Sensory Integration Disorder: Children

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2012年10月15日星期一

What on Earth is Happening to Our Children? A Therapist's Perspective on a Cultural Change

Beginning my career in the early 1980s, I was employed by a public school system to provide speech and language therapy to school aged children within the setting and the time of school attendance. The problems that children displayed those 25-plus years ago would seem to fit into what I would refer to as "traditional" speech and language therapy. By this I mean we saw children who had problems with articulation (the way that sounds are formed into words), deficits in language knowledge and usage (the understanding and expression of the system for encoding and decoding communication information), difficulties in using fluent speech (stuttering), and disorders of the voice (the quality and attributes of the vocal system). Certainly we had a wide severity range for these areas of difficulty, however the number of disabilities that are now diagnosed and treated in comparison to then is mind-boggling!

In today's culture we see a tremendous increase in the incidence and severity of more and more disorders and disabilities. We see comprehension problems, learning with disabilities, attention disorder, Sensory Integration Disorder (SID), Dyslexia and Alexia, and many more. Another increasing disorder is Autism. Let's look at this disorder in detail. In 1980, autism was considered a rare disorder, with an estimated 2-5 per 10,000 people. In 1999, the California Department of Developmental Services issued a report entitled 'Changes in the Population of Persons with Autism and Pervasive Developmental Disorders in California's Developmental Services System: 1987 through 1998' which reported a 273% increase in DSM-IV full-criteria autism cases enrolled in their program during that 10 year period of time. Currently, 1 in every 150 children will be diagnosed with autism, a disorder that brings heartache and chaos to basic family dynamics.

As noted earlier, my career began in a public system setting where I traveled between several different schools to provide speech and language therapy to school aged children. At that time, there was only ONE diagnosed case of Autism in the WHOLE school system, and I was assigned to his case. Today one will find numerous diagnosed cases of Autism in every school! One may wonder what is happening to cause such a dramatic increase in this relatively new disability. As a therapist, I have not only noted the unprecedented increase in the diagnosis of autism or one of the various diagnostic labels that fall within the autism spectrum, but also a broader classification system for the diagnosis. The "picture" of the typical autistic child has made dramatic and wide range changes in the years since beginning in the field of speech and language therapy. An extensive review of the medical, professional, and autism interest group literature results in a wide diversity of opinion and explanation to the apparent escalating rise of autism. One will find an extreme pivotal range from the most traditional and conservative to the most transitional and holistic of theory. There are the ones that state that autism has no cure, while others claim that there is a complete and definite cure.

Many medical professionals will explain it as a way of "better diagnoses" or a change in genetics. Some will blame the Measles-Mumps-Rubella vaccination given to children around their 15-16th month. Others believe it to be a problem of toxins and chemicals found in the foods eaten and the air breathed. Other less common causation theories exist as well. Trying to formulate one's own concrete opinion, given the variety of theories, can be quite confusing.

When we really look at our culture over the past 25 years, many changes have occurred. Our lifestyles and living habits are vastly different. We are now "high-speed" everything: Internet, cell phones, microwaves, drive-through eating, etc. In 1940 processed food constituted only 10% of the American diet, whereas today's diet is 90% processed. A 2005 report issued by the USDA stated every person should consume between 5 to 13 servings of fresh vegetables and fruits daily. But what is the average American person of today feeding their body? A recent national survey indicated that 40% of American people eat NO fresh fruits and vegetables on a daily basis! In knowing that, is it a wonder that we have a rise in health, learning, and developmental disabilities as we do in this country? Illnesses such as cancer; learning disabilities such as dyslexia; and developmental differences such as autism.

So, in summary, what is happening to our children and to our culture? Why are more and more children diagnosed with medical, emotional, and/or learning disorders? Are the modern advances and conveniences in our culture contributing to weaker minds and bodies? These are very big questions, ones I cannot confirm or deny. But one thing is certain - changes are happening with our children.

As a Speech/Language Pathologist of over 26 years and having practiced in a wide variety of therapeutic settings, Lucy brings to her clients a diversity of patient care knowledge. For the past 12 years, she has specialized her practice in the area of processing disorders and remediation of learning impairments, and she has a passion in seeing her clients succeed in their communicative and learning skills. Lucy now desires to extend the knowledge she has gained in processing and learning remediation to as many children as possible to enable them to reach their full learning and communicative potential in life. To view more of her intervention with children and gain knowledge in how to better assist struggling learners, please visit http://www.learningsolutionsathome.com.

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2012年10月11日星期四

5 Effective Special Education Methodologies For Children With Autism

Do you have a child with autism, pervasive developmental disorder, or Aspergers Syndrome? Have you been searching for specific methodologies that could benefit your child's education? This article will discuss 5 that are proven to help children with autism learn.

Curricula that are used to teach children are required by law to be research based which means that they are proven to work to teach children. The problem is that many school districts are sticking to antiquated curricula and methodologies, rather than looking for research based ones.

Below is a list of 7 that you can ask for to benefit your child's education:

1. Applied Behavioral Analysis has been researched since 1987 and is proven to help children with disabilities learn. ABA is intense 1-1 from 25-40 hours per week. Children are taught skills in a simple step by step manner such as teaching colors one at a time. ABA is extremely expensive; between $35,000 and $50,000 per year. For maximum benefit the child should start as close to age 3 as possible and continue for at least 4 years. Many states are beginning to cover autism treatment, so check and see if your state is one of them.

