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Friday, October 31, 2014

Where Science, Policy and Treatment Meet: MAC's Friends of the Autism Center Present Dr. Isaac Kohane Thursday, November 13th in Boston

From Friends of the Autism Center
at Massachusetts Advocates for Children

October 30, 2014

Dr. Isaac Kohane, of Harvard Medical School and Boston’s Children’s Hospital, has been featured on Ted Talks and in Time Magazine.

In an intimate setting with Friends of the Autism Center, together with a noteworthy panel of practitioners, we will have the rare chance to ask Dr. Kohane questions about the practical applicability of his research – to medicine, policy and parenting.

Our panel of experts include: Dr. Margaret Bauman of ICCD, a leading clinician and researcher, Eileen Hagerty, Esq., a special education attorney and partner at Kotin, Crabtree, & Strong, and Susan Senator, renowned author and autism parent.

When:   5:30 - 7:00pm Thursday, November 13, 2014

Where: The Law Firm of DLA Piper,
                   33 Arch Street, 26th floor, Boston, MA 02110

Space is limited and pre-registration is required by Nov. 10th. RSVP to Tania Duarte at tduarte@massadvocates.org, or call 617-357-8431, ext. 229.


Published on Jul 17, 2013. From TEDMED 2013:
Biomedical informaticist, physician and i2b2 founder Dr. Isaac Kohane
wants to turn hospital data systems into "living laboratories"
to study the genetic basis of disease.

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This is an event of the Massachusetts Advocates for Children's "Friends of the Autism Center.” Annual membership is $250 per household. Prospective members are welcome to attend one trial event for free.

Membership dues support the Autism Center's comprehensive efforts to help children on the autism spectrum access services necessary to reach their full potential. The "Friends" connect at two events per year with other Autism advocates - advancing awareness, information, and policy.

ADHD: A Parent's Dilemma - Does Your Child Need Stimulants?

From Psychology Today

By Kevin T. Kalikow, M.D.
October 26, 2014

Recent articles about the alleged overuse of stimulant medicines, such as Ritalin and Adderall, neglect the core issue. As a child psychiatrist, I spend a good part of my day talking with parents who are considering a stimulant medicine for their child. I am by their side as they grapple with hopes and fears and shed light on their real struggles.


Medicines as a Tool 

Medicine, any medicine, is simply a tool to help us obtain what we value. We take statins to lower our cholesterol because we desire a long life. We take oxycodone after a dental procedure because we want to be pain-free. The most important question about the use of any medicine is, what does the user hope to achieve? What do they value?


So, why do parents seek a prescription for stimulant medicines used to treat Attention Deficit Hyperactivity Disorder (ADHD)? What do they hope to achieve?

Some parents want to prevent extreme hyperactivity/impulsivity (I’ve had one patient run into the street and end up in a near-full body cast and two patients who have literally burned the house down). Others want to improve extreme inattention. Because we value life, most of us wouldn’t argue with the use of a stimulant to potentially save a life…or a house.

And, because listening while another person speaks is a basic function, many would accept using medicine to help a child focus long enough to follow a one-step instruction or complete a simple task. So, why the fuss? Why has this issue become a lightning rod for people’s charged emotions?

Healthy Parental Concern

ADHD has become a lightning rod because it evokes parental worry beyond that of their child’s physical safety and basic functioning. Every parent wants their child invited to the dance--whether it’s the seventh grade dance or the adult dance of finding your successful niche in the economy.

With parental involvement and concern at an all-time high, ever-vigilant parents want to assure their child’s success. Parents rarely try to get their undeserving child into Harvard. Most parents know their child’s capabilities.

However, they desperately want them to reach their intellectual potential, to be socially accepted, to be happy with who they are, goals that frequently seem beyond the reach of the child with ADHD. And they want these goals achieved in a home relatively free of nightly screaming over schoolwork.

A mother who resists starting her bright, if disorganized and fairly inattentive, son on medicine sits in my office. What is your concern? I ask. She hesitates, then fighting back tears, responds, “I’m afraid he’ll get left behind, that he won’t realize his potential. He’s as smart as his friends, but he won’t be in the enrichment classes with them. He’ll feel like a failure and will never be seen as the smart kid he is.”

I hear this sentiment frequently.

"Dysfunction" - A Complicated Term

This concern is for neither physical safety nor basic functioning. It is the parental concern for psychological, social, and ultimately financial, well-being. In an age of increased control over bodily function, this use of stimulants has made them the poster child for the elective use of medicine to improve a child’s self-esteem and chances for success.

As such, looking at the use of stimulants brings us to a discussion of what truly constitutes dysfunction, and when does dysfunction become a disorder and when does this disorder merit treatment?

So, what constitutes dysfunction? Is it not living up to what most people are capable of doing or what I am capable of doing? If I earn a B in math, I sound functional. However, if I have an IQ of 130 and am particularly talented in math and hope for a career in engineering, my B sounds arguably dysfunctional.

Dysfunction is Difficult to Define

Childhood dysfunction also includes low self-esteem, a much-maligned form of function. Often heard as a feel-good term reflecting the over-concern of the over-indulgent modern parent, in fact, child mental health professionals often see the ravages of true low self-esteem, caused, in part, by chronic academic disappointment.

Many of these children grow up to be angry adolescents who see themselves as stupid and unsuccessful and who search for an alternate peer group in which they feel accepted. Every parent tries to avoid this dysfunctional outcome.

When does dysfunction become a disorder? For decades, ADHD has been seen as a categorical diagnosis (like pregnancy, you have it or you don’t).

However, a provocative study from the National Institute of Mental Health seemed to find biological evidence of something that many clinicians have known for some time, that ADHD is not a categorical diagnosis, but rather exists on a spectrum. Researchers followed four groups of children-those with ADHD, without ADHD but with many symptoms of ADHD, without ADHD but with only some symptoms of ADHD and, lastly, those without symptoms.

