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One-half of school-aged CSHCN with ASD were aged 5 years and over when they were first identified as having ASD. Just over one-half of school-aged CSHCN with ASD use three or more health care services to meet their developmental needs. More than one-half of school-aged CSHCN with ASD use one or more psychotropic medications to meet their developmental needs.
The median age when school-aged children with special health care needs (CSHCN) and autism spectrum disorder (ASD) were first identified as having ASD was 5 years. School-aged CSHCN identified as having ASD at a younger age (under age 5 years) were identified most often by generalists and psychologists, while those identified later (aged 5 years and over) were identified primarily by psychologists and psychiatrists. Nine out of 10 school-aged CSHCN with ASD use one or more services to meet their developmental needs. Autism Spectrum Disorder (ASD) is a set of complex neurodevelopment disorders characterized by mild to severe problems in social interaction and communication along with restricted repetitive behavior patterns (1). Fewer than one-fifth of school-aged CSHCN with ASD were identified as having ASD within the first 2 years of life.
Two-fifths of school-aged CSHCN with ASD were aged 6 years and over when first identified as having ASD. School-aged CSHCN identified as having ASD before age 5 years were most often identified by generalists (such as pediatricians, family physicians, and nurse practitioners) and psychologists. Relative to those school-aged CSHCN identified at age 5 years and over, those identified as having ASD before age 5 years were more likely to be identified by generalists, specialist pediatricians, neurologists, and multidisciplinary teams. School-aged CSHCN identified as having ASD at age 5 years and over were identified primarily by psychologists and psychiatrists. Across both age groups, approximately 9 out of 10 CSHCN with ASD use one or more of the eight services included in the Pathways survey. Younger CSHCN with ASD are more likely than older CSHCN with ASD to use any of these eight services and to use three or more of these services. The most commonly used services are social skills training and speech or language therapy for both age groups. About 40% of school-aged CSHCN with ASD use behavioral intervention or modification services to meet developmental needs.
Younger CSHCN with ASD are more likely than older CSHCN with ASD to use occupational therapy and speech or language therapy to meet their developmental needs. More than one-half of school-aged CSHCN with ASD use at least one psychotropic medication to meet their developmental needs.
Almost one-third of school-aged CSHCN with ASD use stimulant medications, one-quarter use anti-anxiety or mood-stabilizing medications, and one-fifth use antidepressants. This report describes school-aged CSHCN with ASD, looking at when they were reported to be first identified as having ASD, who made the identification, and the services and medications they currently receive to meet their developmental needs. Most families use a combination of services to address the developmental needs of their CSHCN with ASD. Children with special health care needs (CSHCN): The National Survey of CSHCN (NS-CSHCN) used the CSHCN Screener (11) to identify CSHCN. The Survey of Pathways to Diagnosis and Services is a nationally representative survey about children with special health care needs (CSHCN) aged 6a€“17 years ever diagnosed with autism spectrum disorder (ASD), intellectual disability, or developmental delay. Parents or guardians who previously participated in the 2009a€“2010 NS-CSHCN (sponsored by the Maternal and Child Health Bureau) and who reported that their child had ever been diagnosed with at least one of the three selected developmental conditions were recontacted via landline or cell telephone to participate in the Pathways survey.
Beverly Pringle and Lisa Colpe are with the National Institutes of Health's National Institute of Mental Health, Division of Services and Intervention Research. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
There's nothing like fever in a small child to send a parent into panic: Run to the medicine cabinet, call the pediatrician, head to the emergency room.
But it turns out that fevers may not be all evil all the time, according to a clinical report from the American Academy of Pediatrics.
