User login
Recent comments
Navigation
Behavioral Problems in Children
Behavior problems come in all different sizes for parents with their children, and in many cases the behaviors seem to defy adult logic. All one has to do is a simple web-search of Behavioral Problems to see how many any one search engine can find.
More and more foster/adoptive parents are seeking the advice of specialists who are trained to assess attachment and/or bonding issues because they are overwhelmed, afraid and not at all prepared to deal with the combative or disruptive behavior their children seem "incapable" of improving. Some children are diagnosed with Autism and others are given the Reactive Attachment Disorder or ADHD labels. What's the difference? Testing and treatment.
Since PPL is a website that advocates the needs of abused, neglected and displaced children, I'm wondering if there is a huge group of normal healthy children being wrongly diagnosed by doctors and given very strong anti-psychotics simply because no one is taking the time to delve deeply into the emotional consequences of loss, rage and grief. After all, how many foster/adoptive parents are truly well-prepared for the realities of raising another person's child, and how many of these parents are given truthful histories about the child's previous family? How many of these parents know the difference between behavior disorders, and what causes them? For instance, autism is a disorder that has genetic and chemical properties, affecting brain development. Yet, stress and emotional grief during the first years of life also alters brain-development. The main difference between the autistic child and the stressed child is a matter of scientific interest towards prevention and treatment. That requires formal study.
Already, parents of autistic children are finding more information about the workings of their child's condition. "Studies have found that some people with autism have difficulty interpreting and processing visual motion, especially when they have to interpret subtle or quick movements made by people. Such a deficit, especially if it occurred early in development, could have wide ranging consequences, particularly in the development of social understanding" http://psychology.ucdavis.edu/labs/rivera/site/research/autism.htm Knowing this, parents can be warned and prepared, and seek problem-specific treatments that may help the parents of an autistic child. Focusing on smaller specific problems eliminates the use of a broad, general hit-or-miss approach, that can often hurt the family situation, not help it.
Meanwhile, the RAD and ADHD diagnosis, given to the foster and adopted population, can be given without any scientific study or objective proof. These labels are personal opinion and assumptions, not fact., which means there's more room for error. For the unprepared panicking parent, more often than not, a quick and immediate response is better than slow delay. Of course, that means a simple suggestion:"let's medicate it, and see what happens". It's at this point, a responsible parent needs to remember, anytime a diagnosis is based upon subjective (personal) opinion, red-flags should go up, asking, "How can you be sure you are correct, and what if your wrong?". After all, the only scientific study done on the medications given to these children is long-term adult use side-effects, which include, extrapyramidal reactions, acute dystonias, akathisia, parkinsonism (rigidity and tremor), tardive dyskinesia, tachycardia, hypotension, impotence, lethargy, seizures, and hyperprolactinaemia].
I know if it were my own child, having severe behavior problems, the first thing I would do is ask myself, "what's going on at home, that I may not know about?" Has anything changed to bring my child a sense of panic? I would agree to medication only as a last resort, and I would insist on recent information on what tests have been completed, proving medication will help, not hurt my growing child.
The question is, how much does behavior have to do with biology and parenting-style, and how much of a child's "unsual" or "inappropriate" behavior relates to stress and the feelings of loss, anger and misery? It's a parent's job to ask the tough questions, and prepared for the honest answers. I fear far too many children are being medicated simply because it's easier to sedate an angry child, than fix the family problems that are causing very difficult and troublesome emotional problems.
I believe there is much neuro-science has to learn about brain development, but at least the technology is now here for it to be used so actions to reactions can be studied, and maybe one day, the masking of behaviors with medication will come to an end.
Meanwhile, what if there are serious disorders (requiring serious medications) that can be prevented, simply by keeping a baby with his natural mother or father? Will that mean each state will have to develop better social services, and standards of care for it's families in abusive situations, and not reply on pills as an appropriate replacement for quality care? One has to wonder how long each state can afford to push pills on their young, before drugs, and their related health-problems, become an even bigger problem with age.
Comments
Using FMRI Technology To Understand Hyperlexia
Science Daily — Washington, D.C.
Date:January 12, 2004
Georgetown University Medical Center researchers published the first ever fMRI study of hyperlexia, a rare condition in which children with some degree of autism display extremely precocious reading skills. Appearing in Neuron, the case study uncovers the neural mechanisms that underlie hyperlexia, and suggest that hyperlexia is the true opposite of the reading disability dyslexia.
Hyperlexia is found in very rare cases in children who are on the "autism spectrum," meaning they display some characteristics of autism. Like autistic children, children with hyperlexia have extreme difficulty with oral communication, social interaction and expression, and yet can read surprisingly well at a very young age. By some accounts, hyperlexic children can read at 18 months, sometimes two years before they have ever uttered a single word. They are drawn to print, sometimes reading all the signs and license plates they might encounter during a brief walk through the parking lot.
The child in this case study, Ethan , reads six to eight years in advance of his age. He read dictionaries in his twos, but spoke his first word at age three and a half.
"This advanced reading ability, which would likely surprise any parent, is even more extraordinary given that many of these children begin reading before mastering spoken language, and sometimes before speaking at all," said senior author Guinevere Eden, DPhil, associate professor of pediatrics and director of Georgetown's Center for the Study of Learning. "Current theories of reading development posit that decoding skills are based on linguistic abilities, but our finding suggests that children like Ethan are able to map sound onto print without a solid language basis."
Eden and her colleagues use fMRI technology to study how brains develop and function as children learn to read. Most children acquire reading skills through explicit instruction received over several years of schooling. In this study, the research team wanted to illucidate the neural signature for precocious reading, which arose in the absence of any teaching. Deviations from the normal pattern would suggest that other regions of the brain might have the potential to become involved in the reading process and would shed light onto possible compensatory strategies of the abnormally reading brain.