2. Reading should be taught using a multisensory reading instruction that is Orton-Gillingham based. Make sure that any teacher that teaches your child has received the appropriate amount of training. Also make sure that they are giving your child direct instruction, for the amount of time that the reading system prescribes. Many school districts may use a good multisensory reading program, but do not train the teachers, and do not give the child direct instruction for the prescribed amount.

A few names of multi sensory reading programs are: the Barton Reading and Spelling System, Lindamood Bell system, and the Wilson reading program.

3. Social Skills can be taught by using the SOS system (Social Skills in School) by Dunn. Also Building Social relationships by Bellim, or Social Skills interactive software. A new method for teaching children how to develop relationships is called the Relationship Development Intervention.

4. For Central Auditory Processing disorder there are several effective methods available; Fast ForWord, Earrobics, and Berard Auditory Integration Training (called Berard AIT). Also make sure that the method used is used for the correct amount of time, or progress may be minimal.

5. For children with sensory integration disorder there is a program called the Alert Program: How Does Your Engine Run? Occupational therapy is also used for children with sensory integration dysfunction (SID-which most children with autism have). If your child is receiving occupational therapy for SID, make sure that the schools OT has the correct training, to deal with sensory integration issues. Ask for proof that they are SIPT qualified, before they are allowed to work with your child.

By knowing these 5 methodologies you will be well on your way to helping your child with autism learn. The internet can be used to find more information on those methods that you feel will help your child. 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

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Welcome Children With Autism on Your Playground Using These Simple Planning Tips

When designing a playground to include children with autism, you must understand that there is a spectrum of severity and every child is different. Some children have a more moderate type of autism, while others will have more severe symptoms. There are other diagnoses on the spectrum, most commonly Asperger's Disorder and Pervasive Developmental Disorder. Some researchers even put ADHD and ADD on the spectrum. Despite the differences along the spectrum, there are common symptoms between people with autism and one of those is that 95% of people diagnosed on the spectrum have Sensory Processing Disorders.

Dr. A. Jean Ayres is generally credited with developing both a theory of sensory integration dysfunction, now called Sensory Processing Disorder, and the therapeutic interventions for children who have it. Her work emphasizes the importance of three of the senses: tactile (the sense of touch), vestibular (the sense of movement and gravity), and proprioceptive (the sense of how our body works (muscle and joint information).

People with Sensory Processing Disorders maybe hyper-responsive to sensory input meaning they overreact. While other people maybe hypo-responsive to sensory input meaning they under-react. In many people it is a combination of both. This leads us to the fact that every child is an individual. Therefore, just like every other child, children with autism react differently and enjoy different activities on the playground. However, we can take some information about the three senses talked about above and make some general observations of what should go into a playground that actively welcomes children with autism.

1. The playground should be fenced so that when a child feels the need to flee from over-stimulation, he isn't able to leave the area.

2. The playground should include nature: gardens, grassy areas, trees, etc. Recent studies from University of Illinois found that a walk in nature helps children with ADHD stay attentive.

3. The safety surfacing must meet or exceed all guidelines. Children, who do not feel their senses strongly, may want to climb as high as they can go and jump off. The intense fall enables them to feel the impact. They may not recognize the danger so it is important that the safety surfacing material is maintained on a regular basis.

4. There should be quiet areas where a child may go to regroup when she is over stimulated. This quiet area can be made through landscaping or the use of playground equipment, such as a playhouse.

5. The playground equipment should be spaced a little further apart enabling the child to play without touching or being touched by another child.

6. There should be playground equipment that swings, goes around in circles, and enables children to climb and jump. These activities help children with both their vestibular and proprioceptive systems.

7. There should be equipment such as monkey bars where a child can hang. This puts pressure on their muscles and joints and helps to develop the proprioceptive system.

8. Parents who are raising children with autism often talk about how much their children like to slide, so it is important to keep slides in your playground. You might want to include different types of slides since different types of slides often provide different sensory input.

9. For tactile input, sand and water activities work well. You might want to include a very large sandbox, where a child could cover himself with sand. The weight of the sand will calm some children.

10. There should be play activities that the child can do by himself, while keeping out of the major line of traffic. Play panels such as tic-tac -toe, or a marble maze, often can meet this need.

11. Children with autism often need to work on where their body is in space. Crawling through tunnels is a good activity for this. It may be important to have windows in the tunnels for the caregiver to watch and provide assistance if needed.

These are some beginning thoughts for designing a playground for children with autism. But as always when planning a playground it is important to have members of your community involved in the planning. Some people you might want to include on your planning team to ensure you get good feedback on the needs of children with autism are parents (especially parents), Occupational Therapists who specialist in Sensory Processing Disorders, and Physical Therapists. You may also want to find a few children with autism that are willing to give you their input as they are the ones who will be using the playground.

When the needs of children with disabilities are taken into account at the beginning of the design process, you end up with a playground that can be enjoyed by everyone in your community.

Mara Kaplan is a play expert with 15 years experience in play space design and operations. She is currently conducting research on what parents who are raising children with autism want in a playground. Give your input by completing a short survey
Click Here to read more about Mara's thoughts about playground design guidelines for children with disabilities.

