Monthly Archives: January 2017

Concerning to people in education 

https://youtu.be/oNVtJFK5xdcOk now that we got the silly’s out, but it does display a message that trump hired someone for secartary of education that has no knowledge or any idea how to do her job properly. That to me displays she has no recollection or any idea how to be a businesss women in the cabinet trump has selected. 

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More awareness on mental health

Many of us in the medical field are getting to be more accepting and aware of autism. But, when it comes to mental health people and medical professionals do not have an understanding of treating someone the way someone should be treated equally. People tend to be bias and stigmatize us that have a mental health problem. I should know cause I suffer major depressive disorder anixety social phobia ADHD and panic attacks. Also I have PDD – NOS a form of autism and I manage just fine thank you. 

Institutional autism as orphans

Institutional Autism, Secondary To Orphanage Living ConditionsI have heard the term ‘institutional autism’ as being a complication of living in an institution or orphanage. Autism sounds like a very scary word and I am nervous about this condition. Could you explain this diagnosis and what are the expected outcomes for these children?
Many children who are available for international adoption have either been placed in hospital-run orphanage or a classic institutional care setting for a multitude of reasons. These reasons range can from illness or untimely deaths of biological parents, to the parents’ inability to care for the child’s basic needs necessary for survival.
Over the past 15 years there has been a dramatic rise in the number of children who are internationally adopted and a majority of these children have been raised in an institutional care facility.
In countries from the Eastern European block such as Russia, Romania, Ukraine and Moldova, children are still being placed into orphanages at an alarming rate. Reasons for abandonment stem from the fact that since the fall of the Communism, democracy and freedom have left many people poverty stricken and homeless.
The lower socioeconomic class no longer has the social support of the government to help with their survival. Because of the poor economic situations of these people, families are no longer able to care for the medical, physical and psychological needs of their young. Families that are condemned to a life of poverty find orphanages to be the only viable alternative that their children have for survival and maybe even a future.
Strange as this may sound it does occur all too frequently. Hospital-based institutions are still state-run facilities with little or no resources. Children who have any type of medical condition (even minor problems) are placed in institutions, which also house patients with the more severe and sometimes neuropsychiatric conditions that no child should ever be exposed to. Children with more complicated or chronic medical conditions (such as blood disorders; infectious disease, congenital malformations and classic autism) are doomed to a forgotten life behind closed cold walls of the institutions.
The biggest problem that I personally have with the institutional setting is medical diagnoses that are given to these children. These diagnoses often are false, exaggerated and unfortunately sometimes very real. The disparity to the severity of the medical problems found in these children is is sometimes incomprehensible.
They mix the severely mentally retarded, autistic, and handicapped patients with the relatively normal child who is abandoned, with mild developmental delay or the child who required minor surgery that is unable to acquire the procedure in order to lead a normal and healthy life.. Unfortunately, once a child was placed in a orphanage, that label follows the child for years, especially in countries like communist Romania during the 1980s.
These children were fated to remain there for a life without appropriate medical care or even the possibility of having a family to care for their needs.. Developmental delays are frequently found in many of the orphanage children, even before they are placed in the institution.
This is usually a direct result of poor pre-natal and post-natal factors, nutritional inadequacies and medical neglect. Once placed in an institutional care setting, these minor delays are often misconstrued as a metal deficiency or mental retardation. During the critical years of neurobiological development of the child’s brain, orphanages are notorious for being deficient in providing the social, emotional and cognitive stimulation required for normal development of the child.
Many children are starved, neglected, and forced to stay in their cribs in order to follow safety protocols. Children are frequently and repetitively moved from one age group to another.
As the child ages out, he can no longer learn anything new for the younger children in the group and often regresses to a more immature behavior. All of these factors, combined with profound medical, nutritional, and physical neglect cause these children to revert back to a more primitive state in the child�s mental development.
Speech, language, and intellectual abilities languish, and over time developmental milestones deteriorate to levels where the child may appear to be truly mentally delayed or retarded. As a defense mechanism, in order to maintain the child�s own inner well being, neglected children generally shut out all environmental and interpersonal contact that could cause them harm.
There is sometimes a component of learned helplessness. It is this type of behavior that often gets labeled as Institutional Autism. Once this pattern of regression occurs, it tends to be insidious and progressive.
The following is a list of characteristics that children with Institutional Autism exhibit:-
Loss of physical height and weight. These children look much younger than their chronological age. Severe language delay which can regress to infant babbling Lack of eye contact, aloofness Failure to orient to child’s name Lack of interactive play Lack of interest in peers Failure to use gestures to point or show Sometimes there are severe issues with bed wetting and soiling Behavioral control issues and lack of social development Attention and concentration problems.
Example: – ADHD-like behavior Deficient in learning and memory Institution-acquired autistic behaviors Some of the most worrisome and disturbing characteristics of children afflicted with Institutional Autism are that when they have complete regression, they resort to self-stimulating behaviors in order to fill the lapses regarding loneliness, deprivation and despair.
Examples of these behaviors are:- Rocking and head banging Uncontrollable outbursts of rage and aggression Body thrusting into inanimate objects such as walls Self-mutilating behaviors such as hair pulling and picking at the body During the adoption process many parents are faced with the dilemma of acquiring a child who exhibits some or all of the above mentioned characteristics.
Parents become saddened when the child does not come running or show any type of emotion towards them when they arrive to meet the child. During the first hours to days for these children to be withdrawn, exhibit lack eye contact and lack of communication with the families. Observation over time is the best means to differentiate adjustment problems versus more severe conditions.
After the adoption process is complete and the child returns to the United States, some of these children continue to display some quasi-autistic behaviors learned from in the institution for a period of time after the adoption is completed. It must be remembered that all orphan children have significant impairment in both communication and their social skills.
These children cannot be expected to come home, put on a pair of blue jeans and function immediately in our society. There is a great deal of work that is required to rehabilitate these children. In contrast to true Autism, Institutional Autism tends to improve with time and proper interventional services.
It has also been found that some children who arrive with severe mental impairment upon arrival have a dramatic improvement in their IQ points in the first years post-adoption. I must once again stress the importance of rehabilitation, education and a great deal of work on behalf of the parents in order to obtain these results.

