Monterey Bay Forum

Intriguing as a possible early sign of autism: Lag in motor development (control of head and neck) found in infants who are more likely to develop autism. This study needs to be replicated before the public puts much weight on this finding.

This is a simple test that any mother can do at home. Any suspected delays can lead to early intervention by Early Start services. Parents who suspect motor delays can seek assistance from the Early Start program funded by the federal government.

“Typically, red flags that might lead to an autism diagnosis are issues with social and communicative traits, such as avoiding eye contact or not playing with others. But Dr. Rebecca Landa, the study’s author and director of the Center for Autism and Related Disorders at Kennedy Krieger Institute in Baltimore, says certain disruptions in a child’s motor development may provide important clues.

“For the study, researchers assessed infants in a simple “pull-to-sit” task that measures posture control by firmly – yet carefully – pulling a child’s arms from a position of lying flat on his/her side back into a sitting position (as seen in the videos below). Typically infants achieve this type of posture control by the time they are four months old.

“In one experiment, researchers gave this task to 40 infants who were considered to be genetically high-risk for the disorder because a sibling has autism. They researchers were looking specifically at “head lag” – the inability to control head posture – at 6, 14, 24 and 30 months of age.

“The researchers found 90 percent of subjects eventually diagnosed with autism exhibited head lags as infants, and 54 percent of kids who met social and communication delays criteria exhibited head lag, while 35 percent of children who did not meet that criteria exhibited the lag.

“In a second experiment, Landa and her team examined only six month olds at a single point in time to check for head lag, and found 75 percent of the high risk infants displayed head lag compared with 33 percent of low-risk infants, further emphasizing that head lag is more common in infants that may develop autism.

Landa’s study is to be presented at the International Meeting for Autism Research on May 17 in Toronto.

“While previous research shows that motor impairments are linked to social and communication deficits in older children with autism, the field is just starting to examine this in younger children,” she said in an Institute news release. “Our initial research suggests that motor delays may have an important impact on child development.”

“If some parents try the test at home and are worried, Landa emphasized to The Baltimore Sun that a head lag at six months does not mean a child is definitely going to have autism, but rather is a potential sign that a pediatrician should explore further. http://www.baltimoresun.com/health/blog/bal-poh-autism-test-for-infants,0,1502094.story

“We don’t want to scare parents,” she said. “If I go to the doctor because I’m having problems with balance, he’s not going to assume I have a brain tumor. When a baby shows a head lag there are so many other things it can be. But this is a very real indicator of something wrong with development and easy things can be done to help.”

Dr. Alycia Halladay, director of environmental research for the advocacy and research group Autism Speaks, told WebMD that the findings are “intriguing” but a head lag’s diagnostic value remains uncertain.

“The first step is to replicate these outcomes in larger studies in multiple sites,” she said.

The study adds to recent research aimed at diagnosing autism at an early age. A recent study found differences in nerve connections seen in infants’ brain scans might signal autism, CBS News medical correspondent Dr. Jon LaPook reported.

About 1 in 88 children has autism, according to recent government estimates.

Let’s take the wind out of sails of the SEIU?

How? Through state legislation, stop automatic deductions of union dues from SEIU workers pay checks.

Let workers be free to choose yes or no whether to pay union dues. Many government union workers will opt out of automatic dues removed from their checks. No automatic dues flowing into the SEIU results in less political clout that they can exert.

Why should any worker just to hold a job have to pay SEIU union dues so that the SEIU can use dues to flow into other organizations like Change to Win which seeks to intimidate private companies such as Wellpoint from making political contributions?

Look at who runs Change to Win. The President of SEIU, the Vice President of the SEIU and the Treasurer/Secretary of the SEIU are all key players of Change to Win.

Union front organization such as Change to Win seek to know and limit the political donations made by private corporations. Why? So that the unions are the only big players in who make large donations.

The unions such as SEIU want to control the political free speech exercised by of private corporations.

The SEIU seeks to grow government unions to grow their power.

