Category: Cognition

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Integrated Classrooms Fail Teachers and Students

00ADHD, Cognition, Confidence, Education, Featured news, Self-Esteem September, 19

Source: Ryan McGuire at Gratisography, some rights reserved

Sharon (name changed), an elementary school teacher in London, England, taught a challenging class last year. Out of a large group of 30 students, three were diagnosed with autism, one with dyspraxia, three with ADHD, and two with ODD. Despite her 25 years of experience, she felt stressed balancing the needs of these students with the needs of the class as a whole, and almost resigned from her position. 

Many teachers can identify. Students with special needs are often placed with teachers who have received no training or resources to help. This occurs in schools that have welcomed students with disabilities, but are not yet fully inclusive. Schools like this are said to be integrated. 

According to the United Nations Committee on the Rights of Persons with Disabilities, in an integrated school, students with special needs are placed in existing educational systems. In contrast, inclusion involves making changes to the entire system to allow all students to have access to a learning environment that best suits their needs. These accommodations can range from specially formatted worksheets to in-class tutors to special technologies. The Convention on the Rights of Persons with Disabilities states:

“Placing students with disabilities in mainstream classes without appropriate structural changes to, for example, organization, curriculum and teaching and learning strategies does not constitute inclusion.”

Many schools fail to provide teachers with appropriate resources. And teachers’ training programs do not sufficiently prepare teachers for working with students with special needs. The lack of support places significant stress on teachers who struggle with the dual challenges of educating a large class and catering to each student’s individual needs.  In an interview with the Trauma and Mental Health Report, Josee (name changed), an elementary school teacher in Ontario, said:

“It’s stressful. It’s a lot, especially because I have big classes… and they are two different grades…There are times when I just feel very overwhelmed.”

And it’s not just teachers who are stressed, students are affected as well. Tammy (name changed), who teaches elementary school in Berkley, California, said in an interview that she has observed students suffering self-esteem issues due to their needs not being met in the classroom. In her words:

“It’s heartbreaking to see a child that just has no confidence in their own abilities because they aren’t able to do the work they see their peers doing. It’s a vicious cycle too, they can’t do the work so they check out, and then they fall even farther behind. I try my best to celebrate and make visible some kind of success that child has had, whether it’s social or physical or artistic or whatever, just to give them a more positive self-image, but it’s a really hard thing to spend every day struggling to understand what’s happening around you.”

According to the CDC, in the United States, 15% of children ages 3 to 17 have a neurodevelopmental disability; this includes all developmental disorders, learning and intellectual disabilities, and motor and language disorders. The number of children in the same age group with mental, emotional, or behavioural disorders is estimated at 13% to 20%. These students often require individualized learning and attention within the classroom.  

However, without adequate training or resources, teachers find it difficult to give students the help they need. Rebecca (name changed), an Ontario elementary school teacher  explained in an interview:

No teacher knows exactly what to do with each kid and each diagnosis. Yes, there’s accommodations for academics, but it’s not always the academics that needs help, it’s the behaviour, it’s the self-esteem, it’s their growth, their confidence.

To better help their students, teachers require additional training on how to work with students with various disabilities, as well as assistants or co-teachers in the classroom to share the load. Other resources include technologies to better help students and the ability to consult with specialists. With these resources, schools can take the final steps towards become fully inclusive.

And, in schools that have successfully adopted a philosophy of inclusion, the benefits are significant. In a study conducted by Thomas Hehir, Professor of practice in learning differences at Harvard University:

“There is clear and consistent evidence that inclusive educational settings can confer substantial short- and long-term benefits for students with and without disabilities.”

Schools should keep working toward their goals of inclusion to create classrooms where both students and teachers are given the tools they need to succeed. 

-Roselyn Gishen, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

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What Happens After Children Are Freed From Captivity?

00Caregiving, Cognition, Depression, Embarrassment, Featured news, Law and Crime, Shyness, Trauma July, 19

Source: James Sutton, creative commons

On occasion, we hear of extreme cases of child abuse, making family names like the Turpins infamous.

The 13 Turpin children were held captive in their house, where they were limited to only one meal a day and one shower a year. Twelve of the children were subject to extreme physical abuse, and one suffered from sexual abuse. The eldest child, who was 29 years old, weighed only 82 pounds.

Cases like these often publicize legal proceedings and atrocities committed by the parents, but disregard what happens to these children—the victims— in the aftermath. 

Research on children held captive is sparse, however, there are some studies of other high-profile cases where children suffered extreme deprivation. A well-known one is Genie, a child who was isolated in a small bedroom where she was strapped to a toilet seat during the day, or trapped in a crib with wire covering. She received absolutely no stimulation and was only fed infant food. 