They found that the rate at which children prune their brain’s nerve cells (a normal process) is on a continuum from fastest for kids without ADHD to slowest for kids who meet full criteria for ADHD.

In other words, some symptomatic children, though short of a full-fledged diagnosis of ADHD, have slower brain maturation than their peers. This spectrum concept of diagnosis is perhaps more biologically valid than the categorical model, but puts us on an even steeper and more slippery slope of who merits treatment.

Function and Diagnosis

Without a clear diagnostic boundary, function tells the tale. So, when does dysfunction merit treatment? And, more importantly, who decides and on what basis?

Today, parents see school as a crucial arena for function.

Academic dysfunction, often as measured by grades, can reflect underlying neurological symptoms, such as disorganization and time management problems. Thus, in the competitive academic environment in which the child lives, school dysfunction becomes symptomatic of a medical disorder and, as such, raises the possibility of treatment.

Worried parents see grades below their child’s intellectual potential as reflecting underlying neurological weakness and leading to future vulnerability. And they want relief of the disorder or at least the symptom.

Although these parents are accused of gaming the system, seeking the edge, that is simply an easy to blame, largely fictitious stereotype, rarely seen in the real world.

The Office Visit

Here’s what often happens. A parent calls about their child who is educationally symptomatic: disorganized (yes, more than his peers), forgetful (yes, more than his peers), fooling around in class (yes, more than his peers) and whose grades indicate that he is not living up to his intellectual potential.

Every night the house is in turmoil over homework never written down, never completed or never handed in. This begins with the child lying about homework and concludes with the parent screaming about homework. I evaluate the child. The child falls short of the research criteria necessary for a diagnosis of ADHD. But, he’s somewhere on that spectrum of ADHD symptoms.

His concerned parents, searching for a reassuring “yes” or “no,” though unsure what they will do after their question is answered, inquire, “So, does he have it?”

I answer with a certainty that brings little relief. “Well, he’s on a spectrum.” The parents and I are then left with the philosophical conundrum: Where do you draw the line on a spectrum? Who do you treat?

Usually the parents have tried environmental solutions, such as increasing academic support, but they can’t change the school’s (or college admission committee’s) academic expectations. And so they struggle with the dilemma of medicine, weighing potential benefits and feared risks. Will medicine bring the hoped for relief? Sometimes.

The stimulants help a child focus, whether he has ADHD or not. Even those on the ADHD spectrum might have symptomatic relief.

Notwithstanding the alarmist concerns of many parents, the stimulants have few serious side effects when used responsibly. And the stimulants help many raise their grades in the short-run and arguably in the long-run. Given that grades are, in fact, the proxy most used by colleges for who you are and what you know, the reasoning of these parents is understandable.

Can parents be impatient, misinterpreting normal child development for ADHD? Sure. Does the life of a 21st century child offer sufficient distractions, social, electronic and otherwise, to distract the most focused of children? Absolutely. Do some parents lack the confidence that with maturity their child’s other assets will eventually win the day? Of course.

Hard Choices – Hard Parenting

The physician’s responsibility is to help parents understand these complicating factors. However, parents set their own values. These include a peaceful home, reasonable self esteem, and educational and ultimately financial success. All of these are sometimes more easily attained by stimulants.

We can and should examine our definition of and parameters for success. We should ask how our system of education makes certain children educationally symptomatic and some homes war zones. We should adapt our teaching to assure the success of all children. However, we should not blame the parents for trying to attain what they value, namely their child’s best interests in the world in which we have set before them.

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Kevin T. Kalikow, MD is a child psychiatrist and author of "Your Child in the Balance: Solving the Psychiatric Medicine Dilemma," and "Kids on Meds: Up-to-Date Information About the Most Commonly Prescribed Psychiatric Medications." For more from Dr. Kalikow, see: http://kevinkalikow.com/

Thursday, October 30, 2014

Jessica Minahan, M.Ed., BCBA Speaks on Anxiety and Behavior Monday, 11/3 at Milestones Day School

From Milestones Day School

October 30, 2014

Students with Autism are at greater risk than their typically developing peers for developing anxiety and anxiety disorders such as phobias, OCD, and social anxiety disorder. Without intervention, these children are at risk for poor performance, diminished learning and social/behavioral problems in school.

Understanding the role anxiety plays in a student's behavior is crucial, and using preventive strategies are key to successful intervention. Effective behavior plans for these students must focus on the use of preventive strategies and on explicitly teaching coping skills, self-monitoring and alternative responses.

As a result of this workshop participants will be able to easily implement preventive tools, strategies, and interventions for reducing anxiety, increasing self-regulation, executive functioning and self-monitoring at home and in school settings.

When:   10:30am - 12:30pm Monday, November 3, 2014

Where: Milestones Day School
                 410 Totten Pond Road, Floor 2
                 Waltham, MA 02451

Lunch will be served. To register, please respond to: rsvp@advancingmilestones.com.

Presenter

Jessica Minihan, M.Ed., BCBA is a special educator, behavior analyst, acclaimed author and director of behavioral services at NESCA, a neuropsychology group practice in Newton, MA. Jessica will be selling copies of her books:

The Behavior Code: A Practical Guide to Understanding and Teaching the Most Challenging Students

--and--

(New!) The Behavior Code Companion: Strategies, Tools, and Interventions for Supporting Students with Anxiety-Related or Oppositional Behaviors.

Guests will receive a 30-40% discount on both books at just $20 apiece per copy!

The New Way to Study with ADHD

From ADDitude Magazine

By Ann Dolin, M.Ed.
October 25, 2014

No more late-night cramming — research shows these study techniques help kids with attention deficit learn faster, retain more, and perform better on tests.

For students with ADHD, studying for a test can be daunting. Luckily, there’s new research that shows that students might not need to spend more time studying, but need to study differently. James and John, identical twins with ADHD, are taking the same biology class. They study for the same amount of time, yet James gets an A on the exam and John gets a C+. Why the difference?

