Archive for the 'Treatment' Category

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If we ignore problems, they don’t go away

Ignoring children’s mental health problems will just make things worse. Left to their own devices, very few kids are likely to work things out independently. And a lot more problems exist than we might like to admit exist.

The schools in Virginia identify about 1 student in every 100 students as needing special education services because she or he has emotional or behavioral disorders. Yet, the Virginia Department of Behavioral Health and Developmental Services estimates that 1 in every 5 children will need mental health services. To be sure, not every child who needs mental health services will need special education services, and vice versa. Still, the discrepancy between these numbers illustrates the enormous gaps in recognition of needs and provision of help for children that different agencies offer. Greater coordination and collaboration are important. It should start with understanding and communication. Case management, wrap-around services, and similar practices would be fine results of such communication.

Not all mental health problems are manifested in destructive, overt, disobedient actions. Nor are all mental health problems hidden, repressed, anxiety disorders. They come in lots of shapes and sizes, affect children across the intellectual spectrum, are not confined to any particular ethnic group (nor is any ethnic group immune to them). Mental health problems can strike anywhere, rarely briefly and too often for a lifetime.

Don’t ignore. Deal.

In Virginia (US) we are fortunate to have the Campaign for Children’s Mental Health. Visit this effort to promote awareness and encourage policy makers to recognize the need for action on behalf of children. Learn about the many marvelous organizations that have supported the work of the Campaign for Children’s Mental Health. If you have an organization in your geographical region (whether it is a locality in the US or elsewhere on Earth [or even in the cosmos!]), drop a note in a comment recognizing it, please. Meanwhile, over in the left rail, please check out NAMI, FFCMH, and other Web resources related to children’s mental health.

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Another photo for fun

I was moving some materials from one office to another when I came across this photo of some friends. Believe it or not, I took this with a film camera. Yes, it is from the 1990s, even before 1997 or so, I think.

I suspect it was at one of the annual meetings in Tempe (AZ, US) of the Teacher Educators of Children with Behavior Disorders, as these are some of the usual suspects who attended those meetings. A casual search on any of these folks’ names will reveal that they are prominent contributors to the literature about improving the lives of children and youths with Emotional and Behavioral Disorders, the families of those children and youths, other students who do and do not have disabilities, their teachers and administrators, and on and on. Students who studied just these people’s writing in detail would get quite a valuable education.

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WWC on Lovaas model

The US Department of Education’s What Works Clearinghouse (WWC) released the results of its review of the model for teaching children with Autism that is based on the work of the late Ivar Lovaas on 24 August 2010. The WWC report is based on two of the many studies of the Lovaas method—often called “Applied Behavior Analysis”—and reports positive results for cognitive outcomes.
Continue reading ‘WWC on Lovaas model’

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What do educators need to know?

I’m asking readers of EBD Blog to help me identify important research questions about interventions for students with Emotional and Behavioral Disorders. As I noted in a parallel post on LD Blog, these need to be BIG IDEA questions. What do teachers and parents need to know about how to help students with EBD?

Examples (just for provoking discussion): Continue reading ‘What do educators need to know?’

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ABAI on restraint and seclusion

Based on the work of a task force composed of highly qualified individuals, the Association for Behavior Analysis International (ABAI) has issued position statement about the use of restraint and seclusion in treatment. Members of the task force, which was appointed by the executive board, include Jon S. Bailey, Michael F. Dorsey, Louis P. Hagopian, Gregory P. Hanley, David B. Lennox, Mary M. Riordan, Scott Spreat, and Timothy R. Vollmer (chair).

The Association for Behavior Analysis International (ABAI) and its members strongly oppose the inappropriate and/or unnecessary use of seclusion, restraint, or other intrusive interventions. Although many persons with severe behavior problems can be effectively treated without the use of any restrictive interventions, restraint may be necessary on some rare occasions with meticulous clinical oversight and controls. In addition, a carefully planned and monitored use of timeout from reinforcement can be acceptable under restricted circumstances. Seclusion is sometimes necessary or needed, but behavior analysts would support only the most highly monitored and ethical practices associated with such use, to be detailed below.

In the “below,” the document goes on to present in detail the a set of guiding principles and specific recommendations about the use of seclusion and restraint. Read the statement, “ABAI Statement on Restraint and Seculsion” from the ABAI Website.

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Lovaas obituary

Over on Spedpro I posted a brief account of the research conducted by O. Ivar Lovaas. Professor Lovaas, the eminent behavioral psychologist who developed detailed procedures for teaching individuals with Autism, died earlier this week.