When Genie was found at age 13, she was unable to perform basic functions, such as chewing, biting, standing or walking. She spent years trying to learn to speak but was unable to acquire language fully or normally. After years of testing by psychologists and physicians, her mother forbade further assessment of Genie, and she is now living in the care of the state of California.

Maude Julien, a psychotherapist from France who herself was subjected to captivity by her parents, now treats patients who are victims of trauma. In an interview with The Trauma and Mental Health Report, Maude describes her experiences growing up.

“For about 15 years, I practically never went out. I never went to school; my mother was my home-school teacher. My father wanted to create a superhuman, uncorrupted by this world,” Maude said. “I had to undergo a ‘training of the mind’ in order to become this ‘superhuman.’ He wanted me to believe that the world outside was terrible.”

Maude described the effects of severe trauma caused and explained her recovery process.

“I had to learn the simplest, most basic social conventions like speaking to strangers or finding my way around. Above all, I had to learn how to talk, because my long periods of forced silence had made me almost mute,” Maude said.

“Even though I was learning all this, I was still imprisoned behind the ‘gates’ of conditioning. I could still hear in my head, day and night, the tick-tock of my father timing everything,” she said.

Maude described her recovery as the need to “free herself from the mental and emotional hold” she was under. It took her more than ten years to overcome the consequences of her imprisonment.

Maude explains how reading, and connecting with animals and other people helped her cope with trauma. She attributes her ability to get out of the house to her music teacher and describes her second husband’s parents as an instrumental part in helping her mature.

“I was 24 when I met them and they helped the child inside me grow up. I felt unconditional parental love for the first time; it’s one of the greatest gifts in the world,” Maude said.

Children who have been held captive by a relative often think they deserve it and live with a heavy feeling of shame and guilt. 

“It’s usually shame that prevents victims from seeking help,” Maude said. “They have also a feeling of isolation, because a predator like my father, makes the victim believe that he alone can love and protect them.”

Children reported in these high-profile cases may feel guilty for having “betrayed” their parents, yet may also feel relief for having escaped. She describes living with this duality as being very “painful.”

“They will have to free themselves from the ‘psychological leash’ imposed by their predator,” Maude said. “They will have to learn how to trust certain people, and they will have to learn how to recognize other predators and stay away from them. Most of all, they have to learn how to trust themselves.”

—Amanda Piccirilli, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

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After Children Are Freed From Captivity

00Caregiving, Cognition, Depression, Embarrassment, Featured news, Law and Crime, Shyness, Trauma July, 19

Source: James Sutton, creative commons

On occasion, we hear of extreme cases of child abuse, making family names like the Turpins infamous.

The 13 Turpin children were held captive in their house, where they were limited to only one meal a day and one shower a year. Twelve of the children were subject to extreme physical abuse, and one suffered from sexual abuse. The eldest child, who was 29 years old, weighed only 82 pounds.

Cases like these often publicize legal proceedings and atrocities committed by the parents, but disregard what happens to these children—the victims— in the aftermath. 

Research on children held captive is sparse, however, there are some studies of other high-profile cases where children suffered extreme deprivation. A well-known one is Genie, a child who was isolated in a small bedroom where she was strapped to a toilet seat during the day, or trapped in a crib with wire covering. She received absolutely no stimulation and was only fed infant food. 

When Genie was found at age 13, she was unable to perform basic functions, such as chewing, biting, standing or walking. She spent years trying to learn to speak, but was unable to acquire language fully or normally. After years of testing by psychologists and physicians, her mother forbade further assessment of Genie, and she is now living in the care of the state of California.

Maude Julien, a psychotherapist from France who herself was subjected to captivity by her parents, now treats patients who are victims of trauma. In an interview with The Trauma and Mental Health Report, Maude describes her experiences growing up.

“For about 15 years, I practically never went out. I never went to school; my mother was my home-school teacher. My father wanted to create a superhuman, uncorrupted by this world,” Maude said. “I had to undergo a ‘training of the mind’ in order to become this ‘superhuman.’ He wanted me to believe that the world outside was terrible.”

Maude described the effects severe trauma caused and explained her recovery process.

“I had to learn the simplest, most basic social conventions like speaking to strangers or finding my way around. Above all, I had to learn how to talk, because my long periods of forced silence had made me almost mute,” Maude said.

“Even though I was learning all this, I was still imprisoned behind the ‘gates’ of conditioning. I could still hear in my head, day and night, the tick-tock of my father timing everything,” she said.

