Autism: Early Detection and Treatment is Crucial

Worrying about the well-being of their children is nothing new for mothers. Many sleepless nights are not uncommon with a new mother who may lay awake in bed for hours listening for the cry of a child or wondering if her child is developing the way he/she should be. This is not a revelation to doctors, in fact they see if every day; mothers come in and ask questions like, “Should my child be doing (fill in the blank) yet? Do you think my child is advanced, delayed or right on target in terms of development? Should I be concerned because my child isn’t doing (fill in the blank) yet?” Often these questions are brushed off by doctors with a “let’s wait and see” attitude. Dr. Pauline Filipek, a child neurologist at the University of California-Irvine, is trying to change this response so often given by doctors. According to Filipek, "I hear this from parents all the time, that the pediatrician said, 'Don't worry,' or 'You're imagining things' or 'let’s wait.’ When I give lectures to pediatricians, I tell them, 'Get these phrases out of your lexicon. Get them out of your vocabulary.'" Filipek made this statement in regards to the often overlooked and missed diagnosis of autism. Doctors today are in too much of a hurry to rush through patient visits and too quick to write off the concerns of their patients. The relationship between patient and doctor has been reduced to a five minute exchange, of which the doctor is probably thinking of a handful of different things, none of which focus on the patient. While this is not always the case, it too often is and that is why parental vigilance is essential to ensure sufficient time is taken to properly diagnose their children.

According to the National Institute of Neurological Disorders and Stroke, “Autism is characterized by impaired social interaction, problems with verbal and nonverbal communication, and unusual, repetitive, or severely limited activities and interests.” On average, autism is diagnosed by the time the child is three years old. However, recent studies have shown that the earlier a child is diagnosed with autism, the sooner treatment can begin and the better odds the child has at overcoming this developmental disorder. One such study, published and released by the American Academy of Pediatrics in October 2007, sited two clinical reports that, “will help pediatricians recognize autism spectrum disorders (ASDs) earlier and guide families to effective interventions, which will ultimately improve the lives of children with ASDs and their families.” The most common form of treatment focuses on behavioral and environmental interventions, in which “therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills. Family counseling for the parents and siblings of children with autism often helps families cope with the particular challenges of living with an autistic child.” Family counseling is very important.

The first years of a newborn’s life are crucial in terms of being able to relate to and engage with their parents and family, so now imagine a new mother struggling to connect with her new baby, who refuses to be held or even make eye contact with her. The difficulty in bonding during this time can have long-term negative effects for both mother and child. In an article posted on CNN.com and written by Elizabeth Cohen, a correspondent with CNN Medical News, Briana Vartanian spoke of her experience encountering these problems with her daughter Lola. According to Briana, “Lola never looked at me--she looked through me. She had no idea who Mommy was. And other kids love it when someone comes up to them and smiles. She'd freak out if someone approached her--even if it was me or my husband." Briana knew her daughter was different and, more importantly, she knew something was wrong. But when she approached her doctor about this she, like countless others before and after her, was brushed off and placated with a “Let’s wait and see.” Briana was not satisfied and sought out a second opinion, this time from a pediatric neurologist. Lola, now fourteen months old, was immediately diagnosed with autism and began treatment right away.

The case of Lola is just one of many children whose condition goes unnoticed and undiagnosed for too long before someone realizes that this is not a “Let’s wait and see” situation. Early intervention is vital to the successful treatment of children with autism. This is the premise behind the new push to have all babies screened for autism not once, but twice before the age of two. The American Academy of Pediatrics is pioneering this shift in realizing how crucial early intervention is, especially when dealing with developmental disorders, such as autism. The earlier the better is the way autism and the treatment of it works. The Autism Society of America clearly supports this notion as it states on its website, “Research indicates that early diagnosis is associated with dramatically better outcomes for individuals with autism. The earlier a child is diagnosed, the earlier the child can begin benefiting from one of the many specialized intervention approaches treatment and education.” There is absolutely no evidence to support the idea that waiting to diagnose a child with autism has any benefits. Although, it must be mentioned that many parents may not want to deal with the reality of having a child with autism and so may be decline having their child tested. However, this mentality is not in the best interest and welfare of the child.

