Our Educational Topic for this month is about

Time Out Rooms…

Have you ever wondered what a Time Out room was?

Have you ever even heard of this term before? 

Time Out Rooms

I recently attended an IEP meeting with a family in our POPS support group in our area.  I was shocked to notice that on the proposed crisis plan for the behavior intervention plan, for this special needs child, there was a mention of a Time Out Room being possibly built for this particular child.  

Now mind you, this child has Cerebral Palsy & is in a self-contained classroom & is only in elementary school.  He is a small little fellow that uses a walker as means of walking.  He is not a high school student or even big built for that matter.  

Anyway, I thought it would be good to do a topic on this subject since parents of special needs children may be confronted with this same topic at their child’s IEP meeting. 

So here goes: 

What are Time Out Rooms? 

Time-out rooms, also known as seclusion rooms, are used in special education programs around the country. Usually a means of last resort, they're closet-sized rooms with a lockable door and a window with unbreakable glass.

The idea is, when a student has lost control of their behavior, they can be removed to the time-out room to calm down. Some states have restrictions on how long kids can spend in the rooms -- 15 minutes, for instance, and well-run programs use the rooms within the boundaries of a behavior management program. 

These rooms are built to about the size of a department store fitting room.  They are usually located in the corner of the classroom. It is equipped with padding on walls to secure the child’s safety while in the room. A one way mirror is on the door of the room, so educators can see the child while he/she is in the room.  

What are the guidelines for these rooms? 

"Time out rooms may be used only under the following conditions:

 a. The room is adequately lighted, ventilated and heated, and is free of hazards;

 b. The person is visually monitored by staff on a continual basis.  Bedrooms, bathrooms, and closets shall not be used as time out rooms;

 c. No area which places a person at risk shall be used as a time out room;

 d. The door, if secured by a mechanical device, must be held continuously by a staff person during the time the person is in time out. The device should open automatically when not held.

e. Placement of a person in a time out room must not exceed one hour. 

Teachers who use Time Out rooms should: 

Recognize that time-out should be used after other more “positive” techniques have already been attempted, such as the systematic use of reinforcement of appropriate behavior, as well as other less restrictive punitive techniques have been used (e.g., response cost).  When used, it should be used in combination with techniques designed specifically to teach and reinforce appropriate behavior.  

Recognize that “time-out” can occur in different settings, varying in degree of restrictiveness and depending on such factors as the severity of the behavior, the age of the student, and availability of the different settings.  The least restrictive form of time-out is time-out in the regular classroom (called inclusionary time-out), in which the student is allowed to observe but not actively participate.  The student might remain in his or her seat or be moved to the perimeter of the learning activity.  A more restrictive, and more common, form of time-out (call exclusionary time-out) is moving the student away from the learning activity, such as to a corner of the room, hallway, or study carrel, where he or she cannot participate in or observe the learning activity.  The most restrictive form of time-out, and the most common, is seclusionary time-out in which the student is removed to another room.  Because of the forced removal of the student from teacher, peers, and the educational activity, and the loss of instructional time, this is the most restrictive and intrusive form of time-out and, therefore, its use with students is heavily regulated with numerous procedural safeguards. 

Use time-out durations that are brief; typical durations are from 1 to 5 minutes per episode, depending on the developmental age of the student.  There is no evidence of greater effectiveness with time-out periods longer than 15 minutes, they are more difficult to enforce, and they are more vulnerable to a student finding sources of unplanned reinforcement. Ensure that the physical features and conditions of the time-out location are safe. Monitor the student continuously while he or she is in the time-out situation.

 What are the dangers of Time Out Rooms? 

Time-Out Rooms are a popular strategy used among school teachers for controlling the difficult behaviour of children. It involves removing children from their current environment and the people in this environment, and isolating them for what is usually a brief period of time to enable them to regain control of their behaviour. This can be in the child’s classroom or in the corner of the room, or even a “naughty chair.” It is thought that control is established again when the child can cool off and think about the why their behavior is unacceptable, and that they will avoid this behavior in the future due to the negative feelings associated with Time-Out, such as being alone, feeling bad, and wishing to please a teacher. Time-Out has become such a popular method for modifying children’s behavior that its potential negative impact on children’s psychological development has largely been overlooked.

When a child behaves inappropriately, most teachers speak to the child about why the behavior was wrong (i.e. “you do not speak that way to me because it is rude”), and ask the child to think about the wrongness of the behavior before promising not to behave this way again. The problem with this intervention is that it addresses the child’s behavior but forgets about two important things that are crucial to address in order to alleviate unwanted behavior: the child’s feeling that led to the behavior and why the child was feeling this way.

Behavior does not occur in isolation but is always motivated by emotion, and emotion does not arise for no reason, but is always connected to something that has happened before the child was feeling this way. For example, the child told his mother to "shut up" (behavior) because he was angry (emotion), and he was angry because he felt his mother was ignoring him (situation).
      
While Time-Out does address the outside behavior, it does not examine the inside feelings or motivations. As the motivations and feelings are not addressed and examined, they do not change but remain as they are. Therefore, the behavior does not change and will occur again, until the child’s feelings and situations that led to these feelings are explored between the child and his or her parent.

An example from a different field may help us understand this concept: A person consults a doctor about their hand which has turned bright red with white spots, and the doctor treats this with skin cream, puts on a band aid and sends the patient home. The patient returns one week later saying the rash has not changed, and the doctor puts on more cream, a new band aid, and sends the patient home. Nothing changes. This doctor has overlooked something important when trying to understand what is wrong with this patient: he has neglected to look for internal, unseen reasons for the rash, and has treated just the outside symptom. As the internal cause for the red hand was not recognized and treated (i.e. a problem with blood circulation), the external symptom did not improve.

Time-Out is a very temporary solution that treats only the outside symptom of the child’s difficult behaviour, without looking for the internal source of the problem, and this is why it does not work and children’s symptoms do not improve. 

The following stories of children who have been abused in Time Out Rooms:

A few weeks before 13-year-old Jonathan King killed himself, he told his parents that his teachers had put him in "time-out."

"We thought that meant go sit in the corner and be quiet for a few minutes," Tina King said, tears washing her face as she remembered the child she called "our baby ... a good kid."

But time-out in the boy's north Georgia special education school was spent in something akin to a prison cell -- a concrete room latched from the outside, its tiny window obscured by a piece of paper.

Called a seclusion room, it's where in November 2004, Jonathan hanged himself with a cord a teacher gave him to hold up his pants. Video Watch Jonathan's parents on their son's death ª

Seclusion rooms, sometimes called time-out rooms, are used across the nation, generally for special needs children. Critics say that along with the death of Jonathan, many mentally disabled and autistic children have been injured or traumatized.

Few states have laws on using seclusion rooms, though 24 states have written guidelines, according to a 2007 study conducted by a Clemson University researcher.

Texas, which was included in that study, has stopped using seclusion and restraint. Georgia has just begun to draft guidelines, four years after Jonathan's death.

Based on conversations with officials in 22 states with written guidelines, seclusion is intended as a last resort when other attempts to calm a child have failed or when a student is hurting himself or others.

Michigan requires that a child held in seclusion have constant supervision from an instructor trained specifically in special education, and that confinement not exceed 15 minutes.

Connecticut education spokesman Tom Murphy said "time-out rooms" were used sparingly and were "usually small rooms with padding on the walls."

Only Vermont tracks how many children are kept in seclusion from year to year, though two other states, Minnesota and New Mexico, say they have been using the rooms less frequently in recent years.

Dr. Veronica Garcia, New Mexico's education secretary, said her state had found more sophisticated and better ways to solve behavior problems. Garcia, whose brother is autistic, said, "The idea of confining a child in a room repeatedly and as punishment, that's an ethics violation I would never tolerate."

But researchers say that the rooms, in some cases, are being misused and that children are suffering.

Public schools in the United States are now educating more than half a million more students with disabilities than they did a decade ago, according to the National Education Association.

"Teachers aren't trained to handle that," said Dr. Roger Pierangelo, executive director of the National Association of Special Education Teachers.

"When you have an out-of-control student threatening your class -- it's not right and it can be very damaging -- but seclusion is used as a 'quick fix' in many cases."

Former Rhode Island special education superintendent Leslie Ryan told CNN that she thought she was helping a disabled fifth-grader by keeping him in a "chill room" in the basement of a public elementary school that was later deemed a fire hazard.

"All I know is I tried to help this boy, and I had very few options," Ryan said. After the public learned of the room, she resigned from her post with the department but remains with the school.

School records do not indicate why Jonathan King was repeatedly confined to the concrete room or what, if any, positive outcome was expected.

His parents say they don't recognize the boy described in records as one who liked to kick and punch his classmates. They have launched a wrongful death lawsuit against the school -- the Alpine Program in Gainesville -- which has denied any wrongdoing. A Georgia judge is expected to rule soon on whether the case can be brought before a jury.

Jonathan's parents say the boy had been diagnosed since kindergarten with severe depression and attention deficit hyperactivity disorder. But his father remembers him as a boy who was happy when he sang in the church choir.

"He was a hugger, liked to go fishing with me and run after me saying, 'Daddy, when are we going to the lake?' " Don King said.

King said that he wanted to know if there were similar situations in other schools and that critics of seclusion rooms fear there could be.

"Jonathan's case is the worst of the worst, but it should be a warning. It's reasonable to think that it could happen in all the other schools that use seclusion on disabled children -- largely because the use of seclusion goes so unchecked," said Jane Hudson, an attorney with the National Disability Rights Network.

"This is one of those most unregulated, unresearched areas I've come across," said Joseph Ryan, a Clemson University special education researcher who has worked in schools for disabled kids and co-authored a study on the use of seclusion.

"You have very little oversight in schools of these rooms -- first because the general public doesn't really even know they exist," he said.

There is no national database tracking seclusion incidents in schools, though many have been described in media reports, lawsuits, disability advocacy groups' investigations and on blogs catering to parents who say their child had been held in seclusion.

Disability Rights California, a federally funded watchdog group, found that teachers dragged children into seclusion rooms they could not leave. In one case, they found a retarded 8-year-old had been locked alone in a seclusion room in a northeast California elementary school for at least 31 days in a year.

"What we found outrageous was that we went to the schools and asked to see the rooms and were denied," said Leslie Morrison, a psychiatric nurse and attorney who led the 2007 investigation that substantiated at least six cases of abuse involving seclusion in public schools.

"It took a lot of fighting to eventually get in to see where these children were held."

CNN asked every school official interviewed if a reporter could visit a seclusion room and was denied every time.

In other instances of alleged abuse:

* A Tennessee mother alleged in a federal suit against the Learn Center in Clinton that her 51-pound 9-year-old autistic son was bruised when school instructors used their body weight on his legs and torso to hold him down before putting him in a "quiet room" for four hours. Principal Gary Houck of the Learn Center, which serves disabled children, said lawyers have advised him not to discuss the case.

* Eight-year-old Isabel Loeffler, who has autism, was held down by her teachers and confined in a storage closet where she pulled out her hair and wet her pants at her Dallas County, Iowa, elementary school. Last year, a judge found that the school had violated the girl's rights. "What we're talking about is trauma," said her father, Doug Loeffler. "She spent hours in wet clothes, crying to be let out." Waukee school district attorney Matt Novak told CNN that the school has denied any wrongdoing.

