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Autism Criteria May Be Changed

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How will changing the autism criteria help kids?

That was the headline in today’s paper.  So, if your child was diagnosed with autism in the past, he could be instantly “cured” in the near future—if he doesn’t fit the new definition.  But why doesn’t that sound . . . right?

Here’s what has transpired to date. A panel of experts, appointed by the American Psychiatric Association, is recommending pretty dramatic changes in the present criteria for diagnosing autism.

For example, with the new guidelines, there would no longer be related disorder categories, such as Asperger’s or PDD-NOS (pervasive developmental disorder, not otherwise specified).

Instead, there would be just one autism spectrum disorder, and qualifying for that diagnosis would be much more difficult than the current guidelines.

But here’s the upside. These experts claim that such changes could dramatically affect the rate of autism.(In some places, the rate of autism is now as high as 1 in 100 children.)  In fact, Dr. Fred R. Volkman, director of the Child Study Center at Yale University of Medicine says, “The proposed changes would put an end to the autism epidemic.  We would nip it in the bud.”

Okay, first pause.

Changing statistics do not improve a problem.  For example, we could raise the driving alcohol limit, and thereby greatly reduce the number of people arrested for drunk driving. But a change in those statistics wouldn’t mean we’re now any safer on the road. In fact, changing the criteria for drunk driving (by making it so less people were deemed driving under the influence) would only put everyone more at risk.

Second pause.

Is money partially (or completely) driving this reclassification?  With the current criteria, hundreds of thousands of people receive state-backed special services. So, you gotta wonder if tightening the criteria for autism and eliminating its related disorders isn’t just a creative way to help fix existing state budget problems.

That being said, diagnosing autism and its related disorders has always been subjective, and this latest attempt to change the criteria underscores that point. In other words, such diagnoses have never come about in the same way, for example, as a cancer diagnosis—where there’s tangible “proof.”

And here’s another truth: While parents of kids with Asperger’s and PDD-NOS may presently qualify for certain resources, those services are limited. Often, such assistance does not even render significant results.

So maybe this is one of those blessings in disguise.

Maybe—if such changes pass—more parents will be motivated to learn about brain organization and how they can facilitate positive changes in their child’s brain wiring.  Maybe more parents will no longer be resigned to out-of-bounds behaviors that they’ve been told to “expect” if their child has autism or one of its related disorders.

And maybe, just maybe, the focus will return to this question: How can we best help kids who are struggling?  If that is the driving question, then having or not having a diagnosis becomes irrelevant.

 

Apps for Autism: Helpful or Not?

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Wonder if Steve Jobs knew the iPad would be a hot topic in the autism community.

Knowing that I work with lots of families with autism, many people were interested in what I thought about the recent 60 Minutes segment, “Apps for Autism.”

That’s because at Brain Highways, we experience again and again how nonverbal kids (including those with autism) do speak and communicate their ideas after they’ve integrated retained primitive reflexes and developed their lower centers of the brain.

How’s that possible? Well, since it takes way, way, more highways to speak than to walk, speech (which takes place in the cortex) is going to be a luxury and inaccessible until the cortex is no longer preoccupied with compensating for underdeveloped lower parts of the brain. However, once that development is complete, the cortex is now “available” and, therefore, can focus on developing speech.

But the 60 Minutes story wasn’t about nonverbal kids learning to speak. Rather, it highlighted how some kids with autism were now able to communicate their thoughts by using an app on an iPad. So people were curious about my reaction to this.

I think many were surprised by my answer.  I thought it was great.

Do I believe everyone would prefer if a child actually spoke his thoughts? Yes.  But not everyone knows about brain organization or is willing to do the work.

So if something, in this case the iPad, proves what we’ve always known at Brain Highways— then it’s a great plus for everyone who interacts with nonverbal kids.  Namely, just because a child cannot articulate his thoughts does not mean that he also doesn’t understand what’s being said. Yet, too often, that’s the assumption

In fact, that’s probably why the people in the segment seemed so surprised by what the kids were showing they knew once they began communicating via the iPad.

In short, I say anything that helps people get past a “disability” and makes it easy for them to see, for example, an incredible child who is full of all kinds of thoughts and ideas . . . then bring it on.

