Showing posts with label Education. Show all posts
Showing posts with label Education. Show all posts

Thursday, April 23, 2015

Eleven psychiatrists disciplined at Japanese hospital – fraudulent applications. Newspaper “astounded by the lack of morals”

From The Yomiuri Shimbun [Japan News] (google translate)

We are astounded by the lack of morals of people engaged in medical services at a hospital. It is vital that a thorough investigation is conducted into whether inappropriate medical examinations or treatments were carried out.

At St. Marianna University School of Medicine Hospital in Kawasaki, 11 doctors were recently found to have made fraudulent applications to the Health, Labor and Welfare Ministry to acquire the special status of designated psychiatrist. The health ministry stripped 20 psychiatrists at the hospital, including attending doctors, of the special status. It is believed to be unprecedented for such a large number of doctors to be disciplined for involvement in acquiring the special status by fraudulent means.

There are 14,630 designated psychiatrists working across the country. Through the authority of a prefectural governor or an equivalent official, these psychiatrists are allowed to decide whether mental patients should be “involuntarily hospitalized” to ensure that they do not hurt themselves or others. They are also permitted to decide on “hospitalization for medical protection” for mental patients after receiving consent from the patients’ relatives. As designated psychiatrists have the authority to restrict a patient’s movements, doctors with sufficient knowledge and ample experience in this field are designated by the health minister, on the basis of the Mental Health and Welfare Law. Seeking this status through fraudulent applications is as if the status certification system is not being taken seriously.

To apply for the special status, applicants must have at least three years of working experience as a psychiatrist and to have submitted case reports on at least eight of their patients. The 11 doctors had rewritten the reports of cases treated by senior doctors and submitted them to the ministry as if they themselves had treated the cases. This is abominable.

‘Normal’ practice

What must not be overlooked is that such methods were used so often they had become a normal practice. The hospital has admitted that the transfer of data entered in the reports was carried out by these doctors. The attending doctors also failed in their function of checking such practices. This is indeed a serious problem.

The hospital reportedly became aware of the fraudulent applications of these doctors after the health ministry pointed out striking similarities in the reports. Doctors who obtained the special status fraudulently have decided on involuntary hospitalization of four mental patients and hospitalization for medical protection of about 100 patients.

If doctors made wrong medical judgments to forcibly hospitalize patients, this would constitute a serious human rights problem. Both the Kawasaki city government and the hospital need to delve deeply into the matter to clarify the situation. A designated psychiatrist is eligible for preferential treatment in terms of remuneration for medical services. With the fraudulent acquisition of the special status by these doctors, the hospital received about ¥1.7 million more than it normally would through the treatment of outpatients. Naturally, the hospital has said it will return the money.

With the retraction of the status, the hospital has scaled down treatment in its neuropsychiatric department. As a result, local medical services have been affected.

To prevent a recurrence of fraudulent applications, the health ministry plans to speed up its efforts to make a database of submitted reports in order to determine whether reports have distinct similarities. The ministry will also investigate whether there are similar illicit activities at other hospitals.

Friday, June 06, 2008

School — 1957 vs. 2007

Quoted because of the observations on the psych abuse, but also because of the insights on political correctness As seen on Los Cuatro Ojos

Scenario #1:
Johnny and Mark get into a fistfight after school.

1957 - Crowd gathers. Mark wins. Johnny and Mark shake hands and end up buddies.

2007 - Police called, SWAT team arrives, arrests Johnny and Mark… Charge them with assault, both expelled even though Johnny started it.
Scenario #2:
Jeffrey won’t be still in class, disrupts other students.

1957 - Jeffrey sent to office and given a good paddling by the Principal… Returns to class, sits still and does not disrupt class again.

2007 - Jeffrey given huge doses of Ritalin… Becomes a zombie. Tested for ADHD. School gets extra money from state because Jeffrey has a disability.
Scenario #3:
Billy breaks a window in his neighbor’s car and his Dad gives him a whipping with his belt.

1957 - Billy is more careful next time, grows up normal, goes to college, and becomes a successful businessman.

2007 - Billy’s dad is arrested for child abuse… Billy removed to foster care and joins a gang… State psychologist tells Billy’s sister that she remembers being abused herself and their dad goes to prison… Billy’s Mom has affair with psychologist.
Scenario #4:
Mark gets a headache and takes some aspirin to school.

1957 - Mark shares aspirin with Principal out on the smoking dock.

2007 - Police called, Mark expelled from school for drug violations… Car searched for drugs and weapons.
Scenario #5:
Pedro fails high school English.

1957 - Pedro goes to summer school, passes English, goes to college.

2007 - Pedro’s cause is taken up by state. Newspaper articles appear nationally explaining that teaching English as a requirement for graduation is racist. ACLU files class action lawsuit against state school system and Pedro’s English teacher… English banned from core curriculum… Pedro given diploma anyway… but ends up mowing lawns for a living because he cannot speak English.
Scenario #6:
Johnny takes apart leftover firecrackers from 4th of July, puts them in a model airplane paint bottle, blows up a red ant bed.

1957 - Ants die.

2007 - ATF, Homeland Security, FBI called. Johnny charged with domestic terrorism, FBI investigates parents, siblings removed from home… computers confiscated. Johnny’s Dad goes on a terror watch list and is never allowed to fly again.
Scenario #7:
Johnny falls while running during recess and scrapes his knee. He is found crying by his teacher, Mary… Mary hugs him to comfort him.

1957 - In a short time, Johnny feels better and goes on playing.

2007 - Mary is accused of being a sexual predator and loses her job. She faces 3 years in State Prison… Johnny undergoes 5 years of therapy.

Friday, May 16, 2008

The psychiatric drug connection to Emo Kids

A report in the Guardian newspaper on the "emo" fad labels it as a cult, but of interest to our regular readers is the connection to psychiatric medications. Specifically, paragraphs 61 through 63 of the story read:

"'I was going through an unhappy period at school," she recalls. 'I grew up in the wealthy area of Cheshunt in Hertfordshire, and I was surrounded by spoilt rich kids. I felt that being an emo gave me a defined individuality.'"

"Looking back, she acknowledges that the 'cult', as she calls it, was heavily linked to self-harm and depression."

"Many of her friends were actually taking prescription antidepressants."
SSRI Stories believes 13 year old suicide victim Hannah Bond (featured in the story) may have ingested antidepressants given to her by her friends. This is a fairly common practice.

Wednesday, March 05, 2008

Mental Health Screwup: Girl Must Repeat High School

Another fine example of how the mental health industry keeps screwing things up, this time in the realm of public education. Seems like a typical bureaucratic attitude of typical attitude of "Not Our Fault, Not Our Problem".

From this report from WGCL-TV, CBS 46, Atlanta Georgia.

A Gwinnett County teenager will have to spend another four years in high school while other teens her age go to college, her family said Tuesday.

Daphne and Brian Adams said that several years ago, Gwinnett County schools improperly placed their daughter in classes for the mentally impaired, instead of addressing her language disability.

The school district has told the family that the girl must start over to get a diploma. Her family said their daughter, who is 18, is embarrassed to be in classes with students who are 13 and 14.


“The track that she's on, she's set up to fail,” said Daphne Adams.

Special education attorney Chris Vance said Tuesday that the school system should have realized their mistake. Tests have shown that the girl has an average IQ score of 91.

Her parents said they have spent their retirement savings to help their daughter catch up. They said they want Gwinnett County to reimburse them and pay for private schooling until their daughter graduates.

“She wants a real diploma. She doesn't want a piece of paper,” Adams said.

Tuesday, the school district issued this statement: "There are legal constraints on what a school system can say about individual students. That said, we can assure you that processes and procedures are in place to address students' educational needs and placement."

Thursday, January 24, 2008

Psychologist's Book Slammed on Amazon After Fox News Debacle

As Reported on Gaming Daily

Syndicated radio talk-show host and psychologist Cooper Lawrence is now getting a taste of the gaming and Internet community following her appearance on Fox News in which she criticized Mass Effect (a game she never played) and appeared to talk in an almost condescending tone to GameTrailers' Geoff Keighley (who was barely given the time of day to defend the game).

In the past few days Lawrence's book The Cult of Perfection: Making Peace with Your Inner Overachiever has been slammed with negative reviews on Amazon.com as backlash for her comments on Mass Effect. As of press time, out of 565 reviews 503 are 1-star and 48 are 2-star. Only 12 people have rated her book with a 5-star review.

Moreover, the tags customers associated with the product were telling: ignorant (350), hypocrisy (286), garbage (284), hypocrite (267), junk (264), hack (254), terrible (231), bigot (217), bigoted (197), bias (168).