* A mentally challenged 14-year-old in Killeen, Texas, died from his teachers pressing on his chest in an effort to restrain him in 2001. Texas passed a law to limit both restraint and seclusion in schools because the two methods are often used together.

Federal law requires that schools develop behavioral plans for students with disabilities. These plans are supposed to explicitly explain behavior problems and methods the teacher is allowed to use to stop it, including using music to calm a child or allowing a student to take a break from schoolwork.

A behavioral plan for Jonathan King, provided to CNN by the Kings' attorney, shows that Jonathan was confined in the seclusion room on 15 separate days for infractions ranging from cursing and threatening other students to physically striking classmates.

Howard "Sandy" Addis, the director of the Pioneer education agency which oversees Alpine, said that the room where Jonathan died is no longer in use. Citing the ongoing litigation, he declined to answer questions about the King case but defended the use of seclusion for "an emergency safety situation."

The Alpine Program's attorney, Phil Hartley, said Jonathan's actions leading up to his suicide did not suggest the boy was "serious" about killing himself. Jonathan's actions were an "effort to get attention," Hartley said.

"This is a program designed for students with severe emotional disabilities and problems," he said. "It is a program which frequently deals with students who use various methods of getting attention, avoiding work."

A substitute employee placed in charge of watching the room on the day Jonathan died said in an affidavit that he had no training in the use of seclusion, and didn't know Jonathan had threatened suicide weeks earlier.

The Kings say they would have removed their son from the school if they knew he was being held in seclusion, or that he had expressed a desire to hurt himself.

"We would have home schooled him or taken him to another psychologist," said Don King. "If we would have known, our boy would have never been in that room. He would still be alive."  

Photo of Time Out Rooms:

 More stories of Abuse from Time Out Rooms:

http://news.minnesota.publicradio.org/features/200212/06_pugmiret_timeout/

http://ca.news.yahoo.com/s/cbc/canada_britishcolumbia_bc_school_time_out_rooms

http://www.upi.com/Top_News/2006/05/26/Parents-sue-school-over-time-out-room/UPI-21991148652972/

http://www.rapidcityjournal.com/news/local/top-stories/article_980cdc48-a47b-56a3-91c6-e248e958361f.html

http://www.smh.com.au/news/national/inquiry-into-use-of-timeout-room-in-special-needs-school/2006/08/31/1156817034607.html

http://www.upi.com/Top_News/2005/12/08/Schools-use-of-timeout-rooms-questioned/UPI-25701134101009/

http://earthhopenetwork.net/forum/showthread.php?tid=1676

http://www.capecodonline.com/apps/pbcs.dll/article?AID=/20090119/LIFE/901190302/-1/rss01

http://www.poconorecord.com/apps/pbcs.dll/article?AID=/20081017/NEWS/810170367/-1/NEWS01

http://wcco.com/local/son.storage.closet.2.913602.html

http://www.bellaonline.com/articles/art60315.asp

 WATCH YouTube videos of Time Out Rooms:

http://www.youtube.com/watch?v=-ghQ4CrBu84

http://www.youtube.com/watch?v=mXPpFQRCUiM&feature=PlayList&p=D4ACDECD3A6A757A&index=12

http://www2.tbo.com/video/2009/nov/20/boy-left-in-school-closet-61167/video-news/

I hope our educational topic for this month was helpful to you and your family.  If you want to learn more about Time Out Rooms, please visit any of the following websites above or below or come to our support group to learn more.

http://www.parentdish.com/

http://www.therapyintoronto.com/

http://www.udel.edu/

http://www.november.org/

Our Educational Topic for this month is Bipolar Disorder

Have you ever wondered what Bipolar Disorder is?

Have you ever even heard of this term before?  

 Bipolar Disorder 

About Bipolar Disorder:

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms of bipolar disorder are severe. They are different from the normal ups and downs that everyone goes through from time to time. Bipolar disorder symptoms can result in damaged relationships, poor job or school performance, and even suicide. But bipolar disorder can be treated, and people with this illness can lead full and productive lives. 

Bipolar disorder is not easy to spot when it starts. The symptoms may seem like separate problems, not recognized as parts of a larger problem. Some people suffer for years before they are properly diagnosed and treated. Like diabetes or heart disease, bipolar disorder is a long-term illness that must be carefully managed throughout a person's life.

Symptoms:

Bipolar disorder symptoms are characterized by an alternating pattern of emotional highs (mania) and lows (depression). The intensity of signs and symptoms can vary from mild to severe. There may even be periods when your life doesn't seem affected at all. Bipolar disorder symptoms reflect a range of moods.

Manic phase of bipolar disorder:
Signs and symptoms of the manic phase of bipolar disorder may include:

• Euphoria
• Extreme optimism
• Inflated self-esteem
• Poor judgment
• Rapid speech
• Racing thoughts
• Aggressive behavior
• Agitation
• Increased physical activity
• Risky behavior
• Spending sprees 
• Increased drive to perform or achieve goals
• Increased sexual drive 
• Decreased need for sleep 
• Tendency to be easily distracted
• Inability to concentrate 
• Drug abuse

Depressive phase of bipolar disorder:
Signs and symptoms of the depressive phase of bipolar disorder may include:

• Sadness 
• Hopelessness
• Suicidal thoughts or behavior 
• Anxiety
• Guilt
• Sleep problems
• Appetite problems
• Fatigue
• Loss of interest in daily activities
• Problems concentrating
• Irritability
• Chronic pain without a known cause  

Types of bipolar disorder:
Bipolar disorder is divided into two main subtypes:  

·         Bipolar I disorder. You've had at least one manic episode, with or without previous episodes of depression.  

·         Bipolar II disorder. You've had at least one episode of depression and at least one hypomanic episode. A hypomanic episode is similar to a manic episode but much briefer, lasting only a few days, and not as severe. With hypomania, you may have an elevated mood, irritability and some changes in your functioning, but generally you can carry on with your normal daily routine and functioning, and you don't require hospitalization. In bipolar II disorder, the periods of depression are typically much longer than the periods of hypomania.  

·         Cyclothymia. Cyclothymia is a mild form of bipolar disorder. Cyclothymia includes mood swings but the highs and lows are not as severe as those of full-blown bipolar disorder.

Other bipolar disorder symptoms:
In addition, some people with bipolar disorder have rapid cycling bipolar disorder. This is the occurrence of four or more mood swings within 12 months. These moods shifts can occur rapidly, sometimes within just hours. In mixed state bipolar disorder, symptoms of both mania and depression occur at the same time. Severe episodes of either mania or depression may result in psychosis, or a detachment from reality. Symptoms of psychosis may include hearing or seeing things that aren't there (hallucinations) and false but strongly held beliefs (delusions).  

Causes:

It's not known what causes bipolar disorder. But a variety of biochemical, genetic and environmental factors seem to be involved in causing and triggering bipolar episodes:

·         Biochemical. Some evidence from high-tech imaging studies indicates that people with bipolar disorder have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes. The naturally occurring brain chemicals called neurotransmitters, which are tied to mood, also may play a role. Hormonal imbalances also are thought to be a culprit.  

·         Genes. Some studies show that bipolar disorder is more common in people whose biological family members also have the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder. Some studies also show links between bipolar disorder and schizophrenia, pointing to a shared genetic cause.  

·         Environment. Environment also is thought to play a causal role in some way. Some studies of identical twins show that one twin has the condition while the other doesn't — which means genes alone aren't responsible for bipolar disorder. Environmental causes may include problems with self-esteem, significant loss or high stress.

Risk Factors:

It's estimated that about 1 percent of the population has bipolar disorder. However, some researchers suggest that bipolar disorder occurs on a continuum, and that many more people may have other forms of the disorder, pushing its prevalence as high as 6 percent of the population. In addition, some people may go undiagnosed because they don't seek treatment, because their condition is mistaken for depression or because their symptoms don't meet current diagnostic criteria.  

Bipolar I disorder affects about the same number of men and women, but bipolar II, the rapid cycling form, is more common in women. In either case, bipolar disorder usually starts between ages 15 and 30.  

Factors that may increase the risk of developing bipolar disorder include:

• Having other biological family members with bipolar disorder
• Periods of high stress
• Drug abuse
• Major life changes, such as the death of a loved one  

How is bipolar disorder diagnosed?

The first step in getting a proper diagnosis is to talk to a doctor, who may conduct a physical examination, an interview, and lab tests. Bipolar disorder cannot currently be identified through a blood test or a brain scan, but these tests can help rule out other contributing factors, such as a stroke or brain tumor. If the problems are not caused by other illnesses, the doctor may conduct a mental health evaluation. The doctor may also provide a referral to a trained mental health professional, such as a psychiatrist, who is experienced in diagnosing and treating bipolar disorder.

The doctor or mental health professional should conduct a complete diagnostic evaluation. He or she should discuss any family history of bipolar disorder or other mental illnesses and get a complete history of symptoms. The doctor or mental health professionals should also talk to the person's close relatives or spouse and note how they describe the person's symptoms and family medical history. 

People with bipolar disorder are more likely to seek help when they are depressed than when experiencing mania or hypomania. Therefore, a careful medical history is needed to assure that bipolar disorder is not mistakenly diagnosed as major depressive disorder, which is also called unipolar depression. Unlike people with bipolar disorder, people who have unipolar depression do not experience mania. Whenever possible, previous records and input from family and friends should also be included in the medical history. 

Treatments & Drugs: 

Bipolar disorder is a long-term condition that requires lifelong treatment, even during periods when you feel better. Bipolar disorder treatment is usually guided by a psychiatrist skilled in treating the condition. But you may have others on your treatment team as well, including psychologists, social workers and psychiatric nurses, because the condition can affect so many areas of your life.

Effective and appropriate treatment is vital for reducing the frequency and severity of manic and depressive episodes and allowing you to live a more balanced and enjoyable life. Maintenance treatment — continued treatment during periods of remission — also is important. People who skip maintenance treatment are at high risk of a relapse of their symptoms or having minor episodes turn into full-blown mania or depression. If you have problems with alcohol or substance abuse, you must get treatment for those, too, since they can worsen bipolar symptoms.  

Here are the core treatments for bipolar disorder:  

Medications:
Medications are a vital part of bipolar treatment. Because medications for bipolar disorder can cause serious but rare side effects, you may be reluctant to take medications. But you can work with your psychiatrist and other health care professionals to find a medication regimen that works for you.

Medication options include:  

• Mood stabilizers. Mood stabilizers are most the commonly prescribed medications for bipolar disorder. These medications help regulate and stabilize mood so that you don't swing between depression and mania. Lithium (Eskalith, Lithobid) has been widely used as a mood stabilizer and is generally the first line of treatment for manic episodes. Your doctor may recommend that you take mood stabilizers for the rest of your life to prevent and treat manic episodes.
• Anti-seizure medications. The medications are used to prevent mood swings, especially in people with rapid cycling bipolar disorder. These medications, such as valproic acid (Depakene), divalproex (Depakote) and lamotrigine (Lamictal), also are widely used as mood regulators. These medications are also known as anticonvulsants.
• Antidepressants. Use of antidepressants in bipolar disorder, although once common, is now controversial. Antidepressants may not be advised at all, depending on your situation. There's limited data indicating that antidepressants are effective for bipolar disorder, and in some cases they can trigger manic episodes. Before taking antidepressants, carefully weigh the pros and cons with your doctor. 
• Other medications. Certain atypical antipsychotic medications, such as olanzapine (Zyprexa) and risperidone (Risperdal), may help people who don't gain benefits from anti-seizure medications. And anti-anxiety medications, such as benzodiazepines, may help improve sleep. In addition, one medication, quetiapine (Seroquel), has been approved by the Food and Drug Administration to treat both the manic and depressive episodes of bipolar disorder.  