Recently, in Michigan the SEIU suffered a setback to their political clout. In states including Michigan and California home health care workers were forced to pay union dues.

Persons with developmental disabilities are frequently cared for life long by family members.

It is good news that developmentally disabled persons can stay in their homes thanks to health care provided by parents and relatives. Those who best know and love a relative with disabilities provides care at a fraction of the cost if the person had to be placed in a government run facility.

To deem home health care workers as “government employees” and force them to pay SEIU union wrongfully categorizes people and allows the SEIU to skim off millions of dollars. Home health care workers seek to care for their loved ones — not to do a government job. Recently Michigan has changed their laws. No more taking of union dues from Michigan home health care workers.

Can California wake up and follow Michigan’s lead? Let’s hope so. The necessary labor and employment laws are already in place to protect jobs.

written by drcameronjackson@gmail.com (more…)

Hearing loss in babies has huge effects on their general development: hearing loss impacts language acquisition, speech, psycho-social well being and overall learning.

Research shows that the critical time to stimulate the auditory and brain pathways is during the first six (6) months of your child’s life. So pay particular attention during your child’s first six months that he or she continues to hear normally.

The good news is that children with all degrees of hearing loss — who receive appropriate interventions prior to 6 months of age– can obtain speech and language skills comparable to their normal hearing peers when age 3 years.

What parents can do:
Check and re-check that your baby’s hearing remains normal. Visit your pediatrician for screenings as your doctor recommends. Research recommends hearing screening every 2 months until age one year — and every three months until age two. (more…)

When parents of young children have a concern about their child’s development they often go first to their pediatrician.

Parent concerns might include: “Our child does not turn his head when I call him.” or “ Our child does not make much eye contact or smile.” “He does not play with toys like other children.”

If the pediatrician thinks that more assessment is needed, when MD’s refer out they often refer to to other physicians at large hospitals — such as Stanford Hospital (LPCH), Children’s Health Council and U.C. San Francisco. Physicians know other physicians and often do not know local resources, e.g., licensed psychologists trained in psychological assessment.

When parents are referred to large hospital complexes such as Stanford Hospital, Kaiser Permanente and U.C. San Francisco, parents can help get the best possible assessment by finding out ahead of time:

Will their child’s pediatrician MD automatically send along the child’s medical records as part of the referral process? If not, then the parent needs to request a complete set of medical records and bring the medical records to the appointment.

Who knows the child best besides the parent? Does the child go to a nursery school or day care? Is the child taken care of by a grandparent or neighbor?

Write down the name, address, telephone number and e-mail address for all persons who know your child best. Let those people know that the child will be assessed and that someone from that institution may call to gather information. Bring the list of people who know your child best to the appointment.

Can the parent take a video of the behaviors that concern them? For example, does the child insist on lining up all his toys? Does the child have a melt-down whenever the normal routine changes? If possible, get out your ‘smart phone’ or camera and take a video of those behaviors. Bring the video with you to show whoever does the assessment.

Call ahead of time to the institution where the assessment will be done and find out (and write it down) exactly who will do the assessment? Will it be a team assessment of various areas of functioning or will the assessment be done by only one specialist?

Know that it is Best Practice in the assessment of young children to examine several areas of functioning (e.g., speech, non-verbal communication, gross and fine motor) and that the assessment be done by appropriate specialists.

Depending on the concerns, some times one person doing the assessment is sufficient and sometimes not.

Know that it is Best Practice that records and information be obtained from various sources (MD, school, day care provider, parent, grandparent) over a period of time.

It is often the case that young children do not perform as they typically do when driven several hours to an appointment and then required to do certain activities with persons they do not know.

Summary: Parents can greatly assist in the accurate assessment of young children with possible developmental delays by 1) gathering all medical records and bringing them to the appointment; 2)making a list of all persons who know your child best including email and telephone numbers; 3)inquiring ahead as to exactly who will do the assessment and what areas will be assessed.

And do not be afraid to press the professionals for understandable answers. If they cannot say it so you can understand,they are useless to you and your child.

