ADHD people. They are often creative types.

Are creative people more likely to have issues with ADHD?

Does this make them People with ADHD tend to be writers, musicians, visionaries, inventors, and people who rock the boat at work–they come up with better ways to do things.

There’s nothing wrong with being a nonlinear person except that it can make you miserable in this linear world we live in.”

About 4 percent of American adults suffer from the condition, and they lose between 12 and 56 workdays annually to their symptoms, according to a national screening survey conducted by Harvard Medical School.

More about creativity and attention issues at Musicians and ADHD

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Although commonly linked, ADD and ADHD manifest themselves behaviorally in very different ways. People with ADD tend to be somewhat passive, and more withdrawn than their ADHD counterparts. People with ADD are more easily overwhelmed, while people with ADHD tend to be brasher and have a harder time connecting with the people around them. Both conditions can be extremely painful for the patient socially and psychologically.

There are several medications currently available for the treatment of ADD and ADHD, like Ritalin, Adderal, Concerta, and Clonidine, with varying degrees of effectiveness. Most commonly used ADD and ADHD medications can cause adverse side effects, and many patients find it difficult to stay on them. That is one reason that sufferers of ADD and ADHD and their families have more and more commonly been turning to other treatments, like acupuncture, as adjunct therapy for the treatment of these disorders. Acupuncture can be a helpful tool in the struggle to detached the disruptive natures of Attention Deficit Disorder and Attention Deficiti Hyperactivity Disorder, and it can also help to address some of the unpleasant side effects of the medications used to treat them.

What is acupuncture?

Acupuncture is a form of Traditional Chinese Medicine (TCM) that was developed in China at least 3,000 years ago, and may date back as many as 5,000 years. A word made up of the roots “acus” meaning needle, and “puncture” meaning the piercing of the skin, acupuncture literally translates to “puncture with needles.” By placing hair-fine needles into the skin at strategic points in the body known as “acupuncture points,” acupuncture can encourage to promote healing, alleviate pain, tranquil spasms and ticking, bolster the immune system, and generally encourage good health in myriad ways.

The focus of acupuncture treatment is the “qi” (pronounced “chee”) or the life energy of the body. It is the plan of practitioners of Traditional Chinese Medicine that the qi is flowing though every living thing, and that it is what allows life to occur. Qi flows through the body through channels known as meridians. There are twelve major meridians of the body (and several minor meridians), which are associated with twelve major organ systems of the body. These are the lung, the large intestine, the stomach, the spleen, the heart, the small intestine, the bladder, the kidney, the pericardium, the san jiao (recognized as an organ only in TCM, and is considered to be a heat source of the body), the gall bladder, and the liver meridians. It is through these meridians that the qi flows, promoting life and well being, and affecting the quality of the physical, mental, spiritual, and emotional health.

It is believed that when the qi is out of balance, blocked, or stagnated, illness and afflict result. Pain and illness can also cause the imbalance of the qi, as the chicken and the egg are interconnected, and one will always reach first. The process of acupuncture, of the placing of needles into the acupuncture points (which fall along the meridians) corresponding with the location of the disharmony of the qi will restore the qi to balance and allow it to flow freely again, thereby alleviating the symptomatic problems.

Aside from the needling of acupuncture, there are other devices the acupuncturist may spend to help restore the quality of the qi and return the body’s systems to order. The application of specific herbs, which are heated and smolder above the appropriate acupuncture points, known as moxibusion, sends warmth down into the points. Cupping is the placement of tiny glass cups on the skin of the back. The air inside the cups is either filled with hot smoke, which causes the skin under the cups to be drawn up into the body of the cup as the air inside cools, or a suction gun is attached to the outside of the cup which suctions the air out. This suctioning of the skin can draw toxins from the body and promote healing and balance. Similarly the application of a small amount of electrical current to the end of the acupuncture needle, at high or low frequency, sends an the current down into the point, providing the point with added stimulus.

What does a patient experience during an acupuncture session?  

The acupuncturist will examine the patient first and take a comprehensive medical history. Some of the examination is unique to acupuncture and may seem odd to the patient. For instance, the acupuncturist will take the patient’s pulse, but in doing so, he or she will generally take it three times, and will alternate which fingers he or she is using to read the pulse. The patient’s tongue will also be examined, as deficiencies of the vital organs and depletions of qi are evident in the shape, texture, and color of the tongue.

