Doctors Seek Earlier Diagnosis for Autism
Posted on: Wednesday, 28 May 2008, 12:10 CDT
SEATTLE -- When her toddler son seemed not to notice a door slamming nearby during his checkup, Jo James thought nothing of it. Her husband, a Microsoft manager, also has an uncanny ability to block out his surroundings.
A check of Ben's hearing after a nurse's prompt found nothing amiss. It wasn't until two years and one perceptive Montessori teacher later that his parents finally learned the cause of Ben's obliviousness: autism.
"He didn't mix terribly well socially," Jo James, of Sammamish, Wash., recalled ruefully. "But then, what 2-{-year-old boy does?"
Autism typically isn't diagnosed until after age 2. Yet it may be detectable even in infancy _ before a baby is old enough to display telltale traits such as social ineptitude and compulsive preoccupations. Pioneering research at the University of Washington during the 1990s, for example, found that trained observers can spot, with remarkable accuracy, kids who were later diagnosed with autism by viewing videos of their first birthdays.
Now University of Washington researchers are aiming to decipher those early clues in hopes of short-circuiting autism before it becomes full-blown.
In January, they began an $11.3 million trial to identify latent signs of autism in infants for intensive behavioral therapy. It is the nation's first attempt to test a hypothesis that early intervention may actually prevent autism in high-risk infants by rewiring their brains.
"We know the brain has a lot of potential to respond" to the right stimulation, said Sara Webb, a research assistant professor of psychiatry and behavioral sciences and the principal investigator for the study at University of Washington Autism Center.
The goal is "to teach parents to give the child that missing piece that he's not getting on his own."
SKEPTICAL PARENTS
The study's very premise _ that autism may not be destiny _ has stirred unease and skepticism among some parents. They also fret that it may rekindle the discredited notion that autism is triggered by detached and unloving mothers.
"I object to the message that if parents don't rush out like headless chickens before the child is X age, they've lost them," said Lisa Rudy, a mother and autism advocate from Falmouth, Mass.
The implication is that "if only the mother spent more time bonding with the infant, that child will never develop autism," Rudy added.
But University of Washington researchers say they're not laying any blame on parenting. The goal is akin to averting diabetes through vigilance in a person with a family history of the disease, said Annette Estes, associate director of the Autism Center and a study investigator.
"If you are at risk for diabetes, you look for signs," Estes said. With autism, the genetic "risk factors are present at birth. What we are doing is heightening the parents' awareness."
Though some parents report concerns early on, tiny babies by definition don't have autism. That's because they can't manifest such diagnostic symptoms as language deficits and repetitive rituals.
Yet researchers suspect that babies exhibit subtle clues that precede overt symptoms. For instance, healthy babies react visibly to changes in a person's expression, such as switching from cooing to a sad face. A baby who doesn't seem to register the change may warrant watching, Estes said.
"At 6 months, a baby has a limited repertoire of signs" of autism, she said. "The question is `What are the real early signs?'"
HOW STUDY WILL PROCEED
To answer that, researchers will track 200 infant siblings, 6 months or younger, of kids with autism. The disorder's strong hereditary nature means that 10 or more of those babies will develop autism themselves. The odds for a typical American child are a little greater than 1 in 200.
The infants in the study will be randomly separated into two groups. Mothers in one group will be coached on engaging with their babies. Later, the children will receive up to 25 hours a week of a type of developmental intervention called the Denver Model that uses play to teach appropriate behaviors.
The other group will be monitored but not given treatment. All children will undergo regular brain imaging to measure brain activity during tasks.
In the University of Washington researchers' view, autism is both congenital and perhaps avoidable.
Genetics is the main cause of autism, yet there are cases where one identical twin has it and the other does not. That leaves room for possible environmental causes, but none has yet been definitively isolated.
At the same time, researchers are learning that the brain is a dynamic organ, capable of forging new neural networks well beyond the womb. Just as playing the piano might form particular synaptic connections, Webb said, environmental manipulation could help calm a brain that is threatening to go haywire.
"The unknown is the family environment," Webb said. "We do not know if the amount or the quality of stimulation is the culprit."
That some families with autism reacted warily to the University of Washington's study does not surprise Laura Schreibman, an autism investigator at the University of California, San Diego. Since it was first described in 1943, autism has largely remained a baffling challenge for parents and researchers alike.
In her book, "The Science and Fiction of Autism" (Harvard University Press, 2005), Schreibman debunks popular speculation about origins of and treatments for autism. They include the link to the measles/mumps/rubella vaccine (rejected by scientific consensus), chelation therapy, which is ridding the body of mercury and other metals (ineffective and potentially toxic) and the myth of the frigid "refrigerator" mother.
No cure has been found for autism. And only one type of therapy, behavioral intervention, has shown measurable, albeit mostly anecdotal, success in curbing outward signs of the disorder, Schreibman said.
"I feel so much for these poor parents," she said.
MISSED CLUES
James, the Sammamish mother, wonders how she could have missed it.
As a first-time parent, she didn't know that healthy babies instinctively look up to share a laugh. She didn't notice that Ben never uttered the toddler's universal refrain: "Why?"
Ben, now 4-{, began behavioral therapy shortly after his diagnosis. He made quick strides. He has become more engaging and inquisitive, and sometimes even offers hugs.
Ben's brother, 15-month-old Hugh, is enrolled in the University of Washington study to track whether he might share his sibling's affliction. That seems unlikely. Hugh loves to lock gazes with visitors, and expectantly crawls toward any interest that beckons.
Still, James said of her younger son, "You always have it in the back of your mind, `Could it happen to him, too?'"
James is reassured that although Ben still has autism, his condition has become much less obvious. She doesn't know whether researchers can find a way to cure autism instead of merely masking it. But the distinction may not matter.
Either, James said, "would be fantastic."
___
AUTISM IN INFANTS
Diagnosing autism in children younger than 2 is difficult. That's largely because babies develop at different rates and are too young to clearly exhibit autism's key symptoms, including abnormal speech, indifference to social cues and repetitive behaviors. Researchers at the University of Washington are hunting for the earliest clues of autism. Here are some of the possible signs in infants:
Lack of eye contact
Failure to follow another person's gaze or to point
Not responding to being called by name
Not recognizing a parent or caregiver's voice
Indifference to changes in a person's facial expression
Absence of babbling or vocalizing
Sources: University of Washington; Seattle Times reporting
Interested in enrolling?
___
A BAFFLING DISORDER
Autism was first described in 1943 by a psychiatrist at Johns Hopkins University in 1943, who noticed a group of children displaying extreme aloofness and indifference to other people. Since then, autism has become shorthand for a group of neurodevelopmental disorders, including autistic disorder and Asperger syndrome.
In general, to be diagnosed with autism, children must have marked impairment in social interactions (such as reciprocating emotionally); communication difficulties (delayed or lack of speech, inability to strike up conversation); and repetitive rituals or interests (refusal to deviate from routine, preoccupations with objects).
Source: The Seattle Times
Thursday, May 29, 2008
Tuesday, May 20, 2008
Preschool girls with disabilities may be overlooked
Wendy or Tinkerbell?
Posted on: Sunday, 18 May 2008, 03:00 CDT
The underrepresentation of girls in early special education classesmakes it hard for some to develop socially or academically, and yetlittle special education research has focused on gender, writes JeanneS. Manwaring, a preschool special-educator and University of SouthFlorida doctoral student in special education. Since they are in theminority, preschool girls with disabilities must be encouraged toexpress themselves, she concludes. RedOrbit<(5/18" target=_blank>http://r.smartbrief.com/resp/lfzglErKkIyezDCibGwKOAhU?format=standard>(5/18)
By Manwaring, Joanne S
In a public elementary school in the southeastern United States, aself-contained class of prekindergarten children with disabilities isplaying with PlayDoh. As the children are molding and shaping themodeling compound, the only girl is helping the boys press shapes intotheir Play-Doh. She flutters around the other children showing them howto use the various shapes and encouraging them to roll and press thePlay-Doh. The class comprised 10 boys and 1 girl. When questioned aboutthe disparity in gender because of concern for the lone girl, theteacher commented, "Oh, she does okay, she mothers all the boys." Inanother classroom in the same school district, the single girl in aclass of nine boys struggles to articulate her fantasy role model. Thechildren are talking about their desire to be superheroes, vying foradult attention and pointing to their shuts to help illustrate theirwords describing popular cultural icons such as Superman, Batman, andSpiderman. The boys' exuberant, combined voices dominate the discussionand the adult listeners' attention is drawn to reinforcing the boys' useof language and participation in a discussion. Meanwhile, the littlegirl is overwhelmed by the sheer volume of the boys but persists inattempting to be an active participant in the discussion. Many times shetries to enter the conversation repeating the same phrase of which onlythe word "bell" is understandable. Despite many attempts and promptsfrom the adults for more information, her words are not understood andshe never gets to be a part of the discussion. Later, when the childrenare acting out their favorite superheroes, one of the adults puts allthe clues together to finally comprehend that the little girl wassaying, "Me Tinkerbell." These incidents underscore theunderrepresentation of girls in preschool special educationself-contained classes, leaving them with almost no same gender friendsor peers and thereby limiting them to the single role of motherly"Wendy" as they struggle to identify themselves as "Tinkerbell."Historically, boys have outnumbered girls in special education. Acrossthe developmental age span, the prevalence rates indicate that boys aremore often identified with a disability than girls with a rate of 12%for boys and 8% for girls, respectively. This 4% difference does notaccount for the 33 % difference in enrollment in special education[American Association of University Women, AAUW, 2006). In one largeschool district in the southeastern United States, this disparity inenrollment has resulted in preschool self-contained special educationclasses of predominately male students. The scope of this article is todiscuss the underrepresentation of girls in these special educationclasses and the impact it has on their development. These classes are adistortion of social reality and place girls with disabilities at riskfor appropriate language, peer, and play models. One of the greatestcriticisms of separate, self-contained special education classrooms isthe lack of peer role models, which has prompted a push toward moreinclusive environments for preschoolers. Gallagher (2006], among others,reported increased social interactions by children with disabilitieswhen taught with typical peers in inclusive environments and confirmedthat typical children help to foster social interactions. Therefore, inthese particular self- contained preschool classes, not only areopportunities for typical peer interactions lacking but same gender peerinteraction even between girls with disabilities is not available. Thislack of same gender role models for preschool girls with disabilitiesand the long-term impact on their developing social skills andself-esteem may not be noticed in the education world (Colwell &Lindsey, 2005; Maccoby, 1990). Little research has been conducted on gender and disability and genderroles in self-contained separate special education classes. Recently thedisproportionality of students of color and older girls in specialeducation has come to the attention of the public [Oswald, Best,Coutinho, & Nagle, 2003). Research is beginning to closely examine theidentification of school-age girls with disabilities and the effect ofbeing placed in classrooms that have predominantly boys. In a study onchildren with learning disabilities, the fear and isolation the girlsfelt in separate classrooms and the subsequent effect on theirself-esteem was discussed. Using personal interviews, McGrady, Lerner,and Boscardin (2001) conveyed the girls' sense of isolation anddiscomfort surrounding their being the only girl in a class full ofactive, aggressive boys with varying exceptionalities and behaviors.Popular thought also has it that girls are quieter, more passive, andtheir temperaments suit the sedentary, paper and pencil approach of thepublic schools and therefore do not get identified as having specialneeds. Perhaps in some cases, they do not even get noticed. Or even iftheir needs are identified, they are overwhelmed in a special educationplacement where they are the single girl in a classroom of boys.Furthermore, if older girls are relating the ill effects of theseplacements, then think what may be happening to the preschool- age girlwho may not have the language skills to convey her feelings about thenegative aspects of her placement in special education. The Underrepresentation of Girls The scope of this article is to discuss the impact ofunderrepresentation of girls in separate, self-contained specialeducation classes for preschool children in a large school district inthe southeastern United States. On a regular basis, preschool girlsidentified with special needs are being placed in self- containedclasses where there they may be the only girl. They will not have samegender playmates, language, or readiness models. The girls may beoverlooked in the classroom of 9 or 10 boys or they may adopt theteacher's role because it is the only gender model available to them.This writer contends that girls need same gender peers to develop ageappropriate social, language, and preacademic skills. The articleincludes a simple analysis of the composition of self-containedprekindergarten classes in one school district and the implications ofthe effects of disproportionality of girls within these classrooms basedon research and teacher interviews. Identifying Preschool Children With Special Needs The article focuses on the federally mandated preschool program forchildren ages 3 to 5 with disabilities that is funded through a federalprekindergarten (pre-K) grant and administered by the school district.The children are found eligible through an initial Child Find screeningfollowed by an assessment process conducted by one of the schooldistrict's pre-K assessment teams. These teams consist of apsychologist, a social worker, a speech pathologist, and an occupationaltherapist or physical therapist if necessary. To be eligible to beplaced in the program, a child must have a delay of 2 standarddeviations below average in at least one developmental domain or 1.5standard deviations below average in two domains such as social skills,pre-readiness, independent living skills, motor skills, or behavior. Placement in Self-Contained Classrooms When placing children in self-contained special education classes,several assumptions are made concerning the placement. The primaryassumption is that the placement is in the best interest of the child.Other assumptions include: (a) the class will be taught by a welltrained special educator with an assistant in a small adult to childratio, (b) the curriculum will be developmentally appropriate andmodified to meet individual needs, and (c) the identified special needsof the child will be met in this type of environment. These classesintegrate the Division for Early Childhood's (DEC) and NationalAssociation for the Education of Young Children's [NAEYC) best practiceswith a commercial preschool curriculum. Little thought is given to thecomposition of the class because the focus is on the individual child.This is not necessarily a bad thing, but perhaps a closer look at theclass composition would afford the opportunity to consider the wholechild in terms of the considered placement. Most of the children whoenter these self-contained classrooms are identified at age 3 and havenot had any school experience to determine if their needs could be metin a typical environment. Sometimes a 4- or 5-year-old child is notfunctioning well in a typical preschool or day-care center and afterassessment is found eligible for placement in a special educationclassroom. The school district does not routinely provide instructionfor all preschoolers. The state funds a 3-hour-a-day program for4-year-old children who will be entering kindergarten the following yearthrough private preschools and day cares. The majority of preschoolchildren who are identified with mild to moderate special needs areplaced in self-contained special education classrooms in public schools.With the 2004 reauthorization of the Individuals With DisabilitiesEducation Improvement Act [IDEA), there is a concerted effort toincrease more natural placement opportunities, but the lack of fundingand well- trained personnel impact these placements. Composition of theSelf- Contained Class The reality is that the class by definition is entirely composed ofchildren with special needs. The children's needs range from mild tomoderate and may occasionally be severe in these settings. Many of thechildren are nonverbal or have very limited speech in addition to otherdevelopmental delays. There usually are no typical models forpreacademics, language, play, or child-to-child interaction. Typical isdefined as a child without special needs. Sometimes, a teacher will beable to include 1 or 2 children from the community to be "typicals" inthe self-contained classroom. These children generally have a parent whois on the faculty or has some connection to the school. Because ofincreasing numbers of children with disabilities being enrolled thatresults in large class sizes, this practice is disappearing. The schooldistrict is experiencing huge growth and there is not a limit on thenumber of children placed in a special education classroom. The districtdoes address the very large classes but lack of space, personnel, andfunds often leave the classes overcrowded. Some have as many as 16 or 17children with 2 adults. Most of these pre-K classrooms have as many as 8or 9 boys and only 1 or 2 girls. Disproportional Pattern Emerges The self-contained classrooms are in elementary schools across thedistrict. As this writer traveled throughout the district, more and moreclassrooms with ratios of at least 3 boys to 1 girl were noted. Oftenthere were much greater differences. As this pattern emerged, a simplecomparison analysis of the total number of pre-K self-containedclassrooms was done to discover if the initial impression ofdisproportionality was correct. Teachers were interviewed to determineif they were aware of the underrepresentation and to discover if theywere concerned about the effects of it on the girl or girls in theirclassrooms. The District's pre-K classes that serve children who are identified withmore intense needs are not included in this article. These children arecategorically labeled and placed in different separate self-containedclassrooms in regular public schools or center-based schools. Theirnumbers were