Yesterday Electronic Arts (owner of Mass Effect developer BioWare) sent a letter to Fox News requesting a correction.

Friday, January 11, 2008

The Lives They Left Behind: Suitcases from a State Hospital Attic

An exhibit in New York City that exposes the recent dark ages of psychiatry in the 20th Century. From the NYC City guide

When an old ramshackle New York hospital, once known as the Willard Asylum for the Insane, closed in 1995, workers found a long-forgotten door tucked under pigeon-infested rafters. They pried it open and discovered a roomful of suitcases, covered in cobwebs and bird droppings, seemingly untouched for many years.

The luggage revealed surprising and touching stories about the patients who lived and died at the hospital. Working for nearly a decade, two mental health officials pieced together a dozen of their stories.

What emerged was The Lives They Left Behind: Suitcases from a State Hospital Attic, a free public exhibit, on view December 4, 2007 to January 31, 2008 at The New York Public Library’s Science, Industry and Business Library, 188 Madison Avenue.

The exhibit is presented by the National Alliance on Mental Illness of New York City Metro, The New York Public Library and the New York City Department of Health and Mental Hygiene, with generous support from the New York Community Trust.

[...]

"Hundreds of thousands of people ended UP in mental institutions before the mid-20th century and almost nothing was known of them," said Suitcases co-curator Peter Stastny, a psychiatrist and professor at Albert Einstein College of Medicine. "It was virtually a mass grave. This was really a unique opportunity to learn about their personal and medical histories side by side. That’s incredibly rare."

Suitcases presents a riveting, often appalling slice of psychiatric history in the United States, from the patients' point of view. Two dozen panels feature the stories of patients such as Miss Madeline #22040, a beautiful young Frenchwoman drawn to the occult, who fought her institutionalization for decades, and whose haunting photograph after years of confinement betrays intense suffering. And there was Mr. Lawrence #14956, an immigrant window washer who was institutionalized after being overheard singing loudly, praying and claiming to hear the voice of God. During his time at Willard, Mr. Lawrence dug more than 600 graves until his death at age 90, when he himself was buried in an unmarked grave.

[...]

The materials on display include photographs, panels depicting the patients' stories and cases of their belongings, including clothing and toiletries.
Not that things have gotten all that much better, as our site documents. An Exhibit that people should look into, but be aware that there is some positive spin regarding the "advances" of the modern era.

Friday, December 21, 2007

Problems with Understanding IQ Testing and Your Common Psychologist

Snippets from an book review in the New Yorker regarding the perils of psychological tests for IQ, and the debates about the relationship of IQ to race.

One Saturday in November of 1984, James Flynn, a social scientist at the University of Otago, in New Zealand, received a large package in the mail. It was from a colleague in Utrecht, and it contained the results of I.Q. tests given to two generations of Dutch eighteen-year-olds.

When Flynn looked through the data, he found something puzzling. The Dutch eighteen-year-olds from the nineteen-eighties scored better than those who took the same tests in the nineteen-fifties—and not just slightly better, much better.

Curious, Flynn sent out some letters. He collected intelligence-test results from Europe, from North America, from Asia, and from the developing world, until he had data for almost thirty countries. In every case, the story was pretty much the same. I.Q.s around the world appeared to be rising by 0.3 points per year, or three points per decade, for as far back as the tests had been administered. For some reason, human beings seemed to be getting smarter.

Flynn has been writing about the implications of his findings—now known as the Flynn effect—for almost twenty-five years. His books consist of a series of plainly stated statistical observations, in support of deceptively modest conclusions, and the evidence in support of his original observation is now so overwhelming that the Flynn effect has moved from theory to fact.

What remains uncertain is how to make sense of the Flynn effect. If an American born in the nineteen-thirties has an I.Q. of 100, the Flynn effect says that his children will have I.Q.s of 108, and his grandchildren I.Q.s of close to 120—more than a standard deviation higher.

If we work in the opposite direction, the typical teen-ager of today, with an I.Q. of 100, would have had grandparents with average I.Q.s of 82—seemingly below the threshold necessary to graduate from high school.

And, if we go back even farther, the Flynn effect puts the average I.Q.s of the schoolchildren of 1900 at around 70, which is to suggest, bizarrely, that a century ago the United States was populated largely by people who today would be considered mentally retarded.


[...]

This is not a trivial issue. I.Q. tests are used to diagnose people as mentally retarded, with a score of 70 generally taken to be the cutoff. You can imagine how the Flynn effect plays havoc with that system. In the nineteen-seventies and eighties, most states used the WISC-R to make their mental-retardation diagnoses. But since kids—even kids with disabilities—score a little higher every year, the number of children whose scores fell below 70 declined steadily through the end of the eighties.

Then, in 1991, the WISC III was introduced, and suddenly the percentage of kids labelled retarded went up. The psychologists Tomoe Kanaya, Matthew Scullin, and Stephen Ceci estimated that, if every state had switched to the WISC III right away, the number of Americans labelled mentally retarded should have doubled.

That is an extraordinary number. The diagnosis of mental disability is one of the most stigmatizing of all educational and occupational classifications—and yet, apparently, the chances of being burdened with that label are in no small degree a function of the point, in the life cycle of the WISC, at which a child happens to sit for his evaluation. “As far as I can determine, no clinical or school psychologists using the WISC over the relevant 25 years noticed that its criterion of mental retardation became more lenient over time,” Flynn wrote, in a 2000 paper. “Yet no one drew the obvious moral about psychologists in the field: They simply were not making any systematic assessment of the I.Q. criterion for mental retardation.”
Fortunately Flynn is able to cut through a lot of the BS that is associated with the field, when it comes to debates like IQ vs Race.
Two weeks ago, Flynn came to Manhattan to debate Charles Murray at a forum sponsored by the Manhattan Institute. Their subject was the black-white I.Q. gap in America. During the twenty-five years after the Second World War, that gap closed considerably. The I.Q.s of white Americans rose, as part of the general worldwide Flynn effect, but the I.Q.s of black Americans rose faster. Then, for about a period of twenty-five years, that trend stalled—and the question was why.

Murray showed a series of PowerPoint slides, each representing different statistical formulations of the I.Q. gap. He appeared to be pessimistic that the racial difference would narrow in the future. “By the nineteen-seventies, you had gotten most of the juice out of the environment that you were going to get,” he said. That gap, he seemed to think, reflected some inherent difference between the races. “Starting in the nineteen-seventies, to put it very crudely, you had a higher proportion of black kids being born to really dumb mothers,” he said.

When the debate’s moderator, Jane Waldfogel, informed him that the most recent data showed that the race gap had begun to close again, Murray seemed unimpressed, as if the possibility that blacks could ever make further progress was inconceivable.

Flynn took a different approach. The black-white gap, he pointed out, differs dramatically by age. He noted that the tests we have for measuring the cognitive functioning of infants, though admittedly crude, show the races to be almost the same. By age four, the average black I.Q. is 95.4—only four and a half points behind the average white I.Q. Then the real gap emerges: from age four through twenty-four, blacks lose six-tenths of a point a year, until their scores settle at 83.4.

That steady decline, Flynn said, did not resemble the usual pattern of genetic influence. Instead, it was exactly what you would expect, given the disparate cognitive environments that whites and blacks encounter as they grow older.

Black children are more likely to be raised in single-parent homes than are white children—and single-parent homes are less cognitively complex than two-parent homes. The average I.Q. of first-grade students in schools that blacks attend is 95, which means that “kids who want to be above average don’t have to aim as high.”

There were possibly adverse differences between black teen-age culture and white teen-age culture, and an enormous number of young black men are in jail—which is hardly the kind of environment in which someone would learn to put on scientific spectacles.

Flynn then talked about what we’ve learned from studies of adoption and mixed-race children—and that evidence didn’t fit a genetic model, either.

If I.Q. is innate, it shouldn’t make a difference whether it’s a mixed-race child’s mother or father who is black.

But it does: children with a white mother and a black father have an eight-point I.Q. advantage over those with a black mother and a white father.

And it shouldn’t make much of a difference where a mixed-race child is born.

But, again, it does: the children fathered by black American G.I.s in postwar Germany and brought up by their German mothers have the same I.Q.s as the children of white American G.I.s and German mothers.

The difference, in that case, was not the fact of the children’s blackness, as a fundamentalist would say. It was the fact of their Germanness—of their being brought up in a different culture, under different circumstances.

“The mind is much more like a muscle than we’ve ever realized,” Flynn said. “It needs to get cognitive exercise. It’s not some piece of clay on which you put an indelible mark.”

