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Friday, February 28, 2014

Many Children with Autism Take Multiple Drugs

From SFARI.org
The Simons Foundation Autism Research Initiative

By Laura Geggel
December 3, 2013

"Little is known about the long-term effects of these drugs, or about how the different drugs may interact with one another."

Children with autism often have an array of challenging symptoms — irritability, anxiety, sadness, aggression and inattention — and the few behavioral therapies that may improve these symptoms are time-intensive, expensive and sometimes inaccessible.

It's no surprise then, that many doctors and families turn to medications to alleviate symptoms — for example, antidepressants to relieve sadness, or psychostimulants to increase attention span.

Little is known about the long-term effects of these drugs, or about how the different drugs may interact with one another. Still, it’s common for children with autism to be taking more than one or two of these drugs at the same time, according to two new studies published in the past few weeks.

One of the studies, published in the November issue of Pediatrics, analyzed medication use in 33,565 individuals with autism, from birth to age 20, between 2001 and 2009.

Of the 21,334 children who received prescriptions, 1/3 took a single drug during the study period. Another 1/3 took more than one drug at a time and about 5% took a heavy load of four or more medications.

Read the entire story HERE.

We Need To Teach Kids How To Pay Attention

From The Brilliant Blog

By Annie Murphy Paul
February 22, 2014

“Children need lessons in how to concentrate because of impact of social media,” reads the headline of a recent article in the British newspaper The Independent. The story quotes Tristram Hunt, a Labour Party politician, as saying of students:

“They need to learn the ability to concentrate for sustained periods—especially in today’s world of short attention spans. I think young people need help with being able to do that.”



The article caught my eye because I’ve made similar arguments. In a previous post on the Brilliant Blog, for example, I quoted UCLA psychology professor Patricia Greenfield:

“The informal learning environments of television, video games, and the Internet are producing learners with a new profile of cognitive skills. This profile features widespread and sophisticated development of visual-spatial skills, such as iconic representation and spatial visualization . . .

Formal education must adapt to these changes, taking advantage of new strengths in visual-spatial intelligence and compensating for new weaknesses in higher-order cognitive processes: abstract vocabulary, mindfulness, reflection, inductive problem solving, critical thinking, and imagination.

These develop through the use of an older technology, reading, which, along with audio media such as radio, also stimulates imagination. Informal education therefore requires a balanced media diet using each technology’s specific strengths in order to develop a complete profile of cognitive skills.”


I love Greenfield’s notion that we all need to develop “a complete profile of cognitive skills”—and especially her suggestion that the “informal education” that young people receive via their devices is beneficial and yet also incomplete. Using apps, playing video games and surfing the Web can help kids learn some things—but they are not likely to teach them other things that they really need to know.

Like, for instance, how to pay sustained attention to one thing for an extended period of time. For that purpose, books are better than Internet-connected devices. As I wrote in another Brilliant Blog post about the value of “deep reading” (that is, reading that is immersive and uninterrupted):

“Observing young people’s attachment to digital devices, some progressive educators and permissive parents talk about needing to ‘meet kids where they are,’ molding instruction around their onscreen habits. This is mistaken. We need, rather, to show them someplace they’ve never been, a place only deep reading can take them.”

Developments in Discipline: A Federal Alert on Discrimination and A New Massachusetts Statute

From Special Education Today
A Special Education Law Blog from

the Attorneys at Kotin, Crabtree & Strong, LLP

By Robert K. Crabtree, Esq.
February 27, 2014

Parents and advocates should take note of several important recent developments concerning how schools manage students’ behavior. We post this note to direct attention to some of the more important developments, each of which involves complex and detailed information worthy of more extensive study and discussion as their consequences unfold.

Of most immediate concern is the third item discussed in this post, since it invites readers to consider submitting comments to DESE by March 7 on proposed regulations to govern school discipline policies and practice. We begin, though, by describing a federal publication that highlights the context within which those policies will be applied, noting some of the issues and concerns that give rise to the need for thoughtful and systematic attention to the way in which students, with or without disabilities, are handled when they misbehave.
First, the U.S. Department of Education and the U.S. Department of Justice have jointly issued an eloquent and well-supported memorandum concerning elementary and secondary school discrimination based on race or ethnicity in a “Dear Colleague” letter advising public schools how to “identify, avoid, and remedy discriminatory discipline.” The memo cites data collected by the Office for Civil Rights showing that students from some racial and ethnic groups are disciplined both more frequently and more severely than white students – far more than can be explained by non-discriminatory factors.

For example, African-American students without disabilities are more than three times as likely as their white non-disabled peers to be expelled or suspended. The memo examines the entire disciplinary process, from the response to misconduct in the classroom to long-term suspension and expulsion, noting that even the mildest forms of exclusion from the classroom (for example, being sent to the principal’s office) and even those that do not result in further discipline nevertheless create negative consequences for the student. Those consequences may include reduced academic instruction, possible enhancement of the penalty for any later misconduct, and a cumulative effect on the attitudes of school staff toward the student, potentially throughout the student’s academic career.

