenias, and nephropathy. Since the illness was first described in 1981, medical knowledge of the underlying pathogenesis of AIDS has increased at a rate unprecedented in medical background.

This knowledge has led towards the rapid improvement of therapies directed at controlling HIV virus as well as the multitude of complicating opportunistic infections and cancers.

Francesco Zinzaro has been involved with online marketing for nearly 3 years and likes to write on various subjects. Come visit his latest website which discusses of Mesothelioma Treatment Options and cancer information for the owner of his own health-care.

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

2011年12月30日 星期五

Bipolar Disorder in Children - A Call For Caution


Most treatment professionals working with children and adolescents are acutely aware of the rise in the rate at which children and adolescents, but most significantly pre-pubescent children, are being diagnosed with Bipolar Disorder. While estimates vary from article to article, it is interesting to note several recently reported statistics. The New York Times, in an article released in September of 2007, noted that in the 10 year span from 1993 to 2003, there was a forty-fold increase in the rate at which this population was being diagnosed with Bipolar Disorder, while a more scholarly article (Youngstrom, 2005) noted that marked increases had been found in the rate of diagnosing in children of those involved with Child Protective Services in Illinois. Other writers have pointed to this sharp increase in the rate, some positively (NYT, 2007, Papalos and Papalos, 2006), even saying that there needs to be even more of an increase. Others, however, have expressed alarm at this sharp increase, and have pleaded with professionals to have a more conservative approach to diagnosing this in pre-adults. There is much debate in the field, hotly opinioned views, and contention in the field brought on by the huge gulf between the most liberal, and the most conservative, in terms of this diagnosis. To some extent, this divide is evident between Psychiatrists and Psychologists, and indeed, the previously noted NY Times article pointed out that 90% of the diagnosing of Bipolar Disorder in children was being done by psychiatrists. However, there are many other mental health professionals, including psychologists and other non-psychiatric folk in the field, who take the liberal approach shared by many psychiatrists.

What Drives us to Diagnose Bipolar Disorder in Children and Adolescents?

For those who advocate earlier diagnosing, one of the most commonly quoted reasons is prevention: prevention of a poor childhood, prevention of academic difficulties, prevention of social failure, prevention of kindling, etc. The risk, proponents of earlier diagnosing opine, is that failure to act is a disservice to the child, and to those involved in the child's life. This has been the stated reason driving such professionals as Dr. Dimitri Papalos and his wife, Janice Papalos, and of others, and indeed, any professional with any modicum of empathy has most certainly considered this when reflecting on a case of possible Bipolar Disorder in a child or adolescent. For, if indeed, allowing a child to pass through their childhood without appropriate treatment sentences them to a substandard future, who among us would hesitate to act? The problem is that it is not entirely clear that we have gotten this right, and it is most certainly not clear that what appears to be Bipolar Disorder in children will follow the child into adulthood.

What is this animal we call Childhood Bipolar Disorder?

In adulthood, it is well-accepted that Bipolar Disorder involves discrete periods of Mania, and discrete periods of Depression. Of course, there are the murkier cases involving Mixed episodes, though it is well-accepted that such cases do indeed occur in adulthood. However, as we descend retrospectively into childhood, the waters become murkier and murkier. What does Bipolar Disorder look like in early adolescence? What about late prepubescence? And what about the very young? A review of the literature (Papalos and Papalos, 2006, Youngstrom, 2005, Danner-Ogston, et al, in press, Geller, 1997, etc.) reveals opinions that span the spectrum from the very conservative (let's keep things as they were), to the very liberal (let's diagnose in infancy). Each opinion is justified in some sort of logical argument or another, but most importantly, there is no consensus, and strong evidence supporting a call for caution.

Conservative Approach

The conservative approach to diagnosing Bipolar Disorder in children is to keep things as they are. In other words, the child/adolescent must meet the criteria for Major Depression, and for Mania, in terms of severity of symptoms, and duration of the moods. In this approach, the child would need to evidence severe depression for a week, in most cases, and would have to evince chronic mania for the better part of a week, before they could be considered for the diagnosis. In instances in which there was thought to be a Mixed Episode, these duration criteria could be waived, but the severity criteria could not.

Liberal Approach

In the more liberal approach, opinions vary, but there is a general relaxation of the duration and frequency criteria, to the point that in the most liberal approach, children can cycle from minute to minute! Also noted in the more liberal approach is the tendency to re-define what comprises depression or mania in children, with the most liberal approach defining mania as consisting primarily of chronic and severe irritation, or general anger issues. Depression, in this approach, may primarily manifest as anger, or social withdraw.

Interim Conclusion

The problem with the conservative approach, in some professionals' views, is that we are potentially missing children who should have the diagnosis and treatment. And indeed, when a child or adolescent has significant emotional or behavioral issues, and is not treated, their life does often go from bad to worse. The problem with the liberal approach is that treatment, which is led by the medical approach, involves the introduction of potentially toxic psychotropics into the child's body. Most of the psychotropics used to treat Bipolar Disorder in children and adolescents are prescribed 'off label,' without the sanctioning of the FDA, and without knowledge of the potential long-term side effects of such treatment on the developing body and brain.

Current Research

Because of the saliency of this particular area of mental health, there has been a great deal of research in the past decade or more. NIMH, NAMI, and other organizations have funded multiple studies to answer questions related to this debate. Books have been written on this, including the infamous The Bipolar Child (Papalos and Papalos, 2006, and earlier editions), The Everything Parents Guide to Children With Bipolar Disorder, and others. So what is the state of the science? What do we know?

According to Papalos and Papalos, in an informal research study which involved polling parents who had identified their child as Bipolar, there was a great deal of diversity in what might be seen in a child or adolescent with Bipolar Disorder. Papalos identified traits of moodiness, nightmares, sleep problems, sensory integration difficulties, extreme temper tantrums, depression, food sensitivities, anxiety, hyperactivity, impulsivity, distractibility, oppositional traits, and other traits. Indeed, they were of the mind that because Bipolar Disorder spanned such an array of symptoms (many of which were found in other childhood mental disorders, such as Autism, Asperger's, Oppositional Defiant Disorder, Attention-Deficit/Hyperactivity Disorder, Posttraumatic Stress Disorder or PTSD, etc), one should diagnose this disorder first, and then consider additional diagnoses if the symptoms were not fully explained by the first diagnosis. While Papalos and Papalos's conclusions were by far the most extreme, there are many researchers who feel that a much more liberal interpretation of what Bipolar Disorder is in children, is needed, though they do not go to the extremes that Papalos and Papalos do. The consensus seems to be that children with Bipolar Disorder will not have the same measures of frequency and duration noted in adulthood. Most liberal diagnosticians maintain that children and young adolescents could 'cycle daily, and that they may not demonstrate traditional mania, and that their depression may not necessarily be debilitating. Most liberal diagnosticians also maintain that irritability is part of what may be mania, and that Bipolar Children seem to have severe anger problems. Questions that have not be definitively answered center around differential diagnoses (is it Bipolar Disorder, or PTSD, or both? etc).

