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.
Although I have followed the promotion of secretin as a treatment for Autism pretty much since the first reports about it, I hadn’t checked on it lately. My initial foray into the topic in 1998 resulted in some skepticism with hedges. As the research evolved, it became clear that the skepticism was warranted.
However, I was surprised that Stephen Edelson, writing in a 2008 article entitled The secretin story: Still a promising treatment for autism,” considered “the studies investigating the efficacy of secretin have been very positive.” Coupled with some vaguely remembered notion that fewer than 50% of physicians discouraged use of secretin, the article gave me pause. I thought, “Hmmm. Maybe you’re earlier analysis was hasty, John.” Continue reading ‘Secretin reminder’
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.
Citalopram, one of the class of drugs known as selective serotonin reuptake inhibitors (SSRIs) which are usually used to address depression, did not yield beneficial results in a recent study of whether the use of the drug with children and youth with Autism reduced repetitive behaviors. The study, reported by Bryan King and colleagues, included 149 individuals ages 5 through 17 with moderate or severe Autism who were recruited from various parts of the US. Not only did the treated group appear no better than the placebo group, but the children in the Citalopram group were more likely to have adverse outcomes.
Lack of Efficacy of Citalopram in Children With Autism Spectrum Disorders and High Levels of Repetitive Behavior Citalopram Ineffective in Children With Autism Continue reading ‘Citalopram’s non-effects’
Tom Jackman’s article about Danny Watt to which I referred a few days ago (see this post) is generating a lot of discussion on the Post’s Web site. The comments on Mr. Jackman’s story are informative. For example, at least a half dozen mention having a family member with mental illness. Link to the comments.
The parents of Daniel Watt, a youth who had multiple problems, told the story of their son’s life and suicide. Tom Jackman of the Washington Post reported the story of Danny and his parents, helping explain some of the problems of addressing the needs of children with multiple diagnoses—co-morbid schizoaffective disorder and substance abuse, in Danny’s case.
Danny Watt once leapt from a moving train. He hurtled through the windshield of a rolling car. Got pummeled by drug dealers. Overdosed. Swallowed rat poison. Tried to hang himself.
In his tumultuous 21 years, Danny Watt danced with death in the most amazing, horrible ways. In the end, two college students spotted him facedown in the cold, murky water of the C&O Canal one afternoon in April 2008. The medical examiner said Danny had drowned.
Parade Magazine, the insert into millions of Sunday newspapers in the US, carried a brief piece about seclusion and restraint in the versions to be delivered 26 July 2009 (available on line 25 Jul 2009). The piece doesn’t present anything new, but we can hope that it helps to sustain concern about providing appropriate treatment for individuals with disabilities.
“Hold Me Tight, Let Me Go,” a movie about a UK school for children with Emotional and Behavioral Disorders, will air on US television 28 July 2009 on P.O.V. The film, made by Kim Longinotto (pictured at right), features the children and staff at Mulberry Bush School in the Oxfordshire village of Standlake. P.O.V. (Point of View) provides “documentaries with a point of view.”
Variety describes it as a film “mixing ferocity with tenderness, delicacy with tenacity”–exactly like the unusual school it explores. In Hold Me Tight, Let Me Go, one of Britain’s leading documentary filmmakers takes a verité look at Oxford’s Mulberry Bush School for emotionally disturbed children. Mulberry’s heroically forbearing staff greets extreme, sometimes violent behavior with only consolation and gentle restraint. Kim Longinotto’s unblinking camera captures an arduous process and a nearly unhinged environment, but it also records the daily dramas of troubled kids trying to survive and the moments of hope they achieve with Mulberry’s clear-eyed staff.
Link to the US PBS site, where one can learn when the entire film will be available in different areas. Visit the Mulberry Bush organization’s Web site. See the UK’s Office for Standards in Education, Children’s Services and Skills (Ofsted) listing for the Mulberry Bush School. Link to an extended piece, “Inside the home for angry infants: It costs £123,000 a year to send a child to this special school — because nobody else will have them,” by Caroline Scott in the Times Online (11 May 2009). Learn about other P.O.V. shows.
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;
According to Mary Ann Roser of the Austin (TX, US) Statesman, a clinic that provided chelation therapy for Autism is apparently under investigation by federal authorities. Ms. Roser did not report the nature or cause of the investigation of the CARE Clinics.
CARE Clinics, an autism clinic on Bee Cave Road that was being investigated by insurance companies over insurance claims, was raided by the FBI and IRS agents today.
The clinic has been closed, perhaps permanently.
Agents are removing dozens of boxes of documents, but they declined to say what they are looking for. They directed inquiries to Special IRS Agent Mike Lemoine, who did not immediately return a call.
In an article in May of 2009, Ms. Roser reported that the clinic was having financial trouble.
The owner of an Austin-area clinic that treats children with autism — using techniques that are controversial in mainstream medicine — says investigations by three major insurers have left it with a pile of unpaid claims and a crisis: She’s had to lay off most of her staff and drastically reduce the clinic’s hours.
In addition, Kazuko Grace Curtin said the Texas Medical Board is investigating her medical director. She and the doctor — Jesus Caquias — say the investigation is a way of harassing them because they offer nontraditional care for autism patients.
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.
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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