Fever--which is a symptom of illness, not an illness in and of itself--can actually help the child fight off infection. Finally, in their efforts to reduce body temperature to a "normal" level, parents often do the wrong things. Parents also wake sleep children up to give them more medicine--but most pediatricians surveyed believe that a sick child who is sleeping should not be awakened solely to be given a fever-reducer. The most common fever-reducers are acetaminophen and ibuprofen, which when used as directed are considered safe for otherwise healthy children. In addition to making sure their child is comfortable, parents should also make sure that child is well hydrated. The only time I hustled my child to the ER was when she spiked a fever of 104 degrees (inching towards 105 degrees!) that would not go down with medicine.
Andrea Kane has been writing and producing health and medical news for television, the web and various magazines for almost all of her professional career.
Somehow, somewhere along the way, amidst the writing and reporting frenzy, she managed to produce two terrific daughters, who also appear to have ink running in their veins and are never at a loss for words (the wheels of karma have a tight turning radius indeed). Please read our Terms for using this site and our Privacy Policy; if you dona€™t agree with them, you may not use this site.
We’ve been using this space to bring you information about National Children’s Mental Health Awareness Week along with the not-for-profit Child Mind Institute, who has been sharing some important and helpful information with us. Steven Kurtz, PhD, ABPP, of the Child Mind Institute, is one of the nation’s leading clinicians in the treatment of children’s behavioral problems and disorders, particularly attention-deficit hyperactivity disorder (ADHD).
Diagnosis of ADHD is still made by a good family history and school history, with parents and teachers describing behavior that is consistent over time. To address parents’ concerns about over-diagnosis, a good clinician is careful to screen out children who are just exhibiting normal impulsivity, normal hyperactivity, and normal inattention.
There’s no evidence that things like play therapy and talk therapy actually help alleviate ADHD symptoms in real-life settings.
We teach organizational skills, where we prompt kids to pack their backpack, then check that it’s packed properly, and then reinforce them for doing it. When asked to count, he couldn’t get past the first few digits before careening off to something else. Research is being done to understand how genetics and environment combine in kids with ADHD. On the genetics end, ADHD does tend to run in families and is considered one of the most heritable of psychiatric disorders.
On the environmental end, it’s been connected to low birth weight, a mother’s alcohol or tobacco use during pregnancy, and exposure to lead early in life. Steven Kurtz, PhD, ABPP, is one of the nation’s leading clinicians in the treatment of children’s behavioral problems and disorders, particularly attention-deficit hyperactivity disorder (ADHD) and the social anxiety disorder selective mutism (SM). Richard Zwolinski, LMHC, CASAC is the author of Therapy Revolution: Find Help, Get Better, and Move On Without Wasting Time or Money and is an internationally licensed psychotherapist and addiction specialist with over 25 years experience as well as a consultant to organizations and companies in the fields of mental health and addiction.
Last updated: 30 Apr 2012Views expressed are those solely of the writer and have not been reviewed. I know how expensive it can be to hire a certified behaviorist, so I have attempted to provide as much valuable information as possible for help with specific problems in the form of positive behavior supports and detailed instructions to use time out for kids.
Be sure to return frequently as I will continue to add pages related to specific behavioral problems. Fifteen million children in the United States have psychiatric and learning disorders, but very few of them will be identified and get the help they need.
During National Children’s Mental Health Week (May 6-12, 2012), Speak Up for Kids helps to break down the barriers of that prevent millions of children from getting the early intervention they deserve.
As part of Speak Up for Kids, mental health professionals will give free talks in their communities to share helpful information about childhood mental health disorders and other topics relating to raising healthy, happy kids. Special needs children are as unique as any other child.  Even children who have the same diagnosis may display different symptoms. When evaluating a patient, therapists look at motor skills (actions performed by the brain telling the muscles how to move), behavior and sensory integration ability (how the brain interprets all sensory input). Behavior and sensory issues often go hand-in-hand, as is the case with Autism Spectrum disorder and ADHD and related disorders. In order to simplify the explanation, let’s say that all responses are based on messages coming in to the brain or going out from the brain. This week is Infant Massage Awareness Week in certain areas, so it reminded me of the many benefits fo massage. I am the first to acknowledge that despite my efforts, it is likely that my son’s issues cannot be cured.