Numerous medications are available to treat bipolar disorder. If one doesn't work well for you, there are many others to explore. Your doctor may advise combining certain medications for maximum effect. It can take several weeks after first starting a medication to notice an improvement in your symptoms.

Be aware that all medications have side effects and possible health risks. Certain antipsychotic medications, for instance, may increase the risk of diabetes, obesity and high blood pressure. If you take these medications, talk to your doctor about being monitored for health problems. Also, mood-stabilizing medications may harm a developing fetus or nursing infant. So women with bipolar disorder who want to become pregnant or do become pregnant must fully explore with their health care providers their options and the benefits and risks of medications.  

Psychotherapy:
Psychotherapy is another vital part of bipolar disorder treatment. Several types of therapy may be helpful.

• Cognitive behavioral therapy. This is a common form of individual therapy for bipolar disorder. The focus of cognitive behavioral therapy is identifying unhealthy, negative beliefs and behaviors and replacing them with healthy, positive ones. In addition, you can learn about bipolar disorder and its treatment and what may trigger your bipolar episodes. You also learn effective strategies to manage stress and to cope with upsetting situations.
• Family therapy. Family therapy involves you and your family members. Family therapy can help identify and reduce stressors within your family. It can help your family improve its communication style and problem-solving skills and resolve conflicts.
• Group therapy. Group therapy provides a forum to communicate with and learn from others in a similar situation. It may also help build better relationship skills.

Electroconvulsive therapy (ECT)
Electroconvulsive therapy is geared mainly for people who have episodes of severe depression with suicidal tendencies or for people who haven't seen improvements in their symptoms despite other treatment. Electroconvulsive therapy is a procedure in which electrical currents are passed through your brain to trigger a seizure. Researchers don't fully understand just how ECT works. But it's thought that the seizure causes changes in brain chemistry that may lead to improvements in your mood.

Hospitalization
In some cases, people with bipolar disorder may benefit from inpatient hospitalization. Hospitalization for psychiatric treatment can help stabilize your mood, whether you're in a full-blown manic episode or a deep depression. Partial hospitalization or day treatment programs also are options to consider.  

Coping & Support:

Coping with bipolar disorder can be difficult. Medications can have unwanted side effects, and you may feel angry or resentful about having a serious condition that requires lifelong treatment. During periods when you feel better, you may be tempted to stop treatment. Here are some ways to cope with bipolar disorder:

• Learn about bipolar disorder. Education about your condition can empower you and motivate you to stick to your treatment plan.
• Join a support group. Support groups for people with bipolar disorder can help you reach out to others facing similar challenges.
• Stay focused on your goals. Recovery from bipolar disorder can take time. Stay motivated by keeping your recovery goals in mind and reminding yourself that you can work to repair damaged relationships and financial and legal problems.
• Find healthy outlets. Explore healthy ways to channel your energy, such as hobbies, exercise and recreational activities.
• Learn relaxation and stress management. Try such stress reduction techniques as meditation, yoga or tai chi.  

I hope our educational topic for this month was helpful to you and your family.  If you want to learn more about Bipolar Disorder, please visit any of the following web sties or come to our support group to learn more.

http://www.mayoclinic.com/

http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml 

Our Educational Topic for this month

is about Restraints.

Have you ever heard of this term before in your child’s school?

Has your child been the victim of restraints?

 Restraints

About Restraints:

To restrain involves “preventing from doing, exhibiting, or expressing something,” and restraining means “limiting, restricting or keeping under control. In the human services, the term restraint is used with three different types of restraint procedures: (a) mechanical restraint, (b) chemical restraint, and (c) physical restraint.

Mechanical Restraint:

Mechanical restraint entails the use of any device or object (e.g. tape, ropes, weights, weighted blankets) to limit an individual’s body movement to prevent or manage out-of-control behavior. Mechanical restraints such as handcuffs are universally used in law enforcement, and restraints such as straightjackets and straps have been used in medical and mental health facilities. Mechanical restraints such as tape, straps, tie downs, and a wide variety of other devices have also been used by educators to control student behavior. Mechanical restraints to limit behavior should be distinguished from medically prescribed devices whose purpose is to compensate for orthopedic weaknesses to protect the student from falling or to permit the student to participate in activities at school. For example, mechanical restraints have been employed in school settings in situations where students with physical disabilities such as cerebral palsy may be placed in standing tables or chairs with restraints which permit them to participate in educational activities where their muscles or bones would not otherwise permit their participation.  

Recently, weighted blankets and a variety of other devices have been used with students with autism and attention deficit disorders, apparently to calm them and reduce their hyperactivity but these essentially are a form of restraint. The degree of restriction of these devices varies, and they are not themselves teaching strategies although they may increase the opportunity to learn. None of these devices should be employed in schools unless specifically recommended by an occupational or physical therapist, physician, or school nurse with specific recommendations for lengths of time of use and other circumstances for their use. When prescribed in this way, these assistive devices should not be considered mechanical restraints. 

Seat belts or other restraints in vehicles to promote student safety in school vehicles should also be distinguished from mechanical restraints and should be employed according to state, provincial, and federal policies. Vehicle restraints should not be considered mechanical restraints as described here. Similarly, law enforcement officers using mechanical restraints in accord with appropriate police procedures in school settings should not be considered mechanical restraints for purposes of this document.  

Very little is known about the extent of use of mechanical restraints to control student behavior in school settings. Little is also known about the circumstances when they are used.  

Chemical Restraint:

The second category of restraint is chemical restraint. This type of restraint uses medication to control behavior or restrict a patient’s freedom of movement. One example of this type of restraint can occur in institutional or hospital programs where patients who become agitated are provided with medication specifically to control that agitation or other behaviors. A patient may be injected with medication to manage a crisis which is ongoing. This type of restraint is very unlikely in most school settings other than those schools within institutions or hospitals. However, the use of medications to manage behavioral symptoms has proliferated, including the widespread use in children of medications whose purpose is at least in part to control behavioral symptoms such as hyperactivity and inattention. As a result, one can conclude that the use of chemical restraints among school children in the United States is widespread.  

Educators have typically not been directly involved in the decision to employ these types of medications since they must be prescribed by a physician and since parents have the right to manage the medical care of their children.  

Educators, however, have been criticized for urging (or in some cases requiring) parents to seek medications to control the behavior of their children. Some states, provinces, or school districts have policies which regulate the involvement of educators in making any recommendations to parents regarding medications, and the Individuals with Disabilities Education Act of 2004 prevents schools from requiring the use of medication before receiving special education services.  

Physical Restraint:

The third type of restraint is sometimes referred to as ambulatory restraint, manual restraint, physical intervention, or therapeutic holding but herein is called physical restraint. A physical restraint is defined as any method of one or more persons restricting another person’s freedom of movement, physical activity, or normal access to his/her body. It is a means for controlling that person’s movement, reconstituting behavioral control, and establishing and maintaining safety for the out-of-control client, other clients, and staff. Physical restraints have been in widespread use across most human service, medical, juvenile justice, and education agency programs for a long period of time.  

While there have been some who have proposed physical restraint as a therapeutic procedure for some children, this view has no scientific basis and is generally discredited. Today most schools or programs that employ physical restraint view it as an emergency procedure to prevent injury to the student or others when a student is in crisis, although there is some evidence that it is actually employed for various other purposes including student compliance to adult commands.

While historically the use of these procedures in education has typically been in special education programs, these procedures are now widely believed to be used more broadly with any student and may be viewed as a part of the overall school program. Although data about the extent or circumstances of the use of physical restraint procedures in schools at the present time is not available, most believe that the use of these procedures in schools has increased as more students with difficult or severe behavioral needs are being served in general education schools and classes. 

What is Seclusion?

The Council for Children with Behavioral Disorders defines seclusion as "the involuntary confinement of a student alone in a room or area from which the student is physically prevented from leaving." Using seclusion in schools is highly controversial. The room may be locked and/or not supervised by an adult. Students may be left in these rooms for long periods of time and school staff may not be trained to properly implement the restraint or use of these rooms. Staff may use physical restraints to remove the student from the classroom to a seclusion room, causing injuries to students and staff.  

This room is sometimes referred to as the "time-out" room, but a time-out room should have teacher supervision.  

Abuse and use of restraints in schools:

Children with disabilities are sometimes left open to potential abuse when those who are charged with their care do not understand the difference between "bad behavior" and "behavior as communication". The term "behavior as communication" refers to a child's effort to communicate dislikes, needs, desires, etc. but cannot do so because of a communication deficit (i.e. no speech, limited speech). Sometimes happiness can look the same as sadness, anger the same as excitement...emotions can be very hard to distinguish. 

When a child's "behavior" is seen merely as bad behavior and not as an effort to communicate, the child can become even more frustrated thus causing escalation. Adults who are not properly trained to distinguish these "behaviors" or to decipher the "communication" attempts can sometimes escalate the child to a critical point when the use of physical and/or mechanical restraint comes into play.  

Imagine that you cannot express your thoughts in a way that others can easily understand. Now, imagine that you are a child who cannot communicate your fears, likes, dislikes, or pain. Imagine being misunderstood constantly. Imagine having others schedule every moment of your life without knowing what you would like to do. This is reality for some children. Is it any wonder that these children get frustrated?

The use of restraint or seclusion is only permitted in emergency circumstances. An emergency is the serious, probable, imminent threat of serious bodily harm to self or others. Restraint and seclusion may never be used as a means to punish a student or to gain compliant behavior. Finally, any restraint or seclusion must end once the need to ensure for the safety of the student or others has ended. 

Examples of allegations of death and abuse related to the use of seclusions and restraints at public and private schools:

• A 13-year-old boy with attention deficit hyperactivity disorder at an alternative public school hung himself in a seclusion room weeks after threatening to commit suicide, using a cord a teacher reportedly provided him to hold up his pants.  
• A 7-year-old girl died at a private day treatment center after being held for hours in a face-down, or prone, restraint on the floor by multiple staff members. The staff was allegedly unaware she had stopped breathing until they rolled her limp body over and discovered she had begun to turn blue.  
• A 9-year-old boy in foster care died at a public charter school after his teacher took him to a “time out” room and restrained him using a “basket hold,” which in this case was described as an adult standing behind a child, holding the child’s crossed arms and taking him to the floor. Purportedly, the boy began to make a noise like he was vomiting, then slumped over after being released. The teacher testified that she initially thought he was playing dead and joked with other staffers about planning his funeral.  
• A 17-year-old boy reportedly died from an asthma attack while being restrained by a counselor at a private school for emotionally disturbed teens.  
• Disabled children as young as 6 years old were allegedly placed in strangleholds, restrained for extended periods of time, confined to dark rooms, prevented from using the restroom causing them to urinate on themselves, and tethered to ropes in one public school district.  
• A special education teacher at a public school was accused of using bungee cords and duct tape to fasten children as young as 5 years old to chairs designed to support kids with muscular difficulties. According to parents, their children sustained injuries such as broken arms and bloody noses while in this teacher’s class. A teacher’s aide told investigators that the woman used the restraints on a daily basis to punish the children.
• According to the father of an 8-year-old autistic boy, his son suffered from scratches, bruises and a broken nose after being put in a prone restraint by his public school teacher and aide.  
• A sixth-grade special education student reportedly had his leg broken by the public school teacher who was trying to restrain him. 
• A 12-year-old girl allegedly had her arm fractured by a special education teacher who put her in a “therapeutic hold,” described as being similar to a “bear hug” or hold a student’s arms behind their back.  