Maude described her recovery as the need to “free herself from the mental and emotional hold” she was under. It took her more than 10 years to overcome the consequences of her imprisonment.

Maude explains how reading, and connecting with animals and other people helped her cope with trauma. She attributes her ability to get out of the house to her music teacher and describes her second husband’s parents as an instrumental part in helping her mature.

“I was 24 when I met them and they helped the child inside me grow up. I felt unconditional parental love for the first time; it’s one of the greatest gifts in the world,” Maude said.

Children who have been held captive by a relative often think they deserve it, and live with a heavy feeling of shame and guilt. 

“It’s usually shame that prevents victims from seeking help,” Maude said. “They have also a feeling of isolation, because a predator like my father, makes the victim believe that he alone can love and protect them.”

Children reported in these high-profile cases may feel guilty for having “betrayed” their parents, yet may also feel relief for having escaped. She describes living with this duality as being very “painful.”

“They will have to free themselves from the ‘psychological leash’ imposed by their predator,” Maude said. “They will have to learn how to trust certain people, and they will have to learn how to recognize other predators and stay away from them. Most of all, they have to learn how to trust themselves.”

—Amanda Piccirilli, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

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Misdiagnosis All Too Common for Women with Autism

00ADHD, Autism, Cognition, Featured news, Gender, Health, Wisdom May, 19

Source: Ryan McGuire at Gratisography, Creative Commons

After twenty-eight years of being “dragged through the system,” Emily Swiatek was finally diagnosed with Asperger’s, a branch of Autism Spectrum Disorder (ASD). For Emily, receiving the diagnosis felt like “coming home to a version of yourself that you have been denied of.”

Research shows that Autism Spectrum Disorder is more prevalent in males than females by a ratio of three to one. But there is increasing evidence that this gender difference may be slimmer than we think, and that autism symptoms in women and girls are frequently overlooked and misdiagnosed. 

In an interview with the Trauma and Mental Health Report, Emily explains her frustration with being shuffled from one specialist to another for years, without receiving an adequate explanation for her symptoms: 

“I’ve been through quite a long journey, being given about 10 mental health diagnoses along the way. It was getting to that point where it felt like I was caught in the middle of a guessing game. I kept coming up against the same response of ‘we don’t really understand let’s keep throwing the labels and see what sticks’.” 

The National Autistic Society survey conducted in the United Kingdom found that compared to males, women and girls are more likely to be misdiagnosed, with 42% of females diagnosed with a mental disorder other than autism when being assessed, as opposed to 30% of males. 

Emily’s experience is not unique. Hannah Belcher, who was diagnosed with Asperger’s Syndrome at 23, shares her experience:

“Throughout my life, I’ve been diagnosed with Anxiety, Depression, Bipolar, traits of Borderline Personality Disorder, and ADHD. Some correct and comorbid, some incorrect and misdiagnosed.”

There is no clear explanation as to why women with autism are often misdiagnosed. Child psychiatrist Meng-Chuan Lai, a clinician-scientist at the Centre for Addiction and Mental Health says that while there is a range of different reasons why women receive a diagnosis of ASD later in life, one possibility is that autism characteristics aren’t so evident in females: 

“Girls and women may be more able to master ‘camouflaging’, so ‘typical’ autistic characteristics could be masked when they learn social skills.” 

Lai describes this as the ability to learn neurotypical social behaviours such as eye contact, gestures, holding conversations, and the utilization of social scripts.  These neurotypical behaviours represent those who are not on the autism spectrum in contrast to the neurodiverse behaviours which refer to differently wired brains and cognitive styles attributed to those on the autism spectrum. 

In the foreword for Safety Skills for Asperger Women by Liane Holliday Willey, Tony Atwood describes this “camouflaging” phenomenon, reporting that young girls mask the symptoms of autism by socializing and interacting with their peers, causing a delay in diagnosis.  

Both Hannah and Emily attribute mimicking socialization patterns as an important factor. Emily explains: 

“I’m not a part of that traditional profile of autism… It never even occurred to anyone who was assessing me that somebody who looks like me, somebody who presents like me, could be autistic because I’m smiley, I’m eloquent, I can probably make eye contact if I have to, even though I don’t like it. I’m a very strong mimicker and that masking and mimicking profile is true for me.  I think I very much fit that ‘well behaved little girl’ image—very intelligent, liked reading, very quiet, maybe they’d say I was shy.”  