Cerebral Palsy is a neurological disorder which affects communication between the brain and the muscles. The goal of therapy is to strengthen the core (trunk) muscles and even out the tone as much as possible.
In order to treat properly, the therapist needs to somehow facilitate the use of the weak muscles while inhibiting the spastic tone. I have written about CIT (constraint induced therapy) and motor learning and NDT treatment protocols. Here is what the website has to say: TheraSuit Method® utilizes various tools and exercises.


Moms Clean Air Force (MCAF) is devoted to cleaning up the air our children and unborn babies breathe. If you knew that pollutants in the air had a direct link topremature deaths, asthma, decreased lung function, autism, ADHD and developmental delays, would you do something about it? No one really understands the impact of these diagnoses until they have a child who has a developmental problem or who must be on life –saving medication their whole life. It arose out of our growing understanding of the brain and how the brain’s electrical activity, as measured by an EEG readout, plays a role in the creation of symptoms, such as anxiety or inattentiveness. From the point of view of neurofeedback– or “brain training” as some call it—we see that with certain conditions such as ADHD, Post Traumatic Stress Disorder or anxiety disorder, the brain is habitually making maladaptive choices. One way of explaining this habituation is to say that the brain is not reading the environment accurately and therefore, not responding in a way that is appropriate for the individual’s here-and-now needs.
With the latest research on the brain and the brain’s ability to adapt and change (neuroplasticity), we realize that the brain is much more flexible and, given the right conditions, has the ability to re-organize itself to some degree.
Some proponents of the treatment say that it helps foster speech, improves ability to make eye contact, decreases sensitivity to noise and makes kids on the spectrum more sociable.
In a hyperbaric oxygen therapy room, the air pressure is raised up to three times higher than normal air pressure. The increased oxygen dissolves in your blood during hyperbaric oxygen therapy, and circulates throughout your body.
Advocates of HBOT believe that children with autism have areas of the brain with less blood flow. Healthy eating is essential in order for a baby to thrive and develop and achieve milestones. Cheri Fraker and Laura Walbert are speech pathologists who specialize in the treatment of pediatric feeding disorders. They wrote a great article on therapy techniques and suggestions for introducing new foods. Child development is so complicated that it is a wonder most children develop without the need for intervention. My son is one of those kids who can’t seem to integrate movement patterns that are demonstrated. The programs use movement patterns and auditory (sometimes visual) feedback to help the child improve bilateral integration and improve timing and accuracy of the movements. Disclaimer: ” The opinions and recommendations on this blog are my own, and that caregivers should seek medical advice prior to starting any treatment.
Social skills training and speech or language therapy are the most common, each used by almost three-fifths of these children. ASD symptoms begin before age 3 years and last into adulthood, although symptoms may improve over time. Percent distribution of child's age when parent or guardian was first told that child had autism spectrum disorder among children aged 6a€“17 years with special health care needs and autism spectrum disorder: United States, 2011. Early identification is an important first step toward making sure that children with ASD and their families are able to access and benefit from early intervention, which has been associated with positive developmental outcomes (5a€“7). Social skills training and speech or language therapy are the most commonly used, followed by occupational therapy.
This screener uses the health consequences that children experience as criteria for identifying special health care needs, rather than just specific diagnoses or health conditions. The survey and this report are part of the Pathways to Diagnosis and Services Study, which was sponsored and co-led by the National Institute of Mental Health, using funds available from the American Recovery and Reinvestment Act of 2009. To be eligible, the CSHCN had to be aged 6a€“17 years at the time of the Pathways interview and still living in the same household as the recontacted parent or guardian. Stephen Blumberg and Rosa Avila are with the Centers for Disease Control and Prevention's National Center for Health Statistics, Division of Health Interview Statistics. Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder. Comprehensive synthesis of early intensive behavioral interventions for young children with autism based on the UCLA young autism project model. Identifying children with special health care needs: Development and evaluation of a short screening instrument. Diagnostic history and treatment of school-aged children with autism spectrum disorder and special health care needs. The report points out that the number on a thermometer is just a number and not necessarily indicative of the severity of a child's illness.