The memo points to further possible negative consequences such as a decline in the student’s attitude toward him or herself as a competent learner, and reduction in his or her interest in, hopes for, and ability to stay committed to a positive educational track; these, in turn, can create a downward spiral, leading the student to misbehave more frequently and face discipline again. The potentially serious consequences heighten the importance of a school’s scrupulous avoidance and prevention of discrimination in the exercise of its disciplinary policies. The Dear Colleague letter deserves a full and careful reading.
Second, though the Dear Colleague letter does not focus specifically on discriminatory disciplinary practices against students with disabilities, parents and advocates should note the letter’s reference to some very troubling data on that subject. As the Departments state in footnote 6 of the letter:
While this document addresses race discrimination against all students, including students with disabilities, evidence of significant disparities in the use of discipline and aversive techniques for students with disabilities raises particular concern for the Departments. For example, although students served by IDEA represent 12% of students in the country, they make up 19% of students suspended in school, 20% of students receiving out-of-school suspension once, 25% of students receiving multiple out-of-school suspensions, 19% of students expelled, 23% of students referred to law enforcement, and 23% of students receiving a school-related arrest. Additionally, students with disabilities (under the IDEA and Section 504 statutes) represent 14% of students, but nearly 76% of the students who are physically restrained by adults in their schools.
Third, and of most immediate concern, parents and advocates should educate themselves about a major new Massachusetts law governing exclusion of students from school for misconduct. Chapter 222 of the Acts of 2012, signed into law in August 2012, will take effect on July 1, 2014. Chapter 222 breaks new ground in this state by requiring that all students who are excluded from school, whether the exclusion is long-term or short-term and whether the student is disabled or not, must be afforded the opportunity to continue to make progress while they are suspended, expelled, or otherwise excluded from school.

As Chapter 222’s major progenitors, staff of the Massachusetts Advocates for Children, describe it: “This law will allow students who are excluded from school or facing exclusion to make academic progress during the period of their exclusion through alternative education programs and services provided by the school district. This law will also improve the fairness of the discipline process, and reduce the number and duration of school exclusions.”
The ultimate goal of the new law is to make exclusion the very last resort and to emphasize instead alternative interventions that support students by positive and educational means. Alternative approaches might, for example, involve the principles of restorative justice, or Collaborative Problem Solving (a methodology developed by a group at MGH called Think:Kids).

To the extent that the policies and practices governing school discipline can be successfully oriented away from suspensions and expulsions, the hope is that the typical downward spiral of students caught up in such issues can be interrupted. Where exclusion is the default response, students all too often wind up being held back, dropping out, and becoming prime candidates for the attention of the juvenile courts.
The provisions of this law and their interaction with protections already in place under IDEA are complex, and many of the ramifications for students with or without disabilities will likely only become clear as the law is implemented over the next school years. Right now, though, with only a short time left, there is an opportunity for parents and advocates to have a say as to how the law will be interpreted through the detailed regulations that the MA Department of Elementary and Secondary Education will issue over the next few months.

The draft regulations are subject to public comment only through Friday, March 7, 2014. Comments should be sent to Elizabeth Harris at the Department of Elementary and Secondary Education, by mail to 75 Pleasant Street, Malden, MA 02148, by fax to 781-338-3399, or by e-mail to eharris@doe.mass.edu.
While for the most part the proposed regulations fairly track the language, spirit and purposes of Chapter 222, leaders among disability advocates have raised concerns about certain critical matters. These include a provision intended to address what the DESE calls “emergency removal” conditions (proposed section 603 CMR 53.07). Immediate removal from school in certain serious situations (possession of dangerous weapons or controlled substances, assault on school staff members, being charged with or convicted of felony) is already permitted under other state laws. No provision in Chapter 222 specifically permits the “emergency removal” of students who commit other offenses.

Proposed 603 CMR 53.07, however, states that the principal may remove such a student for up to 5 school days if s/he decides that the “continued presence of the student poses a danger to persons or property, or materially disrupts the order of the school.” The concerns of parent advocates about the proposed regulation focus on the potential for excessively punitive actions by school administrators, to whom the proposed regulations give wide discretion in the exercise of their authority.

Specific concerns include: (1) the length of time – up to a proposed 5 school days – for which a student can be excluded from school on an “emergency” basis (the length of time should be no more than a day or two, depending on the nature of the “emergency”); and (2) the amount of discretion that is left to individuals in authority – primarily school principals – in characterizing incidents of misconduct as warranting “emergency removal” from school.

We also note that proposed section 603 CMR 53.05, concerning the use of exclusion and suspension as only a last resort, presently affords overly broad discretion to school principals to determine when attempts to re-engage the student in learning after an incident of misconduct have been exhausted and suspension is warranted.
Additionally, in section 603 CMR 53.14, some are concerned that the proposed reporting regulation omits mention of certain specifics required by Chapter 222 for school reports to DESE regarding suspensions and expulsions. Whereas the new statute requires that districts collect and report the specific reasons for all exclusions, regardless of duration or type, the proposed regulation simply states that DESE will determine the manner and form of reporting. While the statutory requirement for the specifics still apply and while the actual reporting forms may address this omission, advocates would like to see this requirement for specificity included explicitly in the regulation to emphasize the importance of this critical data.

In light of the ultimate aims of the statute, the regulations ought also to add a requirement to include information about a district’s development and use of non-exclusionary disciplinary alternatives in their reports.
As you can see, we are at the start of what could be a very promising change in the culture of schools around discipline. There will be much more to say about Chapter 222 as its effective date approaches, and then as it begins to be implemented.

We will keep an eye on the developments, and we urge our readers to do the same. Watch this space for additional analysis and updates!

..............................................................................

Robert Crabtree is a partner in the Special Education & Disability Rights practice group at Kotin, Crabtree & Strong, LLP in Boston, Massachusetts.

Thursday, February 27, 2014

First 1,000 Days of Life Could Hold Keys to Autism

From SFARI.org
The Simons Foundation Autism Research Initiative

By Maia Szalavitz
February 17, 2014


Although scientists still don’t know exactly what causes autism, there is widespread agreement that the condition starts to unfold in the earliest moments of life — during fetal development and the first few months of infancy.

That’s why some autism researchers have high hopes for a new project, the
First 1,000 Days of Life, which aims to follow at least 5,000 women and their babies through pregnancy and the first two years after birth.

This prospective design will allow the researchers to track changes as they happen, rather than having parents recall them later, which is subject to bias.

“We’re basically following these children through pediatric electronic health records as they mature,” says Joe Vockley, chief scientific officer at the Inova Translational Medicine Institute in Fairfax, Virginia, which is funding the $75 million project.