Lai notes that another possible reason for the misdiagnosis is that women and girls tend to have restricted and repetitive behaviours that are less likely to be recognized:

“The issue is that some of these narrow interests of autism in males, if you only look at the content, are more traditionally male-typical such as trains, dinosaurs, trucks, and they are most easily recognized by clinicians because of our own stereotypes of autism. For girls, their restricted and repetitive behaviours might not be captured by standardized instruments as they are deemed as less noticeable.”

Recent research has touched on the idea of bias in the way autism is diagnosed. One study showed that girls are more likely to be diagnosed if they had an additional intellectual disability or behavioural issues. However, without these, many women are receiving incorrect diagnoses, or none at all. Hannah agrees:

“Sometimes you might feel like you don’t fit in anywhere, everything everyone thinks about autism is male biased. However, as slow and painful as the journey is, there is always a light at the end of the tunnel. It takes us a little bit longer to get to it, but it is worth the journey.

In a study looking at sex differences between children with autism, researchers recommend new strategies for improving autism recognition in females. In fact, Australia is the first country to form new national guidelines to help increase early diagnosis of women with autism.  Considerations of social camouflaging, anxiety, sensory overload, and depression are being included in these new guidelines.  

If these guidelines are implemented, it will be possible to decrease the number of misdiagnoses in women and girls who have autism, leading to less frustration for these women and more time to learn how to manage their diagnosis. Emily says that since she received her diagnosis, her life has changed for the better:

“It was instant relief the minute I got my diagnosis. It just made sense. It was right. It was instantaneous the difference it made. My general well-being just went up and up and up, and is still on an upward trajectory.”    

-Lucia Chiara Limanni, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

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Misdiagnosis Is All Too Common for Women with Autism

00ADHD, Autism, Cognition, Featured news, Gender, Wisdom May, 19

Source: Ryan McGuire at Gratisography, Creative Commons

After twenty-eight years of being “dragged through the system,” Emily Swiatek was finally diagnosed with Asperger’s, a branch of Autism Spectrum Disorder (ASD). For Emily, receiving the diagnosis felt like “coming home to a version of yourself that you have been denied.”

Research shows that Autism Spectrum Disorder is more prevalent in males than females by a ratio of three to one. But there is increasing evidence that this gender difference may be slimmer than we think, and that autism symptoms in women and girls are frequently overlooked and misdiagnosed. 

In an interview with the Trauma and Mental Health Report, Emily explains her frustration with being shuffled from one specialist to another for years, without receiving an adequate explanation for her symptoms: 

“I’ve been through quite a long journey, being given about 10 mental health diagnoses along the way. It was getting to that point where it felt like I was caught in the middle of a guessing game. I kept coming up against the same response of, ‘We don’t really understand—let’s keep throwing labels and see what sticks.’” 

A survey conducted in the United Kingdom by The National Autistic Society found that compared to males, women and girls are more likely to be misdiagnosed, with 42 percent of females diagnosed with a mental disorder other than autism when being assessed, as opposed to 30 percent of males. 

Emily’s experience is not unique. Hannah Belcher, who was diagnosed with Asperger’s Syndrome at 23, shares her experience: “Throughout my life, I’ve been diagnosed with Anxiety, Depression, Bipolar, traits of Borderline Personality Disorder, and ADHD. Some correct and comorbid, some incorrect and misdiagnosed.”

There is no clear explanation as to why women with autism are often misdiagnosed. Child psychiatrist Meng-Chuan Lai, a clinician-scientist at the Centre for Addiction and Mental Health, says that while there is a range of different reasons why women receive a diagnosis of ASD later in life, one possibility is that autism characteristics aren’t so evident in females: “Girls and women may be more able to master ‘camouflaging,’ so ‘typical’ autistic characteristics could be masked when they learn social skills.” 

Lai describes this as the ability to learn neurotypical social behaviors such as eye contact, gestures, holding conversations, and the utilization of social scripts. These neurotypical behaviors represent those who are not on the autism spectrum, in contrast to the neurodiverse behaviors which refer to differently wired brains and cognitive styles attributed to those on the autism spectrum. 

In the foreword for Safety Skills for Asperger Women by Liane Holliday Willey, Tony Atwood describes this “camouflaging” phenomenon, reporting that young girls mask the symptoms of autism by socializing and interacting with their peers, causing a delay in diagnosis.  

Both Hannah and Emily attribute mimicking socialization patterns as an important factor. Emily explains: 

“I’m not a part of that traditional profile of autism… It never even occurred to anyone who was assessing me that somebody who looks like me, somebody who presents like me, could be autistic because I’m smiley, I’m eloquent, I can probably make eye contact if I have to, even though I don’t like it. I’m a very strong mimicker and that masking and mimicking profile is true for me. I think I very much fit that ‘well behaved little girl’ image—very intelligent, liked reading, very quiet, maybe they’d say I was shy.”  