The first is that there is no "normal" - the body's temperature can fluctuate throughout the day. And contrary to many parents' fears, there's no evidence that fevers worsen the course of an illness or lead to long-term neurological complications in otherwise healthy kids.
Some pediatricians recommend alternating between the two, but the report notes that even though combination therapy can be more effective, it could put children at risk for dosing and timing errors. An infant younger than three months with a fever of 100.4 degrees or higher should be seen by a pediatrician.
Prior to that she was as a staff writer at WebMD (and its predecessor Medcast) and the Wellness Correspondent for travelgirl magazine. For a valid diagnosis a child must show hyperactive, impulsive symptoms or inattention symptoms in more than one setting—if it were only happening at home, for instance, or only at school, the behavior isn’t likely to be ADHD. A child with ADHD will score 3 times higher than typical kids on rating scales for these behaviors, and they will be seriously interfering with his ability to function in school, with friends and with his family. What we do is work through teachers and parents to set up environments for success for kids. It might seem obvious how to pack a backpack, but these kids need a lot of help building what we call executive function skills: planning and organizing and following through. Another very important element is Parent-Child Interaction Therapy, which can be amazingly successful in helping parents and kids together manage the disruptive behavior that often comes with ADHD.
He was the most hyperactive preschooler I have ever seen (and this is saying a lot given that I’ve been seeing kids for 30 years!) He could not stay in the treatment room. It’s the parents, working with the therapist, who will coordinate sending and receiving the daily report cards that are key to the treatment. He is a widely respected clinical researcher and child psychologist, one of sixteen master trainers in Parent-Child Interaction Therapy endorsed by PCIT International, and a dedicated advocate for children with special needs. As readers know, we’re big on healthy eating and have what could be termed a holistic approach to mental health, here at Therapy Soup.
When developing a plan, it is best to have a trained behaviorist involved to be sure it is based on a functional assessment of the childa€™s target behaviors.
However, since I can not evaluate each individual, please note that the interventions may not be applicable for all children.
Also feel free to contact mewith any questions, comments or to request information related to a specific topic or the behavior intervention plans provided.
Stigma, lack of awareness, and misinformation about diagnosis and treatment mean kids miss out on early intervention we know can transform lives. Without treatment, children with psychiatric disorders are more at risk for school failure, bullying, substance abuse, incarceration, and suicide. Help us to ensure that every child receives the early intervention that we know is crucial to transforming lives. Topics include: ADHD, anxiety, behavioral challenges, bullying,depression, trauma, and social media. Motor skills are divided into gross motor (movements of the large muscles) and fine motor (movements of the upper extremities and especially the hands).
Eczema is always problematic, but was especially so with my son because he had it around his rectum. He was recently diagnosed with ADHD combined type. He has trouble adhering to a structured protocol, and needs re-direction and supervision to ensure that he is paying proper attention. Whatever combination of genes produced my wonderful child also wired his brain to work in a certain way. When CP is not treated, the affected muscles have either too much tone on movement or too little tone.
While I don’t usually use my blog to tout political causes, I am going to make an exception for this particular issue.
If you had the opportunity to take measures which would improve the air quality for your unborn child or newborn infant, would you grab hold of that opportunity?
I understand not only because I have a son who has ADHD, but also because I treated so many of these children. Put another way, our brainwave patterns reveal the brain’s functioning and the field of neurofeedback is looking at how that functioning can be altered to alleviate symptoms. Often it is just repeating a “then-and-there” need, a response that was helpful long ago but no longer useful. Currently there is not enough research to make a definitive claim, but some studies suggest that as a complementary treatment, HBOT helps. Hyperbaric oxygen therapy is most commonly used to treat decompression sickness, serious infections, bubbles of air in your blood vessels, and wounds that won’t heal as a result of diabetes or radiation injury.