What if the 'liberals' are right?

If the liberal approach holds up to the scrutiny of time and research, then there are many children who have been provided with attention and treatment, rightly so, which may prevent future problems. Such a proactive approach may well improve public opinion of the mental health field, as well, and may increase funding directed towards mental health problems, or insurance recognition of mental health problems.

What if the 'conservatives' are right?

If the conservatives are right, then we potentially have a public disaster on our hands. Treatment of children and young adolescents with Bipolar medications is unproven, sometimes-to-often ineffective, and marred by the many side effects and potential long term damage that could occur. Bipolar medications can cause agitation, increased behavioral difficulty, moodiness, weight gain, shaking, tiredness, and potentially more serious problems, such as Polycystic Ovarian Syndrome, a sometimes deadly skin disease, tremors, seizures, and death. As well, it may be that teaching a child that they have less control over their emotions and behaviors than a typical child, or that they have no control, could cause them to give up and to actually worsen in their behaviors. Also, there are some that opine that parlaying medications on children at a young age imbues in them a strong belief that substances are the answer for their ills ... and how far down the road from that is the belief that illicit substances may be the answer?

How well are we doing?

Given all the concerns, how are we doing? What do we know about the effectiveness of the more liberal diagnostic and treatment approach? Reviewing the literature, the results are not encouraging. For instance, Dr. March, of Duke University, points out that we have no idea whether children diagnosed at the age of 5 to 7 will actually be Bipolar when they are older. In the NYT article, it is noted that most of the research suggests that these kids are most likely to have depression as they get older, rather than Bipolar Disorder. Generally, it appears that medications often do not address the bulk of the symptoms, and it does appear that their strongest effect is in the sedation category, which is a double-edged sword. Specifically, the child or young adolescent is more manageable, and less volatile, but they also are sometimes less able to focus on academics, and may experience major personality shifts with undesirable effects on their social success. Mood stabilization is often an elusive goal, even with heavy psychopharmacological intervention, and in some instances the mood becomes more unstable during pharmacological treatment. The side effects also often become an issue in and of themselves, necessitating additional medications, diet changes, changes in academic approaches, and even requiring adjustments in the general expectations of the child's ability to function in their world. In some instances, the medications make the child potentially eligible for disability benefits, because of the debilitating effects they have on their functioning. As well, in many instances the pharmacological interventions are being guided by overworked and overwhelmed child and adolescent psychiatrists, who cannot spend the time needed to fully evaluate the child and their needs, and who often are pressured by pharmacological companies, directly and indirectly, to prescribe a particular medication, or to identify a certain portion of their caseload as Bipolar. Overall, even if one accepts the thinking that Bipolar Disorder in children and adolescents is under diagnosed, and that they should be treated with medications, the end result is often partial to full failure in addressing the issue.

Are we missing something?

Researcher completed by Martin Teicher, M.D., Ph.D., (2000) suggests that early trauma, be it sexual, physical, or verbal, has a potentially long-term effect on the developing brain. Indeed, his research indicates that such trauma, and particularly (interestingly) verbal abuse, effects long-term changes in the corpus callosum, and in the precuses, as well as in the hypothalamus, as well as in other areas. The corpus callosum is important in balancing out the right and left brain, and those with underdeveloped corpus collosi tend to be very reactive or unbalanced in their approach to problem solving (interpret: overly emotional and emotionally reactive ... in other words, more likely to be angry, violent, or irrational). Those with underdeveloped precueses tend to be less logical, less integrated in their personality, and generally inappropriate in their reactions. Thus, in his view, many of the behavioral and mood issues that we see in the prepubescent or post-pubescent child may be a result of those early childhood experiences. In other words, he is proving something clinicians on the front line have thought all along: subjecting a child to abuse tends to cause them to experience major personality shifts, and they are often violent and emotional. If Dr. Teicher prevails at the end of the day, it may well be that what we thought was Childhood Bipolar Disorder was actually a trauma disorder. And the implications of that: The difference between labeling the child as potentially temporarily impaired, or permanently impaired.


There is much debate about the frequency by which Childhood Bipolar Disorder occurs in children and adolescents. There is no questioning the conclusion that this is an important area to explore, as the implications for this disorder over the lifetime of a person are serious. However, we need to get it right, because if not, we will either have undiagnosed cases that permanently alter the child's/adolescent's chances for success, or we will have over medicated children struggling to progress under the weight of the side effects of unnecessary medication. Ultimately, it is science that should clear the air ... good, logical, replicable science that will show us what Bipolar Disorder probably looks like, if it indeed exists, in Children. Until we have a scientific consensus, however, caution seems advisable, and the more conservative approach would be to consider other, less long-term conceptualizations for the child's symptom set.


Allen, Michael H. Approaches to the Treatment of Mania. Medscape Today CME activity. Sept 2003, medscape.com

Boodman, S. - 2005 - Going to Extremes - Experts Question Rise in Pediatric Diagnosis of Bipolar Illness, a Serious Mood Disorder. The Washington Post, 2/15/05. pg HE01.

Carey, Benedict - September 3, 2007 - More Children Being Treated For Bipolar Disorder - New York Times.

Costello, E.J.; Angold, A.; Burns, B.J.; Stangl, D.K.; Tweed, D.L.; Erkanli, A.; Worthman, C.M. (1996). The Great Smoky Mountains Study of Youth. Goals, design, methods, and the prevalence of DSM-III-R Disorders. Archives of General Psychiatry, V53, n12.

Danner-Ogston, S., Young, M.D. & Fristad, M.A. (in press). Assessment of bipolar disorder in children. In J. Matson, F. Andrasik & M.L. Matson (Eds.) Assessing Childhood Psychopathology and Developmental Disabilities, NY: Springer.

DelBello, Melissa P, Strakowski, Stephen M, Zimmerman, Molly E, Hawkins, John M, Sax, Kenji W (1999). MRI Analysis of the Cerebellum in Bipolar Disorder: A Pilot Study. Neuropsychopharmacology (1999) 21 63-68.

Dennison, Z.; Teskey, G.C.; Cain, D.P. (1995) Persistence of kindling: Effect of Partial Kindling, retention interval, kindling site, and stimulation parameters. Epilepsy Research, V21 (3), pp171-182.

Dopheide, Julia A. (2006). Recognizing and Treating Depression in Children and Adolescents. American Journal of Health-System Pharmacy. 2006; 63(3): 233-243.

DSM-IV-TR - American Psychiatric Association - 1994

Geller, B; Luby, J. (1997). Child and Adolescent Bipolar Disorder: A Review of the Past 10 Years. J. Am Acad Child Adoles Psychiatry 36: 1168-1176.