The hyperlexic boy, Ethan performed several reading tests while lying down in the fMRI. The researchers then compared hot spots of brain activity in Ethan as he performed these tasks against brain scans of typically developing readers, who were matched to Ethan on either chronological or reading age. Compared to these groups, Ethan demonstrated greater activity in an area on the left side of the brain that is associated with understanding the sounds of speech as well as a region on the right side of the brain that is part of the visual system.
Co-author Peter Turkeltaub, a PhD student, draws an analogy of to the volume control on a radio. "A region of the brain implicated in reading skills, the left superior temporal cortex, is like a dial. When the dial is turned up, you find accelerated readers, or hyperlexics. When the dial is turned down, as has been shown for dyslexic children, you find inefficient readers. The more neurological research we do, the better we may understand how the dial works and what educational interventions may turn the dial toward its optimum point."
Ethan's parents knew something was peculiar with their son at a young age. He did not speak, make eye contact, or respond to typical verbal or non-verbal communications cues. However, he could sit silently in a corner and read books for hours.
Now at age eleven, Ethan attends a public school with an aide, and was recently voted class president. He has an insatiable curiosity for books, magazines, and television, but still has difficulty in social situations. According to his mom Ilene, "the other kids think he is very smart but very unusual. There are times when he says things that make the other kids realize he is not quite the same."
Ilene said, "If I could tell people one thing about hyperlexia, I would remind them that these children have a tremendous gift and that reading is the way to unlock their minds and hearts. Don't try to take their books away to force them to interact with people. Encourage their reading ability, because they have so much to offer the world, just in a more unconventional way."
"Neuroscience is allowing us to better characterize people who were before all bundled under the general autism umbrella," said Eden. "Just as it is extremely helpful to distinguish a child with Asperberger's, identification of hyperlexia can be equally as important for early intervention and appropriately tailored education."
###
This study was funded by the National Institutes of Health's National Institute of Child Health and Human Development (NICHD) and National Association for Autism Research (NAAR).
Note: This story has been adapted from a news release issued by Georgetown University Medical Center.
The Types and Terminology of Autism
www.drspock.com
by Robert Needlman, M.D., F.A.A.P.
reviewed by Robert Needlman, M.D., F.A.A.P.
The terminology of autism can be confusing, in part because it has changed over the years, and in part because different professionals use the same terms to mean different things.
There are several subtypes that fall within the autistic spectrum of disorders. These disorders together are sometimes referred to as "autism" and sometimes as Pervasive Developmental Disorders (PDDs). PDD is a helpful term because it tells you that the conditions are pervasive (affecting multiple areas) and developmental (appearing in the course of development).
The subtypes of PDDs include:
At the risk of making what is already confusing even more so, here are some details about the different subtypes.
Although autistic disorder is a diagnosis, it is a broad one. There are so many variations within the diagnosis that the label itself means little. It is much more helpful to describe each child's unique pattern of developmental strengths and weaknesses.
Simple Theory
It's my belief that behavioral problems can be seen and diagnosed by the medical community much like Diabetes is. There are two types of diabetes. One type is easily and quickly discovered because a child has obvious symptoms of a disorder. The other type develops over time, and pathology (problems) does not present itself until adulthood. One type requires daily medication; the other requires diet and life-style modification. Both types of the same condition can be scientifically tested, diagnosed, and medically managed. Both can be life-threatening, if untreated.
Given the capabilities of fMRI and MEG technologies, I believe the effects of maternal loss, separation and adaptiion to those losses, and long-term abuse/neglect can finally be compared, contrasted and deeply studied and tested through the use of these brain imaging devices. Furthermore, I believe IF certain pathological behaviors can be seen as an affect caused by long-term maternal separation, and is defined as such, it should become the duty of health-care professionals to preserve and protect the natural bond between mother and child, as a unit, keeping both as safe and well as possible so no harm is done to any one, especially the developing child in need of a parent and extended family.
Anecdotal answer
Since PPL is a website that advocates the needs of abused, neglected and displaced children, I'm wondering if there is a huge group of normal healthy children given anti-psychotic medication simply because they are adopted or foster-care children?
I worked at a camp for underprivileged children from NYC last summer where a good number of the children had been in, or in and out of foster homes...some adopted from f/c. One day I had a phone conversation with the director of the program in NYC. He told me that there was a "racket" going in NYC where even if a child spent only one day in foster care, they were compelled to have a psychiatric evaluation. No wonder a number of these kids were on psych meds - some on several - including typical and atypical anti-psychotic meds. I felt so bad for these kids. One boy, when coming in with others for the evening pass, tried to play me out of taking his meds. I took him to a private room, talked to him a little while and then said I was going to bring his meds back to him (in privacy). He was fine with that, so I determined that he was embarrassed (ashamed?) to take his meds in front of his peers (some of whom were also getting psych meds but he didn't necessarily know this). So every night I'd take him back and he'd get his meds privately instead of in the front waiting room of the camp health center. Kids were getting meds for all kinds of reasons (asthma control, allergy control, etc. etc.) and for the most part kids don't think much of it., it's a routine for them. But as for the psych meds, as children get older they become more aware and self-conscious about what their taking and what it could be for. The prescribing of unnecessary psych meds is problematic on many fronts. I think your question is valid. A real lot of ADHD meds were also prescribed for these kids. As a nurse, I would have no authority to change what I had to give them while they were there at camp. Also, problems occur with abruptly discontinuing certain meds, so I had to see that the kids got them, but I thought I'd describe what I saw in response to your query.