After the examination, the patient will lie down on a massage table, either prone or supine, and the acupuncturist will place some needles in the body. The number and situation of the needle sites will vary patient-to-patient, and often visit-to-visit, depending on the needs of the patient at that point. Needles may be placed in the part of the body that is causing the patient trouble, or they may be inserted into locations nowhere approach the source of the harm or problem.

For most, acupuncture treatments are completely painless. The needles are very fine (the average diameter of an acupuncture needle is 0.015”), and they are solid. What many patients don’t realize is that most of the damage that they have experienced due to needle insertion in the medical setting is caused by the hole in the center of the blood arrangement or injection needle, which allows fluid to be either drawn or injected through the shaft of the needle. This hole causes there to be some resistance as the needle is inserted, which pulls on the skin and causes most of the sting that the patient feels. Due to the solid and tiny nature of the needles, acupuncture needles can be inserted into the outer layers of the skin with no or very little discomfort.

Occasionally, if there is a high concentration of qi blocked around a particular point, the patient may experience a small twinge of pain, similar in feeling to a bug bite, and this feeling will typically subside as the treatment continues and the blockage begins to resolve.

Once the needles are in place, the patient will lie quietly in a dim room, generally with soft, non-lyrical, music playing, for anywhere from ten to thirty minutes, depending on the unique need of the patient.

Is acupuncture honorable?

There are few negative side effects to the use of acupuncture. The most common adverse affects include bruising or miniature swelling around the needle site, or soreness. Occasionally, due the relaxing nature of the procedure and the calming affect of acupuncture on the energy of the body, patients may report a slightly sedated feeling, and in rare occasions, experience a vasovagal (wooziness, fainting) episode. These responses are generally mild and determine fleet. There have been very few cases of serious injury due to acupuncture treatment, however, as with all medical therapies, patients should discuss possible side effects of acupuncture before beginning treatment.

Because acupuncture employs the use if needles, it is also important to ensure that the practitioner is maintaining appropriate safety precautions regarding the sterilization of the needles. Most acupuncturists today use disposable needles that are discarded immediately after use in one patient. If the acupuncturist is not using disposable needles, it is appropriate to inquire about their sterilization procedures.

How can acupuncture help with ADD and ADHD?

ADD and ADHD are disorders that cause a host of behavioral and social problems for the sufferer. Because acupuncture works with the energy force in the body and regulates the flow of that energy, it can be an extremely effective tool in addressing behavioral disorders. Acupuncture can help to calm the impulses that make it hard for a patient to stay still. It can also work to improve concentration and bolster the immune system and energy of the patient, which can address both the sluggishness commonly associated with ADD patients and the hyperactivity commonly seen in patients with ADHD. Enhancing the flow of energy in the body can also assist the ADD and ADHD patient to maintain a clear outlook, and can help to regulate sleep.

A second benefit to acupuncture as a complementary therapy for the treatment of ADD and ADHD is that acupuncture can also help to address some of the negative side effects of some of the medications currently used to treat the disorders. Ranging from dizziness, sleeplessness, dry mouth, abdominal afflict, changes in appetite, and myriad other symptoms, most ADD and ADHD medications are associated with some sort of side effects. The side effects experienced will vary patient to patient, and each experience is unique. Once the acupuncturist takes the patient’s medical history, which will include their not only their experience with ADD and ADHD, but also the side effects of the medications utilized to treat the disorder, the acupuncturist will then treat all the disruptions to the inch of energy of the body, including those introduced by medications.

Will acupuncture work for you?

Unfortunately, as with Western medical treatments, no one therapy works for all people. To date, no one really understands how the mechanism of acupuncture works, nor do they know why it is more successful for some than for others. Many people argue that the success of acupuncture is due to a placebo carry out, however, there have been many clinical studies conducted which support its efficacy in myriad ailments and conditions. Acupuncture has also been successfully utilized in small children and animals.