Any questions or comments? Contact Dr. Cameron Jackson DrCameronJackson@gmail.com 831-216-6002

DrCameronJackson@gmail.com

How to increase the IQ of all children? Especially children with ADHD or Autistic Spectrum difficulties?

This technique to raise IQ applies to all children. It can be especially helpful for children with difficulties with focus, attention, sequencing, executive functioning and ‘working memory’ difficulties. Children with those difficulties are often labeled as having ADHD or Autistic Spectrum difficulties.

Can your child’s IQ be changed? Of course. Can parents and relatives help? Yes! And to raise your child’s I.Q. you don’t need Obama-Care, the U.S. Department of Education nor permission from any federal, state or local governmental entity.

How to raise IQ? Teach to the test. Well, not exactly to the test as IQ tests are proprietary information which test makers and test givers protect. But it’s fine to teach the general tasks measured by many I.Q. tests.

All good teachers teach to the test in some sense. Take the teaching of math.

Everyone knows that 5 + 4 =9 and not 8 or 10. There is one correct answer. If you want a child’s math abilities to increase you have to practice. And if you want them to remember – make it fun.

It’s the same for raising IQ. Teach the general tasks that are tested by IQ tests. And make it fun so they remember and want to learn the tasks.

So, let’s start with one way to strengthen a child’s ability to focus and pay attention.

Digit Span: Measuring digit span abilities is one task which is part of many IQ batteries. So how can this ability become stronger for all children? And is it an important task?

Why teach Digit Span? Every kid needs to learn their phone number including the area code. For safety reasons children should be able to state a telephone number so that an adult can be alerted. So, learning a series of digits is an important, useful task. So, how can we make an important task fun. See how below:

Take my telephone number for example. 831 216-6002 [Please do not call it!] Here’s how to teach a child to learn their telephone number digits:

Get a lined pad of paper and in a column write: 0 at bottom, then 1,2,3,4,5,6,7,8.9 Next, draw dots next to the numbers. And then connect the dots with lines.

Look at the visual image how the dots are connected. That visual pattern is what you want your child to learn. You can see the visual pattern in the image at the top of this post.

Is your child a stronger visual learner? A lot of kids with ADHD and autistic spectrum difficulties are stronger visual learners than they are verbal learners. That means if the child can see what to do they can learn it faster than if they just hear what to do.

Now make learning the telephone number digits fun:

Use sounds to teach telephone number/ Digit Span to child

Try different methods: For example, 1) try using a xylophone and see if music helps cement the digits together for your child. Or 2) try using a different color pens for each digit. One is red, two is blue, three is yellow. Always be consistent so color becomes associated with the number. Or 3) try just drawing the pattern over and over again.
You know your child’s strengths so play to those strengths. Make it a fun activity.

How to start? Small chunks. Teach it in two chunks – the first three digits and then the remaining four digits.

Once a child can learn 3 digits forward, teach those digits backwards. 2-1-6 and 6-1-2. Why also teach backwards? That strengths the visual and auditory memory systems.

Just like push ups strengthen physical muscles learning visual and auditory patterns with numbers strengths your child’s focus, attention and concentration. Your child is having fun doing something with you. And, your child is ‘growing’ his or her I.Q.

Pediatricians frequently recommend medications, e.g., Ritalin, Concerta, to assist with attention, concentration and focus. Research shows that a combination of medication (if they work) and cognitive-behavioral therapy for child and family provides the best results.

In my clinical experience, it only takes one concerned, involved, consistent adult to dramatically affect the overall development of children with various disabilities. So this technique can be used by an older brother or sister, aunt or uncle or grandparent. Sometimes the parents themselves have disabilities such that they are not the ideal person to help ‘grow’ their child’s I.Q.

Try the technique and let me know how it goes for you and your child.

Below is the real story of a young person whose I.Q. could grow if… [personal identifying information has been changed to protect privacy].