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2012年10月9日星期二

How Autism Impacts Communication, Social Interaction And Learning In Children

Communication:

Speech is slow to develop in the child with Autism or does not develop at all. Words, if used, may be used out of context or without the intent to communicate at all. Children with Autism may echo the words of others without appearing to understand their meaning. They may use words and then 'lose' them. They make infrequent eye contact and rarely understand or use gestures.

Social:

Children with Autism have difficulty interpreting and using language for social interaction; their motivation to interact is affected and their social use of language is impaired. They may appear indifferent to affection and lack social responsiveness to the interests, needs and feelings of others. They may seek social contact in unusual ways and prefer to be alone rather than in the company of others. They may be unresponsive and may only tolerate approach from people very familiar to them. They are usually unaware of social rules and have difficulty taking turns in games.

Interests/ behaviours:

Children with Autism may respond to objects in unusual and repetitive ways and show intense levels of interest in one area. They are unable to understand that an object may be used for another purpose other than the one they know. Their patterns of play and movement may be ritualised and they may have vocal rituals that involve unusual sounds and/or nonsense words. They are often resistive to change and exhibit ritualistic or compulsive behaviour, abnormal attachments and unusual responses to sensory experiences.

Learning style:

Children with Autism are naturally repetitive and tend to memorize sequences of events or words. They do not naturally integrate information and lack understanding of how to initiate and maintain interactions. They have difficulty screening out irrelevant stimuli and may be disturbed by subtle environmental conditions. They learn better visually and are very literal and concrete. They are visual thinkers and learn from experience. They have difficulty processing transient information, shifting attention, selecting relevant information and generalizing.

Sensory processing:

Children with Autism often have difficulty organising and processing sensory input. 90- 100% of children with autism experience sensory processing deficits. These children work hard to retain a balance between arousal and organising- many odd or ritualistic behaviours are likely to be a way of organising sensory input. Their sensory system is very easily aroused. Autistic children may be distracted or overloaded by subtle changes in environmental conditions that would not concern other children, such as the sound of a fan working in an adjoining room.

There are many ways that parents, teachers and health professionals can support children with Autism so they can reach their full potential. Read our other articles to find out more.

Child of Mine connects parents with services for children. It is Australia's largest video-based directory for parents. It's free, fun and informative. Visit [http://www.childofmine.com.au]

Eileen Simoni

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2012年10月3日星期三

Swing Therapy For Autistic Children

Most of us have no problem combining all our senses. For autistic children (and grownups) however, it's a mighty challenging task. Processing stimuli from the senses of sight, smell, sound, touch, taste, balance and body is overwhelming. Those suffering from autism will often withdraw to avoid over stimulation, or try to sort out the input from their senses with self-developed soothing mechanisms and repetitive behaviours.

A significant amount of occupational therapy for autism focuses on sensory integration through specially designed programs. Some of the greatest tools for sensory integration therapy for autism type disorders are various types of swings. People with various autism spectrum disorders such as Autism, PDD, ADHD, Asperger's, proprioceptive dysfunction and tactile defensiveness will benefit from using swings as part of their therapy.

Additionally, children and adults with Sensory Processing Disorders (also called Sensory Integration Disorders), especially those with proprioceptive or vestibular dysfunction, should definitely have swings or therapy hammocks as a crucial element of their treatment.

The benefits of the hammock can be two-fold. Children who find the smooth, swaying motion soothing, will relax and unwind while using it. However, children who have a vestibular dysfunction will feel uneasy while in the hammock and might initially protest its use. For them, hammock therapy is more about regaining equilibrium and learning to tolerate vestibular stimuli.

The motion of swinging restores balance to the vestibular system, provides proprioceptive input (deep pressure) and generally helps autistic-spectrum children feel more "in balance". The soothing motion of swinging soothes, relaxes and increases concentration. Children who have trouble focusing on tasks such as reading or math, might find it easier to concentrate sitting in a hammock chair, their bodies engaged in a soothing motion.

Setting up a swing in the home is easy and does not require a large investment. A hammock, hammock chair, hanging bag or a therapy platform swing are all relatively inexpensive, easy to find and do not take up a lot of room. Making a platform swing out of a hammock is an easy do-it-yourself project, with instructions available in our blog. Put one in the child's room, playroom or family room for a retreat or a therapy corner for an autistic child.

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2012年9月15日星期六

Dermatillomania in Children

Compulsive skin picking is a type of obsessive-compulsive spectrum disorders (OCSD). OCSD symptoms typically begin during the teenage years or early adulthood, but recent research shows that some children may develop the illness even during the preschool years. Research also indicates that at least one-third of OCSDs in adults begin in childhood. Compulsive skin picking also called psychogenic excoriation is also sometimes seen in children. It is disappointing to know that there are very few resources available to parents whose children suffer from this sometimes debilitating disorder.

Skin picking most likely starts due to inadequate messages from the skin to the central nervous system and a decreased sensitivity to pain. It is more likely to occur during periods of boredom or stress, and occurs most often at bedtime, in the bathroom, in class, and in the car. Through excessive skin picking, children tend to convey messages for which they can't find the words. It may be almost impossible for a child to describe all the thoughts and feelings that are making him to pick but the evidence alone of compulsive picking is enough to signal to a parent that medical intervention is needed.