not available. A future comparison study could prove to beinformative about the identification and representation of thesepopulations in special education. Earlier Study of Disproportionality Interestingly, Hayden-McPeak, Gaskin, and Gaughan (1993) conducted asimilar study that examined gender differences in enrollment, andassessment and educational practices in self- contained pre-K classroomsfor children with disabilities. The study was prompted by concern thatboys were being overidentified, and the researchers wanted to cautionteachers to be sure to teach to the boys* strengths and needs. Over a1-year period they tracked enrollment numbers and determined that boyswere being enrolled at a ratio of 2 boys to 1 girl. They stated thattheir findings match the national enrollment numbers at the time with aratio of 217 boys to 100 girls (Hayden-McPeak et al.). Their researchindicated that teachers pay more attention to boys than girls and theywere more likely to reinforce boys' interactions and initiations even ifthey were being disruptive (Hayden-McPeak et al.). The study concludedwith an admonition to teachers to be more aware of the boys' needs inthe classroom. Teachers were encouraged to have more male- orientedmaterials available and to play more in male-preferred centers such asblocks or cars and trucks. Although certainly there should be concern for overidentification, onecannot help but wonder how the girls fared in those classrooms when theywere outnumbered by 2 to 1, particularly if teachers were beingencouraged to teach to the boys' interests. Furthermore, if these ratioshave remained constant, this has meant girls have been underrepresentedin pre-K self-contained special education classrooms for the last 13years. One has to wonder if their needs have been addressed. That is not to say that teachers have ignored girls but the reality in abusy preschool classroom is that boisterous and more behaviorallychallenging boys will receive more attention. Certainly, this writerrecognizes that there are loud and boisterous girls who can advocate forthemselves but even this type of girl may be overwhelmed in apredominantly male class (Holmes-Lonergan, 2003; Maccoby, 1990). Composition of the Self-Contained Classes in the District Eighty-nine self-contained preschool special education classes forchildren with mild to moderate disabilities were analyzed for thisarticle. These classes were fairly evenly spread out through sevengeographic areas delineated within the district. Although this pre-Kprogram is not available in every elementary school, an effort was madeto place the children in schools closest to their homes or in aneighboring school that does have the program. Some of the schools mayhave two units of this particular special education program. A total of715 children are served in the program. Of the 715 children, 522 areboys and 193 are girls in 75 schools. The ratios throughout the areasvaried from as much as 3:1 to 2:1. For example, in 12 schools, therewere no girls enrolled. In 2 schools, the numbers were even. Girlsoutnumbered boys in three schools but only by one or two. It should be noted that these schools may include one or two typicalchildren in their programs, which may skew the numbers. It is importantto know that these enrollment numbers are not constant because childrenenroll throughout the school year as they reach their third birthday orare otherwise identified with special needs. The only pattern thatclearly emerged is that in most schools boys outnumber girls in theseclassrooms, consistent with the national numbers and with the study of13 years ago. A more detailed analysis would need to be done todetermine if cultural or socioeconomic factors play a role in theenrollment patterns of specific areas in the school district.Nevertheless, the confirmation of the underrepresentation of girls inthe preschool program makes it imperative to examine the effects of thelack of same gender role models for girls on their development ofsocial, language, and play skills. Interviews With Pre-K Teachers Interviews with pre-K special education teachers around the districtindicate their concern over the small number of girls enrolled in theirclasses. The teachers worry that the girls have a tendency to "mother"the boys because it is the only way they know how to interact. If thereare 2 girls in one class, they will play together regularly by choice.If girls from other classrooms visit, the pre-K girls are immediatelydrawn to them and form a single gender play group. They also revealedtheir worry and concern that the single girl in a classroom was lonely.This is not to say that the boys and girls do not play together. They doand their play is fun, engaging, and interactive within the confines ofthe environment. Boys and girls do choose to play together and willchoose a different gendered playmate but the paucity of girls takes awaythe choice to choose a female playmate (Alexander & Mines, 1994). Hence,one also has to wonder about how the lack of girls in the class may havean impact on the boys. It must change the quality, type, and activitylevel of play within the classroom (Alexander & Mines; HaydenMcPeak etal., 1993; Sanders & Harper, 1976). Impact on Play Although there is a growing body of research on play in typicalpreschoolers in typical environments, there is a paucity of research onthe play of children with disabilities in both typical andself-contained environments (Colwell & Lindsey, 2005; Freeman, 2007;Green, Bigler, & Catherwood, 2004; HolmesLonergan, 2003; Ostrov &Keating, 2004). Available research has shown that children preferplaymates of the same gender and usually find same gender playmates morecompatible (Alexander & Hines, 1994; Maccoby, 1990). Each gender alsodisplays preferences for play choices, type of play, and type of toys.Although there are individual differences in preference explained bypersonality type, the preferences run along gender lines. Awareness ofgender differences among children prompts their self-prescribedseparation into same-sex play groups (Hayden- McPeak et al., 1993;Maccoby). The reasons why the genders segregate themselves in play arenot completely understood or known. Some possible explanations includeseparation from boys as a protection, similar interests, similar verbalskills, or adult encouragement for accepted social behavior(HaydenMcPeak et at.J. Maccoby also postulated that girls may becautious of boys' active play styles which feature characteristics ofdominance and competition, and perhaps even more importantly, girls havedifficulty influencing the play scenario when boys are involved. Boyshave been found to be more likely to engage in solitary outdoor fantasyplay whereas girls engage in traditional roles of "house" and "school"(Sanders & Harper, 1976). Sanders and Harper also indicated that boysplay outdoors more, and are encouraged to engage in active, large motor,physically challenging play. Girls on the other hand are encouraged toplay quietly, be more dependent, and are acknowledged and reinforced fortheir communication attempts (HaydenMcPeak et al.). Turner (1991) foundthat certain forms of assertiveness and aggression in boys was not onlytolerated but encouraged. These same types of behavior were discouragedfor girls. These differences in preferences in terms of playmates and play stylesand adult expectations lead to the conclusion that a balance of genderin the classroom is necessary for the optimal development of socialskills (Colwell & Lindsey, 2005). This is particularly true for childrenwith disabilities who may have social skill delays and need every chanceavailable to practice those skills to minimize their delay. Previousresearch provided evidence that girls needed opportunities to choosesame gender playmates, encouragement to engage in rowdy, outdoor play,and to foster assertiveness and independence [Alexander & Mines, 1994J.They also need to be provided opportunities to explore and expandtraditional play roles of "house" and "school" into fantasy play rolesthat encourage greater use of their imaginations (Turner, 1991). Iftheir only knowledge of gender roles is mother or teacher, then girlsare limited as to the type of fantasy play in which they are able toengage. A girl's fantasy role model play may also go unnoticed or shemay be overwhelmed by the volume and number of boys in the classroomlike the girl in the vignette in this article's opening. In addition,her fantasy role model may be unfamiliar or even unknown in the morepopular lexicon of male superheroes in a predominantly male classroom.It is also highly likely that as the single girl, she will not have aleadership role in the classroom and will not determine play choices orplay scenarios during free play time (Colwell & Lindsey;Holmes-Lonergan, 2003; Maccoby, 1990). Although joining the boys'fantasy play is more socially acceptable for girls, the likelihood thatthe boys will follow a girl into girl fantasy play is negligible(Hayden-McPeak et al., 1993; Maccoby). For these very reasons, the lackof girls in a self- contained pre-K special education classroom may bedetrimental to the healthy development of social skills and interactiveplay for girls because of the limited opportunities for same-genderplaymates with similar interests (Colwell & Lindsey). Impact on SocialSkills Currently, there are a number of studies concerning social skilldevelopment. Research has shown that well-developed social skills aregood predictors of academic success (Gallagher & Lambert, 2006; Johnson,Ironsmith, Snow, & Poteat, 2000). Preschool teachers are beingencouraged to teach social skills through direct instruction to preparechildren for kindergarten. In an article on peer relationships inkindergarten and preschool, Johnson et al. stated that good socialskills are a predictor of adjustment in adulthood. In addition, sheclaimed that "children with good social skills who have more friends inpreschool make a better transition into kindergarten. Children's socialbehavior and peer relationships in preschool have a lasting effect ontheir social development as they enter grade school" (p. 209).Therefore, the isolation and limited social opportunities of girls inself-contained preschool special education may impact their socialdevelopment and may impede their academic success in elementary school. Impact on Language As a result of these limited social opportunities, the languagedevelopment of girls may be affected negatively. Male dominatedclassrooms reduce language development for girls because there is alimited number of female conversation partners and topics of interest togirls (Alexander & Hines, 1994). Maccoby (1990) found that boys were notresponsive to girls' verbal requests and that girls avoided interactionswith boys because of their nonresponsiveness. A single girl in a classof 9 or 10 boys has few opportunities to practice interactive languageskills. If similar play interests are valued by children of bothgenders, then similar verbal skills also can play a weight inestablishing and maintaining peer relationships. To promote languageusage, the girls need motivation to talk about topics that interestthem. Ideally, same-gender friends with good verbal skills would enhancethe language development of the girls in self-contained pre-K classes.Many of the children in these classes may be nonverbal. Often most ofthe talking in the room may be done by the adults. Adults prompt forlanguage usage and model language for the students. Although adults maymodel appropriate language, their use of language is not the same as achild's. Children need opportunities to talk with each other independentof adults (Johnson et al., 2000). In addition, boys and girls do notnecessarily use language in the same ways (Hayden-McPeak et al., 1993;Holmes-Lonergan, 2003). Despite limited verbal skills, the girls andboys do talk to each other to some degree in these classrooms. But iftheir skills are limited and their interests dissimilar, the chancesthat language usage will substantially increase and languages skillsimprove are minimal. Impact on Preacademics In a longitudinal study of preschoolers and academic outcomes, Dale,Jenkins, Mills, and Cole (2004) found that there was a significantcorrelation between social skills and academic skills, and that goodpeer relationships help to foster academic motivation. With minimalopportunities for peer relationships, girls will have difficultyestablishing strong enough bonds to mutually motivate each other towardacademic success. In another longitudinal study, Coutinho, Oswald, and Best (2006)followed the long-term outcomes for special education students. Coutinhoet al. found that girls were less likely to earn a high school diploma,more likely to be unemployed or to earn less if working, and more likelyto be a parent. Both Dale et al. (2004) and Coutinho et al, foundsimilar negative outcomes the longer any child was in special education.Dale et al.'s study revealed that extended time in special education canlead to poor academic achievement. These findings are certainly worthconsidering when thinking about preschool girls in self-containedspecial education classes. If long- term studies are beginning to revealnegative outcomes for children in special education, then efforts shouldbe made to limit the negative effects on girls who are underrepresentedin the classroom. Suggestions for Practice Teachers should know and value the individual differences andpreferences of each of their students. They should also be aware ofgender differences and preferences when reflecting on the composition oftheir classes. Teachers can incorporate opportunities that promoteinteraction within and between the genders in the daily schedule. Forexample, they can build on curricular themes and produce various playscenarios in center areas of the classroom. Ideas include setting up aveterinary clinic in the housekeeping area in a theme about animals or abeauty parlor in a theme about community helpers. Promoting and buildingon interactions in these play scenarios will help both boys and girlsfunction more competently in various social settings (Holmes-Lonergan,2003). A study by Green et al. (2004) suggested using stories in whichchildren are engaged in counterstereotypic play to promote cross- genderplay. Teachers could expand on their suggestions by engaging thechildren in cross gender discussions and activities. When facilitatingplay, teachers can create play scenarios that allow for girls to be inleadership roles in balance with the boys. By promoting cross-genderplay, the girls will have increased opportunities to develop theirlanguage and social skills. If girls are overwhelmingly outnumbered intheir classrooms, teachers can look for friendships within the schoolcommunity by collaborating with other teachers who may welcome the samefor their students. Communicating the value of friendship t andsame-gender peer experiences to parents may encourage them to plan playdates in their neighborhoods. Conclusion The underrepresentation of girls in preschool self-contained specialeducation classes results in social isolation and places the girls atrisk for appropriate language, social, academic, and play skills. Theplacement also limits their opportunities to establish same-gender peerrelationships that help to promote prosocial behavior and futureacademic success. Teachers need to be sure to teach to all of thelearning styles in their classrooms and to promote social interactionsbetween both genders to help alleviate the lack of same-genderopportunities for girls. Preschool girls with disabilities need to be encouraged to creativelyexplore their fantasies in an effort to reach their full potential.Given the opportunities to express themselves, not only would"Tinkerbell" take flight and soar through her preschool experience but awhole new generation of female superheroes would capture theimaginations of children everywhere. Research is beginning to closely examine the identification of schoolage girls with disabilities and the effect of being placed in classroomsthat have predominantly boys. On a regular basis, preschool girls identified with special needs arebeing paced in self-contained classes where there they may be the onlygirl. Little thought is given to the composition of the class because thefocus is on the individual child. To promote language usage, the girls need motivation to talk abouttopics that interest them. Teachers can incorporate opportunities that promote interaction withinand between the genders in the daily schedule. References Alexander, G, M., & Hines, M. (1994). Gender labels and play styles:Their relative contributions to children's selection of playmates. ChildDevelopment, 65, 869-879. American Association of University Women. (2006). Women and girls withdisabilities. Retrieved October 15, 2007, from http://www.aauw.org/advocacy/issue_advocacy/actionpages/disabilities.cfm Colwell, M. J., & Lindsey. E. W. (2005). Preschool children's pretendand physical play and sex of play partner: Connections to peercompetence. Sex Roles, 52, 497-509. Coutinho, M. J., Oswald, D. P., & Best, A. M. (2006). Differences inoutcomes for female and male students in special education. CareerDevelopment for Exceptional Individuals, 29, 48-59. Dale, P. S.,Jenkins, J. R., Mills, P. E., & Cole, K. N. (2004). When paths diverge:"Errors of prediction" from preschool test scores to later cognitive andacademic measures. Journal of Special Education, 37, 237-248. Freeman, N. K. (2007). Preschoolers' perceptions of gender appropriatetoys and their parents' beliefs about genderized behaviors:Miscommunication, mixed messages or hidden truths? Early ChildhoodEducation Journal, 34, 357-366. Gallagher, J. (2006), Driving change in special education. Baltimore:Brookes. Gallagher, P. A., & Lambert, R. G. (2006). Classroom quality,concentration of children with special needs and child outcomes in HeadStart. Exceptional Children, 73, 31-52. Green, V. A., Bigler, R., & Catherwood, D. (2004). The variability andflexibility of gender-typed toy play: A close look at children'sbehavioral responses to counterstereotypic models. Sex Roles, 51,371-386. Hayden-McPeak, C., Gaskin, S. T., & Gaughan, L. K. (1993, April). Badboys, good girls: A review of the research on gender differences inpreschoolers and a reexamination of assessment, child rearing, andeducational practices. Paper presented at the Annual Convention of theCouncil for Exceptional Children, San Antonio, TX. Holmes-Lonergan, H. A. (2003). Preschool children's collaborativeproblem-solving interactions: The role of gender, pair type and task.Sex Roles, 48, 505-517. Johnson, C., Ironsmith, M., Snow, C. W., & Poteat, G. M. (2000). Peeracceptance and social adjustment in preschool and kindergarten. EarlyChildhood Education Journal, 27, 207-212. Maccoby, E. E. (1990). Gender and relationships. American Psychologist,45, 513-520. McGrady, H., Lerner, J., & Boscardin, M. L. (2001). The educationallives of students with learning disabilities. In P. Rodis, A. Garrod, &M. Boscardin (Eds.), Learning disabilities and life stories (pp.177-193). Needham Heights, MA: Allyn & Bacon. Ostrov, J., & Keating. C. F. (2004). Gender differences in preschoolaggression during free play and structured interactions: Anobservational study. Social Development, 13, 255-277. Oswald, D. P., Best, A. M., Coutinho, M. J., & Nagle, H. A. L. (2003).Trends in the special education identification rates of boys and girls:A call for research and change. Exceptionality, 11, 223- 237. Sanders, K. M., & Harper, L. V. (1976). Freeplay fantasy behavior inpreschool children: Relations among gender, age, season and location.Child Development, 47, 1182-1185. Turner, P. J. (1991). Relations between attachment, gender and behaviorwith peers in preschool. Child Development, 62, 1475-1488. Jeanne S. Manwaring (CEC FL Federation), Pre-K Exceptional StudentEducation (ESE) District Resource Teacher, Hillsborough County PublicSchools, Tampa, Florida and Doctoral Student, Department of SpecialEducation, University of South Florida, Please address correspondence toJoanne S. Manwaring, 6507 Seabird Way, Apollo Beach, FL 33572 (e-mail:Joanne.Manwaring@sdhc.k12.fl.us). TEACHING Exceptional Children, Vol. 40, No. 5, pp. 60-65. Copyright 2008 CEC. Copyright Council for Exceptional Children May/Jun 2008 (c) 2008 Teaching Exceptional Children. Provided by ProQuest Informationand Learning. All rights Reserved.Source: Teaching Exceptional Children
Posted on: Sunday, 18 May 2008, 03:00 CDT