Which Study Technique Works Best?

John studied diligently for three hours on Thursday night, the day before the test. He reread his notes and the textbook, and reviewed the study guide. He studied in his room. James studied for three hours, but did it over four evenings, Monday through Thursday. He used his notes, an old quiz, and the study guide to create a practice test. He studied in different locations, including Starbucks and the library.

Eighty-four percent of students study by rereading the textbook, as John did. The problem is that re-reading is the most ineffective way of studying for an exam.


Reading is a challenging way for the ADHD brain to learn information. Reading is passive. It’s like learning to play basketball by watching your coach play.

Research shows that the number-one way to study is to make a practice test. Try to predict what your teacher may ask on the exam. Look over your study guide, pull out old quizzes, find important parts of your notes, and ask others in your class what they think is important. Then, create a practice exam.

Cramming Doesn’t Work

What else did James do right? He used a concept educators call “distributed practice.” In other words, he didn’t cram. He studied for three hours over four days, 45 minutes per night. This works for two reasons. The first is that James reviewed the material several times, gaining familiarity with it. Second, and most important, he slept on it. Sleep helps you learn. Your brain is more active at night than during the day. During sleep, you replay the day’s events in your head and you rehash the information you learned. In James’s case, he rehashed the biology material through sleep four times.

John worked hard to study for his exam, and skipped soccer practice on Thursday evening to put in extra time. He stayed in his room without a break. But although John tried to make himself focus, the things in his room (laptop, phone, music) got him off task. John could not regulate his attention while cramming for the test.

James, on the other hand, knew that when boredom set in, he needed shorter work periods or a different place to study. He found, through trial and error, that he was more focused when he studied at locations other than his own house. In other words, James had the concept of metacognition — knowing when and how to use particular strategies for learning — down pat. He knew what helped him to focus and what hindered him. In the end, it wasn’t more time that John needed; he needed to use his time differently.

Here are some other research-based tips that can make a difference for your child with ADHD:

Review Before Bed

"You remember more when you take 10 to 15 minutes just before bed to review what you studied earlier in the day."


Studies show that you remember more when you take 10 to 15 minutes just before you go to sleep to review what you studied or learned earlier in the day. This doesn’t mean that students should do all their studying at bedtime, but reviewing what he has studied allows a a child to process the information as he sleeps.

Exercise Sharpens Focus

Thirty minutes of aerobic exercise a day, four to five days a week, improves focus and executive functioning skills, especially in students with ADHD. If you have a student athlete, encourage him or her to study on the bus or in the car as he travels home from an event. Consider studying right after practice, too. If your child doesn’t play a sport, encourage him to run with your dog or shoot some hoops just before he sits down to do schoolwork. Although any aerobic exercise will do the job, the most helpful exercises for students with ADHD are ballet, yoga, and tai chi, all of which require students to focus on their body and their mind.

Use Your Nose

Smell is a powerful study tool. Research shows that if you are exposed to the same smell when you study and sleep, you may remember more. When your child studies, put a small dish of essential oil nearby; peppermint is a good choice because it relieves stress. Place a small dish of the same scent by her bed while she sleeps. Studies suggest that her brain will associate the scent with the material she studied earlier. This, researchers say, may help her retain more of the information she is trying to remember.

Napping, Breaks and Memory

Most people need to sleep eight to nine hours a night to retain memories, but teenagers need more. Thirty-minute afternoon naps can help. Be sure these siestas aren’t longer than 30 minutes, since extended naps can interfere with sleep at night.

Taking a break helps all kids learn more, especially those with ADHD. Studies show that students remember more when they take breaks between study sessions instead of studying straight through for an extended period. Having downtime enables a student’s brain to review information and material, even when he doesn’t know he’s processing it.

Sip a Sugary Drink

A drink that contains some sugar helps homework performance. Sugary drinks provide glucose, which is the primary source of fuel to the brain. If you’re low on glucose, you won’t be able to focus or perform well.

Gatorade or apple juice delivers glucose, without overloading a child’s system with sugar. Sodas and other drinks with high levels of sugar (up to 10 teaspoons) provide too much glucose, which results in a sugar crash later, impairing memory and clouding thinking. So ask your child to sip (not gulp) a sugary drink. It can bring improved focus and mood.

In the end, encouraging students who struggle with attention to implement a few of these easy-to-use ideas can make a big difference in your child’s performance at school.

Ann Dolin, M.Ed. is president of Educational Connections Inc., and the author of Homework Made Simple. She is also a member of the CHADD professional advisory board.

Pipeline to Prison: Special Education Too Often Leads to Jail for Thousands of American Children

From The Hechinger Report
Independent Education News


By Jackie Mader and Sarah Butrymowicz
October 26, 2014

Grenada, Mississippi— Cody Beck was 12-years -old when he was handcuffed in front of several classmates and put in the back of a police car outside of Grenada Middle School. Cody had lost his temper in an argument with another student, and hit several teachers when they tried to intervene. He was taken to the local youth court, and then sent to a mental health facility two hours away from his home. Twelve days later, the sixth-grader was released from the facility and charged with three counts of assault.

Officials at his school determined the incident was a result of Cody’s disability. As a child, Cody was diagnosed with bipolar disorder. He had been given an Individual Education Program, or IEP, a legal document that details the resources, accommodations, and classes that a special education student should receive to help manage his or her disability.


But despite there being a medical reason for his behavior, Cody was not allowed to return to school. He was called to youth court three times in the four months after the incident happened, and was out of school for nearly half that time as he waited to start at a special private school.

Cody is
one of thousands of children caught up in the juvenile justice system each year. At least one in three of those arrested has a disability, ranging from emotional disability like bipolar disorder to learning disabilities like dyslexia, and some researchers estimate the figure may be as high as 70 percent.

