"I am looking for suggestions on what would be appropriate and positive 'consequences' for my 6 year old, first grade ADHD son if he gets a color change at school instead of taking away recess time? I am also in need of suggestions on how to handle/redirect his excessive and disruptive talking in the classroom." -About.com Forum member
Photo © Vicky Kasala
Alternatives to Losing Recess... originally appeared on About.com ADD / ADHD on Monday, January 31st, 2011 at 14:02:07.
UPDATE: I just learned that most of the responses to this poll come from just one blog: Pharyngula, created by PZ Myers. So no, the responses are NOT the work of a bot, but rather the combined efforts of an actual group of humans! At the same time, since numbers on the other side of the poll are also rising, I assume that others in the blogosphere are getting involved. I'm certainly looking forward to seeing the Colbert Report tonight! Lisa Jo
Dr. Paul Offit is an immunologist whose books, articles and media appearances have placed him at the center of the autism-vaccine controversy. Offit has argued for years that vaccines have no relationship to the rise in autism spectrum diagnoses, and his point of view has earned him avid supporters as well as death threats. On Monday night, he will appear on Stephen Colbert's tongue-in-cheek "news" comedy, The Colbert Report to speak about his new book, "Deadly Choices: How The Anti-Vaccine Movement Threatens Us All". The show will air on Comedy Central, January 31st at 11:30 EST (the interview will take place toward the end of the program).
Should be an interesting show.
NOTE: Comments are turned off; please vote in the poll.
Dr. Paul Offit to Appear on Stephen Colbert's "Colbert Report" originally appeared on About.com Autism on Sunday, January 30th, 2011 at 12:18:57.
SOURCE: AOL Health
A new report from the Department of Health and Human Services, Office of the Inspector General reveals that 13 percent of Medicare patients in the U.S. experience an adverse event each month in American hospitals, and some 15,000 of them die as a result. [1]
The news is startling, particularly since the report points out that 44 percent of adverse incidents occurring in hospitals are avoidable. And all-together, these adverse events are costing Medicare more than $300 million a MONTH.
Kevin K. Golladay, regional inspector general for evaluation and inspections with OIG thinks hospitals need to have greater incentives to reduce errors and adverse events, and the OIG report suggests that the Centers for Medicare & Medicaid Services could perhaps create this incentive by denying payment for conditions acquired while in the hospital setting.
Editorial Comment:
I say bravo to that idea! If that doesn’t get their attention, nothing will.
The unfortunate truth is that Medicare balks at the prospect of paying chiropractors for all the services they are trained (and licensed) to provide, because the Demo project raised costs by almost 100 million in a YEAR.
A close inspection of the financial outlays during the Demo period suggest that, while visits to PTs declined (as expected), PTs merely cranked up their charges to re-capture their shortfall, and that’s why there was an increase in overall cost.
Considering that they blithely ignore this $300 million a MONTH price tag from injuring patients (or 3.6 Billion per year), if seems rather disingenuous that they decline providing full chiropractic care to Medicare patients because of the 100 million a YEAR (much of which was pocketed by PTs).
That’s only 0.027% of the money they currently waste on hospital accidents.
Even more terrifying, Kevin K. Golladay, the regional Inspector General for evaluation and inspections with OIG, told AOL Health that the Medicare population doesn’t experience anymore adverse effects in hospital settings than the general population. That means that percentage-wise, many more people, who have regular insurance, are also dying from these same mistakes.
According to the most in-depth review article written on the topic, the total number of deaths caused by conventional medicine is an astounding 783,936 per year, at a cost of $282 billion dollars. [2]
God help us all.
REFERENCES:
1. Adverse Events in Hospitals: National Incidence Among Medicare Beneficiaries
Department of Health and Human Services
Office of the Inspector General
2. Death By Medicine
LE Magazine ~ March 2004
In the last few days, I've been surprised by responses to my blogs about community inclusion and autism. While I assumed everyone would be behind the idea of community inclusion for kids, teens and adults with autism, it seems my assumptions were incorrect. Many commenters responded that they were quite happy with autism-only programs that offer no opportunity for transition into more general programs. Others said that inclusion was really only possible or important for high functioning individuals.
While I am always glad to see programs developed for people with autism, my frustration is that such programs are generally of short duration (come in for a special "autism event") or limited by age (a program for children with autism ages 6-9). Very often, too, these programs are a great introduction to a venue or activity - but they offer no opportunity for next steps. What happens when your child with autism does well in the "special" music program, but there's no opportunity to grow in the world of music? What if your family attends "special" evenings at the museum, but the museum makes no attempt to train staff who run regular programs or workshops?