Dangers Associated with Restraints:

Restraints, even when applied correctly, have been associated with the following grave physical conditions:

• asphyxiation
• choking
• strangulation
• cerebral and cerebella oxygen deprivation (hypoxia and anoxia)
• broken bones
• lacerations
• abrasions
• injury to joints and muscles
• contusions or bruising
• overheating, dehydration, exhaustion
• blunt trauma to the head
• broken neck
• wrist and leg compression
• dislocation of shoulder and other joints
• hyperextension or hyperflexion of the arms
• exacerbation of existing respiratory problems
• decreased respiratory efficiency
• decrease in circulation to extremities
• deep vein thrombosis
• pulmonary embolism
• cardiac and/or respiratory arrest, and death

9 Things to Know About Use of Restraint and Seclusion for Children in Special Education:

1. Definition of A restraint is--Any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the ability of an individual.
2. Definition of Seclusion is--The involuntary confinement of an individual alone in a room or area from which the individual is physically prevented from leaving. The involuntary confinement of an individual alone in a room or area, from which the individual is physically prevented from leaving. Seclusion should only be used for the management of violent or self-destructive behavior.
3. The Alliance to Prevent Restraint, Aversive Interventions and Seclusion (APRAIS) has stated that: Aversives, restraints, and seclusion can cause emotional, psychological, and/or physical damage as well as death." The most dangerous practice which causes the most injury and death; is of prone restraints which has the child face down! They cannot breath, and some children have died as a result of this barbaric method! 
4. The National Education Association has issued guidelines that discuss restraint or seclusion of violent students, stating that physical restraint should be used with a student only when there is an imminent risk either of harm to a person or property damage.
5. Parents, community members, and professionals have had concerns about the length of time, that students are in time-out, as well as the supervision and safety of students in seclusionary time-out settings.
6. National Disability Rights Network examined all state laws, policies and guidelines. Including the District of Columbia shows that, of the 56 states and territories in the United States: Forty-one percent (41%) have no laws, policies or guidelines concerning restraint or seclusion use in schools;
7. Almost ninety percent (90%) still allow prone restraints; Only forty-five percent (45%) require or recommend that schools automatically notify parents or guardians of restraint/seclusion use.
8. The Office of Special Education Programs (OSEP) in the United States Department of Education oversees the enforcement of IDEA. OSEP has funded a technical assistance project - one focused specifically on positive behavioral interventions and supports and of best practices, including behavioral supports. Because of its emphasis on positive behavioral intervention and supports, you would expect OSEP to be supportive of alternatives and against the violent and abusive practice of restraint or seclusion, but they are not!
9. OSEP has done little, if anything, over the past 33 years to protect children with disabilities, from the use of restraint or seclusion. The most unfortunate outcome of OSEP's lack of back bone is that these procedures continue to be used causing injury, emotional difficulty, and death! 

Best Practices: IDEA recommends that students with behavioral challenges receive a system of positive behavioral interventions and supports. Positive behavioral interventions and supports is a research-based method for improving student behavior and creating a safe and productive school climate. The practice of positive behavioral interventions and supports is: proactive, comprehensive and data driven. It should be noted that this approach has been shown to significantly reduce problem behaviors, disciplinary referrals, and suspensions.

By having this information you will be able to fight for your child, so that they are not injured or killed, by the dangerous practices of restraint and seclusion. Also by knowing what best practices are, you may be able to advocate that these are carried out for your child. This will help your child be safe and also be in an environment where they can learn! 

I hope our educational topic for this month was helpful to you and your family.  If you want to learn more about Restraints, please visit any of the following websites or come to our support group to learn more.

http://www.casecec.org

http://www.wrightslaw.com

http://www.gao.gov

Sample letter requesting “No Restraint”::

http://www.bridges4kids.org/IEP/NoRestraintLetter.html#top

http://www.protectionandadvocacy-sc.org/seclusion.htm

http://ezinearticles.com/?9-Things-to-Know-About-Use-of-Restraint-and-Seclusion-For-Children-in-Special-Education&id=2400248

Our Educational Topic for this month is R.T.I..

Have you ever wondered what R.T.I. stands for?

Have you ever even heard of this term before?  

R.T.I. stands for

Response to Intervention

About RTI:

An Alternative to Traditional Eligibility Criteria for Students with Disabilities:

Response to Intervention integrates assessment and intervention within a multi-level prevention system to maximize student achievement and to reduce behavior problems. With RTI, schools identify students at risk for poor learning outcomes, monitor student progress, provide evidence-based interventions and adjust the intensity and nature of those interventions depending on a student’s responsiveness, and identify students with learning disabilities.  

“Response to Intervention” refers to a process that emphasizes how well students respond to changes in instruction. The essential elements of an RTI approach are: providing scientific, research-based instruction and interventions in general education; monitoring and measuring student progress in response to the instruction and interventions; and using these measures of student progress to shape instruction and make educational decisions.  

A number of leading national organizations and coalition groups, including the National Research Center on Learning Disabilities and the 14 organizations forming the 2004 Learning Disabilities (LD) Roundtable coalition have outlined the core features of an RTI process as follows:

• High quality, research-based instruction and behavioral support in general education.
• Universal (school-wide or district-wide) screening of academics and behavior in order to determine which students need closer monitoring or additional interventions.
• Multiple tiers of increasingly intense scientific, research-based interventions that are matched to student need.
• Use of a collaborative approach by school staff for development, implementation, and monitoring of the intervention process.
• Continuous monitoring of student progress during the interventions, using objective information to determine if students are meeting goals.
• Follow-up measures providing information that the intervention was implemented as intended and with appropriate consistency.
• Documentation of parent involvement throughout the process.
• Documentation that any special education evaluation timelines specified in IDEA 2004 and in the state regulations are followed unless both the parents and the school team agree to an extension.

What Are the Key Terms?

Response to Intervention (RTI) is an array of procedures that can be used to determine if and how students respond to specific changes in instruction. RTI provides an improved process and structure for school teams in designing, implementing, and evaluating educational interventions. 

Universal Screening is a step taken by school personnel early in the school year to determine which students are “at risk” for not meeting grade level standards or those who have behavioral or emotional problems that may interfere with their learning. Universal screening can be accomplished by reviewing recent results of state tests, or by administering an academic or behavioral screening test to all students in a given grade level. Those students whose test scores or screening results fall below a certain cut-off are identified as needing more specialized academic or behavioral interventions.

Student Progress Monitoring is a scientifically based practice that is used to frequently assess students’ academic performance and evaluate the effectiveness of instruction. Progress monitoring procedures can be used with individual students or an entire class.

Scientific, Research-Based Instruction refers to specific curricula and educational interventions that have been proven to be effective—that is, the research has been reported in scientific, peer-reviewed journals.

What Role Does RTI Play in Special Education Eligibility?

IDEA 2004 offers greater flexibility to school teams by eliminating the  requirement that students must exhibit a “severe discrepancy” between intellectual ability and achievement in order to be found eligible for special education and related services as a student with a learning disability. This increased flexibility has led to a growing interest in using RTI as part of an alternative method to traditional ability/achievement discrepancy comparisons.

IDEA 2004 addresses RTI procedures within several contexts:

Effective instruction and progress monitoring. For students to be considered for special education services based on a learning disability they first must have been provided with effective instruction and their progress measured through “data-based documentation of repeated assessments of achievement.” Furthermore, results of the student progress monitoring must be provided to the child’s parents.

Evaluation procedures. The law gives districts the option of using RTI procedures as part of the evaluation procedures for special education eligibility. Comprehensive assessment is still required under the reauthorized law, however. That means that schools still need to carefully examine all relevant aspects of a student’s performance and history before concluding that a disability does or does not exist. As before, schools must rule out learning problems that are primarily the result of factors such as poor vision, hearing, mental retardation, emotional disturbance, lack of appropriate instruction, or limited English proficiency.

Early Intervening Services. IDEA 2004 allows districts the option of using up to 15% of federal special education funds for “early intervening services” for students who have not been identified as needing special education, but who need additional academic and behavioral support to succeed in the general education setting. The types of services that can be included are central to the RTI process, and include professional development for teachers and school staff to enable them to deliver scientifically based academic and behavioral interventions, as well as educational evaluations, services, supports, and scientifically based literacy instruction.

Another central concept with respect to RTI involves instruction and interventions being offered through a flexible process that is targeted to the needs of the individual child. Within Tiered Instruction, all students start within the general curriculum and move through the curriculum receiving adapted and individualized interventions of increasing intensity depending on a student’s earlier response. Generally speaking, once a child has received all tiers of intervention and is not progressing at a typically developing rate, they are then referred for evaluation to determine if special education and related services are warranted.

RTI models vary with respect to the number of tiers involved in the process. There is no “official” recommendation as to the most effective number of tiers. Three tiers of instructional intervention is a common practice.

A three--tier RTI model includes:

Tier 1:

Screening and Group Interventions Students who are “at-risk” are identified using universal screenings and/or results on state or district-wide tests and could include weekly progress monitoring of all students for a brief period. Identified students receive supplemental instruction, or interventions, generally delivered in small groups during the student’s regular school day in the regular classroom.

The length of time for this step can vary, but it generally should not exceed eight weeks. During that time, student progress is closely monitored using a validated screening system such as curriculum based measurement.  At the end of this period, students showing significant progress are generally returned to the regular classroom program. (Note: this step may be broken into 2 separate tiers in a 4-tier model) Students not showing adequate progress are moved to Tier 2.

Tier 2:

Targeted Interventions Students not making adequate progress in the regular classroom in Tier 1 are provided with more intensive services and interventions. These services are provided in addition to instruction in the general curriculum. These interventions are provided in small group settings. In the early grades (K-3) interventions are usually in the areas of reading and math. A longer period of time may be required for this tier, but it should generally not exceed a grading period. Students who continue to show too little progress at this level of intervention are then considered for more intensive interventions as part of Tier 3. Depending on a school’s particular model of RTI, parents may or may not be involved in Tier 2. Ideally, schools involve parents at the earliest stages of RTI by explaining the process in face-to-face meetings, providing written intervention plans and requesting parental consent.

Tier 3:

Intensive Interventions and Comprehensive Evaluation Students receive individualized, intensive interventions that target the student’s skill deficits. Students who do not respond to these targeted interventions are then considered for eligibility as required by the Individuals with Disabilities Education Act (IDEA). The data collected during Tiers 1, 2 and 3 are included and used to make the eligibility decision. (Note: This part of the process may be broken into 2 separate tiers in a 4-tier model).

At any point in an RTI process, IDEA allows parents to request a formal evaluation to determine eligibility for special education. An RTI process cannot be used to deny or delay a formal evaluation for special education. While there is no single, thoroughly researched and widely practiced “model” of the RTI process, it is generally defined as a three-tier (or 3-step) model of school supports that uses research-based academic and/or behavior interventions. At all stages of the process, RTI should focus on discovering how to make the student more successful rather than focusing on the student’s lack of success.