Haugaard, Jeffrey J. (2004). Recognizing and Treating Uncommon Behavioral and Emotoinal Disorders in Children and Adolescents Who have been Severely Maltreated: Bipolar Disorders. Child Maltreatment, 9; 131.

Hazell, PL; Carr, V; Lewin, TJ; Sly, K (2003). Manic Symptoms in young males with ADHD predict functioning but not diagnosis after 6 years. Journal of American Academy of Child and Adolescent Psychiatry, 42 (5), 552-560.

Hlastala, S; Ellen, F; Kowalaski, Jeanne; Sherrill, J.T.; Tu, Xin M.; Anderson, B; Kupfer, D.J. (2000) Stressful Life Events, Bipolar Disorder, and the Kindling Model. Journal of Abnormal Psychology, vol. 109, n. 4, pp. 777-786.

Kowatch, Robert A. , Fristad, Mary, Birmaher, Boris, Dineen Wagner, K; Findling, Robert; Hellander, M (AND THE WORKGROUP MEMBERS) (2005). Treatment Guidelines for Children and Adolescents With Bipolar Disorder: Child Psychiatric Workgroup on Bipolar Disorder. J. Am. Acad. Child Adolesc. Psychiatry, 2005;44(3):213-235.

Lewinsohn, Peter M, Daniel N Klein, John R Seeley (2000) Bipolar disorder during adolescence and young adulthood in a community sample Bipolar Disorders 2 (3.2), 281-293.

MacReady, N. (2006). Mapping the Brain's Mysteries: At the forefront of today's imaging revolution, mind explorers use a futuristic atlas to discover how healthy and diseased brains work. Neurology Now. Vol 2 (3), May/June 2006, pp 10-13.

McNicholas, F.; Baird, G. (2000). Early-Onset Bipolar Disorder and ADHD: Diagnostic Confusion Due to Co-Morbidity: Clinical Child Psychology and Psychiatry. 5; 595.

Miklowitz, D. J.; Otto, Michael W; Frank, Elllen; Reilly-Harrington, Noreen A.; Wisniewski, Stephen R/.; Kogan, Jane N.; Nierenberg, Andrew A.; Calabrese, Joseph R.; Marangell, Lauren B.; Gyulai, L.; Araga, M.; Gonzalez, J.M.; Hierley, Edwin R.; Thase, Michael E.; Sachs, Gary S. Psychosocial Treatment for Bipolar Depression: A 1-year Randomized Trial From the Systematic Treatment Enhancement Program. Arch Gen Psychiatry 2007;64:419-427

Papalos, D; Papalos, J. The Bipolar Child. Broadway Books, 2006 Third Edition.

NIMH Website: nimh.nih.gov/publicat/bipolarupdate.cfm

Trillian's Depression Page. concernedcounseling.com/communities/bipolar/trillian/lithium_2.htm

Tillman, R; Geller, B; Nickelsburg, M.J.; Bolhofner, K; Craney, J.L.; DelBello, M.P.; Wigh, W. (2003). Life events in a prepubertal and early adolescent bipolar disorder phenotype compared to attention-deficit hyperactive and normal controls. Journal of Child and Adolescent Psychopharmacology. Fall; 13 (3): 243-1.

Wagner, K (2000). Childhood Bipolar Disorder. Psychiatric Times, May 2000, Vol. XVII, Issue 5

Wikipedia - Occam's razor. en.wikipedia.org/wiki/Occam's_Razor

Youngstrom, E.A., Findling, R. L., Calabrese, J.R., Gracious, B.L., Demeter, C., DelPorto Bedoya, D., Price, M. (2004). Comparing the Diagnostic Accuracy of Six PotentialScreening Instruments for Bipolar Disorder in Youths Aged 5 to 17 YearsJ. Am. Acad. Child Adolesc

Copyright June 2008. These articles cannot be used in any fashion without the explicit permission of the author, except for individual use.

Disclaimer: This information is not intended to diagnose or treat any condition, and is for the sole purpose of providing alternate perspectives. If you feel that a mental health condition exists in yourself or the person you are reading this article for, you are advised to seek out psychological or psychiatric services.

Jonathan M. Gransee, Psy.D.

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

Autism Therapy - The Various Types

One of the world's most popular developmental disabilities is autism. It usually affects the person's social and communication skills. There are some treatments for autism that can improve the patient's developmental growth. Many patients have, in fact, benefited from therapeutic intervention. Among the commonly used and well-known therapies are RDI or Relationship Development Intervention, ABA or Applied Behavioral Analysis, and DIR/Floortime.

DIR/ Floortime

Made by Serena Wieder and Dr. Stanley Greenspan, the writer of Engaging Autism, this approach is comprehensive and interdisciplinary. It focuses more on the child's emotional development. Such approach to autism intervention is said to be child-centered. It involves not just Floortime specialists but parents as well. They both have to meet at the child's developmental level and agree to use his or her strengths to be able to form new skills. Floortime can be included into the child's daily habit to make the learning process appear more natural.

Relationship Development Intervention

This approach, which is designed by Dr. Steve Gutstein, gives more attention to the quality of life. More than just teaching an individual with life and social skills, this program also promotes genuine relationships and self-empowerment and creates an ability to thrive in such dynamic world. Its website said that this intervention program is parent-based because they are given tools to successfully teach not just Dynamic Intelligence skills but also children motivation. Among the Dynamic Intelligence Skills are dynamic analysis, flexible problem solving, experience sharing, episodic memory, resilience, and self-awareness.

Applied Behavior Analysis

It is considered as a systematic approach to evaluating behavior as well as applying interventions that changes the person's behavior. Practitioners will not qualify as Board Certified Behavior Analyst without a Master's degree and without meeting some criteria. Such approach is science-based and can do well in helping individuals learn new skills and curb improper behavior.

Play Therapy

Originally, this therapy is made to serve as a tool to provide young people with psychotherapy to help them cope with mental disorders, trauma, and anxiety. In the said context, play helps children to act their feelings out and discover some coping mechanisms. Specialists who use play therapy to their patients are actually giving them something similar to Floortime Therapy. Play Project is an additional therapeutic approach utilizing play as an instrument for developing skills in children with autism.

Sensory Integration Therapy

Autistic children usually find it hard to combine their senses to be able to make sense of the environment they are in. A type of occupational therapy, sensory integration therapy puts a child in a room that's specially designed to test and stimulate all his or her senses. The therapist closely works with the patient to promote movement inside the room. This autism therapy works in four principles:

1. The patient has to be successful in meeting the challenges presented via playful activities.

2. The autistic child gets used to fresh and useful tactics in response to the presented challenges.

3. The child with autism is willing to participate because the presented activities are fun

4. The choices of the child are utilized to set off therapeutic experiences in the session.

Sensory integration therapy is created based on the assumption that patient is either under-stimulated or overstimulated by his or her surroundings. It hence, aims to enhance the brain's ability to process the sensory information, making him or her function well in all his daily chores.