Very often, people with autism have significant gifts and talents that are best expressed outside of the school setting. They sing, play an instrument, excel in Lego building or have a talent for swimming. If they're limited to autism-only venues, those talents, it seems to me, have little chance to grow. The opportunities, relationships, repect and self-esteem that could come from exercising and building talents evaporates. To me, this seems like a big deal - but perhaps I'm in a very small minority!
To find out more about how people feel about community inclusion, I've created a poll (below). For purposes of the poll, I'm defining "community inclusion" as "involvement of children, teens, adults and/or families with autism in typical community programs or venues of any sort." That would include church, sports, theater, music, and everything in between.
More About Autism and Community Inclusion
Does Community Inclusion Matter? originally appeared on About.com Autism on Thursday, January 27th, 2011 at 13:24:54.
For parents, caregivers, and teachers of children with ADHD - What are your thoughts about using loss of recess time as a consequence for misbehavior in the classroom? Feel free to share personal experiences your child has had with losing recess.
CLICK HERE TO SHARE or READ RESPONSES
Should a Child With ADHD Lose Recess Time? Why or Why Not? originally appeared on About.com ADD / ADHD on Thursday, January 27th, 2011 at 09:22:31.
This new, single blinded placebo controlled study, conducted by the Faculty of Medicine at Mansoura University, conclusively demonstrates that maintenance care provides significant benefits for those with chronic low back pain.
BACKGROUND: Spinal manipulation (SMT) is a common treatment option for low back pain. Numerous clinical trials have attempted to evaluate its effectiveness for different subgroups of acute and chronic LBP previously, but the efficacy of maintenance SMT in chronic non-specific LBP has never been studied.
In this study, 60 patients with chronic, nonspecific LBP lasting at least 6 months were randomized into 3 groups:
1. One third of them received 12 treatments of sham SMT over a one-month period.
2. One third of them received 12 treatments of SMT during a one-month period, with no follow-up care during the next nine months, and
3. One third of them received 12 SMT visits during the first month, followed by “maintenance” SMT every two weeks, for the next nine months.
To determine any difference among these 3 care groups, researchers measured pain and disability scores, generic health status, and back-specific patient satisfaction at baseline, and at 1-month, 4-months, 7-months, and at 10-months
RESULTS: Patients in manipulative groups (groups 2 & 3) experienced significantly lower pain and disability scores than the sham group at the end of the first 1-month period.
At the 10-month follow-up, only the maintenance group maintained improvements in pain and disability, while the group that only received 1-months care had reverted to their pretreatment pain and disability levels.
CONCLUSIONS: This is the first medically managed trial that clearly demonstrates that maintenance care provides significant benefits to those who suffer from chronic low back pain.
This study re-confirms Descarreaux’s virtually identical 2004 JMPT study, which concluded that “This experiment suggests that maintenance spinal manipulations after intensive manipulative care may be beneficial to patients to maintain subjective post-intensive treatment disability levels”.
It also confirms the findings of Dr. Ron L. Rupert, in his ground-breaking JMPT article, titled:
Maintenance Care: Health Promotion Services Administered to US Chiropractic Patients Aged 65 and Older, Part II which found that:
“The cost of health care for patients receiving MC in this study was far less than that for patients of similar age in the general population, despite the doubling of physician visits (medical plus chiropractic). The greatest difference in health care costs with patients receiving MC was in the areas of nursing care and, especially, hospital care. This reduced need for hospital and nursing home services has recently been corroborated by the research of Coulter et al..” [22]
You may also want to review the Wellness and Chiropractic Page for more information on this topic.
SOURCE: Does Maintained Spinal Manipulation Therapy for Chronic Non-specific Low Back Pain Result in Better Long Term Outcome?
Spine (Phila Pa 1976). 2011 Jan 17. [Epub ahead of print]
"Your child has an autism spectrum disorder."
Yes, it's scary - but what exactly does it MEAN? Is it a life sentence or a challenge to overcome? What are the chances of a cure?
The answers, frustratingly, are always the same: "We really don't know."
While early intervention with intensive behavioral and/or developmental therapy is certainly a good thing, it doesn't guarantee any particular outcome. Higher functioning children do better overall - but not always. Alternative therapies such as special diets can be helpful sometimes, for some children - but not for all.
