Sunday, October 11, 2009

Dr. Amen and ADHD

Dr. Amen is a well known child and adult psychologist specializing in brain imaging science. He believes there are currently 6 types of ADHD not the 3 stated in the Diagnostic Manual.

The brain imaging that he works with is referred to as SPECT imaging (single photon emission computerized tomography). SPECT is a sophisticated nuclear medicine study that looks directly at cerebral blood flow and indirectly at brain activity (or metabolism). In this study, a radioactive isotope (which, as we will see, is akin to a myriad of beacons of energy or light) is bound to a substance that is readily taken up by the cells in the brain.

One kind is a 3D surface brain image, looking at the blood flow of the brain’s cortical surface. These images are helpful for picking up cortical surface areas of good activity as well as underactive areas. They are helpful to look at strokes, brain trauma, the effects from drug abuse, etc. A normal 3D surface scan shows good, full, symmetrical activity across the brain’s cortical surface.

The other kind is a 3D active brain image comparing average brain activity to the hottest 15% of activity. These images are helpful for picking up areas of overactivity, as seen in active seizures, obsessive compulsive disorder, anxiety problems, certain forms of depression, etc. A normal 3D active scan shows increased activity (seen by the light color) in the back of the brain (the cerebellum and visual or occipital cortex) and average activity everywhere else (shown by the background grid).

Physicians are usually alerted that something is wrong in one of three ways: (a) they see too much activity in a certain area; (b) they see too little activity in a certain area; or (c) they see asymmetrical areas of activity, which ought to be symmetrical.

These are "neurotypical" images of the brain.





1. Classic ADHD: Sufferers are inattentive, distractable, disorganized, hyperactive, restless and impulsive SPECT Brain imaging typically shows decreased activity in the basal ganglia and prefrontal cortex during a concentration task. Dr. Amen notes that this subtype of ADD typically responds best to psychostimulant medication.



2. AD/HD, primarily inattentive ADD subtype with symptoms of inattention and also chronic boredom, decreased motivation, internal preoccupation and low energy. Brain SPECT imaging typically shows decreased activity in the basal ganglia and dorsal lateral prefrontal cortex during a concentration task. This subtype of Inattentive ADD also typically responds best to psychostimulant medication.




3. Overfocused ADD, with symptoms of trouble shifting attention, cognitive inflexibility, difficulty with transitions, excessive worrying, and oppositional and argumentative behavior. There are often also symptoms of inattention and hyperactivity-impulsivity. Brain SPECT imaging typically shows increased activity in the anterior cingulate gyrus and decreased prefrontal cortex activity. This subtype of Overfocused ADD typically responds best to medications that enhance both serotonin and dopamine availability in the brain, such as venlafaxine or a combination of an SSRI (such as fluoxetine or sertraline) and a psychostimulant.



5. Limbic ADD, with symptoms of inattention and/or hyperactivity-impulsivity and negativity, depression, sleep problems, low energy, low self-esteem, social isolation, decreased motivation and irritability. Brain SPECT imaging typically shows increased central limbic system activity and decreased prefrontal cortex activity. This Limbic ADD subtype typically responds best to stimulating antidepressants such as buprion or imipramine, or venlafaxine if obsessive symptoms are present.






6. Ring of Fire ADD – many of the children and teenagers who present with symptoms of ADD have the "ring of fire" pattern on SPECT. They often do not respond to psychostimulant medication and in many cases are made worse by them. They tend to improve with either anticonvulsant medications, like Depakote or Neurontin, or the new, novel antipsychotic medications such as Risperdal or Zyprexa. The symptoms of this pattern tend to be severe oppositional behavior, distractibility, irritability and temper problems and mood swings. We think it may represent an early bipolar pattern.
The important thing to remember is that each individual should have a full diagnostic assessment of their condition. Interventions could include:
1. Diet
2. Exercise
3. Medication
4. Supplements
5. Behavioural Interventions - for person with ADHD and family (Neurofeedback)
If medication is given it is important to make sure that there is proper supervision, followthrough and evaluation of the child. You also need to find the right doctor who will spend time with the family to explain the use of the medication and alternatives.



Thursday, October 1, 2009

THE BRAIN AND EARLY CHILDHOOD



The brain weighs approximately 3 pounds and has been the topic of many a research article. The amount of information in relation to how the brain functions is vast but has not even scraped the surface of understanding. There is so much more to learn but there have been many insights that researchers have uncovered that help us when it comes to teaching the young brain to respond to learning.

During the early years 0-10 the brain is at its most vulnerable stage to change. Parents and educators share a desire to maximise the growth and development of children to ensure a strong foundation as they continue to mature. Providing children optimal learning opportunities and engaging environments can encourage the process of acquiring knowledge and the ability to apply that knowledge. Certain methods of learning can be used to help acheive this goal.

Play and the Brain: Play is a complex, lifelong activity. Play usually involves both mental and social skills that promote learning. Here are some things to think about when initiating play activities with your children:

1. Active, Meaningful Learning: Hands on activity, pleasurable, symbolic, practice, exploration, embedded and integrated.

2. Safe Non-Threatening Environments: Encourage risk taking, persistance, ownership, and activities that are intrinsically motivating.

3. Stimulating, Varied Input: Challenging, Varied materials, choice, interaction with peers, sensory input, complex materials

4. Accurate, Timely Feedback: Rewarding, pleasurable, interaction with both peers and adults

Remember at birth a child's brain is not fully functional. As the child experiences their environment(through sensory and tactile modes) along with their genetic inheritance, the brain's neurons and dendrites explode along pathways setting down information neccessary for the child to function. The brain is not static so it is constantly changing and modifying according to the experiences in the environment.

Enriching the Environment: (Diamond & Hopson, 1998)

1. Includes a steady source of positive emotional support
2. Provides a nutritious diet with enough protein, vitamins, minerals and calories
3. Stimulates all senses (not necessarily all at once)
4. Has an atmosphere free of undue pressure and stress but suffused with a degree
of pleasurable intensity
5. Presents a series of novel challenges that are neither too easy or too hard for
the child at his/her stage of development
6. Allows social interaction for a significant percentage of activities
7. Promotes the development of a broad range of skills and interests that are
mental, physical, aesthetic, social, and emotional
8. Gives the child the opportunity to choose many of his or her efforts and to
modify them.
9. Provides and enjoyable atmosphere that promotes exploration and the fun of
learning
10. Allows the child to be an active participant rather than a passive observer.

** An enriched environment gives the child an opportunity to make sense out of what they are learning rather than just taking in meaningless data.
** The brain develops in an integrated fashion. An enriched environment addresses multiple aspects of development simulateously.
** The brain is naturally curious. It constantly seeks connections between the new and the known. Learning is a process of active construction by the learner.
** The brain is innately social and collaborative. Learning is enhanced when the environment provides them with an opportunity to discuss their thinking out loud, to talk with peers and to produce collaborative work.

IQ is not fixed at birth. Intervention programs for impoverished children could prevent children having low IQ's (Ramey & Ramey, 1996).

There are sensitive "windows of opportunity" where some abilities are acquired more easily. Vision and language development seem to have very "tight windows" If sight is not restored by age 3, if the child has had cataracts or blindness the cells in the brain designed to interpret vision to atrophy or be diverted by other tasks (Bruer).

**When we are able to add emotional input into learning experiences to make them more meaningful and exciting, the brain deems the information more important and retention is increased. However extreme emotional experiences may actually do the opposite and cause memory loss rather than retention.

