
________________________________________________________________
Tuesday,
September 8,
2009
Vol. 13 No. 95
TREATMENT
Are Autistic Kids In The Foster Care System Being Over Medicated?
RESEARCH
Scientists Find Three New Gene Links To Alzheimer's
Learning Disability Researcher Says Facebook Better for Memory
EDUCATION
Schools Cope With Challenge of Educating Autistic Students
Mothers Question Schools Ability to Assist Special Needs Students
Schoolyard Bullies, Victims Have Problems Later On
Fired Teaching Assistant Who Reported Abuse By Teacher Is Suing Dept.
of Education
MEDIA
Free Online Autism Course
COMMENTARY
Why Current Thinking About Autism Is Completely Wrong
The Real Health Care Scare
TREATMENT
Are Autistic Kids In The Foster Care System Being Over Medicated?
is.gd/32wUA
Who should we as a society be watching
out for more than kids with disabilities who are in foster care? They
are kids. They are disabled. They don’t have their parents to advocate
for them. They are our responsibility once they enter into the foster
care system.
What if they are being over medicated?
One subject that comes up a lot in the online autism community is the
use of psychotropic medication on autistics. Note that the following is
my opinion and not from the paper: medications, including psychtropic
medications, have their place and can be beneficial, but great care and
monitoring must be taken to insure that they are appropriately used.
Psychotropic medications should not be used as chemical restraints.
That is why I was very interested when I
saw that this paper was going to be published in Pediatrics: State
Variation in Psychotropic Medication Use by Foster Care Children With
Autism Spectrum Disorder is.gd/32xCh
.
The paper has been out for a while but I
couldn’t blog it right away. I wanted to take the time to do this paper
justice. In the end, I don’t know if I have as I’m trying to find a
good “voice” for this post. I keep switching between trying to give an
uncolored presentation of the data and being outraged.
Yes, outraged.
The paper authors are David M. Rubin,
MD, MSCE, Chris Feudtner, MD, PhD, MPH, Russell Localio, PhD, and David
S. Mandell, ScDd.
If you are a regular reader of this
blog, you may know that I have a great admiration for Dr. Mandell and
his group. He asks important questions, often about groups like
autistic racial/ethnic minorities or about autistic adults. Groups I
consider to be the underdogs in the struggle for recognition and
services in the autism communities.
Who could be more of an underdog than
disabled kids in foster care? One of the reasons the authors give for
studying autistic kids in the foster care system is: Second, beyond the
cumulative impact of trauma on psychiatric symptoms after maltreatment,
children with ASD in foster care are particularly vulnerable to the
social and psychological disruptions that foster care placements can
create, such that an excessive variation in the use of psychotropic
medications between states may indicate problems in the ability of
different foster care systems to achieve placement stability for these
children or adequately provide for their well-being.
My read on that—autistic kids are more
vulnerable to being traumatized by the foster care system, and the
states using more meds may be worse at being able to care for these
kids.
The authors list a number of factors
that could play into this, including lack of resources and lack foster
parent or caseworker training. One big factor—the possibility that
these kids are frequently moved around. This is hard on all kids, but
is obviously going to be especially tough on ASD kids.
+ Read more: is.gd/32wUA
• • •
RESEARCH
Scientists Find Three New Gene Links
To Alzheimer's
By Kate Kelland. is.gd/32swM
Reuters - Scientists have found three
new major genetic links to Alzheimer's, affecting up to 20 percent of
people with the brain-wasting disease, and said on Sunday it was the
most significant such discovery in 15 years.
Two large studies found that the three
new genes join the better-known APOE4 gene as significant risk factors
for the most common cause of dementia.
"If we were able to remove the
detrimental effects of these genes through treatments, we could reduce
the proportion of people developing Alzheimer's by 20 percent," Julie
Williams, a professor of Neuropsychological Genetics at Britain's
Cardiff University, told a news conference in London.
Alzheimer's disease affects more than 26
million people globally, has no cure and no good treatment. The need
for effective remedies is pressing, with the number of cases forecast
to go beyond 100 million by 2050.
Current drugs can only delay the
symptoms endured by patients, who lose their memories, the ability to
find their way around and to care for themselves.
Williams, who led one of the two studies
published in Nature Genetics, said that in Britain alone, eradicating
the effects of the three new genes would mean almost 100,000 people
could avoid the disease.
She said the findings were the most
significant genetic discoveries for Alzheimer's in the 15 years since
APOE4 was found to be linked, and said drug companies had shown a keen
interest in their research.
