Category: DSM-5 & Psychology

Diagnostic & Statistical Manual (DSM) & Psychology topics including autism, autistic spectrum disorders, intellectual disability, mental retardation & ADHD

Aptos psychologist: take a look at Easter Seals study about autism and how families cope. www.freedomOK.net/wordpress

April 30, 2009
Divorce, Single Parenting and Autism: Some Data

“Do couples with autistic kids get divorced more frequently than other couples? Shockingly high divorce rates are quoted frequently, for example, Jenny McCarthy on Oprah, where she said it’s 90%, or Dr Colleen Allen, of the Henry Ford Center for Autism and Developmental Disabilities, who is quoted online as saying it’s 86%. Even John McCain, in his 2008 statement on autism for the ASA’s rally stated that “divorce rates of parents of children with autism are well above the national averages.” (Autism Advocate, 3rd Edition, 2008, Vol 52, p. 58.) Unfortunately, the data behind these numbers never seems to be included, so it’s hard to know if they are valid.

“What is well documented and readily available is Easter Seals’ Living with Autism study. Easter Seals, with Mass Mutual Financial Group, and the Autism Society of America, conducted an interactive Harris poll. They interviewed US residents with children 30 or younger, where the child has either an Autism Spectrum Disorder or no special needs diagnosis at all. A total of 1652 parents of children with autism were polled, and there was a control group of 917 parents who didn’t have children with special needs. Many issues were studied, including detailed listing of parents concerns, such as their adult children’s quality of life and ability to live independently. It’s an online poll, so of course there are questions about biases, such as which families chose to participate in the study. The study focuses heavily on looking at financial planning questions, not surprising regarding the sponsorship. Many of the findings aren’t exactly shocking, such as the fact that parents of the special needs children were highly concerned with their child’s independence and quality of life, and that they struggled financially and had concerns about their children’s education.
“But, there was one section of the report that looked at divorce statistics. The report states, “Families living with autism are significantly less likely to be divorced than families with children without special needs. Among those parents with children who have Autism Spectrum Disorder and who have been divorced, only one third say their divorce had anything to do with managing the special needs of their children.” (p. 39) And the rate? 30% for families with autistic children, 39% for the control group without special needs.

“There’s also some information on these divorced families with children on the autism spectrum. The study found that in about half of the divorced families, one parent had sole custody of the child, and 71% of the time the child lived with the parent full time. Certainly, this can be a stress on the single parent, especially when coupled with the fact that over half of families with ASD reported having little or no support from their extended family.Interested? You can download a copy of your own at the Easter Seals website.

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Aptos psychologist: Students suffer when foreign math teachers speak poor English

Why don’t public schools require that math teachers from abroad demonstrate proficiency in speaking English? Schools should not hire foreigh teachers who cannot clearly communicate in English. It is hard enough to learn advanced math and science skills. Adding the burdern of listening to a teacher who cannot speak clear English can be overwhelming.

As a result, students suffer in multiple ways: They don’t learn the advanced math skills. Their self esteem suffers. They drop out of other math and science classes they might have pursued.

I overhead this at lunch yesterday. Hearing this, I turned and said that this happens in college as well as in high school.
I overheard a woman say:

“My daughter, a Junior at Mission High, is getting a A in Advanced Physics and an F in Intermediate Algebra. Because of the F, she cannot participate for the next grading perion on the softball team. There is no way she can raise the F to a decent grade. She cannot understand her math teacher. Her math teacher’s English is so poor that we got a tutor for her. She can learn the math from the tutor and get an A in Advanced Physics. But she cannot understand what her Algebra teacher says…. The school requires that she continue in the Math class …. We have enrolled her at Cabrillo College for the summer to learn the Algebra …

The young woman obviously is bright and capable of learning. To get an A in Advanced Physics she has to know the math. By having a tutor she has picked up the necessary math skills. But to be required to sit in a class she is failing because the teacher cannot communicate — the public school system is failing this young person. He self esteem may suffer. Her abilities to do sports will suffer.

All teachers in California — including substitutes — must pass a basic proficiency test in Math and English. It is a written test. Obviously, there should also be a test in speaking understandable English. Let the public speak up!

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Aptos & there abouts: Find a psychologist through the Monterey Bay Psych Assoc. www.mbpsych.org

There is a Find A Therapist directory to assist. When I searched for “autism” only one name appeared. I would think that more than one psychologist does diagnosis and treatment of autism. Autism is a disorder that can be screened for accurately by 18 months. Probably “developmental disorders” will give you more choices of clinical psychologists who can assist you.