Effort should be made to eliminate the possibility of a physical cause for picking. If there is a physical cause, that must be treated and the urge to pick will probably go away. A number of products are available to help alleviate the discomfort and distress associated with this disorder. Physical impediment devices such as special gloves can be used. They are helpful in only a small number of cases.

Finger nails of children should be regularly trimmed to avoid compulsive skin picking. Also, their fingernails should be clean and tidy to reduce the chances of infection in the areas that a child is picking.

Sensory stimulation can be provided to help reduce the incidence of the picking. An occupational therapist trained in sensory integration can do an assessment and make recommendations for activities that increase sensory stimulation, such as skin brushing and play activities such as playing with a stress ball that are fun as well as effective in reducing the need to pick. A trained professional can also provide insight into the mental outlook of a child and thus prove to be of great help.

It may become necessary to treat skin picking in children with oral or topical medications. There are special formulations of these drugs for children and care should be taken that children receive these special doses. This treatment should be observed for sometime in case there are signs of improvement in these children. It's quite likely to witness these children get better with continued treatment.

Since this disorder results from anxiety, drawing undue attention to the activity could likely make it worse. It is important to note that punishment, lectures, nagging, consequences, undue fussing, blaming and shaming and all the responses we persist in do not work. In fact, the increased anxiety could actually lead to an increase in picking.

Curing dermatillomania isn't as difficult as you may think, too many people rely on lengthy and expensive therapy sessions or medications; Compulsive skin picking can be cured without leaving the house.

If you'd like to know how to cure this disorder please keep reading Dermatillomania Cure

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2012年9月12日星期三

Children With Autism - Recognizing the Signs

1. What is autism?

Autism is considered a spectrum disorder because symptoms and severity vary from individual to individual. Autistic children express differently from each other. Autism is characterized by failure of the child to develop communicative language or form proper social communication. But they show motor and other skills far beyond that of a mentally retarded child.

Autism is characterized by varying degrees of impairment to develop communicative language or form proper social communication. Some of them are obsessively pre occupied with inanimate objects such as lights, running water or spinning objects, and also by repetitive behaviors. Symptoms range from mild to severe. Some of them gradually develop extreme talents such as in mathematics and these are retained mostly throughout the life. Studies of people with autism have found abnormalities in several regions of the brain which suggest that autism results from a disruption of early fetal brain development

There is a milder form of the disorder known as Asperger's Syndrome. Other developmental disorders that fall under the Autism Spectrum Disorders are Rett's Syndrome, PDD-NOS (Pervasive Developmental Disorder, Not Otherwise Specified), and Childhood Disintegrative Disorder. If you have concerns about your child's development, don't wait: speak to your doctor about getting your child screened for autism.

2. What is meant by "On the spectrum"?

Autism is considered a spectrum disorder because symptoms and severity vary from individual to individual. Though the Autistic children show similar traits they are individual and express differently from each other. one child may have not developed speech and have difficulty in learning how to read and write, where as another child can easily read and write and can be attending normal school. Some children may display hypersensitivity to touch noise and other may have no sensory issues at all.

3. How common is autism?

According to the survey by Centers for Disease Control, autism affects as many as 1 in every 100 children and it is rising by 10-15% every year. It is the most prevalent developmental disorder in today's time. Boys are more susceptible than girls to develop Autism but it is seen that girls manifest a more severe form of the disorder that the boys.

4. How do I know my child is Autistic?

No two children with autism are alike, each one managing a different set of symptoms. But there are some signs and symptoms that are common and may be recognized as early as the toddler years, or even sooner. They usually do not have or do not sustain eye contact and have trouble communicating with other people or they may communicate in ways that others cannot easily understand. They may hardly speak and even if they speak it's just babbling and not coherent. They're also prone to repetitive behaviors like flapping their hands constantly or uttering the same phrase over and over again. They may also be over sensitive to sights, sounds and touch.

Criteria for Autism

A total Of 6 or more items of the following with at least 2 from [1], and one each from [2] and [3] are satisfied by the patient:

[1] Qualitative impairment in social interaction:

Marked impairment in facial expression

Failure to develop peer relationships

A lack of spontaneity in sharing interests

Lack of social or emotional reciprocity

[2] Qualitative impairment in communication:

Marked inability to initiate or sustain conversation with others.

[3] Restricted, repetitive and stereotyped pattern of behavior

Encompassing preoccupation with one stereotyped and restricted pattern.

5. How did my child develop autism?

No one is yet able to point to a probable cause. Though a disorder as common as autism would have a known cause, in many ways it's still quite mysteriously not known. Recent studies have suggested a strong genetic basis for autism. There are about 20 sets of genes that may play a part in the development of autism. Genes are not the only one responsible for all the cases; there are other triggers which are yet not discovered.

6. Does vaccination cause autism?

Many studies have been conducted to determine if a link exists between vaccination and increased prevalence of autism, with particular attention to the measles-mumps-rubella (MMR) vaccine and those containing thimerosal. These studies have not found a link between vaccines and autism It remains possible that, in cases, immunization might trigger the onset of autism symptoms in a child with an underlying medical or genetic condition.

As this is a sensitive topic it is best to discuss it with your healthcare provider who will guide you and ensure the optimal well-being of the child. Establishing open communication and trust with a physician who understands each child and his or her family is the best strategy for keeping a child healthy.