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FDA warns seller of chelation product

The U.S. Food and Drug Administration (FDA) issued a warning letter to the producer of a product that is sometimes used by people hoping to eliminate heavy metals from children’s bodies (e.g., chelate mercury from children with autism). In a letter addressed to Boyd D. Haley of CTI Science Inc., Teresa C. Thompson of the Cincinnati District Office of the FDA cited a host of problems in the classification and marketing of the product, OSR#1. Among these problems are the following:
Continue reading ‘FDA warns seller of chelation product’

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Virginia Autism insurance mandate gains traction

In the Virginia (US) legislature (which I sometimes call the “House of Burgess” for fun), efforts to mandate coverage of intensive behavioral therapy (AKA “ABA,” “discrete-trial training,” etc.) by insurance policies gained a little momentum 16 February when Senate Bill 464 passed by a nearly 2-to-1, bi-partisan margin. Earlier this legislative session, one similar bill (HB 303) was rejected by a narrow vote (4-to-4) in the committee on Commerce and Labor of the Virginia House but another (HB 34) may still be alive (I’m too uniformed about legislative processes to know).

The summary of the just-passed Senate bill, whose chief patron is Senator Janet D. Howell of Reston (VA, US), is as follows: Continue reading ‘Virginia Autism insurance mandate gains traction’

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Fish oil and adolescent psychosis

During the 40 weeks after receiving a brief course of ω-3 (“omega three”) polyunsaturated fatty acids, adolescents at risk for psychotic disorders were less likely to progress to psychotic status than similar peers who did not receive the supplement. In the study by G. Paul Amminger and colleagues, the youths in the treated group also had fewer positive, negative, and general symptoms of psychosis and improved overall functioning than those in the control group.

The youths in the treated group received a supplement of two fish-oil capsules twice a day for 12 weeks, and the controls received a placebo of coconut-oil capsules. The researchers then monitored their status and symptoms for the following 40 weeks.
Continue reading ‘Fish oil and adolescent psychosis’

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Science, gastro-intestinal problems, diets, and Autism

In Pediatrics Dr. Timothy Buie and colleagues published a paper providing evidence-based recommendations for pediatricians who evaluate and treat gastrointestinal problems in patients with Autism. The authors, who represent many important scientific groups concerned with allergies, gastrointestinal disorders, nutrition, and similar problems, concluded that children with Autism and related disorders should be assessed and, as approriate, given medical care just as would individuals without Autism. The team encouraged pediatricians to develop and employ “evidence-based algorithms for the assessment of abdominal pain, constipation, chronic diarrhea, and gastroesophageal reflux disease (GERD).”
Continue reading ‘Science, gastro-intestinal problems, diets, and Autism’

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Virginia Campaign for Children’s Mental Health

Twelve key children’s services for community services boards
  1. specialized children’s emergency services;
  2. crisis stabilization;
  3. evaluations for Comprehensive Services Act services;
  4. psychiatric/medication;
  5. office-based mental health therapy;
  6. office-based substance abuse therapy;
  7. mental health case management;
  8. intellectual disabilities case management;
  9. substance abuse case management;
  10. home-based behavioral treatment and support for families;
  11. school-based day treatment; and
  12. local residential services.

Right here in my home commonwealth of Virginia last week, Mira Signe, Vicki Hardy-Murrell, John Morgan, and Margaret Nimmo Crowe explained why it is important that government and private organizations attend to and address issues in children’s mental health. By explaining that Virginia has inadequate services and that one in every five children or youths experience mental health problems at some time during their lives, they made the point that that there is a tremendous need for public focus on these issues. This was the kick-off event for the Campaign for Children’s Mental Health.

The Campaign for Children’s Mental Health is a 3-year sustained effort to make mental health services more available and accessible to Virginia children in need. It will strongly endorse Governor-elect McDonnell’s call for system improvements; urge the General Assembly and state and local government to work collaboratively with the administration to address system deficiencies; and conduct a high-profile three-year advocacy and education drive to build public and political support for improved mental health services for children.

Only about one in 20 of Virginia’s children have access to the key services listed in the accompanying box. So, four out of five children who need these services do not have access to them.

No, Virginia, this is not an acceptable way to treat our children. Let’s do better.

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Remarkable Autism story

In “Autism: A journey of recovery” on the “American Morning” section of the Web site of CNN, reporter Kiran Chetry relates the story of Jake Exkorn and his family. Jake’s remarkable story is one of great losses in competence as a toddler, followed by persistent, intensive therapy during his childhood and substantial progress.

Review the transcript for this Autism story here.

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