To see an awesome Youtube video explaining the RTI- Response to Intervention 3-Tier model , Please click on our POPS Videos page.. I posted a great youtube video for you to view. It's 2 mins & 42 sec. long.. 

What Are the Potential Benefits of RTI?

Perhaps the most commonly cited benefit of an RTI approach is that it eliminates a “wait to fail” situation because students get help promptly within the general education setting. Secondly, an RTI approach has the potential to reduce the number of students referred for special education services while increasing the number of students who are successful within regular education. Since an RTI approach helps distinguish between those students whose achievement problems are due to a learning disability and those students whose achievement problems are due to other issues such as lack of prior instruction, referrals for special education evaluations are often reduced. RTI techniques have been favored for reducing the likelihood that students from diverse racial, cultural or linguistic backgrounds are incorrectly identified as having a disability. Finally, parents and school teams alike find that the student progress monitoring techniques utilized in an RTI approach provide more instructionally relevant information than traditional assessments.

How Can Parents Be Involved in the RTI Process?

The hallmarks of effective home-school collaboration include open communication and involvement of parents in all stages of the learning process. Being informed about your school’s RTI process is the first step to becoming an active partner. Both the National Center for Learning Disabilities and the National Joint Committee on Learning Disabilities advise parents to ask the following questions:

• Does our school use an RTI process? If not, are there plans to adopt one? Be aware that your child’s school may call their procedures a “problem solving process,” or may have a unique title for their procedures, e.g., Instructional Support Team, and not use the specific RTI terminology.
• Are there written materials for parents explaining the RTI process? How can parents be involved in the various phases of the RTI process?
• What interventions are being used, and are these scientifically based as supported by research?
• What length of time is recommended for an intervention before determining if the student is making adequate progress?
• How do school personnel check to be sure that the interventions were carried out as planned?
• What techniques are being used to monitor student progress and the effectiveness of the interventions? Does the school provide parents with regular progress monitoring reports?
• At what point in the RTI process are parents informed of their due process rights under IDEA 2004, including the right to request an evaluation for special education eligibility?

Response-to-Intervention vs. Pre-referral Interventions

Many schools, school districts and even some states have established procedures for pre-referral interventions. Such interventions are designed to provide additional support to struggling students prior to recommending that a student be evaluated for special education. However, little research has been done on the effectiveness of this approach. Pre-referral interventions have frequently been used without close monitoring or documentation of the student’s progress. Monitoring and record keeping provide the critical information needed to make decisions about the student’s future instruction. If monitoring and record keeping doesn’t occur along with pre-referral strategies, the opportunity to make informed decisions about the student’s future instruction and intervention needs is lost. Equally important, the adequacy of the instruction being delivered in the general education classroom where the student was experiencing learning difficulties has not usually been examined. Frequently, the instructional program being used in general education, such as the beginning reading program, is not scientifically based and does not have a high success rate for most children.

In contrast, successful implementation of RTI requires a number of essential components that ensure high-quality instruction, careful monitoring and documenting of progress and close collaboration between general education and special education.

Written Intervention Plans

If your child’s school is using an RTI process to address your child’s difficulties, you should expect to receive a written intervention plan. This plan should include details about how the school is planning on helping your child. The written intervention plan should be fully explained to you and should include the following:

• A description of the specific intervention
• The length of time (such as the number of weeks) that will be allowed for the intervention to have a positive effect
• The number of minutes per day the intervention will be implemented (such as 30 to 45 minutes)
• The persons responsible for providing the intervention
• The location where the intervention will be provided
• The factors for judging whether the student is experiencing success
• A description of the progress monitoring strategy or approach, such as CBM, that will be used
• A progress monitoring schedule
• How frequently you will receive reports about your child’s response to the intervention.

The instructional interventions used as part of an RTI process should provide targeted assistance based on progress monitoring, be delivered by a highly qualified classroom teacher or another specialist and provide additional instruction on an individual or small group basis (with or without technology assistance).

The following practices are NOT appropriate instructional interventions and should not be part of an RTI intervention plan:

• Special or re-assigned seating in the classroom
• Shortened assignments
• Communications with the parent about the child at regular parent-teacher conferences or other informal communications
• Classroom observations
• Suspension
• Retention
• More of the same/general classroom instruction and/or assignments.

I hope our educational topic for this month was helpful to you and your family.  If you want to learn more about R.T.I., please visit any of the following web sties or come to our support group to learn more.

http://www.rti4success.org

http://www.nasponline.org

http://www.nichcy.org 

Some Resources that might help also:

Response to Intervention: A primer

http://www.ncld.org/index.php?option=content&task=view&id=598 

Response to Intervention: Tiers without Tears

http://www.ncld.org/index.php?option=content&task=view&id=549 

SchwabLearning.org: Basic Principles of the

Responsiveness-to-Intervention Approach

www.schwablearning.org/articles.asp?r=1056 

SchwabLearning.org: Responsiveness to Intervention:

Implementation in Schools

www.schwablearning.org/articles.asp?r=1057 

Wrights Law

http://www.wrightslaw.com/info/rti.index.htm

Our Educational Topic for this month is about

Separation Anxiety Disorder.

Have you ever wondered what its like to have Separation Anxiety?

Has your child been diagnosed with having Separation Anxiety Disorder?

Have you ever even heard of this term before?

Separation Anxiety Disorder 101

What is Separation Anxiety Disorder?

Separation anxiety disorder is a medical condition that is characterized by significant distress when a person is away from parents, another caregiver, or home. Unlike the occasional, mild worries that children may feel at times of separation, separation anxiety disorder can dramatically affect a person's life by limiting the ability to engage in ordinary activities. Children with the disorder become extremely upset whenever they separate from their primary caregiver, whether that person is a parent, relative, nanny, or other caregiver. Unlike children who are simply shy, children with separation anxiety disorder may become severely anxious and agitated even when just anticipating being away from their home or primary caregiver.

Separation anxiety disorder affects approximately two to five percent of children. These children, who often have additional anxiety disorders, frequently have other family members with anxiety disorders. The tendency to develop separation anxiety disorder involves complex genetic and environmental factors.

What Does Separation Anxiety Disorder Look Like in Children and Adolescents?

A certain level of separation anxiety is an expected and healthy part of normal development that occurs in all children to varying degrees between infancy and age 6. However, children with Separation Anxiety Disorder have separation worries that are excessive and much greater than their peers. These worries can overwhelm a child, even when they involve brief separations, such as leaving to go to school, going to sleep, or staying behind at home when a parent runs an errand. The child's fears may appear to be irrational, such as the fear that the parent may suddenly die or become ill. Young people with separation anxiety disorder often go to great extremes to avoid being apart from their home or caregivers. They may protest against leaving a parent's side, refuse to play with friends, or complain about physical illness at the time of separating. Frequently, a child tolerates separation from one parent more easily than separation from the other parent.  

At home, children with separation anxiety disorder may experience a combination of the symptoms listed below.

• Consistent and extreme worry and fear when separating from home or primary caregiver. Children also may be extremely frightened and worried when they anticipate separation and may be unwilling to be alone.
• Persistent worry and fear that something bad may happen to their parent or to themselves. They may worry about a parent becoming sick or getting hurt. They also may worry about getting lost if separated.
• Refusal to attend school often develops, due to worries about separating.
• Refusal or reluctance to participate in ordinary outings or activities. The child may not want to go out to dinner, meet friends to play, or engage in after- school programs.
• Difficulty sleeping alone. Children may insist that a parent sleep with them or may insist on sleeping with the parent in the parent's bed.
• Have scary dreams about being separated.
• Frequent physical complaints at times of separating. Children with separation anxiety disorder often complain about stomach aches, headaches, or other physical discomforts when they know they will have to separate.

If left untreated, the condition may lead to considerable limitations in other areas of the child's life. Peer relationships, school functioning, and family functioning may suffer, or depression may develop. In some situations, if a child believes there is no way to reduce extreme anxiety, thoughts of self-harm or not wanting to be alive may develop.

At School:

A child or adolescent with separation anxiety disorder may try to hide symptoms while at school. As a result, a child may appear to have more symptoms at home than at school. For other children, the symptoms are particularly evident at school because of the child's difficulty leaving a parent and the resulting impact on school attendance. At school, a child with separation anxiety disorder may have a combination of the symptoms listed below.

• Difficulty transitioning from home to school. Children may have great trouble separating from their parents in the morning. This may lead to late arrival times, long and tearful morning drop-offs, or tantrums at school.
• Refusal or reluctance to attend school. Anxiety associated with this disorder is powerful and may lead a child to insist on staying at home.  
• Avoidance of activities with peers. Any additional time at school may be resisted.
• Low self-esteem in social situations and academic activities.
• Difficulty concentrating due to persistent worry, which may affect a variety of school activities, from following directions and completing assignments to paying attention.
• Other conditions, such as generalized anxiety disorder, panic disorder, phobias, or depression, which may also be present, compounding any learning challenges. Having one mental health condition does not "inoculate" the child from having other conditions as well.
• Learning disorders and cognitive problems, which are often overlooked. A child's difficulties or frustrations in school should not be presumed to be due entirely to the separation anxiety disorder. If the child still has academic difficulty after symptoms are treated, an educational evaluation for learning disabilities should be considered. A child's repeated reluctance to attend school may be an indicator of an undiagnosed learning disability.
• Behavioral or cognitive effects from medication. If a child is receiving medication for symptoms, new mood changes or behaviors should be discussed with parents, as they can reflect medication side effects.

 At the Doctor's Office:

A child's symptoms of separation anxiety disorder may be evident during an office visit when a child refuses to meet with the clinician alone. This feature alone does not indicate a child has separation anxiety disorder, since children routinely are nervous during office visits. Clinicians may benefit from talking with parents, school staff, and other important caregivers to evaluate a child's functioning in each area to determine the underlying cause of the child's symptoms.

• Symptoms vary and their appearance may change as a child grows. A clinician may need to see a child over time to determine the appropriate diagnosis.
• Other conditions, particularly other anxiety disorders, may look like separation anxiety disorder. These conditions include specific phobias (anxiety triggered repeatedly by the same object or situation, such as spiders or flying), generalized anxiety disorder (extreme anxiety throughout the day regarding many matters), social phobia (anxiety triggered by social situations), and panic disorder (unpredictable panic attacks). The symptoms of mood disorders can also be similar to the symptoms of separation anxiety disorder.
• Depression is also often found in these children.  
• Frequent physical complaints such as stomach aches, headaches, nausea, or injury occur in children with separation anxiety disorder. The clinician must determine whether these complaints warrant further medical investigation.
• Children may have difficulty talking about the fears around separation. Phrasing questions with particular sensitivity and compassion may allow a more complete picture of symptoms to emerge. For example, to elicit information from a child, clinicians might ask, "What do you worry about when you go to bed alone?”
• Children may be unaware, or unwilling to admit, that their behavior may indicate symptoms of a disorder.
• Families may need to be coached about what they can reasonably expect from their child. Children who suffer from separation anxiety disorder will benefit if their family understands that therapy and medicines may reduce, but may not cure, symptoms.

Interventions at Home:

At home, as well as at school, providing a sympathetic and tolerant environment and making some adaptations may be helpful to aid a child or adolescent with separation anxiety disorder.