For more info go to: Monterey Bay Psychological Association

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Join A-Autism Net for Testing on Monterey Bay Forum

Do you work with children with Autistic Spectrum Disorders? Parent of a child? Join A-Autism Net for Testing at www.freedomOK.net/wordpress Tell your stories. Get support. For northern CA parents and professionals. Dr. Jackson is a member of the Asperber’s Ring which is a group of blogs that focus on Asperger’s Disorders and similiar issues.

Dr. Cameron Jackson wants to collaborate with other professionals who screen and treat children with autistic spectrum disorders. One other psychologist is listed in the Monterey Psychological Association as working with autistic children. Contact Dr. Jackson at: cameronjacks@gmail.com

For other resources go to: Web Ring

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Aptos psychologist: Why does Utah have highest rate of Autistic Spectrum Disorder?

Currently, 1 in 150 children in the U.S. are diagnosed with an autistic spectrum disorder (autism, pervasive developmental disorder, asperger’s disorder). Uhah’s rate is 1 in 133 children. Why so much higher? Beats me. The quality of life lead by adults with ASD is higher in Utah. Why? I suspect that family connections and social connections are tighter in Utah compared to a state such as California.

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Aptos psychologist: First born, breach and mother over 35 are risk factors for Autistic Spectrum Disorder children

“Children who are firstborn or breech or whose mothers are 35 or older when giving birth are at significantly greater risk for developing an autism spectrum disorder, University of Utah School of Medicine researchers have reported in a new study with Utah children.

In the April 27, 2009, online issue of the journal Pediatrics, the researchers showed that women who give birth at 35 or older are 1.7 times more likely to have a child with an autism spectrum disorder (ASD), compared with women between the ages of 20-34. Children diagnosed with ASD also were nearly 1.8 times more likely to be the firstborn child, the researchers found.

Although they didn’t identify a causal relationship between breech births and autism, children diagnosed with the disorder were more than twice as likely to have been a breech presentation, meaning they were not born head first.

“The results of this study give us an opportunity to look more closely at these risk factors for children across the autism spectrum, and not only those diagnosed with autism,” said first author Deborah A. Bilder, M.D., assistant professor of psychiatry. “This shows that further investigation of the influence of prenatal factors is warranted.”

Autism is a complex brain disorder that impairs social, communicative, and behavioral development and often is characterized by extreme behavior.

Bilder and her colleagues in the U medical school’s department of psychiatry and the Utah Department of Health examined the birth records of Utah children who had been identified as having an autism spectrum disorder in a 2002 epidemiological study by the U.S. Centers for Disease Control and Prevention (CDC). That study looked at 8-year-old children in Utah’s three most populous counties-Salt Lake, Davis, and Utah-and used nationally accepted criteria for an ASD classification. The researchers compared birth records for children identified with an ASD with unaffected children born in those three counties in 1994. Of that group, 196 were identified with an ASD. Birth certificates were available for 132 of those children, and the researchers examined those records for possible prenatal, perinatal, and neonatal risk factors related to ASD.

Their investigation showed that the mother’s age when giving birth (older than 34), breech presentation, and being firstborn were significant risk factors for the development of an ASD. The researchers also identified a small but significant relationship between the increased duration of education among mothers of those children.

Further investigation would be needed to understand how these three risk factors may relate to ASD. But a possible explanation for the correlation of firstborn children might be that parents are reluctant to have a second child if the first is diagnosed with ASD. A possible interpretation of increased risk associated with advanced maternal age is that changes in genes occurring over time may contribute to autism spectrum disorders. The association found between breech presentation and ASD most likely indicates a shared cause, such as neuromuscular dysfunction. The vast majority of children born breech, however, are healthy.

This study follows several from the University in recent years, which found that Utah has one of the highest autism spectrum disorder rates in the country (one in 133 Utah children has the disorder), helped indentify a gene that may predispose people to autism, and showed that Utah adults with autism have a better quality of life than those in other studies.

For the next step in their research, Bilder and her colleagues want to repeat this study, using a larger population of Utah 8-year-olds from subsequent birth years, to see if it replicates the results of the current study. They also may study the subset of children with breech presentation to determine whether they haven a genetic vulnerability that put them at increased risk for developing an autism spectrum disorder.