According to an article written by Lindsey Tanner and posted on the Associated Press website just yesterday, “Experts say one in 150 U.S. children have the troubling developmental disorder [autism].” Parents are more aware of the signs that may indicate their child is autistic and this awareness is the first step toward helping their child. However, the key element here is still early intervention. If a child has any signs that may point to autism, get them screened today. The earlier a diagnosis is made, the sooner a treatment plan can be implemented, and this will give the child the best odds possible of overcoming this developmental disorder. Children who have been diagnosed with autism and their families deserve the best possible chances and those come with the earliest detection and action possible. This is something parents do not want to “wait and see” on; every day counts so have parents need to have their children screened today.

Bullying: An Epidemic Still Plaguing Our Children

Children who tease each other playfully and engage in mutual, friendly banter are just being kids growing up together. But when does this cross the line and become bullying? In the past, people have referred to bullying as more of a right of passage most children have to go through at some point during their childhood. Parents have often scoffed at the complaints of their children and cast them off as needing to be “toughened up.” Boys, in particular, have been targeted for being “too sensitive” and have often been told to “be a man about it.” These common responses do nothing to alleviate the constant fear, anxiety, insecurity and misery that a child who is being bullied in school lives with every day. School can be difficult enough without the added worry and stress of being at the mercy of bullies. And moreover, children should not have to go to school in fear of what humiliations they will be subjected to that day. It is incumbent upon the adults in society to take action against bullying. The responsibility is not limited to the parents, but it also extends to the teachers, administrators and any other adults present in the school environment. A child has the right to go to school without being afraid. It is society’s duty to ensure this right is upheld and to protect those whose rights are being violated.

Bullying, according to an article posted on KidsHealth.org and reviewed by Michelle New, PhD, is “intentional tormenting in physical, verbal, or psychological ways.” The torment inflicted on the target victims comes in many different forms, such as verbal insults, threats, humiliation, name-calling, rumor spreading, physical abuse, shunning and isolation. There is also an emerging medium involving the latest technologies in which children are finding bullies lurking around every avenue. Cellular phones are used to leave harassing messages and to send mean, nasty, and often threatening text messages. Internet sites designed to promote communication between friends, like MySpace or online chat rooms, have become horrific new channels for derogatory statements, photos and multimedia creations to be displayed in order to further persecute and endlessly hunt these target victims. These forums have grown to be a safe haven for bullies to humiliate, threaten and maliciously tease their victims in a seemingly relentless pursuit to destroy every last shred of peace of mind these victims may have left. Today, society knows a different name and with it comes a new understanding; “Social cruelty” is the new term for bullying and it can be found in every school across America.

Many schools across the U.S. are attempting to deal with this problem in a variety of ways. Peer programs, parent involvement, and early intervention are just a few of the current solutions that are being put together in an effort to stop and prevent bullying. The Winneconne Community School District Middle School Counseling Department in Wisconsin is taking steps to bring about awareness of differences to its students by designating a day during the month of November to “Celebrating Diversity/Building Social Skills.” The Winneconne school district describes this event as, “An effort to raise awareness of acceptable and unacceptable social behavior. Winneconne Middle School participates in the national Teaching Tolerance Mix It Up at Lunch Day in November to confront social cruelty and promote inclusion. Diversity and multi-cultural activities include guest presenters, arts enrichment, and handicapped awareness. Students are informed about the consequences for harassment. Counselor classroom sessions on bullying, teasing, gossip/rumors, name-calling, and ostracism are often presented on Parents Days to increase open discussion of this topic. Opportunities for building self-esteem, respect and friendship and learning empathy and compassion are woven throughout the curricular and co-curricular programs including lunch bunches, Circle of Friends, Peer Helper Team, and SAP Groups.” This is an excellent example of teachers and administrators taking proactive measures to ensure their students are exposed to the moral responsibility they each bear in treating each other with dignity and respect. While schools are a primary focal point when addressing the issue of bullying, there is a new wave of innovation on the horizon in this area.

According to an article posted on ScienceDaily.com, a pan-European group known as Kaleidoscope, a network devoted to the research and innovation of technology-enhanced learning, has created a new tool to combat social cruelty, which is a role playing computer game. Rui Figueiredo, a scientist at the Institudo de Engenharia de Sistemas e Computadores in Portugal and one of the Kaleidoscope researchers involved in the project, says, “This 3-D interactive virtual environment provides a safe haven for individual children, where they witness bullying scenarios without being directly involved.” “FearNot!” is the title of the game and the premise is that each child player is an invisible friend of the victimized main character. The player narrates the storyline and influences the path of the game through the decisions they make when presented with various scenarios. The child bears the responsibility of determining the fate of the victim. Researchers from Germany, Portugal and the UK are currently conducting studies with “FearNot!” on more than 1,000 children throughout Europe and plan to present their findings at the upcoming Kaleidoscope 2007 Symposium, which will be held in Berlin, Germany, on November 26th and 27th.