Across the country, students with emotional disabilities are three times more likely to be arrested before leaving high school than the general population.

Cody Beck reads a book that was assigned by his teacher at
Grenada Middle School. Since April, Cody has been on a
“homebound” program due to behavior, where he does his work at
home and meets with a teacher for four hours each
week for instruction. (Photo by Jackie Mader)

When the special education system fails youth and they end up in jail, many stay there for years or decades. The vast majority of adults in American prisons have a disability, according to a 1997 Bureau of Justice Statistics survey. Data hasn’t been updated since, but experts attribute the high percentage of individuals with disabilities in the nation’s bloated prison population – which has grown 700 percent since 1970 – in part to deep problems in the education of children with special needs.

In Mississippi and across the country, the path to prison often starts very early for kids who struggle to manage behavioral or emotional disabilities in low-performing schools that lack mental health care, highly qualified special education teachers, and appropriately trained staff. Federal law requires schools to provide an education for kids with disabilities in an environment as close to a regular classroom as possible.


But often, special needs students receive an inferior education, fall behind, and end up with few options for college or career. For youth with disabilities who end up in jail, education can be minimal, and at times, non-existent, even though federal law requires that they receive an education until age 21.

“A lot of times, it’s a major setback,” said Elissa Johnson, a staff attorney for the Southern Poverty Law Center. She added that some transgressions are serious, and it’s behavior that needs to be addressed, “But when you’re dealing with students with disabilities, youth court referrals are harmful.”


Nationwide, at least 73 percent of youth with emotional disabilities who drop out of school are arrested within five years, according to a federal study.

Experts say that students with emotional disabilities can be impulsive, inattentive, or aggressive, behavior that gets them in trouble. “When we’re talking about emotional or behavioral disabilities, we’re really talking about kids with serious mental health needs,” said Reece Peterson, a professor of special education at the University of Nebraska-Lincoln.

Learning disabilities can also land special needs children in trouble more often than their peers. “Kids with learning disabilities that are not properly remediated in a school setting start to dislike school, or act up at school, or do things to distract from the fact that they’re not doing well,” said Diane Smith Howard, senior staff attorney for the National Disability Rights Network.

More than
14,600 youth were involved with Mississippi’s juvenile justice system in 2012, but it’s unknown how many were in special education since the state does not track that information. (According to a Mississippi Department of Education (DOE) official, both the DOE and the Public Safety Office believed the other department was responsible. The official said that the DOE will begin to collect that data this year.)

Although numbers fluctuate as students move in and out of the system, some
federal data show that kids with disabilities are overrepresented in the state’s detention facilities. In 2011, 13 percent of students in the state’s public school system qualified for special education. But at the Oakley Youth Development Center, about 27 percent of students had disabilities, according to a federal Office of Civil Rights survey. Officials at the Rankin County Detention Center say that 50 percent of the children they’ve had this year qualify for special education.

Many of these kids enter the justice system shortchanged by schools and far behind their non-disabled peers. In the 2012-13 school year, only 13 percent of eighth-grade students with disabilities scored proficient or above on the state’s language arts exam, compared to 58 percent of non-disabled students. According to a previous Clarion-Ledger review of data, during the 2011-2012 school year, less than a quarter of special education students in Mississippi received a regular diploma, far lower than the national average of 64 percent in 2011.

“Young people who generally end up in trouble were not prepared from the beginning educationally,” said Oleta Garrett Fitzgerald, director of the Children’s Defense Fund’s Southern Regional Office. A 2013 report by the Minneapolis-based PACER Center, a parent training center, warned that one of the biggest reasons students end up in the corrections system is “school failure.”

Many kids across Mississippi also lack access to pre-kindergarten, meaning they may start behind academically, socially, and emotionally, and can miss a critical time period to identify disabilities and begin treatment. Only about
17 percent of children under 5 in Mississippi receive a screening for developmental or behavioral problems, compared to the national average of about 31 percent.

“Early education and nurturing is absolutely critical,” said Fitzgerald. “Children whose needs are met at an early age are able to go to school ready to learn…They’re much less likely to be discipline problems in the classroom.”

First Step — Suspension

To an outsider, Cody seems like any other 14-year-old boy. He’s soft-spoken around strangers and spends his free time playing with his baby sister, hunting with his dad, and building things outside in the family’s wood shop in their modest rural home near Grenada Lake. He aspires to be an underwater welder, like his father.


But from a young age, Cody has struggled to manage his anger. He has outbursts when he argues with others, especially with other children. If he is touched while angry, he tries to get away, even if that means hitting someone else. His parents say he especially tends to clash with “bullies,” which can spiral into heated fights.

In his 2013-14 IEP, it was recommended that Cody receive individual instruction, be placed in a small class with other students with emotional disabilities, and daily therapy sessions. His teachers set short-term goals for Cody, such as “develop the ability to identify impulsive thoughts and consequences” and “develop the ability to identify and express feelings of anger and distress in socially acceptable ways.” In his IEP, his teachers also detailed his academic abilities: he was reading nearly at grade level, but his math and writing skills were several grades behind. They wrote that Cody “tries to do his best work and desires to learn.”


Alfonso Franklin, a project manager for the Mississippi Center
For Justice, talks to a young man in his Youth in Transition
program. Franklin’s program aims to keep youth out of jail by
keeping them in school and providing jobs and mentors.

Robert Beck, Cody’s father, said he also explained to Cody’s teachers what he found to work best in calming Cody down, like speaking in a calm voice and refraining from making physical contact.

Still, from a young age, Cody was suspended for behavioral incidents and missed more than a dozen days of school in the months leading up to his arrest. When asked about the fighting, Cody said he loses his temper when other kids tease him, or when he hears “people talking about my parents, telling me I’m stupid.”

For many students with disabilities, suspensions are often the entry point in the pipeline to the criminal justice system. Statewide, more than 8,000 students with disabilities received an out of school suspension, and nearly half of those received more than one in the 2011-12 school year, according to estimates by the
federal Office of Civil Rights.