The underrepresentation of girls in early special education classesmakes it hard for some to develop socially or academically, and yetlittle special education research has focused on gender, writes JeanneS. Manwaring, a preschool special-educator and University of SouthFlorida doctoral student in special education. Since they are in theminority, preschool girls with disabilities must be encouraged toexpress themselves, she concludes. RedOrbit<(5/18" target=_blank>http://r.smartbrief.com/resp/lfzglErKkIyezDCibGwKOAhU?format=standard>(5/18)
By Manwaring, Joanne S
In a public elementary school in the southeastern United States, aself-contained class of prekindergarten children with disabilities isplaying with PlayDoh. As the children are molding and shaping themodeling compound, the only girl is helping the boys press shapes intotheir Play-Doh. She flutters around the other children showing them howto use the various shapes and encouraging them to roll and press thePlay-Doh. The class comprised 10 boys and 1 girl. When questioned aboutthe disparity in gender because of concern for the lone girl, theteacher commented, "Oh, she does okay, she mothers all the boys." Inanother classroom in the same school district, the single girl in aclass of nine boys struggles to articulate her fantasy role model. Thechildren are talking about their desire to be superheroes, vying foradult attention and pointing to their shuts to help illustrate theirwords describing popular cultural icons such as Superman, Batman, andSpiderman. The boys' exuberant, combined voices dominate the discussionand the adult listeners' attention is drawn to reinforcing the boys' useof language and participation in a discussion. Meanwhile, the littlegirl is overwhelmed by the sheer volume of the boys but persists inattempting to be an active participant in the discussion. Many times shetries to enter the conversation repeating the same phrase of which onlythe word "bell" is understandable. Despite many attempts and promptsfrom the adults for more information, her words are not understood andshe never gets to be a part of the discussion. Later, when the childrenare acting out their favorite superheroes, one of the adults puts allthe clues together to finally comprehend that the little girl wassaying, "Me Tinkerbell." These incidents underscore theunderrepresentation of girls in preschool special educationself-contained classes, leaving them with almost no same gender friendsor peers and thereby limiting them to the single role of motherly"Wendy" as they struggle to identify themselves as "Tinkerbell."Historically, boys have outnumbered girls in special education. Acrossthe developmental age span, the prevalence rates indicate that boys aremore often identified with a disability than girls with a rate of 12%for boys and 8% for girls, respectively. This 4% difference does notaccount for the 33 % difference in enrollment in special education[American Association of University Women, AAUW, 2006). In one largeschool district in the southeastern United States, this disparity inenrollment has resulted in preschool self-contained special educationclasses of predominately male students. The scope of this article is todiscuss the underrepresentation of girls in these special educationclasses and the impact it has on their development. These classes are adistortion of social reality and place girls with disabilities at riskfor appropriate language, peer, and play models. One of the greatestcriticisms of separate, self-contained special education classrooms isthe lack of peer role models, which has prompted a push toward moreinclusive environments for preschoolers. Gallagher (2006], among others,reported increased social interactions by children with disabilitieswhen taught with typical peers in inclusive environments and confirmedthat typical children help to foster social interactions. Therefore, inthese particular self- contained preschool classes, not only areopportunities for typical peer interactions lacking but same gender peerinteraction even between girls with disabilities is not available. Thislack of same gender role models for preschool girls with disabilitiesand the long-term impact on their developing social skills andself-esteem may not be noticed in the education world (Colwell &Lindsey, 2005; Maccoby, 1990). Little research has been conducted on gender and disability and genderroles in self-contained separate special education classes. Recently thedisproportionality of students of color and older girls in specialeducation has come to the attention of the public [Oswald, Best,Coutinho, & Nagle, 2003). Research is beginning to closely examine theidentification of school-age girls with disabilities and the effect ofbeing placed in classrooms that have predominantly boys. In a study onchildren with learning disabilities, the fear and isolation the girlsfelt in separate classrooms and the subsequent effect on theirself-esteem was discussed. Using personal interviews, McGrady, Lerner,and Boscardin (2001) conveyed the girls' sense of isolation anddiscomfort surrounding their being the only girl in a class full ofactive, aggressive boys with varying exceptionalities and behaviors.Popular thought also has it that girls are quieter, more passive, andtheir temperaments suit the sedentary, paper and pencil approach of thepublic schools and therefore do not get identified as having specialneeds. Perhaps in some cases, they do not even get noticed. Or even iftheir needs are identified, they are overwhelmed in a special educationplacement where they are the single girl in a classroom of boys.Furthermore, if older girls are relating the ill effects of theseplacements, then think what may be happening to the preschool- age girlwho may not have the language skills to convey her feelings about thenegative aspects of her placement in special education. The Underrepresentation of Girls The scope of this article is to discuss the impact ofunderrepresentation of girls in separate, self-contained specialeducation classes for preschool children in a large school district inthe southeastern United States. On a regular basis, preschool girlsidentified with special needs are being placed in self- containedclasses where there they may be the only girl. They will not have samegender playmates, language, or readiness models. The girls may beoverlooked in the classroom of 9 or 10 boys or they may adopt theteacher's role because it is the only gender model available to them.This writer contends that girls need same gender peers to develop ageappropriate social, language, and preacademic skills. The articleincludes a simple analysis of the composition of self-containedprekindergarten classes in one school district and the implications ofthe effects of disproportionality of girls within these classrooms basedon research and teacher interviews. Identifying Preschool Children With Special Needs The article focuses on the federally mandated preschool program forchildren ages 3 to 5 with disabilities that is funded through a federalprekindergarten (pre-K) grant and administered by the school district.The children are found eligible through an initial Child Find screeningfollowed by an assessment process conducted by one of the schooldistrict's pre-K assessment teams. These teams consist of apsychologist, a social worker, a speech pathologist, and an occupationaltherapist or physical therapist if necessary. To be eligible to beplaced in the program, a child must have a delay of 2 standarddeviations below average in at least one developmental domain or 1.5standard deviations below average in two domains such as social skills,pre-readiness, independent living skills, motor skills, or behavior. Placement in Self-Contained Classrooms When placing children in self-contained special education classes,several assumptions are made concerning the placement. The primaryassumption is that the placement is in the best interest of the child.Other assumptions include: (a) the class will be taught by a welltrained special educator with an assistant in a small adult to childratio, (b) the curriculum will be developmentally appropriate andmodified to meet individual needs, and (c) the identified special needsof the child will be met in this type of environment. These classesintegrate the Division for Early Childhood's (DEC) and NationalAssociation for the Education of Young Children's [NAEYC) best practiceswith a commercial preschool curriculum. Little thought is given to thecomposition of the class because the focus is on the individual child.This is not necessarily a bad thing, but perhaps a closer look at theclass composition would afford the opportunity to consider the wholechild in terms of the considered placement. Most of the children whoenter these self-contained classrooms are identified at age 3 and havenot had any school experience to determine if their needs could be metin a typical environment. Sometimes a 4- or 5-year-old child is notfunctioning well in a typical preschool or day-care center and afterassessment is found eligible for placement in a special educationclassroom. The school district does not routinely provide instructionfor all preschoolers. The state funds a 3-hour-a-day program for4-year-old children who will be entering kindergarten the following yearthrough private preschools and day cares. The majority of preschoolchildren who are identified with mild to moderate special needs areplaced in self-contained special education classrooms in public schools.With the 2004 reauthorization of the Individuals With DisabilitiesEducation Improvement Act [IDEA), there is a concerted effort toincrease more natural placement opportunities, but the lack of fundingand well- trained personnel impact these placements. Composition of theSelf- Contained Class The reality is that the class by definition is entirely composed ofchildren with special needs. The children's needs range from mild tomoderate and may occasionally be severe in these settings. Many of thechildren are nonverbal or have very limited speech in addition to otherdevelopmental delays. There usually are no typical models forpreacademics, language, play, or child-to-child interaction. Typical isdefined as a child without special needs. Sometimes, a teacher will beable to include 1 or 2 children from the community to be "typicals" inthe self-contained classroom. These children generally have a parent whois on the faculty or has some connection to the school. Because ofincreasing numbers of children with disabilities being enrolled thatresults in large class sizes, this practice is disappearing. The schooldistrict is experiencing huge growth and there is not a limit on thenumber of children placed in a special education classroom. The districtdoes address the very large classes but lack of space, personnel, andfunds often leave the classes overcrowded. Some have as many as 16 or 17children with 2 adults. Most of these pre-K classrooms have as many as 8or 9 boys and only 1 or 2 girls. Disproportional Pattern Emerges The self-contained classrooms are in elementary schools across thedistrict. As this writer traveled throughout the district, more and moreclassrooms with ratios of at least 3 boys to 1 girl were noted. Oftenthere were much greater differences. As this pattern emerged, a simplecomparison analysis of the total number of pre-K self-containedclassrooms was done to discover if the initial impression ofdisproportionality was correct. Teachers were interviewed to determineif they were aware of the underrepresentation and to discover if theywere concerned about the effects of it on the girl or girls in theirclassrooms. The District's pre-K classes that serve children who are identified withmore intense needs are not included in this article. These children arecategorically labeled and placed in different separate self-containedclassrooms in regular public schools or center-based schools. Theirnumbers were not available. A future comparison study could prove to beinformative about the identification and representation of thesepopulations in special education. Earlier Study of Disproportionality Interestingly, Hayden-McPeak, Gaskin, and Gaughan (1993) conducted asimilar study that examined gender differences in enrollment, andassessment and educational practices in self- contained pre-K classroomsfor children with disabilities. The study was prompted by concern thatboys were being overidentified, and the researchers wanted to cautionteachers to be sure to teach to the boys* strengths and needs. Over a1-year period they tracked enrollment numbers and determined that boyswere being enrolled at a ratio of 2 boys to 1 girl. They stated thattheir findings match the national enrollment numbers at the time with aratio of 217 boys to 100 girls (Hayden-McPeak et al.). Their researchindicated that teachers pay more attention to boys than girls and theywere more likely to reinforce boys' interactions and initiations even ifthey were being disruptive (Hayden-McPeak et al.). The study concludedwith an admonition to teachers to be more aware of the boys' needs inthe classroom. Teachers were encouraged to have more male- orientedmaterials available and to play more in male-preferred centers such asblocks or cars and trucks. Although certainly there should be concern for overidentification, onecannot help but wonder how the girls fared in those classrooms when theywere outnumbered by 2 to 1, particularly if teachers were beingencouraged to teach to the boys' interests. Furthermore, if these ratioshave remained constant, this has meant girls have been underrepresentedin pre-K self-contained special education classrooms for the last 13years. One has to wonder if their needs have been addressed. That is not to say that teachers have ignored girls but the reality in abusy preschool classroom is that boisterous and more behaviorallychallenging boys will receive more attention. Certainly, this writerrecognizes that there are loud and boisterous girls who can advocate forthemselves but even this type of girl may be overwhelmed in apredominantly male class (Holmes-Lonergan, 2003; Maccoby, 1990). Composition of the Self-Contained Classes in the District Eighty-nine self-contained preschool special education classes forchildren with mild to moderate disabilities were analyzed for thisarticle. These classes were fairly evenly spread out through sevengeographic areas delineated within the district. Although this pre-Kprogram is not available in every elementary school, an effort was madeto place the children in schools closest to their homes or in aneighboring school that does have the program. Some of the schools mayhave two units of this particular special education program. A total of715 children are served in the program. Of the 715 children, 522 areboys and 193 are girls in 75 schools. The ratios throughout the areasvaried from as much as 3:1 to 2:1. For example, in 12 schools, therewere no girls enrolled. In 2 schools, the numbers were even. Girlsoutnumbered boys in three schools but only by one or two. It should be noted that these schools may include one or two typicalchildren in their programs, which may skew the numbers. It is importantto know that these enrollment numbers are not constant because childrenenroll throughout the school year as they reach their third birthday orare otherwise identified with special needs. The only pattern thatclearly emerged is that in most schools boys outnumber girls in theseclassrooms, consistent with the national numbers and with the study of13 years ago. A more detailed analysis would need to be done todetermine if cultural or socioeconomic factors play a role in theenrollment patterns of specific areas in the school district.Nevertheless, the confirmation of the underrepresentation of girls inthe preschool program makes it imperative to examine the effects of thelack of same gender role models for girls on their development ofsocial, language, and play skills. Interviews With Pre-K Teachers Interviews with pre-K special education teachers around the districtindicate their concern over the small number of girls enrolled in theirclasses. The teachers worry that the girls have a tendency to "mother"the boys because it is the only way they know how to interact. If thereare 2 girls in one class, they will play together regularly by choice.If girls from other classrooms visit, the pre-K girls are immediatelydrawn to them and form a single gender play group. They also revealedtheir worry and concern that the single girl in a classroom was lonely.This is not to say that the boys and girls do not play together. They doand their play is fun, engaging, and interactive within the confines ofthe environment. Boys and girls do choose to play together and willchoose a different gendered playmate but the paucity of girls takes awaythe choice to choose a female playmate (Alexander & Mines, 1994). Hence,one also has to wonder about how the lack of girls in the class may havean impact on the boys. It must change the quality, type, and activitylevel of play within the classroom (Alexander & Mines; HaydenMcPeak etal., 1993; Sanders & Harper, 1976). Impact on Play Although there is a growing body of research on play in typicalpreschoolers in typical environments, there is a paucity of research onthe play of children with disabilities in both typical andself-contained environments (Colwell & Lindsey, 2005; Freeman, 2007;Green, Bigler, & Catherwood, 2004; HolmesLonergan, 2003; Ostrov &Keating, 2004). Available research has shown that children preferplaymates of the same gender and usually find same gender playmates morecompatible (Alexander & Hines, 1994; Maccoby, 1990). Each gender alsodisplays preferences for play choices, type of play, and type of toys.Although there are individual differences in preference explained bypersonality type, the preferences run along gender lines. Awareness ofgender differences among children prompts their self-prescribedseparation into same-sex play groups (Hayden- McPeak et al., 1993;Maccoby). The reasons why the genders segregate themselves in play arenot completely understood or known. Some possible explanations includeseparation from boys as a protection, similar interests, similar verbalskills, or adult encouragement for accepted social behavior(HaydenMcPeak et at.J. Maccoby also postulated that girls may becautious of boys' active play styles which feature characteristics ofdominance and competition, and perhaps even more importantly, girls havedifficulty influencing the play scenario when boys are involved. Boyshave been found to be more likely to engage in solitary outdoor fantasyplay whereas girls engage in traditional roles of "house" and "school"(Sanders & Harper, 1976). Sanders and Harper also indicated that boysplay outdoors more, and are encouraged to engage in active, large motor,physically challenging play. Girls on the other hand are encouraged toplay quietly, be more dependent, and are acknowledged and reinforced fortheir communication attempts (HaydenMcPeak et al.). Turner (1991) foundthat certain forms of assertiveness and aggression in boys was not onlytolerated but encouraged. These same types of behavior were discouragedfor girls. These differences in preferences in terms of playmates and play stylesand adult expectations lead to the conclusion that a balance of genderin the classroom is necessary for the optimal development of socialskills (Colwell & Lindsey, 2005). This is particularly true for childrenwith disabilities who may have social skill delays and need every chanceavailable to practice those skills to minimize their delay. Previousresearch provided evidence that girls needed opportunities to choosesame gender playmates, encouragement to engage in rowdy, outdoor play,and to foster assertiveness and independence [Alexander & Mines, 1994J.They also need to be provided opportunities to explore and expandtraditional play roles of "house" and "school" into fantasy play rolesthat encourage greater use of their imaginations (Turner, 1991). Iftheir only knowledge of gender roles is mother or teacher, then girlsare limited as to the type of fantasy play in which they are able toengage. A girl's fantasy role model play may also go unnoticed or shemay be overwhelmed by the volume and number of boys in the classroomlike the girl in the vignette in this article's opening. In addition,her fantasy role model may be unfamiliar or even unknown in the morepopular lexicon of male superheroes in a predominantly male classroom.It is also highly likely that as the single girl, she will not have aleadership role in the classroom and will not determine play choices orplay scenarios during