EBD Blog

In the November 2009 issue of Pediatrics, Tanya Froehlich and colleagues reported that maternal smoking during pregnancy and children’s exposure to lead were associated with diagnoses of attention-deficit hyperactivity disorder (ADHD). Each factor alone was linked to ADHD, and the two in combination had an even greater association ADHD.

OBJECTIVE: The study objective was to determine the independent and joint associations of prenatal tobacco and childhood lead exposures with attention-deficit/hyperactivity disorder (ADHD), as defined by current diagnostic criteria, in a national sample of US children.
Continue reading ‘ADHD and smoking and lead’

The Substance Abuse and Mental Health Services Administration, which is a part of the US Department of Health and Human Services, maintains a Web site where users can search for and learn more about methods for preventing or treating some Emotional and Behavioral Disorders. It’s called the “National Registry of Evidence-based Programs and Practices” (NREPP) and, for those who are concerned about employing or recommending evidence-based practices, it’s worth reviewing.

The National Registry of Evidence-based Programs and Practices (NREPP) is a searchable online registry of mental health and substance abuse interventions that have been reviewed and rated by independent reviewers.

The purpose of this registry is to assist the public in identifying approaches to preventing and treating mental and/or substance use disorders that have been scientifically tested and that can be readily disseminated to the field. NREPP is one way that SAMHSA is working to improve access to information on tested interventions and thereby reduce the lag time between the creation of scientific knowledge and its practical application in the field.

NREPP is a voluntary, self-nominating system in which intervention developers elect to participate. There will always be some interventions that are not submitted to NREPP, and not all that are submitted are reviewed. In addition, new intervention summaries are continually being added. The registry is expected to grow to a large number of interventions over the coming months and years. Please check back regularly to access the latest updates.

Although NREPP originally focused on substance abuse, its coverage is broader now. Look for resources about, for examples, Across Ages; Aggressors, Victims, and Bystanders: Thinking and Acting To Prevent Violence; Al’s Pals: Kids Making Healthy Choices; All Stars; Caring School Community; CASASTART; Children’s Summer Treatment Program (STP); Coping Cat; Creating Lasting Family Connections (CLFC)/Creating Lasting Connections (CLC); Early Risers “Skills for Success”; Families and Schools Together (FAST); Guiding Good Choices; Incredible Years; Keep A Clear Mind (KACM); Keepin’ it REAL; Lions Quest Skills for Adolescence; Multisystemic Therapy (MST) for Juvenile Offenders; Multisystemic Therapy With Psychiatric Supports (MST-Psychiatric); Positive Action; Primary Project; Project Northland; Project Towards No Tobacco Use; Project Venture; Promoting Alternative THinking Strategies (PATHS), PATHS Preschool; Protecting You/Protecting Me; Right Decisions, Right Now: Be Tobacco Free; SAFEChildren; Second Step; SMARTteam; Storytelling for Empowerment; Strengthening Families Program; Strengthening Families Program: For Parents and Youth 10-14; Success in Stages: Build Respect, Stop Bullying; Too Good for Drugs; and Too Good for Violence;

Children and youths with ADHD and their families ought to know about systems of care. Systems of care are networks of services that are coordinated across different agencies and groups within the community. A system of care focuses on the needs of individuals and should be designed so that it takes advantage of that person’s strengths (i.e., is “strengths based”) and unique characteristics (e.g., ethnic background and native language).

Systems of care have been studied extensively in the disciplines focused on Emotional and Behavioral Disorders. They are not just for kids “lost to the streets.” The coordination of services can be beneficial for individuals with ADHD, too.

Learn more about ADHD and systems of care from the SAMHSA, the US Substance Abuse and Mental Health Services Administration. Download a PDF.

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.

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.

In “Failing Sam,” Jessica Shyu—who taught special education for two years at an American Indian reservation school in New Mexico—makes an important point about what we provide educationally for students with Emotional and Behavioral Disorders. Teachers may become lulled by having a quiet, disruption-free classroom and overlook the need to provide beneficial instruction. She recalls a particularly challenging student named “Sam.”

His reputation preceded him. A week before he even arrived at school, the teachers were eagerly sharing horror stories they’d heard about the 12-year-old. It was a mix of rumor and truth. They told me about his alcohol problem. They told me about how he doused his cousin with gasoline and lit her on fire. They told me I would be lucky to get him to sit down and not hurt anyone.

Continue reading ‘Teaching them matters’

As exploring readers will know, I long ago doubted that food components (especially sugar and dyes and flavorings) were causes of hyperactive behavior in children. There are good reasons for my doubt. Meta-analyses of studies that tested additive-free diets revealed essentially no benefits of the diets. Other studies showed that suspected factors—especially sugar—were not culpable in hyperactive behavior. Indeed, other analyses have provided plausible explanations for why we are misled by apparent causal connections.

But, the idea persists and is even getting renewed coverage in the popular media. Melinda Fulmer provided an article to the Los Angeles (CA, US) Times describing recent examinations of the effects of additives on child behavior. Here’s her lead:

Almost every parent has a story about their [sic] kid bouncing off the walls after downing a package of jelly beans or eating a neon blue-frosted cupcake at school. Most blame the sugar.

But some new research suggests that the rainbow of artificial colors may have a bigger effect on children’s behavior. And in other parts of the world, some organizations are starting to take action on these ingredients.

I guess it’s time to revisit this topic. Do I have time to do so? No, but if I presented a mistaken perspective earlier, I should correct it.