The importance of addressing the topic of social cruelty cannot be overlooked or pushed aside. Recent events dealing with students bringing guns to school in an effort to literally wage war on their tormentors cannot be ignored. Victims are being pushed to their breaking points and when this happens the American people watch the horror unfold on television, as lives are shattered and scarred forever. People who have scoffed at the notion of bullying being a real issue in schools have been forced to rethink their perspectives as they question how children, and we must not forget that these individuals attacking their peers and teachers are still children, can be capable of such atrocities. The answer lies not in what the police find hidden in their bedrooms at home, but in paying closer attention to their past. A CNN.com article, written a few short months after the now infamous Columbine High School shooting, points the finger at bullying as a primary force in the actions of these young students against their peers. The article stresses the importance of addressing the issue of bullying by saying, “Recent school shootings across the country have put a spotlight on bullying. The shooters in those tragedies had said they'd been made to feel like social outcasts. [Dorothy] Espelage is concerned that ignoring bullying behavior is the same as condoning it.”

Dorothy Espelage, a psychologist and professor at the University of Illinois at Urbana-Champaign, lead a study that established a new perspective on the prevalence of bullying in middle schools. It was previously thought that only about 15 percent of the student body of a typical junior high school engaged in regular bullying behaviors. However, the findings of this study suggest the actual reality is closer to 80 percent. This is a significant increase from what researchers had formerly believed to be an accurate evaluation. This study links the prevalence of bullying to the increase in violent attacks on peers by the victims. A child who, from a young age, has been constantly victimized and relentlessly tormented by peers has years of suffering, anger, aggression and resentment that have been bubbling inside of them until it explodes outward. People respond with shock and unimaginable horror, and yet it too bears a responsibility. In turning a blind eye to the problems of social cruelty in schools, society is walking away from its accountability to the children of our nation and therefore is just as culpable as those who wield the guns.

The Kaleidoscope network is pioneering a shift in thinking as well as a new method in reaching children. By creating a video game to teach children values in regards to bullying, they are tapping a medium children already gravitate toward. This is crucial in communicating to children on a level they are comfortable with and, thus, to which they are more likely to respond positively. The importance of early intervention cannot be emphasized enough. Children must be taught to bear moral responsibility and accountability towards one another. It is the duty of the teachers and administrators in schools and parents at home, to instill these values within children. The responsibility rests upon the adults to be ever more vigilant and watchful so as to address any problems between students as quickly and effectively as possible. A new age of understanding, tolerance and acceptance of one another is dawning. Kaleidoscope is at the forefront in sending the message that social cruelty is a problem of epic proportions that warrants serious research in an attempt to find effective solutions.

Values vs. Labels: Children’s Fashion

Baby couture. Kid’s high-fashion. Fashion-forward kids. Designer children’s clothing. These are the terms many new mothers are concerning themselves with. The questions are no longer about the most ergonomic baby carriers or bottles, but instead about the exterior look and aesthetic value they possess. Baby strollers are no longer sought out for their safety and portability, but rather their appearance and coordination with the outfits of their parents. The material nature of American society promotes a fashion-conscious framework from which parents are now feeling the pressure in regards to the fashion of their children. No longer is it good enough for parents to have Dolce & Gabbana clothes and accessories for themselves, but now their children have to have those labels as well.

Babies and children are being paraded around in designer clothes, which they will no doubt grow out of within months, in an effort by their parents to exude a level of coolness, status and wealth consistent with the image of their parents. In an article by TIME, Esprit President Douglas Tompkins states, "Some people like to dress their kids up and parade them around for presentation." This article also suggests, “A well-dressed child may be the ultimate status symbol.” The notion of children being an extension of their parents is as old as time, but now there are new standards for these children. Dal Dearmin, a vice president at the advertising firm of Quinn & Johnson/BBDO was quoted saying, "Kids are the BMWs of the '80s." While Dearmin’s statement may be a little facetious, it hits home with the implication that children are often used as an accessory to the image of their parents. Parents want their children to reflect positively back on them, but it seems now it is less about politeness and manners, and more about high-fashion clothes, accessories and designer labels.

The social ramifications of placing so much emphasis on appearance and fashion trends extend far beyond the image of parents. Children, in some cases, are being taught that what they wear is more important than how they behave, and more importantly, how they treat other children. Values taught in the home are transitioning from building successful social relationships to making sure the neighbors know you can afford a 24-carat gold-plated baby carriage and your children shop exclusively on Rodeo Drive. Raising children to be a status symbol is a crime against society that will only further divide the have and the have-nots, while continuing to promote this era of shallow materialism.