free play time (Colwell & Lindsey;Holmes-Lonergan, 2003; Maccoby, 1990). Although joining the boys'fantasy play is more socially acceptable for girls, the likelihood thatthe boys will follow a girl into girl fantasy play is negligible(Hayden-McPeak et al., 1993; Maccoby). For these very reasons, the lackof girls in a self- contained pre-K special education classroom may bedetrimental to the healthy development of social skills and interactiveplay for girls because of the limited opportunities for same-genderplaymates with similar interests (Colwell & Lindsey). Impact on SocialSkills Currently, there are a number of studies concerning social skilldevelopment. Research has shown that well-developed social skills aregood predictors of academic success (Gallagher & Lambert, 2006; Johnson,Ironsmith, Snow, & Poteat, 2000). Preschool teachers are beingencouraged to teach social skills through direct instruction to preparechildren for kindergarten. In an article on peer relationships inkindergarten and preschool, Johnson et al. stated that good socialskills are a predictor of adjustment in adulthood. In addition, sheclaimed that "children with good social skills who have more friends inpreschool make a better transition into kindergarten. Children's socialbehavior and peer relationships in preschool have a lasting effect ontheir social development as they enter grade school" (p. 209).Therefore, the isolation and limited social opportunities of girls inself-contained preschool special education may impact their socialdevelopment and may impede their academic success in elementary school. Impact on Language As a result of these limited social opportunities, the languagedevelopment of girls may be affected negatively. Male dominatedclassrooms reduce language development for girls because there is alimited number of female conversation partners and topics of interest togirls (Alexander & Hines, 1994). Maccoby (1990) found that boys were notresponsive to girls' verbal requests and that girls avoided interactionswith boys because of their nonresponsiveness. A single girl in a classof 9 or 10 boys has few opportunities to practice interactive languageskills. If similar play interests are valued by children of bothgenders, then similar verbal skills also can play a weight inestablishing and maintaining peer relationships. To promote languageusage, the girls need motivation to talk about topics that interestthem. Ideally, same-gender friends with good verbal skills would enhancethe language development of the girls in self-contained pre-K classes.Many of the children in these classes may be nonverbal. Often most ofthe talking in the room may be done by the adults. Adults prompt forlanguage usage and model language for the students. Although adults maymodel appropriate language, their use of language is not the same as achild's. Children need opportunities to talk with each other independentof adults (Johnson et al., 2000). In addition, boys and girls do notnecessarily use language in the same ways (Hayden-McPeak et al., 1993;Holmes-Lonergan, 2003). Despite limited verbal skills, the girls andboys do talk to each other to some degree in these classrooms. But iftheir skills are limited and their interests dissimilar, the chancesthat language usage will substantially increase and languages skillsimprove are minimal. Impact on Preacademics In a longitudinal study of preschoolers and academic outcomes, Dale,Jenkins, Mills, and Cole (2004) found that there was a significantcorrelation between social skills and academic skills, and that goodpeer relationships help to foster academic motivation. With minimalopportunities for peer relationships, girls will have difficultyestablishing strong enough bonds to mutually motivate each other towardacademic success. In another longitudinal study, Coutinho, Oswald, and Best (2006)followed the long-term outcomes for special education students. Coutinhoet al. found that girls were less likely to earn a high school diploma,more likely to be unemployed or to earn less if working, and more likelyto be a parent. Both Dale et al. (2004) and Coutinho et al, foundsimilar negative outcomes the longer any child was in special education.Dale et al.'s study revealed that extended time in special education canlead to poor academic achievement. These findings are certainly worthconsidering when thinking about preschool girls in self-containedspecial education classes. If long- term studies are beginning to revealnegative outcomes for children in special education, then efforts shouldbe made to limit the negative effects on girls who are underrepresentedin the classroom. Suggestions for Practice Teachers should know and value the individual differences andpreferences of each of their students. They should also be aware ofgender differences and preferences when reflecting on the composition oftheir classes. Teachers can incorporate opportunities that promoteinteraction within and between the genders in the daily schedule. Forexample, they can build on curricular themes and produce various playscenarios in center areas of the classroom. Ideas include setting up aveterinary clinic in the housekeeping area in a theme about animals or abeauty parlor in a theme about community helpers. Promoting and buildingon interactions in these play scenarios will help both boys and girlsfunction more competently in various social settings (Holmes-Lonergan,2003). A study by Green et al. (2004) suggested using stories in whichchildren are engaged in counterstereotypic play to promote cross- genderplay. Teachers could expand on their suggestions by engaging thechildren in cross gender discussions and activities. When facilitatingplay, teachers can create play scenarios that allow for girls to be inleadership roles in balance with the boys. By promoting cross-genderplay, the girls will have increased opportunities to develop theirlanguage and social skills. If girls are overwhelmingly outnumbered intheir classrooms, teachers can look for friendships within the schoolcommunity by collaborating with other teachers who may welcome the samefor their students. Communicating the value of friendship t andsame-gender peer experiences to parents may encourage them to plan playdates in their neighborhoods. Conclusion The underrepresentation of girls in preschool self-contained specialeducation classes results in social isolation and places the girls atrisk for appropriate language, social, academic, and play skills. Theplacement also limits their opportunities to establish same-gender peerrelationships that help to promote prosocial behavior and futureacademic success. Teachers need to be sure to teach to all of thelearning styles in their classrooms and to promote social interactionsbetween both genders to help alleviate the lack of same-genderopportunities for girls. Preschool girls with disabilities need to be encouraged to creativelyexplore their fantasies in an effort to reach their full potential.Given the opportunities to express themselves, not only would"Tinkerbell" take flight and soar through her preschool experience but awhole new generation of female superheroes would capture theimaginations of children everywhere. Research is beginning to closely examine the identification of schoolage girls with disabilities and the effect of being placed in classroomsthat have predominantly boys. On a regular basis, preschool girls identified with special needs arebeing paced in self-contained classes where there they may be the onlygirl. Little thought is given to the composition of the class because thefocus is on the individual child. To promote language usage, the girls need motivation to talk abouttopics that interest them. Teachers can incorporate opportunities that promote interaction withinand between the genders in the daily schedule. References Alexander, G, M., & Hines, M. (1994). Gender labels and play styles:Their relative contributions to children's selection of playmates. ChildDevelopment, 65, 869-879. American Association of University Women. (2006). Women and girls withdisabilities. Retrieved October 15, 2007, from http://www.aauw.org/advocacy/issue_advocacy/actionpages/disabilities.cfm Colwell, M. J., & Lindsey. E. W. (2005). Preschool children's pretendand physical play and sex of play partner: Connections to peercompetence. Sex Roles, 52, 497-509. Coutinho, M. J., Oswald, D. P., & Best, A. M. (2006). Differences inoutcomes for female and male students in special education. CareerDevelopment for Exceptional Individuals, 29, 48-59. Dale, P. S.,Jenkins, J. R., Mills, P. E., & Cole, K. N. (2004). When paths diverge:"Errors of prediction" from preschool test scores to later cognitive andacademic measures. Journal of Special Education, 37, 237-248. Freeman, N. K. (2007). Preschoolers' perceptions of gender appropriatetoys and their parents' beliefs about genderized behaviors:Miscommunication, mixed messages or hidden truths? Early ChildhoodEducation Journal, 34, 357-366. Gallagher, J. (2006), Driving change in special education. Baltimore:Brookes. Gallagher, P. A., & Lambert, R. G. (2006). Classroom quality,concentration of children with special needs and child outcomes in HeadStart. Exceptional Children, 73, 31-52. Green, V. A., Bigler, R., & Catherwood, D. (2004). The variability andflexibility of gender-typed toy play: A close look at children'sbehavioral responses to counterstereotypic models. Sex Roles, 51,371-386. Hayden-McPeak, C., Gaskin, S. T., & Gaughan, L. K. (1993, April). Badboys, good girls: A review of the research on gender differences inpreschoolers and a reexamination of assessment, child rearing, andeducational practices. Paper presented at the Annual Convention of theCouncil for Exceptional Children, San Antonio, TX. Holmes-Lonergan, H. A. (2003). Preschool children's collaborativeproblem-solving interactions: The role of gender, pair type and task.Sex Roles, 48, 505-517. Johnson, C., Ironsmith, M., Snow, C. W., & Poteat, G. M. (2000). Peeracceptance and social adjustment in preschool and kindergarten. EarlyChildhood Education Journal, 27, 207-212. Maccoby, E. E. (1990). Gender and relationships. American Psychologist,45, 513-520. McGrady, H., Lerner, J., & Boscardin, M. L. (2001). The educationallives of students with learning disabilities. In P. Rodis, A. Garrod, &M. Boscardin (Eds.), Learning disabilities and life stories (pp.177-193). Needham Heights, MA: Allyn & Bacon. Ostrov, J., & Keating. C. F. (2004). Gender differences in preschoolaggression during free play and structured interactions: Anobservational study. Social Development, 13, 255-277. Oswald, D. P., Best, A. M., Coutinho, M. J., & Nagle, H. A. L. (2003).Trends in the special education identification rates of boys and girls:A call for research and change. Exceptionality, 11, 223- 237. Sanders, K. M., & Harper, L. V. (1976). Freeplay fantasy behavior inpreschool children: Relations among gender, age, season and location.Child Development, 47, 1182-1185. Turner, P. J. (1991). Relations between attachment, gender and behaviorwith peers in preschool. Child Development, 62, 1475-1488. Jeanne S. Manwaring (CEC FL Federation), Pre-K Exceptional StudentEducation (ESE) District Resource Teacher, Hillsborough County PublicSchools, Tampa, Florida and Doctoral Student, Department of SpecialEducation, University of South Florida, Please address correspondence toJoanne S. Manwaring, 6507 Seabird Way, Apollo Beach, FL 33572 (e-mail:Joanne.Manwaring@sdhc.k12.fl.us). TEACHING Exceptional Children, Vol. 40, No. 5, pp. 60-65. Copyright 2008 CEC. Copyright Council for Exceptional Children May/Jun 2008 (c) 2008 Teaching Exceptional Children. Provided by ProQuest Informationand Learning. All rights Reserved.Source: Teaching Exceptional Children
Common Q&A's ABOUT EXTENDED SCHOOL YEAR PROGRAMS AND SERVICES
QUESTIONS AND ANSWERS
1. Who is eligible for extended school year programs and services? The Committee on Special Education (CSE) must determine whether astudent requires extended school year special education services inorder to prevent substantial regression. Substantial regression would beindicated by a student's inability to maintain developmental levels dueto a loss of skill, set of skill competencies or knowledge during themonths of July and August. In accordance with Section 200.6 (j) of theCommissioner's Regulations, students must be considered for twelve-monthspecial services and/or programs to prevent substantial regression ifthey are:* Students whose management needs are determined to be highlyintensive and require a high degree of individualized attention andintervention and who are placed in special classes;* Students with severe multiple disabilities, whose programsconsist primarily of habilitation and treatment and are placed inspecial classes;* Students who are recommended for home and/or hospitalinstruction whose special education needs are determined to be highlyintensive and require a high degree of individualized attention andintervention or who have severe multiple disabilities and requireprimarily habilitation and treatment; students whose needs are so severethat they can be met only in a seven-day residential program; or* Students receiving other special education services who, becauseof their disabilities, exhibit the need for twelve-month special serviceand/or program provided in a structured learning environment of up to 12months duration in order to prevent substantial regression. Both quantitative and qualitative information should be reviewed by theCSE to substantiate the need for providing such services and programs. Astudent is eligible for a twelve-month service or program when theperiod of review or reteaching required to recoup the skill or knowledgelevel attained by the end of the prior school year is beyond the timeordinarily reserved for that purpose at the beginning of the schoolyear. The typical period of review or reteaching ranges between 20 and40 school days. As a guideline for determining eligibility for anextended school year program, a review period of eight weeks or morewould indicate that substantial regression has occurred.
2. What is the CSE's obligation to provide integrated extendedschool year programs and services for students whose IndividualizedEducation Programs (IEPs) must be implemented in integrated settings inorder for the student to benefit from the special education servicesneeded to prevent substantial regression?If a student's IEP specifies that special education services must beprovided in a setting with nondisabled peers in order for the student tobenefit from the special education services to prevent substantialregression, and the school district operates summer programs fornondisabled students, then the school district must provide methods formeeting the Least Restrictive Environment (LRE) requirements thatinclude, but are not limited to:* locating special classes in settings where nondisabled childrenattend during the summer; and* having students with disabilities interact with theirnondisabled peers to the greatest extent possible duringnon-instructional parts of the school day (e.g., during lunchtime forstudents attending full-day 9000 special classes).However, if a student's IEP specifies that special education servicesmust be provided in a setting with nondisabled peers in order for thestudent to benefit from the special education services to preventsubstantial regression, and the school district does not operate summerprograms for nondisabled students, then the school district must providealternative methods for meeting the Least Restrictive Environment (LRE)requirements. These include:* providing opportunities for participation (even part-time) inother summer programs operated by the school district or those availablein a neighboring district and in programs operated by BOCES;* providing special education services to students in approvedsummer school programs for nondisabled children that integrate childrenwith disabilities;* locating special classes in settings where nondisabled childrenattend during the summer; and* providing special education services to students in settingsthat the parent has arranged and pays for the child to attend. The CSEmust determine whether the student's IEP goals can be appropriately metat the setting identified by the parent and the district must ensurethat such programs are approved by a governmental agency to operate asummer program, and approved by local authorities for fire, health andsafely requirements.
3. Must the IEP for the extended school year program be identicalto the IEP developed for the school year program?An IEP developed for an extended school year program may differ from theIEP developed for the school year program. The Committee determines thetype and amount of services that a student needs for an appropriateextended school year program. The IEP developed for the extended schoolyear program should focus on the areas in which the student is expectedto experience regression. Extended school year programs or services may, at the recommendation ofthe CSE, be provided in a location that differs from one in which thestudent attends during the school year, provided that the CSE determinesthat the setting is appropriate for the student to benefit from thespecial education services and meet their IEP goals.
4. What programs and services can be recommended for July-August? A Committee should first determine if a student with a disability iseligible for an extended school year program. The IEP for theJuly-August program should indicate those areas where the student needsservices to prevent substantial regression. While some students withdisabilities require a continuation of their full-day 10-month programs,others may only require services in specified areas of development toprevent substantial regression. In order to provide the specific programs and services to meet thestudent's needs, a variety of program options can be considered. A CSEmay recommend any one of the following special education programs andservices as determined appropriate to the needs of the individualstudent:* related services at a site determined by the CSE including, butnot limited to, an approved summer school program*<http://www.vesid.nysed.gov/specialed/applications/esy/qa2008.htm#_ftn1>recreational program, or the student's home; or * specialized instruction in combination with related services asappropriate, provided by a certified special education teacher at a sitedetermined by the CSE including, but not limited to, an approved summerschool program, a community recreational or educational program, or thestudent's home; or * full or half-day**<http://www.vesid.nysed.gov/specialed/applications/esy/qa2008.htm#_ftn2>daily instruction in special class programs which may include relatedservices. (Home or hospital instruction may be required by some students inaccordance with Section 200.6 of the Regulations of the Commissioner.)
5. What is the required length of time that extended school yearprograms and services must be provided? The approved program providing half-day or full-day special classinstruction must operate for at least 30 days. However, the frequencyand duration of the special education programs and services provided toan individual student would be determined by the CSE and could be lessthan 30 days in duration.
6. If the CSE recommends the provision of specialized instructionand/or related services to be provided at summer recreational oreducational program in which the parent has enrolled the students, whois responsible for the fees to enroll the student in the program? Camping and recreational programs are not to be construed as extendedschool year special education programs and related services. Whilespecial education services identified on a student's IEP must be madeavailable as part of a free appropriate public education (FAPE), schooldistricts are not required to pay for the enrollment and other fees atsummer recreational or nonapproved educational programs in which theparents have enrolled their school-aged child. FAPE is defined asspecial educational related services that are provided at public expensein conformity with a student's IEP.
7. If a local school district recommends an appropriate integratedextended school year program for a student with a disability and theparent unilaterally places the student in another setting such as asummer camp program, must the school district make services available atthe other setting?No. The school district would have the option of providing therecommended extended school year program or making the servicesavailable at another setting.
