Topic Overview
What is attention deficit hyperactivity disorder (ADHD)?
Attention deficit hyperactivity disorder (ADHD) is a condition in which a person has trouble paying attention and focusing on tasks, tends to act without thinking, and has trouble sitting still. It may begin in early childhood and can continue into adulthood. Without treatment, ADHD can cause problems at home, school, work, and with relationships. In the past, ADHD was called attention deficit disorder (ADD).
What causes ADHD?
The exact cause is not clear, but ADHD tends to run in families.
What are the symptoms?
The three types of ADHD symptoms include:
* Trouble paying attention. People with ADHD are easily distracted and have a hard time focusing on any one task.
* Trouble sitting still for even a short time. This is called hyperactivity. Children with ADHD may squirm, fidget, or run around at the wrong times. Teens and adults often feel restless and fidgety and are not able to enjoy reading or other quiet activities.
* Acting before thinking. People with ADHD may talk too loud, laugh too loud, or become angrier than the situation calls for. Children may not be able to wait for their turn or to share. This makes it hard for them to play with other children. Teens and adults seem to "leap before they look." They may make quick decisions that have a long-term impact on their lives. They may spend too much money or change jobs often.
How is ADHD diagnosed?
ADHD is often diagnosed when a child is between 6 and 12 years old. Teachers may notice symptoms in children who are in this age group.
First, the child will have a physical exam to make sure that he or she does not have other problems such as learning disabilities, depression, or anxiety disorder. The doctor will use guidelines from the American Psychiatric Association to diagnose ADHD. The doctor may also look at written reports about the child’s behavior. Parents, teachers, and others who have regular contact with the child prepare these reports.
How is it treated?
There is no cure for ADHD, but treatment may help control the symptoms. Treatment may include medicines and behavior therapy. Parents and other adults need to closely watch children after they begin to take medicines for ADHD. The medicines may cause side effects such as loss of appetite, headaches or stomachaches, tics or twitches, and problems sleeping. Side effects usually get better after a few weeks. If they don't, the doctor can lower the dose.
Therapy focuses on making changes in the environment to improve the child’s behavior. Often, counseling and extra support at home and at school help children succeed at school and feel better about themselves.
How does ADHD affect adults?
Many adults don't realize that they have ADHD until their children are diagnosed. Then they begin to notice their own symptoms. Adults with ADHD may find it hard to focus, organize, and finish tasks. They often forget things. But they also often are very creative and curious. They love to ask questions and keep learning. Some adults with ADHD learn to manage their lives and find careers that let them use those strengths.
But many adults have trouble at home and work. As a group, adults with ADHD have higher divorce rates. They also are more likely to smoke and have more substance abuse problems than adults without ADHD. Fewer adults with ADHD enter college, and fewer graduate. Treatment with medicine, counseling, and behavior therapy can help adults
Sunday, January 30, 2011
Anxiety
Topic Overview
Anxiety
Feeling worried or nervous is a normal part of everyday life. Everyone frets or feels anxious from time to time. Mild to moderate anxiety can help you focus your attention, energy, and motivation. If anxiety is severe, you may have feelings of helplessness, confusion, and extreme worry that are out of proportion with the actual seriousness or likelihood of the feared event. Overwhelming anxiety that interferes with daily life is not normal. This type of anxiety may be a symptom of another problem, such as depression.
Anxiety can cause physical and emotional symptoms. A specific situation or fear can cause some or all of these symptoms for a short time. When the situation passes, the symptoms usually go away.
Physical symptoms of anxiety include:
* Trembling, twitching, or shaking.
* Feeling of fullness in the throat or chest.
* Breathlessness or rapid heartbeat.
* Lightheadedness or dizziness.
* Sweating or cold, clammy hands.
* Feeling jumpy.
* Muscle tension, aches, or soreness (myalgias).
* Extreme tiredness.
* Sleep problems, such as the inability to fall asleep or stay asleep, early waking, or restlessness (not feeling rested when you wake up).
Anxiety affects the part of the brain that helps control how you communicate. This makes it more difficult to express yourself creatively or function effectively in relationships. Emotional symptoms of anxiety include:
* Restlessness, irritability, or feeling on edge or keyed up.
* Worrying too much.
* Fearing that something bad is going to happen; feeling doomed.
* Inability to concentrate; feeling like your mind goes blank.
Anxiety disorders
Anxiety disorders occur when people have both physical and emotional symptoms. Anxiety disorders interfere with how a person gets along with others and affect daily activities. Women are twice as likely as men to have problems with anxiety disorders. Examples of anxiety disorders include panic attacks, phobias, obsessive-compulsive disorder, and post-traumatic stress disorder (PTSD).
Often the cause of anxiety disorders is not known. Many people with an anxiety disorder say they have felt nervous and anxious all their lives. This problem can occur at any age. Children who have at least one parent with the diagnosis of depression are more than twice as likely to have an anxiety disorder than other children.
Anxiety disorders often occur with other problems, such as:
* Mental health problems, such as depression or substance abuse.
* A physical problem, such as heart or lung disease. A complete medical examination may be needed before an anxiety disorder can be diagnosed.
Panic attacks
A panic attack is a sudden feeling of extreme anxiety or intense fear without a clear cause or when there is no danger. Panic attacks are common. They sometimes occur in otherwise normal, healthy people and will usually last for several minutes.
Symptoms include feelings of dying or losing control of yourself, rapid breathing (hyperventilation), and a racing heart. You may feel dizzy, sweaty, or shaky. Other symptoms include trouble breathing, chest pain or tightness, and an irregular heartbeat. These symptoms come on suddenly and without warning.
Sometimes symptoms of a panic attack are so intense that the person fears he or she is having a heart attack. Many of the symptoms of a panic attack can occur with other illnesses, such as hyperthyroidism, coronary artery disease, or chronic obstructive pulmonary disease (COPD). A complete medical examination may be needed before an anxiety disorder can be diagnosed.
People who have repeated unexpected panic attacks and worry about the attacks are said to have a panic disorder.
Phobias
Phobias are extreme and irrational fears that interfere with daily life. People with phobias have fears that are out of proportion to real danger. And although these people are aware that their fears are not rational, they are not able to control them.
Phobias are common and are sometimes present with other conditions, such as panic disorder or Tourette's disorder. Most people deal with phobias by avoiding the situation or object that causes them to feel panic (avoidance behavior).