That also includes kids who are in programs organizing their brain. The apps for autism fall under what we call “building into the structure”—where we encourage parents to help kids compensate (in this case communicate their ideas) while they’re building highways.

The 60 Minutes segment also noted it was interesting that kids with autism were so attracted to the easy touch-and-swipe iPad screens. However, this too makes sense when we look at kids with underdeveloped brains.  In such case, there is often a huge disconnect between what they’re thinking they want to do and what their body then actually does.

Yet with the iPad, it’s practically effortless to do just that. So, it’s really not surprising that such kids like using it.

We see the same reaction with our non-electronic “brain toys” at our site.  With very little effort from these kids, such toys produce an immediate really cool visual and/or auditory effect.  So, just like the iPad, kids are very attracted to them.

There was something else to glean from the 60 Minutes segment.  Near the end, they showed a boy who did not seem very enthralled with the app.  The teacher kept trying to redirect him to use the iPad to communicate, but he clearly wasn’t interested—until by mistake, he touched something, and a lion appeared and growled. That seemed to catch his attention and amuse him.

So what to learn from that part of the segment? Well, before we get down to business . . . (in this case: “This is how you will use this app to communicate.”), we need to allow all kids some time to first explore and play with whatever’s new.  Not everything always has to be an instructional moment.

Bottom line: It’s positive when compensations make something easier for kids who are trying to function with a disorganized brain.  But I also want parents to know we can help kids beyond that. We can actually help kids organize their brain so there are now an endless number of possibilities available to them.

And within that same process, such kids will be able to share their thoughts and ideas . . .  even if an iPad or some other compensation is not around.

Bipolar Kids?

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Kids who are diagnosed as being bipolar are often given medications that have only been approved for adults.

I felt encouraged when I started reading, “Mommy, Am I Really Bipolar?” in the June 27 issue of Newsweek. In the beginning of the article, Dr. Stuart Kaplan, a child psychiatrist with close to five decades of experience, makes the case there is no scientific basis for a bipolar diagnosis for kids.

He claims the bipolar childhood diagnosis only took hold for two main reasons.  First, the authors of a book called The Bipolar Child were featured on 20/20 and Oprah. Following those broadcasts, pharmaceutical companies immediately seized on the current buzz. They began to offer lucrative opportunities for doctors to give industry-sponsored talks to other doctors, with the hopes that more kids would be diagnosed as bipolar and be prescribed their already adult-approved drugs.

In 2006, I was mistakenly invited to attend one of those talks. I say it was an error because I thought I was being invited to a dinner to share ideas on innovative ways to help kids who struggled with attention issues.

I did not know that I was going to be the only non-doctor in the room.  I did not know that the expensive dinner would be complete with centerpieces and take-home goodies that had the sponsoring drug company’s name on everything. I did not know the guest speaker was going to be a psychiatrist who was paid by the drug company. And yes, this psychiatrist spent more than an hour convincing the rest of the doctors in the room to consider a childhood bipolar diagnosis and to use these new drug options with their patients.

So five years later, no surprise that I find myself feeling rather enthused when reading Dr. Kaplan’s article. Here, he’s telling the world that hundreds of thousands of children in the United States are taking adult drugs for a diagnosis he believes does not exist in childhood.  He even goes on to mock how “not waking easily” in the morning has now become considered a sign of being bipolar (this behavior is on the accepted checklist).

The more I read, the more I’m loving it.  Someone in the medical community is challenging what often seems like an indiscriminate prescribing of powerful drugs to young children. Someone with clout is getting others to think about exploring whether this (and other) behaviors could actually be related to something else less ominous.

For example, I’ve met lots of kids with underdeveloped vestibular systems who have trouble waking up in the morning.  How do we know there was a vestibular connection? Well, once these kids’ vestibular systems improved (by doing specific movements, not by taking drugs), they awakened easily.

So I’m smiling as I continue to read, believing that Dr. Kaplan is setting the stage for what’s going to be a good thought-provoking article for mainstream America. But then I read a little more—and, boy, was I ever wrong.

True, he does not believe these kids are bipolar . . . but (are you ready?) he claims these are really kids who have severe ADD and OCD. Worst of all, his point is misdiagnosing these kids means they’re now missing out on being treated with drugs for those diagnoses.