Jose is age 17 and a twin. His brother has been diagnosed with mental retardation. Jose’s father is in prison. Jose has an older sister diagnosed with depression. Jose’s mother has various physical disabilities and receives social security, disability. Jose has one older sister who is completing college, has a job and has a boy friend. This sister has been a positive, involved person in his life. This sister is the main person who takes Jose places, listens, helps him set goals and complete tasks. Jose’s teachers over the years report that he shows substantial difficulties with attention, concentration and focus. Jose’s pediatrician tried Jose on five different medications without success. County Mental Health referred Jose to a local counseling service where he received one-to-one therapy from a therapist to address ADHD. Jose’s cognitive I.Q. abilities to think abstractly visually and verbally are in the Low Average range. When Jose’s “working memory” abilities are tested they are low, i.e. in the Deficient range.

Can Jose’s ‘working memory’ be improved? I think so. If there are concerned adults that stay involved with Jose.

DrCameronJackson@gmail.com

To see a book recently published by Dr. Cameron Jackson go to: http://www.smashwords.com/books/view/109312

Some simple techniques can assist children with attention deficit hyperactivity disorder (ADHD) and/ or autistic spectrum disorder (ASD)to be happier and achieve appropriate goals. These techniques are easy for parents and teachers to implement.

Of course a child is not a car but think of the following analogy:

Every car to get to a destination needs a driver. Parents can assist children to get into the driver’s seat and drive their ‘car’ to appropriate ‘destinations’.

Here’s how to assist children who have difficulties with focus, attention, concentration, ‘executive functioning’ or ‘working memory’ difficulties. Executive functioning and working memory are words used by school psychologists. What the parent sees is a child who can’t seem to figure out what comes first and appear disorganized.

What to do: Get a pad of 8 by 12 inch lined paper.

On one per sheet of paper —
1) Write at the top, a Goal that parents/teachers want the child to achieve.
2) Write out all the Steps required to accomplish the Goal.
3) Order the steps from first to last using KISS (Keep It Simple, Simple)
4) Figure out an appropriate Reward for child accomplishing the steps.
Set it up so child can get partial reward for partial completion.
5) Decide the number of Days child needs to complete the Goal.
6) Draw up a Graph with Days across Top of Page and Goals listed on left.

Here’s an example of a Behavior Plan for a child who shows symptoms of both ADHD and ASD:

Gina is 8 years old and was exposed in utero to illegal drugs and alcohol. Her biological mother lost parental rights and Gina has been in foster care since age two. Since age four, Gina has received County Mental Health therapy and medication to assist with focus, attention and concentration. The therapy provided by County Mental Health focuses only on helping Gina to label emotions and better express her emotions appropriately.

Gina’s foster mother and her teacher agree that Gina’s adaptive functioning abilities are considerably below what they expect for her age. Her foster mother wants Gina to 1) wash her face & brush her teeth; 2) make her bed; 3) put toys in basket in her room; 4) set the table with utensils and plates before dinner.

Goals:

Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Wash face & clean teeth
Make bed
Put toys in basket
Set table with utensils & plates

Spiritual/ religious beliefs need to be integral to a successful Behavioral Plan.
For example, Gina’s foster mother goes to church and rests on Sunday. Therefore the behavior plan is for six days a week and no work on Sunday, their day of rest. Six days a week time four goals = 24 Goals for Gina to achieve. For each Goal achieved she earns one (1) dime. During the week she puts stickers on the sheet and gets her motivators (dimes) which she puts into a plastic, clear jar. That way she can see exactly what she has earned towards a new toy on the weekend. Her foster mother believes Gina can find age appropriate toys for around $2.50 to $3.00 a toy.

What makes a Behavioral Plan successful?
The answer is simple: practice and more practice so the Steps are as simple as possible and the child gets rewarded for partial and then complete finishing the Goal.

For example, Gina when we started could not make her bed said her foster mom. Well, the cover was too big and too heavy for a thin, small 8 year old to move around. Thus, by simplifying and making a bed simply tossing a light duvet (down comforter) on a twin bed and putting the pillow in place — then making a bed by an 8 year old is simple and possible.

