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’
Twelve key children’s services for community services boards
specialized children’s emergency services;
crisis stabilization;
evaluations for Comprehensive Services Act services;
psychiatric/medication;
office-based mental health therapy;
office-based substance abuse therapy;
mental health case management;
intellectual disabilities case management;
substance abuse case management;
home-based behavioral treatment and support for families;
school-based day treatment; and
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.
Down load the press release (source of the excerpt quoted here).
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.
Trine Tsouderos and Patricia Callahan, the Chicago Tribune reporters who have provided exemplary examinations of unsupported therapies for Autism, continued their series of stories on the topic with a piece entitled “Autism: Kids Put At Risk” in the Los Angeles Times. In this briefer (though still well-researched) article they devote most of the coverage to examining the physicians who prescribe chelation, hyperbaric oxygen therapy, anti-testorsterone drugs, mega-doses of vitamins, and many other unproven regimens and other doctors who have serious doubts about the consequences, including the safety, of such therapies.
In a smallish-but-well-done study, Geraldine Dawson and colleagues reported in Pediatrics that the Early Start Denver Model (ESDM)—a variant of the behavioral methods that have often been found to be effective—produced salutary benefits for young children with Autism. The children who received the ESDM intervention had significantly greater gains in IQ than those in a community treatment control and their social behavior kept pace with the standards for their non-disabled peers while the social behavior of the community controls declined relative to the standards.
OBJECTIVE To conduct a randomized, controlled trial to evaluate the efficacy of the Early Start Denver Model (ESDM), a comprehensive developmental behavioral intervention, for improving outcomes of toddlers diagnosed with autism spectrum disorder (ASD). Continue reading ‘ESDM benefits toddlers’
Michael Aman and co-authors (and there are at least 25 of them) reported that a combination of medication and parent training in behavior management was more effective than medication alone in reducing behavior problems. They assigned families randomly assigned to receive either risperidone as well as parent management training or risperidone alone. After 24 weeks, they assessed the children’s behavior with parent-report measures. The parents who learned to use behavior management strategies reported lower levels of non-compliant behavior and irritability. Continue reading ‘Meds plus behavior management for Autism’
The second installment of Chicago Tribune reporters Trine Tsouderos’ and Patricia Callahan’s investigation of alternative treatments for Autism is available. Liz Ditz cited it in her comment on my earlier post about the first installment of this exemplary piece of journalism, but I am repeating the link here so that it will be readily apparent to readers. For even more on the coverage of questionable alternative therapies by Ms Tsouderos and Ms. Callahan, see the post entitled “The Unethical Treatments that ‘Autism is Vaccine Injury’ (And Other False Premises) Give Rise To” on Liz Ditz’s blog.
Writing in the Chicago (IL, US) Tribune under the headline “Autism treatments: Risky alternative therapies have little basis in science” Trine Tsouderos and Patricia Callahan reported about the background and myriad problems with many treatments used as therapy for children with Autism. They expose the lack of evidentiary support for therapies ranging from mega-doses of vitamins to chelation and show the relationships between practitioners of these therapies and a couple of organizations well-known among those who follow Autism.
The Tribune found children undergoing daylong infusions of a blood product that carries the risk of kidney failure and anaphylactic shock. Researchers in the field emphatically warn that the therapy should not be used to treat autism.
Children are repeatedly encased in pressurized oxygen chambers normally used after scuba diving accidents, at a cost of thousands of dollars. This unproven therapy is meant to reduce inflammation that experts say is little understood and may even be beneficial.
Children undergo rounds of chelation therapy to leach heavy metals from the body, though most toxicologists say the test commonly used to measure the metals is meaningless and the treatment potentially harmful.
Reporters Tsouderos and Callahan conducted interviews with an impressive array of advocates for the therapies (including representatives of Autism One, Autism Research Institute, and Defeat Autism Now) and doubters (mostly serious scientists). They combed through the weak and barely related research that many of the advocates use as well as the evidence showing limited or no benefits of the therapies.
All in all, these reporters deserve kudos for the unflinching thoroughness of their reporting. I encourage readers to read, reread, and disseminate the article. Here’s a link to “Autism treatments: Risky alternative therapies have little basis in science.” Flash of the electrons to Liz Ditz, whose Twitter post about this article alerted me to it.
Doreen Granpeesheh and colleagues reported that a randomized trial of hyperbaric-oxygen therapy did not produce beneficial effects on children with Autism. The results of the study—double-blind, placebo controlled procedures, making it scientifically sound—showed no significant differences in direct observations of toy play, hyperactivity, appropriate vocalizations, vocal stereotypy, physical stereotypy, aggression, self-injury, property destruction or on standardized assessment employing a host of psychological measures. Continue reading ‘More reason to doubt benefits of HBOT’
Children and youths who were treated with “atypical antipsychotic medications” (aripiprazole, olanzapine, quetiapine, or risperidone) gained substantial weight and had changes in their metabolism in a study reported by Christoph Correll and colleagues in the Journal of the American Medical Association. The drugs, which are used to treat childhood schizophrenia, bipolar disorder, and (sometimes) Autism, also caused changes in blood lipids.
Drug
Brand Name
clozapine
Clozaril
risperidone
Risperdal
quetiapine
Seroquel
olanzapine
Zyprexa
The medications, which are also known as second generation antipsychotics, are marketed under the names shown in the table at the right.
On average, the children’s weight gains differed across the different medications, ranging from 8.5 kg with olanzapine to 4.4 kg with aripiprazole. For better than half of the children, the gains amounted to more than 7% of their body weight. Changes in the children’s metabolism varied by drug, too; olanzapine caused the largest problems and aripiprazole caused no changes in metabolism (e.g., cholesterol).
The National Autism Center released the report of its National Standards Project. The project was designed to identify interventions that are or are not beneficial for individuals with Autism or Autism Spectrum Disorder and it presents known therapies in three categories: established, emerging, unestablished (including a subsection on “ineffective/harmful treatments”).
In summary, the National Standards Project, a primary initiative of the National Autism Center, seeks to:
describe the age, diagnosis, and skills/behaviors targeted for improvement associated with treatment options
identify the limitations of the current body of research on autism treatment
offer recommendations for engaging in evidence-based practice for ASD
Under the headline, “Hyperbaric chamber: healthy or hype?” in multiple news sources, Chris Woolston reported about various uses of hyperbaric oxygen therapy (HBOT). He has quotes from an advocate and, hooray, from people who know better.
EBD Blog provides news and commentary about Emotional and Behavioral Disorders in children and youths. These problems have sometimes been called "emotional disturbance" or even "serious emotional disturbance." Whatever they are called, these problems are real, painful, and important. They often affect other people as well as having deleterious effects on school, social relations, and other aspects of the individuals' lives.
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