I'd like to give you a FREE DVD (worth $97) on shaping your child's autistic behaviors. Click here to claim your FREE DVD today! We only have 250 DVD available, so hurry and get your FREE DVD today and start understanding and helping your child!

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

2011年12月29日 星期四

Autism Is A Disability Not A Disorder

These parents have to realize that Autism is not a disorder but just a disability that can be rectified. This disability causes various difficulties in brain functions and also the behavioral aspects of the children. For your child who is suffering from autism the whole world is strange and lonely, he needs your love and support a lot at this time. They need comfort and care so that they do not feel lonely in this strange world.

Autism does not have a permanent cure but it can be treated to ensure that the children who are affected by this autism can lead a normal life. There is occupational therapy and physical therapy to develop the individual's ability. Occupational therapy concentrates on improving their day to day works like wearing their shirt, bathing, combing their hair, tying a shoe lace etc. On the other hand physical therapy concentrates on using massage like therapies to improve the person's body movements. Other than this there are four other common methods of treating Autism, they are behavior modification, communication therapy, dietary modification and medications.

Behavior modification concentrates on making them good citizens by making their social skills and behavior polished. These include methods like sensory integration therapy and social stories to make these children understand how to behave in the public. Communication therapy includes making the individuals who are affected by this Autism to speak well or communicate through signs. The change of diet in the dietary modification is controversial as food is not found to a factor of Autism. There are some medications also that enable pacification of such Autistic children who sometimes go into an uncontrollable state. Again it is to be remembered that autism is a disability and not a disorder.

Hope Autism Service offer Autism Therapy & Autism Treatment for brain disorder that typically appears during a child's first three years and lasts throughout a person's lifetime.

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

7 Areas That Should Be Addressed in IEP's For Children With Autism

Do you have a child with autism, pervasive developmental disorder (PDD), or Asperger's disorder? Do you have difficulty getting special education personnel to listen to your input on what services your child needs?

Would you like a short list of areas that should be addressed at your child's IEP meeting? This article will give you 7 areas that need to be discussed at your child's IEP meeting; to determine what special education and related services your child requires, in order to get a free appropriate public education (FAPE).

Area 1: The nonverbal and verbal communication needs of the child

Impairment in communication can negatively affect a child with autism's education, and should be addressed, possibly by direct services from a Speech Language Pathologist.

Area 2: The need to develop social interaction skills

One of the characteristics of autism is that children have impairments in social interaction with other people. Children may need services in this area to help them develop appropriate social interaction skills.

Area 3: The needs resulting from the student's unusual responses to sensory experience

Many children with autism have sensory integration dysfunction that can have a detrimental affect on their education. Special education services may need to be given by an experienced trained SIPT qualified occupational therapist.

Area 4: The needs resulting from resistance to environmental change or change in daily routines

Rigidity in routines and resistance to change is another characteristic of autism spectrum disorders. Picture schedules and verbal notice to the child of change in schedules and routine, may help.

Area 5: The needs resulting from engagement in repetitive activities and stereotyped movements

Another characteristic of autism is the existence of ritualistic behaviors. Strategies can be developed to help your child decrease these behaviors.

Area 6: The need for any positive behavioral interventions, strategies, and supports to address any behavioral difficulties resulting from autism.

Many school districts still want to punish children with disabilities for negative behavior, even though IDEA requires positive behavioral strategies be considered.

Area 7: Other needs that may impact progress in education, and social and emotional development.

Some children with autism have medical needs, trouble with organization, executive function, and generalization. You should bring up any other area that causes your child to have educational need, and make sure that needed special education services are written in your child's IEP!

By addressing these seven areas in your child's IEP you will be able to determine if your child needs any special education services in these areas! Good Luck!

JoAnn Collins is the mother of two adults with disabilities, and has helped families navigate the special education system, as an advocate, for over 15 years. She is a presenter and author of the book "Disability Deception; Lies Disability Educators Tell and How Parents Can Beat Them at Their Own Game." The book has a lot of resources and information to help parents fight for an appropriate education for their child. For a free E newsletter entitled "The Special Education Spotlight" send an E mail to: JoAnn@disabilitydeception.com

For more information on the book, testimonials about the book, and a link to more articles go to: http://www.disabilitydeception.com.

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

2011年12月28日 星期三

A Parent's Introduction to Aspergers Syndrome

Aspergers Syndrome (AS) is in the category of developmental disorders of the Autism Spectrum Disorders (ASD) that is under the umbrella of Pervasive Developmental Disorders or PDD. It is different from Autism because there is not a specific delay of language or cognitive development, but does share the clumsiness (tripping, bumping, dropping things, etc.) aspects, although these are not particular to the diagnosis.

Why call it Aspergers?

It is named after Hans Asperger who, in 1944, described children in his pediatric practice who lacked nonverbal communication skills, were non-empathetic with their peers, and were physically clumsy. It is sometimes referred to as a high functioning autism.


Aspergers Syndrome is treated mainly through behavioral therapy that is designed to work on communication skills, social skills, coping mechanisms, and helping with obsessions and repetitive routines. Most people with AS learn to cope with their differences, but may need support and encouragement to maintain their independence.

A typical treatment program for a child with Aspergers Syndrome includes:

The training of social skills for more effective interpersonal interactions
Cognitive behavioral therapy to improve stress management relating to anxiety or explosive emotions, and to cut back on obsessive interests and repetitive routines
Medication, for coexisting conditions such as depression and anxiety
Occupational or physical therapy to assist with poor sensory integration and motor coordination
Social communication intervention, which is specialized speech therapy to help with the pragmatics of the give and take of normal conversation
The training and support of parents, particularly in behavioral techniques to use in the home

Kids with Aspergers don't usually share the withdrawn isolation of children with autism and will openly, but often very awkwardly, approach and engage others in social situation. However, their inability see things through others eyes, and the tendency to go overboard going on and on about their latest obsession, makes them appear selfish, uncaring and insensitive toward other people. This is not necessarily true, they just don't realize how they are perceived or that other people have different interests and feelings than they do.

Many of the children with Aspergers will actually memorize reactions in specific social situations, and recite definitions or examples of emotion, but have a very hard time acting on any of that knowledge in a real situation. Or they will use a rigid application of the specific social rules they have memorized. This can come across as forced eye contact, or the plastered on smile, or laughing at the wrong time. They want friends and do seek out social contact, but over the years their failures in these situations can be devastating.

Kids with Aspergers will sometimes develop very focused and intense interest in something or some activity, that will completely dominate their time and their life, almost to the exclusion of everything else, and they will try to draw whoever they can into the same interest. This is usually seen as normal childhood interest and behavior at first, until the obsessive qualities become apparent and problems relating to anything or anyone else starts happening.