“Many of those kids get in further trouble out of school,” said Reece Peterson, “and they end up in the juvenile justice system.”


Several special education students who have been arrested said in interviews that their trouble with the law was preceded by frequent suspensions for fighting or “talking back.”

One 16-year-old special education student at Oakley Youth Development Center, a long-term center for incarcerated youth, said in the past, “loud noises and childish people” would set him off. A 15-year-old student at Oakley who qualifies for special education said that she was incarcerated after assaulting a police officer. She had already been suspended from school numerous times for things like “playing in the hall” during class or talking back to teachers.

.........................................................................................................
What would have happened to Cody Beck in a different state?

Like Cody Beck, thousands of special education students in Mississippi lose valuable time in school through suspensions, expulsions and arrests each year. According to federal data, more than 8,000 special education students in Mississippi received an out-of-school suspension in the 2011-2012 school year– about 14 percent of all special education students in the state. Experts say a suspension can lead to bigger trouble for students later on, including time in jail. By comparison, just 5 percent of Utah’s students with special needs were given an out-of-school suspension, one of the lowest rates in the country.

Keeping all students in school is a priority, said Utah Department of Education director of special education Glenna Gallo. Although she couldn’t speak directly to a student in Cody’s situation, she said that Utah educators are taught to prevent disruptive behavior from leading to arrest. “We have quite of a few of our staff trained in crisis de-escalation,” she said, adding that teachers and administrators are given strategies for calming down students with behavioral disabilities without touching them.

The Utah Department of Education has provided administrators with workshops in crisis intervention strategies, which includes referring special education students to mental health services instead of suspending them. Sending a student to a private treatment program, as in Cody’s case in Mississippi, would only be a last resort. “Utah generally keeps their students within the school community,” Gallo said.


Sarah Butrymowicz

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

School discipline policies often do not take into account students with disabilities. They may, for example, include zero tolerance policies not only for serious behavior, but also for
disrespect or noncompliance. Experts say this can lead schools to disproportionately suspend special education students, whose actions may be manifestations of their disability.

A
2013 report by several nonprofits found that some Mississippi school discipline policies include vague or subjective language, like expulsion for “any action which is deemed disorderly conduct or misconduct.”

In Caledonia, Mississippi, several parents interviewed said that deputies who work in the nearby Lowndes County School District respond in extreme ways, such as pulling out a Taser gun when kids, including those with behavioral or emotional disabilities, act out in school. (Officials from the district said that no Taser guns have been used on children at school, but police officers on the campuses do carry them. The district’s security guards do not.)

Not Enough Teachers, Not Enough Counseling

One of the main reasons special needs children are jailed more often than their peers is because teachers aren’t trained in how to manage kids who are insubordinate or disruptive, according to the
2013 report by the PACER Center. For years, Mississippi has experienced a shortage of highly qualified special education teachers, especially in the lowest-performing schools. (Nearly one-third of Mississippi’s districts are considered “critical needs” districts by the state.)

Reece Peterson says discipline needs to move to a more “teaching-based” approach so that students explicitly learn correct behavior. “If [a student] has a disability that has characteristics of being aggressive and acting out, we can’t simply punish him for that,” Peterson said. “We would want to provide some sort of service or intervention for it.”

But these resources are lacking in Mississippi. During the 2011-12 school year, only about half the children ages 2 to 17 who have problems that require counseling received mental health care, compared to more than 60 percent nationwide. Paul Bowen, administrator of the Rankin County Youth Court, said he sees many youth who have untreated mental health problems. The detention facility provides counseling while the youth are incarcerated, but few continue once they get home. “Many of these children would respond positively,” Bowen said. “But they’re dependent on adults to get them there and many families can’t afford those services.”


There have been some efforts to find solutions. In 2013, administrators at the Rankin County Detention Center rolled out a new behavior management program called Positive Behavioral Interventions and Supports, or PBIS, which aims to teach and reward positive behaviors, rather than focusing on punishment and negative behaviors.

Paul Bowen said that since the program launched, the detention center has seen a 65 percent decrease in incidents related to behavior. Some states, like Minnesota, have rolled out this program in all schools.

In the absence of school-based efforts and resources, a handful of nonprofits have launched programs to keep the most at-risk students out of the justice system. In the Delta town of Ruleville, Alfonso Franklin, a project manager at the Mississippi Center for Justice, runs a program aimed at helping boys transition out of the system, or keeping them out from the start. He frequently tracks down students who are absent from school, checks in with their teachers, and organizes speakers to talk about the impact of getting arrested.


“I’m trying to be proactive,” Franklin said, adding that there are few recreational activities or resources in rural Mississippi. “Everything we talk to them about is about not becoming a victim to the system.”

Efforts like these are critical, experts say, since preventing an arrest in the first place is much easier than helping kids stay out of jail once they’ve spent time there. Dennis Daniels, superintendent of the Oakley Youth Development Center, said that Oakley sees so many students with disabilities because communities and schools tend to “deal with the behavior before they deal with the disorder.”

“There’s nobody dealing with their disabilities,” Daniels said. “If you don’t get them help in the community, they get locked up.”

No Way Back

After an arrest, families say they often encounter districts that are reluctant to let those children return to school, or schools that are ill-equipped to handle them. “The school district might say ‘I’m uncomfortable with you returning to school, we’re going to put you in an alternative program,” said Smith Howard.


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

After an arrest, many students lose valuable learning time and fall even further behind, while others become a frequent fixture in youth courts and a patchwork system of detention centers, youth jails, and alternative schools for education.

A 2006 study found that for all students, a first-time arrest during high school nearly doubles the odds of that student dropping out, while a court appearance nearly quadruples the odds of dropout.