A phobic disorder occurs when the avoidance behavior becomes so extreme that it interferes with your ability to participate in your daily activities. There are three main types of phobic disorders:
* Fear of being alone or in public places where help might not be available or escape is impossible (agoraphobia)
* Fear of situations where the individual might be exposed to criticism by others (social phobia)
* Fear of specific things (specific phobia)
Use the Check Your Symptoms section to decide if and when you should see a doctor.
Anxiety
Feeling worried or nervous is a normal part of everyday life. Everyone frets or feels anxious from time to time. Mild to moderate anxiety can help you focus your attention, energy, and motivation. If anxiety is severe, you may have feelings of helplessness, confusion, and extreme worry that are out of proportion with the actual seriousness or likelihood of the feared event. Overwhelming anxiety that interferes with daily life is not normal. This type of anxiety may be a symptom of another problem, such as depression.
Anxiety can cause physical and emotional symptoms. A specific situation or fear can cause some or all of these symptoms for a short time. When the situation passes, the symptoms usually go away.
Physical symptoms of anxiety include:
* Trembling, twitching, or shaking.
* Feeling of fullness in the throat or chest.
* Breathlessness or rapid heartbeat.
* Lightheadedness or dizziness.
* Sweating or cold, clammy hands.
* Feeling jumpy.
* Muscle tension, aches, or soreness (myalgias).
* Extreme tiredness.
* Sleep problems, such as the inability to fall asleep or stay asleep, early waking, or restlessness (not feeling rested when you wake up).
Anxiety affects the part of the brain that helps control how you communicate. This makes it more difficult to express yourself creatively or function effectively in relationships. Emotional symptoms of anxiety include:
* Restlessness, irritability, or feeling on edge or keyed up.
* Worrying too much.
* Fearing that something bad is going to happen; feeling doomed.
* Inability to concentrate; feeling like your mind goes blank.
Anxiety disorders
Anxiety disorders occur when people have both physical and emotional symptoms. Anxiety disorders interfere with how a person gets along with others and affect daily activities. Women are twice as likely as men to have problems with anxiety disorders. Examples of anxiety disorders include panic attacks, phobias, obsessive-compulsive disorder, and post-traumatic stress disorder (PTSD).
Often the cause of anxiety disorders is not known. Many people with an anxiety disorder say they have felt nervous and anxious all their lives. This problem can occur at any age. Children who have at least one parent with the diagnosis of depression are more than twice as likely to have an anxiety disorder than other children.
Anxiety disorders often occur with other problems, such as:
* Mental health problems, such as depression or substance abuse.
* A physical problem, such as heart or lung disease. A complete medical examination may be needed before an anxiety disorder can be diagnosed.
Panic attacks
A panic attack is a sudden feeling of extreme anxiety or intense fear without a clear cause or when there is no danger. Panic attacks are common. They sometimes occur in otherwise normal, healthy people and will usually last for several minutes.
Symptoms include feelings of dying or losing control of yourself, rapid breathing (hyperventilation), and a racing heart. You may feel dizzy, sweaty, or shaky. Other symptoms include trouble breathing, chest pain or tightness, and an irregular heartbeat. These symptoms come on suddenly and without warning.
Sometimes symptoms of a panic attack are so intense that the person fears he or she is having a heart attack. Many of the symptoms of a panic attack can occur with other illnesses, such as hyperthyroidism, coronary artery disease, or chronic obstructive pulmonary disease (COPD). A complete medical examination may be needed before an anxiety disorder can be diagnosed.
People who have repeated unexpected panic attacks and worry about the attacks are said to have a panic disorder.
Phobias
Phobias are extreme and irrational fears that interfere with daily life. People with phobias have fears that are out of proportion to real danger. And although these people are aware that their fears are not rational, they are not able to control them.
Phobias are common and are sometimes present with other conditions, such as panic disorder or Tourette's disorder. Most people deal with phobias by avoiding the situation or object that causes them to feel panic (avoidance behavior).
A phobic disorder occurs when the avoidance behavior becomes so extreme that it interferes with your ability to participate in your daily activities. There are three main types of phobic disorders:
* Fear of being alone or in public places where help might not be available or escape is impossible (agoraphobia)
* Fear of situations where the individual might be exposed to criticism by others (social phobia)
* Fear of specific things (specific phobia)
Use the Check Your Symptoms section to decide if and when you should see a doctor.
Age of Majority: Preparing Your Child for Making Good Choices
By National Center on Secondary Education and Transition. Public domain.
Last Reviewed:August 2008
The Individuals with Disabilities Education Act (IDEA) is a law ensuring services to children with disabilities throughout the nation. IDEA governs how states and public agencies provide early intervention, special education and related services to more than 6.5 million eligible infants, toddlers, children and youth with disabilities. Infants and toddlers with disabilities (birth-2) and their families receive early intervention services under IDEA Part C. Children and youth (ages 3-21) receive special education and related services under IDEA Part B.
Parents want their children to have the skills they need to succeed as adults. While this is important for every young person, youth with disabilities often face extra challenges. That's why they need to be actively involved in setting their high school goals and planning for their transition to adulthood well before they reach the age of majority. (In most states, the age of majority is 18, but there are exceptions. It is important to know your state's laws.)
The Individuals with Disabilities Education Act (IDEA) gives states the authority to elect to transfer educational decision-making rights to students at the age of majority. In a state that transfers rights at the age of majority, beginning at least one year before a student reaches the age of majority under State law, the student's individualized education program (IEP) must include a statement that the student has been informed of his or her rights, if any, under Part B of IDEA , that will transfer to the student upon reaching the age of majority. The public agency shall provide any notice required by Part B to both the student and the parents. (This regulation does not apply to students who have been determined to be incompetent under state law.)
In a state that has elected to transfer educational decision-making rights at the age of majority, students become responsible for their educational program. Students, not their parents, are the primary participant in developing their IEP and they become responsible for making other decisions, such as consenting to any changes in placement or requesting mediation or due process hearings to resolve disputes.
Reaching the age of majority can be an exciting time for most students. Transferring rights to young adults who are unable to make informed decisions or take responsibility for their choices, however, carries many risks. Will students decide to drop out of high school or accept a quick diploma and become ineligible for much-needed transition services? Many of the decisions young adults make affect their quality of life after high school.