“It’s a wonderful model,” says Lisa Croen, director of the Autism Research Program at Kaiser Permanente Northern California, who is not involved in the project. Croen is helping lead two studies that are trying to track autism’s origins in early development.

Read the rest of this article HERE.

Free Parent Workshop March 5th: When and How to Talk to Your Kids about Their Learning Issues

From Academy MetroWest

February 26, 2014

Great topic; great speaker!

On Wednesday, March 5th, A-List Neuropsychologist Dr. Gretchen Felopulos from Mass. General's LEAP (Learning and Emotional Assessment Program) will discuss "When and How to Talk to Your Kids About their Learning Issues."

This talk is free and open to the public.

When:   7:15 - 8:45pm, Wednesday, March 5, 2014

Where:  Academy MetroWest
                    218 Speen Street, Natick, MA

For more information or to RSVP, please call 508-655-9200 or email info@academymetrowest.com.

Report Questions Value of Entrance Exams in Predicting College Success

From Education Week


February 19, 2014

A new study finds "no significant differences" between the college grades and completion rates of students who submit ACT or SAT scores with their college applications and those who do not. A more reliable predictor of academic success, the research concludes, is students' high school grades.

The
report analyzed data for 123,000 students who enrolled in 33 colleges that do not require applicants to submit test scores from college-entrance exams. It features a diverse swath of public and private four-year institutions of varying sizes— including Bates College and Washington State University—representing a 5 percent sample of those higher education institutions with optional testing policies.

The fundamental question posed was, "Are college admission decisions reliable for students who are admitted without SAT or ACT scores?"

The answer? Yes.

The report, published Feb. 18 on the
National Association for College Admission Counseling website, was coauthored by William Hiss—a professor and former dean of admissions at Bates College in Lewiston, Maine—and Valerie Franks, a former assistant dean of admissions at Bates.

About 30 percent of students were admitted without providing test scores and the study found no significant difference in either cumulative Grade Point Average or graduation rates between submitters and non-submitters. Those who did not submit scores had GPAs that were .05 lower than submitters (2.83 vs. 2.88) and the difference in graduation rates was .6 percent.

"By any standard, these are trivial differences," the report says.

Grades were a better predictor of student performance. Students with strong high school GPAs generally perform well in college, despite modest or low testing on the ACT or SAT. Students who had weak GPAs in high school, even with markedly stronger testing performance, had lower college GPAs and graduate at lower rates, the report finds.

"All students need to hear the sustained, consistent message from their high schools and from colleges and universities that the importance of a successful high school record cannot be overestimated," the study says.

It also notes that students who choose not to submit test scores are more likely to be the first in their families to go to college, as well as women, minorities, recipients of need-based financial aid, and students with learning disabilities.

Barriers to Admission

In a phone interview, Hiss said that there are increasing numbers of students from these groups who need to get through college, and that standardized testing can create a barrier.

"Our report is not a Jihad on the ACT and SAT," said Hiss. "It's a statement that high school matters a lot. We are artificially truncating the pool of young people who would succeed in college if colleges would let them in and give them a chance."

David Hawkins, the director of public policy and research for NACAC, said in an email that the new report is in keeping with the 2008 recommendations of the
NACAC Commission on the Use of Standardized Testing in Undergraduate Admission. It encouraged institutions to conduct research on standardized admission test scores to determine what, if any, benefit the institution derives in predicting student success at the institution. Hawkins served on the advisory committee for the Hiss study.

The new study found the optional testing policies will work successfully at broadly different kinds of institutions.

Optional-testing policies have been the focus of debate for years. Now there are about 850 four-year colleges and universities (out of 2,800) that do not use SAT or ACT scores for admitting a substantial number of students for bachelor-degree programs, according to the
National Center for Fair and Open Testing.

The College Board, which administers the SAT, argues that high school GPA and SAT scores in combination are the best predictors of college success.

"The SAT is among the most rigorously researched and designed tests in the world and dozens of internal and external studies show that the SAT is a valid predictor of college success for all students," said Cyndie Schmeiser, chief of assessment of the College Board, in a statement.

"It's important to note that test-optional schools are our members and our partners. We respect the decisions they make about their admissions processes, and we will continue to listen to our members, evolve our programs, and work to expand access to opportunity for all students."

Wayne Camera, a senior vice president of research at ACT, Inc., said that it's better for admissions officers to have more sources of reliable information when making decisions about students rather than less. While there are legitimate reasons for colleges to adopt test-optional policies, he maintains the study ignores the fact that admissions officers can and do ignore or deemphasize information when it is inconsistent with the overall student record.

"We believe that colleges and admissions decisions are best served when all students are playing on a level playing field and similar information is available," he said.

More Toxic Chemicals Damaging Children's Brains, New Study Warns

From the HuffPost Blog "Green"

By Lynne Peeples

February 14, 2014

The number of industrial chemicals, heavy metals and pesticides proven capable of derailing normal brain development -- and robbing children and society of dollars, IQ points and future potential -- has doubled over the last several years, according to a new paper published Friday.

Dr. Philippe Grandjean, one of the co-authors, suggested that the world is facing a "silent pandemic" of "chemical brain drain."

"We have an ethical duty to protect the next generation," he said. "In particular, the next generation’s brains."

As a medical student in the 1970s, Grandjean remembers watching a young Japanese teenager, Shinobu Sakamoto, on the TV news. Sakamoto struggled to walk and talk, but was determined to let the world know about her people's plight. Many in her fishing village of Minamata had unknowingly consumed seafood heavily tainted with methylmercury. Her mom had done so while Sakamoto was in her womb.

"I was shocked, as they didn't teach us anything about the effects of pollution on human health" in medical school, recalled Grandjean, chair of environmental medicine at the University of Southern Denmark and an adjunct professor at the Harvard School of Public Health. "That was the moment I decided to do something about it."

Grandjean has spent the decades since investigating chemicals capable of damaging the developing brain. He started with lead, then mercury. "Every time I turned over a stone, I found something new," he said.