After his arrest, Cody’s team of special education teachers and school officials decided to send him to the Millcreek Day Treatment center, a privately run facility in the northwest Mississippi town of Batesville, which is accredited by the state of Mississippi as a “special non-public school.” There, Cody’s parents say he was mixed with “a lot of problem kids and the school work wasn’t challenging.”


Cody said he was frequently given worksheets and word searches. One of his assignments as a seventh-grade student was to read and complete a 68-page packet called “How I Learned to Control My Temper,” which is written at a low-elementary level and tells the story of a boy who learns different ways to handle his temper. It includes several pages of activities, like drawing pictures, and playing tic-tac-toe.

Megan Williams, a therapist at Millcreek that the school provided for comment, said that although she can’t speak about any former or current students, she guesses the packet was “not from the teacher, but from the therapist.” (At Millcreek, Cody had daily access to a special education teacher and a therapist.) Regarding the classwork, Williams said that “each classroom is different,” and she was not able to speak about the academic program at the facility.

In dozens of daily reports sent home by Millcreek, Cody’s behavior seemed to improve, although there were still a few behavioral incidents that resulted in time out of school. For several stretches of time, he received perfect or near perfect scores for “respecting others,” “following directions,” and his individual goal to “stay positive.” On several reports, teachers commented that Cody “did all class work” and “ignored negativity.”

After an incident last October, however, Millcreek referred Cody to a behavioral treatment center in Tennessee. When he was released, his father and stepmother asked the school district to move Cody to back to the public school, where they wanted him to receive more challenging work. Instead, school officials offered to put him on a “homebound program” where he would complete work sent home every day, and spend two hours twice a week working with a teacher at a regular school. In the future, they said, he could possibly transition back to the regular school.


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“When we’re talking about emotional or behavioral disabilities, we’re really talking about kids with serious mental health needs,” Reece Peterson, a professor of special education at the University of Nebraska-Lincoln

Officials at Grenada Middle School said they couldn’t discuss individual students. Bea Colbert, director of special education for the Grenada School District, said that the decision to put a child on a homebound program “depends on the individual circumstances.” The amount of time a child spends homebound also varies by child, Colbert said, but could be based on how well the child has been working with the academic teacher, “how much time [in school] they’re able to tolerate,” or how well the child is doing in counseling sessions.


“Our ultimate goal for every child is to be in their least restrictive environment and to earn a traditional diploma,” Colbert said. “But for some children, that may not be a realistic goal.”

Cody’s parents said they were torn, since they knew he may not be ready to handle a large class, but they didn’t want him to be isolated. In April this year, they agreed to keep him at home, but they said his education now consists of him spending most of his days alone, teaching himself the material that is sent home from school.


When teachers at Grenada Middle School wanted to move him on to eighth grade this year, his parents argued that he has missed too much school, and has not learned enough, to move on. This year, Cody is repeating seventh grade.

“What they’re doing now is not providing him with an education,” said Bobbi Jo Beck, Cody’s stepmother. She said she fears that if he doesn’t learn how to interact with others and control his temper, future incidents could lead to more arrests and jail time, which is something she sees frequently at her job as a nurse at a county jail. “It scares me,” Bobbi Jo said. “I don’t want that to happen to him.”


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This story was produced in partnership with the Juvenile Justice Information Exchange, the only national news outlet reporting the juvenile justice issue daily. Read more about efforts to improve education in Mississippi.

Wednesday, October 29, 2014

Role of School Staff in the Recovery of Students with Concussions

From Charles P. Fox, Esq.'s
Special Education Law Blog

By Charles P. Fox, Esq.
October 22, 2014

We are hearing a lot about concussions in the news these days. To the recent disbelief of sports commentators and fans, a University of Michigan football coach left a 20-year-old quarterback in a game after a blow to the head despite his stumbling in the field immediately after impact.

Meanwhile, NFL players have regularly been making the news for, to put it delicately, behaving badly. There is speculation that some of the domestic violence in which these players have engaged may be the result of head trauma, a hypothesis deemed plausible by a Univ. of Pennsylvania professor known as a “neuro-criminologist.”

The fact remains, however, that concussions are traumatic brain injuries. Although most patients with concussions are expected to recover fully, young children and teens, because of their developing brains, along with the elderly, are most vulnerable to the effects of concussion. Thus, these children will need careful monitoring as they return to school and other activities.

According to the Centers for Disease Control (CDC), an estimated 248,418 children were treated in emergency rooms in 2009 for sports and recreational-related injuries that included a concussion. A concussion is defined as a bump, blow, or jolt to the head. Concussions are considered a “mild” traumatic brain injury because they are usually not life-threatening. Yet the effects of concussion can be serious and long-lasting with symptoms lasting for days, weeks, or longer.

A study published recently in Radiology showed that even one concussion can structurally change the brain, leading to increased risks of cognitive problems and depression. The most commonly affected areas of the brain include those sites responsible for executive function-- memory, attention, judgment, and higher-order thinking--as well as sites related to depression, anxiety, and post-traumatic stress disorder.

The four categories into which symptoms fall--cognitive; physical; emotional/mood; or sleep related—obviously can affect a student’s ability to learn.


As delineated in a brochure from the CDC on “Returning to School After a Concussion: A Fact Sheet for School Professionals, the effects on learning are vast: increased problems paying attention, memory issues or difficulty learning new material; longer time needed to complete work; difficulty organizing and shifting between tasks; inappropriate or impulsive behavior, difficulty dealing with stress; emotional lability; fatigue; sensitivity to noise and light; and such physical symptoms as headache, nausea, or dizziness.

Yet according to the CDC, these symptoms can be difficult to sort out and may be missed, particularly when the student appears “well.”

Unfortunately, parents may not recognize when their children are having difficulty. A recent symposium on pediatric sports medicine at the American Academy of Pediatrics (AAP) National Conference cites the “misconceptions” parents had regarding concussions.