Lai notes that another possible reason for the misdiagnosis is that women and girls tend to have restricted and repetitive behaviors that are less likely to be recognized:

“The issue is that some of these narrow interests of autism in males, if you only look at the content, are more traditionally male-typical such as trains, dinosaurs, trucks, and they are most easily recognized by clinicians because of our own stereotypes of autism. For girls, their restricted and repetitive behaviours might not be captured by standardized instruments as they are deemed as less noticeable.”

Recent research has touched on the idea of bias in the way autism is diagnosed. One study showed that girls are more likely to be diagnosed if they had additional intellectual disabilities or behavioral issues. However, without these, many women are receiving incorrect diagnoses or none at all. Hannah agrees: “Sometimes you might feel like you don’t fit in anywhere, everything everyone thinks about autism is male-biased. However, as slow and painful as the journey is, there is always a light at the end of the tunnel. It takes us a little bit longer to get to it, but it is worth the journey.”

In a study looking at sex differences between children with autism, researchers recommend new strategies for improving autism recognition in females. In fact, Australia is the first country to form new national guidelines to help increase early diagnosis of women with autism. Considerations of social camouflaging, anxiety, sensory overload, and depression are being included in these new guidelines.  

If these guidelines are implemented, it will be possible to decrease the number of misdiagnoses in women and girls who have autism, leading to less frustration for these women and more time to learn how to manage their diagnosis. Emily says that since she received her diagnosis, her life has changed for the better: “It was instant relief the minute I got my diagnosis. It just made sense. It was right. It was instantaneous the difference it made. My general well-being just went up and up and up, and is still on an upward trajectory.”    

-Lucia Chiara Limanni, Contributing Writer, The Trauma and Mental Health Report

-Copyright Robert T. Muller

LinkedIn Image Credit: Victoria Labadie/Shutterstock

This article was originally published on Psychology Today

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A Brain Stimulation Device May Power Healing

00Cognition, Cognitive Stimulation Therapy, Environment, Featured news, Health, Neuroscience February, 18

Source: UCI Research at flickr, Creative Commons

Promising new treatments for neurological disorders are aimed at transforming disease management through neuroplasticity—the brain’s ability to alter its structure and function to adapt to changes in the environment. Leading-edge research is investigating how technological solutions can enhance neuroplasticity, boosting recovery from neurological damage.

In September 2016, Helius Medical Technologies announced positive results for its pilot study using a brain stimulation device to treat pediatric Cerebral Palsy (CP). CP affects muscle control due to injury or malformation of the brain. For the study, some participants received standard physiotherapy, while others received standard physiotherapy along with 20 minutes of brain stimulation with Helius’s experimental device.

Those who received brain stimulation showed improvements in muscle spasms and gross lower limb motor function, over those who did not. And, there were improvements in quality of life, social status, and cognitive function. One explanation is that the brain stimulation device heightens the brain’s natural ability to heal, producing enhanced benefits from physiotherapy.

This new method of brain stimulation is termed cranial nerve non-invasive neuromodulation (CN-NINM). A successful feasibility study was done for the treatment of Multiple Sclerosis (MS), and studies are underway for Parkinson’s disease, brain injury, and stroke. Participants are reporting improvements in mental health and wellbeing, such as greater mental clarity and increased energy. And benefits may extend to other neurological conditions as well.

The brain stimulation device used in these studies comes from decades of work by researchers at the University of Wisconsin-Madison, in the Tactile Communication and Neurorehabilitation Laboratory (TCN Lab). The team named the device the Portable Neuromodulation Stimulator (PoNS). The PoNS consists of a small array of electrodes that transfer an electrical current to the patient’s tongue, activating areas of the brainstem and cerebellum. Researchers theorize that this activation induces a sequence of activity that spreads through the brain.

In his book, The Brain’s Way of Healing, researcher and psychiatrist Norman Doidge explains how brain stimulation enhances neuroplastic healing. Doidge says an underlying cause of symptoms in neurological disorders is a dysregulation of electrical activity in the brain. He explains the sequence of activity caused by the PoNS may help the brain balance the electrical activity in its networks of brain cells. Balancing promotes rest and relaxation of these cells, allowing further stimulation alongside appropriate rehabilitative therapy. Stimulation reactivates dormant or dysregulated brain cells, and reintegrates them into functioning networks. Taken together, these changes make an ideal state for neuroplastic healing to take place.