7. What help my child needs if He/She is Autistic?

Do not Panic first understand and learn about Autism from the right source that can be your doctor. You will need a good team of doctors, therapists, psychologists and teachers who understand and have experience with autism and can respond to his needs appropriately. Your healthcare provider can guide you toward various intervention programs and suggest complementary therapies. It also helps to associate with the existing network of parents facing the same challenges as you.

8. How to I deal with the diagnosis of Autism?

It is difficult to come to terms with the diagnosis that your child is having Autism but there is always a brighter side to every adversity. As we know the Autistic children have some special capabilities which the normal kids may not process. For e.g. some of the children we saw one was having an extraordinary power to memorize things only after reading once, one of them was brilliant in drawing and another in playing musical instrument. So do not blame your self or feel sad or hopeless. Take the right steps understand the disorder and if take care from your healthcare provider who will guide you with the exact nature of the disorder and how to deal with it. Keep the faith.

9. What therapies do I need for my child with Autism?

There are various therapies that are useful some of them are -

• Speech Language Therapy (SLT)

• Occupational Therapy (OT)

• Sensory Integration

• Physical Therapy (PT)

• Social Skills

• Picture Exchange Communication system

• Auditory Integration Therapy

10. What role Homeopathy plays in Autism?

Homeopathy is a holistic treatment and it plays a vital role in treatment of Autistic children. With the Constitutional Homeopathic treatment we can achieve increased level of concentration, decrease in hyperactivity and channeling of the energy in a constructive method. Homeopathic remedies act at the level of the Psycho Neuro endocrinal axis. Homeopathic treatment is safe and without side effects.

11. Can Autistic children become independent?

Yes Autistic children can become independent with the right intervention programs, therapy and proper care from the early stages once the child is detected with Autism. A sustained effort is needed to achieve the desired outcome from therapy and treatment. As Autistic children are having special capabilities which when nurtured properly can be a great asset in making the individual independent.

Dr Santosh Joshi graduated from the University of Pune India in the year 1999-2000.
With a firm grounding in classical homeopathy and the experience achieved by working with senior Homeopaths. He was an active participant in the seminars organized in Pune during his college years. He has also given case presentation on Homeopathy.He practices Homeopathy in the city of Mumbai India and he treats his global patients via the Online treatment procedure.

You can call him on: +919819155780
Email: tosh116@gmail.com

For more details visit us at: http://www.homeopathyclassical.blogspot.com

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2012年9月11日星期二

Understanding Non-Verbal Learning Disorder in Children

Non verbal communication is a generally accepted and used mode of communication. Looking and understanding any signs is easy for many, but there are some people who find it difficult to understand the facial expressions, body language, gestures, postures etc. This difficulty in understand non-verbal communication is known as non-verbal learning disorder.

Non-verbal learning disorder is a neurological disorder, which is being promoted as a new term within the broader area of 'learning disabilities', though it has been considered since the earliest days of learning disabilities diagnosis.

It is strange to find that people/kids with this disability have no problem verbally communicating with anyone. In fact, NVLD kids have very good vocabulary, reading, memory power in the early years of childhood. When these children move to schools, there will be difficulty in interpersonal communication and therefore become physically weak and become not adaptable to the environment.

A few tips for parents who's kids are diagnosed to having NVLD are:

1. Provide structure and routine.

2. Help the child to cope up with anxiety and sensory difficulties.

3. Be logical, organized, clear, concise and concrete. Do not use jargon or sarcasm.

4. Be specific about cause and effect relationships.

5. Help your child develop organizational and management skills.

6. Teach the child about gestures, postures, body language.

7. Help the child in group activities. This is important to help the child socialize.

It is going to be a little difficult for parents to cope with the child's disorder, but with a positive attitude, support and help from family, one can cope with the disorder. Support from family is an integral part of the child's growth and learning to cope with the disability.

For more information, log on to http://www.edurite.com.

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2012年9月6日星期四

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.

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2012年8月31日星期五

Gifted Children - Do They Have Sensory Sensitivities?

Gifted children are a joy and wonder to watch as they effortlessly progress through many different facets of growth and development. Their intellectual capabilities are far beyond those of their peer age group. They possess outstanding abilities and are capable of performing at astonishingly higher levels of performance when compared to other children. Although there are many standardized tests of intelligence that help educators and professionals accurately identify gifted students, parents usually recognize their advanced development first.

It is very likely that most parents recognize that there is something unique and special about their gifted child during the first three years of life. Gifted children demonstrate extraordinary growth and development skills during this time. They accomplish and surpass expected milestones months or even years before other children their same age. Parents observe their children rapidly progressing through various stages of development and they are often described as "ahead of their age". Some of the signs of a gifted child include:

Many gifted children learn to read earlier than expected and can more easily understand what they read.
They learn basic skills more quickly and apply reasoning at an early age.
They are curious and ask more questions about "how" and "why".
Gifted children usually communicate well verbally with their parents, siblings, peers, and even strangers -- and they usually have an expanded vocabulary.
They appear to be very organized and efficient.
Gifted children enjoy a challenge and seek opportunities to grow developmentally and solve new problems.
They are able to understand abstract ideas, non-verbal communication, and other types of communication.
These are just some of the potential characteristics of gifted children. There are many more signs that indicate a child has a special talent and ability to learn, communicate, grow, and develop. Parents and teachers who recognize these signs will often give gifted children many more opportunities to learn and excel.
But recent studies also indicate that gifted children may suffer from sensory sensitivities more often than their non-gifted peers. Based on his research, W. Roedell, in his article published in Roeper Review, theorizes that the gifted child often has intense sensitivity. This means that gifted children may undergo more stress due to their inability to effectively process some of the sensory signals travelling through their bodies and to their brains.