Some states have a legal process to determine if a student who receives special education and has reached the age of majority continues to need help in planning her or his IEP. Students may not necessarily have the ability to provide informed consent to their educational program even though they have not been determined to be incompetent. Such states have a mechanism to determine that a student with a disability, who has reached the age of majority under State law and has not been determined incompetent, still does not have the ability to provide informed consent with respect to his or her educational program. In such cases, the State shall establish procedures for appointing the parent, or, if the parent is not available another appointed individual, to represent the educational interests of the student throughout the student's eligibility under Part B of IDEA.
Helping Your Child Prepare for the Age of Majority
As parents, we can begin to help our children prepare for adult-hood by looking at the role we play in their lives. Do we try too hard to sway our children's decisions? Do we tend to speak for our children instead of letting them speak for themselves? Can we separate our own desires from our children's wishes? It can be hard to let go of our parental role when we love our children and worry
about their future. But we may need to step back and look at our own actions. Our role is to help our children to become comfortable making their own decisions and capable of making good choices. Children develop decision-making skills over time. Young children can practice these skills within the family. Older children can take increasing responsibility for the decisions that affect their lives.
Age of majority is the legal age established under state law at which an individual is no longer a minor and, as a young adult, has the right and responsibility to make certain legal choices that adults make.
Rights that transfer in most states-
In states that transfer educational rights at the age of majority, all of the educational rights provided to the parents transfer to the student when he or she reaches the age of majority. These educational rights may include the right to. . .
* receive notice of and attend individual education program (IEP) meetings.
* consent to reevaluation.
* consent to change in placement.
* request for mediation or a due process hearing to resolve a dispute about evaluation, identification, eligibility, IEP, placement, or other aspects of a free appropriate public education (FAPE).
Teaching Young Children How to Make Decisions
* Include your child in purchasing decisions. Does your child help select his or her own clothing and help with grocery shopping and meal planning?
* Discuss important decisions such as vacation plans and major purchases as a family. Routinely state your thoughts out loud so your children have a model for good decision making: "We are not ready to decide on that yet, let's talk about it tomorrow after dinner;" or "Let's gather more information before we buy this."
* Practice with your child what he or she should do if lost.
Teaching Older Children How to Make Decisions
* Encourage your child to participate in planning his or her IEP and even leading the IEP meeting.
* Role-play IEP meetings with your child ahead of time to help him or her clarify what he or she wants from the meeting. Practice how to step out of the meeting to discuss a decision in private. Ask your child if he or she wants to invite anyone to the meeting for support.
Additional Tips for Helping Your Child Make Informed Decisions
* Help your child develop good working relationships with school personnel and other IEP team members so there is little disruption when he or she reaches the age of majority.
* Do not allow educators to pressure your child into making decisions he or she is not capable of handling.
* Avoid being overprotective. Do not interfere with your child's desires when it is not truly necessary.
* Stay involved even after you are no longer the primary participant in the development of your child's IEP. IDEA does not address parents' attendance at IEP meetings once a student has reached the age of majority. The school or student could, however, invite a parent to attend the meeting as an individual who is knowledgeable about the student's educational needs and abilities.
Transfer of Rights
In a state that transfers rights at the age of majority, beginning at least one year prior to the student reaching the age of majority under state law, the student's IEP must include a statement that the student has been informed that his or her rights under Part B, if any, will transfer. The school must comply with IDEA notification requirements to both the student and the parents.
Families should understand how their state implements these IDEA regulations. Ideally, the student, parents, and other family members will all continue to be actively involved in planning the services and programs for the student's transition into adulthood. As parents of children with disabilities, our challenge is to seek opportunities for our children to make choices for themselves beginning at a very early age and continuing throughout their school years. Community education programs often have classes for teens on assertiveness or independent living skills. Centers for Independent Living offer workshops on self-determination and living skills for young adults. Leadership workshops and camps can also be beneficial in teaching these skills.
Guardianship
If a state elects to transfer rights at the age of majority, IDEA requires at least one year of notice to parents and students before a student reaches the age of majority. This notice alerts families to consider whether or not their child is capable of representing him or herself.
At the age of majority, students are granted certain legal rights, such as the right to vote, marry, obtain a credit card, consent to medical treatments, make living arrangements, and sign contracts. Each of the 50 states determines what rights transfer to individuals at the age of majority within that state. Some students may not be able to recognize when a decision needs to be made, consider possible options, or recognize the consequences of their decisions without additional support. For these students, guardianship, conservatorship, or another form of representation by an advocate may be appropriate.
When the student reaches the age of majority under State law (except for a child with a disability who has been determined to be incompetent under State law)-
(A) The public agency shall provide any notice required by IDEA to both the individual and the parents;
(B) All other rights accorded to parents under IDEA transfer to the child;
(C) The agency shall notify the individual and the parents of the transfer of rights; and
(D) All rights accorded to parents under IDEA transfer to children who are incarcerated in an adult or juvenile Federal, State, or local correctional institution [20 U.S.C. 1415(m)].
Under guardianship, a person is considered to be legally incompetent. The individual loses the authority to make all the decisions granted to adults. A person called the guardian is assigned by the court to make these decisions. The guardian is usually a parent. The person under guardianship is legally referred to as the ward.
Many states also offer limited guardianship, sometimes called conservatorship. People who are granted conservatorship for another individual are assigned limited decision-making responsibility based on the individual's needs. These responsibilities are carefully outlined in a court order. Conservatorship is designed to allow a person to retain as many of his or her rights as possible. A person under conservatorship is not considered to be legally incompetent. He or she retains as many rights as deemed appropriate by the court. Different people have different limitations under conservatorship, depending on their individual vulnerabilities. The person the court appoints to make decisions on behalf of the individual is called the conservator. The person who has a conservator assigned is considered the conservatee.
Obtaining guardianship or conservatorship for a person requires a petition to be filed with a court alleging that the person needs such an arrangement, a court hearing on the case, and annual reports filed with the court regarding the status of the arrangement. The petition for guardianship or conservatorship often involves numerous complicated forms, although it is not required that an attorney be involved in the process. Petitioners can obtain necessary forms from the probate court.