The lesson to be drawn from black and white differences was the same as the lesson from the Netherlands years ago: I.Q. measures not just the quality of a person’s mind but the quality of the world that person lives in.
And of course, these results also mean that a person's IQ is changeable, given enough time, proper environment, education, and other therapeutic methods.

Thursday, December 20, 2007

Parents suing NY State school district over kid's referral to psychiatrist

As one commenter noted on this story:

So let me get this straight..

THE SCHOOL assigns the kids to write an essay on "what would a person do if he had 24hours to live? "That is a MORBID!!!! question/assignment. Psyche services for the TEACHER whose morbid enough to come up with this trend of thought.

So now the TEACHERS LEADs the kid down this MORBID path...he answers honestly just as morbid as the question is and he needs psyche services?

What a warped bunch of a- holes these educators are. No wonder our kids are nuts!!!

[...]

I hope a whole lot of these so called educators get fired. Incompetents fools. Each and everyone of us sit in front of the boob tube and watch "movies." Did it ever occur to anyone out there that those violent scenes came out of someones morbid minds? That begs the question why hasn't the likes of Steven King/ these screen writers/ directors ever been psyche evaluated? How about Susan Lucci? why hasn't she been evaluated? for her to play role a totally psychotic dysfunctional Erica Kane is a day at the office.

POINT BEING: This kid sees SICK/DYSFUNCTIONAL Psychos all day long all over the place and NO ONE QUESTIONS it. So why is every body questioning him for having the same morbid imagination as any screen writer after some morbid teacher asked him to write an essay on a morbid topic... such as what would you do before you got snuffed out?

[...]
Here is the news item as reported in the Times Herald Record

The parents of a teenager referred to Child Protective Services because educators believed he was suicidal are suing the Warwick Valley School District.

In a federal claim, Everett Cox III, a former Warwick school board member, and Nan Ping Peng allege school officials violated their due process rights and their son's privacy rights. They want the district to pay for a private school.

"There's a level of recklessness here," said the parents' Goshen lawyer, Michael Sussman. "A kid has the right to speak out in response to a school assignment without a fear of his family being destroyed."

Sussman has had a string of legal victories suing school districts over due process violations. But those have been over suspensions from school or sports teams. This latest case gets at a more complex issue: how far schools should go to ensure children who are talking or writing about violence are not a danger to themselves or others.

Sussman said educators should be able to discriminate between a real problem and a kid who's in tune with a violent popular culture, and let parents decide what's best for a student.

But Pam Atkins, director at the Psychological Counseling Center at SUNY New Paltz, said school counselors have a duty to be sensitive to students' writing about violent behavior, and always err on the side of caution.

"Parents are specialists in raising children," Atkins said. "They are not specialists in suicide and homicide. We like to think we know our kids but so often our worries and our feelings about children interfere with our ability to see the truth about what's going on."

Warwick school officials declined comment. Their call to CPS came near the end of a school year in which the student had been in a fight with another student, been suspended for drawing on a school wall and written at least two school assignments that included references to violent activity, including suicide.

At the school's insistence, the student was evaluated by a psychologist in February, after he wrote the first essay. In April, in response to an assignment about how he would live his last 24 hours, the student wrote about doing drugs, taking poison and shooting himself.

He submitted the assignment before the April 16, 2007, massacre at Virginia Tech in Blacksburg, Va., in which a disturbed student killed 33 people, including himself. After the attack, school officials called the Child Protective Services hotline and, according to the suit, said the student was homicidal and suicidal and his parents provided "a minimal degree of care to their son."

The CPS psychiatrist who evaluated the student recommended a follow-up examination and sent him home with his parents.

NYU Bows to Critics and Pulls Ransom-Note Ads

As noted by the WSJ Health Blog, NYU Bows to Critics and Pulls Ransom-Note Ads

After sparking widespread criticism, the New York University Child Study Center decided this afternoon to pull ads, which featured ransom notes that personified mental illnesses as kidnappers of children suffering from the conditions.

The center’s campaign, which began earlier this month, featured images of ransom notes to drive home the message that 12 million children are being held hostage by mental health problems, such as depression and autism. See the Health Blog’s previous post on the NYU controversy here.
The campaign provoked the ire of many patient groups, who called the ads stigmatizing and fear-inducing. NYU received thousands of phone calls and e-mails since the ads became widely publicized, with about 70% against the campaign.

This from a facility who is supposed to specialize in understanding the mind (and thus people), and communication and education. Their attempt to educate and communicate with the public merely antagonized, revealing something of a lack of expertise. Hmmmmmmmm.

Tuesday, December 18, 2007

The Diagnosis and Treatment of Childhood

Having noticed web traffic looking for this article, we are providing for the benefit of readers a full copy of the satire with the title “The Diagnosis and Treatment of Childhood”, which also fits well with the satire "Babies: 100% suffer from Depression" cited earlier on this site. Note that the actual title this satire is not “The Diagnosis and Treatment of Childhood”, but is rather is “The Etiology and Treatment of Childhood”. It still works.



The Etiology and Treatment of Childhood
by Jordan W. Smoller

University of Pennsylvania
http://users.erols.com/geary/humor/

Childhood is a syndrome which has only recently begun to receive serious attention from clinicians. The syndrome itself, however, is not at all recent. As early as the 8th century, the Persian historian Kidnom made references to "short, noisy creatures," who may well have been what we now call "children." The treatment of children, however, was unknown until this century, when so-called "child psychologists" and "child psychiatrists" became common. Despite this history of clinical neglect, it has been estimated that well over half of all Americans alive today have experienced childhood directly (Suess, 1983). In fact, the actual numbers are probably much higher, since these data are based on self-reports which may be subject to social desirability biases and retrospective distortion.

The growing acceptance of childhood as a distinct phenomenon is reflected in the proposed inclusion of the syndrome in the upcoming Diagnostic and Statistical Manual of Mental Disorders, 4th edition, or DSM-IV, of the American Psychiatric Association (1990). Clinicians are still in disagreement about the significan clinical features of childhood, but the proposed DSM-IV will almost certainly include the following core features:

Congenital onset

Dwarfism

Emotional lability and immaturity

Knowledgy deficits

Legume anorexia


Clinical Features of Childhood

Although the focus of this paper is on the efficacy of conventional treatment of childhood, the five clinical markers mentioned above merit further discussion for those unfamiliar with this patient population.

CONGENITAL ONSET

In one of the few existing literature reviews on childhood, Temple-Black (1982) has noted that childhood is almost always present at birth, although it may go undetected for years or even remain subclinical indefinitely. This observation has led some investigators to speculate on biological contribution to childhood. As one psychologist has put it, "we may soon be in a position to distinguish organic childhood from functional childhood" (Rogers, 1979).

DWARFISM

This is certainly the most familiar marker of childhood. It is widely known that children are physically short relative to the population at large. Indeed, common clinical wisdom suggests that the treatment of the so-called "small child" (or "tot") is particularly difficult. These children are known to exhibit infantile behavior and display a startling lack of insight (Tom and Jerry, 1967).

EMOTIONAL LABILITY AND IMMATURITY

This aspect of childhood is often the only basis for a clinician's diagnosis. As a result, many otherwise normal adults are misdiagnosed as children and must suffer the unnecessary social stigma of being labelled a "child" by professionals and friends alike.

KNOWLEDGE DEFICITS


While many children have IQs with or even above the norm, almost all will manifest knowledge deficits. Anyone who has known a real child has experienced the frustration of trying to discuss any topic that requires some general knowledge. Children seem to have little knowledge about the world they live in. Politics, art, and science--children are largely ignorant of these. Perhaps it is because of this ignorance, but the sad fact that most children have few friends who are not, themselves, children.

LEGUME ANOREXIA

This last identifying feature is perhaps the most unexpected. Folk wisdom is supported by empirical observation--children will rarely eat their vegetables (see Popeye, 1957, for review).

Causes of Childhood

Now that we know what it is, what can we say about the causes of childhood? Recent years have seen a flurry of theory and speculation from a number of perspectives. Some of the most prominent are reviewed below.

Sociological Model

Emile Durkind was perhaps the first to speculate about sociological causes of childhood. He points out two key observations about children:

the vast majority of children are unemployed, and

children represent one of the least educated segments of our society. In fact, it has been estimated that less than 20% of children have had more than fourth grad education.

Clearly, children are an "out-group." Because of their intellectual handicap, children are even denied the right to vote. From the sociologist's perspective, treatment should be aimed at helping assimilate children into mainstream society. Unfortunately, some victims are so incapacitated by their childhood that they are simply not competent to work. One promising rehabilitaion program (Spanky and Alfalfa, 1978) has trained victims of severe childhood to sell lemonade.