• Learn about the disorder and how it is experienced by the child. Parents can more easily sympathize with a child's struggles if they understand how the child feels.
• Listen to the child's feelings. Isolation can foster low self-esteem and depression in children with separation anxiety disorder. The simple experience of being listened to empathically, without receiving advice, may have a powerful and helpful effect.
• Keep calm when a child is upset about separating. If a child sees a parent is able to remain calm, the child can model the parent's attitude.
• Gently remind the child that he or she survived the last separation. Reassurance goes a long way and may help reduce the child's anxiety.
• Anticipate transition points that can cause apprehension, such as going to school or meeting friends for play. If a child tolerates separation from one parent more easily than from the other parent, arrange school drop-off, bedtime, and other transitions to be handled where possible by the parent from whom it is easier to separate.  
• Planning for enjoyable activities at school or wherever the child is going, or describing when and how the child can contact the parent, may diminish anxiety.
• Firmly, consistently, and caringly set limits. ("I know you'd like Mommy to bring you to bed, and I know this is hard for you. Mommy said good night and she'll see you first thing in the morning, and you'll make breakfast together. You've got her picture beside you to remind you that she's thinking about you. Good night now.")
• Teach relaxation techniques. Relaxation techniques include deep breathing, counting to 10, or visualizing a soothing place. Teaching children or adolescents how to relax will empower them to develop mastery over symptoms and improve a sense of control over their body.
• Help a child who has been absent from school to return to school as quickly as possible. Even if a shorter school day is necessary initially, children's symptoms are more likely to decrease when they discover that they can survive the separation.
• Support the child's participation in activities. Helping the child or adolescent to get through the separation fears and to engage in activities will encourage continued participation in healthy activities.
• Praise the child's efforts to address symptoms. Young people often feel that they only hear about their mistakes. Even if improvements are small, every good effort deserves to be praised.

 Interventions at School:

There are many ways that schools can help a child with separation anxiety disorder. Meetings between parents and school staff, such as teachers, guidance counselors, or nurses, will allow for collaboration to develop helpful school structure for the child. The child may need particular changes (accommodations/modifications) within a classroom. Examples of some accommodations, modifications, and school strategies include the following:

• Schedule check-ins on arrival to reduce the child's initial anxiety and facilitate transition into school.
• Accommodate late arrival due to difficulty separating.
• Identify a safe place where the child may go to reduce anxiety during stressful periods. Developing guidelines for appropriate use of the safe place will help both the student and staff.
• Develop relaxation techniques to help reduce anxiety at school. The same techniques that are useful at home can often be implemented at school as well.  
• Provide times for the child to convey messages to family. Brief (a minute or so) contact with family may substantially reduce anxiety and may help children recognize that their connection to their parent is intact. (In some children, this strategy may instead heighten awareness of the separation.) In preparation for possible times when the parent is not available, identify additional people for the child to contact.
• Ask the parent to send short notes for the child to read as a reward for staying in school. These can be placed in the child's lunchbox or locker, so that they can be obtained after the child has succeeded in class for an interval.
• If the child or adolescent is avoiding school, address the cause and initiate an immediate plan for him or her to return. The young person may require gradual reintroduction to school and may readjust more quickly if allowed to attend for partial days at first.
• Encourage the child to help develop interventions. Enlisting the child's ideas in the task will lead to more successful strategies and will foster the child's ability to problem-solve. However, sometimes children will try to negotiate a "date" to attempt to return to school or go to some other activity. In most cases this strategy is not successful, and it can increase conflict ("You promised you'd go today").
• Provide assistance to the child during interactions with peers. An adult's help may be very beneficial for both the child and his or her peers.
• Be aware that transitions may be difficult for the child. When a child with separation anxiety refuses to follow directions, for example, the reason may be anxiety rather than intentional.
• Reward a child's efforts. Every good effort, or step in the desired direction, deserves to be praised.

Flexibility and a supportive environment are essential for a student with separation anxiety disorder to achieve success in school. School faculty and parents working together may be able to develop remedies to reduce a child's challenges. 

I hope our educational topic for this month was helpful to you and your family. 

For more information about Separation Anxiety disorder, please contact www.massgeneral.org or   www.nimh.nih.gov  or www.mentalhealth.samhsa.gov or call 1-866-615-6464 or 1-800-789-2647.   You can also contact your child’s doctor.  

Our Educational Topic for this month

is about Depression.

Have you ever wondered what being depressed feels like?

Has your child or family member been diagnosed with being depressed? 

Depression 

About this Medical Illness:

Depression is a serious medical illness that involves the brain. It's more than just a feeling of being "down in the dumps" or "blue" for a few days. If you are one of the more than 20 million people in the United States who have depression, the feelings do not go away. They persist and interfere with your everyday life.  

Depression can run in families, and usually starts between the ages of 15 and 30. It is much more common in women. Women can also get postpartum depression after the birth of a baby. Some people get seasonal affective disorder in the winter. Depression is one part of bipolar disorder.

There are effective treatments for depression, including antidepressants and talk therapy. Most people do best by using both.

Depression Overview

Throughout the course of our lives, we all experience episodes of unhappiness, sadness, or grief. Often, when a loved one dies or we suffer a personal tragedy or difficulty such as divorce or loss of a job, we may feel depressed (some people call this "the blues"). Most of us are able to cope with these and other types of stressful events.

Over a period of days or weeks, the majority of us are able to return to our normal activities. But when these feelings of sadness and other symptoms make it hard for us to get through the day, and when the symptoms last for more than a couple of weeks, we may have what is called clinical depression. The term "clinical depression" is usually used to distinguish "true" depression from the blues.

Clinical depression is not just grief or sadness. It is an illness that can challenge your ability to perform even routine daily activities. At its worst, depression may lead you to contemplate or commit suicide. Depression represents a burden for both you and your family. Sometimes that burden can seem overwhelming.

There are several different types of depression (mood disorders that include depressive symptoms):

Major depression is a change in mood that lasts for weeks or months. It is one of the most severe types of depression. It usually involves a low or irritable mood and/or a loss of interest or pleasure in usual activities. It interferes with one's normal functioning and often include physical symptoms. A person may experience only one episode, but often there are repeated episodes over an individual's lifetime.

Dysthymia is less severe than major depression but usually goes on for a longer period, often several years. There are usually periods of feeling fairly normal between episodes of low mood. The symptoms usually do not completely disrupt one's normal activities.

Bipolar disorder involves episodes of depression, usually severe, alternating with episodes of extreme elation called mania. This condition is sometimes called by its older name, manic depression. The depression that is associated with bipolar disorder is often referred to as bipolar depression.

Seasonal depression, which medical professionals call seasonal affective disorder, or SAD, is depression that occurs only at a certain time of the year, usually winter. It is sometimes called "winter blues." Although it is predictable, it can be very severe.

Adjustment disorder is distress that occurs in relation to a stressful life event. It is usually an isolated reaction that resolves when the stress passes. Although it may be accompanied by a depressed mood, it is not considered a depressive disorder.

Some people believe that depression is "normal" in people who are elderly, have other health problems, have setbacks or other tragedies, or have bad life situations. On the contrary, clinical depression is always abnormal and always requires attention from a medical or mental-health professional. The good news is that depression can be diagnosed and treated effectively in most people. The biggest barrier to overcoming depression is recognizing that someone is depressed and seeking appropriate treatment.

Symptoms & Behaviors:

• Sadness
• Loss of interest or pleasure in activities you used to enjoy
• Change in weight
• Difficulty sleeping or oversleeping
• Energy loss
• Feelings of worthlessness
• Thoughts of death or suicide  

The Cause:

The causes of depression are complex. Genetic, biological, and environmental factors can contribute to its development. In some people, depression can be traced to a single cause, while in others, a number of causes are at play. For many, the causes are never known.

Currently, it appears that there are biochemical causes for depression, occurring as a result of abnormalities in the levels of certain chemicals in the brain. These chemicals are called neurotransmitters. The abnormalities are thought to be biological and are not caused by anything you did. 

If you need more information about Depression, please contact www.nimh.nih.gov  or  www.mentalhealth.samhsa.gov or call 1-866-615-6464 or 1-800-789-2647.  You could also contact your family doctor.  

My own family’s experiences with Depression!

          As most of you know, my life hasn’t always been this great.  I grew up in a house filled with many episodes of outburst & violent situations.  My father was an alcoholic & suffered from manic depression, also called Bipolar disorder today.   Growing up, he was truly a violent person towards my mom & my siblings.  

            When I was 10 years old, my father committed suicide by drinking Anti Freeze.  He had also swallowed a good many prescription pills as well. But, by the time he arrived at the hospital it was too late to save him from this devastating illness.  After many hours of lingering in pain, he finally died of congested heart failure.  He was only 43 years old. 

            Can you believe that a man with a beautiful wife, three lovely daughters, & a handsome son would feel that he had no reason to live?  That he couldn’t see how blessed he was to have such a family to call his own.  After all these years I’m still asking the question “Why”??    But, I guess I’ll never know the answer.  I even still do the “If Only’s”.  If Only he could be here today to get the help & treatment he needed.  Things could have been different in all my family’s lives.  

            My other experience with Depression was with my son, Brandon.  Brandon is currently being home schooled & loving it. In public school, however, he was a very unhappy person.  He suffered with failing grades, ridicule from his peers, had very low self-esteem, and he hated attending school.  He was truly a nervous-wreck. 

            When he was 10 years old, Brandon came home from school after having one of many bad days in a row. He had been yelled at by his teacher, called names by his peers, and then he came home to deal with us after having failed another test grade. That day, however, broke the camel’s back, so to speak.  After saying to me that he was going to kill himself, that this would make everyone happy & everyone would finally leave him alone, he went into his room & locked the door.  It took my husband & I a good while to get that door open. When we did, I found him crying on his bed & saying he really wanted to do it, but couldn’t.  Later that evening, I found a belt & a kitchen knife underneath his bed covers. From that point on, I knew things had to change around our household. I vowed to God that night that Brandon was never going to walk in my father’s footsteps.   

            It took us a good six weeks at the Saluda center in Rock Hill to convince him that his life was worth living. Glenforest School in Columbia also helped improve his self image too.  After many months, he finally realized that he did have a purpose in life.  

Little did I know at the time, some of that purpose was helping me start our POPS support group.

As they say, little blessings always come in HUGE packages. 

I hope our educational topic for this month was helpful to you and your family.  If you find yourself depressed or if you have a family member who seems depressed,

Please get help. 

It’s never too late to realize how SPECIAL & BLESSED you are.  You do have a purpose in life! That purpose could be to change the world one blessing at a time.

Our Educational Topic for this month is O.D.D..

Have you ever wondered what O.D.D stands for?

Has your child or family member been diagnosed with ODD?

 Have you ever even heard of this term before?

O.D.D. stands for

Oppositional Defiant Disorder 

About the Disorder: 

Oppositional Defiant Disorder is a persistent pattern (lasting for at least six months) of negativistic, hostile, disobedient, and defiant behavior in a child or adolescent without serious violation of the basic rights of others. 

Children or adolescents with oppositional defiant disorder (ODD) seem angry much of the time. They are quick to blame others for mistakes and act in negative, hostile, and vindictive ways. All children & adolescents exhibit these behaviors at times, but in those with ODD, these behaviors occur more frequently. Children & adolescents with ODD generally have poor peer relationships. They often display behaviors that alienate them from their peers. In addition, they may have an unusual response to positive reinforcement or feedback. For instance, when given some type of praise they may respond by destroying or sabotaging the project that they were given recognition for. 

