Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Misinformation about autism is very common. Claims of a cure for autism are
constantly presented to families of individuals with autism. There are various
treatment models found within both the educational and clinical settings. Yet,
there is only one treatment approach that has prevailed over time and is
effective for all persons, with or without autism. That treatment model is an
educational program that is suitable to a student's developmental level of
performance. For adults, that treatment model refers to a vocational program
that is suitable to the individual's developmental level of functioning.
Under the Individuals with Disabilities Educational Act (IDEA) Act of 1990,
students with a handicap are guaranteed an "appropriate education" in the Least
Restrictive Environment (LRE), which is generally considered to be as normal an
educational setting as possible. As a result of this legislation,
children with autism have often been placed in a mainstreamed classroom and pulled out
for whatever supplementary services were needed. Depending on the child's needs,
he or she could be placed up to 100% of the school day in a mainstreamed or a
special education setting or any combination of the two.
There is an increasing
trend, however, among the advocates for children with autism, to segregate these
children into small, highly structured and controlled academic settings that are
almost free from auditory and visual stimulation. All instruction is broken down
into manageable segments. Information is presented in tiny units and the child's
response is immediately sought. A classic stimulus-response approach is used to
maximize learning. Each unit of information is mastered before another is
presented. A fundamental behavior such as putting hands on the tabletop, for
example, must be mastered before the child is required to perform any other
tasks, or before more information is presented. The long-term effects of this
type of treatment as well as the ability of the child to transfer this to a
broader context continue to be evaluated. For people with autism whose symptoms include self injurious behaviors, the focus of treatment has shifted from restriction and punishment to more of a focus on understanding potential motivators for negative behaviors, as well as rewarding and otherwise encouraging appropriate behaviors.
Individuals with autism need to be taught how to communicate and interact with
others. This is not a simple task, and it involves the entire family as well as
other professionals. Parents of a child or adult with autism must continually
educate themselves about new treatments and keep an open mind. Some treatments
may be appropriate for some individuals but not for others. Many treatments have
yet to be scientifically proven. Treatment decisions should always be made
individually after a thorough assessment and based on what is suitable for that
person and his or her family.
It is important to remember, despite some recent denials, that autism is
usually a lifelong condition. The kind of support that is appropriate will change as the individual
develops. Families must beware of treatment programs that give false hope of a
cure. Acceptance of the condition in a family member is a very critical,
foundational component of any treatment program and is understandably quite
difficult.
Several medications have been tried or are under current scrutiny for the
treatment of autism. No medication has consistently proven to be of benefit for
either curing or comprehensively managing autism in
closely controlled clinical trials.
In the past, a piece on a television news
show prompted a great deal of interest in the
hormone secretin as a treatment
for autism. A child with autism who has with chronic gastrointestinal complaints showed
dramatic improvement following some routine testing performed by a
gastroenterologist during which a small dose of secretin was administered. The
family and their physicians felt that the secretin may have resulted in the
improvement in the symptoms of autism. Many physicians began prescribing
secretin, which can be costly for their autistic patients. However, studies published appear to completely refute
the claim that secretin treatment benefits autistic patients. This example
underscores the importance of good clinical trials in determining whether a drug
will help patients with autism.
Some medications have been found to help address some symptoms that may present in autism. For example, haloperidol (Haldol), is thought to help treat aggression and methylphenidate has been determined to be helpful in addressing hyperactivity in persons with autism. Risperidone (Risperdal) has been found to be quite helpful in many people whose autistic symptoms include odd, repetitive behaviors (stereotypies), hyperactivity, irritability, throwing tantrums, being aggressive towards others of injuring oneself.
Persons with autism seem to have a higher mortality rate at younger ages compared to average individuals. This is particularly true for mortality that is related to seizures or infection. It is, therefore, important for the autistic population to receive good medical care from practitioners who have knowledge and experience in addressing their unique medical needs. Due to a number of potential factors, autistic persons tend to be vulnerable to nutritional problems. Specifically, factors like variations in appetite, refusal of many foods, food allergies and side effects to some medications can disproportionately impact the food intake, and therefore the nutritional status of this population. As individuals with autism also seem to be vulnerable to emotional struggles like anxiety, depression and attention problems, the involvement of mental health professionals should be sought when appropriate.
Psychotherapeutic approaches that have been found to help improve functioning in some persons with autism include comprehensive behavioral therapy to address problematic behaviors. Social skills training and support are important in helping people with autism navigate interactions with others, since many of this population crave social interaction despite their limitations in engaging others socially. Cognitive behavioral treatment in verbal individuals with anxiety and voice output communication who are less verbal are considered promising areas of treatment as well .
Epilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are many causes of epilepsy. Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced.
Learning disabilities can cause an individual to have trouble learning and using skills such as reading, listening, writing, reading, speaking, reasoning, and performing mathematics. There is no cure for learning disabilities. Parents and teachers working together to properly diagnose learning disabilities can properly plan a course of education. For some, medication may be appropriate as complimentary treatment.
Fragile X syndrome is the most common inherited form of mental retardation. It's caused by a mutation on the X chromosome. People with Fragile X syndrome suffer from physical, social, emotional, speech, language, sensory, intelligence, and learning impairments. There is no definitive treatment for Fragile X, though there are ways to minimize the symptoms.
Learn about mitochondrial disease, genetic disease in which include a group of neuromuscular diseases that are caused by damage to the mitochondria Common mitochondrial myopathies include Kearns–Sayre syndrome, myoclonus epilepsy, and mitochondrial encephalomyopathy. Symptoms of mitochondrial disease include heart failure, exercise intolerance, dementia, muscle weakness, movement disorders, deafness, blindness, stroke-like episodes, and more. There is no specific treatment for mitochondrial disease.
Seizures are divided into two categories: generalized and partial. Generalized seizures are produced by electrical impulses from throughout the brain, while partial seizures are produced by electrical impulses in a small part of the brain. Seizure symptoms include unconsciousness, convulsions, and muscle rigidity.
Good parenting helps foster empathy, honesty, self-reliance, self-control, kindness, cooperation, and cheerfulness, says Steinberg, a distinguished professor of psychology at Temple University in Philadelphia. It also promotes intellectual curiosity, motivation, and desire to achieve. It helps protect children from developing anxiety, depression, eating disorders, antisocial behavior, and alcohol and drug abuse.
Asperger syndrome (AS, Asperger's syndrome) is an autism spectrum disorder. Asperger syndrome is characterized by a degree of impairment in language and communication skills, and repetitive or restrictive thoughts or behaviors. The most common symptom of Asperger syndrome is the obsessive interest in a single object or topic. Other conditions that may co-exist with Asperger syndrome include: ADHD, tic disorders, depression, anxiety disorders, and OCD. Diagnosis of Asperger syndrome is complicated, and treatment is generally directed toward minimizing the symptoms of the syndrome and behavioral and educational interventions.
Pervasive development disorders (PPDs) are conditions involving developmental delays in children. There are five types of PDDs: autism, Asperger's syndrome, childhood disintegrative disorder, Rett's syndrome, and pervasive development disorders not otherwise specified (PDDNOS).
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
Landau-Kleffner syndrome (LKS, infantile acquired aphasia, acquired epileptic aphasia, or aphasia with convulsive disorder), a childhood disorder that occurs between the ages of 3 and 7, is characterized by the sudden loss of speech, epileptic seizures, depression, hyperactivity, and aggressiveness.
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