A child's brain moving from pre-school to kindergarten to grade one does not automatically change from an experience or play based learning brain to a "sit down" higher order advanced thinking brain. Therefore many researchers still agree that up untill the end of grade 2 or even grade 3 children still learn best through projects, learning centers and playful activities.

Suggestions for grade primary classrooms:

* Child initiated learning, centers for construction, sand, water play, socio-dramatic play, woodworking, puppet center, cooking center, library center, science/math center, block building/manipulative center, etc....

Strengthen each child's natural curiousity to investigate, hypothesis, and look for cause and effect. These as well as play activities present for the child many different opportunities to engage and interact within their environment. Encourage each child's individual ability and tailor the learning to their needs. Building on the child's interests and strengths will lead to pleasurable learning experiences and continued motivation for life long learning.

Tuesday, September 22, 2009

A FEW THOUGHTS ON TEACHING!

I became a teacher because I had excellent relationships with those that taught me in both primary school and high school. Their ability to engage and connect with me made me realize that teaching was what I wanted to do as a career when I had the opportunity to do so. Teachers guided me and counselled me when I was experiencing the typical adolescent dilemmas. They encouraged me to excel and find my passions and interests as I became a young adult. I remember them not for the curriculum they taught me but for the life lessons that they helped me learn.

My philosophy is very much centered on these experiences I had with my teachers as a child. I believe that children continually go through developmental stages in their lives where they need discipline, guidance and support. Teaching is not all about delivering curriculum or information but connecting to engage them to make personal decisions that encourage their own growth and development.

I have learned that initially my methods were authoritarian and controlling. I needed to feel that I was in control of the classroom and all those within it. I did not recognize the complexity of the situation in relation to the different way students responded to my style of teaching. It was my classroom and they would do as I told them. I did achieve outcomes using this style of teaching but was very concerned with those students who were not managing to keep up with the level of information that they were required to learn. I remember a deputy principal saying to me “ Don’t worry about her we’ll just pass her and move her on to the next grade.” This child was having difficulty reading and writing in grade 9. I realized at that point that the outcomes that I was getting were superficial. Was I actually teaching these kids to learn or was I imparting information that they needed only to pass the tests?

My style of teaching began to change as I started to work with high risk children. Using this authoritarian style was not as effective as using it with those children whose behaviour was compliant and socially acceptable. The high risk children needed different methods and it took a few years to figure out that maybe I needed to change my approach rather than expecting them to do all the changing. Evaluating children’s needs using a holistic perspective was required from me so I could understand the underlying motivation and function of their behaviour in relation to their learning.

The number of damaged children that I have encountered has encouraged me to look beyond their “academic marks” and find the things that help them create their own peace in their lives. Fixing them is not my responsibility. The only person that I have the power to fix or change is me. I do not control anyone else but myself. I am still working towards this understanding as I know there are some days and some people who I would love to control to get them to do what I want them to. I now know that this will only increase my stress levels and make me unhealthy.

Teaching our children that they have the power to make their own decisions and solve their own problems, I believe, will create children who feel powerful within themselves and hopefully not have to feel powerful over others. Those that feel powerful within tend to help others because they want to share their positive feelings. People who are negative and unhappy want you to feel the same way as well so they try to get you in the same frame of mind as them. (Power over you) Children that are able to understand that they control themselves and can make decisions in relation to others will be far better off as they encounter situations where others are trying to take power from them in negative and hurtful ways.

People who try to be powerful over others are seeking this feeling of happiness and satisfaction but may only receive short term gratification. They may feel happiness and satisfaction as an immediate feeling but will have to continually seek it out from others as they can never retain it (a bit like taking drugs - you need more to maintain the high but never reach the ultimate feeling as you need to keep taking more and more which will ultimately destroy yourself.) We can only retain this feeling if we make the decision within to seek happiness and satisfaction through our own behaviour and interactions with our environment and that others do not have control over how we react. Wouldn't it be great if everyone made the decision to be happy, help and understand others (powerful within) rather than try to be powerful over others.

I know, I know, naive and wishful thinking but I can dream can't I...... I can also teach.....

Thursday, September 3, 2009

Sensory Motor Regulatory Patterns

THESE WONDERFUL ACTIVITIES WERE SENT TO ME BY: Author: Bill Nason,LLP


Sensory Motor Regulatory Patterns

Purpose: Calm and organize nervous system

Promote emotional attunement

Establish “facial gazing” and “emotion sharing”

Establish adult as soothing support when distressed.

Use very simple interactive activities, such as peek-a boo, “I am going get you”, rocking back and forth, sandwiching/squishing with bean bag, etc. that provides repetitive, rhythmic interaction patterns.

Sit (stand) face to face, at eye level, with close physical contact. This allows you to regulate activity, keep child focused, and encourages facial gazing.

Add rhythmic singsong or chatting (like “row, row, row your boat”) to the rhythmic pattern. This uses your voice, touch, and facial expression to engage the child.

Use exaggerated gestures, animated facial expressions, and exciting vocal noises to engage the child, establish facial gazing, and share enjoyment.

Your primary objective is to establish facial gazing so that the child can reference your emotions. Start the rhythmic pattern and establish facial gazing. If child averts his gaze (turns away), hesitate and pause the interaction until child returns gaze, than immediately restart pattern. If needed you can stutter or exaggerate the movement, slow it down or speed it up, or raise or lower your voice to draw child’s gaze back to you.

You can greatly enhance the emotion sharing by spotlighting the exciting part of the pattern. Hesitating, pause, exaggerate, or draw out the moment just before the climax (just before dropping, tickling, etc.). For example, in peek-a-boo, just before showing your animated face, draw out the words “peek, aaaaaaaaaaa, boo!”. This creates anticipation and excitement.

Stay with same pattern for a while to create sense of predictability and familiarity. As the child becomes comfortable with the pattern, you can add simple variations to the pattern. Keep it very simple at first and add small variations to provide novelty and excitement. If child seems too anxious by the change, back up to previous pattern.

Try to pick only a few patterns to start out with. Keep them simple and do them the same way at first so that they become familiar and predictable for the child.

Eventually you we feel the child start to help regulate the activity. As you hesitate, child may actively attempt to regulate the pattern.

It is important that you lead the activity, and don’t let the child control or direct the interaction. You want the child to learn to follow your lead and allow you to regulate interaction.

Remember what your objectives are. You are focusing on establishing “facial gazing”, “emotion sharing”, and “engagement”.

Most importantly, engage the child and have fun!