The line-up has now grown to a dozen "bona fide brain drainers," said Grandjean. That's twice as many chemicals as he and co-author Philip Landrigan, chairman of the department of preventative medicine at the Mount Sinai School of Medicine in New York City, listed in their first review of the science in 2006.

Joining methylmercury, lead, arsenic, PCBs, toluene and ethanol, according to the authors' updated list, are manganese, fluoride, DDT, chlorpyrifos, tetrachloroethylene and polybrominated biphenyl ethers.

The consequences of exposure in the womb or during the first years of life to any of these heavy metals, pesticides, solvents, flame retardants and other industrial compounds may not always be as obvious as they were for Sakamoto. But the effects on society, experts warn, can be profound.

An estimated one in six children in the U.S. is now affected by a cognitive or behavioral disorder, and that rate appears to be on the rise. Experts suggest that increases in the number of kids with autism and attention deficit hyperactivity disorder, for example, can't be explained by increased awareness or surveillance alone. Environmental pollutants are among the suspects.

Still, the new paper's concerns go much further.

Reduce one child's IQ by five points and the difference may be imperceptible. The child might be just a little slower to learn, a little shorter of attention and a little less successful on tests and at work -- which economists estimate could equate to $90,000 in lost lifetime earnings.

Reduce the average IQ among all children in the U.S. by five points, however, and the impact is striking: About half as many members of that generation will be "intellectually gifted," twice as many will be "intellectually impaired," and billions of dollars of productivity will be lost.

And that doesn't take into account the costs of diagnosis, treatment, special education, incarceration and other indirect costs, such as an estimated rise in traffic accidents attributed to more distracted drivers.

A potential shifting of the bell curve should ring alarms for policymakers, business leaders and parents alike, experts say. They add that the current list of chemical culprits likely represents just the tip of the iceberg.

"The number is going to increase. Right now, it's just a matter of not having data available," said David Bellinger, an expert in children's environmental health at Harvard, who has found associations between three of the brain poisons -- lead, methylmercury and organophosphate pesticides (a class that includes the newly added chlorpyrifos) -- and drops in the combined nationwide IQ of 23 million, 17 million and 0.3 million points, respectively.

Adding to the problem, Bellinger added, is that "the regulatory process in this country is inherently conservative: You have to prove something is bad [before you can ban it] rather than prove something is good [before you can authorize it]."

Representatives of the chemical industry, meanwhile, called the new paper "flawed."

"The authors focus largely on chemicals and heavy metals that are well understood to be inappropriate for children's exposure, highly regulated and/or are restricted or being phased out," the American Chemistry Council told HuffPost in an emailed statement. "They then extrapolate that similar conclusions should be applied to chemicals that are more widely used in consumer products without evidence to support their claims."

The industry group further emphasized that its members "go to great lengths to ensure products are safe."

Most of today's knowledge about chemicals and their effects on the human brain is based on the study of adults -- typically those who have suffered occupational exposures or tried to kill themselves. With these data, scientists have tallied a total of 214 neurotoxic chemicals. Another thousand chemicals have been shown to be toxic to animals' brains, while thousands more have yet to be studied for neurotoxicity.

Science has come a long way since Grandjean’s medical school days, when his professors taught that the fetus is well protected inside the mother’s womb. Scientists now know that hundreds of chemicals can course through umbilical cord blood.

But proving that a specific chemical can harm a child's growing gray matter is extremely difficult and time-consuming, which experts suggest is why the list currently stands at only 12.

"The default assumption is that if it's not good for the adult brain, it's even worse for the child's," said Bellinger.

Timing is critical. At certain times while the baby is still inside the womb, brain cells are added at a rate of 250,000 every minute -- with each neuron migrating to a specific location in the brain, where it begins building intricate networks with other cells. During the first few years of a baby's life, 700 new neural connections are formed every second.

"The brain has to go through very complicated and delicate stages of development that have to happen at the right time and in the right sequence. If that doesn't happen, you don't get a second chance," said Grandjean, who has recently published a book on the topic titled Only One Chance.

"That kid is stuck with that brain the rest of his or her life," Grandjean added.

Some children may be more at risk than others, noted Bruce Lanphear, an environmental health expert at Simon Frasier University in British Columbia. "If you grow up in an impoverished neighborhood, you could be exposed to lead, airborne pollutants, tobacco smoke and high levels of pesticides," he said. "Each of these can chip away at learning abilities or elevate risks of ADHD."

What's more, some of these chemicals may magnify the effects of others. Lead, for example, has been shown to cause more harm in children who are also exposed to tobacco smoke or manganese.

Sheela Sathyanarayana, a pediatric environmental health expert at Seattle Children's Hospital, noted at least a few things that parents and expecting parents can do to reduce potential neurotoxic exposures inside their home. She recommended avoiding fish known to contain high levels of mercury, such as tuna, as well as minimizing dust, removing shoes when coming indoors and keeping windowsills clean.

She also welcomed the paper's recommendation of a new agency -- much like the World Health Organization's International Agency for Research on Cancer -- that could coordinate research and grade the evidence for a chemical's propensity to wreak havoc on the developing brain.

Some progress has already been made, including the newly adopted Minamata Convention on Mercury, which addresses human activities contributing to widespread mercury pollution and was inspired by the tragedy in Sakamoto's village. But, as Grandjean noted, even chemicals long-banned in the U.S., such as chlorpyrifos, are still turning up inside American homes or being exported to developing countries.

"This is like climate change," he said. "We just can’t afford to do this experiment. Once we finally get enough evidence, it's too late."

Grandjean added his fear of a potentially ironic "vicious cycle."

"If the next generation does not have the cognitive skills that we hope they will have," said Grandjean, "they will not be able to clean up after us ... or care for us."