Some children or adolescents develop ODD as a result of stress and frustration from divorce, death, loss of family, or family disharmony. ODD may also be a way of dealing with depression or the result of inconsistent rules and behavior standards. 

If not recognized and corrected early, oppositional and defiant behavior can become ingrained. Other mental health disorders may, when untreated, lead to ODD. For example, a student with AD/HD may exhibit signs of ODD due to the experience of constant failure at home and school.  

Symptoms & Behaviors:

Symptoms of this disorder may include the following behaviors when they occur more often than normal for a child or adolescents age group:

*  Losing one’s temper

*  Arguing with adults

*  Defying adults or refusing adult requests or rules

*  Deliberately annoying others

*  Blaming others for their own mistakes or misbehavior

*  Being touchy or easily annoyed

*  Swearing or using obscene language

*  Having a low opinion of oneself

*  Sudden unprovoked anger

*  Arguing with adults

*  Being resentful and angry

The person with Oppositional Defiant Disorder is moody and easily frustrated, has a low self-esteem of him or herself, and may abuse drugs. 

Instructional Strategies and Classroom Accommodations that may help:

*  Remember that students with ODD tend to create power struggles. Try to avoid these verbal exchanges. State your position clearly and concisely.

*  Give 2 choices when decisions are needed. State them briefly and clearly.

*  Post the daily schedule so students know what to expect.

*  Praise students when they respond positively.

*  Make sure academic work is at the appropriate level. When work is too hard, students become frustrated. When it is too easy, they become bored. Both reactions lead to problems in the classroom.

*  Pace instruction. When students with ODD have completed a designated amount of a non-preferred activity, reinforce their cooperation by allowing them to do something they prefer or find more enjoyable or less difficult.

*  Systematically teach social skills, including anger management, conflict resolution strategies, and how to be assertive in an appropriate manner. Discuss strategies that        students may use to calm themselves when they feel their anger escalating. Do this when students are calm.

*  Provide consistency, structure, and clear consequences for the student’s behavior.

*  Select material that encourages student interaction. Students with ODD need to learn to talk to their peers and to adults in an appropriate manner. However, all cooperative learning activities must be carefully structured.

*  Maximize the performance of low-performing students through the use of  individualized instruction, cues, prompting, the breaking down of academic tasks, debriefing, coaching, and providing positive incentives.

*  Allow students to redo assignments to improve their score or final grade.

*  Structure activities so the student with ODD is not always left out or is the last one picked. 

The Cause:

The cause of Oppositional Defiant Disorder is unknown at this time. The following are some of the theories being investigated:

1. It may be related to the child's temperament and the family's response to that temperament.

2. Oppositional Defiant Disorder is inherited in some families.

3. There may be neurological causes.

4. It may be caused by a chemical imbalance in the brain. 

Treatment:

Treatment of Oppositional Defiant Disorder usually consists of group, individual and/or family therapy and education, providing a consistent daily schedule, support, limit- setting, discipline, consistent rules, having a healthy role model to look up to, training in how to get along with others, behavior modification, and sometimes residential or day treatment and/or medication. 

I hope our educational topic for this month was helpful to you and your family.  If you need more information about ODD, please contact http://www.nimh.nih.gov/  or  http://www.mentalhealth.samhsa.gov/ or call 1-866-615-6464 or 1-800-789-2647.  

Our Educational Topic for this month is about

Autism.

Have you ever wondered what it is like to have Autism?

Do you have a family member that has been diagnosed with having Autism?

Have you ever even heard of this term?

Autism 

About this disorder:

Autism is a disorder that can affect the way a child behaves, thinks, communicates, and interacts with others. Kids with autism are affected in different ways. Some have only mild symptoms and grow up to live independently, while others have more severe symptoms and need supported living and working environments throughout their lives.

Autism affects up to one in every 150 school-age children, which translates to about 560,000 kids, according to the U.S. Centers for Disease Control and Prevention (CDC). It's more common in boys than girls, and is usually diagnosed when a child is between 15 and 36 months old, although signs of the disorder can show up earlier.

While there is no cure for autism, and researchers are unsure of its cause, a variety of therapies and resources are available to help kids with autism and their families.

Autism tends to run in families, so experts think it may be something that you inherit. Scientists are trying to find out exactly which genes may be responsible for passing down autism in families.

Other studies are looking at whether autism can be caused by other medical problems or by something in your child’s surroundings.

Some people think that childhood vaccines cause autism, especially the measles-mumps-rubella, or MMR, vaccine. But studies have not shown this to be true.

Signs of Autism:

There are three distinctive behaviors that characterize autism.  Children with Autism have difficulties with social interaction, problems with verbal and nonverbal communication, and repetitive behaviors or narrow, obsessive interests.  These behaviors can range in impact from mild to disabling.

The hallmark feature of autism is impaired social interaction.  Parents are usually the first to notice symptoms of autism in their child.  As early as infancy, a baby with autism may be unresponsive to people or focus intently on one item to the exclusion of others for long periods of time.  A child with autism may appear to develop normally and then withdraw and become indifferent to social engagement. 

Children with autism may fail to respond to their name and often avoid eye contact with other people.  They have difficulty interpreting what others are thinking or feeling because they can’t understand social cues, such as tone of voice or facial expressions, and don’t watch other people’s faces for clues about appropriate behavior.  They lack empathy. 

Many children with autism engage in repetitive movements such as rocking and twirling, or in self-abusive behavior such as biting or head-banging.  They also tend to start speaking later than other children and may refer to themselves by name instead of “I” or “me.”  Children with autism don’t know how to play interactively with other children.  Some speak in a sing-song voice about a narrow range of favorite topics, with little regard for the interests of the person to whom they are speaking. 

Many children with autism have a reduced sensitivity to pain, but are abnormally sensitive to sound, touch, or other sensory stimulation.  These unusual reactions may contribute to behavioral symptoms such as a resistance to being cuddled or hugged.   

Children with autism appear to have a higher than normal risk for certain co-existing conditions, including fragile X syndrome (which causes mental retardation), tuberous sclerosis (in which tumors grow on the brain), epileptic seizures, Tourette syndrome, learning disabilities, and attention deficit disorder.  For reasons that are still unclear, about 20 to 30 percent of children with autism develop epilepsy by the time they reach adulthood.  While people with schizophrenia may show some autistic-like behavior, their symptoms usually do not appear until the late teens or early adulthood.  Most people with schizophrenia also have hallucinations and delusions, which are not found in autism.

Treatment Options:

There is no cure for autism.  Therapies and behavioral interventions are designed to remedy specific symptoms and can bring about substantial improvement.  The ideal treatment plan coordinates therapies and interventions that target the core symptoms of autism:  impaired social interaction, problems with verbal and nonverbal communication, and obsessive or repetitive routines and interests.  Most professionals agree that the earlier the intervention, the better.

Educational/behavioral interventions: 

Therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills.  Family counseling for the parents and siblings of children with autism often helps families cope with the particular challenges of living with an autistic child.   

Medications: 

Doctors often prescribe an antidepressant medication to handle symptoms of anxiety, depression, or obsessive-compulsive disorder.  Anti-psychotic medications are used to treat severe behavioral problems.  Seizures can be treated with one or more of the anticonvulsant drugs.  Stimulant drugs, such as those used for children with attention deficit disorder (ADD), are sometimes used effectively to help decrease impulsivity and hyperactivity.

Other therapies: 

There are a number of controversial therapies or interventions available for autistic children, but few, if any, are supported by scientific studies. Parents should use caution before adopting any of these treatments

Parents of a child with autism are often desperate to get help. Although the most widely accepted treatment is an early intervention program and ongoing therapy, there are also other alternative treatments that are considered controversial.

In facilitated communication (FC), a "facilitator" supports the hand, arm, or shoulder of the person with a communication disorder and assists him or her in extending a finger to either point to or press the keys of a computer keyboard or a communication picture board. Supporters say that FC communicates the thoughts of a person otherwise unable to "speak." However, critics say that it's the facilitator communicating, not the person with the disability.

The hormone secretin has gotten recent attention as a breakthrough treatment for autism. Its only current FDA-approved use is in the diagnosis of gastrointestinal problems, but researchers and physicians are studying the possible link to improved communication and social interactions in children who have received injections of secretin. The Autism Society of America urges families to conduct thorough research before asking a doctor to prescribe secretin for their child. Large-scale studies have yet to endorse the initial findings, so caution is urged.

Some parents who have been frustrated by conventional therapies have turned to other controversial treatments, such as swimming with dolphins, neurofeedback, music therapy, social-skills therapy, gluten-free and dairy-free diets, vitamins, anti-anxiety pills, steroids, and eliminating toxins from the home.

Some parents also have used the Hyperbaric Chambers to help.. More information about the Hyperbaric Chamber is on this website, please see our Forum & check out our POPS videos for more information.

For more information & resources to help:

You can also contact the South Carolina Autism Society ♦ 806 12th Street ♦ West Columbia, South Carolina 29169 ♦ 803-750-6988 Also at: http://www.scautism.org/  

I hope our educational topic for this month was helpful to you and your family.  If you want to learn more about Autism, please visit or contact any of the following websites or come to our support group to learn more. http://www.kidshealth.org/parent/medical/brain/autism.html http://www.webmd.com/brain/autism/autism-topic-overview

http://www.ninds.nih.gov/disorders/autism/detail_autism.htm 

Our Educational Topic for this month is about

CHARGE Syndrome.

Have you ever wondered what CHARGE Syndrome is?

Has someone in your family been diagnosed with having CHARGE Syndrome?

Have you ever even heard of this before? 

CHARGE Syndrome 101 

What is CHARGE Syndrome? 

http://www.chargesyndrome.org/

http://www.deafed.net/

Our Educational Topic for this month is about

Learning Styles.

Have you ever wondered what your learning style is?

Do you consider yourself a Visual learner, an Auditory learner or a Kinesthetic learner?

Have you ever even heard of these terms?

Learning Styles 101

What is a learning style?

My own experience with learning styles with my son:

            As most of you know, Brandon & I have been home schooling for almost 4 years now.  When we first started, Brandon & I had to figure out which way he learns best.  We had to figure out which learning style did Brandon have & how in the world was I going to teach him in a way that he could learn & retain the information being taught. 

After sitting down & discussing this with Brandon, we both wrote out several ways of how Brandon retains information.  Our list consisted of things like:

Ÿ  I can learn better by listening to my words as I read them out loud

Ÿ  I can better remember spelling words by walking & saying, instead of writing them over & over on paper

Ÿ  I can do math better by using a calculator & seeing how my numbers relate to each other

Ÿ  I can remember important information by highlighting them in my book and going back and studying them later

After talking for several hours about how he learns best, then we both got down to business & began to figure out which ways might be best in teaching him. This is when we first discovered Assistive Technology.  As most of you know, we discovered “Kurzweil”.  The best scan & read program on the market.  This little tool has helped bring Brandon’s reading comprehensive skills up tremendously.  I would scan into the computer his reading pages in his textbook & it highlights each word as it reads it to him.  This way he is seeing, hearing, & feeling all in one.  This helps with visual, auditory, & kinesthetic learning.

Not only did we discover Assistive Technology, but we also discovered that Brandon needed to do physical activities while learning in order to retain information too. This meant going out to buy an exercise ball, a treadmill, & exercise equipment to bounce on while doing his vocabulary words, to walk on while saying his spelling words, & to work with while learning different topics about his body in science.