To understand what this means, it is important to understand how sensory integration works. Sensory integration is the ability for people to process sensory data and information collected from the five senses and from the environment surrounding them. It is a neurological process that carries the stimuli to the brain where it is processed, organized, and evaluated for usable information or actions. When sensory integration is interrupted or does not function properly, it is like a mis-fire or mis-cue to the brain. Pieces or parts of information are missing and it is difficult for the brain to process the data. This can result in problems with daily living skills, academic progress, or social interactions.

While parents may be swelled with pride and adoration as they watch their young gifted child grow and develop - and justifiably so - they may overlook this important aspect of their child's development and behaviour. They may believe that their child has difficulty socializing with peers because "he is just smarter than they are" or "he needs more mature interactions". Unfortunately, the real problem may be that he may be experiencing sensory integration dysfunction and it is too difficult for the child to engage in social interactions, develop friendships, or enjoy activities with other children.

If a gifted child is affected by sensory integration challenges, it is possible that he or she may have more functional problems than other children. They could become more aggressive, impulsive, withdrawn, and introverted than other children. They do not experience the gratification and developmental processes associated with healthy social interactions because they do not participate in social activities as often.

So where does all of this information and data lead us when it comes to helping gifted children overcome sensory integration dysfunction, or teaching them to manage through some of the challenges associated with this issue?

Educators, therapists, and counselors must be keenly aware of this issue and must evaluate gifted children carefully to assess whether or not it is a problem. Utilizing this information when developing and observing children in classroom settings, activities, and social activities becomes vital to understanding any special needs of gifted children.

For example, although gifted children may be well above their peers in intellectual capacity and application, they may experience more sensitivity and have difficulty processing certain noises, sights, or sounds. They may find that bright fluorescent lighting creates a feeling of confusion or anxiety for the gifted child. Turning down the lights to accommodate the child may help. If the child is more sensitive to loud noises, then playing music at a lower volume or speaking in a softer tone may be beneficial. Parents and teachers both need to understand the sensory stimulus that affects a child and help the child learn to deal with the challenge. But they must also teach the child how to cope with the sensory sensitivities in various ways.

In "Sensory Sensitivities of Gifted Children", there is an indepth view and analysis into this topic. The theories and hypotheses that are addressed through various researchers indicates that gifted children may have different sensory modulations (or different ways of processing sensory stimuli) than those who are not gifted. W. Roedell theorizes that "gifted children's unique challenges and skills are likely embedded in a neurological system that perceives and responds to the environment differently from children of typical intelligence."

As parents, teachers, and professionals, we must learn to understand the gifted child better and evaluate whether or not sensory integration challenges are present. This also means that we must find tools and resources to help gifted children manage their sensory challenges so they can focus, concentrate, and become more socially engaged. Until now, many educators and professionals believed that sensory integration dysfunction was a problem associated with children who had ADHD, hyperactivity, or other disorders. This new research opens up a whole new world of possibilities to provide the gifted child with better guidance and resources related to the sensory processing.

Rather than assume a gifted child is just acting inappropriately in a social environment, or that the child has behavior problems, or even that the child just doesn't want to play with children his own age due to his higher intelligence level, parents and professionals should explore the tools, resources, and information that can better assess and uncover the real problem. A higher intellectual capacity is just one aspect of a gifted child's life and world. They excel above their peers in this area, but they may also experience psychosocial issues that deter them from engaging in vital and rewarding developmental social interactions with others.

Accessing information and tools to support the growth and development in all aspects of the gifted child's life is an important part of the educational and nurturing process. For further information on research or resources related to gifted children and sensory sensitivities, or sensory processing difficulties, refer to the full studies noted in this article.

References:

Roedell, W. (1984). Vulnerabilities of highly gifted children. Roeper Review, 6, 127-130.

Miller, L., Anzalone, M., Lane, S., Cermak, S., & Osten, E. (2007). Concept evolution in sensory integration: A proposed nosology for diagnosis. American Journal of Occupational Therapy, 61, 135-140.

Gere, D. R., Capps, S. C., Mitchell, D.W. & Grubbs, E. (2009) Sensory sensitivities of gifted children. American Journal of Occupational Therapy, 64, 288-295.

Debbie Hopper, an accredited occupational therapist, has a Masters Degree in Occupational Therapy from the University of Sydney. Debbie is passionate about her mission of researching, evaluating, and making the most valuable resources and tools easily accessible to parents, teachers, and therapists.

With post-graduate training in sensory integration assessment and intervention, Debbie brings significant focus to this area of growth and development through LifeSkills4Kids.com.au. Debbie's passion gives her a relentless drive and motivation to continually research new and innovative resources to help children learn and benefit from all life skills.