The study’s other authors are Judith P. Zimmerman, Ph.D., research assistant professor of psychiatry; Judith Miller, Ph.D., associate professor of psychiatry; and William M. McMahon, M.D., chairman of the Department of Psychiatry.

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Aptos psychologist: Why huge increase in autism in California?

What do you think are likely enviornmental causes of huge incease in autism? Why the huge increase in California? Tell us what you think. Pesticides? Contaminated water? Pollution? Something that gets into the food source? Routine ultas-sounds of babies? More overweight and older women having baies later? Diet? Women returning to work earlier as two incomes are needed to survive? The following was released by the M.I.N.D. Instutute in Jam., 2009:

“A study by researchers at the UC Davis M.I.N.D. Institute has found that the seven- to eight-fold increase in the number children born in California with autism since 1990 cannot be explained by either changes in how the condition is diagnosed or counted – and the trend shows no sign of abating.

“Published in the January 2009 issue of the journal Epidemiology, results from the study also suggest that research should shift from genetics to the host of chemicals and infectious microbes in the environment that are likely at the root of changes in the neurodevelopment of California’s children.

“It’s time to start looking for the environmental culprits responsible for the remarkable increase in the rate of autism in California,” said UC Davis M.I.N.D. Institute researcher Irva Hertz-Picciotto, a professor of environmental and occupational health and epidemiology and an internationally respected autism researcher.

Hertz-Picciotto said that many researchers, state officials and advocacy organizations have viewed the rise in autism’s incidence in California with skepticism.

The incidence of autism by age six in California has increased from fewer than nine in 10,000 for children born in 1990 to more than 44 in 10,000 for children born in 2000. Some have argued that this change could have been due to migration into California of families with autistic children, inclusion of children with milder forms of autism in the counting and earlier ages of diagnosis as consequences of improved surveillance or greater awareness.

Hertz-Picciotto and her co-author, Lora Delwiche of the UC Davis Department of Public Health Sciences, initiated the study to address these beliefs, analyzing data collected by the state of California Department of Developmental Services (DDS) from 1990 to 2006, as well as the United States Census Bureau and state of California Department of Public Health Office of Vital Records, which compiles and maintains birth statistics.

Hertz-Picciotto and Delwiche correlated the number of cases of autism reported between 1990 and 2006 with birth records and excluded children not born in California. They used Census Bureau data to calculate the rate of incidence in the population over time and examined the age at diagnosis of all children ages two to 10 years old.

The methodology eliminated migration as a potential cause of the increase in the number of autism cases. It also revealed that no more than 56 percent of the estimated 600-to-700 percent increase, that is, less than one-tenth of the increased number of reported autism cases, could be attributed to the inclusion of milder cases of autism. Only 24 percent of the increase could be attributed to earlier age at diagnosis.

“These are fairly small percentages compared to the size of the increase that we’ve seen in the state,” Hertz-Picciotto said.

Hertz-Picciotto said that the study is a clarion call to researchers and policy makers who have focused attention and money on understanding the genetic components of autism. She said that the rise in cases of autism in California cannot be attributed to the state’s increasingly diverse population because the disorder affects ethnic groups at fairly similar rates.

“Right now, about 10 to 20 times more research dollars are spent on studies of the genetic causes of autism than on environmental ones. We need to even out the funding,” Hertz-Picciotto said.

The study results are also a harbinger of things to come for public-health officials, who should prepare to offer services to the increasing number of children diagnosed with autism in the last decade who are now entering their late teen years, Hertz-Picciotto said.

“These children are now moving toward adulthood, and a sizeable percentage of them have not developed the life skills that would allow them to live independently,” she said.

The question for the state of California, Hertz-Picciotto said, will become: ‘What happens to them when their parents cannot take care of them?’

“These questions are not going to go away and they are only going to loom larger in the future. Until we know the causes and can eliminate them, we as a society need to provide those treatments and interventions that do seem to help these children adapt. We as scientists need to improve available therapies and create new ones,” Hertz-Picciotto said.

Hertz-Picciotto and her colleagues at the M.I.N.D Institute are currently conducting two large studies aimed at discovering the causes of autism. Hertz-Picciotto is the principal investigator on the CHARGE (Childhood Autism Risk from Genetics and the Environment) and MARBLES (Markers of Autism Risk in Babies-Learning Early Signs) studies.