8. Who can provide specialized instruction to students receivingextended school year services in settings other than approved specialclass programs? Specialized instruction can be provided by an appropriately certifiedspecial education teacher as a special education itinerant teacherservice and, in certain circumstances, as a consultant teacher service.For example, if specialized instruction is to be provided at the site ofa summer camp or recreational program or nonapproved educational programat which a student's parents/guardians have enrolled their child, theCSE could recommend specialized instruction provided by a specialeducation itinerant teacher.Some students who are eligible for extended school year services may bereceiving consultant teacher services during the school year to aid themin benefiting from regular education classes. Consultant teacherservices means direct and/or indirect services provided to a studentwith a disability who attends general education classes on a full-timebasis and/or to such student's general education teachers. In individualcases, it may be appropriate to continue consultant teacher services forthose students who attend approved summer school programs (8NYCRR 110).
9. Must transition services be provided as an extended school yearservice? For some students with disabilities, ages 15-21, transition services maybe required to prevent substantial regression. These activities mayinclude instruction, community experiences, related services,preparation for employment or other post-school living objectives and,when appropriate, the acquisition of adult daily living skills orfunctional vocational evaluation. A school district may establish formalagreements with other programs to obtain transition services such asvocational training programs approved by the Education Department oranother State agency.
10. What is the role of the paraprofessional in providing extendedschool year services? A teacher aide or a teaching assistant recommended on a student's IEPcan be provided only if a certified teacher provides the specialeducation instruction and the required supervision of theparaprofessional. Teacher aides may assist a certified teacher byperforming non-teaching duties otherwise performed by teachers (e.g.,assist students with behavioral/management needs, assist in physicalcare tasks). Persons hired as teacher aides may not perform the teachingduties of a general or special education teacher, even if they hold ateaching license or certificate.A teaching assistant may provide direct instructional services tostudents under the general supervision of a certified teacher. However,the duties and responsibilities of a teaching assistant do not includeacting as a primary instructor. As appropriate, a consultant teacher orspecial education itinerant teacher providing direct instructionalservices to a student could provide the required on-site supervision***<http://www.vesid.nysed.gov/specialed/applications/esy/qa2008.htm#_ftn3>of a teaching assistant for a student enrolled in a summer schoolprogram, a summer camp or a community recreation or education program.General supervision requires that certified teachers provide directionand guidance to teaching assistants concerning the direct instructionalservices they are providing to students.
11. Can the school district apply for reimbursement of the cost of ageneral education teacher employed by a public school or BOCES as aspecial education cost for services provided in an integrated setting?No. The school district will receive reimbursement only for the cost ofspecial education services provided by appropriately licensed orcertified staff to a student during the months of July and August. Forstudents attending approved summer school programs following Part 110 ofthe Regulations of the Commissioner, the district may include thestudent's attendance for purposes of State Aid.
12. How can the school district apply for State Aid reimbursementfor the provision of related services only or specially designedinstruction provided during extended school year programs?The Department is authorized to approve programs and to establish ratesfor all special services and programs provided during July/August, bothpublic and private. Therefore, any school district or agency that plansto operate a July/August program must first apply to the Department forapproval. Applications for programs serving school-age students can beobtained by going to:http://www.vesid.nysed.gov/specialed/applications/home.html. Foradditional technical assistance regarding the July/August extendedschool year application process, please call the Office of VESID/CentralOffice Administrative Support Services Team (COASST) at (518) 473-6108.Funding approval must be granted through the System to Account forChildren (STAC) for each eligible student who is to receive specialeducation and/or related services during July and August in order fordistricts to receive the correct amount of State Aid under Section 4408of the NYS Education Law. Questions regarding the filing of STAC formsmay be directed to the STAC and Special Aids Unit at (518) 474-7116.*<http://www.vesid.nysed.gov/specialed/applications/esy/qa2008.htm#_ftnref1> Approved summer school programs are those elementary, secondary andBOCES general education programs approved in accordance with Part 110 ofthe regulations of the Commissioner of Education.**<http://www.vesid.nysed.gov/specialed/applications/esy/qa2008.htm#_ftnref2> STAC forms for school-age students enrolled in a special class on ahalf-day basis should indicate half-time in item 11b.***<http://www.vesid.nysed.gov/specialed/applications/esy/qa2008.htm#_ftnref3> A certified teacher must provide periodic on-site generalsupervision of the paraprofessional. A paraprofessional may provideservices related to a student's IEP at times when the teacher is not atthe program site. However, the supervision must be accessible to theparaprofessional by telephone or other means during the time whenon-site supervision is not occurring at the program.
1. Who is eligible for extended school year programs and services? The Committee on Special Education (CSE) must determine whether astudent requires extended school year special education services inorder to prevent substantial regression. Substantial regression would beindicated by a student's inability to maintain developmental levels dueto a loss of skill, set of skill competencies or knowledge during themonths of July and August. In accordance with Section 200.6 (j) of theCommissioner's Regulations, students must be considered for twelve-monthspecial services and/or programs to prevent substantial regression ifthey are:* Students whose management needs are determined to be highlyintensive and require a high degree of individualized attention andintervention and who are placed in special classes;* Students with severe multiple disabilities, whose programsconsist primarily of habilitation and treatment and are placed inspecial classes;* Students who are recommended for home and/or hospitalinstruction whose special education needs are determined to be highlyintensive and require a high degree of individualized attention andintervention or who have severe multiple disabilities and requireprimarily habilitation and treatment; students whose needs are so severethat they can be met only in a seven-day residential program; or* Students receiving other special education services who, becauseof their disabilities, exhibit the need for twelve-month special serviceand/or program provided in a structured learning environment of up to 12months duration in order to prevent substantial regression. Both quantitative and qualitative information should be reviewed by theCSE to substantiate the need for providing such services and programs. Astudent is eligible for a twelve-month service or program when theperiod of review or reteaching required to recoup the skill or knowledgelevel attained by the end of the prior school year is beyond the timeordinarily reserved for that purpose at the beginning of the schoolyear. The typical period of review or reteaching ranges between 20 and40 school days. As a guideline for determining eligibility for anextended school year program, a review period of eight weeks or morewould indicate that substantial regression has occurred.
2. What is the CSE's obligation to provide integrated extendedschool year programs and services for students whose IndividualizedEducation Programs (IEPs) must be implemented in integrated settings inorder for the student to benefit from the special education servicesneeded to prevent substantial regression?If a student's IEP specifies that special education services must beprovided in a setting with nondisabled peers in order for the student tobenefit from the special education services to prevent substantialregression, and the school district operates summer programs fornondisabled students, then the school district must provide methods formeeting the Least Restrictive Environment (LRE) requirements thatinclude, but are not limited to:* locating special classes in settings where nondisabled childrenattend during the summer; and* having students with disabilities interact with theirnondisabled peers to the greatest extent possible duringnon-instructional parts of the school day (e.g., during lunchtime forstudents attending full-day 9000 special classes).However, if a student's IEP specifies that special education servicesmust be provided in a setting with nondisabled peers in order for thestudent to benefit from the special education services to preventsubstantial regression, and the school district does not operate summerprograms for nondisabled students, then the school district must providealternative methods for meeting the Least Restrictive Environment (LRE)requirements. These include:* providing opportunities for participation (even part-time) inother summer programs operated by the school district or those availablein a neighboring district and in programs operated by BOCES;* providing special education services to students in approvedsummer school programs for nondisabled children that integrate childrenwith disabilities;* locating special classes in settings where nondisabled childrenattend during the summer; and* providing special education services to students in settingsthat the parent has arranged and pays for the child to attend. The CSEmust determine whether the student's IEP goals can be appropriately metat the setting identified by the parent and the district must ensurethat such programs are approved by a governmental agency to operate asummer program, and approved by local authorities for fire, health andsafely requirements.
3. Must the IEP for the extended school year program be identicalto the IEP developed for the school year program?An IEP developed for an extended school year program may differ from theIEP developed for the school year program. The Committee determines thetype and amount of services that a student needs for an appropriateextended school year program. The IEP developed for the extended schoolyear program should focus on the areas in which the student is expectedto experience regression. Extended school year programs or services may, at the recommendation ofthe CSE, be provided in a location that differs from one in which thestudent attends during the school year, provided that the CSE determinesthat the setting is appropriate for the student to benefit from thespecial education services and meet their IEP goals.
4. What programs and services can be recommended for July-August? A Committee should first determine if a student with a disability iseligible for an extended school year program. The IEP for theJuly-August program should indicate those areas where the student needsservices to prevent substantial regression. While some students withdisabilities require a continuation of their full-day 10-month programs,others may only require services in specified areas of development toprevent substantial regression. In order to provide the specific programs and services to meet thestudent's needs, a variety of program options can be considered. A CSEmay recommend any one of the following special education programs andservices as determined appropriate to the needs of the individualstudent:* related services at a site determined by the CSE including, butnot limited to, an approved summer school program*<http://www.vesid.nysed.gov/specialed/applications/esy/qa2008.htm#_ftn1>recreational program, or the student's home; or * specialized instruction in combination with related services asappropriate, provided by a certified special education teacher at a sitedetermined by the CSE including, but not limited to, an approved summerschool program, a community recreational or educational program, or thestudent's home; or * full or half-day**<http://www.vesid.nysed.gov/specialed/applications/esy/qa2008.htm#_ftn2>daily instruction in special class programs which may include relatedservices. (Home or hospital instruction may be required by some students inaccordance with Section 200.6 of the Regulations of the Commissioner.)
5. What is the required length of time that extended school yearprograms and services must be provided? The approved program providing half-day or full-day special classinstruction must operate for at least 30 days. However, the frequencyand duration of the special education programs and services provided toan individual student would be determined by the CSE and could be lessthan 30 days in duration.
6. If the CSE recommends the provision of specialized instructionand/or related services to be provided at summer recreational oreducational program in which the parent has enrolled the students, whois responsible for the fees to enroll the student in the program? Camping and recreational programs are not to be construed as extendedschool year special education programs and related services. Whilespecial education services identified on a student's IEP must be madeavailable as part of a free appropriate public education (FAPE), schooldistricts are not required to pay for the enrollment and other fees atsummer recreational or nonapproved educational programs in which theparents have enrolled their school-aged child. FAPE is defined asspecial educational related services that are provided at public expensein conformity with a student's IEP.
7. If a local school district recommends an appropriate integratedextended school year program for a student with a disability and theparent unilaterally places the student in another setting such as asummer camp program, must the school district make services available atthe other setting?No. The school district would have the option of providing therecommended extended school year program or making the servicesavailable at another setting.
8. Who can provide specialized instruction to students receivingextended school year services in settings other than approved specialclass programs? Specialized instruction can be provided by an appropriately certifiedspecial education teacher as a special education itinerant teacherservice and, in certain circumstances, as a consultant teacher service.For example, if specialized instruction is to be provided at the site ofa summer camp or recreational program or nonapproved educational programat which a student's parents/guardians have enrolled their child, theCSE could recommend specialized instruction provided by a specialeducation itinerant teacher.Some students who are eligible for extended school year services may bereceiving consultant teacher services during the school year to aid themin benefiting from regular education classes. Consultant teacherservices means direct and/or indirect services provided to a studentwith a disability who attends general education classes on a full-timebasis and/or to such student's general education teachers. In individualcases, it may be appropriate to continue consultant teacher services forthose students who attend approved summer school programs (8NYCRR 110).
9. Must transition services be provided as an extended school yearservice? For some students with disabilities, ages 15-21, transition services maybe required to prevent substantial regression. These activities mayinclude instruction, community experiences, related services,preparation for employment or other post-school living objectives and,when appropriate, the acquisition of adult daily living skills orfunctional vocational evaluation. A school district may establish formalagreements with other programs to obtain transition services such asvocational training programs approved by the Education Department oranother State agency.
10. What is the role of the paraprofessional in providing extendedschool year services? A teacher aide or a teaching assistant recommended on a student's IEPcan be provided only if a certified teacher provides the specialeducation instruction and the required supervision of theparaprofessional. Teacher aides may assist a certified teacher byperforming non-teaching duties otherwise performed by teachers (e.g.,assist students with behavioral/management needs, assist in physicalcare tasks). Persons hired as teacher aides may not perform the teachingduties of a general or special education teacher, even if they hold ateaching license or certificate.A teaching assistant may provide direct instructional services tostudents under the general supervision of a certified teacher. However,the duties and responsibilities of a teaching assistant do not includeacting as a primary instructor. As appropriate, a consultant teacher orspecial education itinerant teacher providing direct instructionalservices to a student could provide the required on-site supervision***<http://www.vesid.nysed.gov/specialed/applications/esy/qa2008.htm#_ftn3>of a teaching assistant for a student enrolled in a summer schoolprogram, a summer camp or a community recreation or education program.General supervision requires that certified teachers provide directionand guidance to teaching assistants concerning the direct instructionalservices they are providing to students.
11. Can the school district apply for reimbursement of the cost of ageneral education teacher employed by a public school or BOCES as aspecial education cost for services provided in an integrated setting?No. The school district will receive reimbursement only for the cost ofspecial education services provided by appropriately licensed orcertified staff to a student during the months of July and August. Forstudents attending approved summer school programs following Part 110 ofthe Regulations of the Commissioner, the district may include thestudent's attendance for purposes of State Aid.
12. How can the school district apply for State Aid reimbursementfor the provision of related services only or specially designedinstruction provided during extended school year programs?The Department is authorized to approve programs and to establish ratesfor all special services and programs provided during July/August, bothpublic and private. Therefore, any school district or agency that plansto operate a July/August program must first apply to the Department forapproval. Applications for programs serving school-age students can beobtained by going to:http://www.vesid.nysed.gov/specialed/applications/home.html. Foradditional technical assistance regarding the July/August extendedschool year application process, please call the Office of VESID/CentralOffice Administrative Support Services Team (COASST) at (518) 473-6108.Funding approval must be granted through the System to Account forChildren (STAC) for each eligible student who is to receive specialeducation and/or related services during July and August in order fordistricts to receive the correct amount of State Aid under Section 4408of the NYS Education Law. Questions regarding the filing of STAC formsmay be directed to the STAC and Special Aids Unit at (518) 474-7116.*<http://www.vesid.nysed.gov/specialed/applications/esy/qa2008.htm#_ftnref1> Approved summer school programs are those elementary, secondary andBOCES general education programs approved in accordance with Part 110 ofthe regulations of the Commissioner of Education.**<http://www.vesid.nysed.gov/specialed/applications/esy/qa2008.htm#_ftnref2> STAC forms for school-age students enrolled in a special class on ahalf-day basis should indicate half-time in item 11b.***<http://www.vesid.nysed.gov/specialed/applications/esy/qa2008.htm#_ftnref3> A certified teacher must provide periodic on-site generalsupervision of the paraprofessional. A paraprofessional may provideservices related to a student's IEP at times when the teacher is not atthe program site. However, the supervision must be accessible to theparaprofessional by telephone or other means during the time whenon-site supervision is not occurring at the program.
Monday, May 12, 2008
Are Anxiety Disorders All in the Mind?
Are Anxiety Disorders All in the Mind?
Researchers Find Link Between Altered Dopamine Activity and Social Anxiety Disorder According to an Article in The Journal of Nuclear Medicine
Reston, Va.—Using single-photon emission computed tomography (SPECT), researchers in The Netherlands were able to detect biochemical differences in the brains of individuals with generalized social anxiety disorder (also known as social phobia), providing evidence of a long-suspected biological cause for the dysfunction.
The study, which was reported in the May issue of the Journal of Nuclear Medicine, compared densities of elements of the serotonin and dopamine neurotransmitter systems in the brains of 12 people diagnosed with social anxiety disorder, but who had not taken medication to treat it, and a control group of 12 healthy people who were matched by sex and age.
Both groups were injected with a radioactive compound that binds with elements of the brain's serotonin and dopamine systems. Once administered, the radiotracer revealed functional alterations in these systems by measuring the radioactive binding in the thalamus, midbrain and pons (known to be acted upon by serotonin) and in the striatum (known to be acted upon by dopamine). The altered uptake activity in these regions indicated a greater level of disordered function.
"Our study provides direct evidence for the involvement of the brain's dopaminergic system in social anxiety disorder in patients who had no prior exposure to medication," said Dr. van der Wee, M.D., Ph.D., at the department of psychiatry and the Leiden Institute for Brain and Cognition at the Leiden University Medical Center, Leiden (and previously at the Rudolf Magnus Institute of Neuroscience, University Medical Center in Utrecht, The Netherlands). "It demonstrates that social anxiety has a physical, brain dependent component."