Guardianship, and to a lesser extent conservatorship, severely limits an individual's right to make independent decisions and should only be considered when there is no less restrictive alternative. If your child is not able to make educational decisions but does not need guardianship or conservatorship, you may want to explore procedures within your state that may allow an advocate to represent the educational interests of your child.
Graduation: Another Transition Consideration
Regular Diploma If a student with a disability graduates with a regular diploma, the student loses eligibility for a free appropriate public education (FAPE). However, if a student graduates with any other type of diploma or certificate, the student may retain eligibility for education services.
Timely Notice Schools must notify parents before proposing to graduate a student with disabilities because it is considered a change in placement. This notice must be given within a reasonable time before graduation to ensure that parents and students have the opportunity to plan for, or challenge, the pending graduation.
In some States, there may be additional laws and procedures that allow for a lesser determination of competency for specific purposes, such as competency for providing informed consent with respect to the individual's educational program. Under the State procedures established in such cases for appointing the parent, if the parent is not available, a guardian or surrogate could be an appropriate individual to represent the educational interests of the student [34 CFR Appendix P. 12617; Federal Register Vol. 64, March 12, 1999].
Last Reviewed:August 2008
The Individuals with Disabilities Education Act (IDEA) is a law ensuring services to children with disabilities throughout the nation. IDEA governs how states and public agencies provide early intervention, special education and related services to more than 6.5 million eligible infants, toddlers, children and youth with disabilities. Infants and toddlers with disabilities (birth-2) and their families receive early intervention services under IDEA Part C. Children and youth (ages 3-21) receive special education and related services under IDEA Part B.
Parents want their children to have the skills they need to succeed as adults. While this is important for every young person, youth with disabilities often face extra challenges. That's why they need to be actively involved in setting their high school goals and planning for their transition to adulthood well before they reach the age of majority. (In most states, the age of majority is 18, but there are exceptions. It is important to know your state's laws.)
The Individuals with Disabilities Education Act (IDEA) gives states the authority to elect to transfer educational decision-making rights to students at the age of majority. In a state that transfers rights at the age of majority, beginning at least one year before a student reaches the age of majority under State law, the student's individualized education program (IEP) must include a statement that the student has been informed of his or her rights, if any, under Part B of IDEA , that will transfer to the student upon reaching the age of majority. The public agency shall provide any notice required by Part B to both the student and the parents. (This regulation does not apply to students who have been determined to be incompetent under state law.)
In a state that has elected to transfer educational decision-making rights at the age of majority, students become responsible for their educational program. Students, not their parents, are the primary participant in developing their IEP and they become responsible for making other decisions, such as consenting to any changes in placement or requesting mediation or due process hearings to resolve disputes.
Reaching the age of majority can be an exciting time for most students. Transferring rights to young adults who are unable to make informed decisions or take responsibility for their choices, however, carries many risks. Will students decide to drop out of high school or accept a quick diploma and become ineligible for much-needed transition services? Many of the decisions young adults make affect their quality of life after high school.
Some states have a legal process to determine if a student who receives special education and has reached the age of majority continues to need help in planning her or his IEP. Students may not necessarily have the ability to provide informed consent to their educational program even though they have not been determined to be incompetent. Such states have a mechanism to determine that a student with a disability, who has reached the age of majority under State law and has not been determined incompetent, still does not have the ability to provide informed consent with respect to his or her educational program. In such cases, the State shall establish procedures for appointing the parent, or, if the parent is not available another appointed individual, to represent the educational interests of the student throughout the student's eligibility under Part B of IDEA.
Helping Your Child Prepare for the Age of Majority
As parents, we can begin to help our children prepare for adult-hood by looking at the role we play in their lives. Do we try too hard to sway our children's decisions? Do we tend to speak for our children instead of letting them speak for themselves? Can we separate our own desires from our children's wishes? It can be hard to let go of our parental role when we love our children and worry
about their future. But we may need to step back and look at our own actions. Our role is to help our children to become comfortable making their own decisions and capable of making good choices. Children develop decision-making skills over time. Young children can practice these skills within the family. Older children can take increasing responsibility for the decisions that affect their lives.
Age of majority is the legal age established under state law at which an individual is no longer a minor and, as a young adult, has the right and responsibility to make certain legal choices that adults make.
Rights that transfer in most states-
In states that transfer educational rights at the age of majority, all of the educational rights provided to the parents transfer to the student when he or she reaches the age of majority. These educational rights may include the right to. . .
* receive notice of and attend individual education program (IEP) meetings.
* consent to reevaluation.
* consent to change in placement.
* request for mediation or a due process hearing to resolve a dispute about evaluation, identification, eligibility, IEP, placement, or other aspects of a free appropriate public education (FAPE).
Teaching Young Children How to Make Decisions
* Include your child in purchasing decisions. Does your child help select his or her own clothing and help with grocery shopping and meal planning?
* Discuss important decisions such as vacation plans and major purchases as a family. Routinely state your thoughts out loud so your children have a model for good decision making: "We are not ready to decide on that yet, let's talk about it tomorrow after dinner;" or "Let's gather more information before we buy this."
* Practice with your child what he or she should do if lost.
Teaching Older Children How to Make Decisions
* Encourage your child to participate in planning his or her IEP and even leading the IEP meeting.
* Role-play IEP meetings with your child ahead of time to help him or her clarify what he or she wants from the meeting. Practice how to step out of the meeting to discuss a decision in private. Ask your child if he or she wants to invite anyone to the meeting for support.
Additional Tips for Helping Your Child Make Informed Decisions
* Help your child develop good working relationships with school personnel and other IEP team members so there is little disruption when he or she reaches the age of majority.
* Do not allow educators to pressure your child into making decisions he or she is not capable of handling.
* Avoid being overprotective. Do not interfere with your child's desires when it is not truly necessary.
* Stay involved even after you are no longer the primary participant in the development of your child's IEP. IDEA does not address parents' attendance at IEP meetings once a student has reached the age of majority. The school or student could, however, invite a parent to attend the meeting as an individual who is knowledgeable about the student's educational needs and abilities.
Transfer of Rights
In a state that transfers rights at the age of majority, beginning at least one year prior to the student reaching the age of majority under state law, the student's IEP must include a statement that the student has been informed that his or her rights under Part B, if any, will transfer. The school must comply with IDEA notification requirements to both the student and the parents.