Biological Model

The observation that childhood is usually present from birth has led some to speculate on a biological contribution. An early investigation by Flintstone and Jetson (1939) indicated that childhood runs in families. Their survey of over 8,000 American families revealed that over half contained more than one child. Further investigation revealed that even most non-child family members had experienced childhood at some point. Cross-cultural studies (e.g., Mowgli and Din, 1950) indicated that family childhood is even more prevalent in the Far East. For example, in Indian and Chinese families, as many as three out of four family members may have childhood.

Impressive evidence of a genetic component of childhood comes from a large-scale twin study by Brady and Partridge (1972). These authors studied over 106 pairs of twins, looking at concordance rates for childhood. Among identical or monozygotic twins, concordance was unusually high (0.92), i.e., when one twin was diagnosed with childhood, the other twin was almost always a child as well.
Psychological Models

A considerable number of psychologically-based theories of the development of childhood exist. They are too numerous to review here. Among the more familiar models are Seligman's "learned childishness" model. According to this model, individuals who are treated like children eventually give up and become children. As a counterpoint to such theories, some experts have claimed that childhood does not really exist. Szasz (1980) has called "childhood" an expedient label. In seeking conformity, we handicap those whom we find unruly or too short to deal with by labelling them "children."

Treatment of Childhood

Efforts to treat childhood are as old as the syndrome itself. Only in modern times, however, have human and systematic treatment protocols been applied. In part, this increased attention to the problem may be due to the sheer number of individuals suffering from childhood. Government statistics (DHHS) reveal that there are more children alive today than at any time in our history. to paraphrase P.T. Barnum: "There's a child born every minute."

The overwhelming number of children has made government intervention inevitable. The nineteenth century saw the institution of what remains the largest single program for the treatment of childhood-- so-called "public schools." Under this colossal program, individuals are placed into treatment groups based on the severity of their condition. For example, those most severely afflicted may be placed in a "kindergarten" program. Patients at this level are typically short, unruly, emotionally immature, and intellectually deficient. Given this type of individual, therapy is essentially one of patient management and of helping the child master basic skills (e.g. finger-painting).

Unfortunately, the "school" system has been largely ineffective. Not only is the problem a massive tax burden, but it has failed even to slow down the rising incidence of childhood.

Faced with this failure and the growing epidemic of childhood, mental health professionals are devoting increasing attention to the treatment of childhood. Given a theoretical framework by Freud's landmark treatises on childhood, child psychiatrists and psychologists claimed great successes in their clinical intervention.

By the 1950's, however, the clinicians' optimism had waned. Even after years of costly analysis, many victims remained children. The following case (taken from Gumbie and Poke, 1957) is typical.

Billy J., age 8, was brought to treatment by his parents. Billy's affliction was painfully obvious. He stood only 4'3" high and weighed a scant 70 lbs., despite the fact that he ate voraciously. Billy presented a variety of troubling symptoms. His voice was noticably high for a man. He displayed legume anorexia, and, according to his parents, often refused to bathe. His intellectual functioning was also below normal--he had little general knowledge and could barely write a structured sentence. Social skills were also deficient. He often spoke inappropriately and exhibited "whining behaviour." His sexual experience was non-existent. Indeed, Billy considered women "icky." His parents reported that his condition had been present from birth, improving gradually after he was placed in a school at age 5. The diagnosis was "primary childhood." After years of painstaking treatment, Billy improved gradually. At age 11, his height and weight have increased, his social skills are broader, and he is now functional enough to hold down a "paper route."

After years of this kind of frustration, startling new evidence has come to light which suggests that the prognosis in cases of childhood may not be all gloom. A critical review by Fudd (1972) noted that studies of the childhood syndrome tend to lack careful follow-up. Acting on this observation, Moe, Larrie, and Kirly (1974) began a large-scale longitudinal study. These investigators studied two groups. The first group consisted of 34 children currently engaged in a long-term conventional treatment program. The second was a group of 42 children receiving no treatment. All subjects had been diagnosed as children at least 4 years previously, with a mean duration of childhood at 6.4 years.

At the end of one year, the results confirmed the clinical wisdom that childhood is a refractory disorder--virtually all symptoms persisted and the treatment group was only slightly better off than the controls.

The results, however, of a careful 10-year follow-up were startling. The investigators (Moe, Larrie, Kirly, & Shemp, 1984) assessed the original cohort on a variety of measures. General knowledge and emotional maturity were assessed with standard measures. Height was assess by the "metric system" (see Ruler, 1923), and legume appetite by the Vegetable Appetite Test (VAT) designed by Popeye (1968). Moe et al. found that subjects improved uniformly on all measures. Indeed, in most cases, the subjects appeared to be symptom-free. Moe et al. report a spontaneous remission rate of 95%, a finding which is certain to revolutionize the clinical approach to childhood.

These recent results suggests that the prognosis for victims of childhood may not be so bad as we have feared. We must not, however, become too complacent. Despite its apparently high spontaneous remission rate, childhood remains one of the most serious and rapidly growing disorders facing mental health professionals today. And, beyond the psychological pain it brings, childhood has recently been linked to a number of physical disorders. Twenty years ago, Howdi, Doodi, and Beauzeau (1965) demonstrated a six-fold increased risk of chicken pox, measles, and mumps among children as compared with normal controls. Later, Barby and Kenn (1971) linked childhood to an elevated risk of accidents--compared with normal adults, victims of childhood were much more likely to scrape their knees, lose their teeth, and fall off their bikes.

Clearly, much more research is need before we can give any real hope to the millions of victims wracked by this insidious disorder.

REFERENCES

American Psychiatric Association (1990). The diagnostic and statistical manual of mental disorders, 4th edition: A preliminary report. Washington, D.C.; APA.

Barby, B., & Kenn, K. (1971). The plasticity of behavior. In B. Barby & K. Kenn (Eds.), Psychotherapies R Us. Detroit: Ronco press.

Flintstone, F., & Jetson, G. (1939). Cognitive mediation of labour disputes. Industrial Psychology Today, 2, 23-35.

Fudd, E.J. (1972). Locus of control and shoe-size. Journal of Footwear Psychology, 78, 345-356.

Gumbie, G., & Pokey, P. (1957). A cognitive theory of iron- smelting. Journal of Abnormal Metallurgy, 45, 235-239.

Howdi, C., Doodi, C., & Beauzeau, C. (1965). Western civilization: A review of the literature. Reader's digest, 60, 23-25.

Moe, R., Larrie, T., and Kirly, Q. (1974). State childhood versus trait childhood. TV Guide, May 12-19, 1-3.

Moe, R., Larrie, T., Kirly, Q. (1974). Spontaneous remission of childhood. In W.C. Fields (Ed.), New Hope for Children and Animals. Hollywood: Acme Press.

Popeye, T.S.M. (1957). The use of spinach in extreme circumstances. Journal of Vegetable Science, 58, 530-538.

Popeye, T.S.M. (1968). Spinach: A phenomenological perspective. Existential botany, 35, 908-813.

Rogers, F. (1979). Becoming my neighbour. New York: Soft Press.

Ruler, Y. (1923). Assessing measurements protocols by the multi-method multiple regression index for the psychometric analysis of factorial interaction. Annals of Boredom, 67, 1190-1260.

Spanky, D., & Alfalfa, Q. (1978). Coping with puberty. Sears catalog, 45-46.

Suess, D.R. (1983). A psychometric analysis of green eggs with and without ham. Journal of Clinical Cuisine, 245, 567-578.

Temple-Black, S. (1982). Childhood: an ever-so sad disorder. Journal of Precocity, 3, 129-134.

Tom, C., & Jerry, M. (1967). Human behavior as a model for understanding the rat. In M. de Sade (Ed.). The Rewards of Punishment. Paris: Bench Press.

Friday, November 30, 2007

Swift firing of psychologist from teaching position restores School Board confidence

Apparently the Volusia County School Board has had a recent string of bad publicity due to their own screwups, misdeeds, and general incompetence. So the opportunity to do something to do their job, and also improve their reputation was a welcome relief. From the Daytona Beach News Journal.

Volusia County School Board members said Thursday they support the firing of an Atlantic High School teacher after a past fraught with lawsuits, allegations and a sex scandal was exposed to school officials.

They also believe it's a one-of-a-kind case.

Connie Reynolds, 52, of Ormond Beach was hired this summer to teach biology, anatomy and physiology at Atlantic after working as a substitute the previous year. On Tuesday, she lost her job, a job she loved, leaving her "reeling," she said by telephone Thursday.

"I did . . . exactly what I was supposed to do," she said.

On her job application she checked "yes" to a box asking whether she ever had a professional license revoked.