Autism, Kanner, and institutions

This is not a pleasant subject to write about, but I think someone needs to do it. If I try to search for formal data about it on Google, I find my own prior post on it where I quote Kanner as he notes a very consistent lack of institutionalization in autistic adults who were doing particularly well in their 20s and 30s. I also find a comment by Michelle Dawson (she has obviously already studied what institutionalization can do to autistics), plus a comment on Autism Diva’s blog about Alfred N’s fate. That’s about it. 
The more recent outcome studies, for whatever reason, also do not seem to explore the effects of institutionalization on outcome, as far as I’m aware.
The following is from Kanner (1971), a follow-up study on 11 autistic children originally reported by Leo Kanner in 1943.
Richard M., Barbara K., Virginia S., and Charles N. (Cases 3, 5, 6, and 9), who spent most of their lives in institutional care, have all lost their luster early after their admission. Originally fighting for their aloneness and basking in the contentment that it gave them, originally alert to unwelcome changes and, in their own way, struggling for the status quo, originally astounding the observer with their phenomenal feats of memory, they yielded readily to the uninterrupted self-isolation and soon settled down in a life not too remote from a nirvana-like existence. If at all responsive to psychological testing, their IQ’s dropped down to figures usually referred to as low-grade moron or imbecile.
The four autistics mentioned in the preceeding paragraph were placed in institutions from an early age. 
Kanner lost track of two cases, Paul A. (Case 4) and Alfred N. (Case 8). However, it’s notable that Alfred, a child with an IQ of 140, was placed in many different schools and hospitals. At one point he was given Thorazine. 
Two other cases, Donald T. (Case 1) and Frederick W. (Case 2), were considered success stories by Kanner. They were never placed in institutions. 
John F. (Case 10) died suddenly at the age of 29. 
The remaining 2 cases were not considered success stories by Kanner. But they did not do poorly. Herbert B. (Case 7) was placed in a home only for a short period of time. He was still mute in adulthood, but he ended up in a farm where he was able to help out with various chores. Elaine C. (Case 11) was apparently first institutionalized in 1950 at the age of 18. As of 1970, she was still at Hudson River State Hospital and was reported to be independent, neat and clean.
Kanner comments on the institutionalization factor as follows.
One cannot help but gain the impression that State Hospital admission was tantamount to a life sentence, with evanescence of the astounding facts of rote memory, abandonment of the earlier pathological yet active struggle for the maintenance of sameness, and loss of the interest in objects added to the basically poor relation to people; in other words, a total retreat to near-nothingness…
The question arises whether these children might have fared better in a different setting or whether Donald and Frederick, the able bank teller and the duplicating machine operator, would have shared the dismal fate of Richard and Charles in a State Hospital environment. Even though an affirmative answer would most likely be correct, one cannot get away from wondering whether another element, not as yet determinable, may have an influence on the future of autistic children…
Maybe a life sentence is too dismal. It’s not impossible for autistics to manage to come out of institutions and resume their lives. But this is probably extremely rare.
Not institutionalizing autistic children when they are young doesn’t guarantee independence and employment, of course. But it appears to be practically a requirement if that sort of outcome is to be attained. Note that Kanner reached this conclusion after analyzing 96 cases, not just the 11 mentioned.
Now, why is it that strong warnings against institutionalization are not issued by doctors and other professionals? Why is it that instead some autism associations give the impression that institutionalization is indicated unless there’s treatment?