MORE GENES OUT THERE TO CATCH Williams
and colleagues at Cardiff's Medical Research Council Centre for
Neuropsychiatric Genetics and Genomics carried out a genome-wide
association study -- a scan of the entire genetic map -- involving more
than 16,000 people from eight countries. They identified two new genes
-- called Clusterin and PICALM -- that increase the risk of developing
Alzheimer's.
A second genome-wide study conducted by
Philippe Amouyel and colleagues at the Institut Pasteur de Lille in
France, studied more than 6,000 people with Alzheimer's and nearly
9,000 healthy people in France, Belgium, Finland, Italy and Spain. They
identified Clusterin and a third gene called CR1.
Amouyel said the disease risks
associated with each gene were difficult to quantify, and said all
three genes were relatively common. The scientists also stressed that
an as yet unknown combination of many genetic and other environmental
factors cause Alzheimer's.
The researchers said Clusterin may
explain 10 percent of Alzheimer's cases, PICALM around 9 percent and
CR1 4 percent. By comparison, 20 to 25 percent of Alzheimer's cases are
linked to APOE.
Three gene variations have also been
associated with rare, early-onset forms of Alzheimer's that run in
families. Identifying the genes can help researchers understand the
underlying causes of a disease and design drugs to fight them.
Michael Owen, director of the Cardiff
centre, said their study also found evidence that other genes could
play a role in the risk of developing Alzheimer's.
"It's a bit like we have been fishing
with a fishing net and we've pulled out some fish. We know there are
more fish there, and with a finer mesh net we can catch them," he said.
The Cardiff team now plans a further
study involving 60,000 participants to look deeper into genetic causes
of Alzheimer's.
• • •
Learning Disability Researcher Says
Facebook Better for Memory
By Chris Crum. is.gd/32m6p
Results from a recent study indicate
that Facebook may actually be good for your brain, while services like
Twitter and YouTube may not be, at least when it comes to the part of
the brain that deals with memory.
The study was led by Dr. Tracy Alloway,
Director of the Centre for Memory and Learning in the Lifespan at the
University of Sterling in Scotland. Alloway has a PhD in Cognitive
Psychology and has worked on several government-funded projects dealing
with memory and learning.
"My research interest is in how working
memory impacts learning in typically developing children, as well as in
those with ADHD, Autism, Language Impairments, Dyspraxia, and Learning
Disabilities," says Alloway. "I have numerous international
collaborations to investigate whether assessments of working memory are
culture-fair, or if a child’s background, as indexed by language,
culture, and income differences, mediates the relationship between
working memory and learning."
According to Alloway, keeping up with
friends on Facebook stretches the working memory in a way that Twitter
and YouTube cannot do. "On Twitter you receive an endless stream of
information, but it's also very succinct," Alloway is quoted as saying.
"You don't have to process that information." She applies the same
rationale to texting.
"Your attention span is being reduced
and you're not engaging your brain and improving nerve connections,"
she says.
If Facebook really is better for our
brains than Twitter, it's a good thing Facebook seems to be doing
everything it can to become more like Twitter, despite its much, much
larger piece of the market share.
• • •
EDUCATION
Schools Cope With Challenge of
Educating Autistic Students
By Carol McGraw in The Gazette,
Colorado. is.gd/32kFY
It’s mid-morning, and Teresa Wright is
relaxing on her living room couch, sighing that familiar sigh mothers
everywhere emit after a hectic morning getting the kids off to school.
But Wright has more on her mind than
making sure the kids have their lunches and homework assignments. Three
of her five sons — an 11-year-old and 9 year old twins — have autism
spectrum disorder, and over the years, she and her husband, Patrick,
have worked endlessly to make sure the boys’ school experiences have
been productive.
She has nothing but praise for
Fountain-Fort Carson School District 8, where her children attend
classes. But even though D-8’s program for autistic students is
considered one of the best in the area, she says, having autistic
children in any school system is a never-ending job of making sure
they’re getting the education they need.
“I tell parents new to autism that you
have to advocate for your child all the time."
More and more parents have been learning
that lesson in recent years as the number of students with autism has
exploded. One in every 150 children is diagnosed with an autism
spectrum disorder; 14 years ago only one in 10,000 children was thought
to have it. In Colorado, the number jumped from 246 students in 1998 to
2,416 in 2008.
Faced with this dramatic increase,
public school systems are struggling to give autistic students the best
education they can in the least restrictive environment, as required by
federal law. But finding money and trained workers to get the job done
makes it difficult.