Wednesday, February 26, 2014

CEO Mom: Chief Education Officer in the Family

From Smart Kids with LD

February 24, 2014

A national survey confirms what many parents know intuitively: Moms are the Chief Education Officers (CEOs) of the family.

According to an article in Education Week, the survey of more than 5,000 adults, conducted online by Sylvan Learning, found that “88% of mothers of school-aged children believe that they are primarily responsible for their child’s academic success and deserve the so-called CEO title.”

What does it mean to be the Chief Education Officer? Simply put, Mom CEOs take a proactive role in their child’s education. Jeffrey Cohen, Sylvan Learning’s CEO (Chief Executive Officer), describes these parents as “working partners with teachers to ensure their children achieve academic and personal success.”

Challenging Role

Just as any high-level manager will attest, being on top can take its toll. A large number of CEO moms report that helping their children with homework (44%) and understanding their school curriculum (35%) is the primary stressor in their lives.


Another 30% were concerned about the lack of time they had to help their children, while 20% said quality family time suffered due to academics.

Are Schools Asking to Drug Kids for Better Test Scores?

From The Wall Street Journal Blog "Mind & Matter"

By Alison Gopnik
February 21, 2014

In the past two decades, the number of children diagnosed with Attention Deficit Hyperactivity Disorder has nearly doubled. One in five American boys receives a diagnosis by age 17. More than 70% of those who are diagnosed—millions of children—are prescribed drugs.

A new book, "The ADHD Explosion" by Stephen Hinshaw and Richard Scheffler, looks at this extraordinary increase. What's the explanation? Some rise in environmental toxins? Worse parenting? Better detection?

Drs. Hinshaw and Scheffler—both of them at the University of California, Berkeley, my university—present some striking evidence that the answer lies, at least partly, in changes in educational policy.


Many people have suspected that there is a relationship between the explosion in ADHD diagnoses and the push by many states, over this same period, to evaluate schools and teachers based on test scores. But how could you tell? It could just be a coincidence that ADHD diagnoses and high-stakes testing have both increased so dramatically.

Drs. Hinshaw and Scheffler used a kind of "natural experiment." Different parts of the country introduced new educational policies at different times. The researchers looked at the relationship between when a state introduced the policies and the rate of ADHD diagnoses.


They found that right after the policies were introduced, the diagnoses increased dramatically. Moreover, the rise was particularly sharp for poor children in public schools.

The authors suggest that when schools are under pressure to produce high test scores, they become motivated, consciously or unconsciously, to encourage ADHD diagnoses—either because the drugs allow low-performing children to score better or because ADHD diagnoses can be used to exclude children from testing. They didn't see comparable increases in places where the law kept school personnel from recommending ADHD medication to parents.


Drugs don't 'cure' a disease called ADHD the way
that antibiotics cure pneumonia. Getty Images

These results have implications for the whole way we think about ADHD. We think we know the difference between a disease and a social problem. A disease happens when a body breaks or is invaded by viruses or bacteria. You give patients the right treatment, and they are cured. A social problem—poverty, illiteracy, crime—happens when institutions fail, when instead of helping people to thrive they make them miserable.

Much debate over ADHD has focused on whether it is a disease or a problem, "biological" or "social." But the research suggests that these are the wrong categories. Instead, it seems there is a biological continuum among children. Some have no trouble achieving even "unnatural" levels of highly focused attention, others find it nearly impossible to focus attention at all, and most are somewhere in between.

That variation didn't matter much when we were hunters or farmers. But in our society, it matters terrifically. School is more essential for success, and a particular kind of highly focused attention is more essential for school.


Stimulant drugs don't "cure" a disease called ADHD, the way that antibiotics cure pneumonia. Instead, they seem to shift attentional abilities along that continuum. They make everybody focus better, though sometimes with serious costs. For children at the far end of the continuum, the drugs may help make the difference between success and failure, or even life and death.

But the drugs also lead to more focused attention, even in the elite college students who pop Adderall before an exam, risking substance abuse in the mad pursuit of even better grades.

For some children the benefits of the drugs may outweigh the drawbacks, but for many more the drugs don't help and may harm. ADHD is both biological and social, and altering medical and educational institutions could help children thrive. Behavioral therapies can be very effective, but our medical culture makes it much easier to prescribe a pill.


Instead of drugging children's brains to get them to fit our schools, we could change our schools to accommodate a wider range of children's brains.
From Infographic Journal

By Irma Wallace
February 21, 2014

There is no one resource more important than our children. Special Education Degree has created an infographic entitled “Budget Cut Blues: How Special Education Students Are Among the Biggest Victims of Federal Spending Drops,” detailing how we are leaving our children with special needs behind due to the latest round of budget cuts.

Tuesday, February 25, 2014

Drs. Ann Helmus and Angela Currie Speak Thursday, 2/27 in Andover: Tips For Helping Your Child Achieve Academic Success at Home

At The Pike School
Sponsored by the Andover Parent-to-Parent Program

February 24, 2014

Does your house feel like a volcano that is about to erupt during the after-school hours? Does your child struggle with time management and organization?

Dr. Ann Helmus, a licensed clinical neuropsychologist who has practiced for more than 16 years, and her colleague, Pediatric Neuropsychologist Dr. Angela Currie, will be coming to Andover once again to share practical strategies to help parents support their children at home.

Ann Helmus, Ph.D.
The emotional side of home work will be discussed along with suggestions to avoid melt downs that leave everyone frustrated and exhausted. In addition, developmentally-appropriate tips to help your child become more independent with time management and organizational skills will be shared.

When:    7:30 - 9:00pm Thursday,
                    February 27, 2014

Where:  Pike School
                    34 Sunset Rock Road,
                    Andover, MA 01810

This program is free and open to the public.

Autism and the Average

From Cracking the Enigma

By Jon Brock
February 14, 2014

Around this time every year, my almost-namesake, John Brockman, publishes on his website, Edge, a selection of answers to an Annual Question. What have you changed your mind about? What is your favourite deep or beautiful explanation? What should we be worried about?