Institutionalization for the rich

DALLAS — A Texas couple is planning to construct a $12 million community for people with autism on nearly 29 acres of land that was formerly a polo ranch in the Denton County town of Cross Roads.
It will include 15 homes, a community center and access to a ‘transitional academy’ that is designed to help young adults with autism develop the skills needed to live and work independently.
Clay Heighten, a retired emergency doctor and founder of a real estate management company, and his wife Debra Caudy, a retired medical oncologist, are leading the project.

The inspiration is their 19-year old son, Jon, who is on the severe end of the autism spectrum and requires a high level of supportive care.
Both worry that people like Jon have little options as adults. “It’s about offering a choice,” explained Heighten.

“We’re trying to create something that would provide an enriched quality of life, so that people like Jon eventually require less supervision,” he said.
In October 2015, the couple invested $745,000 to purchase the land, and last year created a nonprofit called 29 Acres to raise money for the project.

They have had $1 million committed, predominantly from a handful of other North Texas families who also have children with autism. The hope is to break ground on construction by the fall.

Aging with autism
Though early in its development, the project is already catching the attention of local and national autism experts, who say there is demand for innovative models to help transition children with autism into adulthood.
Dr. Patricia Evans, a pediatric neurologist and neurodevelopment specialist at the Children’s Health Center for Autism and Developmental Disabilities in Dallas, and others say that as research and supportive services have proliferated for children, not enough emphasis has been put on the “oncoming onslaught of adults” especially those on the severe end of the spectrum, who are going to need help.

About 50,000 students with autism exit high school each year in the U.S. and an estimated half million will enter adulthood over the next decade, according to a 2015 report from the A.J. Drexel Autism Institute in Philadelphia.