To sign up to our newsletter, visit us at http://www.lifeskills4kids.com.au

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2012年8月28日星期二

Halloween Fun For Children With Sensory Processing Issues

Halloween parties, costumes, masks, and treats--you can't count on any of these being fun for the child with sensory issues! No wonder October 25-31 was chosen to be National Sensory Awareness Week, drawing attention to the 1 in 20 children who have the hidden disability of sensory processing disorder, also known as SPD, or sensory integration dysfunction. Fortunately, you can make Halloween more enjoyable for the child who struggles with sensory issues.

Costumes and masks often involve new sensations against the skin and body that a child may find repulsive. Experiment beforehand with any make-up, masks, wigs, or hats and see if the child can truly tolerate them for a few hours. For a costume, consider working from the basic pieces of a soft, cotton top and bottom, such as a sweatsuit or pieces of clothing purchased at a used clothing store or pulled from his play clothes pile. Add elements and props that he can hold or wear comfortably. Start looking for a costume early, when the selection is best. Purchase a used costume or costume elements through eBay, second hand shops, and Craigs List to keep your costs down because after trying a costume for a few minutes, your child may realize it is too tight, scratchy, or uncomfortable in some other way.

Treats with plenty of sugar and artificial colors and flavors should be limited for all children, but kids with sensory issues are often more sensitive to these substances. Let her gather all her loot post trick or treating and choose the favorites, then have the rest mysteriously disappear overnight (maybe after using them as math counters!). Or hoard it to use a piece at a time as rewards for overcoming challenges, doing extra chores, or use in therapy. If your child has an occupational therapist or speech therapist, speak to this professional about the possibilities. For example, sour candies in particular can be good for helping a child with poor self-regulation who is stuck in the "loose and floppy" mode to become more alert so she can focus and attend to homework or school work.

If your child has food allergies and intolerances, skip the highly processed, sugary treats altogether. Have a party instead of going Trick or Treating, and provide healthy, fun snacks and nonfood items such as stickers, pencils, and small toys.

Offer opportunities to escape from the noise and bustle of a party or trick or treating. A quieter street to walk down or an empty bathroom or bedroom where she can regroup will help her avoid sensory overload. Let her know what to expect from the occasion, from kids jostling her in doorways and running past her on the street to scary sounds and lighting changes like strobe lights at a Halloween party. And consider celebrating Halloween at a nature center, zoo, or cultural center with a quieter, more structured program, or having a small party at home.

You may want to use this opportunity to talk about fears and how to manage them. Books such as Go Away Big Green Monster by Ed Emberley, featuring a monster the younger child constructs then deconstructs as he turns the pages, can help ease anxiety about monsters and other scary creatures.

And if you do not celebrate Halloween, or your child finds it too scary, consider creating an occasion to give her the "just right" challenge of dressing in unfamiliar clothing and using her imagination to pretend she is someone else for a short time. Costumes and dress-up play encourage young children to break out of cause-and-effect, parallel play and graduate to cooperative, imaginative play, which are important developmental skills. Whatever you do on October 31, please be sensory smart and understanding of your child with sensory issues.

Nancy Peske is an author and editor and the parent of a child who at age 2 was diagnosed with sensory processing disorder and multiple developmental delays. Coauthor of the award-winning Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Processing Issues, available from Penguin Books, Nancy offers information and support on her blog and website at http://www.sensorysmartparent.com She has been active in the SPD community since 2002.

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Sensory Activities for Autistic Children

Autism, a disorder that creates behavioral, social, and communication challenges, exists within the Autism Spectrum group of disorders. Autism can affect the child's ability to integrate input coming from different senses. Sensory integration therapy can help a child by stimulating and challenging all of his or her senses. Some sensory activities for autistic children can also help a child learn to tolerate different tactile experiences. In addition, the children can learn to have fun while being creative.

Some autistic kids are overly sensitive to touch; some prefer touching and stroking soft, smooth items for hours. Many children with ASD cannot tolerate the feel of new clothes, or scratchy textiles. Still others pat and explore the faces of their caregivers.

Some sensory activities for autistic children include rubbing or stroking their skin with different textures. Use firm pressure to stimulate the deep pressure receptors and to avoid exciting the nervous system. Other ways of encouraging building tolerance to rough or scratchy textiles can include play with sandpaper shapes and letters, or plastic or wooden blocks with raised letters. Create a sensory board with clippings of all different types of fabric and other materials that are made up of different textures: sandpaper, string, smooth glass, corduroy, aluminum foil that's been crinkled up and then straightened out, and cardboard.

Another sensory activity to have the child perform is to play with colored rice. This project is both tactile and artistic; the goal is to help build tolerance to different textures while creating a work of art, which makes it a favorite of many sensory activities for autistic children. Take one cup of dry white rice, one teaspoon of rubbing alcohol, a medium-sized bowl and a spoon, aluminum foil or waxed paper, and three to four drops of food coloring. Use the rice:rubbing alcohol:food coloring ratio for each color you'd like. Put the rice in the bowl, add the rubbing alcohol, and drip on the food coloring, making sure to stir well between each drop. When the rice is the intensity you like, spread it onto the foil or waxed paper and allow it to dry. Repeat it with the other colors. To make art with the rice, have the child draw a picture or word onto card stock or bristol board, then trace the image or word with white glue, one section at a time. The child can drizzle the colored rice onto the glue. As with many sensory activities for autistic children, some kids may become overwhelmed if they have too much colored rice at once. Try placing a small amount of rice into a small paper cup and refill as necessary.