Three years ago, the Montana Board of Psychology effectively ended Reynolds' 20-year career as a clinical psychologist when it confirmed an administrative law judge's determination that she had an inappropriate relationship with a client, according to reports in the Billings (Mont.) Gazette.

But Volusia school district personnel assigned to scrutinize her application never asked her why she had lost her license. Had they known it involved an inappropriate relationship with a client, Reynolds would not have been hired, said Nancy Wait, a district spokeswoman.

Several board members contacted Superintendent Margaret Smith and other district officials with concern. They said they were pleased with the administration's response.

An additional set of eyes will review teacher applications before hiring is complete, board member Candace Lankford said. "This isn't a pattern," she said.

Board Chairman Al Williams also called Smith on Thursday.

"I feel confident we don't have any other situations like this," he added.

Of four board members interviewed, Williams -- a former school personnel director -- was the only one who raised questions about Reynolds' firing.

"This person did something wrong when she was in Montana. Do you continue to punish her when she comes here?" he said. "If it wasn't anything toward a child . . . she made a mistake. You give her two or three probationary periods to make sure."

But he later said he wasn't questioning the call to fire Reynolds, adding it's a "tough decision."

Other board members expressed empathy for Reynolds, but qualified it.

"By the same token, my first concern is the students. If she as a mature person had an inappropriate relationship, that's a red flag," board member Judy Conte said.

Reynolds said she does not believe she has any legal recourse over the firing. State law allows a school district to terminate a teacher without cause within the 97-day probation period.

Reynolds said she was still hopeful Thursday that a school district somewhere might be willing to take a chance on her, adding that she had an excellent evaluation.

"Every day, I woke up and said, 'I get to do something where I'm loving everything I did,' " Reynolds said. "I was a good teacher."

In addition to convincing another school district to hire her, Reynolds could face another hurdle. Cheryl Etters, a spokeswoman for the Department of Education, said she could not comment on the status of Reynolds' temporary teaching certificate, citing a statute that refers to an "investigation" that must be kept confidential.

Sunday, November 25, 2007

Dr. Drug Rep - how a psychiatrist became easily corrupted by easy big money

From the Blue Ridge Now website. Originally from the NY Times Magazine, which also supplies this nifty illustration Also seen here

Key point, if the drug companies pay you money, you become their employee. It is not practical to be objective in the long run, and it becomes a question of the money vs your medical integrity.

Far too long to quote in full, here are some key snippets:

On a blustery fall New England day in 2001, a friendly representative from Wyeth Pharmaceuticals came into my office in Newburyport, Mass., and made me an offer I found hard to refuse. He asked me if I’d like to give talks to other doctors about using Effexor XR for treating depression. He told me that I would go around to doctors’ offices during lunchtime and talk about some of the features of Effexor. It would be pretty easy. Wyeth would provide a set of slides and even pay for me to attend a speaker’s training session, and he quickly floated some numbers. I would be paid $500 for one-hour “Lunch and Learn” talks at local doctors’ offices, or $750 if I had to drive an hour. I would be flown to New York for a “faculty-development program,” where I would be pampered in a Midtown hotel for two nights and would be paid an additional “honorarium.”

[...]

A few weeks later, my wife and I walked through the luxurious lobby of the Millennium Hotel in Midtown Manhattan. At the reception desk, when I gave my name, the attendant keyed it into the computer and said, with a dazzling smile: “Hello, Dr. Carlat, I see that you are with the Wyeth conference. Here are your materials.”

She handed me a folder containing the schedule of talks, an invitation to various dinners and receptions and two tickets to a Broadway musical. “Enjoy your stay, doctor.” I had no doubt that I would, though I felt a gnawing at the edge of my conscience. This seemed like a lot of money to lavish on me just so that I could provide some education to primary-care doctors in a small town north of Boston.

The next morning, the conference began. There were a hundred or so other psychiatrists from different parts of the U.S. I recognized a couple of the attendees, including an acquaintance I hadn’t seen in a while. I’d heard that he moved to another state and was making a bundle of money, but nobody seemed to know exactly how.

I joined him at his table and asked him what he had been up to. He said he had a busy private practice and had given a lot of talks for Warner-Lambert, a company that had since been acquired by Pfizer. His talks were on Neurontin, a drug that was approved for epilepsy but that my friend had found helpful for bipolar disorder in his practice. (In 2004, Warner-Lambert pleaded guilty to illegally marketing Neurontin for unapproved uses. It is illegal for companies to pay doctors to promote so-called off-label uses.)

[...]

When it came to side effects, Effexor’s greatest liability was that it could cause hypertension, a side effect not shared by S.S.R.I.’s. Sussman showed us some data from the clinical trials, indicating that at lower doses, about 3 percent of patients taking Effexor had hypertension as compared with about 2 percent of patients assigned to a placebo. There was only a 1 percent difference between Effexor and placebo, he commented, and pointed out that treating high blood pressure might be a small price to pay for relief from depression.

It was an accurate reading of the data, and I remember finding it a convincing defense of Effexor’s safety. As I look back at my notes now, however, I notice that another way of describing the same numbers would have been to say that Effexor leads to a 50 percent greater rate of hypertension than a placebo. Framed this way, Effexor looks more hazardous.

And so it went for the rest of the afternoon. $750 if I had to drive an hour. I would be flown to New York for a “faculty-development program,” where I would be pampered in a Midtown hotel for two nights and would be paid an additional “honorarium.”


If I gave talks to primary-care doctors about Effexor, I reasoned, I would be doing nothing unethical. It was a perfectly effective treatment option, with some data to suggest advantages over its competitors. The Wyeth rep was simply suggesting that I discuss some of the data with other doctors. Sure, Wyeth would benefit, but so would other doctors, who would become more educated about a good medication.

A few weeks later, my wife and I walked through the luxurious lobby of the Millennium Hotel in Midtown Manhattan. At the reception desk, when I gave my name, the attendant keyed it into the computer and said, with a dazzling smile: “Hello, Dr. Carlat, I see that you are with the Wyeth conference. Here are your materials.”

[...]

When it came to side effects, Effexor’s greatest liability was that it could cause hypertension, a side effect not shared by S.S.R.I.’s. Sussman showed us some data from the clinical trials, indicating that at lower doses, about 3 percent of patients taking Effexor had hypertension as compared with about 2 percent of patients assigned to a placebo. There was only a 1 percent difference between Effexor and placebo, he commented, and pointed out that treating high blood pressure might be a small price to pay for relief from depression.

It was an accurate reading of the data, and I remember finding it a convincing defense of Effexor’s safety. As I look back at my notes now, however, I notice that another way of describing the same numbers would have been to say that Effexor leads to a 50 percent greater rate of hypertension than a placebo. Framed this way, Effexor looks more hazardous.

And so it went for the rest of the afternoon.

[...]

As the reps became comfortable with me, they began to see me more as a sales colleague.
I received faxes before talks preparing me for particular doctors. One note informed me that the physician we’d be visiting that day was a “decile 6 doctor and is not prescribing any Effexor XR, so please tailor accordingly. There is also one more doc in the practice that we are not familiar with.” The term “decile 6” is drug-rep jargon for a doctor who prescribes a lot of medications. The higher the “decile” (in a range from 1 to 10), the higher the prescription volume, and the more potentially lucrative that doctor could be for the company.

A note from another rep reminded me of a scene from “Mission: Impossible.” “Dr. Carlat: Our main target, Dr. , is an internist. He spreads his usage among three antidepressants, Celexa, Zoloft and Paxil, at about 25-30 percent each. He is currently using about 6 percent Effexor XR. Our access is very challenging with lunches six months out.” This doctor’s schedule of lunches was filled with reps from other companies; it would be vital to make our sales visit count.

[...]

Driving home, I went back over the talk in my mind. I knew I had not lied — I had reported the data exactly as they were reported in the paper. But still, I had spun the results of the study in the most positive way possible, and I had not talked about the limitations of the data. [...] I realized that in my canned talks, I was blithely minimizing the hypertension risks, conveniently overlooking the fact that hypertension is a dangerous condition and not one to be trifled with. Why, I began to wonder, would anyone prescribe an antidepressant that could cause hypertension when there were many other alternatives? And why wasn’t I asking this obvious question out loud during my talks?

[...]

In 2002, the drug industry’s trade group adopted voluntary guidelines limiting some of the more lavish benefits to doctors. While the guidelines still allow all-expenses-paid trips for physicians to attend meetings at fancy hotels, they no longer pay for spouses to attend the dinners or hand out tickets to musicals. In an e-mail message, a Wyeth spokesman wrote that Wyeth employees must follow that code and “our own Wyeth policies, which, in some cases, exceed” the trade group’s code.