CHARGE is the largest epidemiologic study of reliably confirmed cases of autism to date, and the first major investigation of environmental factors and gene-environment interactions in the disorder. MARBLES is a prospective investigation that follows women who already have had one child with autism, beginning early in or even before a subsequent pregnancy, to search for early markers that predict autism in the younger sibling.

“We’re looking at the possible effects of metals, pesticides and infectious agents on neurodevelopment,” Hertz-Picciotto said. “If we’re going to stop the rise in autism in California, we need to keep these studies going and expand them to the extent possible.”

The study was funded by grants from the National Institute of Environmental Health Sciences (NIEHS) and by the M.I.N.D. Institute.

In 1998, dedicated families concerned about autism helped found the UC Davis M.I.N.D. (Medical Investigation of Neurodevelopmental Disorders) Institute. Their vision? Experts from every discipline related to the brain working together toward a common goal: curing neurodevelopmental disorders. Since that time, collaborative research teams at the M.I.N.D. Institute have turned that initial inspiration into significant contributions to the science of autism, fragile X syndrome, Tourette’s syndrome, learning disabilities and other neurodevelopmental disorders that can limit a child’s lifelong potential.

UC Davis M.I.N.D.

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Aptos psychologist: Conservatorships protect developmentally disabled persons. Your regional center can test & provide report to Superior Courts.

With a few modifications, this is from the Santa Clara web site.

“Who decides if an adult is developmentally disabled (DD)?

“The Regional Center in your community (San Andreas Regional Center covers Santa Clara County, Santa Cruz County, San Benito and Monterey County) will test the proposed conservatee to see if s/he is developmentally disabled.

“Generally, a person qualifies as developmentally disabled if s/he has an IQ less than 70 or is diagnosed with autism. There are five eligible conditions to qualify under at any age for Regional Center services. The dsability must have been present before the person became age eighteen.

“Other conditions can qualify too. If the Regional Center accepted the person as a consumer shortly after birth, then s/he automatically qualifies.

“But, if the person has never been tested or accepted as a regional center consumer, s/he must be tested.

“If the Regional Center feels the person does not qualify, and you disagree, you can appeal to the Area Board in your region. In Santa Clara County, the area board supervising the San Andreas Regional Center is Area Board VII.

“What kinds of decisions does a limited conservator make?

At the hearing, the judge will say exactly what rights the conservator has.

Because developmentally disabled people can usually do many things on their own, the judge will only give the limited conservator power to do things the conservatee cannot do without help.

The conservator may:

* Decide where the DD adult will live (but, NOT in a locked facility).
* Look at the DD’s adult confidential records and papers.
* Sign a contract for the DD adult.
* Give or withhold consent for most medical treatment (NOT sterilization and certain other procedures).
* Make decisions about the DD adult’s education and vocational training.
* Place the DD adult at a state hospital for the developmentally disabled (a locked facility, like Agnews Developmental Center).
* Give or withhold consent to the DD adult’s marriage.
* Control the DD adult’s social and sexual contacts and relationships.
* Manage the DD adult’s financial affairs.

“Any adult developmentally disabled person for whom guardianship or
conservatorship is sought pursuant to this article shall be informed
by a member or designee of the regional center and by the court of
the person’s right to counsel; and if the person does not have an
attorney for the proceedings the court shall immediately appoint the
public defender or other attorney to represent the person. The
person shall pay the cost for such legal service if able.

“If an affidavit or certificate has been filed, as provided in
Section 416.7, evidencing the inability of the alleged
developmentally disabled person to be present at the hearing, the
psychologist …. assisting in preparing the report and
who is required to visit each person as provided in Section 416.8
shall communicate such information to the person during the visit,
consult the person to determine the person’s opinion concerning the
appointment, and be prepared to testify as to the person’s opinion,
if any.

416.17. It is the intent of this article that the director when
acting as guardian or conservator of the person of a developmentally
disabled person through the regional center as provided in Section
416.19 of this article, shall maintain close contact with the
developmentally disabled person no matter where such person is living
in this state; shall act as a wise parent would act in caring for
his developmentally disabled child; and shall permit and encourage
maximum self-reliance on the part of the developmentally disabled
person under his protection.

The above is from the web site for Superior Court of Santa Clara County

To contact San Andreas Regional Center for information, go www.sarc.orgSan Andreas Regional Center

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Aptos psychologist: new 1 oz. bottles for breastfeeding make it easier to collect and store. Babies can be fed directly from bottle.