Families should understand how their state implements these IDEA regulations. Ideally, the student, parents, and other family members will all continue to be actively involved in planning the services and programs for the student's transition into adulthood. As parents of children with disabilities, our challenge is to seek opportunities for our children to make choices for themselves beginning at a very early age and continuing throughout their school years. Community education programs often have classes for teens on assertiveness or independent living skills. Centers for Independent Living offer workshops on self-determination and living skills for young adults. Leadership workshops and camps can also be beneficial in teaching these skills.
Guardianship
If a state elects to transfer rights at the age of majority, IDEA requires at least one year of notice to parents and students before a student reaches the age of majority. This notice alerts families to consider whether or not their child is capable of representing him or herself.
At the age of majority, students are granted certain legal rights, such as the right to vote, marry, obtain a credit card, consent to medical treatments, make living arrangements, and sign contracts. Each of the 50 states determines what rights transfer to individuals at the age of majority within that state. Some students may not be able to recognize when a decision needs to be made, consider possible options, or recognize the consequences of their decisions without additional support. For these students, guardianship, conservatorship, or another form of representation by an advocate may be appropriate.
When the student reaches the age of majority under State law (except for a child with a disability who has been determined to be incompetent under State law)-
(A) The public agency shall provide any notice required by IDEA to both the individual and the parents;
(B) All other rights accorded to parents under IDEA transfer to the child;
(C) The agency shall notify the individual and the parents of the transfer of rights; and
(D) All rights accorded to parents under IDEA transfer to children who are incarcerated in an adult or juvenile Federal, State, or local correctional institution [20 U.S.C. 1415(m)].
Under guardianship, a person is considered to be legally incompetent. The individual loses the authority to make all the decisions granted to adults. A person called the guardian is assigned by the court to make these decisions. The guardian is usually a parent. The person under guardianship is legally referred to as the ward.
Many states also offer limited guardianship, sometimes called conservatorship. People who are granted conservatorship for another individual are assigned limited decision-making responsibility based on the individual's needs. These responsibilities are carefully outlined in a court order. Conservatorship is designed to allow a person to retain as many of his or her rights as possible. A person under conservatorship is not considered to be legally incompetent. He or she retains as many rights as deemed appropriate by the court. Different people have different limitations under conservatorship, depending on their individual vulnerabilities. The person the court appoints to make decisions on behalf of the individual is called the conservator. The person who has a conservator assigned is considered the conservatee.
Obtaining guardianship or conservatorship for a person requires a petition to be filed with a court alleging that the person needs such an arrangement, a court hearing on the case, and annual reports filed with the court regarding the status of the arrangement. The petition for guardianship or conservatorship often involves numerous complicated forms, although it is not required that an attorney be involved in the process. Petitioners can obtain necessary forms from the probate court.
Guardianship, and to a lesser extent conservatorship, severely limits an individual's right to make independent decisions and should only be considered when there is no less restrictive alternative. If your child is not able to make educational decisions but does not need guardianship or conservatorship, you may want to explore procedures within your state that may allow an advocate to represent the educational interests of your child.
Graduation: Another Transition Consideration
Regular Diploma If a student with a disability graduates with a regular diploma, the student loses eligibility for a free appropriate public education (FAPE). However, if a student graduates with any other type of diploma or certificate, the student may retain eligibility for education services.
Timely Notice Schools must notify parents before proposing to graduate a student with disabilities because it is considered a change in placement. This notice must be given within a reasonable time before graduation to ensure that parents and students have the opportunity to plan for, or challenge, the pending graduation.
In some States, there may be additional laws and procedures that allow for a lesser determination of competency for specific purposes, such as competency for providing informed consent with respect to the individual's educational program. Under the State procedures established in such cases for appointing the parent, if the parent is not available, a guardian or surrogate could be an appropriate individual to represent the educational interests of the student [34 CFR Appendix P. 12617; Federal Register Vol. 64, March 12, 1999].
The Counseling Solutions Adolescent Outpatient Aftercare Program
The Counseling Solutions Adolescent Outpatient Aftercare Program utilizes two major therapeutic techniques and the Competent Child Psychological Skills Curriculum Model in servicing adolescent clientele,
The first therapeutic technique is the evidenced based Hazeldon “Living in Balance” Program which addresses the initial transition from intensive therapeutic recovery to outpatient living.
The second therapeutic technique extends the program to the family. As developed by Jose Szapocznik and William Kurtines and featured in SAMHSA Best Practices 2006, the program titled Brief Strategic FamilyTherapy (BSFT) uses traditional structural family therapy categories applied in an integrated fashion as follows: joining, diagnosis, and restructuring techniques.
The Competent Child Psychological Skills Curriculum augments the BSFT technique by providing guided mental health skills activity and practice with the family therapy.
The first therapeutic technique is the evidenced based Hazeldon “Living in Balance” Program which addresses the initial transition from intensive therapeutic recovery to outpatient living.
The second therapeutic technique extends the program to the family. As developed by Jose Szapocznik and William Kurtines and featured in SAMHSA Best Practices 2006, the program titled Brief Strategic FamilyTherapy (BSFT) uses traditional structural family therapy categories applied in an integrated fashion as follows: joining, diagnosis, and restructuring techniques.
The Competent Child Psychological Skills Curriculum augments the BSFT technique by providing guided mental health skills activity and practice with the family therapy.
A psychoeducational evaluation includes assessment in the following areas:
Executive Functions- abilities such as attention and concentration, drive and motivation, mental flexibility, planning and organizational skills, ability to recognize and correct mistakes, ability to respond to feedback cues, and the ability to understand the consequences of behavior.
Intelligence- The intelligence test samples many of those cognitive skills that are needed to learn in school including verbal comprehension and expression, verbal and nonverbal reasoning, concept formation, vocabulary development, numerical reasoning and problem solving ability, auditory and visual immediate memory, visual perception and discrimination, spatial visualization, and visual-motor coordination.
Reasoning and Concept Formation- Reasoning is the ability to make inferences, thaw conclusions, and make judgments. Concept formation is the development of concepts that are ideas based on common characteristics of a group of objects, events or qualities.
Memory Functions-
Language Functions- Speech skills encompass articulation (speech/sound production), voice, and fluency. Language skills include grammar, sentence length and structure, vocabulary and meaning, and auditory processing (auditory discrimination, auditory memory, auditory sequencing, auditory closure).