Looking back on the year I spent speaking for Wyeth, I’ve asked myself if my work as a company speaker led me to do bad things. Did I contribute to faulty medical decision making? Did my advice lead doctors to make inappropriate drug choices, and did their patients suffer needlessly?


Monday, November 19, 2007

Ritalin: The scandal of kiddy coke

Snippets from a longer story in the Daily Mail

Eight months ago, Daniel, now 14, was put on Risperdal - an antipsychotic drug usually given to schizophrenics.

"It was as if my son had been replaced by a doped-up zombie,' says Hayley, 35, who took him off it a month later.

"I could hardly wake him in the morning. It was as if all his personality was disappearing, like a patient in a mental institution."

Last week, it emerged that around 8,000 British youngsters are being treated with this powerful tranquilliser and another, similar drug called Zyprexa - despite the fact that their dangerous side-effects range from diabetes to brain tumours.

Hundreds of thousands of others are still being prescribed Ritalin, an amphetamine-like stimulant which has the same effect as "speed" and cocaine, and which, according to new evidence from the U.S., doesn't even work in the long-term.

[...]

Recent findings also suggest that Ritalin can stunt growth as well as causing heart problems, insomnia and weight problems.

In the U.S., there have been 51 deaths among children and adults taking Ritalin since 1999.

According to the Medicines and Healthcare Products Regulatory Agency, 11 British children on Ritalin have died.

The cause of two deaths was heart-related: one had a heart attack, the other an enlarged heart.

One was recorded as a "sudden death". One died of a brain haemorrhage; another of a swelling in the brain.

Two committed suicide, and the last died of neo-natal respiratory distress syndrome.

Not surprisingly, experts fear that inappropriate drugs are not only being used to control children's behaviour, but are being massively over-prescribed to some children who are simply naughty.

ADHD, they say, is nothing more than a symptom of Britain's time-poor society, where children of parents working long hours are cracking under the strain of family life.

There are criticisms, too, that some doctors dole out pills when therapy would be a safer option.

In the U.S., where one in ten children takes Ritalin and where doctors write two million prescriptions a month, the situation is even worse.

A growing body of experts is even questioning whether ADHD exists at all.

"As a society, we are quick to reach for a pill," says David Healy, one of the world's leading psycho-pharmacology experts, and Professor of Psychiatry at Cardiff University.

"There's much less willingness on the part of the medical profession to say to parents: 'You have an awkward child. You must discipline them.'

"So we prescribe pills instead.

"The drugs used to treat ADHD are the same as speed and cocaine.

"We react with horror to the idea that our kids would use such drugs, but don't react about drugs such as Ritalin being given to them.

"There's a risk that your child won't grow as well.

"There are high risks that children will go on to use street drugs, too, because they will have grown used to their effects."

Professor Healy says anti-psychotic drugs such as Risperdal were used in the Soviet Union to extract information from political prisoners.

"People who took them would tell anything to anyone," he says.

"When you think about giving these drugs to kids, it's a whole new ball game."

Dr Tim Kendall of the Royal College of Psychiatrists, who is heading a team drawing up new NHS guidelines for ADHD, insists there is a place for drugs in treatment, but admits: "We have a situation where GPs prescribe anti-psychotics inappropriately.

"There is no real excuse for prescribing drugs which are associated with such severe side-effects."

But even where Ritalin is used, Dr Kendall says guidelines do not make it clear when doctors should diagnose ADHD and when they should prescribe drugs.

"If you diagnose people loosely, you could end up with 16 per cent of the child population with ADHD.

"Under tight criteria, only 1.6 per cent would be diagnosed," he says.

"A generous understanding would be to say that doctors have reached a point where they don't know what else to offer, and they haven't got the right support to help parents."

[...]

Thursday, November 15, 2007

Girls get extra school help while boys get Ritalin


From USA Today. An important insight into another angle on ADHD

At last June's graduation at Franklin High School just outside of Milwaukee, three of the four students who tied for valedictorian were girls. Among the National Honor Society members, 76% were girls. And girls comprised 85% of the students on Franklin's 4.0 honor roll.

The superintendent of schools for this upper-middle-class suburb, Gerald Freitag, investigated those numbers after the parents of a boy filed a complaint. He found that the skewed performances by gender at Franklin pretty much mirror the imbalances across the state — and the nation.

This week, teachers at the middle school feeding into Franklin received training on how to reach out to boys. And high school teachers will continue the gender-sensitivity classes they began last school year.

But reversing the trend will not be easy. In classrooms nationwide, girls are pulling ahead of boys academically. Recent federal testing data show that what starts out as a modest gap in elementary-level reading scores turns into a yawning divide by high school. In 12th grade, 44% of girls rate as proficient readers on federal tests, compared with 28% of boys. And while boys still score slightly higher on federal math and science exams, their advantage is slipping.

Most startling is that little is being done to correct the imbalances. All of the major players — schools, education colleges and researchers — largely ignore the gender gap.

Instead of pursuing sound solutions, many educators merely advocate prescribing more attention-focusing Ritalin for the boys, who receive the drug at four to eight times the rate of girls, according to different estimates. "Too often the first reaction to an attention problem is 'Let's medicate,' " says Rockville, Md., child psychologist Neil Hoffman. "Some schools are quick to recommend solutions before they've fully evaluated the problem."

Playing to girls' strengths

One reason boys are losing academic ground to girls appears linked to a shift by schools to more word-based learning for which girls' brains are believed to have an advantage. Over the years, even math problems have become more word oriented, according to education researchers. But because schools are doing little to help boys adjust, males risk becoming second-class academic citizens. Already the academic success girls enjoy in high school translates into more college acceptances — 56% of the students on campuses are female.

The full impact from this shift is something society has yet to discover. But a drop in earnings for males is one likely result. Workers with only a high school diploma earn $20,000 a year less than those with a bachelor's degree.

One fact explains why educators are ignoring boys' needs: You can't address a problem that you don't admit exists. The U.S. Department of Education concedes that no serious research is available comparing different instructional methods that might help boys. In fact, many education researchers are hostile toward research aimed at exploring gender differences in learning.

Last April, when Kenneth Dragseth, superintendent of schools in Edina, Minn., presented a paper describing his district's gender gap at the American Educational Research Association's annual meeting in Chicago, he says the reception ranged from chilly to hostile. Female education researchers in the audience questioned whether helping boys would mean hurting girls.

Their attitude follows years of lobbying by groups such as the American Association of University Women, which alerted educators to the fact that girls were being shortchanged academically in the fields of math and science. The extra attention helped focus schools on girls' difficulties, but it has made it too easy for educators to overlook the problems of boys. Among them:

•Boys and girls learn differently. The best research on boy-girl learning differences is produced more by accident than by design. The lack of data in this field can hurt girls as much as boys. For instance, as part of an ongoing 20-year dyslexia study focusing on Connecticut schools, Yale neuroscientist and pediatrician Sally Shaywitz discovered that schools were identifying four times as many dyslexic boys as girls. Yet when her team entered schools to screen children, it diagnosed just as many dyslexic girls as boys. Shaywitz found that the mostly female teaching staff was quicker to identify rambunctious boys than quiet girls.

The results are just one example of what might be learned about the role gender plays in education, especially in elementary school, where 85% of teachers are women.

• Future teachers aren't trained to deal with learning differences. Therapist Michael Gurian, author of Boys and Girls Learn Differently!, has visited more than 100 education colleges. But he has not found one that offers courses on male-female brain differences. His discovery explains why many new teachers arrive in classrooms clueless about what teaching techniques might work best for boys' learning styles.

• Boys lack advocates. The special efforts made by schools to steer more girls into advanced math and science classes came after powerful advocacy groups embraced the problem. But Gurian and other advocates for boys say they run into resistance from educators who point to males' success in the workforce as proof that advocacy for boys is unnecessary.

In spite of the lack of research, anecdotal evidence shows that far more effective strategies are available for teaching boys than plying them with Ritalin. Patricia Henley runs a boy-friendly charter school in Kansas that hires many male teachers. It also recognizes boys' natural tendency to favor active learning by conducting more class work on the chalkboard and allowing more student movement within the classroom. And the school trains teachers to deal with boys' particular styles. For instance, because boys volunteer answers more slowly than girls do, teachers are told to count to 10 before calling on a student.

Beginning in the early 1990s, groups such as the American Association of University Women performed an important service by alerting the public to an educational failing. Their persistence helped convince educators that schools were ignoring important problems plaguing girls, such as the loss of self-esteem among middle school girls who had been successful students throughout elementary school.

Today's education system fails many boys. They deserve the same kind of attention to address why they are losing ground.