Article Date: 23 Apr 2009

“Thermo Fisher Scientific Inc. has expanded its line of Snappies breastfeeding solutions with the new small volume 1oz container. Responding to the demand for more feeding choices, this sterile, leak-proof, airtight container can be used for the collection, storage and feeding of expressed breast milk. Designed to work with most popular breast pumps, 1oz Snappies container makes it even easier to collect and store smaller volumes of colostrum safely and conveniently. Babies can be fed directly from the container, eliminating the need for bags and bottles, as well as making breastfeeding easier both in the first few days after birth, and throughout the early, critical months at home.

“Snappies containers come in both 1oz and 2.3oz sizes. Snappies have been manufactured with a sterile interior, and are designed to work with standard ring-sized breast pumps typically used in hospital neo-natal care units. The containers allow mothers to pump directly into the bottles and a hinged flip-top lid conveniently locks back out of the way while in use, enabling the container to be opened and closed with one hand. In addition, the unique triple-seal design offers a complete airtight and leak-proof solution, ensuring maximum shelf life for breast milk when stored in the refrigerator or freezer. The hinged lid eliminates concerns about dropping or misplacing the lid, and the lid closes with an exclusive audible “snap” to indicate airtight closure. Furthermore, each Snappies Container features a built-in label section to quickly and easily record the mother’s name, date and collection time, and eliminate any potential identification problems.

Go to http://www.snappiescontainers.comSnappies

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Aptos psychologist: sensory integration helps children with autistic spectrum disorders (ASD)

Article Date: 15 Apr 2009

“Occupational therapy helps people develop the life skills needed for living independent and satisfying lives, and it’s also helpful for children diagnosed with ASD,” said Dr. Skip Freedman, Executive Medical Director at AllMed Healthcare Management, a leading independent review organization (IRO). “Occupational therapists who treat children with ASD seek to help them develop suitable responses to stimuli in their environment.”

“Four clusters of behavior characterize autism: disturbances in social interaction, deficits in communication, behavioral abnormalities, and disturbances of sensory and perceptual processing.

Of these, the inability to communicate is key. Children with ASD learn to talk later, don’t learn to talk at all or sometimes lose the ability to talk. Others may learn to talk, but find using language effectively in social interactions difficult.

“Children with ASD can be both under- and over-responsive to sensory stimuli. Disturbances in the children’s perception of auditory stimulation are common.

“Based on analysis of the interactions of an ASD child’s skills, challenges and occupations, occupational therapists can intervene to help the child select alternative behaviors and tailor the intervention for the child’s specific needs and personality. This increases the child’s gaining new skills.

Sensory-based Integration

“Traditionally, occupational therapists focused on the child’s fine and gross motor skills, motor planning, and acquiring self-help skills. For example, they would work with ASD children to develop skills for buttoning their shirts, tying their shoes or work on their handwriting.

” Now, occupational therapists who specialize in ASD work with children on integrating the information coming in through their senses. Sensory integration and sensory-based interventions help children improve their self-regulation and develop acceptable behavioral responses. This integration effort improves the child’s sensory information processing and helps the child sort out acceptable from unacceptable behaviors. Additionally, the occupational therapist also may work with the child on his social and play skills.

Other Interventions

“Occupational therapists find relationship-based intervention treatments help a child with ASD grow both socially and emotionally. Often they use adult imitation involving many positive responses, prompts and cues to facilitate interaction between the children and their peers. This helps to show the positive effects of social engagement. Also, they engage the children in structured-play activities that include cueing, promoting and positive reinforcement to improve social interactions and taking turns.

Occupational therapists find that modeling and practice can have positive effects on activities such as turn-taking, joint attention, eye contact, nonverbal communication and language. Often they use social stories during therapy sessions to involve ASD children actively and to improve their targeted behaviors.

The philosophy and goals of occupational therapists align well with intervention for children with ASD, making them an integral part of the treatment team.

“Pediatricians can help parents identify early intervention programs available through a state’s department of social services or department of health,” said Freedman. “Often, parent’s health-insurance plan can fund occupational therapy.”

To cover occupational therapy for ASD, most health insurers may request documentation that includes integration and praxis tests (SIPT) results, short- and long-term treatment goals and require a therapist to have sensory integration credentials.

Source: AllMed Healthcare Management

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