  1. Rocking, swaying, or dancing together. Standing or sitting, hold child’s hands or arms, and rock, sway, or dance in a simple rhythmic movement. Chant or sing.
  2. “1,2,3…bop!” Gently clap hands and tap cheeks. Take her hands in yours, clap them softly together to the count of “1..2..3” and “bop!” tap her hands to your cheeks. Than, repeat to her cheeks.
  3. Peek-a-boo, using child’s hands or feet. Animate your facial expressions and voice.
  4. Leg presses. Lie child down. Knell in front of him and bend his knees so they are up in the air, with your face between them. While counting to three bounce his knees slightly. Chant “1..2..3…pause/hesitate…PRESS!” and press his knees down and in toward his chest. Allow your face to follow so it comes into close to his gaze.
  5. Blowing up balloon. Adult blows up balloon with animated expressions. Gently let air out on child’s hand or neck, make squeaky noises while letting air out, or let go of balloon to fly around the room. Variation: have child press against your cheeks as you blow. . In addition, tie the balloon and gently tap it back and forth.
  6. Blowing bubbles, face to face, while child touches, claps, or tries to catch them. Get close, wait to child references your face before blowing the bubble.
  7. “Up..up..up…drop!” With child lying down, hold her arms and gradually lift her upper body with stuttering pauses (“up..up..up”). Hesitate, than let child drop back down with animated excitement.
  8. “I am going to get you, get you, get you!”….than tickle, poke or kiss the child.
  9. Rocking/rowing back and forth. Sit facing each other, holding each others arms. Slowly rock back and forth (to “row your boat”), or pull each other (stretch) back and forth.
  10. Crash, fall, or jump together into bean bags. Stand side by side, count to three…pause.. and fall together. Lie there a moment and tickle each other.
  11. Push child backward into bean bags. With child’s back to bean bags, count 1,2,,3 and push child to fall backwards into bean bags. Cuddle and tickle together on bags.
  12. Pillow press with bean bag or large pillow. With child lying down, chat, “I am going to get you!” and squish him with a beanbag. Keep your face close to his for emotion sharing.
  13. Friendly pillow fights. Use animated faces and excited vocals to create anticipation.
  14. Sit and bounce together on therapy balls. Hold hands and bounce or sway together. Add excitement by creating a chant and falling off!
  15. Toss a ball back and forth, or try to hit each other with a soft ball.
  16. Clapping hands or drumming to music. Get face to face, take her hands and clap them to a simple beat, with animated singing.
  17. Swinging. With child in a swing. Stand in front of her, take her legs and swing her back and forth. On the way up, hold and pause to elicit anticipation, than let her drop and swing back. Variation: As she swings, grab feet each time she comes back. Variation: Pretend to be kicked each time child comes back at you.
  18. “This is the way the cowboy rides!”. Sit child on your knees, facing you. Take her arms and gently bounce her on your knees. Start with “this is the way the lady rides”, than “gentleman rides”, than “cowboy rides” as you increase the intensity of bouncing.
  19. Making a sandwich. Make a sandwich with the child as meat. Lie child on a large pillow or couch cushion. Child pretends to be their favorite meat. Pretend to spread mustard, catsup, pickles, etc. on her in tickling fashion. Next place another large pillow on top of child and pretend to eat her.
  1. Rolling prone on ball: Lie child prone on a ball. Holding his hands, roll him back and forth to “Row, row, row your boat”. Pause and go faster for “merrily, merrily, merrily, merrily, life is but a DREAM” and roll child off ball into your arms.
  2. Bounce and fall off ball. Knee in front of child. Hold child and bounce him on a ball to Humpty Dumpty. Pause and draw out “h...a..d….a…g..r..e..a..t…..” and bounce child off onto a bean bag to “FALL!”
  3. Rolling ball on child: With child lying down, roll therapy ball over body and sing (to rhythm of “Mary had a little lamb”) “Were rolling out the cookie dough, cookie dough, cookie dough, repeat, …pause/hesitate….and bouncing it to pieces (bounce ball on child)”.
  4. Swinging. Hold child’s legs and swing back and forth while chanting. After a few swings, swing child up and hold…pausing (sharing excited facial expressions) and letting him drop.
  5. Making a hot dog roll: Lie child on one end of a roll out blanket. Pretend to make a hot dog roll. Put on mustard, catsup, relish, etc and than roll him tight in the blanket…and pretend to eat him.
  6. Sit child on top of the back of a couch, that is up against a wall. To “Humpty Dumpty”, when you get to “had a great….pause/hesitate….FALL” pull the child so he slides down the couch to the cushion.
  7. “Wheels on the bus”: Sit child on your lap. Hold arms and rotate to “Wheel on the bus go round and round”, then back and forth to “Wipers go swish, swish, swish”, then bounce to “people on the bus go up and down”.
  8. Using face paint, sit face to face and paint each others’ faces.
  9. Sit with your child in front of you. Let the child brush and “do you hair” with ribbons, curlers, barrettes. Make funny faces and excited statements.
  10. Sit side by side in front of a mirror. Take turns tracing each other’s face on the mirror.
  11. Sit face to face and feed each other ice cream out of a bowl. Use animated face and excited vocal to “emotion share”.

These are only the beginning! Use your creativity and improvise as you go along. Any simple interactive games can be adapted for facial gazing, social referencing, and emotion sharing.

Friday, July 31, 2009

Learning to Read: Why It is Crucial to a Child's Future


"The National Institute of Child Health & Human Development (NICHD) considers that teaching
and learning in today’s schools reflect not only significant educational concerns, but public health
concerns as well." Children who do not learn to read or understand language, cannot verbalize an opinion or thought, solve problems and cannot calculate and reason mathematically may find that the opportunity for leading a rewarding and fulfilling life are seriously compromised. School failure may have devastating consequences for children and may hinder their ability to interact successfully in society. Since reading forms the basics fundamental for all academic learning it is paramount children learn and become proficient at this skill. Children who experience difficulties may crush the child's excitement for life long learning and pursuits.

Many young people have vocalized their embarassment when asked to read in front of their peers with the knowledge that they are lacking the skills to do so. This perpetuates the feelings of failure even at a very young age if asked day after day to perform this skill in front of the class. They begin to feel less positive about their abilities in school and may start to exhibit behaviour that is negative in order to "escape" a task so are not perceived as incompetent at this task. Once these feelings become entrenched learning becomes more difficult as the child grows older and self-esteem and motivation continue to decline.

G. Reid Lyon, Ph.D., states that poor readers lag far behind in vocabulary development and in the acquisition of strategies for understanding what they read, and they frequently avoid reading and other assignments that require reading. By high school, the potential of these students to enter college has decreased substantially. Students who have stayed in school long enough to reach high school tell us they hate to read because it is so difficult and it makes them feel “dumb.”

This is extremely important to be aware of as it is an indicator for young people who drop out of school as they experience more difficulty in high school. Dropping out of education decreases the adolescents ability to acquire a job and sustain a positive lifestyle. Not learning to read and express themselves puts children at risk as they grow into adults.

Dr. Lyon has found that children who receive stimulating oral language and literacy experiences from birth onward appear to have an edge when it comes to vocabulary development, developing a general aware-ness of print and literacy concepts, understanding and the goals of reading. If young children are read to, they become exposed, in interesting and entertaining ways, to the sounds of our language. Oral language and literacy interactions open the doors to the concepts of rhyming and alliteration, and to word and language play that builds the foundation for phonemic awareness – the critical understanding that the syllables and words that are spoken are made up of small segments of sound (phonemes). Vocabulary and oral comprehension abilities are facilitated substantially by rich oral language inter-actions with adults that might occur spontaneously in conversations and in shared picture book reading.

Dr. Lyon also believes that ultimately, children’s ability to comprehend what they listen to and what they read is inextricably linked to the depth of their background knowledge. Very young children who are provided opportunities to learn, think, and talk about new areas of knowledge will gain much more from the reading process. With understanding comes the desire to read more. Thus, ensuring that reading practice and the development of new vocabulary takes place.
Children that practice reading develop fluency, automaticity, and the ability to read with
expression, and to apply comprehension strategies to what they are reading to facilitate
understanding. It all starts very early, with those initial language and literacy interactions that
expose the child to the structure of our language and how print works (Lyon, 2003).

Substantial research supported by NICHD shows clearly that without systematic, focused, and intensive interventions, the majority of children rarely “catch up.” Failure to develop basic reading skills by age nine predicts a lifetime of illiteracy. Unless these children receive the appropriate instruction, more than 74% of the children entering first grade who are at-risk for reading failure will continue to have reading problems into adulthood. On the other hand, the early identification of children atrisk for reading failure coupled with the provision of comprehensive early reading interventions can reduce the percentage of children reading below the basic level in the fourth grade (i.e., 38%) to six percent or less. (Lyon, 2003).