The good news, however, is that many children who are at one point diagnosed with an autism spectrum disorder do improve to the point where they lose the diagnosis. And many, many adults with autism discover and develop impressive talents, abilities and skills.
Find out more about autism and outcomes:
Autism: What's the Prognosis? originally appeared on About.com Autism on Wednesday, January 26th, 2011 at 09:04:23.
Recess and Students with ADHD originally appeared on About.com ADD / ADHD on Tuesday, January 25th, 2011 at 11:12:54.
David Giwerc provided input for the recent "What is ADHD Coaching?" article. Gerwic, a longtime advocate, educator and professional in the field of ADHD, is founder and president of the ADD Coach Academy. Recently, the ADD Coach Academy became the first and only comprehensive ADHD coach training program to be fully accredited by the International Coach Federation (ICF). The ICF has very rigorous training and testing criteria to establish credibility and confidence in the consistent quality of its certified coaches. I just wanted to publicly congratulate David and the ADD Coach Academy.
Read More About the ICF Accreditation
ADHD Coach Training Program Receives Coveted Accreditation originally appeared on About.com ADD / ADHD on Tuesday, January 25th, 2011 at 10:07:31.
ADHD can make dealing with the challenges of everyday life rather frustrating. It can be hard to get and remain organized, manage time, stay on task, and sustain motivation toward goals. ADHD coaches help their clients address these and similar practical matters.
Photo © Stockbyte
What is ADHD Coaching? originally appeared on About.com ADD / ADHD on Tuesday, January 25th, 2011 at 10:04:49.
SOURCE: ChiroACCESS ~ January 21, 2011
Dr. Cheryl Hawk [*] invites all DCs to participate in a new practice-based research program:
ICON — The Integrated Chiropractic Outcomes Network.
It is open to any licensed chiropractic practitioner, and eventually we hope to include other professions as well. ICON will focus on prevention and health promotion, and I hope we may be able, at some point, to gather data on chiropractic maintenance/wellness care.
The U.S. Agency for Healthcare Research and Quality (AHRQ) defines a Practice-Based Research Network (PBRN) as a group of clinicians and practices working together in ambulatory care to answer community-based health care questions and translate research findings into practice.
PBRNs address research questions that require a real-world setting to be answered. Ambulatory care settings, partnering with academic institutions, form the “laboratory” in which these research questions are pursued.
Attached is a letter of invitation with more information, and an interest form. If you would like to participate, please complete and return the interest form to Cheryl at cheryl.hawk@logan.edu
If you know other doctors who might be interested, please let me know, or forward this information to them.
Please download these 2 important documents:
1. The Invitation to ICON: Integrated Chiropractic Outcomes Network
2. Your Application for Participation
Read ChiroACCESS’ Full Announcement
* Cheryl Hawk, DC, PhD, CHES, program director — Logan College of Chiropractic
These days, there are quite a few community program available for children, teens and families with autism. Most are not true "inclusion" programs; they are, instead, "autism only" programs intended to provide entry-level access to everything from sports to art to movie theaters.
Many families take advantage of these programs, and quite a few really do a good job of making something inaccessible (loud movies, for example) more accessible. A family that attends a movie during an "autism" night may have the sound turned down low, and they're likely to be interrupted a bit as kids jump up and down. But they really are partaking in the same movie-going experience as everyone else.
All too often, though, community programs for people with autism are simply dead ends. They don't provide a stepping stone or scaffolding to help the child, teen or family with autism build the skills to join the general community. Families can take part in these special programs, or not. But there's no support for or interest in taking the next step - or even in creating programs to support families with older or adult children on the autism spectrum.
I just got off the phone with a representative of a music education program for children with autism - a wonderful idea, in theory. She seemed offended, however, when I asked whether autistic music students perform at recitals with typical music students. She seemed very uncomfortable with the thought that her instructors might facilitate inclusion of autistic music students in typical school bands. Every aspect of the music program is, apparently, hermetically sealed off from the rest of the world.
I've seen many sports programs available only to young children with autism. These programs, run by well-meaning adults, are specifically geared to teaching social skills rather than sports skills. There's no interaction between the "special" and the "typical" youth sports directors. As a result, when the children age out of such programs they're no more able to play a typical sport than they were before they started. And now, as they begin to enter their teen years, they have no place to go.
Of course, every program and opportunity for the autism community is more than we had before. But I'm getting to the point where I'm no longer grateful "just to be allowed in the door."
If community members are willing to make the effort to provide programs for kids with autism, I'm thrilled. But what is the point of such programs if they simply become dead ends?