The diagnosis uses the identification of the stereotypical and repetitive behaviors as a central part of how it is diagnosed, but confirmation is done by ruling out anything else that can cause the same symptoms. The motor behaviors that are observed are things like the hand flapping or twisting, complex whole body movements and walking on tip toes, repeating the same word or sound over and over again are all typical repetitive behaviors of AS.

Other Issues

Your child may display symptoms that aren't a part of an Aspergers Syndrome diagnosis, but still affect the child and your whole family. They may have perception difficulties, and problems with fine or gross motor skills, handling emotions, and difficulty sleeping. Many kids on the spectrum (Autism Spectrum) have trouble with SI, or Sensory Integration, and can be overly sensitive or under sensitive to sound light, touch, texture, taste, smell, pain, temperature and other things that stimulate the senses. It may feel soft and nice to you, but to them, it can be actually painful.

Children with Aspergers are more likely to have sleep problems, including difficulty in falling asleep, waking up often at night, and early morning awakenings. Aspergers is also associated with alexithymia, which means having problems identifying and describing ones emotions. My daughter certainly has emotions and feelings, but she has no idea how to describe them or even what they are, or why they are there. Very frustrating.

Special Education

Children with AS may require special education services because of their social and behavioral difficulties, although many attend regular education classes. Teens and tween with Aspergers may have difficulty with self-care, organization and disturbances in social and romantic relationship. They are usually very smart, but the inability to properly express and the awkwardness of social contact keep many from leaving home as adults, although some gain independence in work and domicile, even marrying and raising a family. Teen and preteen years are hard enough on kids without social difficulties, but can be very traumatic for a kid dealing with Aspergers.

Coexisting Conditions

Anxiety with AS is very common, and is usually centered on change or transition. That is why a consistent schedule is so important. Anxiety and stress during social situations is inevitable because of the constantly changing nature of humans and relationships and situations, there isn't a single right thing to do in every situation. Stress and anxiety will show up usually as a behavior, such as withdrawal, an obsession, hyperactivity, or even aggressive or oppositional behavior.

Depression, and other mood disorders, can be the end result of the constant stress and frustration of failing to properly socialize and make friends. Medication and behavior therapy can be used to deal with co-existing problems such as anxiety, depression, inattention, obsessive compulsion, and aggression.

Getting the family involved by helping them to understand what is going on with their child or brother or sister, will have a big impact on the child's future. It will also help with being able to deal with everything that is involved in dealing with a child with Aspergers Syndrome and bring some semblance of normalcy back to the family. Getting help early and involving the whole family as a built in support system has the best effect on long term outcomes for a child with Aspergers Syndrome.

Judson Greenman, advocate and father of four very special girls started these websites as a way of sharing the joys and challenges of Raising Special Kids - from one parent to another. See it all at http://www.my-special-kids.com and http://www.anieleirose.org

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

Attention Deficit Hyperactivity Disorder - What Criteria to Use When Deciding Treatment

When it comes to treatment for attention deficit hyperactivity disorder, many parents are at a loss as regards which treatment options to go for. Very often, they do not ask the right questions about the powerful mind altering drugs which are prescribed in tons across Europe and America. This article should help you to decide on what criteria to adopt before deciding which treatment is right for your child.

The first criteria to take into consideration is to see if the treatment you choose will affect your child's sleep in a positive or negative way. Many of the psychostimulants such as Adderall XR, Ritalin and Celexa have some side effects as regards sleep challenges and leave many children with a sleep deficit. This has a knock on effect at school and interferes with daytime functioning.

Hasbro Children's Hospital (Providence RI) recently carried out a survey. When psychiatrists and child psychologists were asked about how many children were suffering from insomnia in their care, the numbers were very high. In preschoolers it can be as high as 20%, while in school kids this rose to about 33%.

If your child is suffering from sleep challenges because of the medication he is on, it is high time to reconsider and find alternative treatment. Otherwise it means that more prescription drugs are given to solve the sleeping problem and this leads into a downwards spiral where too many drugs are given to children. There are other ways of treating attention deficit hyperactivity disorder.

The second criteria when selecting the right ADHD treatment for attention deficit hyperactivity disorder, is to make sure that child behavior modification is an integral part of the treatment. Pills or medication will never teach social, learning or coping skills! This is recommended by the NIMH who say that medication must be combined with behavioural therapy or effective parenting skills. This is also supported by the research carried out at the University of Buffalo.

The third criteria in selecting treatment for ADHD is to ensure that the lifestyle changes you employ are actually compatible with your ADHD child's condition. For example, make sure that crowded places such as shopping malls are reduced to a bare minimum. As ADHD children suffer from a sensory overload, noisy environments are more than likely to lead to a meltdown. The answer is to increase green time activities. You can help an ADHD child by breaking down tasks and routines. There are ways of preparing for bedtime which will induce better sleep such as winding down time before bed. The computer is NOT the way to do that. TVs and computers off an hour before bedtime are great ways to enforce this.

The bottom line is to choose an attention deficit hyperactivity disorder treatment which will cause your child the minimum of discomfort in side effects. You can also ensure that the lifestyle changes and routines actually are helping him to grow and develop into a happier and more confident child.

Why not check out my website below for more ideas. You will be so glad you did!

Yes, you CAN raise happier, calmer and better behaved children. Discover more info on attention deficit hyperactivity disorder and how the selecting the right treatment can turn your child around.

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

2011年12月27日 星期二

Combating Visual Perceptual Disorders In Autism

Visual perceptions can affect a number of kids that have autism and you should not assume that all autistic children are affected in a certain way since autism can cause unique type of symptoms in different child.

Do your best to match the most accurate remedies according to the signs that is shown in your child.

With the case of visual perception, there are methods available out there for your child to use which can effectively improve their condition. Those approaches let them view the world in a new light thus making learning and understanding of situations smoother than before.

At the same time, utilizing those tactics can possibly control behavioral issues that are associated with autism.

People who have their sensory easily overwhelmed and distorted are also common among the population that are not suffering from autism. This characteristic have brought about many studies on it and over the years there are multiple treatment options that is being made available.

For autistic individuals, they usually discover that the sensory overload that are generated by lights, colors, contrast, shapes and patterns is simply too unbearable and this is the reason why you see them acting out or totally isolating themselves in general.

Complication of the sensory could be due to a genetic condition and what autism did is to naturally enhance it.

What this mean is that if the parents have problem with reading or been treated previously for visual perceptive issues, then the child would almost certainly need help too.

One practical way of treating visual-perceptual disorders is by using the Irlen Method. In a nutshell, this process takes color and then use it to achieve a better harmonized surrounding.

Helen Irlen had pioneered the studies of visual perception and is credited with the discovery of Scotopic Sensitivity Syndrome (SSS) or also known as Irlen Syndrome.

Have you ever heard of suggestions that improve the speed and technique of your reading by placing a color filter over the page? If you do, then you will comprehend better what the Irlen Method can achieve.

Studies have shown that this method does work. The result can be seen exceptionally well if your autistic child's level of reading is at the intermediate stage.