More importantly, if Ms. Fulmer and the LA Times are promulgating untrustworthy information, they need to correct it.

Link to Ms. Fulmer’s story. Link to learn more about Ms. Fulmer’s reporting. Link to my previous (AKA “ancient history”) observations about the food additives research.

Over on Kenny Handleman’s ADDADHDBlog I learned of a product recall for Daytrana.

Do you or your child take the Daytrana patch for ADD/ADHD? If you do you need to know that the company that manufactures this drug, Noven Pharmaceuticals, is recalling two lot numbers.

Fortunately, the recall is for problems with the packaging. Parents still probably should learn about this product recall. Here’s link to Dr. Handleman’s blog entry.

Here’s a description of a highly touted intervention.

[Method X] is recognized worldwide as a general method to reinforce the body’s protective abilities for people of all ages who suffer from various disorders and pre-illness conditions, i.e. practically healthy people.

[Method X] involves the organized interaction between [therapy agent] and person, with optimal conditions to offer benefits to the person as well as the [therapy agent].

[Method X] can assist in the following tasks:

- Correction of psychological development for people with nervous system disorders
- Development of cognitive activity for people with psycho-neurological disorders
- Development of children’s speech
- Removal of chronic pain
- Reduction of neurological and vegetative-vascular reactions
- Relief from psychosomatic conditions
- Reduction of unintentional movements, tics and spasms
- Rehabilitation of people, victims of violence or other stressful situations
- Psycho-emotional training for specialists whose work is connected with extremely stressful situations
- Leisure and relaxation for healthy people–children and adults

The main component of [Method X] is the psychological effect from the interaction between [the client] and [the therapy assistant] in an unaccustomed environment and the physical therapy effect from [Y and Z] made by these [therapists].

Would you want to use this therapy for yourself or your child?

I would! But, that’s because I know what the therapy is.

Examining the effects of a training program designed to promote self-regulation, Adele Diamond and colleagues found that “Tools of the Mind” (Tools) improved performance of preschoolers in regular classrooms with regular teachers. Weak self-regulatory and executive function skills are consistently associated with ADHD. In their study, which appeared in Science 30 November 2007, the researchers compared Tools to a balanced-literacy program and found that the preschoolers receiving the Tools program out-performed peers who had been randomly assigned to the control condition on tasks consider to reflect executive function.

Link to the study (subscription required for full text).

When should a student’s right to participate in education be denied because his or her behavior is inimical to rights of other students’ to benefit from education? When is one student’s behavior so problemsome that his “right” to be in a classroom is trumped by his peers’ right to participate in an orderly learning environment?

Most educators, I would hazard a guess, want to make it possible for students to participate in a minimally restrictive environment. Although the “least restrictive environment” clause of the US special education law is buried pretty deeply in the structural outline of legal guarantees, it is advocated strongly by many people (educators, parents, attorneys, etc.) concerned about special education. And, many advocates argue that it—the “right” to the “least restrictive environment”—is the ace of trumps.

Is it? When does the balance shift from the access rights of an individual to the access rights of the individual’s peers? When are the interests of an individual to participate in “mainstream” education of lesser importance than the interests of peer students’ access to an environment that is conducive to learning (i.e., not disrupted)?

These and some other matters are the likely subjects of discussion at a forthcoming meeting on classroom disruptions. Suitably scheduled for Hallowe’en, the meeting will be held in Washington (DC, US). here’s the basic info:

Class Disrupted: Disorder and Its Effects on Learning and School Culture

October 31, 2007

Location: Washington, DC

Many teachers and principals struggle to create and maintain positive classroom and school cultures–free of disruption, disrespect, bullying, intimidation, and violence. While public school systems are rightly focused on meeting AYP and the other requirements of No Child Left Behind, they must also address the fact that without order and respect, little learning and progress can be achieved. Student misbehavior that goes unaddressed in the hallways and the classroom undermines instruction, stifles the development of character and social skills, and contributes to teacher burnout. This forum will:

* Examine disorderly conditions in schools, including factors contributing to the problem, looking beyond traditional concerns about safety and violence, to acts of disrespect, disregard for school rules, and disruptive behavior;
* Highlight the consequences of disorder in schools, specifically on learning and culture;
* Present new ideas on how law impacts student discipline at the school level; and
* Share key perspectives on what must be done to help restore respect and order and maintain safe and productive schools.

Date: October 31, 2007
Time: 8:00 a.m. – 2:30 p.m.
Registration begins at 8:00 a.m.
Lunch will be provided
Location:

Carnegie Endowment for International Peace
1779 Massachusetts Ave., N.W.
Washington, D.C.

If you’re interested in this topic, contact RSVP@cgood.org. (or for more information, contact Ali Kliegman at akliegman [at] cgood.org or 212.681.8199 x14.

Flash of the electrons to Elona Hartjes of Teachers At Risk whose post, “Class Disrupted: Disorder and Its Effects on Learning and School Culture” brought this to my attention.

The annual meeting of Teacher Educators for Children with Behavioral Disorders (TECBD), now named after Rob Rutherford who founded it, will be held 15-17 November 2007 in Tempe (AZ, US). Steve Forness, Cheryl George, and John Maag are among the people who’ll be speaking this year.

Every year, EBDBlog has announced the call for papers, so this is nothing new. There is still time to propose a presentation for this year’s meeting. Potential presenters may submit proposals for sessions using the TECBD site.

Link to the Web site for TECBD. Link for proposing presentations.