Lyon state that The National Reading Panel (NRP), convened by the NICHD and the Department of Education, found that instructional programs that provided systematic instruction in phonemic aware-ness, phonics, guided repeated reading to improve reading fluency, and direct instruction in vocabulary and reading comprehension strategies were significantly more effective than approaches that were less explicit and less focused on the reading skills to be taught (e.g.,approaches that emphasize incidental learning of basic reading skills).

The challenge now is to integrate research and study with appropriate strategies for learning to read. Identifying children at a young age is crucial to intervention and promoting an ability to read, comprehend and express through language and the written word. Children who experience difficulties need comprehensive strategies from a young age but many do not receive the extra help they require. The future for these children may become very bleak if difficultires are not rectified early in their lives.

Wednesday, July 8, 2009

ADHD: Effective Interventions for the Classroom

CLICK ON THE IMAGE

The chart above gives teachers ideas on strategies that they can implement in the classroom. The chart was developed by Robert Reid (1999). Other factors that need to be taken into consideration are:

1. Set up the environment: Watch for placement of too many stimulating objects. The main teaching area should be fairly bland as ADHD students become overwhelmed and attracted to stimulating objects. The placement of objects int he classroom needs to be analyzed but also the location of the student within the classroom. Open classrooms can be difficult for ADHD students as it may prove distracting. Have two desks for the ADHD child so they may move from one desk to the other. Stand up desks, seated desks, study carrels - depending on the individual needs of the student.

2. Transition time and instruction giving: Be clear and concise. Stay away from too many instructions at once as ADHD children may have difficulty processing auditory language in a quick and efficient manner. Transition time tends to be unstructured and can pose problems. Give the student a job or something that they need to do while transitioning. Pre-plan and make sure the child is aware of when the transition will be taking place.

3. Organization and time on task: Make sure the student is organized - color code their work, schedule and books. Strategies that teach them what they need to do when stuck are also good - Cognitive strategies with visual cues.

4. Task length: Be aware of the length of time it may take your ADHD child to complete an assignment versus others in the class. Where do they start the assignment and where do they stop? What happens when they finish the task? These questions need to be answered to aid the child in completing tasks and to decrease their tendency to become distracted by other stimulus.

5. Engagement and Proactive: Enter into conversations with the child about their interests and strengths. What do they like to do?? Can you implement these interests in their daily task completions? Find the triggers for their behaviours and be proactive. Triggers may be shown when the student becomes frustrated by their work or by another student. By intervening upon recognition of the trigger it may hopefully decrease the escalation.

6. Peer Tutoring: Train peers to help others with work or social skills. Peers can be extremely beneficial in this process but most would require training to learn how to communicate with students who exhibit behaviours that may not be typical.

7. Self monitoring: Get the student to self-monitor their behaviour. Teach them to recognize their own triggers and implement strategies before they get to a level of frustration where they cannot cope.

Tuesday, June 30, 2009

Luke Deserves So Much More

Luke Deserves So Much More

Stephen Drill - Article from Sunday Sun

June 21, 2009 10:26am

LUKE Modra spends 20 hours a day locked in a spartan room. He's alone. His guards pass his food through the door.

He has a TV in his room, but no remote control.

For Luke, simple luxuries such as toasters or a kettle are banned in the suburban Melbourne house that has become his prison.

Luke has never broken the law. He has never been charged or convicted of any wrongdoing.

But he has been given a life sentence - autism, a complex condition of developmental disorders that affect communication and social skills.

"Everybody deserves somebody to love, something to look forward to. Luke doesn't have that now," his mother, Ellen, said.

Luke, 20, is considered one of Victoria's most severe autistic cases. So bad are his symptoms that his heartbroken parents have been unable to care for him at home for the past five years. Because of his violent tendencies, he now lives in a Department of Human Services residential property. He shuns human contact and even his carers are frightened to be in the same room with him.

And his devoted parents are desperate for help. While Mark and Ellen acknowledge they are unable to care for Luke, they argue the care provided by the DHS is not right for their boy. "He has almost no interaction with other human beings," Mr Modra said. "It's like living in a private hell." Mr Modra said Luke spent all day tearing up his clothes because he was so bored. "But if you were in there, you would be doing the same thing," his father said.

Meredith Ward, from the Victorian advocacy body Autism Family Support Association, agrees.She said she had not heard of any other case in which an autistic person was cared for in the manner of Luke Modra. Ms Ward has seen Luke's accommodation, describing it as a jail. "For an adolescent, the DHS should be able to come up with some other support model," Ms Ward said. "He has no quality of life - and neither does his family."

Ellen and Mark are fighting for their son's dignity and are determined to restore some joy to his life. They say he deserves that. Mrs Modra remembers the joy she felt bringing her much-longed for baby boy home from Waverley Hospital in 1988. She considered she had achieved life's ultimate trifecta: the perfect baby, the loving husband and the sprawling family home.

Mrs Modra, now 50, left her job as a medical scientist at the Peter MacCallum Cancer Institute to be a stay-at-home mother. Husband Mark was earning a comfortable wage as an engineer and she said life was near perfect. 'HOW could I be so lucky?" she said this week.

It was a mother's instinct that first made Mrs Modra suspect something was wrong. She said the family celebrated the joy of Luke's first smile, his first words, his first steps and all the milestones of a child's life. But there was a nagging doubt in his mother's mind.

The maternal health nurse told her she had nothing to worry about; Luke was doing well for his age. Mrs Modra said she noticed that at family birthday parties Luke never seemed to mix with his many cousins. "If they were playing in one room, he may just sit alone in another," she said.

Mrs Modra raised her concerns with her siblings, who also had young children. She also talked to other mothers about Luke's shyness. "But they would say, without realising Luke had a disability, that he was talkative," she said. "They would give as an example that he could come into a room and tell you the name of nearly every piece of furniture."

Mrs Modra shared her concerns with doctors, but said they assured her all was well.

When Luke was 2 1/2, the Modras welcomed another baby, daughter Hannah. Two years later - on a Friday in 1993 - the Modras were called to the Royal Children's Hospital. A doctor gave them four pieces of paper and left the room. On the final page, buried in almost the last paragraph, was the word which shattered their lives. Luke was autistic.

"It was 5.30pm and the doctor waltzed back in and suggested we call some support services to discuss the condition," Mrs Modra said. "He then showed us the door." Ellen and Mark went home in tears. Later, Luke went to Essex Heights Primary School in Mt Waverley, which under principal June McDonald was renowned for its inclusive program for children with disabilities.

But in 2000, Luke was moved to Bulleen Heights Special School and his parents say his violent episodes worsened. Ellen, who was looking after Luke and four other children at home on her own, would drop off her oldest son at the school gate where she said he would be met by up to six men who would "look at home on the Collingwood back line".

She said they would frog march him into his "classroom", an isolated area fenced off from the other students. "The school suggested Luke go on medication, mild sedatives to keep him a little bit calmer, a little bit easier to control," Mrs Modra said. Reluctantly, the Modras agreed, but the school continually asked for dosage increases so that Luke could be kept under control. Luke's violence became worse.

The shattered parents said the medication turned their son, who had been able to read, write and communicate, into a "zombie". "His eyes would roll back in his head, his tongue became wooden and he would go into spasms," Mr Modra said. After seeking further advice, Luke was taken off medication. He remains non-medicated.