Help! My doctor's not listening to me

CNN has a series of continuing stories about patients taking control over their own medical care, and the care of people close to them. This snippet caught our attention.

When Shelly's son, Travis, started to misbehave in first grade, her pediatrician diagnosed attention deficit and hyperactivity disorder and prescribed stimulant drugs.

After months on the drugs and several dosage changes, the medications didn't help, says Shelly, who asked that her last name not be used.

Shelly took Travis to another pediatrician, then another and another.

In all, she says, eight doctors prescribed stimulants such as Ritalin -- often increasing the dosage -- even though she explained they hadn't worked before.

"They just kept saying, 'You need to give it time,' " Shelly says. "But he was so jacked up on drugs he couldn't sleep at night. We thought, 'These drugs aren't working, so why do they keep increasing the dosage?' "

Finally, after three years of trying stimulants to treat ADHD, a psychologist diagnosed in Travis a high-functioning form of autism. At 9, Travis stopped the ADHD drugs and started therapy for autistic children.

His behavior improved, his grades went up, and now at 14, his mother says, he's a "model student."

"I cringe and cry when I think back on the three years wasted knocking on doors," she says.
This is a hard won victory, even though we are not thrilled by some of the issues related to the treatment of autism. We are glad to have more people standing up for themselves.

Special Note: Empowered Patient, a regular feature from CNN Medical News correspondent Elizabeth Cohen, helps put you in the driver's seat when it comes to health care.

Saturday, October 06, 2007

Rotenberg 'School of Shock' Doctor Defends Electric Shock for Kids, While Mother Jones Exposes His Lies Yet Again

Following the recent expose in Mother Jone's Magazine, Doctor Matthew Israel has been given the opportunity to defend himself and the psychiatric practices used at the Rotenburg School via a long and detailed letter published in Mother Jones itself. This is far too long to publish here, but suffice it to say the Doctor feels he was the victim of a smear job, dishonest journalism, etc.

Mother Jones has done him a great service in publishing his letter, but he has not gotten away scot free. They have responded to his letter by pointing out his own most damaging errors of fact, and standing their ground regarding continuous his moral lapses. You can see the Mother Jones editorial response below, as published online here

We applauded Mother Jones for the original expose, and continue in our own low opinion of the "Rotten-Berg" School of Electric Pain. We persist in our claim that the school should be labeled the Rotten-Berg School. Here are links to our own earlier reports on the story:

Here is the Mother Jones Response to psychiatrist Israel's letter:
EDITORS' RESPONSE TO MATTHEW ISRAEL REGARDING "SCHOOL OF SHOCK"

THE USE OF SKIN SHOCK


In support of JRC's use of skin shock, Israel and his defenders stress the violent and self-abusive behavior of some students, and argue that those students have not benefited from other forms of treatment. Israel writes: "It is well documented in scientific articles and in court findings that some special needs children and adolescents have behaviors that are so self-abusive, aggressive or destructive as to be life-threatening and self-maiming."

The facts:

The use of skin shock is not restricted to such "low functioning" students. A report of an investigation by the New York State Education Department states: "JRC employs a general use of Level III aversive behavioral interventions [which include skin shock] to students with a broad range of disabilities, many without a clear history of self-injurious behaviors. JRC employs a general use of Level III aversive behavioral interventions to students for behaviors that are not aggressive, health dangerous or destructive.".…

THE DEATH OF A STUDENT

Israel writes:

"Ms. Gonnerman discusses California student Danny Aswad's death as though it had something to do with JRC or me. It did not. JRC had ceased its operations in California a year or two prior to his death which was from natural causes."

The facts:

According to the 1982 complaint filed by the State of California, this student was in the care of Behavior Research Institute at the time of his death. The complaint states that the student died while in restraints that kept him flat on his stomach in bed, and had been restrained on numerous occasions over the preceding seven months, despite the fact that such restraint was "contraindicated" because he suffered from a circulatory disorder.

Dr. Israel helped found Behavior Research Institute in California, which was a branch of the entity by the same name that he founded in Rhode Island (later renamed as JRC). Dr. Israel was a consultant to Behavior Research Institute at or at least shortly before the time the student died. Dr. Israel has previously defended the Behavior Research Institute, saying that the death was not the result of treatment.

DR. IWATA'S VISIT

Israel writes:

"Her statement that Dr. Iwata has visited the Rotenberg Center is false."

The facts:

Dr. Iwata visited the Rotenberg Center to review its practices at the request of Massachusetts officials. A copy of the report he wrote in 1995 was obtained by Mother Jones. At the time, the Rotenberg Center was still located in Rhode Island, but it already employed the skin shock aversive treatment that it still uses today.

SOCIALIZING AND ISOLATION

Israel writes:

"Ms. Gonnerman incorrectly states that the only time that JRC students can socialize freely is in the Big Reward Store. This is not true. There are many other places where students can socialize with each other such as on the playground, on field trips, at their residences, etc."

The facts:

In an interview with Jennifer Gonnerman, Dr. Israel stated: "We need to marshal every possible reward you can find to reward desired behavior. So even opportunities for some of the high functioning students to socialize with other students or staff, instead of those being routinely provided, those actually have to be earned. Everything you want has to be earned."

The report by the New York State Education Department states: "During five observations involving a total of 59 students, there were no instances of students socializing with other students and only five instances observed of students socializing with staff. Social interactions between students reportedly occur in the Big Reward Store where students go to select a reward for keeping contracts. When questioned about friendships and social interactions among students, the students interviewed stated that they were unable to socialize in a natural way."

Israel writes:

"The title page contains the word 'Isolation.' Isolation is never used as a punishment at JRC."

The facts:

Again, Dr. Israel himself has confirmed that some students must earn the opportunity to socialize with other students or staff. A report of an investigation by the New York State Education Department says that students may be restrained on four-point restraint boards or in chairs "for extensive periods of time (e.g. hours or intermittently for days)." Students are sometimes confined to "conference rooms," which in some cases isolate them from everyone except a single staff member.

FOOD DEPRIVATION

Israel writes:

"The title page contains the phrase 'Food Deprivation.' Food deprivation is never used as a punishment at JRC."

The facts:

According to JRC, about 10 percent of the students are in a "Contingent Food Program" or a "Specialized Food Program." These programs require students to meet behavioral requirements in order to earn food. The New York State Education Department report says that students must "earn" meals by not displaying certain behaviors, and that if they do not they are "made to throw a predetermined caloric portion of their food into the garbage."

Students in the Contingent Food Program are given "make-up meals" at the end of each day, but according to JRC "make-up food is deliberately intended to be an unattractive option." Students in the Specialized Food Program do not receive "make-up food" unless they have eaten less than 26 percent of their normal daily caloric target. These programs are part of the court-approved treatment plans for the students, and students' weight is monitored. The program is altered or suspended if the student drops below a certain weight.

According to the New York State Education Department report, "The Contingent Food Program and Specialized Food Program may impose unnecessary risks affecting the normal growth and development and overall nutritional/health status of students subjected to this aversive behavior intervention."

USE OF OTHER THERAPIES BEFORE SHOCK TREATMENT

Israel writes:

"Before JRC uses aversives with any student, positive and educative procedures are tried for an average of 11 months to try to change serious problematic behaviors."

The facts:

The article does not assert that other treatments are not tried before aversives are used. However, according to the New York State Education Department report, "JRC may decide prior to a student's acceptance into the program that he/she requires aversive procedures based on historical and current behavioral information provided by parents, the CSE and other records/reports." In addition, in some cases, "the use of aversive procedures may be a condition of the student's acceptance and continued enrollment in the program." Letters from parents of students at JRC appear to support these findings.

SAFEGUARDS

Israel writes:

"There are many safeguards at JRC to make sure that the skin-shock procedure is used carefully, professionally and properly. They include prior parental consent, prior individualized court authorization (the judge appoints an attorney to represent the child's interests in this process), prior approval by a Human Rights Committee and a Peer Review Committee, clearance from a physician and a psychiatrist to insure that there are no medical contraindications, etc."

The facts:

The article discusses parental and court consent, and expressly reports that court approval is required in all cases. (Attorneys who have represented students in approval proceedings have told Mother Jones that court approval is routinely granted, sometimes over their objections.) The article doesn't suggest that other safeguards are not also employed in deciding to use or in monitoring the use of skin shock treatment.

However, some of the procedures are apparently required as the result of JRC's settlement with the State of Massachusetts, and according to the New York State Education Department report "the integrity of the behavioral programming at JRC is not sufficiently monitored by appropriate professionals at the school and in many cases the background and preparation of staff is not sufficient to oversee the intensive treatment of children with challenging emotional and behavioral problems."