This year's question was particularly intriguing. What scientific idea is ready for retirement? Diverse answers include: big data, universal grammar, entropy, string theory, radical behaviourism, common sense, carbon footprints, neuroplasticity, the continuity of time, the idea that science is self-correcting.

My favourite response, however, came from Nicholas Christakis, a physician and social scientist at Yale University. His answer: the Average.

"Ever since the landmark invention of diverse statistical techniques 100 years ago that allow us to properly compare the difference between the averages of two groups, we have deluded ourselves into thinking that it is such differences that are the salient—and often the only—important difference between groups. We have spent a century observing and interpreting such differences. We've become almost obsessed, and we should stop."

As an autism researcher, this is an issue particularly close to my heart. Despite the incessant talk about the "heterogeneity problem" in autism research, most autism studies begin and end with the question of whether or not on average people with autism are different on some measure to people who don't have a diagnosis.

This carries with it the assumption that it is the average (and not the variation around the average) that matters; that it captures some essential property of autism. It also invariably leads to contradictory findings, where one study finds some interesting difference on average between autistic and non-autistic people - and another finds no difference or even the opposite effect.


My latest article for the Simons Foundation Autism Research Initiative elaborates on this point. It was inspired initially by a wonderful essay by Stephen Jay Gould, discussing life-expectancy statistics in the context of his own background in evolutionary biology. As Gould wrote:

"All evolutionary biologists know that variation itself is nature’s only irreducible essence. Variation is the hard reality, not a set of imperfect measures for a central tendency. Means and medians are the abstractions."

This, I argue, is an important lesson for autism research.

"We have to take heterogeneity seriously as the object of investigation, rather than an excuse for inconsistent results or an inconvenience in our quest to understand the essence of autism."

The search for autism's core essence is something that has driven research ever since Kanner first described autism in 1943. However, seventy years later, we're still not much closer to an answer - as evidenced by the controversies surrounding the latest attempt to redefine autism in DSM-5.

There's no denying that "autism" is a useful meme in terms of raising awareness and in communicating in very broad terms the kinds of difficulties a person may face. "Autism" also serves an important purpose in bringing together likeminded people for support, advocacy, and research.

"...given the incredible diversity within autism, it's not clear that autism is an actual thing to be explained either."

Clearly, the symptoms that affect people diagnosed with autism are real and for many present huge challenges. However, autism is not an explanation for those challenges - it is those challenges. And given the incredible diversity within autism, it's not clear that autism is an actual thing to be explained either.

So, inspired by John Brockman, my question to you is this: Are we now at the point where, as a scientific concept, "autism" is ready for retirement?

About Jon Brock

Jon Brock is a research fellow at the ARC Centre for Cognition and its Disorders at Macquarie University in Sydney, Australia. His research focuses on cognitive and neural mechanisms involved in developmental disorders including Autism, Williams Syndrome and Down Syndrome. Publications can be downloaded here.

As well as on his own blog, Brock has also written for the Simons Foundation Autism Research Initiative, the Thinking Person's Guide to Autism and The Conversation. Translations of some of his posts can be found on the Spanish-language website Autismo Diario.

Jessica Minahan Speaking in Littleton 2/26: Cracking the Behavior Code: Understanding and Teaching Students with Anxiety

From the Littleton SEPAC


February 24, 2014

The National Institutes of Health (NIH) reports that one in four thirteen- to eighteen- year-olds has had an anxiety disorder in their lifetime. Without intervention, these children are at risk for poor performance, diminished learning, and social/behavior problems in school. Understanding the role anxiety plays in a student’s behavior is crucial, and preventive strategies are key to successful intervention.

Effective behavior plans for these students must avoid the reward- and punishment-based consequences from traditional behavior plans, and focus instead on the use of preventive strategies and on explicitly teaching coping skills, self-monitoring and alternative responses.

Easy to implement preventive tools, strategies and interventions for reducing anxiety, increasing self-regulation, executive functioning and self-monitoring will be discussed.

When:   7:00 - 9:00pm Wednesday, February 26, 2014

Where:  Littleton High School
                    Kiva Room
                    56 King Street, Littleton, MA 01460

This event is free and open to the public.

Presenter

Jessica Minahan, M.Ed., BCBA is a board-certified behavior analyst, special educator and Director of Behavioral Services atNESCA (Neuropsychology & Education Services for Children & Adolescents), as well as a school consultant to clients nationwide (www.jessicaminahan.com).

Minahan has over thirteen years of experience supporting students who exhibit challenging behavior in both urban and suburban public school systems.

She is also the co-author ofThe Behavior Code: A Practical Guide to Understanding and Teaching the Most Challenging Students, with Dr. Nancy Rappaport (Harvard Education Press, 2012).

Monday, February 24, 2014

How IDEA Fails Families Without Means: Causes and Corrections from the Frontlines of Special Education

From the Journal of Gender, Social Policy & the Law
The American University School of Law

By Elisa Hyman, Dean Hill Rivkin and Stephen A. Rosenbaum
Volume 20, Issue 1, Article 3, 2011

Introduction

As a quintessential civil rights issue, the struggle for equal educational opportunity for students with disabilities whose families have few resources is waged daily from the parapets of the Individuals with Disabilities Education Act (IDEA), a complex entitlement statute.

Dissimilar to the progress made under the IDEA for their wealthier peers, low-income children are not reaping the educational benefits that effective advocacy has achieved for students with disabilities who can afford determined advocates, skilled counsel, and knowledgeable experts to navigate the highly technical mandates of the statute and corresponding regulations.

Among others, these benefits include identification and certification under the IDEA and Section 504 of the Rehabilitation Act, development of an enforceable Individualized Education Program (IEP) with a continuum of services calibrated to the precise needs of each eligible child; rich compensatory services for the failure of school systems to comply with the requirements of a Free Appropriate Public Education (FAPE); the provision of a focused private education, in a residential setting if appropriate; protections from school discipline, including continuing educational services following more than ten days of out-of-school suspension, and the formulation of a staged transition plan to ensure meaningful opportunities upon a student’s departure from the school system.