The social consequences of endorsing this superficial set of values and passing them along to children will filter through the many prongs of society and affect the way children grow up. School is an enormous factor for children; it is where they learn to interact and relate to one another. For a child whose parents cannot afford the latest trendy clothes or the Coach backpacks, school can be a harrowing daily experience. Cruelty within schools is nothing new, but now some parents are presenting their children with a new way to feel superior to others. Teaching children that having more expensive clothes and toys means you are better than others will not remain an ideology in the home. Those same children will likely take this highfalutin attitude they have been instilled with out into the world and instead of looking at others with eyes of understanding and appreciation for what they have, often they are looking with eyes of ridicule and contempt. This idea of high fashion for children may seem trivial to some and cast off as nothing more than parents enjoying dress-up time with their children. There are many profound and lasting issues at stake here that merit the attention, time, and thought of society as a whole.

Purging Disorder: Does this mean a revision to DSM-IV?

Eating disorders are not new to the American public, nor are they new to the medical community. Doctors around the country have dealt with bulimia and anorexia for decades, however there appears to be a new kind of eating disorder emerging. Pamela Keel, a psychology professor at the University of Iowa, led the research study and found that this is in fact a new disorder. “Purging disorder” is the term being used to describe this new phenomena and it is much harder to detect than either bulimia or anorexia. The reason purging disorder is so difficult to identify is that it does not fall within the already established parameters of known eating disorders. Purging disorder shares some characteristics with bulimia and some with anorexia, however it does not share all traits with either. Medical doctors who are encountering this disorder are unsure of what category to place purging disorder into and so are left scratching their heads as to the course of treatment.

The DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, is the ruling authority within the medical community. Unfortunately, medical professionals are unable to consult DSM-IV because it does not have a category that would include purging disorder. Bulimia and anorexia have their own realm within diagnoses and are quite distinguishable from each other. However, the rising rates of purging disorder begs us to examine whether or not it warrants a revision to the DSM-IV in which it can be seen as similar to but separate from both bulimia and anorexia.

Bulimia is an eating disorder in which people, most often women (women are ten times more likely to suffer from an eating disorder than men), will binge eat to the point where people have complained of pain in their chest and abdomen. The person will then induce vomiting and expel the massive amounts of food consumed just moments prior. Purging disorder is similar in that it contains the vomiting component of bulimia; however the consumption of food is no where near that of bulimia. People with purging disorder often eat a regular amount of food or very little food. The fact that there is no binge eating coupled with the purging clearly takes purging disorder away from the diagnosis of bulimia.

Anorexia is an eating disorder that is broken down into two subdivisions; Anorexia Restricting subtype and Anorexia Binge-and-Purge subtype. Anorexia restricting subtype is where the person restricts their diet so as to limit the amount of food consumed even to the point of refusing to eat any food at all. However, there is no purging component to this type of anorexia. So while purging disorder contains the element of eating little to no food, it also contains the element of purging, which excludes it from this diagnosis.
Anorexia binge-and-purge subtype is just as it sounds; the person will binge-eat and then induce vomiting. We must keep in mind that to a person suffering from anorexia the term “binge-eat” will vary greatly than in terms of a person suffering from bulimia. A person suffering from this second subtype of anorexia will likely go from eating nothing to eating what would amount to a normal meal and to them it is considered a huge amount of food and they immediately engage in purging.

The chief element to a person suffering from anorexia of either subtype is that the person is noticeably under weight. A person with a normal weight cannot be anorexic because in either subtype of anorexia there is always an aspect of restricting; this is a crucial dividing line between bulimia and anorexia. Taking notice of the areas in which these two disorders come close to but never crossover with one another is how the DSM-IV has defined the separate diagnoses of Anorexia and Bulimia. But now there is a new disorder on the rise and no one is sure about where it fits in. Purging disorder is characterized by a person of normal weight who eats either very little or enough that amounts to a small meal and who purges immediately after eating. The defining characteristics of Anorexia and Bulimia are exclusive of one another and so the fact that purging disorder contains both of these exclusive elements suggests that a revision to the current definitions set forth by DSM-IV is absolutely needed.

*It is important to note that the use of the term “purging” in this post is seen for the most part as vomiting, however other forms of purging include taking laxatives, excessive exercise and other compensatory behaviors, in which the goal is to purge calories from the body.