We also discovered that he needed to take breaks frequently, especially while doing math. He would get so frustrated so easily doing math problems, so he needed to take small breaks in between his math lessons to gather up his thoughts & regroup in order to better understand the task at hand.

Once we both understood exactly how he learned & what ways he learned, then the easy part was teaching him in the way he needed to be taught.  Brandon is a visual, an auditory, & a kinesthetic learner all in one. After finding all this out, this made my job a lot easier at being his teacher. 

Brandon has certainly come along way in almost 4 years. 

Actually, we both have.   LOL!

I hope our educational topic for this month was helpful to you and your family.  If you would like more info on the various learning styles, please visit the websites of http://vudat.msu.edu/learning_styles/, http://www.upsidedownschoolroom.com/learningstyles.shtml, http://www.chaminade.org/inspire/learnstl.htm

Our Educational Topic for this month is

about

Holoprosencephaly.

Have you ever wondered what Holoprosencephaly is?

Has your child or family member been diagnosed with Holoprosencephaly?

             Holoprosencephaly 101                

Holoprosencephaly:

Holoprosencephaly (HPE) is a birth defect that occurs during the first few weeks of intrauterine life. HPE is a disorder in which the fetal brain does not grow forward and divide as it is supposed to during early pregnancy (incomplete cleavage of the embryonic forebrain/failure of the prosencephalon to cleave into the cerebral and lateral hemispheres).

Children diagnosed with HPE may have a small head (microcephaly), excessive fluid in the brain (hydrocephalus), variable degrees of mental retardation, epilepsy, endocrine abnormalities, or abnormalities of other organ systems such as cardiac, skeletal, genitourinary, and gastrointestinal. Mildly affected children may exhibit few symptoms and may live a normal life.

Facial deformities are often present in many children diagnosed with HPE. Mild forms of facial abnormalities may include a flat single-nostril nose (cebocephaly), close set eyes (hypotelorism), cleft lip and/or palate, or just one upper middle tooth (single maxillary central incisor). More severe facial deformities may include a single central eye (cyclopia), a nose located on the forehead (proboscis), or missing facial features.

What are the possible types of Holoprosencephaly?

This brain malformation can range from mild to severe and is classified into four types:

(1) Alobar (severe)--where the brain is not divided and there are severe abnormalities (there is an absence of the interhemispheric fissure, a single primitive ventricle, fused thalami, and absent third ventricle, olfactory bulbs and tracts and optic tracts).

(2) Semi-Lobar (moderate)--where the brain is partially divided and there are some moderate abnormalities; where there are two hemispheres in the rear but not the front of the brain (there are partially separated cerebral hemispheres and a single ventricular cavity).

(3) Lobar (mild)--where the brain is divided and there are some mild abnormalities (there is a well developed interhemispheric fissure however there is some fusion of structures).

(4) Middle Interhemispheric Variant (MIHV) -- where the middle of the brain (posterior frontal and parietal lobes) are not well separated. 

What causes Holoprosencephaly?

The cause of Holoprosencephaly (HPE) is currently unknown. Often, no specific cause can be identified. Suggested risk factors include maternal diabetes, infections during pregnancy (syphilis, toxoplasmosis, rubella, herpes, cytomegalovirus), and various drugs taken during pregnancy (alcohol, aspirin, lithium, thorazine, anticonvulsants, hormones, retinoic acid). Women with previous pregnancy loss and first trimester bleeding are also more likely to have a child diagnosed with Holoprosencephaly.

Although many children with Holoprosencephaly have normal chromosomes, specific chromosomal abnormalities have been identified in some patients. There is evidence that in some families, HPE is inherited (autosomal dominant as well as autosomal or X-linked recessive inheritance). Features consistent with familial transmission of the disease (e.g., a single central maxillary incisor) should be carefully assessed in parents and family members.

Several genes have been identified that play a role in Holoprosencephaly, specifically sonic hedgehog, ZIC2, TGIF, and SIX3.

PREVENTION

Because the cause of holoprosencephaly (HPE) is poorly understood, there is no known method of prevention for the disorder.

Infants born to diabetic mothers may have an increased risk of having HPE. Diabetic mothers can help reduce their risks of having children with birth defects and congenital disorders, such as HPE, by strictly controlling their blood sugar levels. Therefore, expectant mothers with diabetes are encouraged to choose doctors with expertise in diabetes care. This helps ensure that the pregnant mother and the fetus obtain the best possible care before and during pregnancy.

Infants born to mothers who have infections, such as herpes, syphilis, cytomegalovirus, rubella, and toxoplasmosis, may have an increased risk of developing HPE. Therefore, pregnant mothers who have symptoms of infections should seek prompt medical treatment.

All of the information for this educational topic came from these websites http://www.holoprosencephaly.net/Holoprosencephaly  &

http://www.genome.gov/  & http://www.stanford.edu/group/hpe/about/  

& http://www.wellness.com

If you want more information about the Hyperbaric Oxygen Chamber

Treatments, Please go to www.hboinfo.com/ncarolina.htm   for more information.

I hope our educational topic for this month was helpful to you and your family. 

For more information about Holoprosencephaly, please contact the above websites & information.   You may also contact your child’s doctor.

Our Educational Topic for this month

 is

about

Becoming an Advocate.

Have you ever wondered what its like to be an Advocate?

Do you consider yourself an Advocate for your child?

Have you ever even heard of this term?

Advocacy 101

Why Advocate?

Good special education services are intensive and expensive. Resources are limited. If you have a child with special needs, you may wind up battling the school district for the services your child needs. To prevail, you need information, skills, and tools.

Who can be an advocate? Anyone can advocate for another person. Here is how the dictionary defines the term “advocate“:

Ad-vo-cate – Verb, transitive. To speak, plead or argue in favor of.
Synonym is support.

1. One that argues for a cause; a supporter or defender; an advocate of civil rights.
2. One that pleads in another’s behalf; an intercessor; advocates for abused children and spouses.
3. A lawyer. (The American Heritage Dictionary of the English Language, Third Edition)

An advocate performs several functions: 

Ÿ  Supports, helps, assists, and aids

Ÿ  Speaks and pleads on behalf of others

* Depends and argues for people or causes

 Different Types of Advocates

Special education advocates work to improve the lives of children with disabilities and their families. You are likely to meet different types of advocates.

Ÿ  Lay Advocates

Lay advocates use specialized knowledge and expertise to help parents resolve problems with schools. When lay advocates attend meetings, write letters, and negotiate for services, they are acting on the child’s behalf. Most lay advocates are knowledgeable about legal rights and responsibilities. In some states, lay advocates represent parents in special education due process hearings.

 Ÿ  Educational Advocates

Educational advocates evaluate children with disabilities and make recommendations about services, supports and special education programs. When educational advocates go to eligibility and IEP meetings, they are acting on the child’s behalf. Some educational advocates negotiate for services. Others are less knowledgeable about special education law and how to use tactics and strategies.

Ÿ  School Personnel

Teachers and special education providers often see themselves as advocates. Teachers, administrators, and school staff often provide support to children and their families. But because they are employed by school districts, school personnel are limited in their ability to advocate for children with disabilities without endangering their jobs.

Ÿ  Parents

Parents are natural advocates for their children. Who is your child’s first teacher? You are. Who is your child’s most important role model? You are. Who is responsible for your child’s welfare? You are. Who has your child’s best interests at heart? You do.  You know your child better than anyone else. The school is involved with your child for a few years. You are involved with your child for life. You should play an active role in planning your child’s education.  The law gives you the power to make educational decisions for your child. Do not be afraid to use your power. Use it wisely. A good education is the most important gift you can give to your child.

What Advocates Do

Advocacy is not a mysterious process. Here is a quick overview of advocacy skills.

Ÿ  Gather Information

Advocates gather facts and information. As they gather information and organize documents, they learn about the child’s disability and educational history. Advocates use facts and independent documentation to resolve disagreements and disputes with the school.

Ÿ  Learn the Rules of the Game

Advocates educate themselves about their local school district. They know how decisions are made and by whom.  Advocates know about legal rights. They know that a child with a disability is entitled to an “appropriate” education, not the “best” education, nor an education that “maximizes the child’s potential.” They understand that “best” is a four-letter word that cannot be used by parents or advocates.   Advocates know the procedures that parents must follow to protect their rights and the child’s rights.

Ÿ  Plan and Prepare

Advocates know that planning prevents problems. Advocates do not expect school personnel to tell them about rights and responsibilities. Advocates read special education laws, regulations, and cases to get answers to their questions.  Advocates learn how to use test scores to monitor a child’s progress in special education.   They prepare for meetings, create agendas, write objectives, and use meeting worksheets and follow-up letters to clarify problems and nail down agreements.

Ÿ  Keep Written Records

Because documents are often the keys to success, advocates keep written records. They know that if a statement is not written down, it was not said. They make requests in writing and write polite follow-up letters to document events, discussions, and meetings.

Ÿ  Ask Questions, Listen to Answers

Advocates are not afraid to ask questions. When they ask questions, they listen carefully to answers. Advocates know how to use “Who, What, Why, Where, When, How, and Explain Questions” (5 Ws + H + E) to discover the true reasons for positions.

Ÿ  Identify Problems

Advocates learn to define and describe problems from all angles. They use their knowledge of interests, fears, and positions to develop strategies. Advocates are problem solvers. They do not waste valuable time and energy looking for people to blame.

Ÿ  Propose Solutions

Advocates know that parents negotiate with schools for special education services. As negotiators, advocates discuss issues and make offers or proposals. They seek “win-win” solutions that will satisfy the interests of parents and schools.

Being an advocate for others

The best way to become a good advocate for your child is to do what you would do if you wanted to catch the flu. Expose yourself to as many opportunities to advocate as possible.

Ask other parents if they would like to have a friendly face at their IEP team meeting. Assure them that you don't know enough to go with them as an advocate, but you will be there to support them and reassure them.

When you go to IEP meetings as a friend, you can be more detached and less involved emotionally. You can better observe the personalities and the games that are being played. You can see what some people do to push the parents' "buttons."

You will become more aware of meeting dynamics and what is going on because you do NOT have the same emotional attachment that you do when you go to your own child's IEP meetings.

You will find you can put this knowledge and information to good use when you go to your child's IEP meetings. You will be prepared for the games that are played and you will know and understand the personalities you are dealing with.

Finally, you are likely to find that advocating for other children is much easier than advocating for your child. You will be motivated to become a real advocate.

When you advocate for other children, you will continue to make progress on the advocacy learning curve. When you do attend your child's IEP meetings, you will be less emotional and more detached.

You will be surprised at how many parents would LOVE to have just one friendly face at their IEP meetings. You may discover that you LOVE learning how to advocate for other children.

Then, we all will benefit.

If you need more information about being an advocate, please visit the Wrightslaw website, this is where most of this information came from at www.wrightslaw.com . Or you can read Pete Wright’s books called From Emotions to Advocacy & Special Education Law.  There are really some great articles on the Wrightslaw website, one in particular that I included in this educational topic was, “How to Hone Your Advocacy Skills and Help Other Parents “by Pat Howey

I hope our educational topic for this month was helpful to you and your family.  If you want to become an advocate or want to learn more about advocacy, Please contact ProParents at 1-800-759-4776 or email them at PROParents@proparents.org or

P & A-Protection & Advocacy at 1-866-232-4525 or email them at info@protectionandadvocacy-sc.org