After five years at the special school, Luke was told he was no longer welcome. His teachers said the 15-year-old was too dangerous to be in the company of children as young as eight. At the same time, respite carers said he was too hard to handle.

Finally, breaking under the stress of caring for Luke at home without respite care, Mrs Modra marched into a DHS office and demanded a short respite. Luke has not been home since, remaining in the care of the DHS.

And on the eve of his 21st birthday, his parents revealed that he spends up to 20 hours a day in solitary confinement in a "community based" DHS property. They say his carers will not be in the same room as him and that they deliver his food through the door.

"When Luke goes out, he has to walk through a specially designed cage so he and his carers never share the same space," his father said. Even DHS insiders, who asked not to be named, said Luke's carers were unable to handle him. "They are really good at keeping him in isolation," a source said.

His carers say they can't be in the same room as the strong young man because he can be violent. Luke's family admits he is no angel, but says he deserves better. "There has to be a better, more humane way to deal with people with severe autism rather than just locking them up and throwing away the key," Mrs Modra said. DHS spokesman Brendan Ryan said if Luke's parents had concerns, they were "happy to discuss them".

BUT Mr Ryan said the DHS was satisfied with Luke's level of care. "He is receiving a wide and intensive level of care," he said. Mr Ryan said there were staff at Luke's house 24 hours a day.Speech pathologists were also provided, he said.

Mr and Mrs Modra say they have been offered $350,000 a year to pay for carers if they take Luke home. That is estimated to be tens of thousands of dollars less than the cost of keeping Luke in DHS care.

His parents have bought a flat for Luke next to their house and Mrs Modra has returned to work to help pay the mortgage. But the couple say they cannot yet have Luke at home because they are still trying to cope with the tragic death of their 17-year-old daughter, Hannah, in January.

In a diary found days after her death, one of Hannah's last wishes was that Luke have proper care. "Her dream was to one day get married to a fantastic husband who would ride bikes and go on hikes with Luke, that was in her diary," Ellen said. "She died two days after she wrote that."

Ellen said Hannah had a close relationship with her brother. "Hannah was the sort of girl who would always come to see Luke," she said. "She saw the worst of it. She really hated it."

The Modras are regular churchgoers and said that faith had given them hope. "What we have always wanted is for Luke to be a valued member of society," Mrs Modra said.

"I just want kids like Luke to be supported and respected and to live happy and productive lives."

Tuesday, June 23, 2009

Thinking Positively: How Some Characteristics of ADHD Can be Adaptive and Accepted in the Classroom


Are ADHD kids annoying? This is a question that I ask in my seminars. Depending on the course and the teacher comments range from "oh yea" , "Sometimes", "Not Really" I then tell my participants that what ever they think they are they are" Our intervention is typically guided by our perception of the child or student. How can behaviours that are displayed by some of our ADHD kids be accepted in the classroom?
Sherman, Rasmussen and Baydala note that children who are ADHD respond to salient or novel stimuli and become easily distracted. Thus attention problems result in decreasing ability to attend to tasks that require sustained attention.
Some strategies that may help children read and write
  • paraphrasing
  • limiting distractions
  • scanning for headings
  • graphic organizers - flow charts, models of written work, and aiding in self-editing
The authors found that strategies helpful for ADHD students are beneficial for all students.

Thinking differently can change how we intervene with our ADHD children. Rather than always telling them to "Be quiet" "Sit down" Use these as their strengths not their deficits. If the child is always talking rather than tell them to stop actually tell them you love how good they are at communicating. Use the problem solving technique and let them know your concerns."I like it when you talk but when you are talking and when I am talking no one else can hear us. What can we do to make sure that only one person speaks at a time?"
Give them the responsiblity to solve the problem rather than trying to coerce them to stop and risk escalation.
Sherman, Rasmussen and Baydala note that children who are exceptional with music, art, sport exhibit those behaviours that have been labeled negative or non-compliant. For instance energetic, impulsive, creative, impatient, distractable are labels used in a negative manner but when examined using a positive mind set they take on a whole different meaning.
Do academic acheivements define who our children are? Are there characteristics that are beneficial in other environments but not applicable to school? Does this make children failures? Maybe it is the system that is failing these children not the children failing within the system!

Thursday, June 18, 2009

People With Autism Better at Problem Solving


A new study done by Harvard and University of Montreal compared the abilty of 15 Autistics and 18 non-autistics in completing the Raven's Standard Progressive Matrices (RSPM) - a test that measures hypothesis-testing, problem-solving and learning skills.

"While both groups performed RSPM test with equal accuracy, the autistic group responded more quickly and appeared to use perceptual regions of the brain to accelerate problem-solving," says lead author Isabelle Soulières, a post-doctoral fellow at Harvard University who completed the experiment at the Université de Montréal. Critics of the study said that autistic people would not be able to complete the test because of its complexity. The study showed that Autistics could complete the test as efficiently and had more highly developed perception than non-Autistics.

"This study builds on our previous findings and should help educators capitalize on the intellectual abilities of autistics," says senior researcher Laurent Mottron, the new Marcel & Rolande Gosselin Research Chair in Autism Cognitive Neuroscience of the Université de Montréal and psychiatry professor. "The limits of autistics should constantly be pushed and their educational materials should never be simplified." The researchers hypothesized that Autistics would be able to complete the complex test and surpassed their expectations.

Never underestimate a child because of their diagnosis!

Saturday, June 13, 2009

Building A Solid Foundation for School - A Communities Approach


The Australian Research Alliance for Children and Youth presented a paper titled "Building a Solid Foundation for School - A Communities Approach. The paper argues that there are more factors involved in school readiness than just the child's ability or maturity level. Readiness for school involves a partnership between the family, child, school, the community and the services provided within that community. The integration or partnership of these components build a solid foundation that caters for the social, emotional, physical and cognitive needs of all those involved in the partnership.

The child can no longer be looked at as a bystander to their own development and involvement. The authors note that "The agentic child is defined as a social actor who participates in his/her life and co-constructs education with adults and peers [2]. It is the collaboration between the child and the adults that makes for a successful process. Indeed, recent policies focusing on
young children assert this view." Children are shaped by the process of involvement in the experiences they encounter. They are not passive participants. Therefore the collaborative partners must work together to provide the child with positive experiences as they enter school or transition from one school to another. "The process of starting school should not be sur-rounded by loss and grief; rather it should be a time of optimism and excitement, as solid foundations, which have been built over time, support the transition to a new way of being – that of a school student."

To improve outcomes for children we must work together as a community to nurture the needs of the child. Providing quality resources and programming for the child and the family throughout their entire school life is required to promote a healthy lifestyle as an adult. Family daycares can provide early literacy and numeracy curriculum and information to parents as more children are in daycare from an early age.

Parents and children can become involved in community organized events that showcase important issues like safety, hygiene, nutrition, how to look after their body, traffic safety and many more. These programs in the community can be beneficial for child, parents and the agencies offering the event.

The paper outlines many strategies that schools can implement as children transition into school: play based learning, welcoming events, rest breaks and more.

This information is extremely important to consider for our children with disabilities as the community becomes an outlet for services to aid in the transition of children into a suitable school environment. The school also needs to look at the child's strengths, interests, ability level in order to implement a program that is based in the individual child.

The paper encourages communities to become more involved as the education of our children becomes more complex. The collaboration of partnerships within the community is paramount in giving children the most engaging and positive experiences to enhance life long learning.