Auditory Processing- Auditory memory is the ability to remember information presented orally. Auditory sequential memory is the ability to remember a sequence of information presented orally (a series of sounds within a word, a series of words within a sentence, a series of ideas within a story).
Auditory sequential processing is the ability to process verbal information in the correct sequence.
Auditory-visual associative memory is the ability to remember verbal and visual information presented simultaneously (sounds associated with letters).
Auditory figure-ground is the ability to discriminate a speaker’s voice in the presence of background noise. Auditory closure is the ability to understand a word or message when part of the stimulus is missing.
Visual Processing- Visual memory is the ability to remember information presented visually. Visual sequential memory is the ability to remember visual information presented in a sequence. Visual discrimination is the ability to differentiate the shapes of letters, numbers, words, pictures or objects. Visual figure-ground discrimination is the ability to perceive objects as separate from the background. Visual closure is the ability to discriminate pictures or words with parts missing Visual processing speed is the ability to quickly process visual information.
Tactile Function- Tactile function is the ability to perceive touch.
Emotional Functioning- Projective or personality tests provide information about a student’s coping skills, emotional controls, and inner conflicts. These measures look at the student’s attitudes toward himself, family, peers, and school. Projective testing is often necessary to determine whether psychological problems are interfering with the student’s ability to learn.
Motor Functions- Graphomotor skills are fine motor skills demonstrated when using a pencil.
Academic Functions- Basic reading skills include word attack and sequencing skills used to decode unfamiliar words. Written expression is the ability to express ideas in writing with appropriate vocabulary, grammar, syntax, spelling, punctuation, and capitalization. Math computation is the ability to calculate numerical problems Mathematical reasoning is the ability to understand the relationship between mathematical concepts and operations.
Pre-vocational and Vocational- Vocational Aptitude tests generally measure skills such as fine eye-hand coordination, manual dexterity, general learning, math computation, and visual perception.
Vocational Interest tests measure the student’s vocational interests.
Intelligence- The intelligence test samples many of those cognitive skills that are needed to learn in school including verbal comprehension and expression, verbal and nonverbal reasoning, concept formation, vocabulary development, numerical reasoning and problem solving ability, auditory and visual immediate memory, visual perception and discrimination, spatial visualization, and visual-motor coordination.
Reasoning and Concept Formation- Reasoning is the ability to make inferences, thaw conclusions, and make judgments. Concept formation is the development of concepts that are ideas based on common characteristics of a group of objects, events or qualities.
Memory Functions-
Language Functions- Speech skills encompass articulation (speech/sound production), voice, and fluency. Language skills include grammar, sentence length and structure, vocabulary and meaning, and auditory processing (auditory discrimination, auditory memory, auditory sequencing, auditory closure).
Auditory Processing- Auditory memory is the ability to remember information presented orally. Auditory sequential memory is the ability to remember a sequence of information presented orally (a series of sounds within a word, a series of words within a sentence, a series of ideas within a story).
Auditory sequential processing is the ability to process verbal information in the correct sequence.
Auditory-visual associative memory is the ability to remember verbal and visual information presented simultaneously (sounds associated with letters).
Auditory figure-ground is the ability to discriminate a speaker’s voice in the presence of background noise. Auditory closure is the ability to understand a word or message when part of the stimulus is missing.
Visual Processing- Visual memory is the ability to remember information presented visually. Visual sequential memory is the ability to remember visual information presented in a sequence. Visual discrimination is the ability to differentiate the shapes of letters, numbers, words, pictures or objects. Visual figure-ground discrimination is the ability to perceive objects as separate from the background. Visual closure is the ability to discriminate pictures or words with parts missing Visual processing speed is the ability to quickly process visual information.
Tactile Function- Tactile function is the ability to perceive touch.
Emotional Functioning- Projective or personality tests provide information about a student’s coping skills, emotional controls, and inner conflicts. These measures look at the student’s attitudes toward himself, family, peers, and school. Projective testing is often necessary to determine whether psychological problems are interfering with the student’s ability to learn.
Motor Functions- Graphomotor skills are fine motor skills demonstrated when using a pencil.
Academic Functions- Basic reading skills include word attack and sequencing skills used to decode unfamiliar words. Written expression is the ability to express ideas in writing with appropriate vocabulary, grammar, syntax, spelling, punctuation, and capitalization. Math computation is the ability to calculate numerical problems Mathematical reasoning is the ability to understand the relationship between mathematical concepts and operations.
Pre-vocational and Vocational- Vocational Aptitude tests generally measure skills such as fine eye-hand coordination, manual dexterity, general learning, math computation, and visual perception.
Vocational Interest tests measure the student’s vocational interests.
Monday, December 6, 2010
Bulimia Nervosa
Topic Overview
Is this topic for you?
Bulimia is one of the most common eating disorders. If you want information on other eating disorders, see the topics Anorexia Nervosa and Binge Eating Disorder.
What is bulimia nervosa?
Bulimia (say “boo-LEE-mee-uh”) is a type of eating disorder. People with bulimia will eat a large amount of food in a short time (binge). Then they will do something to get rid of the food (purge). They may vomit, exercise too much, or use medicines like laxatives.
People who have bulimia may binge because food gives them a feeling of comfort. But eating too much makes them feel out of control. After they binge, they feel ashamed, guilty, and afraid of gaining weight. This causes them to purge.
Without treatment, this “binge and purge” cycle can lead to serious, long-term health problems. Acid in the mouth from vomiting can cause tooth decay, gum disease, and loss of tooth enamel. Any type of purging can lead to bone thinning (osteoporosis), kidney damage, heart problems, or even death.
If you or someone you know has bulimia or another eating disorder, get help. Eating disorders can be dangerous. And willpower alone is not enough to overcome them. Treatment can help a person who has an eating disorder feel better and be healthier.
What causes bulimia?
All eating disorders are complex problems, and experts do not really know what causes them. But they may be caused by a mix of family history, social factors, and personality traits. You may be more likely to have bulimia if:
Any one of these can be a sign of an eating disorder that needs treatment.
How can I know if someone has bulimia?
Bulimia is different from anorexia nervosa, another eating disorder. People who have anorexia eat so little that they become extremely thin. People who have bulimia may not be thin. They may be a normal size. They may binge in secret and deny that they are purging. This makes it hard for others to know that a person with bulimia has a serious problem.