Dead End Programs for Children with Autism originally appeared on About.com Autism on Monday, January 24th, 2011 at 17:12:34.
Last year, HBO released a really fine "biopic" entitled Temple Grandin. Temple Grandin, for those who don't know, is a staple of the autism world. Rather severely autistic as a youngster, Grandin - with the help of f riends and family - managed her challenge and built on her extraordinary abilities to earn a Ph.D,, become an internationally beloved speaker and author, and create a name for herself as an agricultural innovator.
HBO did a terrific job with Temple Grandin, due in large part to the fact that the writers and actors worked closely with Grandin herself. Grandin say she "thinks in pictures," and unique production techniques allow us to see just what she means by this. And beautiful Claire Danes proved her acting ability by literally becoming a woman for whom beauty and feminine allure are essentially irrelevant.
Danes earned a Golden Globe for her work in the film, and Temple Grandin joined her on the red carpet. Appropriately, Grandin came in her version of evening wear: black jeans and a western top with fancy embroidery. Said Grandin during her interview with USA Today: "Western is how I dress... I would be too out of character if I wore an evening gown."
Claire Dane's Golden Globe Boosts Sales of HBO's "Temple Grandin" originally appeared on About.com Autism on Friday, January 21st, 2011 at 13:53:26.
January 13, 2011 — The US Food and Drug Administration (FDA) today announced that it is asking drug makers to limit the amount of acetaminophen in prescription combination pain relievers to no more than 325 mg per tablet or capsule to reduce overdoses and the severe liver injury that can follow.
The decision, to be phased in over 3 years, affects dozens of prescription analgesics that contain both acetaminophen and another ingredient, typically opioids such as codeine, oxycodone, and hydrocodone. Some of these combination products now have as much as 750 mg of acetaminophen per dose.
The new dose restriction does not apply to numerous over-the-counter (OTC) pain relievers and cold, sinus, and cough medicines that contain acetaminophen. Normally, the maximum level allowed for these products is 500 mg, although a few extended-action pain relievers that are taken less frequently can go up to 650 mg.
Please review our Iatrogenic Injury Page to learn more about how NSAIDs kill tens of thousands of Americans every year!
The following survey reveals a depressing new trend in medicine. Although primary care physicians (PCPs) see the largest percentage of chronic pain patients (52%), they are also the least likely to feel confident in their ability to manage musculoskeletal and neuropathic pain, and are least likely to favor mandatory pain education for all PCPs.
How bizarre is that? Here’s the abstract:
Pain Management by Primary Care Physicians, Pain Physicians, Chiropractors, and Acupuncturists: A National Survey
South Med J. 2010 (Aug); 103 (8): 738-747
Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, NY 10003, USA. bbreuer@chpnet.org
OBJECTIVES: Chronic pain is a serious public health problem and is treated by diverse health care providers. In order to enhance policies and programs to improve pain care, we collected information about the distribution of pain patients among four major groups of pain management providers: primary care physicians (PCPs), pain physicians, chiropractors, and acupuncturists, and the variation in the attitudes and practices of these providers with respect to some common strategies used for pain.
METHODS: National mail survey of PCPs, pain physicians, chiropractors, and acupuncturists (ntotal = 3,000).
RESULTS: Eight hundred seventeen responses were usable (response rate, 29%). Analyses weighted to obtain nationally representative data showed that:
PCPs treat approximately 52% of chronic pain patients,
pain physicians treat 2%,
chiropractors treat 40%, and
acupuncturists treat 7%.
Of the chronic pain patients seen for evaluation, the percentages subsequently treated on an ongoing basis range from 51% (PCPs) to 63% (pain physicians). Pain physicians prescribe long-acting opioids such as methadone, antidepressants or anti-convulsants, and other nontraditional analgesics approximately 50-100% more often than PCPs. Twenty-nine percent of PCPs and 16% of pain physicians reported prescribing opioids less often than they deem appropriate because of regulatory oversight concerns.
Of the four groups, PCPs are least likely to feel confident in their ability to manage musculoskeletal and neuropathic pain, and are least likely to favor mandatory pain education for all PCPs.
CONCLUSIONS: There is substantial variation in attitudes and practices of the various disciplines that treat chronic pain. This information may be useful in interpreting differences in patient access to pain care, planning studies to clarify patient outcomes in relation to different providers and treatment strategies, and designing a system that matches chronic pain patients to appropriate practitioners and treatments.