Register for your FREE webinar training with a child autistic behavioural specalist now and discover the key to unlocking childhood Autism VISIT.
autismininfants.org

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Advice For Parents of Children With Sensory Integration Disorder

Some children can overreact when exposed to too much environmental stimuli. This disorder involving the senses is called sensory integration disorder. If your child has difficulty in high stimulation situations and has a high level of anxiety or stress he may be suffering from this disorder. Sensory integration disorder can effect your child's learning development and behavior. It also causes difficulties with processing information from the five classic senses, the sense of movement , and/or the positional sense (proprioception).

This condition is usually diagnosed by an occupational therapist. There is no known cure but many treatments are available. One common sensitivity is to the sense of touch. If your child shows signs of sensitivity to his sense of touch here are some things you can do to make life a little easier for both of you.

1. Choose the fabric for your child's clothing carefully.

Children with SID will find fabrics like wool too scratchy and irritating. Purchase 100% cotton fabrics instead.

2. Be careful when choosing the style of your child's clothing.

Remove any irritating tags on the collar and look for loose fitting clothes.

3. Choose grooming products wisely.

Don't purchase soaps or shampoos with extra additives or dyes. These may be irritating and harsh to your child.

Disorders that may be related to SID

Autism spectrum disorders

Attention-Deficit/Hyperactivity Disorder (ADHD)

Temper Tantrums

Don't worry this disorder is more common than you might think. It's okay. With the right treatment and attention your child will be able to manage herself with this disorder and life can be more peaceful at home.

Ms. Talbert is a mother of three and editor of Healthy Moms - Parenting, Pregnancy, Health and Women's Issues.

She lives in Sacramento, CA with her family.

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2012年8月27日星期一

Chiropractic Fundamentals - Neurological Integration in Children

Some 30 years ago, Dr Jean Ayres identified a process which correlates neural function and a child's degree of success in school. This process is known as neurological integration.

Problems with neurological integration are evident in a child that is very sensitive to bright lights, loud sounds, or quick movements. They may have a very high pain tolerance or throw themselves against people or walls. There is an apparent increase or decrease in activity levels. Coordination problems, speech and language delays, and issues with attentiveness and self-regulation all indicate a problem with neurological integration. Most of these children are quickly diagnosed with something along the lines of ADHD or ADD by the medical profession.

When an infant is playing or interacting, their brain gathers information and attempts to organise it. If the information becomes scrambled or disorganized, this is evident in the infant's behavior. ADHD and ADD are purely a diagnosis of symptomology and not the cause in some cases.

"The number of young children entering school exhibiting sensory processing disorders is increasing every year and currently is estimated to affect 12 to 17 per cent of all children in the United States," according to the Sensory Integration Education and Research Foundation.

"It is extremely important for parents and education professionals to be proactive in the neurological development and wellbeing of children," says Chiropractor Cody Hanish. "The learning capabilities of infants and children exhibiting neurological integration disorders can greatly increase through chiropractic care."

Foot position

According to Foot Levelers, a recent survey of 52 five-year-old children showed that 92.3 per cent had knocked knees, and 77.9 per cent had hyperpronation of their feet, or underdevelopment of the ankle bone or heel bone which restricts the foot's range of motion. While knocked knees tend to go away, pronation of the feet do not.

"Pronation is the most common foot problem we see at our Chiropractic. All three foot arches, medial longitudinal, lateral longitudinal, and transverse, are far too weak to keep the foot in proper alignment which causes the tarsal bones to drop," says Cody. "Considering the importance of the feet in sending neurological information to the brain, this is extremely concerning."

Postural control

The act of standing or moving relays signals from the body to the brain and then back again. The body automatically and reflexively takes on a particular posture based on a combination of responses from the feet and other limb positions. All of this is controlled by the brain's messages to these areas.

Over the surface of the feet, there are millions of pressoreceptors (receptors that sense pressure). These receptors send information about your body in space to the brain which then coordinates the body to accommodate to the particular position.

Any disruption in this process can not only affect balance but many other senses as well. Instability can be triggered by malfunctioning responses to visual cues, vestibular, and proprioceptive reflexes, according to studies performed by Nashner, Norre, and Lord et al.

"Research shows how foot positioning directly interferes with the neurological development of children," says Cody. "It's easy to see the importance of foot position, posture, and the effects it has on health and wellbeing in the long term."

Cody Hanish, a Sydney Chiropractor and Doctor of Chiropractic, has provided this summary out of a series of articles on chiropractic care written by John de Voy. Cody is practicing together with John at John's Wynyard Chiropractic practise based in Sydney, Australia.

Cody himself first saw a chiropractor at age 17 following multiple sports-related injuries and two severe car accidents. His own chiropractic care has allowed him to pursue his love of sports and live an active lifestyle. Like many other successful chiropractors, his personal experience with his recoveries has given him the compassion and interest in sports-related injuries and post-trauma spinal rehabilitative care.

You can find more articles on pediatric and chiropractic care at the Sydney Wynyard Chiropractic Website.

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Introduction

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.

Conclusion:

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.

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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.

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