If you are concerned about someone, look for the following signs. A person may have bulimia if she:
Bulimia can be treated with psychological counseling and sometimes medicines, such as antidepressants. The sooner treatment is started, the better. Getting treatment early can make recovery easier and prevent serious health problems.
By working with a counselor, a person with bulimia can learn to feel better about herself. She can learn to eat normally again and stop purging.
Other mental health problems such as depression often happen with bulimia. If a person has another condition along with bulimia, more treatment may be needed, and it may take longer to get better.
Eating disorders can take a long time to overcome. And it is common to fall back into unhealthy ways of eating. If you are having problems, don't try to handle them on your own. Get help.
What should I do if I think someone has bulimia?
It can be very scary to realize that someone you care about has an eating disorder. If you think a friend or loved one has bulimia, you can help.
Is this topic for you?
Bulimia is one of the most common eating disorders. If you want information on other eating disorders, see the topics Anorexia Nervosa and Binge Eating Disorder.
What is bulimia nervosa?
Bulimia (say “boo-LEE-mee-uh”) is a type of eating disorder. People with bulimia will eat a large amount of food in a short time (binge). Then they will do something to get rid of the food (purge). They may vomit, exercise too much, or use medicines like laxatives.
People who have bulimia may binge because food gives them a feeling of comfort. But eating too much makes them feel out of control. After they binge, they feel ashamed, guilty, and afraid of gaining weight. This causes them to purge.
Without treatment, this “binge and purge” cycle can lead to serious, long-term health problems. Acid in the mouth from vomiting can cause tooth decay, gum disease, and loss of tooth enamel. Any type of purging can lead to bone thinning (osteoporosis), kidney damage, heart problems, or even death.
If you or someone you know has bulimia or another eating disorder, get help. Eating disorders can be dangerous. And willpower alone is not enough to overcome them. Treatment can help a person who has an eating disorder feel better and be healthier.
What causes bulimia?
All eating disorders are complex problems, and experts do not really know what causes them. But they may be caused by a mix of family history, social factors, and personality traits. You may be more likely to have bulimia if:
- Other people in your family are obese or have an eating disorder.
- You have a job or do a sport that stresses body size, such as ballet, modeling, or gymnastics.
- You are the type of person who tries to be perfect all the time, never feels good enough, or worries a lot.
- You are dealing with stressful life events, such as divorce, moving to a new town or school, or losing a loved one.
- Teens. Like other eating disorders, bulimia usually starts in the teen years. But it can start even earlier or in adulthood.
- Women. About 10 out of 11 people who have bulimia are female. But some boys and men have it too.1
- While bulimia often starts in the teen years, it usually lasts into adulthood and is a long-term disorder.
- What are the symptoms?
- People with bulimia:
- Binge on a regular basis. They eat large amounts of food in a short period of time, often over a couple of hours or less. During a binge, they feel out of control and feel unable to stop eating.
- Purge to get rid of the food and avoid weight gain. They may make themselves vomit, exercise very hard or for a long time, or misuse laxatives, enemas, water pills (diuretics), or other medicines.
- Base how they feel about themselves on how much they weigh and how they look.
Any one of these can be a sign of an eating disorder that needs treatment.
How can I know if someone has bulimia?
Bulimia is different from anorexia nervosa, another eating disorder. People who have anorexia eat so little that they become extremely thin. People who have bulimia may not be thin. They may be a normal size. They may binge in secret and deny that they are purging. This makes it hard for others to know that a person with bulimia has a serious problem.
If you are concerned about someone, look for the following signs. A person may have bulimia if she:
- Goes to the bathroom right after meals.
- Overeats but does not gain weight.
- Is secretive about eating, hides food, or will not eat around other people.
- Exercises a lot, even when she does not feel well.
- Often talks about dieting, weight, and body shape.
- Uses laxatives or diuretics often.
- Has teeth marks or calluses on the back of her hands or swollen cheeks or jaws. These are caused by making herself vomit.
Bulimia can be treated with psychological counseling and sometimes medicines, such as antidepressants. The sooner treatment is started, the better. Getting treatment early can make recovery easier and prevent serious health problems.
By working with a counselor, a person with bulimia can learn to feel better about herself. She can learn to eat normally again and stop purging.
Other mental health problems such as depression often happen with bulimia. If a person has another condition along with bulimia, more treatment may be needed, and it may take longer to get better.
Eating disorders can take a long time to overcome. And it is common to fall back into unhealthy ways of eating. If you are having problems, don't try to handle them on your own. Get help.
What should I do if I think someone has bulimia?
It can be very scary to realize that someone you care about has an eating disorder. If you think a friend or loved one has bulimia, you can help.
- Talk to her. Tell her why you are worried.
- Urge her to talk to someone who can help, like a doctor or counselor. Offer to go with her.
- Tell someone who can make a difference, like a parent, teacher, counselor, or doctor. The sooner your friend or loved one gets help, the sooner she will be healthy again.
Anorexia Nervosa
Topic Overview
Is this topic for you?
Anorexia is one of the most common eating disorders. If you would like information about other eating disorders, see the topics Bulimia Nervosa and Binge Eating Disorder.
What is anorexia nervosa?
Anorexia nervosa (say "an-uh-RECK-see-uh nur-VOH-suh") is a type of eating disorder. People who have anorexia have an intense fear of gaining weight. They severely limit the amount of food they eat and can become dangerously thin.
Anorexia affects both the body and the mind. It may start as dieting, but it gets out of control. You think about food, dieting, and weight all the time. You have a distorted body image. Other people say you are too thin, but when you look in the mirror, you see a fat person.
Anorexia usually starts in the teen years. Early treatment can be very effective. But if not treated early, anorexia can become a lifelong problem. Untreated anorexia can lead to starvation and serious health problems, such as bone thinning (osteoporosis), kidney damage, and heart problems. Some people die from these problems.
If you or someone you know has anorexia, get help right away. The longer this problem goes on, the harder it is to overcome. With treatment, a person with anorexia can feel better and stay at a healthy weight.
What causes anorexia?
Eating disorders are complex, and experts don't really know what causes them. But they may be due to a mix of family history, social factors, and personality traits. You may be more likely to have anorexia if:
What are the symptoms?