Doidge shares a story about Broadway singer Ron Husmann’s remarkable recovery, which Doidge attributes to neuroplastic healing. Multiple Sclerosis led Ron to lose control of his bladder, mobility, and singing voice. Devastated by the loss of his voice and feeling he had nothing to lose, Ron travelled to the TCN Lab. He spent two weeks in intensive speech therapy, accompanied by brain stimulation with the PoNS device. By the end of his stay, Ron was singing and dancing again.

Brain stimulation and modulation are not new. They are central to established, FDA-approved treatments, such as deep brain stimulation (DBS), for neurological disorders. But, an important difference between the PoNS device and deep brain stimulation is that DBS is a highly invasive treatment. It involves the insertion of an electrode into the patient’s brain, and introduces several possible risks, including infections and strokes. And so, DBS is only used as a last resort. But the PoNS is non-invasive and presents few risks. Plus, the effects of the PoNS appear to continue even after the stimulation ends, whereas the benefits of DBS tend to end when stimulation is turned off.

Reported side effects for treatment by the PoNS, though, include increased salivation, mild headaches, and jaw pain. To reduce side effects, researchers teach participants swallowing and relaxation techniques that manage saliva and tension in the jaw.

Although early evidence for the PoNS device is impressive, skeptics point out that the number of participants used in the studies is small, which reduces confidence in reported outcomes. And although the team at the TCN Lab has shown that the PoNS increases activity in key brain areas, theories on how, precisely, it contributes to healing are still unclear.

Still, the PoNS shows promise as an addition to rehabilitation programs, and as a way of promoting physical and mental health. This technology is one to watch.

–Stefano Costa, Contributing Writer, The Trauma and Mental Health Report.

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report.

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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In Long-Term Care, Patient-on-Patient Violence on the Rise

00Aging, Anger, Cognition, Dementia, Featured news, Health, Trauma November, 17

A January 2016 Vancouver Sun article reported on 16 seniors in British Columbia (BC) killed in the last 4 years from violence in long-term care facilities.

While the mention of violence in nursing homes conjures images of support workers abusing patients, these altercations actually took place between patients. In each case, either one or both of the people involved suffered from a severe cognitive disability.

In one case, Karl Otessen, who suffered from dementia, had experienced multiple outbursts in which he would attack staff or rip off his clothes. He was on medication, and behavioral strategies had been implemented by the nurses, yet Otessen’s final attack resulted in a fractured hip, and he later died from related complications.

This sort of violence by a patient is rarely premeditated, making it difficult to prevent. The Alzheimer’s Society describes dementia patients as having difficulty describing their needs, leading to frustration and aggression. And dementia often causes decreased inhibition, resulting in violent and unpredictable outbursts.

In an interview with Global News, Sara Kaur, a support worker at a long-term care center in Mississauga, said that “Conflict can be prevented by understanding dementia and a senior’s inability to communicate simple needs.” By understanding the causes and symptoms of a mental-health disorder, a long-term care facility employee has a better chance of resolving potentially violent situations in a productive manner.

Many facilities have reported that they are under-staffed and under-equipped. But an article from Healthy Debate Canada, a publication focusing on the Canadian health care system, notes that:

“While we need more staff in long term care, just establishing an arbitrary number for staffing ratio isn’t the solution; it’s equally important to look at how much time staff are able to spend directly with residents, and whether they have the training they need to provide quality care.”

In Otessen’s case, although nurses tried to use a number of behavioural techniques to calm him, if a specific mental-health treatment plan had been in place, it’s possible that his violent behavior would have been reduced or eliminated entirely.

The Ontario Long Term Care Association, which examines progressive practices for long-term care homes, has suggested the use of specialized teams of nurses and support workers who are trained in identifying the triggers that lead to aggression in dementia patients. After identifying those triggers, the goal is to then create a solution to address the issue and protect other patients.

Using specialized teams may reduce the burden on regular support workers while also addressing the mental health needs of patients in an individualized manner. It is not enough to issue facility-wide policy changes to address behavioural issues when their causes vary from case to case.

The issue of patient-on-patient violence won’t be resolved without further attention. In Canada alone, there are currently over 750,000 individuals living with dementia, a number projected to double in 15 years. The growing elderly population must be considered when implementing budgetary and training changes to long-term care facilities.

–Andrei Nistor, Contributing Writer, The Trauma and Mental Health Report.

–Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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In Long-Term Care, Patient-on-Patient Violence on the Rise

00Aging, Anger, Cognition, Dementia, Featured news, Health, Trauma November, 17

Source: SpaceShoe at flickr, Creative Commons

A January 2016 Vancouver Sun article reported on 16 seniors in British Columbia (BC) killed in the last 4 years from violence in long-term care facilities.