Serotonin and dopamine (neurotransmitters, or substances responsible for transferring signals from one neuron to another) act upon receptors in the brain. If the neurotransmitters are out of balance, messages cannot get through the brain properly. This can alter the way the brain reacts to normal social situations, leading to anxiety.
Other neuroimaging studies have shown abnormalities in glucose and oxygen consumption in the brain, according to van der Wee, who also points to causality as an additional issue. "Most of the people involved in these earlier studies were known to be already suffering from the disorder, so we do not know if the abnormalities were present before the onset of the disorder," he said.
Based on earlier studies, some researchers have suggested that social anxiety disorder is a result of the interplay between a genetic or acquired biological vulnerability and environment. More recent research has indicated that social anxiety disorder might be related to an imbalance of the neurotransmitter serotonin. This is the first time the brain's dopaminergic system was examined directly.
"Although there are no direct implications for treatment as a result of this study yet, it is another piece of evidence showing biological abnormalities, which may lead to new therapeutic approaches and insight into the origins of the disorder," said Dr. van der Wee.
According to the National Institute of Mental Health, social anxiety disorder affects approximately 15 million American adults and is the third most common mental disorder in the United States, after depression and alcohol dependence. The essential feature of the disorder is the fear of being evaluated by others, with the expectation that such an assessment will be negative and embarrassing. It tends to run a chronic and unremitting course and often leads to the development of alcoholism and depression. The disorder most often surfaces in adolescence or early adulthood, but it can occur at any time, including childhood.
Co-authors of "Increased Serotonin and Dopamine Transporter Binding in Psychotropic Medication-Naïve Patients With Generalized Social Anxiety Disorder Shown by 123-I-β-(4-Iodophenyl)-Tropane SPECT" include J. Frederieke van Veen, Irene M. van Vliet, Herman G. Westenberg, Department of Psychiatry; and Henk Stevens, Peter P. van Rijk, Department of Nuclear Medicine, all from the Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands.
To obtain a copy of this article—and online access to the Journal of Nuclear Medicine—please contact Kathryn Wiley at (703) 326-1184 or send an e-mail to kwiley@snm.org. Current and past issues of the Journal of Nuclear Medicine can be found online at jnm.snmjournals.org. Print copies can be obtained by contacting the SNM Service Center, 1850 Samuel Morse Drive, Reston, VA 20190-5316; phone (800) 513-6853; e-mail servicecenter@snm.org; fax (703) 708-9015. A subscription to the journal is an SNM member benefit.
About SNM—Advancing Molecular Imaging and TherapySNM is an international scientific and professional organization of more than 16,000 members dedicated to promoting the science, technology and practical applications of molecular and nuclear imaging to diagnose, manage and treat diseases in women, men and children. Founded more than 50 years ago, SNM continues to provide essential resources for health care practitioners and patients; publish the most prominent peer-reviewed journal in the field (The Journal of Nuclear Medicine); host the premier annual meeting for medical imaging and sponsor research grants, fellowships and awards. SNM members have introduced and continue to explore biological and technological innovations in medicine that noninvasively investigate the molecular basis of diseases, benefiting countless generations of patients. For more information visit www.snm.org.
Related Items
JNM article: "Increased Serotonin and Dopamine Transporter Binding in Psychotropic Medication-Naïve Patients With Generalized Social Anxiety Disorder Shown by 123-I-β-(4-Iodophenyl)-Tropane SPECT"
Figure 1: Binding ratios for 5-HTT in left and right thalamus
Figure 2: Binding ratios for DAT in striatum
Researchers Find Link Between Altered Dopamine Activity and Social Anxiety Disorder According to an Article in The Journal of Nuclear Medicine
Reston, Va.—Using single-photon emission computed tomography (SPECT), researchers in The Netherlands were able to detect biochemical differences in the brains of individuals with generalized social anxiety disorder (also known as social phobia), providing evidence of a long-suspected biological cause for the dysfunction.
The study, which was reported in the May issue of the Journal of Nuclear Medicine, compared densities of elements of the serotonin and dopamine neurotransmitter systems in the brains of 12 people diagnosed with social anxiety disorder, but who had not taken medication to treat it, and a control group of 12 healthy people who were matched by sex and age.
Both groups were injected with a radioactive compound that binds with elements of the brain's serotonin and dopamine systems. Once administered, the radiotracer revealed functional alterations in these systems by measuring the radioactive binding in the thalamus, midbrain and pons (known to be acted upon by serotonin) and in the striatum (known to be acted upon by dopamine). The altered uptake activity in these regions indicated a greater level of disordered function.
"Our study provides direct evidence for the involvement of the brain's dopaminergic system in social anxiety disorder in patients who had no prior exposure to medication," said Dr. van der Wee, M.D., Ph.D., at the department of psychiatry and the Leiden Institute for Brain and Cognition at the Leiden University Medical Center, Leiden (and previously at the Rudolf Magnus Institute of Neuroscience, University Medical Center in Utrecht, The Netherlands). "It demonstrates that social anxiety has a physical, brain dependent component."
Serotonin and dopamine (neurotransmitters, or substances responsible for transferring signals from one neuron to another) act upon receptors in the brain. If the neurotransmitters are out of balance, messages cannot get through the brain properly. This can alter the way the brain reacts to normal social situations, leading to anxiety.
Other neuroimaging studies have shown abnormalities in glucose and oxygen consumption in the brain, according to van der Wee, who also points to causality as an additional issue. "Most of the people involved in these earlier studies were known to be already suffering from the disorder, so we do not know if the abnormalities were present before the onset of the disorder," he said.
Based on earlier studies, some researchers have suggested that social anxiety disorder is a result of the interplay between a genetic or acquired biological vulnerability and environment. More recent research has indicated that social anxiety disorder might be related to an imbalance of the neurotransmitter serotonin. This is the first time the brain's dopaminergic system was examined directly.
"Although there are no direct implications for treatment as a result of this study yet, it is another piece of evidence showing biological abnormalities, which may lead to new therapeutic approaches and insight into the origins of the disorder," said Dr. van der Wee.
According to the National Institute of Mental Health, social anxiety disorder affects approximately 15 million American adults and is the third most common mental disorder in the United States, after depression and alcohol dependence. The essential feature of the disorder is the fear of being evaluated by others, with the expectation that such an assessment will be negative and embarrassing. It tends to run a chronic and unremitting course and often leads to the development of alcoholism and depression. The disorder most often surfaces in adolescence or early adulthood, but it can occur at any time, including childhood.
Co-authors of "Increased Serotonin and Dopamine Transporter Binding in Psychotropic Medication-Naïve Patients With Generalized Social Anxiety Disorder Shown by 123-I-β-(4-Iodophenyl)-Tropane SPECT" include J. Frederieke van Veen, Irene M. van Vliet, Herman G. Westenberg, Department of Psychiatry; and Henk Stevens, Peter P. van Rijk, Department of Nuclear Medicine, all from the Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands.
To obtain a copy of this article—and online access to the Journal of Nuclear Medicine—please contact Kathryn Wiley at (703) 326-1184 or send an e-mail to kwiley@snm.org. Current and past issues of the Journal of Nuclear Medicine can be found online at jnm.snmjournals.org. Print copies can be obtained by contacting the SNM Service Center, 1850 Samuel Morse Drive, Reston, VA 20190-5316; phone (800) 513-6853; e-mail servicecenter@snm.org; fax (703) 708-9015. A subscription to the journal is an SNM member benefit.
About SNM—Advancing Molecular Imaging and TherapySNM is an international scientific and professional organization of more than 16,000 members dedicated to promoting the science, technology and practical applications of molecular and nuclear imaging to diagnose, manage and treat diseases in women, men and children. Founded more than 50 years ago, SNM continues to provide essential resources for health care practitioners and patients; publish the most prominent peer-reviewed journal in the field (The Journal of Nuclear Medicine); host the premier annual meeting for medical imaging and sponsor research grants, fellowships and awards. SNM members have introduced and continue to explore biological and technological innovations in medicine that noninvasively investigate the molecular basis of diseases, benefiting countless generations of patients. For more information visit www.snm.org.
Related Items
JNM article: "Increased Serotonin and Dopamine Transporter Binding in Psychotropic Medication-Naïve Patients With Generalized Social Anxiety Disorder Shown by 123-I-β-(4-Iodophenyl)-Tropane SPECT"
Figure 1: Binding ratios for 5-HTT in left and right thalamus
Figure 2: Binding ratios for DAT in striatum
Thursday, May 8, 2008
OMRDD is pleased to announce that it will be holding a series of Public Forums
SAVE THE DATE(S)
State of New YorkOffice of Mental Retardation and Developmental DisabilitiesAnnounces a series of Public Forums for theFive Year Comprehensive Plan: 2008 - 2012
"We help people with developmental disabilities live richer lives."The New York State Office of Mental Retardation and DevelopmentalDisabilities (OMRDD)is pleased to announce that it will be holding a series of Public Forumsonits new Five Year Comprehensive Plan for Services for the Period 2008through 2012.A schedule of the Public Forum dates and times is listed below. Details for some locations will be announced at a later date. Please register by calling the contact number listed below.Video presentation of forums can be viewed online at www.omr.state.ny.us<http://www.omr.state.ny.us/> following the events.OMRDD intends to utilize the ideas, suggestions, and comments receivedthrough the public forums to develop a Draft Comprehensive Plan. OMRDDurgesself-advocates, parents of people with developmental disabilities, otherfamily members, non-profit providers, professionals, advocates, andotherinterested parties to participate. OMRDD is particularly interested inhearing about the following themes, but commentary is not limited solelytothese themes.1. OMRDD Vision StatementPeople with developmental disabilities* enjoy meaningful relationships with friends, family and othersin their lives,* experience personal health and growth,* live in the home of their choice, and* fully participate in their communities.* What issues most impact on OMRDD's ability to deliver the VisionStatement outcomes for the people we serve?* How can OMRDD and its partners (self-advocates, families,providers and other agencies) improve services to deliver these outcomesforthe people we serve?2. Quality of Services and Customer Satisfaction* How can we better involve self-advocates and families asproductive partners?* What are the key indicators of quality for the people we serve?* What are the national and local best and promising practices NewYork State should consider implementing or replicating?3. Building Community* How can we promote full community participation and contribution?* How can we encourage communities to become more responsive andinclusive?4. Equity and Access to Services* How can OMRDD as a system better support people to truly makeinformed choices about their supports and services?* How do we ensure all individuals, including those with autismspectrum disorders, the aging, people with medical frailties, children,andothers, are provided fair and equitable access to person centeredservices?* How do we better facilitate access to supports and services acrossservice systems for people with multiple disability needs?5. Workforce Capacity into the Future* How do we sustain quality and stability in both direct support andclinical workforce areas in an era of changing workforce demographics?* How do we develop the next generation of leaders throughout thesystem to meet the challenges of tomorrow?Speakers will be asked to register in advance of the forum, limit theircomments to five (5) minutes, and bring three (3) copies of the testimony. Written testimony can alsobesubmitted to Cynthia Redshaw at OMRDD, 44 Holland Avenue, Albany, NY 12229.For general information about the Public Forums, please contact OMRDD's Bureau of Planning:Phone: (518) 474-4904 Fax: (518) 473-0054 E-mail:cynthia.redshaw@omr.state.ny.us<mailto:cynthia.redshaw%40omr.state.ny.us> ____________________________________________________________2008 - 2012 Comprehensive Plan: Public Forum Schedule(To register, obtain more information or directions to the hearinglocation,or to arrange for a special accommodation, please call the contactpersonfor that forum at the number listed below.)Long Island: Wednesday, June 4, 2008 - 4 pm to 7 pmEncore Room at the Sheraton Long Island Hotel on Motor Parkway,Hauppauge,NY (Contact: Dr. Richard Evangelista (631) 434-6111)Fishkill: Thursday, June 5, 2008 - 4 pm to 7 pmHoliday Inn, 542 Route 9, Fishkill, NY (Contact: Robert Slawinski (845) 471-9226 x151)Syracuse: Monday, June 9, 2008 - 11 am to 3 pmLocation to be Announced(Contact: Valerie Bushey (315) 473-6977)Queensbury/Lake George: Wednesday, June 11, 2008 - 4:30 pm to 7:30 pm Location to be Announced (Contact: Anne Timmons (518) 581-3038)Buffalo: Tuesday, June 17, 2008 - 2 pm to 5 pm Location to be Announced (Contact: Debby McElwain (716) 517-3831)Binghamton: Monday, June 23, 2008 - 4 pm to 7 pmLocation to be Announced. (Contact: Joseph Mahon (607) 770-0255)New York City: Thursday, June 26, 2008 - 3:30 pm to 5:30 pm and 6 pm to8:30pm 75 Morton St., Manhattan, NY(Contact: Yvonne Anglero (212) 229-3081)Janice FitzgeraldParent to Parent of NYSwww.parenttoparentnys.org518-359-3006, fax 518-359-2151As parents of children with exceptional needs, we have to understandearlyon that our sons and daughters are human beings with potential and thatweare the ones best positioned to unlock that potential. Part of the workatParent to Parent of NYS is to empower parents to face the challenges andbelieve in their child and advocate so they can reach their potential.
State of New YorkOffice of Mental Retardation and Developmental DisabilitiesAnnounces a series of Public Forums for theFive Year Comprehensive Plan: 2008 - 2012
"We help people with developmental disabilities live richer lives."The New York State Office of Mental Retardation and DevelopmentalDisabilities (OMRDD)is pleased to announce that it will be holding a series of Public Forumsonits new Five Year Comprehensive Plan for Services for the Period 2008through 2012.A schedule of the Public Forum dates and times is listed below. Details for some locations will be announced at a later date. Please register by calling the contact number listed below.Video presentation of forums can be viewed online at www.omr.state.ny.us<http://www.omr.state.ny.us/> following the events.OMRDD intends to utilize the ideas, suggestions, and comments receivedthrough the public forums to develop a Draft Comprehensive Plan. OMRDDurgesself-advocates, parents of people with developmental disabilities, otherfamily members, non-profit providers, professionals, advocates, andotherinterested parties to participate. OMRDD is particularly interested inhearing about the following themes, but commentary is not limited solelytothese themes.1. OMRDD Vision StatementPeople with developmental disabilities* enjoy meaningful relationships with friends, family and othersin their lives,* experience personal health and growth,* live in the home of their choice, and* fully participate in their communities.* What issues most impact on OMRDD's ability to deliver the VisionStatement outcomes for the people we serve?* How can OMRDD and its partners (self-advocates, families,providers and other agencies) improve services to deliver these outcomesforthe people we serve?2. Quality of Services and Customer Satisfaction* How can we better involve self-advocates and families asproductive partners?* What are the key indicators of quality for the people we serve?* What are the national and local best and promising practices NewYork State should consider implementing or replicating?3. Building Community* How can we promote full community participation and contribution?* How can we encourage communities to become more responsive andinclusive?4. Equity and Access to Services* How can OMRDD as a system better support people to truly makeinformed choices about their supports and services?* How do we ensure all individuals, including those with autismspectrum disorders, the aging, people with medical frailties, children,andothers, are provided fair and equitable access to person centeredservices?* How do we better facilitate access to supports and services acrossservice systems for people with multiple disability needs?5. Workforce Capacity into the Future* How do we sustain quality and stability in both direct support andclinical workforce areas in an era of changing workforce demographics?* How do we develop the next generation of leaders throughout thesystem to meet the challenges of tomorrow?Speakers will be asked to register in advance of the forum, limit theircomments to five (5) minutes, and bring three (3) copies of the testimony. Written testimony can alsobesubmitted to Cynthia Redshaw at OMRDD, 44 Holland Avenue, Albany, NY 12229.For general information about the Public Forums, please contact OMRDD's Bureau of Planning:Phone: (518) 474-4904 Fax: (518) 473-0054 E-mail:cynthia.redshaw@omr.state.ny.us<mailto:cynthia.redshaw%40omr.state.ny.us> ____________________________________________________________2008 - 2012 Comprehensive Plan: Public Forum Schedule(To register, obtain more information or directions to the hearinglocation,or to arrange for a special accommodation, please call the contactpersonfor that forum at the number listed below.)Long Island: Wednesday, June 4, 2008 - 4 pm to 7 pmEncore Room at the Sheraton Long Island Hotel on Motor Parkway,Hauppauge,NY (Contact: Dr. Richard Evangelista (631) 434-6111)Fishkill: Thursday, June 5, 2008 - 4 pm to 7 pmHoliday Inn, 542 Route 9, Fishkill, NY (Contact: Robert Slawinski (845) 471-9226 x151)Syracuse: Monday, June 9, 2008 - 11 am to 3 pmLocation to be Announced(Contact: Valerie Bushey (315) 473-6977)Queensbury/Lake George: Wednesday, June 11, 2008 - 4:30 pm to 7:30 pm Location to be Announced (Contact: Anne Timmons (518) 581-3038)Buffalo: Tuesday, June 17, 2008 - 2 pm to 5 pm Location to be Announced (Contact: Debby McElwain (716) 517-3831)Binghamton: Monday, June 23, 2008 - 4 pm to 7 pmLocation to be Announced. (Contact: Joseph Mahon (607) 770-0255)New York City: Thursday, June 26, 2008 - 3:30 pm to 5:30 pm and 6 pm to8:30pm 75 Morton St., Manhattan, NY(Contact: Yvonne Anglero (212) 229-3081)Janice FitzgeraldParent to Parent of NYSwww.parenttoparentnys.org518-359-3006, fax 518-359-2151As parents of children with exceptional needs, we have to understandearlyon that our sons and daughters are human beings with potential and thatweare the ones best positioned to unlock that potential. Part of the workatParent to Parent of NYS is to empower parents to face the challenges andbelieve in their child and advocate so they can reach their potential.