The lifetime cost of supporting an individual with autism is $2.4 million if the person has intellectual disability, and at least 40 percent do, according to a 2014 study in JAMA Pediatrics. Health care economists estimate the yearly cost of autism in the United States is $236 billion.
The CADD center at Children’s Health recently formed a multi-disciplinary clinic to transition young adults from pediatric clinicians to adult-based primary, mental health and other specialists. The growing demographic has led to focus on needs beyond medical expenditures.
Residential care, supportive living accommodations and productivity loss account for some of the highest costs. “The employment and housing situation for people with autism lags way behind,” said Michael Bernick, a fellow with The Milken Institute, an economic think tank.
About 87 percent of young adults with autism live with a parent at some point after high school, compared to about 21 percent of all young adults. Compared to young adults with other types of disabilities, fewer on the autism spectrum have a paying job between high school and their early 20s.
Bernick anticipates more attention in coming years as people with autism seek to integrate into mainstream life. “Separate communities can play a role, especially for the more severely impacted,” he said. “There is no dearth of adults on the spectrum who would be interested.”
A passion project
The founders of 29 Acres hope the community, situated on a plot of land just south of U.S. Highway 380 in Cross Roads, will fill in some of the gaps.
The initial design includes space for a 7,100-square-foot community center, and 15 homes of around 3,000 square feet that can be divided into duplexes or quads and house 56 people.
Four homes will be built during phase one, and the first set of residents could move in by 2018.
When complete, the complex will employ about 200 full- and part-time staff, including security guards, administration and one-on-one specialists who are experienced in living with and caring for people with developmental challenges.
The town of Cross Roads is on the cusp of a suburban transformation and that was part of the appeal for Heighten and Caudy.
They wanted a location where the autism community could feel safe but also have access to the surrounding community and not feel isolated.
There are plans to build a bus stop near the property and make ride-sharing services like Uber and Lyft available so that residents can get to work, grocery shop and feel a part of the community.
A key feature of 29 Acres will be a transition program that could cost upwards of $50,000 per student. The hope is that scholarships will offset much of the cost. The academy is designed with the support of Jeff Ross, founder and director of a similar transition to independent living institutes in Arizona and California. This will be the third project he’s assisted in building.
“To me, that’s the way you advance best practices — by collaborating with people who are already using a curriculum with a proven track record,” Caudy said. “That way we can pool our resources and increase the cohort to make better determinations on outcomes.”
In fact, identifying best practices was a key priority of the Autism Cares Act, signed into law in 2014. It called for proposals on programs that would help transition young adults with autism from existing school-based services to adult services.
The local academy aims to work with nearby academic institutions to employ graduate students and fellows to participate in research that improves outcomes for young adults with autism.
Finally, the property may bring on businesses like Smile Biscotti, a bakery founded in Arizona in 2013 by a young adult with autism.
Jon Heighten has been baking, packaging and selling it from home after his parents launched Smile Biscotti DFW in November.
Need for options
While promising, experts note that when it comes to autism there is no one-size-fits-all approach.
The range of what is considered success for someone with autism is just as diverse as the condition’s wide-ranging spectrum. Trying to live alone or hold down a job may not be the best option for everyone.
“Just because they can live alone, doesn’t mean it’s a good thing,” Evans said.
Depression and isolation are common issues for people with autism. Over one-quarter of adolescents on the spectrum also tend to wander, or impulsively leave a supervised situation, increasing the risk of getting lost.
Residents at 29 Acres will be screened to evaluate their level of need. They will be involved in the design of their own program and be able to make determinations about where they see themselves down the road.
Not everyone will be a good candidate for an independent-living program, but they will still be able to live on the property, with professional support for their unique needs.
Jon Heighten, for example, will never be able to live completely on his own, his mom explained. One can get a sense of the challenge some families face when they have children with autism while watching Jon go about his day.
He doesn’t speak much, but sometimes repeats back what is said to him. “Happy birthday!” he excitedly responded to those wishing him well during his party in December.
He’s thrilled about tackling projects and smiles brightly when someone praises his good work. It’s not uncommon for him to stand and suddenly leave a room, wandering off with no clear destination.
Not surprisingly, parents are often the first to come up with creative solutions to manage. Evans is aware of other families who have children with autism in North Texas who have collectively purchased homes together. They share the space, like a co-op, working together to support one another.
There are many recent efforts to assist people with autism in finding work, according to Bernick. They include targeted hiring by large employers, the launch of autism-focused small businesses and internet-based creative programs.
“But we need a wider range of options,” he said, noting that he too became involved in the autism community when his son was diagnosed in 1991. “All of us parents have the concern,” he said.
Jon Heighten turned 19 last month, but his parents got the idea to start 29 Acres when he was in his early teens. That’s when they began to look for housing and employment options diverse enough to meet his needs if they were no longer alive to take care of him.
“We couldn’t find anything. So we just decided to do it ourselves,” said Caudy, who is 59. “We want to do it not just for him, but for many of the others out there like him. The need is enormous.”
Multimedia journalist Tommy Noel contributed to this report.