Under these conditions, your lungs can gather up to three times more oxygen than would be possible breathing pure oxygen at normal air pressure.


Oxygen-rich blood stimulates your body to release substances called growth factors and stem cells, which promote healing.
Refusal to eat or avoidance of food by a baby or child can be a seemingly endless nightmare for parents.
I am talking about kids with coordination issues which can interfere with their ability to swim, dance, hit a ball, catch a ball, etc.
There is no one best treatment for ASD, but the American Academy of Pediatrics recommends early behavioral intervention once a child is diagnosed (2). Among school-aged CSHCN with ASD, a majority were aged 5 years and over when they were first identified as having ASD, while only one in five was identified as having ASD within the first 3 years of life. Twelve percent of CSHCN with ASD do not use any of the eight services included in the survey, whereas fewer than one-half use behavioral intervention or modification services, the most well-established and efficacious intervention for ASD (2,8,9). Specific medication names were not solicited, but if the parent knew the name of the drug but not the type, the interviewer could refer to a list of drug names matched to type of medication. Of the parents or guardians with eligible CSHCN, 71% were successfully recontacted and 87% agreed to participate. Michael Kogan is with the Health Resources and Services Administration's Maternal and Child Health Bureau, Office of Epidemiology and Research.
The goal of treating a fever should be to make the child comfortable rather than getting body temperature down to a certain number, the report concluded.
Harrison says he's seen perfectly healthy kids with temperatures over 100 degrees after they've been running around on a warm day. Doses should be determined by weight not age, and medicine should be measured with a proper measuring device and not any old spoon. While we can assume that some kids are misdiagnosed, a much bigger problem is the many children who are not diagnosed and not treated, who are failing in school, in conflict with friends and families and at risk for dangerous behavior.
And we use specialized behavioral therapy—with systematic reinforcement—to help kids learn to focus their attention, and reel in their impulsive and hyperactive behavior. There are also non-stimulant medications that help some kids who don’t respond to stimulants, or who experience negative side effects from them.
He made it all the way from 1 to 14, and at the end of the row of toys, he double fist pumped and said, “I got to the end of the line!” The medication helped him focus and actually enjoy the activity. It’s the parents who will coach their kids about behavior expectations and then reinforce that behavior at restaurants, church, temple, family gatherings, etc. Parents can learn effective techniques for reinforcing appropriate behaviors and discouraging negative ones. Customized plans typically list detailed triggers for the individual, replacement behaviors, proactive strategies, and how to respond to each target. The Child Mind Institute’s Speak Up for Kids is about standing with these kids and families so our message is heard: childhood mental health matters and treatment works. For example, when you want to pick up a glass of water, your eyes see the glass and your brain automatically calculates how far you need to reach, how firmly you need to grip, how strongly you need to hold, how far you need to lift and how to move your muscles to drink and swallow. Well, infant massage fosters good parent-child interaction, helps with eye contact, improves sensory responses and can actually help with muscle tone and development. He is hyperactive and inattentive and spends his days constantly chewing items he shouldn’t be chewing. The consequence is that children with this disorder have difficulty achieving their developmental milestones and performing ADL’s (activities of daily living). This inequality of tone causes the limbs to be forced into positions and postures which don’t allow normal function to occur. Although I have not seen the results personally, the principles underlying the treatment are sound. Or are you the kind of person who thinks something should be done, but would rather leave the solution to others who are willing to get involved? In the years since I started working, there has been a marked increase in children diagnosed with asthma, autism, cerebral palsy, respiratory problems, ADHD and more. For example, the brainwave patterns of individuals with ADHD will be different than in those without ADHD. We have come to understand that the brain gets habituated, in an attempt to be efficient—why reinvent the wheel each time?—not realizing that it is not being effective! Lack of coordination can be a symptom of motor planning problems (dyspraxia), proprioception (knowing where the body is in space) or processing problems. The instructor will show him how to reach forward and elongate his body so he can use his arms and legs properly, and inevitably he either moves his arms or his legs, but not both at the same time.