Semantic-Pragmatic Language Evaluation
Whether pursuing speech and language evaluation, therapy, or altering current speech and language goals and objectives based on a child’s performance, a thorough assessment of an individual’s language ability is essential to securing a therapist (and services) who will address your child’s specific communication needs. More importantly, a speech and language assessment should be individualized with regard to the types of standardized test batteries selected based on parent/educator’s concerns, previous testing (in both cognitive and speech and language domains), and the cognitive and linguistic profiles of any given subtype of autism, such as Asperger Syndrome (AS), High-Functioning Autism (HFA) PDD-NOS and Autistic Disorder (also known as classic autism) and other developmental disabilities.
A semantic-pragmatic language evaluation, administered by a qualified speech and language pathologist with expertise in the field of autism (and the ability to accurately interpret normative data in terms of relative strengths and weaknesses and how they affect one’s ability to engage in social communication), can identify strengths and weaknesses in the areas of language known as content and use and provide differential diagnosis of a secondary (to autism) language disorder known as semantic-pragmatic language disorder. This disorder:
Selectively affects the language areas of content (particularly meaning and intent) and use (otherwise known as pragmatic language) despite the presence of average to superior form (grammar, speech) or expressiveness
More common in children with AS and HFA (and may not be as apparent or even detected if the proper assessment tools are not used)
Can be present in children without an autism spectrum disorder (Rapin & Allen, 1983; Bishop & Rosenbloom, 1987).
Rapin and Allen described a “semantic-pragmatic syndrome…in which there is fluent and syntactically complex expressive language, but the child has problems in understanding discourse.” Children with deficits in semantics and pragmatics can have impairments in one or more of the following higher-order language skills: figurative language, rules of social language (conflict resolution, generating multiple solutions, debating/disagreeing, accepting consequences, offering compromises) conversational skills (personal introductions, topic initiation, topic maintenance, turn taking, conversational repairs, self-monitoring skills, etc.), and presupposition or perspective taking (incorporating the thoughts and ideas of the listener into conversations, taking their feelings and emotions into account). In the context of academics, children with the aforementioned deficits will have difficulty with assignments that require descriptions of: social characteristics, similarities and differences, overall themes, social nuisances, cause and affect vs. correlation, as well as, comprehension and use of: idioms, figurative language, and overall problem solving abilities including sequencing and predicting.
Many people with a HFA or AS have not been able to qualify for speech and language services in the school or have been discharged from these services due to average to superior performance on the assessments utilized. A majority of tests used in schools districts assess basic area of language including form and speech production or intelligibility. However, many of these students require speech and language therapy to focus on areas of higher-order language, areas that are often not evaluation in a school-based assessment. It should be noted that speech-language pathologists working in school environments are only allotted a small amount of time for testing by their school districts. Therefore they do not have the time that is often needed to conduct comprehensive assessments of all areas of language. A center-based semantic-pragmatic language evaluation allows for a more in-depth evaluation of the language areas affected in HFA and AS.
Gina-Marie Muscillo, speech language pathologist and Stacey Kanin, clinical fellow-speech language pathologist at the Center for Autism, are pleased to offer center-based independent semantic-pragmatic language evaluations for children, adolescents, and adults with HFA, AS, or symptoms of this disorder. Potential candidates for this assessment include people with basic conversational skills (using basic language to talk with others). This type of evaluation typically involves 3-4 hours of standardized testing in the areas of content and use. Specific tests are chosen based on several factors including the patient’s age, primary diagnosis, parental concerns, academic functioning/educator’s concerns, and a review of previous evaluations and IEP’s (1-2 years prior). The tests concentrate on figurative language, inference, ambiguity, contextualized meaning, social judgment, and problem-solving using open-ended questioning and at times visual stimuli. Informal observations are also made regarding a client’s understanding and use of supralinguistics including sarcasm, irony, and humor. The presence of a semantic-pragmatic language disorder is determined after an in-depth review of: previous evaluations across disciplines (speech and language, social work, psychiatry, psychology), current IEP, and results from the semantic-pragmatic language evaluation. Tests Recommendations as to academic modifications, speech and language therapy, specific language goals and objectives, therapy materials and programs, and social skills groups are provided in the final report. Information obtained from this evaluation may warrant a recommendation for further diagnostic testing.
For people over the age of 21 interested in a semantic-pragmatic language evaluation:
At this time standardized testing of higher-order language, is not currently available for people over the age of 21. A semantic-pragmatic language disorder can still be diagnosed by a speech-language pathologist. The testing used for people under the age of 21 is implemented and assessed subjectively by the speech-language pathologist. Informal observations and age-equivalents are also utilized to determine the presence of the disorder.
For more information or to schedule an appointment please contact Gina-Marie Muscillo-Moravcik or Stacey Kanin at the Fay J. Lindner Center for Autism 516-802-8600
A semantic-pragmatic language evaluation, administered by a qualified speech and language pathologist with expertise in the field of autism (and the ability to accurately interpret normative data in terms of relative strengths and weaknesses and how they affect one’s ability to engage in social communication), can identify strengths and weaknesses in the areas of language known as content and use and provide differential diagnosis of a secondary (to autism) language disorder known as semantic-pragmatic language disorder. This disorder:
Selectively affects the language areas of content (particularly meaning and intent) and use (otherwise known as pragmatic language) despite the presence of average to superior form (grammar, speech) or expressiveness
More common in children with AS and HFA (and may not be as apparent or even detected if the proper assessment tools are not used)
Can be present in children without an autism spectrum disorder (Rapin & Allen, 1983; Bishop & Rosenbloom, 1987).
Rapin and Allen described a “semantic-pragmatic syndrome…in which there is fluent and syntactically complex expressive language, but the child has problems in understanding discourse.” Children with deficits in semantics and pragmatics can have impairments in one or more of the following higher-order language skills: figurative language, rules of social language (conflict resolution, generating multiple solutions, debating/disagreeing, accepting consequences, offering compromises) conversational skills (personal introductions, topic initiation, topic maintenance, turn taking, conversational repairs, self-monitoring skills, etc.), and presupposition or perspective taking (incorporating the thoughts and ideas of the listener into conversations, taking their feelings and emotions into account). In the context of academics, children with the aforementioned deficits will have difficulty with assignments that require descriptions of: social characteristics, similarities and differences, overall themes, social nuisances, cause and affect vs. correlation, as well as, comprehension and use of: idioms, figurative language, and overall problem solving abilities including sequencing and predicting.
Many people with a HFA or AS have not been able to qualify for speech and language services in the school or have been discharged from these services due to average to superior performance on the assessments utilized. A majority of tests used in schools districts assess basic area of language including form and speech production or intelligibility. However, many of these students require speech and language therapy to focus on areas of higher-order language, areas that are often not evaluation in a school-based assessment. It should be noted that speech-language pathologists working in school environments are only allotted a small amount of time for testing by their school districts. Therefore they do not have the time that is often needed to conduct comprehensive assessments of all areas of language. A center-based semantic-pragmatic language evaluation allows for a more in-depth evaluation of the language areas affected in HFA and AS.
Gina-Marie Muscillo, speech language pathologist and Stacey Kanin, clinical fellow-speech language pathologist at the Center for Autism, are pleased to offer center-based independent semantic-pragmatic language evaluations for children, adolescents, and adults with HFA, AS, or symptoms of this disorder. Potential candidates for this assessment include people with basic conversational skills (using basic language to talk with others). This type of evaluation typically involves 3-4 hours of standardized testing in the areas of content and use. Specific tests are chosen based on several factors including the patient’s age, primary diagnosis, parental concerns, academic functioning/educator’s concerns, and a review of previous evaluations and IEP’s (1-2 years prior). The tests concentrate on figurative language, inference, ambiguity, contextualized meaning, social judgment, and problem-solving using open-ended questioning and at times visual stimuli. Informal observations are also made regarding a client’s understanding and use of supralinguistics including sarcasm, irony, and humor. The presence of a semantic-pragmatic language disorder is determined after an in-depth review of: previous evaluations across disciplines (speech and language, social work, psychiatry, psychology), current IEP, and results from the semantic-pragmatic language evaluation. Tests Recommendations as to academic modifications, speech and language therapy, specific language goals and objectives, therapy materials and programs, and social skills groups are provided in the final report. Information obtained from this evaluation may warrant a recommendation for further diagnostic testing.
For people over the age of 21 interested in a semantic-pragmatic language evaluation:
At this time standardized testing of higher-order language, is not currently available for people over the age of 21. A semantic-pragmatic language disorder can still be diagnosed by a speech-language pathologist. The testing used for people under the age of 21 is implemented and assessed subjectively by the speech-language pathologist. Informal observations and age-equivalents are also utilized to determine the presence of the disorder.
For more information or to schedule an appointment please contact Gina-Marie Muscillo-Moravcik or Stacey Kanin at the Fay J. Lindner Center for Autism 516-802-8600
Wednesday, May 7, 2008
How the Brain Learns to Read Can Depend on the Language
SCIENCE JOURNAL
By ROBERT LEE HOTZ
How the Brain Learns to Read Can Depend on the Language
May 2, 2008; Page A10
For generations, scholars have debated whether language constrains theways we think. Now, neuroscientists studying reading disorders havebegun to wonder whether the actual character of the text itself mayshape the brain.Studies of schoolchildren who read in varying alphabets and characterssuggest that those who are dyslexic in one language, say Chinese orEnglish, may not be in another, such as Italian.Proceedings of The National Academy of Sciences The images, made using functional magnetic resonance imaging, show brainregions with significant activation during a rhyming task. (a and b) Thecortical activation associated with rhyme judgment contrasted in normaland dyslexic Chinese readers. (c) Brain regions showing groupdifferences during rhyme judgment.Dyslexia, in which the mind scrambles letters or stumbles over text, istwice as prevalent in the U.S., where it affects about 10 millionchildren, as in Italy, where the written word more closely correspondsto its spoken sound. "Dyslexia exists only because we invented reading,"said Tufts University cognitive neuroscientist Maryanne Wolf, author of"Proust and the Squid: The Story and Science of the Reading Brain."Among children raised to read and write Chinese, the demands of readingdraw on parts of the brain untouched by the English alphabet, newneuroimaging studies reveal. It's the same with dyslexia, psychologistLi Hai Tan at Hong Kong Research University and his colleagues reportedlast month in the Proceedings of the National Academy of Sciences. Theproblems occur in areas not involved in reading other alphabets.Using two brain-imaging techniques, they identified striking differencesin neural anatomy and brain activity between children able to read andwrite Chinese easily and classmates struggling to keep pace. Both wereat odds with patterns of brain activity among readers of the Englishalphabet.Even when readers in both languages looked at the same writtencharacters, the brain activity was different, other researchers found.Arabic numerals of standard arithmetic -- used by readers of Chinese andEnglish alike -- activate different brain regions depending on which ofthe two languages people had first learned to read, researchers at theChinese Academy of Sciences and China's Dalian University of Technologyreported in 2006.JOIN THE DISCUSSION<http://forums.wsj.com/viewtopic.php?t=2366> <http://forums.wsj.com/viewtopic.php?t=2366> <http://forums.wsj.com/viewtopic.php?t=2366> How much reading do you do in a day? Do you find yourself stumbling overwords from time to time? Share your view<http://forums.wsj.com/viewtopic.php?t=2366> with Robert Lee Hotz andother readers in an online forum<http://forums.wsj.com/viewtopic.php?t=2366> ."In this sense, we may regard dyslexia in Chinese and English as twodifferent brain disorders," Dr. Tan said, "because completely differentbrain regions are disrupted. It's very likely that a person who isdyslexic in Chinese would not be dyslexic in English."By any measure, reading is a complex and peculiar task. At the speed ofthought, readers of English turn letters they see into sounds, soundsinto words, and words into meaning. Fluency is measured in milliseconds.Spelling variations are speed bumps in the brain.Until recently, researchers who study reading abilities focused mostlyon Western alphabets. English and 218 other languages, from Alsatian toZulu, share variations of the same Latin character set. But that set isonly one of 60 writing systems used among the world's remaining 6,912spoken languages. Even so, those studies convinced many scientists andeducators that the brain's response to the written word, regardless ofthe language, is universal.The new research suggests they're wrong. The schooling required to readEnglish or Chinese may fine-tune neural circuits in distinctive ways.To learn the ABCs of English, we essentially harness our listeningskills to a phonetic code. To become literate in Chinese, however, wemust make much heavier use of memory, motor control andvisual-perception circuits located toward the front of the brain.Children can master the 6,000 or so Chinese characters used in Mandarinand Cantonese text only by laboriously copying them out over and overagain, until each abstract form becomes second nature."We have to recognize that the writing system in China is different, thedemands on the brain are different and the characteristics of dyslexiaare different," said Georgetown University pediatric learning specialistGuinevere Eden, who is incoming president of the International DyslexiaAssociation.RECOMMENDED READINGWords do make a lasting impression, depending on the alphabet in whichwe read and write them.Indeed, in Chinese text, reading engages different parts of the brainthan English text. At the University of Hong Kong, linguist Li-Hai Tan<http://www.hku.hk/fmri/people_tan.htm> and his colleagues reported in The Proceedings of the National Academy of Sciences<http://www.pnas.org/cgi/content/abstract/105/14/5561> that the readingproblems of dyslexia also affect the brain differently depending uponthe writing system.In Nature Neuroscience<http://www.nature.com/neuro/journal/v6/n7/abs/nn1065.html> , GeorgetownUniversity dyslexia expert Guinevere Eden<http://explore.georgetown.edu/people/edeng/?PageTemplateID=131> andher colleagues tracked how literacy reorganizes the brain by studyingneural changes in people between the ages of 6 and 22 years old as theylearned to read and write English.As the mother of a son with reading difficulties, Tufts University childdevelopment expert Maryanne Wolf<http://ase.tufts.edu/crlr/staff/maryanne.html> explores theneurobiology of reading in Proust and the Squid: The Story and Scienceof the Reading Brain<http://www.amazon.com/Proust-Squid-Story-Science-Reading/dp/0060186399>.Harvard experimental psychologist Steven Pinker<http://pinker.wjh.harvard.edu/> explains how the mind works byexamining how we use words in The Stuff of Thought: Language as a Windowinto Human Nature<http://www.amazon.com/Stuff-Thought-Language-Window-Nature/dp/0670063274/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1209566880&sr=8-1> . The U.S. National Research Council consulted psychologists,neurobiologists, and educators about the literacy problems plaguing asmany as four in ten American children for its report "Preventing ReadingDifficulties in Young Children."(http://books.nap.edu/catalog.php?record_id=6023)To document the effects on brain development, Dr. Eden and hercolleagues are launching a five-year study in Beijing and Washington tocompare the neural changes in 60 schoolchildren learning to read eitherChinese or English. "Nobody has ever done this across two writingsystems," Dr. Eden said.In ways that ancient scribes never imagined, text has transformed us.Every brain shaped by reading, whether it is schooled in Chinese orEnglish text, measurably differs -- in terms of patterns of energy useand brain structure -- from one that has never mastered the writtenword, comparative brain-imaging studies show. "There are realdifferences that emerge because of literacy," Dr. Wolf said.Some social psychologists speculate that the brain changes caused byliteracy could be involved in cultural differences in memory, attentionand visual perception. In January's Psychological Science, MITresearchers reported that European-Americans and students from severalEast Asian cultures, for example, showed different patterns of brainactivation when making snap judgments about visual patterns.No one knows which came first: habits of thought or the writing systemthat gave them tangible form. A writing system could be drawn from thearchaeology of the mind, perpetuating aspects of mental life conceivedat the dawn of civilization."Once you have different writing systems in place," said University ofMichigan social psychologist Richard Nisbett. "They may reinforce theperceptual and cognitive trends that preceded the invention of writing.They may go hand in glove."* Email me at sciencejournal@wsj.com. For a discussion on today'scolumn, go to the Science Journal forum<http://forums.wsj.com/viewtopic.php?t=2366> .( http://forums.wsj.com/viewtopic.php?t=2366 )