A second example:
Gina has never set the table for dinner. Part of the reason is that the plates are too high for her to reach and they are china easily breakable. Also, the utensils are not easy to get to. This is easily solved by moving plastic plates and smaller folks and spoons to one drawer that the child can reach. The point is to set it up so the child can successfully achieve the Goals.

Overall point: Parents can set simple ‘destinations’ for their child to drive their ‘car’ towards and by keeping the steps simple and practising the steps again and again their child can achieve those destinations to goals that parents set.

Very important: the hugs and ‘You did great!’ and ‘Keep trying!’ are as important and at times more important than any reward system. Parents – whether biological parents or foster parents – are the fire to ignite important, life long change in children.
Send comments to DrCameronJackson@gmail.com

Many CA children are wrongly diagnosed by reputable institutions such as Stanford Hsoital (LPCH) with Intellectual Disability/ Mental Retardation.

Read the story of Maria below. To make a referral to Stanford hospital ( LPCH) as County Mental Health did with Maria is simply wrong. County Mental Health actions — and lack of actions — harm children who deserve better.

Maria’s story is not unusual. The story describes how many children are routinely mis-diagnosed by Stanford hospital (LPCH). Information concerning Maria and the actual parties involved have been changed or not specified to maintain privacy.

Maria, not the child’s real name, was for real exposed in utero to multiple illegal drugs. And as is true for many children exposed in utero to drugs, Maria, now age eight, has substantial difficulties that affect her overall development. Front and center, she has substantial difficulties with with executive functioning, attention and concentration.

Maria was removed at birth from her biological parents. She lives with a foster mother who only speaks Spanish and a handful of other children. In the home, she has no daily chores and prefers to play by herself. For the last several years, Maria has received County mental health services (medications and therapy) to assist with her dificulties related to inutero drug exposure.

In the home, Spanish is the principal language spoken by the foster mother. At school, Maria’s special education classes (SDC) are in English. Maria speaks a mixture of Spaish and English. For example she know shapes (circle, rectangle) and colors in English but not Spanish; on the other hand, she knows animals and and common home items better in Spanish.

Through her public school, Maria’s cognitive abilities have been assessed in Spanish, English and also with non-verbal tests. At school, she performs best on non-verbal, visual tests of intelligence that have less cultural bias. Assessed on multiple occasions, Maria performs variously. On I.Q. tests that do not rely on lanugae she performs in the Average to Low Average range.

County mental health gave Maria a diagnosis of Pervasive Developmental Disorder, Not Otherwise Specified (PPP-NOS). Saying that they sought more ‘diagnostic clarity’, the County recently referred Maria to Lucile Packard Children’s Hospital (LPCH) located in Stanford, CA.

Though County Menal Health initiated the referral to Stanford hospital (LPCH) they did not send along their own mental health records. The Mental Health therapist or psychiatrist could have put relevant mental health summary records in an envelope and given it to the family to take with them. That did not happen.

Nor did County Mental Health assist so that relevant school psychological assessments accompanied their referral to Stanford hospital (LPCH). With a Release signed by the mother the County Mental Health therapist could have ensured that school assessments accompanied the County’s referral to Stanford hospital. That did not happen.

As a result, there was no collaboration between County Mental Health, the local schools and local physicians. As a result Stanford hospital (LPCH) lacked up-to-date relevant records available for review. Very importantly, and one wonders about arrogance by Stanford hospital, LPCH routinely does not seek out additional information other than what it gets from their own assessment.

The family had to travel two to two and a half hours each way to go to Stanford hospital (LPCH). Although there are numerous licensed psychologists trained in assessment and diagnosis the County routinely chooses to refer outside the County to LCPH. If they wanted to, County Mental Health could reaadily refer to the local Psychological Association. Every County in CA has a psychological association.