The data is mounting to support the thesis that students from families without resources are systematically deprived of educational outcomes that would allow them to pursue gainful employment or further educational opportunities. The links between poverty, race, and disability are “well-documented.”

Low-income students with disabilities are more frequently pushed out of public education through punitive discipline, sheer neglect, or other more subtle strategies. Low-income students of color with unidentified educational disabilities are disproportionately referred for prosecution in juvenile court.

If scrupulously observed by school systems, and rigorously enforced, the IDEA has the power to stem this phenomenon...

Read the rest of this article HERE, or download a PDF (52 pages).

Early Childhood Education Can Pay Big Rewards to Families, Society

From ScienceDaily

February 14, 2014

High quality early childhood education for disadvantaged children can simultaneously reduce inequality and boost productivity in America, contends James Heckman, a professor of economics at the University of Chicago and one of the nation's leading experts on early childhood education.

"With the global rise in income inequality, children born into disadvantaged environments are at much greater risk of being unskilled and facing many obstacles in life -- which is bad for individuals and bad for societies," said Heckman, who delivered a talk "Giving Kids a Fair Chance Early in Life: A Strategy that Works" on February 14 at the American Association for the Advancement of Science annual meeting.

He pointed out that economic and socially related gaps in cognitive and non-cognitive skills emerge early, and can be traced in part to adverse early environments.

"With smart policies we can arrest the polarization between skilled and unskilled, focusing on early years when change is possible," he said. Strong early childhood education programs can help overcome the gaps and help children become better prepared for success in life, he said.

Heckman spoke at a seminar titled "Talking to Kids Really Matters: Early Language Experience Shapes Later Life Chances." At the session, scholars discussed the importance of verbal engagement by caretakers in the development of children's language and cognitive abilities.

"Researchers have found that the timing, quality and quantity of talking with children are crucial to the development of language and cognitive abilities."

Researchers have found that the timing, quality and quantity of talking with children are crucial to the development of language and cognitive abilities. In one study, some mothers spoke many thousands of words a day to children, while another spoke only 600 words to her infant over a 10-hour day, organizers of the seminar pointed out.

The gap reduces the children's vocabularies and undermines their performance in school, scholars contend. Early childhood education programs can make up for some of the differences.

Heckman has studied extensively early childhood programs, including the Perry Preschool Project and the Abecedarian Project, and found that they were especially effective in helping children from disadvantaged families succeed in school and later in life.

"...people who received services when they were younger scored higher on achievement tests, attained higher levels of education, required less special education, earned higher wages, had better physical health, were more likely to own a home, and were less likely to go on welfare or be incarcerated than other children from similar backgrounds."

When the oldest participants were studied (at age 40 for the Perry program and age 35 for Abecedarian), the people who received services when they were younger scored higher on achievement tests, attained higher levels of education, required less special education, earned higher wages, had better physical health, were more likely to own a home, and were less likely to go on welfare or be incarcerated than other children from similar backgrounds.

Non-cognitive skills, which can be fostered at an early age, are as important in the children's futures as are academic preparation, Heckman said. Those skills include perseverance, attentiveness, motivation, and self-confidence. Those skills help students perform better in school and later on jobs, he has found.

Sunday, February 23, 2014

Teen Suicides In Privileged Suburb: We Have To Keep Talking - Part II

From WBUR 90.9 FM's Blog "CommonHealth"

By Dr. Gonzalo Bacigalupe
February 21, 2014

"It is simply immoral to accept suicide as part of the cost of educating successful citizens."

In Newton, an affluent suburb of Boston, three high school students have died by suicide in the last four months.

From a community forum to formal school letters, parents have heard mainly about the links between suicide and mental illness. But Dr. Gonzalo Bacigalupe, a Newton dad and president of the American Family Therapy Academy, thought that no one was addressing head-on the elephant in the room. He went public this week in a post headlined, “Is High-Achiever School Culture Breaking Our Kids?” 


Dr. Gonzalo Bacigalupe
It quickly went viral. His concerns will sound familiar to parents from Palo Alto to Westchester, who see their sleep-deprived children struggling to meet the sky-high expectations of their top-scoring high schools and their hoped-for colleges. And his post evoked an outpouring of comments from Newton and beyond. They ranged from concrete examples of how teachers exacerbate the pressure on kids to arguments that it’s really the students themselves — and their parents — who should be blamed for the stress.

Here, Dr. Bacigalupe, a professor in the Department of Counseling and School Psychology at the University of Massachusetts Boston, argues that this painful discussion, though fraught, is healthy. He calls on schools to let parents help more in the difficult task of supporting students through this most vulnerable period. And he calls for an overarching community plan to make teens’ quality of life as high as their test scores.


......................................................................

A week ago, when I began writing my column calling for a different conversation about this year’s tragic series of suicides in Newton, I could not have imagined that I would spend the following week responding to the comments it evoked. It is a privilege to participate in this conversation and a tremendous responsibility to have initiated such a powerful public dialogue through this blog, social media, mainstream media and confidential email exchanges with parents, adolescents and colleagues.

Most of the exchanges have been civil and passionate, and they reflect a real need for a dialogue among parents, our children, the school staff, public officials and the community at large. This is a difficult conversation; everyone who has engaged in it wishes it weren’t something we needed to talk about. The suicide of a child is a devastating blow to all our lives.

I am deeply grateful to all of you who responded, even those who seemed to misunderstand my position; I appreciate your telling everyone where you stand, of sharing your stories. This is the exercise of community democracy and connection that this tragedy calls for. The dilemmas we confront are not unique to Newton.


Many communities have confronted similar tragedies and are trapped in the worshiping of high achievement at all cost.