Monday, June 1, 2009

Talking to Your Kids About Their Abilities

Tito Rajarshi Mukhopadhyay is a remarkable young man from south India with a special talent. Severely autistic and nearly non-verbal, Tito can communicate his thoughts and feelings through remarkable prose and poetry - written in fluent English. Tito's view of the world provides an extraordinary opportunity to explore the hidden world of autism.

Children with a disability know they are different in some way to their peers but sometimes have difficulty expressing their feelings around these issues. They may present behaviour that seems aggressive or non-compliant as a way to communicate their sadness or fear around being different than their peers. Some important things that may help:

1. Adults sometimes get very busy. Remember to take the time to sit down and talk with your kids not at them. Try to discuss things that may be bothering them.

2. Actively listen. Acknowledge their feelings. If your kids say that they hate being different. Our first reaction is to say something along the lines of: "Sam, your not so different than other people your age" or "Sam it's ok to be different, everyone is different" What happens is we as adults move into the mode of not acknowledging their actual feelings and we immediately try to solve the problem or make it better. Another approach is "Sam, you hate feeling different? What's going on?" or "I can see that your upset about feeling different, what is happening that you feel different?"

3. As children begin to communicate with you about their feelings you are actually teaching them by acknowledging their feelings how to problem solve on their own. The potential of any child unless they are severely brain damaged cannot be predetermined. As we make assumptions about what someone is capable of doing because they have been diagnosed with a particular disorder may in fact become a self fulfilling prophecy. There are many people out there who have accomplished things beyond anyone's expectations even their own.

4. When we have conversations with our children it is so important to help guide them but not overpower them as they need to become capable of making their own decisions. Some kids may seem like they are not able to make decisions for themselves and we try to "persuade" them by exerting control or force. This rarely works with positive outcomes and is based in "power over" punitive philosophies.

5. Caregivers, teachers do need to ascertain a baseline of skills and work toward their strengths while working on their deficits as well. Sometimes we concentrate way too much on what they can't do rather than what they can.

6. A reader of these posts asked how they would tell their older child that he will not be able to drive. It might be important to talk to this young man about his feelings as he I'm sure wants to be like all the rest of the young men his age. Get down to the emotional baseline and see what is acutally going on for him as it may become more about the emotion surrounding his idea that he may not be able to drive. Use the collaborative problem solving method that encourages acknowledgement and solutions based on Dr. Ross Greene. See previous posts.

The following people are truly inspirational:

1. Sophie Delezio: http://news.ninemsn.com.au/article.aspx?id=98939
2. Eric Weihenmayer: http://www.touchthetop.com/
3. Famous people with Autism/Aspergers;
  • Gary Numan, British singer and songwriter [15]
  • Dawn Prince-Hughes, PhD, primate anthropologist, ethologist, and author of Songs for the Gorilla Nation [16]
  • Judy Singer, Australian disability rights activist [17]
  • Vernon L. Smith, Nobel Laureate in Economics [18]
  • Satoshi Tajiri, creator of Pokémon [19]
  • Daniel Tammet, British autistic savant, believed to have Asperger Syndrome [20]
  • Alonzo Clemons, American clay sculptor [31]
  • Tony DeBlois, blind American musician [32]
  • Leslie Lemke, blind American musician [33]
  • Jonathan Lerman, American artist [34]
  • Thristan Mendoza, Filipino marimba prodigy [35]
  • Jerry Newport is an author, savant, and has Asperger's. His wife, Mary Newport, is also a savant on the autistic spectrum [36]
  • Derek Paravicini, blind British musician [37]
  • James Henry Pullen, gifted British carpenter [38]
  • Matt Savage, U.S. autistic jazz prodigy [39]
  • Henriett Seth-F., Hungarian autistic savant, poet, writer and artist [40]
  • Tito Mukhopadhyay, author, poet and philosopher [41]
  • Taken from: http://autism.lovetoknow.com/Famous_People_with_Autism

Friday, May 29, 2009

Casein Free and Gluten Free Diet: Affect on Children with Autism and ADHD




1. What is a casein free diet?
A casein free diet is where dairy (protein) is removed or any other food product containing casein.
Fortified cereals, ice cream, processed meats, salad dressings are just a few of the foods that could contain casein. In order to know for sure if a particular food contains casein be sure to read the label. It sometimes is not obvious that the particular food item contains dairy product or casein.

2. What is a gluten free diet?
A gluten free diet eliminates the wheat, barley, rye, oats, and any products made from these grains.

3. How do these products affect kids with autism?
The most studied theory is that eating or drinking milk protein leads to high levels of protein by-products, called casomorphines, in some children with autism. These by-products may then affect behavior like a drug would. Specifically, in these children, casomorphines could reduce their desire for social interaction, block pain messages, and increase confusion. If milk protein is taken out of the diet, the idea is that this will reduce the level of casomorphines, and behavior will improve as a result.
http://autism.healingthresholds.com/therapy/casein-free-diet

Some children with autism and ADHD experience gastrointestinal difficulties, irritable bowel syndrome, leaky gut syndrome, blood toxification and allergic reactions to foods.

4. What may be in dairy that may cause these problems?
About a dozen pesticide residues are commonly found in non-organic cow's milk. (The source of these pesticides, of course, is the food that the cows were given to eat.) Also commonly found are hormonal residues from hormones that were given to the cows prior to milking, as well as antibiotics. Finally, from cow's milk products like cheese, cream, or butter packaged in plastic containers, residues of the plastic itself are found in the dairy products. These residues are called packaging migrants, and they include the substances DEHP and DEHA (diethylhexyl phthalate and diethylhexyl adipate).

5. Research for Casein or Gluten Free Diets?
Autistic Spectrum and Dietary Intervention
http://paleodiet.com/autism/#res -


The most important thing to remember about any intervention is for the child to be examined by a qualified practitioner to ascertain the degree if any of intolerance to casein or gluten. Nutrition must be examined to aid in children's ability to cognitively process and self-regulate but again it depends on the child and their own particular needs.

Wednesday, May 27, 2009

The Brain in the Gut - Implications for ADHD and Autism


Reference: Taken from "A contemporary view of selected subjects from the pages of The New York Times, January 23, 1996. Printed in Themes of the Times: General Psychology, Fall 1996. Distributed Exclusively by Prentice-Hall Publishing Company.



The Enteric Nervous System: The Brain in the Gut

The gut has a mind of its own, the "enteric nervous system". Just like the larger brain in the head, researchers say, this system sends and receives impulses, records experiences and respond to emotions. Its nerve cells are bathed and influenced by the same neurotransmitters. The gut can upset the brain just as the brain can upset the gut.

The gut's brain or the "enteric nervous system" is located in the sheaths of tissue lining the esophagus, stomach, small intestine and colon. Considered a single entity, it is a network of neurons, neurotransmitters and proteins that zap messages between neurons, support cells like those found in the brain proper and a complex circuitry that enables it to act independently, learn, remember and, as the saying goes, produce gut feelings.

The gut's brain is reported to play a major role in human happiness and misery. Many gastrointestinal disorders like colitis and irritable bowel syndrome originate from problems within the gut's brain. Also, it is now known that most ulcers are caused by a bacterium not by hidden anger at one's mother.

Details of how the enteric nervous system mirrors the central nervous system have been emerging in recent years, according to Dr. Michael Gershon, professor of anatomy and cell biology at Columbia-Presbyterian Medical Center in New York. He is one of the founders of a new field of medicine called "neurogastroenterology."

