EBD Blog

Under the headline “Time to reexamine bipolar diagnosis in children,” Brendan Borrell reports on proposed changes in the American Psychiatric Association
s Diagnostic and Statistical Manual for the identification of bipolar disorder. In addition to presenting the basic information, Mr. Borrell has alternative views by Dr. Gabrielle Carlson and Dr. David Axelson.

Psychiatrists in favor of a new label, temper dysregulation disorder, cite a spike in bipolar diagnoses. But others worry it will add uncertainty to the treatment of an already confusing condition.

I wonder which side the psychiatrists who were concerned about the change from “manic depressive” to “bipolar” are on with this newest change. Will I have to change the category label in EBD Blog?

Link to Mr. Borrell’s story. Use the short link for this entry: http://wp.me/peQI7-iw

I rarely point to posts on the Huffington Posts, but an entry by Liane Kupferberg Carter entitled “Autism: A time for civility” deserves recognition. Ms. Carter, the mother of a child with Autism, notes how factionation (if I may create than word) among people with interests in Autism has created divides not needed. The basic notion is that in contemporary diagnoses, Autism reflects a diverse spectrum of disorders. Educators, parents, policy-makers, and others need to accept the diversity and not fight among ourselves. Ms. Carter makes this point well. I encourage readers to read her post.

AST Online’s most recent newsletter (as of this date) provides lots of helpful information. Check it!

Janie Shelton and colleagues at the University of Califonia at Davis reported that women over 40 years of age who give birth have an increased risk of the child having Autism. By studying a large sample of births, the researchers were able to disentangle the relative contributions of maternal and paternal age to the likelihood of having a child with Autism.

This study conflicts with some previous research that pointed at paternal age as a factor in Autism (see the EBD Blog page by Leslie Feldman on Fathers’ Age as Contributor to Risk for Autism). The Shelton et al. analysis expressly examined the relative contributions and points at maternal age as an independent factor. Additional research will help to clarify the relationships.
Continue reading ‘Maternal age increases risk of Autistic offspring’

As the US House of Representatives prepares to make statements about and amend HR 4247, Representative Joe Courtney (CN, US) posted a statement on the blog maintained by the House committee that will debate the legislation. The post, “Rep. Joe Courtney: Congress Must Make Schools Safe Havens for Children,” touts Representative Courtney’s perspective on the legislation. There’s lots more about the proposed legislation via that blog and related resources. Take a look.

Also, read the actual proposed legislation, “Preventing Harmful Restraint and Seclusion in Schools Act” and the position statements by the Council for Children with Behavior Disorders about seclusion and restraint and “Position Summary on Restraint and Seclusion.”

The US Congress is considering legislation to prevent abusive restraint and seclusion of students in schools. This is a welcome consequence of the highly visible reports about terrible abuses of students’ right to be free from harm. However, as much as I support this initiative, it is important to make clear that the laws (and regulations resulting from them) must be crafted carefully.

Here’s some text from the press efforts by the US House of Representatives about this important legislation. I follow it with a cautious support of the law.
Continue reading ‘US legislators consider law for preventing abusive restraint and seclusion’

As most readers probably know, the UK General Medical Council censured Dr. Andrew Wakefield for his research that supposedly shows a link between immunization with the measles-mumps-rubella (MMR) vaccine and autism. The Autism corner of the blogosphere has been rife with discussion (more than what I can up with keep). However, Liz Ditz has been maintaining a catalog of notes pro and con regarding the finding. For those who are interested, read Andrew Wakefield: Dishonesty, Misleading Conduct, and Serious Professional Misconduct: Blog Posts Critical of Verdict; Blog Posts Approving of Verdict

Also see theBBC news coverage, MMR scare doctor ‘acted unethically’ panel finds, and the UK Telegraph story, “GMC brands Dr Andrew Wakefield ‘dishonest, irresponsible and callous’.”

I want to note that readers should understand that the GMC investigation, though very important, did not expressly examine the scientific basis of Dr. Wakefield’s case. The findings discuss whether he was qualified to do the work and followed procedures in seeking approval for it. The scientific strength of the findings from the study in question have been examined extensively by well-qualified researchers and found wanting, though (see, for example, Hornig et al., 2008).

Buie et al.’s “Take-Away Messages”

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’

A new study from the US Center for Disease Control (CDC) puts the prevalence of Autism Spectrum Disorders (ASD) at 0.9% (one in every 110) of 8-year-old children. Writing in Morbidity and Mortality Weekly Report, Catherine Rice of the CDC’s National Center on Birth Defects and Developmental Disabilities reported the results of her study 18 December.

In what is called a surveillance study, Ms. Rice examined educational and medical records of children age 8 in 2006, because that age appears to be a peak age for prevalence of ASD. Research teams from sites that participate in the Autism and Developmental Disabilities Monitoring (ADDM) Network monitor public health records. Ms. Rice’s report aggregated the data from 10 sites.
Continue reading ‘New prevalence study of ASD’

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.

• Down load the press release (source of the excerpt quoted here).
• Read coverage in these newspapers:
  • Lynchburg News and Advance—Coalition pushes mental-health care for children
  • Washington Examiner&mdash:Advocates start bid to expand children’s mental health services under bleak budget;
  • Richmond Times Dispatch— Coalition advocate mental-health care for children
  • Washington Post (blog)—New coalition has AG’s support for mental health reforms
• Visit (and support) the Web site of the Campaign for Children’s Mental Health.
• Download pdfs of “Survey of Community Services Board Child and Adolescent Services” and “Review of Community Services Board Child and Adolescent Services“; these are report by James W. Stewart, Inspector General for Virginia’s Mental Health, Mental Retardation & Substance Abuse Services (now called Behavioral Health and Development Services). The list of key services comes from these reports;
• Visit the < href="http://www.facebook.com/pages/The-Campaign-for-Childrens-Mental-Health/183467424796?v=wall" target="_blank">Facebook page;
• Listen to a brief (3+ min) interview with Ms. Crowe from WMRA: Pushing for Children’s Mental Health Reform.

I’m going a little afield here, as this is not about children or youth. Still, I thought it might be interesting to a reader or two. Using images of the brains of adults with Autism and other adults without Autism, Michael Lombardo and colleagues examined activity in two parts of the individuals brains considered to be involved in thinking about oneself or about others. They found that the individuals with Autism showed differences from their not-Autistic matches in the area of the brain (cingulate cortex) that is active during social interactions and bonding.

All of the participants who had Autism diagnoses (N=29) were pretty high functioning. They were, on average, 26 years old, their average full-scale IQ was almost 116, and on the ADI-R social, communication, and repetitive scales their average (SD) ratings were 17.87 (4.73), 14.83 (3.58), and 5.78 (2.71) respectively.
Continue reading ‘Self- and other-referents in Autism’

Writing under the headline “Pros and cons of screening teens for depression,” Brendan Borrell examined some of the issues that sometimes roar around surveying youths to identify those who are depressed or at risk for depression. Mr. Borrell’s article, which is one in a series of articles about depression appearing in the Los Angeles Times, addressed concerns such as parental reservations about testing of their children without permission, false positive identification of a high percentage of students, and the absence of adequate treatment for many who need help.

Mr. Borrell established the importance of the issue in his lead:

By the time a teenager graduates high school, about one out of nine of his or her peers has attempted suicide. Suicide is the third leading cause of death among young people, behind car accidents and homicide, and 10% to 12% of teens ponder suicide every day.

Continue reading ‘Screening teens’