FADING OUT SKIN SHOCK TREATMENT

Israel writes:

"As time goes on, many [students] are able to graduate completely from needing this ]skin shock] therapy."

The facts:

Data provided by Israel indicates that 43% of school-age students are receiving skin shocks, while only 3% percent have "graduated" or been "faded off" the shock devices. Among adult residents, 85% are attached to the shock device, while only 6% have been "faded off."

According to the New York State Education Department report, "JRC's policy states: ‘GED fading will not occur until the student has gone a minimum of one year with no major behaviors.' . . . The criterion of one year without a 'major disruptive behavior' is extremely long and is not determined based on the circumstances for each individual student. . . . Many NYS students remain on the GED for the entire time they attend the center."

Wednesday, September 19, 2007

A Commentary on the Dangerousness of a Certain Psychiatrist

An interesting commentary on the dangerousness of a certain psychiatrist, Dr. Eileen Bazelon, as seen in this blog entry - the comments are also a worthy read. This is interesting and certainly worth further investigation given Bazelon's membership in a number of patient's rights organizations.

I didn’t know her name when I was a student at Bryn Mawr College and was in a deep depression my senior year, but I knew the reputation of my college’s psychiatrist and I knew that for me to seek psychiatric help as a student was to risk expulsion, loss of all my hard work thus far and even deeper depression. So despite the fact that I was unable to get myself to go to classes or do any work or even eat except once a day in the evening, I never walked over to the health center because I was not willing to risk losing everything.

I decided it was better to risk losing my life than losing my diploma. In the end a wonderful professor, now gone, walked over to my dorm room and offered to call my parents for me and my dean and did so. The late Katrin Burlin saved me. But she knew better than to refer me to the Health Center (than known as the Infirmary if I recall correctly) too.

I never thought about why she didn’t refer me there until later, but I had been accepted to an Ivy League University for graduate school with a full scholarship and stipend and being expelled by the college’s psychiatrist would have put an end to that.

I am disappointed and angry that the same psychiatrist is hosting a conference on what to do about “dangerous” behavior on campus now.

From all I have heard from more recent graduates, students at Bryn Mawr still have to fear expulsion for being mentally ill and apparently Dr. Bazelon not only does not feel confidentiality is an issue in cases of need to warn but also when she feels like sharing patients/students’ confidential medical information with her daughter as soon after Virginia Tech’s tragedy, her daughter wrote an article for an online publication that gave confidential details of the cases of two expelled former students.

Here I am on the Commitment Taskforce of the Supreme Court Justice’s Commission on Mental Health Law Reform all these years later with kidney failure from forced and abusive psychiatric treatment and fear of forced treatment; and the psychiatrist in chief at my alma mater is still working to undermine the rights and the confidentiality of women with psychiatric illness.

How sad.

How scary.

How maddening.

Too bad I already pledged for this year’s alumnae fund.

Conference Asks: What Should Colleges Do About Dangerous Behavior on Campus?

Inspired by the shootings at Virginia Tech, Bryn Mawr resident psychiatrist Eileen Bazelon ‘65 has convened a group of nationally recognized experts to discuss the law and ethics of balancing students’ right to privacy against their own safety and that of their communities. The one-day conference, to take place in Thomas Great Hall on Monday, Sept. 24, is open to college and university administrators, counselors, deans, security officers, legal counsel and other interested parties.
Full story: http://www.brynmawr.edu/news/alum/2007-09/dangerous.shtml

Monday, September 17, 2007

It's getting so that even a school psychologist is worried about the psych drugs in school

It's getting so that even a school psychologist is worried about the psych drugs in school. Note how zombie robotic behavior is increasingly the desired norm, not bright, intelligent independent thinking kids. Ourselves, we happen to disagree with the general diagnosis of ADHD, believing it to be a case where other conditions are too frequently misdiagnosed - An editorial from the Cincinatti Enquirer

Having spent 10 years in the public school systems as a school psychologist, I am disturbed by the upward trend in the diagnosis of attention deficit hyperactivity disorder. Even more troubling is the estimated 6 to 10 percent of students who receive stimulant medication as a form of treatment.

ADHD is widely defined as a developmental disability manifested in problems with sustained attention, impulse control and maintaining appropriate levels of activity. To many parents' surprise, there is no specific "test" used to identify who has ADHD and who does not. Furthermore, it is argued by many psychologists that the means and measures used to make the diagnosis are far too vague and subjective.

Many parents seek psychostimulant medication for their children. At a recent luncheon, I overheard a mother openly and enthusiastically discussing her child's long awaited ADHD diagnosis and consequent daily dose of "the magic pill." She was thrilled that her son's teacher reported that he had "completely changed his personality" and just "sits quietly during class" since the medication. Ironically, in the same conversation, this mother was complaining about the horrible drug and alcohol problem in their high school.

There is no quick fix for distractible, disorganized, "free-spirited," at times exasperating children, nor should there be. We need to embrace the differences in our children and not expect all children to sit quietly and listen.

I would argue that all children fall somewhere on the ADHD continuum at different points in their development. Sure, there are some extreme psychiatric cases where Ritalin may be needed, but certainly not for 6 percent of our school-age population. For parents who struggle with children who have high levels of activity and short attention span, there are many ways to help them without Ritalin.

Parents and educators working together in a truly collaborative manner to teach these children will demonstrate not only their strong level of commitment, but the value of perseverance, communication and hard work. These are the problem-solving skills we should be teaching our children. Taking a drug to "fix it," on the other hand, is a dangerous lesson to teach.

Saturday, September 15, 2007

Happiness classes ‘depress pupils’

Another experiment in modern psychology gone badly wrong. As seen here.

Classes in happiness and emotional wellbeing, intended to tackle ill-discipline and improve social skills, may instead leave children depressed and self-obsessed, according to a new report.

The research, which draws on the findings of more than 20 international academic studies, describes the government programme in secondary schools as a “large-scale psychological experiment”.

It finds little evidence that the classes, which encourage children to express feelings openly and empathise with others, lead to any long-term improvement in emotional well being or academic success.


Ed Balls, the children’s secretary, announced last week that happiness classes would be introduced to state secondary schools after a successful two-year pilot of the programme. The technique is called Seal - Social and emotional aspects of learning.

Balls said the classes would “help to cultivate the right attitude” and would help tackle indiscipline. But the report by Carol Craig, a psychologist and chief executive of the Centre for Confidence and Wellbeing in Glasgow, concludes the classes risk harming some children.

“A focus on the self can create an obsession with how you feel and can lead in some kids to depression,” said Craig. “Seal may work for some children but this is not like arithmetic or French grammar - if it doesn’t work it will lead to psychological problems.”

Craig’s conclusion was supported by Nick Emler, professor of psychology at Surrey University: “It is disturbing that the government wishes to introduce this programme without proper evaluation.”

Anthony Seldon, master of Wellington College in Berkshire and a pioneer of happiness classes, defended their merits.

“You are trying to help people with long-term coping skills,” he said. “I don’t think there is any sane way to exist as a human being except to get in touch with your feelings and thoughts.”

Alan Smithers, education professor at Birmingham University, said Seal “looks like a panic measure” to tackle problems highlighted earlier this year by the Unicef table of child well being in which Britain came bottom out of 21 countries.

Monday, August 20, 2007

Dr. Matt Israel of the Rotenberg Center and his Electric Shock Program for Kids

Food deprivation. Isolation. Electric shocks. Inside the taxpayer-funded program that treats American kids like enemy combatants. The main feature in Mother Jones this week is an expose about Dr. Matt Israel of the Rotenberg Center in Massachusetts and his Electric Shock Program for Kids, running under the title of School of Shock They ask the question: Eight states are sending autistic, mentally retarded, and emotionally troubled kids to a facility that punishes them with painful electric shocks. How many times do you have to zap a child before it's torture?

The Rotenberg Center is the only facility in the country that disciplines students by shocking them, a form of punishment not inflicted on serial killers or child molesters or any of the 2.2 million inmates now incarcerated in U.S. jails and prisons. Over its 36-year history, six children have died in its care, prompting numerous lawsuits and government investigations. Last year, New York state investigators filed a blistering report that made the place sound like a high school version of Abu Ghraib. Yet the program continues to thrive—in large part because no one except desperate parents, and a few state legislators, seems to care about what happens to the hundreds of kids who pass through its gates.
Their sidebar articles include:
The main articles are too long to even begin to quote in full here, we will probably be featuring the sidebars over the next few days.

The most effective treatments used by the psych industry for troubled teenagers have these things in common: They use family-based therapies; they treat adolescents with empathy, dignity, and respect; and, except for very short periods of emergency stabilization, they keep teens at home. Things that should be common sense to begin with.