While the mention of violence in nursing homes conjures images of support workers abusing patients, these altercations actually took place between patients. In each case, either one or both of the people involved suffered from a severe cognitive disability.

In one case, Karl Otessen, who suffered from dementia, had experienced multiple outbursts in which he would attack staff or rip off his clothes. He was on medication, and behavioral strategies had been implemented by the nurses, yet Otessen’s final attack resulted in a fractured hip, and he later died from related complications.

This sort of violence by a patient is rarely premeditated, making it difficult to prevent. The Alzheimer’s Society describes dementia patients as having difficulty describing their needs, leading to frustration and aggression. And dementia often causes decreased inhibition, resulting in violent and unpredictable outbursts.

In an interview with Global News, Sara Kaur, a support worker at a long-term care center in Mississauga, said that “Conflict can be prevented by understanding dementia and a senior’s inability to communicate simple needs.” By understanding the causes and symptoms of a mental-health disorder, a long-term care facility employee has a better chance of resolving potentially violent situations in a productive manner.

Many facilities have reported that they are under-staffed and under-equipped. But an article from Healthy Debate Canada, a publication focusing on the Canadian health care system, notes that:

“While we need more staff in long term care, just establishing an arbitrary number for staffing ratio isn’t the solution; it’s equally important to look at how much time staff are able to spend directly with residents, and whether they have the training they need to provide quality care.”

In Otessen’s case, although nurses tried to use a number of behavioural techniques to calm him, if a specific mental-health treatment plan had been in place, it’s possible that his violent behavior would have been reduced or eliminated entirely.

The Ontario Long Term Care Association, which examines progressive practices for long-term care homes, has suggested the use of specialized teams of nurses and support workers who are trained in identifying the triggers that lead to aggression in dementia patients. After identifying those triggers, the goal is to then create a solution to address the issue and protect other patients.

Using specialized teams may reduce the burden on regular support workers while also addressing the mental health needs of patients in an individualized manner. It is not enough to issue facility-wide policy changes to address behavioural issues when their causes vary from case to case.

The issue of patient-on-patient violence won’t be resolved without further attention. In Canada alone, there are currently over 750,000 individuals living with dementia, a number projected to double in 15 years. The growing elderly population must be considered when implementing budgetary and training changes to long-term care facilities.

–Andrei Nistor, Contributing Writer, The Trauma and Mental Health Report.

–Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

Copyright Robert T. Muller.
 

This article was originally published on Psychology Today

faces-73493_1280-470x260.jpg

Expressing the Inner Voice May Bring Benefits

00Cognition, Featured news, Health, Optimism, Self-Help, Self-Talk November, 17

Source: geralt at Pixabay, Public Domain

An app called Dragon Anywhere allows people to talk to their smart phone with no word or time limits. Talking out loud with a piece of technology is socially acceptable these days, but what about when no one or no thing is listening?

Many associate hearing voices or talking to oneself with mental illnesses like schizophrenia. And because these behaviours deviate from the norm, they make people uncomfortable.

But might there be benefits to expressing inner voices out loud?

James McConnell, an American biologist and animal psychologist, has said that talking to oneself is psychologically healthy. And neuroscientist Jill Bolte Taylor, in her book My Stroke of Insight, argues that speaking out loud makes the mind more focused, and even calls it “a powerful instrument”.

In an article in The Quarterly Journal of Experimental Psychology, Gary Lupyan and Daniel Swingley discuss the functions of talking to oneself, also known as self-directed speech. Compared to thinking about a word (e.g., chair), hearing a word out loud can make us better visual detectors of that word in our surroundings. Speaking facilitates the search. This phenomenon is called the label feedback hypothesis.

It is unclear, however, whether the label feedback hypothesis can be applied to broader concepts like happiness. Can happiness literally be spoken into existence?

Proponents of positive affirmations think so, noting the benefits of repeating positive statements directed toward oneself. A study at the University of California, Los Angeles, showed that students who repeated positive affirmations produced fewer stress hormones. And another study published in the Personality and Social Psychology Bulletin by a team of researchers from Columbia, Berkeley, and Google found positive self-affirmations help those in low-power positions perform better.

Self-talk has other benefits as well. In a PsychCentral piece, Talking to Yourself: A Sign of Sanity, psychologist Linda Sapadin notes that giving voice to our goals focuses attention, controls emotions, and keeps distractions away.

In fact, this may be the best way for some individuals to get organized. While a number of people are visual learners, using calendars and to-do lists, it may be that others do better by simply speaking out loud.