The idea is to use the color filters and then evaluate whether there is any improvement in reading speed and comprehension. The wave length of lights that are causing discomfort must be eliminated.

Sensitivity to the wrong light or color can lead to fatigue, strain and an environment with higher distortion. Offending colors can be filtered by observing for any positive changes and then implementing the color that works with the individual at all time.

Please keep in mind that the technique require a bit of trial and error effort since you need to determine which color is the one that is is blocking the undesirable light.

Different child will respond differently to the various colors.

The usage of these color filters will usually take place throughout their life. Yearly evaluation is needed to determine the effectiveness of the colors because fading colors means fading benefit.

Other than reading, you may apply it to copying, handwriting or during usage of computer.

Another thing to take note is that your autistic child would probably appreciate the usage of the color filters during the entire day instead of only when reading. There are glasses designed especially for this purpose by having colored lenses.

Beside the filters and lenses, you can also consider using colored light bulbs within the surrounding of an autistic persons who have visual perception condition. A wonderful application to this is when your child is too young with limited language capability thus by observing for any difference in behavior could mean an indication of a problem.

An important aspect to remember here is that an individual with visual perception disorder will prefer and feel more comfortable with indirect natural lighting or incandescent lighting. Avoid fluorescent lightning and maintain a dimly lit room instead of bright.

There are 4 main criteria that the above approach will benefit your child namely depth perception, social integration, education and their physical wellness.

Depth perception is improved when the right colors assist the child to establish how near or far they are from a certain object. Their world will turn more three-dimensional.

In the area of social integration, the autistic child will feel more relaxed. This will give them a conducive environment to clearly interpret expressions on the faces of people around them.

Uncomfortable feeling like light-headedness and headaches can be greatly reduced while reading and the child will feel more motivated during learning session.

All this contribute to them being less stressed out so that their physical well being can develop properly.

There are clinics and professionals all around the world that have been certified in the Irlen Method. Help your child deal better with their autism by carefully testing this method or any other technique and minimize their visual processing problems.

Danial Dawood is involved with various companies and individuals in the area of information management and unique learning resources. If you are struggling to find out more about autism [http://www.usfreeads.com/766497-cls.html] and all you get are those that seems to be written for doctors, outdated and contains only part of the information, then you need to take a look at this complete guide for autism.

Develop a workable plan and put your mind at ease, visit here for more info [http://www.usfreeads.com/766497-cls.html].

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

4 Proven Ways to Trade in Turbulence For Peace With the ADHD Child

What does flying on an airplane and parenting a child with ADHD have in common? Sooner or later you are bound to experience some turbulence.

There are many parents who struggle with children with behaviors common to Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder (ADD/ADHD), Oppositional Defiant Disorder (ODD), Reactive Attachment Disorder (RAD), Post Traumatic Stress Disorder (PTSD), Attachment Disorder and sensory integration challenges.

While it may not be apparent, these children tend to be naturally sensitive in nature and often act out what they feel. They are usually gifted, intellectually, intuitively, artistically or in other ways. Because of this they can also be known as spirited children. When parents understand the true nature of their child from this perspective, it allows them to more easily help their child assimilate in the world and be successful.

Some of the turbulence parents may experience when parenting a spirited child includes: hyperactivity, emotional outbursts, sibling fighting, lack of focus, arguing and lack of cooperation. With airplane turbulence, there is little you can do about it, except avoid flying. As a parent, there is something you can do.

Spirited, sensitive children have the equivalent of a built-in energy sensor. They quickly detect when they receive more attention, energy and emotions from parents and teachers. It can be easy for a child who tends to be more needy, sensitive or intense to unconsciously decide that he or she gets more 'juice' and things are more exciting when engaged in negative behavior. The child can presume this even if his or her parents or teachers have good intentions, unless they know techniques to override this. When this pattern is repeated over and over, it can become deeply ingrained. The spirited child can even become addicted to engaging in negative behavior in order to get the 'juice' and attention they seek.

Utilizing techniques based on the Nurtured Heart Approach developed by Howard Glasser can override these negative behavior patterns. When the parent gives encouraging feedback and applies other techniques of the approach, he or she provides the child with direct experiences of success. They do this in an innovative way that the spirited child can integrate on every level - mentally, emotionally, physically and spiritually.

Instead of struggling with the intense child, parents and teachers can transform the behaviors of the spirited child into new positive patterns. This is accomplished by giving the child heartfelt frequent feedback that focuses on positive choices and behaviors.

When encouraging feedback is consistently given in a way the child can absorb, the child begins to build his or her internal reception of it. This creates new positive patterns for successful choices. Through this process the spirited child also regains trust in his or her decision-making and abilities.

Some of the feedback includes:

* Noticing and describing in detail what the child is doing when nothing is going wrong. For example: "Johnny, you are really focusing intently on that book!"

* Teaching the child important values like good manners, respect, and good attitude by giving acknowledgement and appreciation when the child expresses nuances of that quality, not when the child has made a mistake.

* Actively letting the child know when the rules are not being broken. Enthusiastically articulating when the child is not hitting, not arguing, not yelling or teasing. This is a powerful way to teach rules when the child is more open to listening.

* Clearly making requests to the child specifically and directly. Using the phrase 'I need you to...please.' or "You need to... " to obtain the child's cooperation for completion of a task. Then give specific appreciation to the child for completing or even moving in the direction of completing the request. For example "I appreciate you putting your shoes away so we can have a floor that is clean and clear to walk on. That's cooperation!"

Additionally, having specific rules, boundaries and unwavering consequences are other essential components for sustainable success. The spirited child's first-hand experiences greatly help to build his or her confidence and cooperation. They serve as an important foundation for the child to repattern negative behavior so that the child can learn how to channel his or her energy into positive pursuits. By providing these learning opportunities, you are teaching your child to embrace and use his or her intensity as a gift on many levels. It is then that the spirited, sensitive child can be at peace with himself or herself, within the family and the world.

Tami Gulland is author of "Embracing Your Spirited Child: A Transformational Guide for Parents of Children with ADD/ ADHD, ODD, PTSD and Attachment Disorder." She is also the founder of The Center for Family Love. The Center for Family Love is an online resource with a mission to serve parents of sensitive and intense children to restore harmony at home and create healthy, heartfelt connections.

To learn the secret to creating real harmony with your child and the hidden factor impacting your child's behavior, visit: http://tamigulland.com/bonus/subscribe_ep_bonuses.html

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

5 Reasons Why Your Child Receiving Special Education May Be Misbehaving

Does your child with autism have increased behavioral difficulty at school? Do you sometimes wonder, why your child misbehaves at certain times of day at school, or while doing certain activities? To determine what your child is receiving from the behavior a functional behavioral assessment (FBA) must be conducted. But this article, will give you a few things that could be causing your child's behavior.