According to this report, about half of parents whose children were being treated for concussion knew that concussions could cause headaches and difficulties in concentration for their children. Another 92% knew that children needed to stop playing a sport and be evaluated by a physician when a concussion was suspected. However, only 26% of parents were familiar with guidelines for the resumption of sports and school work.

This lack of information can affect the treatment or recovery of a patient. Using a brain that is “concussed” can worsen symptoms or prolong recovery. Cognitive activities can further stress the brain, which is why a balance between cognitive exertion and rest is sought during recovery. An article entitled Returning to Learning Following a Concussion in Pediatrics discusses the need for academic “adjustments” during recovery.


Typically, students will need shortened days, class notes, supplemental tutoring, or reduction of assignments or expectations. Additionally, teachers should consider administering weekly symptom check lists to identify areas that may need more targeted intervention. Students, depending upon their age, can self-rate such symptoms as headaches, pain, dizziness, difficulty concentrating, decreased attention, or memory issues.

Students whose recovery is prolonged past three weeks may well need to be considered for 504 Plans or formal IEPs. Thus, the role of school staff is paramount during recovery from concussion.

Chances are that the most children with concussions had never previously been identified as students with disabilities who required either special education or accommodations. I believe that all children who have had a concussion should go through a screening and be considered as a possible candidate for a case study at an appropriate time post injury. Hopefully these children will be able to recover fully and return to school and other activities without special education or a 504.


But for those students for whom this is not the case, their parents are very likely unfamiliar with the world of special education IEPs or 504 Plans. Thus, the educators, along with parents and the doctors, will need to watch the progress of these students carefully and if warranted, begin more formal evaluations to ensure the delivery of appropriate services.

The previously mentioned CDC Fact Sheet on "Returning to School after a Concussion" may prove invaluable to school staff. School staff have a vital and proactive role in this process.

Tuesday Evening, November 18th at NESCA: Free Presentation on the Benefits of Therapeutic Yoga

From NESCA

October 28, 2014

Hannah Gould, M.Ed., RYT
You are invited to a presentation, from 7:00 - 9:00pm on Tuesday, November 18th, on NESCA's therapeutic yoga program, by Instructors Hannah Gould, M.Ed., RYT and Ann-Noelle McCowan, M.A., RYT.

Therapeutic yoga uses movement, breathing, mindfulness exercises and meditation techniques to bring children to an awareness of what is happening in their bodies and minds, and provide specific tools they can use to regulate themselves.

Games, music and other fun yoga-based activities are incorporated to engage children and teach targeted skills.

Many children respond better to the body-based approach used in therapeutic yoga than to traditional talking-based therapies. This approach can be especially powerful for kinesthetic learners and those with language processing difficulties.


Introducing "Yoga Connects"

Yoga Connects is a unique parent-child yoga program designed to meet the needs of young people with autism and other special challenges. Parents participate side-by side with their children, sharing the experience of yoga together. Yoga Connects utilizes a visual yoga curriculum and specialized teaching approach developed by Hannah Gould.

Yoga Connects is a six-week program that empowers parents to facilitate effective sessions at home. With Yoga Connects, yoga becomes a meaningful shared activity and provides a daily respite from stress for both parent and child.

No yoga experience is required - the curriculum includes all of the yoga sequences and visual supports parents will need, and the trusting relationship between parent and child provides the safe ground for yoga to be a successful experience.

When:   7:00 - 9:00pm Tuesday, November 18, 2014  

Where: NESCA, Lower Lobby Meeting Room
                  55 Chapel Street, Newton, MA 02458

There is ample, free, off-street parking in the lot directly opposite the main entrance to the building.

This program is free and open to the public, but advance registration is requested; RSVP by calling 617-658-9800, or by email to arenzi@nesca-newton.com.

Tuesday, October 28, 2014

Signs of Autism by 18 Months (Evident) in Younger Siblings

From Yale University
via Futurity

By Karen Peart
October 20, 2014

About 20 percent of children who have older siblings with autism also develop the disorder. Of those children, 57 percent show symptoms as early as 18 months.


The findings stress the need for early and repeated screening in the first three years of life so that, if necessary, intervention can begin as soon as possible.

A large-scale study has identified specific social-communicative behaviors that distinguish infants with autism spectrum disorder (ASD) from their typically and atypically developing high-risk peers as early as 18 months of age.

“While the majority of siblings of children with ASD will not develop the condition themselves, for those who do, one of the key priorities is finding more effective ways of identifying and treating them as early as possible,” says Katarzyna Chawarska, associate professor in the Child Study Center and the Department of Pediatrics at Yale University School of Medicine.

“Our study reinforces the need for repeated diagnostic screening in the first three years of life to identify individual cases of ASD as soon as behavioral symptoms are apparent.”


Patterns of Behavior

For the study, published in the
Journal of the American Academy of Child & Adolescent Psychiatry, researchers pooled data from eight sites participating in the Autism Speaks Baby Siblings Research Consortium. The team closely examined social, communicative, and repetitive behaviors in 719 infants when they were 18 months old.

The team looked for patterns that might predict a later diagnosis of ASD. They then followed up when the participants were age 3.

“Our research suggests that about half of the siblings who are later diagnosed with ASD display signs suggestive of ASD at 18 months, and in those who appeared asymptomatic at 18 months, symptoms appeared between 18 and 36 months,” Chawarska says.


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Original Study
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What was most interesting to the research team was that different patterns of behaviors at 18 months may be predictive of ASD later on. In about 50 percent of siblings, a combination of poor eye contact and lack of communicative gestures or imaginative play is most strongly associated with later ASD diagnosis.

In a small percentage of those later diagnosed with ASD, eye contact may be relatively normal, but they begin to display early signs of repetitive behaviors and have limited non-verbal communication skills.

“So not only do the behavioral symptoms appear at different ages, but different combinations of early symptoms may predict the diagnostic outcome,” Chawarska says.