Ah, not to be discouraged. Dr. Kaplan ends his article with hope that the tide may be turning.  The American Psychiatric Association is presently deciding on new criteria that could dramatically reduce the bipolar “fad diagnosis.”  They are recommending a new diagnosis called temper disregulation disorder, citing that this would be a more accurate way to describe extreme irritability in children.

Too cynical to think that drug companies are already starting to ponder what could be prescribed for this diagnosis?

Well, I’m not giving up that, someday, the article I thought I was going to read will be printed in mainstream media.  But guess for now, that time has yet to come.

 

Why Schools Fail

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What would it take to ensure
joyful learning in the classroom?

Bill Gates, along with other well-known philanthropists, has now contributed billions of dollars to improve education.

What kind of change has all that money created? Well, Newsweek recently gave the overall results a disheartening B-minus to C-minus grade.

So I guess money wasn’t the simple answer.

But what if, before ever donating a dime, all those philanthropists had first answered this straight-forward question: How can we make learning joyful?
Yep, when we answer that question, we may be surprised at how much everything else falls into place. Here is how I believe we can make learning enjoyable.

1) We rewrite standards.
I’ve yet to read a state standard that includes the word joy as part of any criterion. Somewhere along the way, we decided that it’s only, for example, important to learn how to read—but it’s irrelevant whether we ever enjoy reading. But I don’t think you can separate the two.

So I want to see the words “with joy” tacked onto whatever skills are spelled out in existing standards. Think we’d see a change in classrooms if such qualifying words were part of how we measure success?

2) We present lessons that trigger a positive physiological response in the brain.
When we provide opportunities to move, engage multiple senses, and interact with peers while learning, the brain is able to process information efficiently and stay alert. It may even release dopamine, a neurotransmitter related to pleasure and motivation.

In contrast, if the brain becomes frustrated or feels “threatened” (e.g. “I can’t do this”), it immediately shuts down, going to the survival part of the brain. With repeated failure, the child then additionally creates a general brain map that says: I can’t learn. I’m not smart.

3) We present curriculum that parallels natural brain development.
For example, since there’s a growth spurt of dendrites in the right hemisphere during ages 4-6, we should be engaging these kids in activities that include lots of movement, music, creative thinking, fantasy and other activities reflective of the right side of the brain. We actually used to do that with our youngsters.

But without any research to back up the change, we switched to a left-brain focus (e.g. reading, writing) that begins as early as kids start school. Any surprise that so many children are now struggling?

4) We encourage and honor thinking over finding the “right” answer.
Not sure how getting it “right” ever came to rule in the classroom. But it’s a completely different learning environment when kids feel as though their ideas and reflections and questions are valued more than getting the correct answer.

Decades ago there was a “just say no” campaign against drugs. Well, how about parents “just say no” to stressful learning. Starting today, let’s make learning without joy . . . unacceptable, unpopular, offensive.

I’m lucky. I think learning is one of the most blissful experiences. That’s why it makes me sad that so many kids have no idea what I’m taking about.

Are Chinese Mothers Really Superior?

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Parenting presents different challenges when the brain is not organized as intended.

Amy Chua is a professor of law at Yale. Yet, her case that Chinese mothers are superior to Western parents is weak.

In her article, Why Chinese Mothers are Superior, she claims that the solution to substandard performance is “always to excoriate, punish and shame the child. The Chinese parent believes that their child will be strong enough to take the shaming and to improve from it.”

Well, lucky for Ms. Chua that her kids must have developed their lower centers of the brain and inhibited their primitive reflexes.  Otherwise, I think she’d have a very different take on parenting.

That’s because it doesn’t matter how much a parent screams or threatens or takes away belongings (she gives several examples where she is proud to have done this) when such development is incomplete. The truth is, no parent—Chinese or Western— can “will” a brain to do something if it’s not wired to do so.

So I’d like to suggest different criteria for identifying superior parents. I think that title should go to moms and dads who know whether their child has completed their lower brain development—and who then learn how to help their child build those highways, if warranted.

That, Amy Chua, is the best way to guarantee our children become who they are supposed to be.

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