“It affects our budget greatly,” says
Brian Printz, executive director of special programs in District 8,
which has one of the highest number of autistic students in the region.
“Our most expensive kids can cost $60,000 a year if they need to
participate in special programs outside the district. Or if they have a
para-professional for one-on-one support and other specialists, it can
easily cost $25,000 to $40,000.” Other districts report similar costs.
While school districts get federal and
state funds to help meet the needs of disabled students, that still
covers only about 20 percent of the extra cost of educating them,
Printz says. The rest must come from the district budget.
The costs can be astronomical for
severely autistic students, who often need intense, one-on-one
instruction to master not only rudimentary classroom subjects, but
basic life skills such as eating, toilet training, and verbal and
non-verbal communication.
Schools programs better, but
not perfect The Wrights know all too well what schools are up against
in trying to meet the needs of the growing population of autistic
children — and what a good program can do to help them.
+ Read more: is.gd/32kFY
• • •
Mothers Question Schools Ability
to Assist Special Needs Students
By Eric Fossell for wsaz.com . is.gd/32ptU
Huntington, W.Va. (WSAZ) – Seeing her
son come home from school in tears after classmates called him “Retard”
and placed a “Kick Me” sign on his back marked the turning point for
Mary Calhoun Brown.
Likewise, Kim Scott pulled her son out
of Cabell County Schools after a diagnosis of bipolar disorder failed
to bring him the educational attention she said he needed.
Both mothers decided to home school
their sons, and they’re on a mission to educate parents and educators
about the lack of resources in public and private schools for kids with
behavioral and mood disorders.
Throughout our region – in West
Virginia, Ohio and Kentucky – suicide ranks as one of the top three
leading causes of death for 11- to 18-year-old youths, according to the
latest statistics from the Centers for Disease Control and Prevention.
Furthermore, 90 percent of youth suicide victims had a major
psychiatric disorder – typically bipolar disorder or depression.
Scott, whose 13-year-old son suffers
from bipolar disorder, said a lack of knowledge and trained staff in
private and public schools makes the issue even more traumatic,
especially during the middle school years.
“There’s absolutely no training, even
though people have been talking about this for years,” she said. “It’s
the worst statistics of any disability group,” she added, referring to
youths with behavioral and mood disorders.
Kathy McCoy, special education director
for Cabell County Schools, confirmed that not every middle school is
equipped to deal with some mood and behavioral disorders.
“We do not have a self-contained
classroom at every middle school for students with severe behavioral
difficulties,” she said. “We do have such a classroom at both high
schools (Huntington and Cabell Midland). Everything depends on the
needs of the student. We try to keep kids in their home schools if at
all possible."
Both Scott and Brown, whose 14-year-old
son was diagnosed with Asperger’s syndrome (commonly known as a mild
form of autism), said they’re fortunate to have the resources and time
to home school their sons.
“We struggled all through 6th grade,”
Brown said. “My son cried ever day. I told him, ‘I’ll give you two
years at home.’ "
While home schooling is a personal
choice with obvious benefits, it has isolation drawbacks – even for
kids with special needs, said Cabell County Schools Superintendent Bill
Smith.
+ Read more: is.gd/32ptU
• • •
Schoolyard Bullies, Victims
Have Problems Later On
By Amy Norton. is.gd/32tUU
Reuters Health - School children
who bully or are victims of bullying may face higher risks of anxiety,
depression and other psychological disorders later in life, a new study
finds.
The study, which followed more than
5,000 children in Finland, found that boys and girls who were
frequently bullied were at greater risk than their peers of needing
psychiatric treatment in their teens or early 20s.
The same was true of boys who were
perpetrators of the bullying -- with the highest risks of mental health
problems seen among boys who were both perpetrators and victims.
The findings, reported in the Archives
of General Psychiatry, add to evidence that schoolyard bullying can
have substantial psychological consequences -- and that, at least among
boys, those who are both bullies and victims are the most troubled of
all.
"Parents and teachers should be aware
that frequent school bullying should not be considered normal behavior,
but has potentially serious consequences," lead researcher Dr. Andre
Sourander, of the University of Turku in Finland, told Reuters Health
in an email.
The study included 5,038 children who
were followed from the age of 8 until age 24. At the outset, just over
6 percent of boys and almost 4 percent of girls were being frequently
bullied, based on reports from the children, their parents and teachers.
Of boys, 6 percent routinely bullied
other kids, while almost 3 percent were both bullies and victims. Among
girls, less than one percent were either bullies or "bully-victims."