The gut contains 100 million neurons - more than the spinal cord. Major neurotransmitters like serotonin, dopamine, glutamate, norephinephrine and nitric oxide are in the gut. Also two dozen small brain proteins, called neuropeptides are there along with the major cells of the immune system. Enkephalins (a member of the endorphins family) are also in the gut. The gut also is a rich source of benzodiazepines - the family of psychoactive chemicals that includes such ever popular drugs as valium and xanax.

In evolutionary terms, it makes sense that the body has two brains, said Dr. David Wingate, a professor of gastrointestinal science at the University of London and a consultant at Royal London Hospital. "The first nervous systems were in tubular animals that stuck to rocks and waited for food to pass by," according to Dr. Wingate. The limbic system is often referred to as the "reptile brain." "As life evolved, animals needed a more complex brain for finding food and sex and so developed a central nervous system. But the gut's nervous system was too important to put inside the newborn head with long connections going down to the body," says Wingate. Offspring need to eat and digest food at birth. Therefore, nature seems to have preserved the enteric nervous system as an independent circuit inside higher animals. It is only loosely connected to the central nervous system and can mostly function alone, without instructions from topside.

This is indeed the picture seen by developmental biologists. A clump of tissue called the neural crest forms early in embryo genesis. One section turns into the central nervous system. Another piece migrates to become the enteric nervous system. According to Dr. Gershon, it is only later that the two systems are connected via a cable called the vagus nerve.

The brain sends signals to the gut by talking to a small number of "command neurons," which in turn send signals to gut interneurons that carry messages up and down the pike. Both command neurons and interneurons are spread throughout two layers of gut tissue called the "myenteric plexus and the submuscosal plexus." Command neurons control the pattern of activity in the gut. The vagus nerve only alters the volume by changing its rates of firing.

The plexuses also contain glial cells that nourish neurons, mast cells involved in immune responses, and a "blood brain barrier" that keeps harmful substances away from important neurons. They have sensors for sugar, protein, acidity and other chemical factors that might monitor the progress of digestions, determining how the gut mixes and propels its contents.

As light is shed on the circuitry between the two brains, researchers are beginning to understand why people act and feel the way they do. When the central brain encounters a frightening situation, it releases stress hormones that prepare the body to fight or flee. The stomach contains many sensory nerves that are stimulated by this chemical surge - hence the "butterflies." On the battlefield, the higher brain tells the gut brain to shut down. A frightened running animal does not stop to defecate, according to Dr. Gershon.

Fear also causes the vagus nerve to "turn up the volume" on serotonin circuits in the gut. Thus over stimulated, the gut goes into higher gear and diarrhea results. Similarly, people sometimes "choke" with emotion. When nerves in the esophagus are highly stimulated, people have trouble swallowing.

Even the so-called "Maalox moment" of advertising can be explained by the interaction of the two brains, according to Dr. Jackie D. Wood, chairman of the department of physiology at Ohio State University in Columbus, Ohio. Stress signals from the head's brain can alter nerve function between the stomach and esophagus, resulting in heartburn.

In cases of extreme stress, Dr. Wood say that the higher brain seems to protect the gut by sending signals to immunological mast cells in the plexus. The mast cells secrete histamine, prostaglandin and other agents that help produce inflammation. This is protective. By inflaming the gut, the brain is priming the gut for surveillance. If the barrier breaks then the gut is ready to do repairs. Unfortunately, the chemicals that get released also cause diarrhea and cramping.

There also is an interaction between the gut brain and drugs. According to Dr. Gershon, "when you make a drug to have psychic effects on the brain, it's very likely to have an effect on the gut that you didn't think about." He also believes that some drugs developed for the brain could have uses in the gut. For example, the gut is loaded with the neurotransmitter serotonin. According to Gershon, when pressure receptors in the gut's lining are stimulated, serotonin is released and starts the reflexive motion of peristalsis. A quarter of the people taking Prozac or similar antidepressants have gastrointestinal problems like nausea, diarrhea and constipation. These drugs act on serotonin, preventing its uptake by target cells so that it remains more abundant in the central nervous system.

Gershon also is conducting a study of the side effects of Prozac on the gut. Prozac in small doses can treat chronic constipation. Prozac in larger doses can cause constipation - where the colon actually freezes up. Moreover, because Prozac stimulates sensory nerves, it also can cause nausea.

Some antibiotics like erythromycin act on gut receptors to produce ascillations. People experience cramps and nausea. Drugs like morphine and heroin attach to the gut's opiate receptors, producing constipation. Both brains can be addicted to opiates.

Victims of Alzheimer's and Parkinson's diseases suffer from constipation. The nerves in their gut are as sick as the nerve cells in their brains. Just as the central brain affects the gut, the gut's brain can talk back to the head. Most of the gut sensations that enter conscious awareness are negative things like pain and bloatedness.

The question has been raised: Why does the human gut contain receptors for benzodiazepine, a drug that relieves anxiety? This suggests that the body produces its own internal source of the drug. According to Dr. Anthony Basile, a neurochemist in the Neuroscience Laboratory at the National Institutes of Health in Bethesda, MD, an Italian scientist made a startling discovery. Patients with liver failure fall into a deep coma. The coma can be reversed, in minutes, by giving the patient a drug that blocks benzodiazepine. When the liver fails, substances usually broken down by the liver get to the brain. Some are bad, like ammonia and mercaptan, which are "smelly compounds that skunks spray on you," says Dr. Basile. But a series of compounds are also identical to benzodiazepine. "We don't know if they come from the gut itself, from bacteria in the gut or from food, but when the liver fails, the gut's benzodiazepine goes straight to the brain, knocking the patient unconscious, says Dr. Basile.

The payoff for exploring gut and head brain interactions is enormous, according to Dr. Wood. Many people are allergic to certain foods like shellfish. This is because mast cells in the gut mysteriously become sensitized to antigens in the food. The next time the antigen shows up in the gut, the mast cells call up a program, releasing chemical modulators that try to eliminate the threat. The allergic person gets diarrhea and cramps.

Many autoimmune diseases like Krohn's disease and ulcerative colitis may involve the gut's brain, according to Dr. Wood. The consequences can be horrible, as in "Chagas disease," which is caused by a parasite found in South America. Those infected develop an autoimmune response to neurons in their gut. Their immune systems slowly destroy their own gut neurons. When enough neurons die, the intestines literally explode.

A big question remains. Can the gut's brain learn? Does it "think" for itself? Dr. Gershon tells a story about an old Army sergeant, a male nurse in charge of a group of paraplegics. With their lower spinal cords destroyed, the patients would get impacted. "At 10am every morning, the patients got enemas. Then the sergeant was rotated off the ward. His replacement decided to give enemas only after compactions occurred. But at 10 the next morning everyone on the ward had a bowel movement at the same time, without enemas." Had the sergeant trained those colons?

The human gut has long been seen as a repository of good and bad feelings. Perhaps emotional states from the head's brain are mirrored in the gut's brain, where they are felt by those who pay attention to them.

How does this affect our children with Autism, ADHD and oppositional behaviour when they have increased anxiety in social situations?? Does the food children ingest that they may be sensitive to, create a condition in the gut that influences the cognition in the brain or vice versa?? Allergic reactions to food and the increased use of medications may create an imbalance in the gut, which effect the neurotransmitters to the brain as well as increase in hormonal release in the gut causing increased pain. The emotional highs and lows for ADHD children and Autistic children may be influenced by the "gut brain" responding to the "head brain". Getting a full and complete physical should be required for all children diagnosed with a disability. That means all bloods, feces, urine, swabs and any other medical/psychological/developmental/emotional//social assessments for complete and holistic intervention.