“Linking these developmental dynamics with underlying neurobiology may advance our understanding of causes of ASD and further efforts to personalize treatment for ASD by tailoring it to specific clinical profiles and their developmental dynamics.”

The Economic Impact of School Suspensions

From The Atlantic

By Lucia Graves
October 26, 2014

A recent report found that African-American girls were suspended at much higher rates than their white peers, a phenomenon that leads long-term to lower earnings and educational attainment.


Tiambrya Jenkins was just 14 years old when she got into a fistfight that would change the course of her educational trajectory. Following an after-school scuffle between Jenkins and a white classmate, the two girls—both freshmen at Rome High School in Georgia—were transferred to an alternative school as punishment.

Her white classmate was allowed to return to their original school after 90 days. But Jenkins spent the rest of the year at the transitional academy, a place she describes as more like prison than school. "It was really, really boring. You just sat there all day until the bell rang," she says. "They didn't teach us anything."

At the academy, minor missteps such as talking out of turn or violating the dress code were used as reasons to delay a student's return to high school, Jenkins says. Simple organizational mistakes like showing up late or forgetting class materials were seen as acts of defiance, and could turn the clock back to zero on a student's 90 days at the transitional academy. After forgetting her notebook one day and suffering the consequences, Jenkins began stashing spares in an abandoned house across the street from the school, "just in case."

Two years later, Jenkins is back at her old high school, but she still feels hopelessly behind. Once a top math student, she'll be lucky to achieve a passing mark in advanced algebra this year. "I don't even know what we're learning," Jenkins says. "The teacher, she'll be teaching something, and I don't even know what it is. I just see a bunch of numbers on the board."

Share of Disciplined Female Students, by Race




Jenkins is not alone in her experience. A recent report finds African-American girls were suspended at six times the rate of white girls, and more than any other group of girls (and several groups of boys). This is despite evidence that African-American students do not misbehave more frequently than their peers.


The study, released in September by the NAACP Legal Defense and Educational Fund and the National Women's Law Center, outlines the barriers to African-American girls staying in school and shows how poor educational outcomes can limit their opportunities, from lower graduation rates to setbacks in expected lifetime earnings.

Education levels have an extraordinary impact on future wages, with academic attainment standing in as a rough proxy for future wealth. A female African-American college graduate typically sees an increase of about $657,000 over the course of her lifetime as compared to a female African-American high school graduate, according to the report. Should she fail to graduate from high school, her financial outlook worsens considerably.


In 2013, 43 percent of African American women without a high school diploma were living in poverty, compared to 29 percent with a high school diploma and just 9 percent with a bachelor's degree, U.S. Census data show. Helping African-American girls successfully complete high school, then, could stave off a lifetime of poverty for them and their families.

"There's this widespread misperception that girls—all girls—are successful in schools. Full stop," says Fatima Goss Graves, vice president for education and employment at the National Women's Law Center. "Much of this is fueled by not having data broken down by race and gender. Girls of color end up being invisible too often in these conversations."


A close look at the data reveals that in 2010, one-third (34 percent) of African-American girls didn't graduate from high school on time. Only 18 percent of white female students and 22 percent of all female students could say the same. And African-American girls are more than twice as likely as whites to be held back a grade.

The reasons for such setbacks have less to do with student behavior, the report's authors argue, than with disproportionate and overly punitive disciplinary practices that remove African-Americans from classes for minor and subjective infractions (examples include violations of dress code or even wearing natural hairstyles).

"Traditional" middle-class notions of femininity, which value passivity in girls, can clash with stereotypical images of African-American females as loud, assertive, and provocative, and generate differing punishments for similar conduct."

Subjective offenses like "disobedience" or "disruptive behavior" may signify little more than a student's failure to conform to dominant gender norms or fit a teacher's view of what constitutes appropriate "feminine" behavior.

Rosalind Wiseman, a best-selling author and educator, certainly sees the discipline gap in those terms. "Adults of every background need to challenge the ways in which we exercise our authority over students—all students—but especially minority students who have a legacy of domination," she says.


To illustrate the point, Wiseman recalled a time she saw a white male vice principal reprimanding a young black teenager for acting out in the classroom. When the boy questioned him, the administrator construed the inquiry as disrespectful and and the informal talking-to quickly morphed into a formal detention, enraging the young man. "What you're really saying in cases like this," Wiseman says, "is, 'Get back in your place, which is below me.' "

In her work training educators in social and racial awareness, Wiseman—best known as the author of the book that inspired the movie Mean Girls—encourages teachers to start at the ground floor. Teachers of all races need to understand and be aware of their own racial assumptions and biases, she explains, then have the maturity to face it and be able to manage their behavior as a result. It also helps to view punishments such as detention and suspension as a last resort.

Some principals, like Pete Cahall at Wilson Senior High School in Washington, D.C, are already doing that. Three years ago, Wilson had 332 suspensions; two years ago the number dropped to 224; and last year, there were just 209 suspensions. "I'm not pleased with 209 suspensions," Cahall says, noting that while African-Americans make up half the student body, they account for 80 percent of those suspended. "I'd like to cut that by another 20 percent this year because I don't think suspension really solves the problem."


Usually, he adds, kids act out because they're frustrated or embarrassed that they can't do the work. "If you take them out of school for 10 days, they're just further behind."

What's worse, Cahall found quite often it was adults who were causing, or at least escalating, the problems. "A kid would do something minor," Cahall says, "and teacher would get in their face and and yell." In recent years, he's started doing teacher trainings in how to better manage student behavior. He also handpicks his staff and instructs teachers to think about every kid in context.


"You don't know what's going on in the life of a child," Cahall says. "You don't know if their parents are beating them at home or what, so you've got to be compassionate and drill down to get to the root of the problem."

For Jenkins, however, such compassionate resolutions look increasingly out of reach.

"My whole life has been affected by a fight that I was in when I was 14," she says. "It's not something that you can take back and not something that was premeditated, and I still have to deal with the consequences every day."