Changes you need to know about Obamacare 

The outcome of the repeal-and-replace Obamacare debate could affect more than you might think, depending on just how the GOP congressional majority pursues its goal.
Beyond the Affordable Care Act’s marquee achievements like guaranteeing health coverage for people with pre-existing conditions and allowing children to stay on parents’ plans until age 26, the roughly 2,000-page law created a host of other provisions that affect the health of nearly every American.
Some of these measures are evident every day. Some enjoy broad support, even though people often don’t always realize they spring from the statute.
Here’s a sampling of sleeper provisions that could potentially land on the cutting-room floor:
1. Calorie counts at restaurants and fast-food chains
Feeling hungry? The law tries to give you more information about what that burger or muffin will cost you in terms of calories, part of an effort to combat the ongoing obesity epidemic. Under the ACA, most restaurants and fast food chains with at least 20 stores must post calorie counts of their menu items. Several states, including New York, already had similar rules before the law.
Although there was some pushback, the rule had industry support, possibly because posting calories was seen as less onerous than such things as taxes on sugary foods or beverages. The final rule went into effect in December after a one-year delay.
One thing is still not clear: Does simply seeing that a particular muffin has more than 400 calories cause consumers to choose carrot sticks instead? Results are mixed. One large meta-analysis done before the law went into effect didn’t show a significant reduction in calorie consumption, although the authors concluded that menu labeling is “a relatively low-cost education strategy that may lead consumers to purchase slightly fewer calories.”
2. Private breast-milk pumping space at work
Breast-feeding, but going back to work? The law requires employers to provide women break time to express milk for up to a year after giving birth and provide someplace other than a restroom to do so in private. In addition, most health plans must offer breast-feeding support and equipment, such as pumps, without a patient copayment.
3. Limits on surprise medical bills from ER visits
If you find yourself in an emergency room, short on cash, uninsured or not sure if your insurance covers costs at that hospital, the Affordable Care Act provides some limited assistance. If you are in a hospital that is not part of your insurer’s network, the law requires all health plans to charge consumers the same copayments or co-insurance for out-of-network emergency care as they do for hospitals within their networks. Still, the hospital could “balance bill” you for its costs, including ER care, that exceed what your insurer reimburses it.
If it’s a nonprofit hospital, and about 78 percent of all hospitals are, the law requires it to post online a written financial assistance policy, spelling out whether it offers free or discounted care and the eligibility requirements for such programs. While not prescribing any particular set of eligibility requirements, the law requires hospitals to charge lower rates to patients who are eligible for their financial assistance programs. That’s compared with their gross charges, also known as chargemaster rates.
4. Community health support from nonprofit hospitals
The health law also requires nonprofit hospitals to justify the billions of dollars in tax exemptions they receive by documenting how they go about trying to improve the health of the community around them.
Every three years, these hospitals have to perform a community needs assessment for the area the hospital serves. They also have to develop strategies to meet these needs and update them annually. The hospitals then must provide documentation as part of their annual reporting to the Internal Revenue Service. Failure to comply could leave them liable for a $50,000 penalty.
5. A woman’s right to choose her OB-GYN
Most insurance plans must allow women to seek care from an obstetrician-gynecologist without having to get a referral from a primary care physician. While the majority of states already had such protections in place, those laws did not apply to self-insured plans, which are the type often offered by large employers. The health law extended the rules to all new plans. Proponents say direct access makes it easier for women to seek not only reproductive health care, but also screening for such things as high blood pressure or cholesterol.
6. Expanded therapy coverage for children with autism
Advocates for children with autism and people with degenerative diseases argued that many insurance plans did not provide care their families needed. That’s because insurers would cover rehabilitation to help people regain functions they had lost, such as walking again after a stroke, but not care needed to either gain functions patients never had, such as speech therapy for a child who never learned how to talk, or to maintain a patient’s current level of function. The Affordable Care Act requires plans to offer coverage for such treatments, dubbed habilitative care, as part of the essential health benefits in plans sold to individuals and small groups.

Sensory overload and what is it?

Sensory overload occurs when one or more of the body’s senses experiences over-stimulation from the environment. There are many environmental elements that impact an individual. Examples of these elements are urbanization, crowding, noise, mass media, technology, and the explosive growth of information.[1] Sensory overload is commonly associated with sensory processing disorder. Like its opposite sensory deprivation, it has been used as a means of torture.
Irritability

“Shuts down”, or refuses to participate in activities and/or interact with others

Avoids touching or being touched

Gets overexcited

Covers eyes around bright lights

Makes poor eye contact

Covers ears to close out sounds or voices

Complains about noises that do not affect others

Having difficulty focusing on an activity

Constantly changing activities, never completing a task

Irritation caused by shoes, socks, tags, or different textures

Over-sensitivity to touch, movement, sights, and/or sounds

Has trouble with social interactions

Extremely high or extremely low activity levels[1]

Muscle tension

Fidgeting and restlessness

Angry outbursts

Sleeplessness/fatigue

Difficulty concentrating

Hearing: Loud noise, or sound from multiple sources, such as several people talking at once.

Sight: Crowded or cluttered spaces, bright lights, strobing lights, or environments with lots of movement such as crowds or frequent scene changes on television.

Smell and taste: Strong aromas or spicy foods.

Touch: Tactile sensations such as being touched by another person or the feel of cloth on skin.[5]

Vestibular: such as dizziness or motion sickness.