Matt Duczeminski explains in his book 6 Benefits of Talking to Yourself (No, You’re Not Crazy) that talking through your thoughts helps distinguish big tasks from smaller ones, for example, getting organized by talking through a to-do list.

But not all self-talk is useful. In fact, talking about our failures and putting ourselves down can be quite harmful. As Sapadin puts it, “That kind of self-talk is worse than no talk at all.” And it can lead to a self-fulfilling prophecy, where we view ourselves negatively and act accordingly, attracting others who reinforce those beliefs.

The link between negative self-talk and depression is also quite strong. In fact, those who engage in more negative self-talk experience more stress and inferior health, both psychologically and physically. Language and cognition expert, Steven Hayes, says negative thoughts are like passengers in the backseat of the car you’re driving. You hear them, but your focus should be on the task ahead.

Another way of coping with negative self-talk is by giving your negative voice a name. Brené Brown, author of the New York Times Bestsellers The Gifts of Imperfection and Daring Greatly, calls her inner critic ‘The Gremlin’, making light of the little voice inside her head.

So… if you’ll listen to yourself, keep talking.

But be kind to you.

–Marjan Khanjani, Contributing Writer, The Trauma and Mental Health Report.

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report.

Copyright Robert T. Muller.

This article was originally published on Psychology Today

faces-73493_1280-470x260-1.jpg

Expressing the Inner Voice May Bring Benefits

00Cognition, Featured news, Health, Optimism, Self-Help, Self-Talk November, 17

Source: geralt at Pixabay, Public Domain

An app called Dragon Anywhere allows people to talk to their smart phone with no word or time limits. Talking out loud with a piece of technology is socially acceptable these days, but what about when nobody else is listening?

Many associate hearing voices or talking to oneself with mental illnesses like schizophrenia. And because these behaviours deviate from the norm, they make people uncomfortable. But might there be benefits to expressing inner thoughts out loud in this way?

James McConnell, an American biologist and animal psychologist, has said that talking to oneself is psychologically healthy. And neuroscientist Jill Bolte Taylor, in her book My Stroke of Insight, argues that speaking out loud makes the mind more focused, and even calls it “a powerful instrument.”

In an paper in The Quarterly Journal of Experimental Psychology, Gary Lupyan and Daniel Swingley discuss the functions of talking to oneself, also known as self-directed speech. Compared to thinking about a word (e.g., chair), hearing a word out loud can make us better at visually detecting that thing in our surroundings. Speaking facilitates the search. This phenomenon is called the label feedback hypothesis.

It is unclear, however, whether the label feedback hypothesis can be applied to broader concepts like happiness. Can happiness literally be spoken into existence?

Proponents of positive affirmations think so, noting the benefits of repeating positive statements directed toward oneself. A study at the University of California, Los Angeles, showed that students who repeated positive affirmations exhibited lower levels of stress hormones. And another study published in the Personality and Social Psychology Bulletin by a team of researchers from Columbia, Berkeley, and Google suggests that positive self-affirmations help those in low-power positions perform better.

Self-talk has other benefits as well. In a PsychCentral piece, “Talking to Yourself: A Sign of Sanity,” psychologist Linda Sapadin notes that giving voice to our goals focuses attention, controls emotions, and keeps distractions away.

In fact, this may be the best way for some individuals to get organized. While a number of people are visual learners, using calendars and to-do lists, it may be that others do better by simply speaking out loud.

Matt Duczeminski explains in his book 6 Benefits of Talking to Yourself (No, You’re Not Crazy) that talking through your thoughts helps distinguish big tasks from smaller ones, for example, getting organized by talking through a to-do list.

But not all self-talk is useful. In fact, talking about our failures and putting ourselves down can be quite harmful. As Sapadin puts it, “That kind of self-talk is worse than no talk at all.” And it can lead to a self-fulfilling prophecy, where we view ourselves negatively and act accordingly, attracting others who reinforce those beliefs.

The link between negative self-talk and depression is also quite strong. In fact, those who engage in more negative self-talk experience more stress and inferior health, both psychologically and physically. Language and cognition expert, Steven Hayes, says negative thoughts are like passengers in the backseat of the car you’re driving. You hear them, but your focus should be on the task ahead.

Another way of coping with negative self-talk is by giving your negative voice a name. Brené Brown, author of the New York Times Bestsellers The Gifts of Imperfection and Daring Greatly, calls her inner critic The Gremlin, making light of the little voice inside her head.

So… if you’ll listen to yourself, keep talking. But be kind.

–Marjan Khanjani, Contributing Writer, The Trauma and Mental Health Report.

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report.

Copyright Robert T. Muller

This article was originally published on Psychology Today