Reason 1: Your child could be having difficulty with their behavior, due to a health concerns. When my daughter Angelina was younger she would have behavioral outbursts that seemed to be tied to not feeling well. I would take her home, she would go to bed, and wake up and do just fine.

Also if your child has seizures, the behavior could be seizure related. Keep track of the behavior and check with your child's doctor, if you think there could be a health reason for the behavior.

Reason 2: Many children with autism or other disabilities have sensory integration dysfunction; which can negatively affect their behavior. Some children misbehave, because they are wanting, sensory stimulation. Or some children are trying to avoid sensory stimulation.

You can learn more about sensory integration dysfunction, by reading a book about the disorder. Or search the internet for treatments and things that can be done in the classroom to help your child.

Reason 3: Your child could be trying to escape hard academics, or a situation that they cannot handle.

Investigate and make sure that your child is being taught academics at their level so that they do not get frustrated.

Reason 4: Some children misbehave because they are trying to get attention, from other students or special education personnel.

Reason 5: If your child is not receiving an appropriate education in the right type of placement, they may experience a lot of behavioral difficulty.

When my daughter Angelina was younger, she would throw herself on the ground to avoid hard academics. Also if a child is unable to learn academics, it might be time to consider functional skills training. In my advocacy I have seen many children positively respond to functional skills, without behavior. Angelina also responded very well to increased functional skills training rather than a focus on academics.

By learning if any special circumstances are causing your child's behavior difficulties, you will be able to try some different things to see if they help! Good Luck!

JoAnn Collins is the mother of two adults with disabilities, and has helped families navigate the special eduation system, as an advocate, for over 15 years. She is a presenter and author of the book "Disability Deception; Lies Disability Educators Tell and How Parents Can Beat Them at Their Own Game." The book has a lot of resources and information to help parents fight for an appropriate education for their child. For a free E newsletter entitled "The Special Education Spotlight" send an E mail to: JoAnn@disabilitydeception.com For more information on the book, testimonials about the book, and a link to more articles go to: http://www.disabilitydeception.com

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

2011年12月26日 星期一

Confused About Early Childhood Development Milestones?

Early childhood development is the foundation to everyone's life. Nevertheless, each child has their own personalities and ways about them as well as similarities such as meeting developmental milestones in a relatively similar time in their lives from talking to walking.

Doctors tell parents not to compare their child with other children according to their early childhood development. One child might start walking at nine months and one might be 14 months. Both could be healthy yet have their own time schedule. Often children are around a year old when they are walking or at least starting to walk.

Taking notice of early childhood development is important though. If a child continues to miss milestones and aren't meeting early childhood development there could be a problem. This is why doctors are parents observe these things. Talking, crawling and other important elements are important parts of development. Doctors will monitor a child. It could be the child is not sitting up on schedule, but they are doing other things related to gross motor skills, such as crawling and rolling over. It could be a sign of something or it could be the child is just skipping that part of development then it will come in eventually. Otherwise a child continues to be monitored and eventually tested to ensure they don't have a disorder or condition that needs treatment.

Another part of early childhood development is fine motor skills. This includes the movements of their fingers, toes, lips, tongue and hands as well as their feet. Sometimes it might be something small that a parent doesn't even notice could mean anything. An example is walking on their tiptoes. Doing this a little is normal, but constant tiptoe walking could indicate an issue. Giving complete answers to every question presented by the doctor and the nurse will help determine if there are any early childhood development disorders that need immediate attention.

Any child with a neurological disorder or sensory integration dysfunction can hear properly but process the information differently leading to confusion. Such children are hypersensitive or insensitive to any of the five senses or with all of the senses. Most of the early childhood development disorders are diagnosed by an occupational therapist, especially sensory processing disorder.

Speech skills and articulation are also parts of early childhood development. Your baby won't be able to answer questions with words as they are still learning about speech. Parents are suggested to talk to their baby. They will learn to answer you even if it is only in babbles now then it will continue to actually words when getting older. A baby can articulate, even if they are not making words they are starting to make clear sounds, which leads to speech. Once they understand the proper sounds by listening they will be learning the correct pronunciation of every word. However, each child is different and may reach the required milestones within a flexible range of 3-4 months and sometimes that is what makes the diagnosis about late development so difficult.

For the latest videos and training information on child development as well as books and curricula please visit www.childdevelopmentmedia.com .

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

How to Spot Autism in Your Child and Manage It

Autism Spectrum Disorders include a number of chronic, no progressive disabilities characterized by lack of social interaction, communication, and behavior. Autism, pervasive developmental disorder NOS, Asperger disorder, childhood disintegrative disorder, and Rett disorder are all encompassed into the Autism Spectrum of Disorders.

Characteristics of Autism Spectrum Disorders

Limited eye contact and facial expression
Difficulty developing peer relationships
Indifference to social overtures
Lack of social reciprocity
No engagement in pretend play
Impaired reciprocal communication
Language development delayed
Persistent question asking and repeating
Restrictive, stereotyped patterns of behavior
Repetitive, self-stimulatory behaviors (rocking, spinning)
Preoccupation or fascination with a single object or subject


Autism is more common in males and is usually diagnosed between 8 months and 3 years of age. Lack of attachment to mother during infancy is often present. It was believed in the past that MMR vaccine or thimerosal (vaccine preservative) causes autism, but current data research shows no link between MMR vaccines and autism. It is now more commonly believed that autism is caused by multiple environmental factors. The essential features of autism are impaired social interactions and communication. Restricted group of activities and interests, with stereotyped behaviors, rituals, or mannerisms. Siblings of children with autism appear to be at greater risk of developing the disorder.

Pervasive Developmental Disorder NOS (Not Otherwise Specified)

Pervasive Developmental Disorder NOS is the diagnosis given to children who have symptoms such as impaired social interaction and communication skills and/or repetitive, stereotyped behaviors, but with a symptom profile that does not meet diagnostic criteria for autism.

Asperger Syndrome

Asperger syndrome is characterized by difficulty forming relationships/relating to others and development of intense interest in very specific topics. Asperger does not necessarily need to have impaired language production, but very often these children do not understand abstract forms of language such as sarcasm and metaphors, and as a result have a hard time forming interpersonal relationships.

Childhood Disintegrative Disorder

This disorder is characterized by normal development up to the age of 2 years, followed by loss of previously achieved language, social, and motor developmental milestones. Affected children may show disordered communication and social interactions and may have repetitive movements or stereotypes. Loss of skills must occur before 10 years of age.

Rett Disorder

This is an x-linked disorder that occurs only in girls, as boys usually succumb to the disorder in utero and die. The children in this disorder develop normally until 6 months of age and begin to exhibit symptoms of autism, language delay, psychomotor retardation, decreased head growth, breathing abnormalities, seizures, and poor coordination of gait and trunk movements. Mutations in the MECP2 gene are strongly associated with Rett Disorder.

