EBD Blog

Shari Roan’s article entitled “Jani’s at the mercy of her mind” illustrates the difficulties encountered by children with schizophrenia and their families. For those who do not know about schizophrenia in children, this journalistic case study will be a good introduction.

It’s been a rough week. A few days ago, at UCLA’s Resnick Neuropsychiatric Hospital, 6-year-old Jani toppled a food cart and was confined to her room. She slammed her head against the floor, opening a bloody cut that sent her into hysterics. Later, she kicked the hospital therapy dog.

Jani normally likes animals. But most of her animal friends — cats, rats, dogs and birds — are phantoms that only she can see. January Schofield has schizophrenia. Potent psychiatric drugs — in doses that would stagger most adults — seem to skip off her. She is among the rarest of the rare: a child seemingly born mentally ill.

Here’s a video segment (7:45) from the story; it’s by Don Kelsen and Tim French.

Link to Ms. Roan’s article. For other resources about childhood schizophrenia, see these links:

• The American Academy of Child and Adolescent Psychiatry’s Facts for Families page about schizophrenia.
• The recruitment page for the US National Institute of Mental Health’s “Childhood-onset Schizophrenia Study.”
• The Merck Manuals’ entry about childhood schizophrenia.
• The NARSAD page about childhood-onset schizophrenia.
• The North American Society for Childhood Onset Schizophrenia (Web site).
• Mayo Clinic definition.
• The US National Alliance for Mental Illness’s (NAMI) fact sheet about early-onset schizophrenia.
• Pam Belluck’s excellent article, “Living With Love, Chaos and Haley” from the New York Times (22 Oct 2006).
• Living with Childhood-onset Schizophrenia (Web site)

Summer in the US finds children and youths out of school and, perhaps, less vulnerable to some of the problems that are associated with the social and academic demands that are part of schooling. As a result, perhaps fewer of the familiar problems illustrated in this poster are apparent during summer.

If summer seems like a relief from such problems, though, that could be an important indicator that those very problems need to be addressed. A few weeks away from school probably will not cure them. Those same difficulties may still be occurring, just less obviously, and they are likely to recur soon.

Individuals or the families of children who experience the kinds of problems noted in the poster should consult the resources available from the US government’s Substance Abuse and Mental Health Services Administration. One will not find easy cures there, but by carefully perusing the resources available one can learn what signs to monitor and where to go to get help.

The image is hot. Click it to get to a good starting place.

In the US state of Michigan, a major health insurance provider will now reimburse families for the cost of providing therapy for children with autism. The case, Johns v. Blue Cross Blue Shield of Michigan, arose because Blue-Cross-Blue-Shield denied payment for behavioral treatment often called “ABA” to the family of a child with Autism. The case was settled in favor of the family last week.

Represented by Gerard Mantese, Mr. Christopher Johns alleged that the insurer should pay for the therapy for his son under the provisions of the policy. The insurance company refused and Mr. Johns sued. During depositions, Mr. Mantese and others on the Mr. Johns’ legal team learned of a draft memorandum identifying the behavioral therapy as effective and that a representative of the insurer would probably elect the behavioral therapy if that representative had a child with Autism.

Because Mr. Johns’ complaint was part of a class action suit, many other families will also benefit from the settlement. In an independent analysis of the case, Tresa Baldas discussed the implications.

The $1 million class action settlement from Blue Cross Blue Shield of Michigan comes amid a legislative wave in which a growing number of a states are passing laws that require insurance companies to pay for autism treatments and screenings. To date, 13 states have such laws, the most recent being Connecticut, Colorado and Nevada. New Jersey is currently considering an autism bill, and Pennsylvania’s law goes into effect July 1.

The June 17 Michigan settlement, meanwhile, has autism advocates hopeful that insurance companies will stop claiming that behavioral therapy for autistic children is experimental, and start paying for it.

“It is a significant victory for the families, obviously, and it marks a trend, hopefully, that insurance companies will start to look at autism treatment differently,” said Areva Martin, an attorney at Los Angeles-based Martin & Martin who is currently handling about 30 autism cases. She believes the labeling of autism treatments as experimental is “absurd.”

I wonder what this will mean for the California rules that do not expressly exclude behavioral therapies, but set requirements for deciding whether they are reimbursable (see my earlier post on that story).

Link for a quasi-news article about the settlement. Read another of the law firm’s press releases. Here’s link to Ms. Baldas’ analysis of the case.

Even though many schools in the US have closed for the summer or are about to do so, I want to remind folks that this is not a good time to take a break from considering the mental health needs of children and youth. Although they are likely to wax and wane over time, mental health problems don’t take many vacations.

Learn more about US resources for individual children and youths who have emotional and behavioral disorders by surfing the rich resources assembled by the Substance Abuse and Mental Health Services Administration (SAMSHA) of the US Department of Health and Human Services. Although some of the materials may be a tad out of date (e.g., prevalence figures have been updated for some disorders such as Autism), there are still plenty of valuable materials available from SAMHSA.

Go there! Compare what you see learn there with what’s available at other trustworthy sites. Learn what to do and from whom help is available.

Edward G. Carr, a widely respected respected authority on Autism, was killed in an automobile accident Saturday 20 June. I’ve posted an obituary on SpedPro.

Over on Autism Street, Dad Of Cameron (“Do’C”) has assembled a list of sources that have questioned the strength of the evidence about hyperbaric oxygen therapy for Autism. I’m pleased he included the resources from EBD Blog. Thanks!

Adolescents who are at risk for later episodes of major depressive disorders differ from their peers who are not at risk on multiple measures of rapid eye movement (REM) and hypothalamic-pituitary-adrenal (HPA) activity during sleep, according to a study by Uma Rao and colleagues that appeared this fall in Neuropsychopharmacology . Early depressive episodes that occur during adolescence are strongly associated with other later problems in other areas such as interpersonal relationships, pregnancy, educational attainment, employment, and suicidal behavior; finding predictors of later problems is important for primary and secondary prevention.

Rao and colleagues compared youths at risk for major depressive disorder with peers using electroencephalographic (EEG) and HPA measures. They then followed the youths for 5 years and correlated their EEG and HPA measures with the chances of later episodes of depression. Here’s the abstract:
Continue reading ‘Sleep predictors of later depression’

Sheldon Braaten announced that the call for papers for the regular conference sponsored by the Council for Children with Behavior Disorders has been extended. Here’s the text of his message.

8th Biennial International Conference on Children and Youth with Behavioral Disorders

“Strategies for Promoting Academic and Behavioral Competence of Students with Emotional/Behavioral Disorders”

At the
Four Points by Sheraton Denver Southeast
Denver, Colorado
September 23-26, 2009

Call for Proposals – Deadline has been Extended
Continue reading ‘CCBD call for papers extended’

In Scientific American, Daniel Lametti wrote an article providing background research on mirror neurons and implications for future research. The article, “Mirroring Behavior: How mirror neurons let us interact with others,” only has a few words about Autism and mirror neurons. However, readers of EBD Blog who are new to the topic and who want to understand the concepts in general will likely benefit from reading it.

Link to Mr. Lametti’s article.