The researchers used Finland's system of
national registers to follow the study group's rate of psychiatric
hospital admissions and prescriptions for antidepressants, anti-anxiety
drugs and anti- psychotics.
Overall, one-third of boys who had been
both bullies and victims ended up taking a psychiatric medication at
some point between the ages of 13 and 24, while 17 percent were
admitted to a psychiatric hospital. That compared with rates of 12
percent and 5 percent, respectively, among boys who had not been
involved in bullying.
Among girls, 32 percent of those who had
been frequently bullied were eventually prescribed a psychiatric
medication, compared with 16 percent of girls who had not been bullied.
Meanwhile, 12 percent of victims were hospitalized for psychiatric
treatment, versus 4 percent of other girls.
When the researchers considered the
children's emotional health and behavior at the start of the study,
only boys who were already showing problems were at increased risk of
later psychiatric conditions.
But with girls, those who were bullied
were at heightened risk of later problems even if they initially showed
no emotional or behavioral difficulties.
It's not clear why this gender
difference exists, according to Sourander's team, but it's possible
that different forms of bullying have different long-term effects, they
note. With boys, bullying is often overt and physical, while for girls,
it is more likely to come in the "subtle" form of teasing, gossip and
exclusion.
One of the main messages from the
findings, Sourander noted, is that schools need to keep bullying
incidents from escalating.
"The education systems are of central
importance (in) early detection," he said. "Failure of the school
system to take preventive action should be considered a failure to
discharge the school authority's duty of care."
SOURCE: Archives of General Psychiatry,
September 2009.
• • •
Fired Teaching Assistant Who Reported Abuse By Teacher Is Suing
Dept.
of Education
By Dorian Block NY Daily News is.gd/30gNS
A teaching assistant who says she was
fired for reporting abuse by a teacher - using a bogus cover story - is
suing the Department of Education for $500,000.
Elba Rivera, who worked at Public School
32 in the Belmont section of the Bronx, said she saw special education
teacher Helene Sorkin violently push a 10-year-old into a door Feb. 14,
2007.
"She yelled at him. He sucked his teeth
at her. She didn't like that so she grabbed him against his arm and
slammed him against the wall," Rivera said yesterday.
"She kept on shoving him in the stomach
and screaming at him. She said, 'Go ahead, to tell his parents, that
nobody would believe him and no one would care.'...She shoved him 10 or
11 times."
Rivera reported the incident in an
e-mail to the Education Department, but claimed she was a relative of
the student to protect her identity, according to the suit filed in
Bronx Supreme Court. Sorkin was not disciplined, and Rivera was fired
last September for "filing a false report of corporal punishment," the
suit says.
The suit claims Sorkin forced students
to sign a form denying the incident happened. The mother of one student
told the Daily News her daughter did witness it.
+ Read more: is.gd/30gNS
• • •
MEDIA
Free Online Autism Course
By Janet Harriett.
The Open University has a free online
course, The Autistic Spectrum, From Theory to Practice, which provides
an overview of psychological research into Autism Spectrum Disorders.
The course is written at a college undergraduate level. Units
focus on:
* Identifying autism and autism spectrum
disorders
* Mapping the spectrum
* Cognitive and social explanations of
autistic conditions
* Biological explanation of autistic
conditions
* Helping autistic people
In addition to the unit text, the course
includes suggestions for further reading The Open University estimates
that the full course takes about 20 hours to work through. If you are
interested in learning more about autism and ASD, this OpenCourseWare
is an excellent resource to start with is.gd/32yO8.
• • •
COMMENTARY
Why Current Thinking About Autism
Is Completely Wrong
By Mark Hyman, MD, Practicing physician
and pioneer in functional medicine on huffingtonpost.com. is.gd/32o26
"Autism is caused by poor mothering."
That was the belief of the medical community until the late 1960s.
"Autism is a genetic brain disorder."
That is what most people -- and most of the medical community --
believe today.
I'm here to tell you that neither one of
these statements is true.
Think about it. Rates of autism have
skyrocketed over the years, from an estimated 1 child in 3,000 to just
1 in 150 kids today. Sure, wider criteria for diagnosis and better
detection might explain some of it -- but not an increase of this
magnitude.
The real reason we are seeing increasing
rates of autism is simply this: Autism is a systemic body disorder that
affects the brain. A toxic environment triggers certain genes in people
susceptible to this condition. And research supports this position.
Today I will review some of this
research and explain how imbalances in the 7 keys systems of the body
may be the real cause--and thus the real cure--of autism.