Management of Autism Spectrum Disorders

The management of autistic disorders is most successful when a multidisciplinary approach is adopted. Intensive behavioral and sensory integration therapy, speech and language training therapy, social modeling, family support, and pharmacologic intervention all must be undertaken as soon as diagnosis is established, although not much evidence exists that shows pharmacologic therapy with antipsychotic (risperidone and aripiprazole) helps these children, but research is currently under way to develop pharmacologic drugs for treatment of autism. The best prognostic indicator of future success in these children is the extent of language development present. The earlier that treatment begins, the better are the chances for the child to live a normal life.

Copyright c 2010 - Yana G. Yevstegneeva, 3rd-year Medical Student. All Rights Reserved Worldwide.

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

2011年12月25日 星期日

Eating Disorders, Hypnotizability, and the Use of Hypnosis as a Part of the Therapeutic Process

Hypnotizability in eating disordered populations can be viewed as a personality trait as well as ability. In addition to hypnotic performance, in the literature hypnotizability correlates with eating disorders. In eating disordered populations, bulimics are significantly more hypnotizable than anorexics; anorexics of the purging subtype generally are more hypnotizable than restricting anorexics.

In one study, researchers found that 73% of 30 bulimic patients were moderately to highly hypnotizable. They also studied hypnotizability in bulimic populations and confirmed previous findings of hypnotizability in this population. In another study of bulimic patients, researchers found that bulimics were highly hypnotizable when compared with other psychiatric patients and show high dissociative ability. High hypnotizables are hypersensitive to psychological and physiological changes. They generally have superior sensory memory and have a superior ability to transfer information from sensory memory to short term memory. This ability could be used to rapidly learn and retain operant anxiety. This is the possible reason that bulimics find strong emotion or feelings intolerable for them.

In 1986 H. M. Pettinati reported that having the ability to experience dissociation may be a relevant factor in regards to the high hypnotizability found in bulimic patients. Clinicians have compared the acts of binge eating and purging to dissociative experiences.

In another group of 30 bulimics, 75% had experienced dissociation. Dissociation has not been found to be a feature of anorexia nervosa of the restricting type. Researchers found higher scores in bulimics and purging anorexics on the Dissociation Questionnaire (DIS-Q. They reported that hypnotizability and dissociation can be related to body image distortion which is common in both anorexia and bulimia nervosa. An individual who is highly hypnotizable can easily absorb or internalize the messages from society that promote a slim body shape as the ideal. This is the factor that is known as suggestibility. Internalization of the thin body ideal leads to body dissatisfaction.

Both anorexics and bulimics have been found to have equivalent body image disturbances; both populations overestimate their body size. This population utilizes restrained eating as a strategy to meet societys ideal and also to reduce negative affect.

Many anorexics are of low hypnotic ability and as a result they frequently demonstrate a hyposensitivity to psychological and physiological changes, a tendency to deny psychological causation of behavior, and a propensity to remain in denial of the severity of their illness. The anorexic that is low in hypnotic ability is subject to stress disorders because he or she is relatively insensitive to or deficient in attention to relationships between psychological states and physiological states. They have a psychological insensitivity to changes in mood and feelings. They have a lack of proprioceptive or interoceptive awareness which means they lack the ability to discriminate between different feeling states in the body, such as being hungry and being full. Many anorexics are alexithymic, meaning they have no words for moods.

Clinical hypnosis can be one of the most effective interventions in the treatment of eating disordered clients. Rapport must first be established as clients can view hypnosis as something that is going to take away their perceived control. Relaxation is the best place to start. Teaching relaxation techniques while the client is in an altered state is not only effective but also helps the client intensify the transference with the clinician. Hypnosis can be used to build ego strength and used in ego integration, to modify eating disordered behaviors, to alter body distortion, to teach sensitivity to being hungry and full, and age progression. Age regression should be used rarely and then only by an experienced hypnotherapist as many underlying issues may surface before the client is ready to deal with them.

The addition of clinical hypnosis by a skilled professional greatly enhances the treatment of an eating disordered client. Clients find that hypnosis actually helps them regain control and maintain a healthy weight.

Jeanne Rust, PhD is the CEO and Founder of Mirasol, a treatment program for women and teens with anorexia, bulimia, obesity, and binge eating disorder. Her treatment philosophy is integrative combining the best of the medical model of treatment with the most effective alternative ones. Learn more about eating disorders at http://www.mirasol.net

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

Autism and Alternative Treatments - 6 Natural Approaches That Can Help

When treatments for Autism are being considered, medication is usually first attempted. For many reasons, including concerns about the side effects of medication, this is changing. More people are searching out natural solutions. Here are some alternative treatments used for Autism.

Autistic children are often sensitive to certain foods. Behavioral problems or meltdowns can occur when these foods are eaten. Sometimes just very small amounts trigger the symptoms. Some diets that have been used to help treat Autism include gluten-free and dairy-free. Rotation diets may also be used to identify the triggers.

Omega 3 Fatty Acids

Omega 3 has been found to be helpful in treating Autism, as well as many other disorders. Omega 3 supplements are claimed to aid in better quality sleep patterns, improved social interaction, and general health and well-being. The most potent forms are found in fish oil which is available in capsule or liquid form. There are many brands which have enhancements that reduce, conceal, or remove the fishy taste.

Music Therapy

Several studies have found music therapy to be very beneficial to the Autistic child. Sometimes an Autistic individual will sing along with music even though they will not speak. Music therapy can be used as a calming tool or a way to help the Autistic person work on skills such as speech, muscle development, or sensory issues. The music can also be beneficial in social interaction through group activities.

Sensory Integration

Autistic individuals can be very sensitive to sounds, tastes, textures, and smells. Sensory integration therapy helps the child to deal with these heightened and often overwhelming responses to their own senses.

Speech Therapy

Speech therapy is important for any child with Autism. Children with Autism usually misuse words, and they often have difficulty understanding the meanings of words. Speech therapists can help teach gestures and communication skills to nonverbal children and can recommend special equipment to help your child communicate.

Play Therapy

Play therapy can be a very useful treatment. Play therapy allows the child to relax and focus on things they enjoy. A therapist will play on the floor with the child and will give the child various toys to see if the child takes a liking to one of them. If the child begins to play the therapist will then try to interact with the child.

After the therapist has formed a relationship with the child they might include other children into play therapy. This can open doors for the child to interact and increase their ability to relate with others. Usually a therapist does the play therapy, however the parent can engage their child in the therapy after they have learned the techniques used.

These are just a few of the many alternative treatments available for Autism. They can also be combined with medication to build a better treatment plan.

There are so many unknowns when it comes to Autism. Gaining knowledge is so very important. You may find http://www.myautisminfo.com to be a helpful tool. http://www.myautisminfo.com has articles, videos and other resources to help you grow in knowledge and understanding of the different issues surrounding Autism.

by Deborah Lee

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

較新的文章 較舊的文章 首頁