People who have anorexia often strongly deny that they have a problem. They do not see or believe that they do. It is usually up to their loved ones to get help for them. If you are worried about someone, you can look for certain signs.
People who have anorexia:
If your doctor thinks that you may have an eating disorder, he or she will compare your weight with the expected weight for someone of your height and age. He or she will also check your heart, lungs, blood pressure, skin, and hair to look for problems caused by not eating enough. You may also have blood tests or X-rays.
Your doctor may ask questions about how you feel. It is common for a treatable mental health problem such as depression or anxiety to play a part in an eating disorder.
How is it treated?
All people who have anorexia need treatment. Even if you or someone you care about has only a couple of the signs of an eating disorder, get help now. Early treatment gives the best chance of overcoming anorexia.
Treatment can help you get back to and stay at a healthy weight. It can also help you learn good eating habits and learn to feel better about yourself. Because anorexia is both a physical and emotional problem, you may work with a doctor, a dietitian, and a counselor.
There are no medicines to treat anorexia. But if you are depressed or anxious, your doctor may prescribe an antidepressant medicine.
If your weight has dropped too low, you will need to be treated in a hospital. People who have lost a large portion of their weight need to take part in a live-in (inpatient) treatment program for people with eating disorders. This type of treatment can be costly, but it gives the best chance of recovery.
Anorexia can take a long time to overcome, and it is common to fall back into unhealthy habits. If you are having problems, don't try to handle them on your own. Get help now.
What should you do if you think someone has anorexia?
It can be very scary to realize that someone you care about has an eating disorder. If you think a friend or loved one has anorexia, you can help.
Is this topic for you?
Anorexia is one of the most common eating disorders. If you would like information about other eating disorders, see the topics Bulimia Nervosa and Binge Eating Disorder.
What is anorexia nervosa?
Anorexia nervosa (say "an-uh-RECK-see-uh nur-VOH-suh") is a type of eating disorder. People who have anorexia have an intense fear of gaining weight. They severely limit the amount of food they eat and can become dangerously thin.
Anorexia affects both the body and the mind. It may start as dieting, but it gets out of control. You think about food, dieting, and weight all the time. You have a distorted body image. Other people say you are too thin, but when you look in the mirror, you see a fat person.
Anorexia usually starts in the teen years. Early treatment can be very effective. But if not treated early, anorexia can become a lifelong problem. Untreated anorexia can lead to starvation and serious health problems, such as bone thinning (osteoporosis), kidney damage, and heart problems. Some people die from these problems.
If you or someone you know has anorexia, get help right away. The longer this problem goes on, the harder it is to overcome. With treatment, a person with anorexia can feel better and stay at a healthy weight.
What causes anorexia?
Eating disorders are complex, and experts don't really know what causes them. But they may be due to a mix of family history, social factors, and personality traits. You may be more likely to have anorexia if:
- Other people in your family have an eating disorder, such as anorexia or bulimia nervosa.
- You have a job or do a sport that stresses body size, such as ballet, modeling, or gymnastics.
- You are the type of person who tries to be perfect all the time, never feels good enough, or worries a lot.
- You are dealing with stressful life events, such as divorce, moving to a new town or school, or losing a loved one.
- Teens. Like other eating disorders, anorexia usually starts in the teen years with strict dieting and rapid weight loss. But it can start even earlier or in adulthood.
- Women. About 9 out of 10 people with anorexia are female. But some boys and men have it too.1
What are the symptoms?
People who have anorexia often strongly deny that they have a problem. They do not see or believe that they do. It is usually up to their loved ones to get help for them. If you are worried about someone, you can look for certain signs.
People who have anorexia:
- Weigh much less than is healthy or normal.
- Are very afraid of gaining weight.
- Refuse to stay at a normal weight.
- Think they are overweight even when they are very thin.
- Obsess about food, weight, and dieting.
- Strictly limit how much they eat. For example, they may limit themselves to just a few hundred calories a day or refuse to eat certain foods, such as anything with fat or sugar.
- Exercise a lot, even when they are sick.
- Vomit or use laxatives or water pills (diuretics) to avoid weight gain.
- Develop odd habits about food, like cutting all their food into tiny pieces or chewing every bite a certain number of times.
- Become secretive. They may pull away from family and friends, make excuses not to eat around other people, and lie about their eating habits.
- Feel weak, tired, or faint.
- Have thinning hair, dry skin, and brittle nails.
- Stop having menstrual periods.
- Feel cold all the time.
- Have low blood pressure and a slow heartbeat.
- Have purplish skin color on their arms and legs from poor blood flow.
- Have swollen feet and hands.
- Grow a layer of baby-fine hair all over their body.
If your doctor thinks that you may have an eating disorder, he or she will compare your weight with the expected weight for someone of your height and age. He or she will also check your heart, lungs, blood pressure, skin, and hair to look for problems caused by not eating enough. You may also have blood tests or X-rays.
Your doctor may ask questions about how you feel. It is common for a treatable mental health problem such as depression or anxiety to play a part in an eating disorder.
How is it treated?
All people who have anorexia need treatment. Even if you or someone you care about has only a couple of the signs of an eating disorder, get help now. Early treatment gives the best chance of overcoming anorexia.
Treatment can help you get back to and stay at a healthy weight. It can also help you learn good eating habits and learn to feel better about yourself. Because anorexia is both a physical and emotional problem, you may work with a doctor, a dietitian, and a counselor.
There are no medicines to treat anorexia. But if you are depressed or anxious, your doctor may prescribe an antidepressant medicine.
If your weight has dropped too low, you will need to be treated in a hospital. People who have lost a large portion of their weight need to take part in a live-in (inpatient) treatment program for people with eating disorders. This type of treatment can be costly, but it gives the best chance of recovery.
Anorexia can take a long time to overcome, and it is common to fall back into unhealthy habits. If you are having problems, don't try to handle them on your own. Get help now.
What should you do if you think someone has anorexia?
It can be very scary to realize that someone you care about has an eating disorder. If you think a friend or loved one has anorexia, you can help.
- Talk to her. Tell her why you are worried. Let her know that you care.
- Urge her to talk to someone who can help, like a doctor or counselor. Offer to go with her.
- Tell someone who can make a difference, like a parent, teacher, counselor, or doctor. A person with anorexia may insist that she does not need help, but she does. The sooner she gets treatment, the sooner she will be healthy again.
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