Nearly 400 parents attended a community forum
on teen suicide at Newton South High School.
(Martha Bebinger/WBUR)

Having lived in Newton for almost two decades, I have a deep love for this community — a safe, beautiful, very privileged city, packed with intelligent, highly accomplished individuals from all walks of life. It is the city I call my own after having immigrated to this country 26 years ago.

My own two children, one a graduate and the other a current student, have used the academic opportunities that these institutions offer but have also struggled with some of the tensions we have been addressing in this dialogue. Although some readers responded angrily that I was blaming teachers and the school staff, my intention was to invite everyone to assess our own responsibility in making the learning experiences of our children less stressful.

This is not about choosing between lowering stress and encouraging high achievement. This is a false choice; it is simply immoral to accept suicide as part of the cost of educating successful citizens. In a television interview this week, I suggested that if we have been able to develop a culture of high expectations and achievement, we should also be able to foster an environment in which every teen thrives.

We have the resources to prevent the occurrence of these tragedies. Preparing our children to live in a demanding and changing work landscape does not mean that we have to push them over the edge to test their survival skills when they are at the most developmentally vulnerable stage in their lives. Their brains are still growing. Teens rely heavily on the parts of the brain that house the emotional centers when making decisions; the more rational, frontal regions of their brains are not fully developed. Their decision-making may often be impaired by the emotional, social and cognitive demands of adolescence.

Each teen is obviously different and evolving; we must treat them accordingly and, as parents and others who love these children, we are probably the experts at that assessment. Why do the schools not invite more conversation with parents about their children’s needs?

Beyond that, why do schools not encourage parents to participate more actively in their children’s educational experiences? How many teachers know what their students’ parents do, their skills and their achievements? In our town there are accomplished scientists, professionals, artists, trade workers, business owners, politicians and more. Why not invite them to inspire students by talking about how they use mathematics in their careers, or engage them in conversations between local experts (who happen to be parents!) on health care reform or economic inequality or the effects of sleep deprivation on academic achievement?


It is not the content of those discussions that matters the most; what’s important is making parents part of the overall learning of all of our children. It is about opening up what seems a fortress rather than a milieu for community interaction.

Many parents, and some professionals, wrote to me personally about children who were pulled out of the school and placed in a private school because parents felt dismissed in their concerns about their children’s stress. Or, of children who despite their amazing success after graduating from high school always perceived themselves as somehow lacking, in deficit.

The perception that being a parent who cares or advocates will lead to being labeled a “helicopter parent” by staffers can create serious barriers to collaborative engagement.

Parents are trapped in a no-win paradox. If we engage, we are perceived as too intrusive. If we do not connect with teachers, we are seen as indifferent and disengaged. Many parents are afraid that conversations among school staff, despite their best intentions, are often demeaning to parents.

I do really believe teachers care about their students. I also teach, I know this is a tough job, and it is the source of a lot of pressure from administrators, students and parents. But this is the nature of the job, and it is why we invest tremendous resources — “public” means we pay real estate taxes to support our schools. We have the right to demand that those who work in our public school system be responsive to our concerns. We are not the enemy.

One of my biggest concerns in this tragedy has been the lack of a community response of our school system officials. Addressing the aftermath of a suicide through crisis response and grief counseling seems appropriate and necessary. In addition, there are programs to detect and assess which children may be at higher risk. But we are missing two important elements of a complete response — elements that address the fact that any suicide, or suicide attempt, stems from multiple causes.

• First, the vulnerability to attempting suicide may not only be related to serious mental health problems like depression, post-traumatic disorders or severe anxiety. It can also be related to lack of social capital, isolation and cultural factors including, for instance, the immigrant experience of many of our teens. For immigrant families, learning to navigate the various systems that support a child at school should not be taken for granted. Indeed, the “language” of school is quite complex and vast.

It takes time, for example, for even an educated parent to understand the difference between an AP, Honors or Curriculum One class, and all its variations. In my experience, even affluent communities make too many assumptions about the community in which we live. In Newton, 22 percent of public school students are English language learners — a 74 percent increase since 2005, with 70 different languages spoken by their families. A sizable group has an income much lower than the average high income, or one single parent or two working parents in highly stressful jobs. For many parents, even some affluent immigrants, the culture of the school can be a mystery. The school system needs to do a better job of reducing the mystery for all parents.

• Second, we need to have a public conversation and together develop a strategy that systemically addresses the cultural dilemma in which we are stuck. I am not sure what our community is planning; an initiative proposed by the Department of Health was considered by the City Council, but I don’t know what its status is since no public officer has contacted me. Therefore, I don’t have information about the city’s or the schools’ efforts to strengthen suicide prevention efforts. As a concerned parent who has been willing to share his opinion in public, I find this troublesome. If I don’t know, I doubt that any other parents do, either.

We can learn from communities that faced the same dilemmas. We need, as the Palo Alto City documents state, “public schools where all children thrive emotionally, socially, and academically.” A supportive school environment will not be born just from the efforts of school personnel; it requires the participation of the whole community. We need families involved, and also alumni, the elderly and all the social institutions that constitute the community as a whole. It has to be a process that is long term, a sustained effort.

We need to invest in organizers and experts at leading difficult conversations across a community. We need to enlist social scientists that can help us continuously understand what parents and students are concerned about. One survey will not do it, but several will help, and they should be made public for discussion and implementation.

Many cities and towns (including Needham, Mass., which went through a similar tragedy a few years ago) have developed community coalitions to address suicide proactively. Each of these cities confronted the dilemma as a community. Not only did they implement generally accepted best practices, but they also involved the whole community in designing a local innovation that addresses the specifics of that community.

If our ranking of educational achievement is one of the highest in the country, we should also create a community that ranks at the top in quality of life for our children and teenagers. We are not a war-torn or economically deprived community; we are one of the most privileged places on earth.


We can do better.