Keep researching...
http://www.cbc.ca/health/story/2007/09/27/autism-study.html

Tuesday, May 26, 2009

Learning Organizations and Shared Leadership


Acknowledging the transformations that are occurring in understanding leadership and how organizations are structured is a continuing dilemma within the field of education. Schools have found themselves in an environment experiencing discontinuous change and the expectation that they re-evaluate their core business in order to achieve the most beneficial outcomes for their students. The business of education is undergoing a shift in leadership paradigms as learning organizations and multiple leadership roles evolve as prominent models to structure public education in the 21st century.

The reality of establishing a learning organization and shared leadership may be daunting for educators for some believe that the operation of a school is very different from running or managing a corporation or private business. However, the devolution of education from large district control to the individual school system has required leaders to re-evaluate their purpose within the school. The ability of the school to sustain itself over the long term is paramount to the survival of the system. Therefore, leaders within education must find ways to not only sustain their futures but also provide the necessary cultivation of knowledge for all the members within their school community to be able to compete within a global market and cope with the discontinuous change that the 21st century is experiencing (Sabah & Orthner, 2007).

The analysis of business management models is essential for helping schools transform their traditional hierarchical system to a system that understands that organizations can benefit from the creation of a learning organization that shares leadership among its participants. Senge (1997) explains that an organization creates a vision that empowers all participants within an organization to strive to embody new capabilities and learn new skills through practice and performance. He also notes that leadership is collective and leaders serve because they choose to serve, the notion that the way people think, act and view the world are inseparable, and that learning can be dangerous, as learning must become “transformational” in order to meet the needs of a changing society (Senge, 1997; pg.18).

As all the participants become accountable and responsible for achieving the vision of the organization, a learning community forms and is sustainable only by the continued involvement of the people in the organization. Bowen, Ware, Rose, & Powers (2007) cite Hiatt-Michael (2001) who states that a learning community has members who accept responsibility for acquiring new ideas that develop and maintain the environment. The learning community requires working together to harness member’s existing knowledge and experiences and focus on understanding and respecting other member’s diversity within the organization (Bowen, Ware, Rose, & Powers, 2007). Utilizing this definition of learning organizations the willingness of members to embrace innovations becomes paramount to the change that schools need to undergo to face new challenges and improve student outcomes (Bowen, Ware, Rose, & Powers, 2007).

Friday, May 22, 2009

Neurotherapy for ADHD and Autism


The issues that were identified by the two educators were the increasing number of students displaying symptoms of or being diagnosed with oppositional behaviour, Attention Deficit Hyperactivity Disorder or Autistic Spectrum Disorder and the schools ability or inability to adapt to accommodate the unique needs of today’s children. This paper will define these disorders and explore innovative approaches like neurotherapy and biofeedback to improve various cognitive skills related to attention and memory and to improve the negative behaviours that may be associated with each disorder.

Stanovich and Jordan (1998) have stated that “today’s teachers must deal, as never before, with heterogeneity in their classroom”. Students in the classroom who are severely disruptive may have a variety of mental health issues including Attention Deficit Hyperactivity Disorder, Oppositional Defiance and Conduct Disorder (Cook, 2005) and Autistic Spectrum Disorders. The American Psychiatric Association (1994) estimates that Attention Deficit Hyperactivity Disorder effect between 3-5% of the school aged population. The prevalence for Oppositional Defiance Disorder and Conduct Disorder may lie somewhere between 4 – 15% of the school aged population (Cook, 2005). Children who have been diagnosed ADHD may have a co-morbid diagnosis of Oppositional Defiance Disorder or Conduct Disorder (Jensen, Martin & Cantwell, 1997).

Attention Deficit Hyperactivity Disorder is a neuropsychological disorder that has a strong genetic link within families (Barkley, 1998). Children with ADHD may exhibit behaviour such as a lack of self-control, impulsiveness, inattentiveness and restlessness (Barkley, 1998). They can also be oppositional, disorganized, and verbally or physically abusive to peers and teachers and may have difficulty sitting in their seats (Campbell, 1994). Children with ADHD have difficulty moderating their behaviour in response to certain stimuli (Abikoff, 1985; Barkley, 1998). They are also at a greater risk of school failure and a later diagnosis of a disruptive behaviour disorder (ODD or CD) due to their impulsiveness and actions within a classroom setting (Campbell, 1994).

Evidence is showing that people who have ADHD have difficulties in their frontal lobe which is responsible for executive functioning; attention and impulse control (Chamberlain & Sahakian, 2006). Research using EEG (Electroencephalograph) measurements of brain wave activity in many individuals with ADHD show reduced activity in the prefrontal region and frontal lobes (i.e. cortical slowing) (Gottfried, 2006, Monastra et. al 1999). Niika Quistgard-Devivo (2006) in her article Scatterbrain includes a reference from Dr. Daniel Amen (Assistant Clinical Professor of Psychiatry and Human Behaviour at the University of California) that ADHD may be due to “a lack of blood flow and electrical stimulation to the frontal cortex – the area of the brain involved in prioritizing and focusing. Scans usually show reduced activity in the decision making area of the brain”.

Autism is the most recognized form of a group of disorders referred to as Autistic Spectrum Disorders or Pervasive Development Disorders (Seigal, 1996). According to the Diagnostic and Statistical Manual for Mental Disorders (1994), Autism is diagnosed in reference to three categories: Qualitative Impairments in Reciprocal Social Interaction, Qualitative Impairments in Communication and Restricted, Repetitive and Stereotyped Patterns of Behaviour. Diagnosis can occur as early as 18 months or by the age of three (Seigal, 1996). Claudia Wallis in her article for Time Magazine (May 2006), Inside the Autistic Mind, refers to a statistic from The Center for Disease Control and Prevention that 1 in every 166 children born in the United States will fall “somewhere on the Autistic Spectrum”

The Center for Disease Control and Prevention state that Autism effects the brain in many areas as well as the wiring that connects one part of the brain with another. Autism is a “global disorder that affects reasoning, memory, balance, multi-tasking, and other skills (Center for Disease Control and Prevention, 2006; Williams, Goldstein & Minshew, 2006). Darling (2004) has also noted that children with autism may have problems with gut function that inhibit neurotransmitters to the brain that may effect brainwave activity.

Neurotherapy and biofeedback are innovative treatments being offered to help improve the symptoms of ADHD, Oppositional Behaviour and Autism (Jaruseiwicz, 2002; Perl, 2002). Neurofeedback is a form of biofeedback based on operant conditioning and can be used as a non-pharmacological treatment for ADHD (Butnick, 2005, Alhambra et al, 1995). The client is given information in relation to their state of arousal exactly as it is occurring as measured by the Electroencephalograph (EEG) machine (Gottfried, 2005, Butnick, 2005). The use of EEG feedback has been found to strengthen brain function and regulation of brain wave activity (Robbins, 2000).

Perl (2002) found improvements in impulsiveness, activity level, attention, completing tasks, and fewer aggressive outbursts as shown by the post TOVA (Test of Variables of Attention). Monastra (2002) has also found a decrease in the symptoms of ADHD with neurofeedback as shown by results using the TOVA and the Attention Deficit Disorders Evaluation Scale. Monastra (2002) also notes that children using Ritalin benefited from the Neurofeedback but those who were taken off the medication and had not completed the Neurofeedback sessions showed no retention of improvement. Those that were taken off the medication and completed the Neurofeedback training retained the improvement in symptoms of ADHD (Monastra, 2002).

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One of the biggest issues that I hear about from teachers and caregivers is the behaviour of the children or youth in their school, program ...