Maria was recently assessed by Lucile Packard Children’s Hospital (LPCH). Of importance, the LPCH assessment did not request nor review Maria’s multiple prior school assessments. And LPCH did not review Maria’s medical records nor her mental health records.

LPCH limited the assessment of Maria’s current functional abilities to the ratings that they obtained that day from Maria’s foster mother. No ratings were obtained from Maria’s teachers. Based on a one day assessment, done in English using a Wechsler IQ test known to have strong cultural biases, LPCH gave Maria diagnosis of Intellectual Disability/ Mental Retardation.

Yes this 9 year old child suffers from dificulties related to in utero drug exposure. And she has not yet stabilized her language abilities because she hears only Spanish at home and English at school. And yes on certain tests of executive functioning, attention and concentration she scores quite low.

Maria and other children referred by County mental halth deserve an accurate diagnosis based on a thorough review of relevant school, medical and mental health records. County mental health should collaborate with local psychological associations and use locally trained psychologists who can visit schools and observe children in their home enviornment. When referring outside the County, County Mental Healh should see that relevant school, medical and mental health records accompany their referral.

As I wrote above, to make a referral to Stanford hospital ( LPCH) as County Mental Health did with Maria is simply wrong. County Mental Health’s actions and lack of actions harm children who disserve better.

With an erroneous diagnosis in hand, County Mental Health will close Maria’s case saying that her supposed diagnosis of intellectual disability makes it impossible for her to profit from therapy. And with this diagnosis the schools probably will refer the family to social security.

What Maria truly needs is: 1) time to develop and stabilize her language abilities; 2) training in how to use schedules and other techniques that assist persons with problems with attention and concentration. Just because this eight year old tends to skip from step 1 to 4 does not mean she cannot learn to do tasks correctly. With correct interventions, Maria will be happier and society will not have to support her as an adult.

Commnets welcome. Send to: DrCameronJackson@gmail.com

A mother of child with special needs (Asperger’s Disorder) emailed me asking for help. She lives in Redlands, CA. Her child has an Autistic Spectrum Disorder, is hearing impaired and has epilepsy. The child is in elementary school.

Parenting a child with these kinds of problems can be overwhelming. As there are many parents who face these difficulties, perhaps a general post may be helpful both for this one mother and for other families. Most importantly, know that there is help, there are resources and you don’t have to do this job alone.

The mother wants an advocate to assist her in the IEP process. She asks for immediate help. (more…)

DrCameronJackson@gmail.com

How “helpful” are the respite services provided to families with a disabled child?

In California, children with autism are assisted by the regional centers. There are non-profits and operate individually though connected loosely together. A child made eligible by one regional center is usually accepted by other regional centers though the case may be reviewed.

Due to CA budget issues typically families are offered 24 hours of respite a month though the number may be considerably increased depending on the individual’s particular circumstances. “Respite” is supposed to be time away from the disabled child and someone else takes care of the child so that parents get a real break.

In the Santa Cruz, Monterey, San Benito and Santa Clara Counties parents can receive respite hours away from their diabled child through varous agencies. The agencies take care of the paper work issues which negatively impact the overall helpfulness.

Below is from the parent of an autistic child that finds government “help” not helpful. And why not helpful. (more…)

DrCameronJackson@gmail.com

A woman recently wrote poignantly, Put my disabled son on Death’s Row in San Quintin and he will get three square meals, medical care and perhaps even a room with a view… The woman wrote in response to the proposed $568.6 million cut in money allocated for the 246,000 disabled in California served under the Lanterman Act.

The woman’s feelings are understandable given that it costs taxpayers $50 to 70 K per inmate in CA prison compared to the cost to care for each disabled person. Run the math ($4 billion in CA budget allocated last year divided by 246,000 disabled persons equals $16,260 spent per disabled person).

Maybe it’s time to put the family of each disabled person served by CA regional centers in the driver’s seat. Why not have vouchers that follow each disabled person — akin to school vouchers — that give families choice? That way people will become knowledgeable as what things cost and more empowered by making the choices they think best. (more…)