By ROBERT LEE HOTZ
How the Brain Learns to Read Can Depend on the Language
May 2, 2008; Page A10
For generations, scholars have debated whether language constrains theways we think. Now, neuroscientists studying reading disorders havebegun to wonder whether the actual character of the text itself mayshape the brain.Studies of schoolchildren who read in varying alphabets and characterssuggest that those who are dyslexic in one language, say Chinese orEnglish, may not be in another, such as Italian.Proceedings of The National Academy of Sciences The images, made using functional magnetic resonance imaging, show brainregions with significant activation during a rhyming task. (a and b) Thecortical activation associated with rhyme judgment contrasted in normaland dyslexic Chinese readers. (c) Brain regions showing groupdifferences during rhyme judgment.Dyslexia, in which the mind scrambles letters or stumbles over text, istwice as prevalent in the U.S., where it affects about 10 millionchildren, as in Italy, where the written word more closely correspondsto its spoken sound. "Dyslexia exists only because we invented reading,"said Tufts University cognitive neuroscientist Maryanne Wolf, author of"Proust and the Squid: The Story and Science of the Reading Brain."Among children raised to read and write Chinese, the demands of readingdraw on parts of the brain untouched by the English alphabet, newneuroimaging studies reveal. It's the same with dyslexia, psychologistLi Hai Tan at Hong Kong Research University and his colleagues reportedlast month in the Proceedings of the National Academy of Sciences. Theproblems occur in areas not involved in reading other alphabets.Using two brain-imaging techniques, they identified striking differencesin neural anatomy and brain activity between children able to read andwrite Chinese easily and classmates struggling to keep pace. Both wereat odds with patterns of brain activity among readers of the Englishalphabet.Even when readers in both languages looked at the same writtencharacters, the brain activity was different, other researchers found.Arabic numerals of standard arithmetic -- used by readers of Chinese andEnglish alike -- activate different brain regions depending on which ofthe two languages people had first learned to read, researchers at theChinese Academy of Sciences and China's Dalian University of Technologyreported in 2006.JOIN THE DISCUSSION<http://forums.wsj.com/viewtopic.php?t=2366> <http://forums.wsj.com/viewtopic.php?t=2366> <http://forums.wsj.com/viewtopic.php?t=2366> How much reading do you do in a day? Do you find yourself stumbling overwords from time to time? Share your view<http://forums.wsj.com/viewtopic.php?t=2366> with Robert Lee Hotz andother readers in an online forum<http://forums.wsj.com/viewtopic.php?t=2366> ."In this sense, we may regard dyslexia in Chinese and English as twodifferent brain disorders," Dr. Tan said, "because completely differentbrain regions are disrupted. It's very likely that a person who isdyslexic in Chinese would not be dyslexic in English."By any measure, reading is a complex and peculiar task. At the speed ofthought, readers of English turn letters they see into sounds, soundsinto words, and words into meaning. Fluency is measured in milliseconds.Spelling variations are speed bumps in the brain.Until recently, researchers who study reading abilities focused mostlyon Western alphabets. English and 218 other languages, from Alsatian toZulu, share variations of the same Latin character set. But that set isonly one of 60 writing systems used among the world's remaining 6,912spoken languages. Even so, those studies convinced many scientists andeducators that the brain's response to the written word, regardless ofthe language, is universal.The new research suggests they're wrong. The schooling required to readEnglish or Chinese may fine-tune neural circuits in distinctive ways.To learn the ABCs of English, we essentially harness our listeningskills to a phonetic code. To become literate in Chinese, however, wemust make much heavier use of memory, motor control andvisual-perception circuits located toward the front of the brain.Children can master the 6,000 or so Chinese characters used in Mandarinand Cantonese text only by laboriously copying them out over and overagain, until each abstract form becomes second nature."We have to recognize that the writing system in China is different, thedemands on the brain are different and the characteristics of dyslexiaare different," said Georgetown University pediatric learning specialistGuinevere Eden, who is incoming president of the International DyslexiaAssociation.RECOMMENDED READINGWords do make a lasting impression, depending on the alphabet in whichwe read and write them.Indeed, in Chinese text, reading engages different parts of the brainthan English text. At the University of Hong Kong, linguist Li-Hai Tan<http://www.hku.hk/fmri/people_tan.htm> and his colleagues reported in The Proceedings of the National Academy of Sciences<http://www.pnas.org/cgi/content/abstract/105/14/5561> that the readingproblems of dyslexia also affect the brain differently depending uponthe writing system.In Nature Neuroscience<http://www.nature.com/neuro/journal/v6/n7/abs/nn1065.html> , GeorgetownUniversity dyslexia expert Guinevere Eden<http://explore.georgetown.edu/people/edeng/?PageTemplateID=131> andher colleagues tracked how literacy reorganizes the brain by studyingneural changes in people between the ages of 6 and 22 years old as theylearned to read and write English.As the mother of a son with reading difficulties, Tufts University childdevelopment expert Maryanne Wolf<http://ase.tufts.edu/crlr/staff/maryanne.html> explores theneurobiology of reading in Proust and the Squid: The Story and Scienceof the Reading Brain<http://www.amazon.com/Proust-Squid-Story-Science-Reading/dp/0060186399>.Harvard experimental psychologist Steven Pinker<http://pinker.wjh.harvard.edu/> explains how the mind works byexamining how we use words in The Stuff of Thought: Language as a Windowinto Human Nature<http://www.amazon.com/Stuff-Thought-Language-Window-Nature/dp/0670063274/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1209566880&sr=8-1> . The U.S. National Research Council consulted psychologists,neurobiologists, and educators about the literacy problems plaguing asmany as four in ten American children for its report "Preventing ReadingDifficulties in Young Children."(http://books.nap.edu/catalog.php?record_id=6023)To document the effects on brain development, Dr. Eden and hercolleagues are launching a five-year study in Beijing and Washington tocompare the neural changes in 60 schoolchildren learning to read eitherChinese or English. "Nobody has ever done this across two writingsystems," Dr. Eden said.In ways that ancient scribes never imagined, text has transformed us.Every brain shaped by reading, whether it is schooled in Chinese orEnglish text, measurably differs -- in terms of patterns of energy useand brain structure -- from one that has never mastered the writtenword, comparative brain-imaging studies show. "There are realdifferences that emerge because of literacy," Dr. Wolf said.Some social psychologists speculate that the brain changes caused byliteracy could be involved in cultural differences in memory, attentionand visual perception. In January's Psychological Science, MITresearchers reported that European-Americans and students from severalEast Asian cultures, for example, showed different patterns of brainactivation when making snap judgments about visual patterns.No one knows which came first: habits of thought or the writing systemthat gave them tangible form. A writing system could be drawn from thearchaeology of the mind, perpetuating aspects of mental life conceivedat the dawn of civilization."Once you have different writing systems in place," said University ofMichigan social psychologist Richard Nisbett. "They may reinforce theperceptual and cognitive trends that preceded the invention of writing.They may go hand in glove."* Email me at sciencejournal@wsj.com. For a discussion on today'scolumn, go to the Science Journal forum<http://forums.wsj.com/viewtopic.php?t=2366> .( http://forums.wsj.com/viewtopic.php?t=2366 )
Thursday, May 1, 2008
'Israel must do more to raise awareness about autism'
Suzanne Wright talks in numbers. For her, the world is clearly measured in the percentages of children and adults who suffer from the neurobiological development disorder known as autism, and for her those figures speak louder than a thousand words.
Suzanne and Bob Wright, founders of Autism Speaks.Photo: Ariel Jerozolimski
"In your [former] country, the UK, the percentage is very high: One in 80 children is diagnosed with autism," begins Suzanne, as we sit together in her suite at the David Citadel Hotel in Jerusalem on Monday.
Later on in our interview, she adds that in her native US, it's one out of every 150 children, with one in 94 boys being diagnosed - and in Israel, the official estimate is one in 214.
"Its roughly one percent of the male population globally," continues Suzanne, who together with her husband Bob founded one of the US's fastest-growing nonprofit organizations, Autism Speaks, three years ago.
"[Our main goal] is to formulate a real understanding of autism and its significance on the population of each country," joins in Bob, who stepped down as chairman and CEO of NBC Universal last year and currently serves as vice chairman of NBC's parent company, General Electric. "The two most important things we need to focus on are early diagnosis of autism and its treatment. Simultaneously we must fund all the necessary global research, finding the cause and a cure."
The dynamic couple, who travel worldwide to raise awareness of the condition, believes that cases of autism in children globally have reached epidemic proportions, with public awareness trailing far, far behind.
As part of their work with autism, the couple is in Israel this week to discuss mutual cooperation with government officials, professionals and scientists in the field. Among those who met with the Wrights were leaders from Alut, the Israeli Society for Autistic children, as well as Welfare and Social Services Minister Isaac Herzog and the prime minister's wife, Aliza Olmert.
While Bob and Suzanne clearly run their charity like a high-powered business venture, it is their personal connection to autism that makes their compassion for the unexplained condition even more impressive.
"Our grandson was diagnosed with autism three years ago," explains Suzanne. "He was developing beautifully, and then problems started appearing at 18 months. By the time he turned two-and-a-half, he was gone."
Some of the doctors blamed his regression on the birth of his next sibling, recalls Suzanne. "They said that sometimes that happens to boys when a new baby is born, but in light of this autism epidemic, I say that we need to end these old wives' tales now. They can no longer be told to young mothers, because it is not the truth. The truth is that we need to be screening for autism."
"It is time to focus intensely on early diagnosis and intervention," agrees Bob. "While not every child flourishes from intervention, there is proof that if children are helped during their early years, then when they get to first grade, they will most likely be able to function at an age-appropriate level."
After their grandson's diagnosis, the Wrights decided that "something of this magnitude" needed a "national voice." The two set up Autism Speaks with a $12 million donation from Jewish philanthropist Bernie Marcus.
In the three years since its inception, the Wrights have succeeded in raising awareness of the condition via $100 million in donated media advertising, created local support networks for families and initiated a nationwide annual walkathon for autism that politicians have no choice but to "pay attention to," says Bob.
Internationally, the two have been working together with statesmen and -women from across the globe, including Sheikha Mozah Bint Nassar al-Missnad, wife of the Emir of Qatar, who assisted Autism Speaks in convincing the United Nations to take up the challenge, too.
"During a presentation last June at the UN, we thought of having a resolution for world autism awareness day," says Suzanne. "No one thought it would happen so quickly, but after Sheikha Mozah cosponsored it with me, we persuaded 50 countries in the UN to be our cosponsors, and on December 18, 2007, the gavel came down and World Autism Day [marked April 2] was born."
The couple highlights that the UN has only agreed to have similar recognition days for AIDS and diabetes.
In terms of their future work with Israel, the Wrights say they are impressed with the efforts being made by organizations such as Alut and children's special-needs hospice Aleh, as well as the cooperation here between the nonprofit sector, the government and medical institutions.
However, they say, Israel, like the rest of the world, still has a long way to go in raising awareness.
"If our [autistic] kids had crutches like polio victims or had their hair shaved off like children with cancer, if we had a visual picture of how terrible autism is, it would change the world," says Suzanne with conviction. "However, we have to rely on our advocacy and the facts in order to change the world."
She finishes, "It is an epidemic that is all around the world, and it is time we brought this to the global stage - because when Autism speaks, the world has to listen."
http://www.jpost.com/servlet/Satellite?cid=1208870516535&pagename=JPost%2FJPArticle%2FShowFull
Suzanne and Bob Wright, founders of Autism Speaks.Photo: Ariel Jerozolimski
"In your [former] country, the UK, the percentage is very high: One in 80 children is diagnosed with autism," begins Suzanne, as we sit together in her suite at the David Citadel Hotel in Jerusalem on Monday.
Later on in our interview, she adds that in her native US, it's one out of every 150 children, with one in 94 boys being diagnosed - and in Israel, the official estimate is one in 214.
"Its roughly one percent of the male population globally," continues Suzanne, who together with her husband Bob founded one of the US's fastest-growing nonprofit organizations, Autism Speaks, three years ago.
"[Our main goal] is to formulate a real understanding of autism and its significance on the population of each country," joins in Bob, who stepped down as chairman and CEO of NBC Universal last year and currently serves as vice chairman of NBC's parent company, General Electric. "The two most important things we need to focus on are early diagnosis of autism and its treatment. Simultaneously we must fund all the necessary global research, finding the cause and a cure."
The dynamic couple, who travel worldwide to raise awareness of the condition, believes that cases of autism in children globally have reached epidemic proportions, with public awareness trailing far, far behind.
As part of their work with autism, the couple is in Israel this week to discuss mutual cooperation with government officials, professionals and scientists in the field. Among those who met with the Wrights were leaders from Alut, the Israeli Society for Autistic children, as well as Welfare and Social Services Minister Isaac Herzog and the prime minister's wife, Aliza Olmert.
While Bob and Suzanne clearly run their charity like a high-powered business venture, it is their personal connection to autism that makes their compassion for the unexplained condition even more impressive.
"Our grandson was diagnosed with autism three years ago," explains Suzanne. "He was developing beautifully, and then problems started appearing at 18 months. By the time he turned two-and-a-half, he was gone."
Some of the doctors blamed his regression on the birth of his next sibling, recalls Suzanne. "They said that sometimes that happens to boys when a new baby is born, but in light of this autism epidemic, I say that we need to end these old wives' tales now. They can no longer be told to young mothers, because it is not the truth. The truth is that we need to be screening for autism."
"It is time to focus intensely on early diagnosis and intervention," agrees Bob. "While not every child flourishes from intervention, there is proof that if children are helped during their early years, then when they get to first grade, they will most likely be able to function at an age-appropriate level."
After their grandson's diagnosis, the Wrights decided that "something of this magnitude" needed a "national voice." The two set up Autism Speaks with a $12 million donation from Jewish philanthropist Bernie Marcus.
In the three years since its inception, the Wrights have succeeded in raising awareness of the condition via $100 million in donated media advertising, created local support networks for families and initiated a nationwide annual walkathon for autism that politicians have no choice but to "pay attention to," says Bob.
Internationally, the two have been working together with statesmen and -women from across the globe, including Sheikha Mozah Bint Nassar al-Missnad, wife of the Emir of Qatar, who assisted Autism Speaks in convincing the United Nations to take up the challenge, too.
"During a presentation last June at the UN, we thought of having a resolution for world autism awareness day," says Suzanne. "No one thought it would happen so quickly, but after Sheikha Mozah cosponsored it with me, we persuaded 50 countries in the UN to be our cosponsors, and on December 18, 2007, the gavel came down and World Autism Day [marked April 2] was born."
The couple highlights that the UN has only agreed to have similar recognition days for AIDS and diabetes.
In terms of their future work with Israel, the Wrights say they are impressed with the efforts being made by organizations such as Alut and children's special-needs hospice Aleh, as well as the cooperation here between the nonprofit sector, the government and medical institutions.
However, they say, Israel, like the rest of the world, still has a long way to go in raising awareness.
"If our [autistic] kids had crutches like polio victims or had their hair shaved off like children with cancer, if we had a visual picture of how terrible autism is, it would change the world," says Suzanne with conviction. "However, we have to rely on our advocacy and the facts in order to change the world."
She finishes, "It is an epidemic that is all around the world, and it is time we brought this to the global stage - because when Autism speaks, the world has to listen."
http://www.jpost.com/servlet/Satellite?cid=1208870516535&pagename=JPost%2FJPArticle%2FShowFull
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