The idea is to teach your child to move in a specific pattern and use both sides uniformly so that a precisely timed and accurate pattern emerges. Nearly all children (94%) with ASD have special health care needs, defined as requiring health or related services beyond those required by children generally (3,4). A wide range of health care providersa€”including general and specialist physicians, mental health specialists, and othersa€”were the first professionals to identify CSHCN as having ASD. Younger CSHCN with ASD are more likely than older CSHCN with ASD to use any services and multiple services, in part because they are more likely to use occupational therapy and speech or language therapy to meet their developmental needs. A total of 4,032 interviews were completed from Februarya€“May 2011, an average of 9 months after the initial interview. Also, some parents start giving the child medicine when there is a minimal fever (under 100.4 degrees). There is concern among some parents that it is being over-diagnosed, and does the research support their concerns?
Once he finally did get inside, he spent on average 20 seconds on every activity available–enjoying every one of them like it was the most fascinating activity in the world, but moving on almost immediately. Kids can learn to more effectively rein in behavior, so they can be happier at home and at school.
While we don’t discount the role of medication and other treatments, we believe there is evidence that diet does influence mental (behavioral) health, although we know this is still a controversial perspective. As a result, he started to hold back his bowel movements because they were painful when they touched his wounded skin. When his kindergarten nap blanket was sent home at the end of the year, it was misshaped and ragged from chewing. I can help my son learn to “harness” some of these behaviors in ways that will promote better attention and ultimately better learning. I watched a few videos of the treatment, and it looks like Therasuit accomplishes easily the exercises which are so difficult for a therapist to do manually. Many of our current mental health conditions we could describe as the result of the brain’s misperception of what it needs to do in the present in order to be efficient and effective. It could be related to swallowing problems (dysphagia) or motor planning problems (dyspraxia) or sensory problem or sucking problems or all of the above.
He needs hand-over-hand assistance and many repetitions before he is able to form the motor memory.
Clapping hands is a pattern which requires hands to move away from each other and then come together at exactly the same time. This report provides information on diagnosis and treatment of school-aged (6a€“17 years) children with special health care needs (CSHCN) and ASD. A majority of CSHCN recognized as having ASD at age 5 years and over were identified by psychologists and psychiatrists, whereas no one type of health care provider identified more than 20% of CSHCN recognized as having ASD before age 5 years. More than one-half of school-aged CSHCN with ASD use at least one psychotropic medication, with stimulants being the most common.
This report presents selected measures of diagnostic history and health care experience for the 1,420 CSHCN who were reported to have an ASD at the time of the Pathways interview. For children and adults with motor or sensory problems, the information is either interpreted incorrectly or isn’t sent correctly. They unanimously agreed that although it might seem like ADHD is currently over-diagnosed, in actuality it is probably under-diagnosed. It is the beneficial effect in a patient following a particular treatment that arises from the patient’s expectations concerning the treatment rather than from the treatment itself. Children who were preemies, children with autism, children with SPD, children with ADHD, children with genetic disorders and normally developing children can all make their parents anxious over their refusal to eat or their food pickiness. Medication use spans a variety of medication classes, perhaps reflecting treatment of co-occurring symptoms or absence of clear practice guidelines for psychotropic medication use in children with ASD (10). I can help decrease dysfunctional symptoms, and promote improvement in function, but I can’t undo what nature has done. Interestingly enough, my son constantly asks to have his tummy rubbed or his back massaged. The NS-CSHCN response and realization rates were about 25%; unpublished analyses suggest no significant nonresponse bias in estimates of the prevalence or characteristics of CSHCN with ASD. Massage is one of my favorite techniques for addressing these needs and helping him to get calm and organized. For more information about the Pathways survey, including questionnaire content, please visit Survey of Pathways to Diagnosis and Services website.



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