A New Understanding of Autism
Dramatic scientific discoveries have
taken place during the last 10 to 20 years that reveal the true causes
of autism -- and turn conventional thinking on its head. For example,
Martha Herbert, MD, a pediatric neurologist from Harvard Medical School
has painted a picture of autism that shows how core abnormalities in
body systems like immunity, gut function, and detoxification play a
central role in causing the behavioral and mood symptoms of autism.
She's also given us a new way of looking
at mental disease (and disease in general) that is based on systems
biology. Coming from the halls of the most conservative medical
institution in the world, this is a call so loud and clear that it
shatters our normal way of looking at things.
Everything is connected, Dr. Herbert
says. The fact that these kids have smelly bowel movements, bloated
bellies, frequent colds and ear infections, and dry skin is not just a
coincidence that has nothing to do with their brain function. It is
central to why they are sick in the first place! Yet conventional
medicine often ignores this.
My friend and mentor, Sidney Baker, MD
-- a pioneer in the treatment of autism as a body disorder that affects
the brain -- often says, "Do you see what you believe or do you believe
what you see?"
The problem in medicine is we are so
stuck in seeing what we believe that we often ignore what is right in
front of us because it doesn't fit our belief system. Nowhere is this
true more than in the treatment of autism.
This is in the front of my mind, because
I see so many behavioral symptoms in kids from learning disabilities to
attention-deficit hyperactivity disorder (ADHD) and even autism.
And I see the rates of medication use
skyrocketing for these kids -- from stimulants to anti-psychotics (one
of the fastest growing drug categories) to anti-seizure medicine, and
more. There is another way ... Let me tell you a story about a little
boy I saw recently.
Sam's Case: Autism as a Systemic Disorder
+ Read more: is.gd/32o26
• • •
The Real Health Care Scare
By James Moore, Author,
Communications Consultant, Novelist Manque', Genial Wiseacre,
huffingtonpost.com. is.gd/32r7S
In all of the white-hot vitriol
being spewed over a national health care plan, very little attention is
being directed at the pharmaceutical companies and the potential
conflicts of interest involving the doctors doing their research. In
America, we are generally of the belief that by the time a drug or
vaccine has made it into the marketplace there has been enough testing
conducted by the FDA and objective physicians and researchers that we
can trust its safety. Frequently, we are wrong. Great profit tempts
drug manufacturers to deceive or cut corners to get more quickly to the
market. Pfizer recently agreed to pay $2.3 billion in fines as a
penalty for marketing drugs "off label," which means for other than
their prescribed purpose. Merck, too, has a $4.85 billion legal
settlement for Vioxx, a painkiller that doubled the risk of stroke and
heart attack, and Eli Lilly agreed to almost $1.5 billion in penalties
for illegal marketing of its top-selling anti-psychotic drug. .
Those numbers may look big but they are
nothing compared to revenues. Pfizer earned $44.2 billion last year and
can handily absorb the penalty. Industry experts don't expect the off
label marketing to end because the profitability is so great. With this
kind of money at stake, willful deception with off label marketing, and
a public record of failure, why are we so inclined to readily accept
drugs and vaccines from these manufacturers?
As autumn approaches, we are once more
being whipped into a frenzy about H1N1 and a need for another
vaccination. Imagine the profits if only it were government mandated. I
am not anti-vaccine. I am, however, pro-full disclosure. Vaccinations
are one of the most important advancements in medical history.
Nonetheless, when they became huge profit centers, the numbers of
vaccines on the schedule for our children rose to the point where there
are now 42 recommended and, in many cases, most are required for
admission to public school facilities. Because we are inclined to trust
our physicians and federal regulators, we generally take the needle.
But we need to look more closely. The
internecine relationships between drug companies and researchers and
their institutions deserve constant scrutiny. As an example, the
highest-profile proponent of vaccines like the MMR for children, Dr.
Paul Offit has been made a wealthy man by Merck, the pharmaceutical
giant that manufactures MMR. Offit did not conduct the research on the
MMR (Measles-Mumps-Rubella) vaccine but sold a patent to Merck for a
vaccine against rotavirus, which causes diarrhea in children.
Children's Hospital of Philadelphia (CHOP), where Offit works, sold its
royalty rights on the vaccine, which, according to a financial analyst
firm's filing, netted the hospital $153 million. Based on hospital
distribution guidelines, Offit, as the inventor, appears to have earned
as much as $45 million for his 30 percent share.
+ Read more: is.gd/32r7S
Note: The opinions expressed in COMMENTARY are those of the author and
do not necessarily represent the views of the Schafer Autism Report.