For the treatment of patients with ADD and ADHD, there is no magic bullet for the treatment or cure. Patients with ADD and ADHD should continue to be treated by their general practitioner as well as the psychologists, psychopharmacologists, and other health care provider(s) as ordered by the treating team of physicians. Acupuncture can wait on the patient to manage the symptoms associated with ADD and ADHD, and may provide some relief which will assist the patient to accept greater abet from the therapies available to him or her, and can abet with the side effects of those therapies. Nonetheless, acupuncture should be utilized in conjuncture with worn western treatment, as an adjunct treatment, and not in place of it. Taking advantage of everything the medical knowledge of both hemispheres has to offer is a great blueprint to ensure the most effective treatment for this disruptive, often limiting and painful condition. Acupuncture can be an generous complementary therapy for the treatment of ADD and ADHD.

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There is a strong genetic component to bipolar disorder and it is more likely to develop in children who have one or more parents with the disorder. Bipolar, can be difficult to diagnose because in children and adolescents, manic episodes often emerge as bouts of irritability and tantrums. While it may steal adults weeks or months to cycle through their mood swings, children with bipolar can have cycles several times day. Adolescents dealing with bipolar disorder may often use drugs or alcohol to self-medicate making an accurate diagnosis even more difficult.

The behaviors presented by a bipolar student, in a classroom setting, can be very challenging. They may include, but are not exiguous to: irritability, depression, fast-changing moods, impulsive decisions, illogical beliefs, presentations of an over-inflated ego, extreme and unusual cravings for sweets and carbohydrates, hallucinations, expressing the thought they are invulnerable, unrealistic goal setting and racing speech.

These students struggle with completing assignments, staying on task and remembering instruction. They are often easily distracted by their own grandiose planning. When in a depressive cycle, they will isolate and find it difficult to interact with others. Because their instability of behaviors, these students struggle with discover relationships and may be loners.

If you have a student in class who has been diagnosed with bipolar disorder, here are some ideas for assisting them from the Child and Adolescent Bipolar Foundation (www.bpkids.org): use recorded books instead of reading assignments when concentration is low, shatter assignments into smaller segments and monitor student progress at regular intervals, be aware of the student’s mood cycles – when energy is low, decrease class requirements – when energy is high, provide more opportunities for accomplishment and allow students to remove themselves from the class to regain self-control if they become overwhelmed by a mood swing.

Medication will usually be of immense wait on to children and adolescents who are coping with bipolar disorder. However, some children and teens may be sensitive to the medications and react negatively. As a classroom teacher, it may be helpful for you to educate yourself about the types of bipolar medications students are taking and be aware of side effects. Then if a child or adolescent should have a reaction, you can seek appropriate assistance.

Bipolar illness lasts a lifetime and it is a very complicated disorder. Therefore, it may be helpful, to get permission to speak with any mental health practitioners who are involved with the child. These professionals can help you gain a better understanding of the disorder, and work with you to develop effective interventions for the student in you classroom. In turn, you provide to the mental health professional fine insight into how the child acts in and academic setting, which can help the professional treat the child in a more holistic manner.

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Constantly having your internal pendulum swinging from gratified for the world, and then the next second huddled in a ball under the covers of my bed balling my eyes out because I was suddenly so wretched that I just didn’t feel like I could possibly deal with the weight of it even one more second, was taking such a toll on my life that I was starting to honestly wonder if I wasn’t going just the littlest bit insane.

Not a pleasant feeling if you have ever had that niggling little feeling in the back of your head. That little suspicion in the back of your mind that everything that you know, trust, and have built the foundation of your adult life on may all be a figment of your very active imagination. All made possible by those over-reactive litle nerve receptors in the smoking little gray matter in your head. In other words, your life is all just gain believe and you have done it unprejudiced to survive the disordered choas of your mind.

My Bipolar manifests itself in the forms of speedy cycling. This is laymens terms for major swings in between moods such as I can go from being a normal happy individual at noon and by 1P.M. I can be so depressed that you would think that my favorite pet has died. When in all actuallity nothing has happened in that status of time that would warrant that type of response from something with a normally functioning brain. To put it even simpler, I way overreact to most situations and stresses that are in everyones everday life.

If say I was in the middle of a down swing in a manic cycle so to speak, I could spill a glass of juice and in my mind this would be cause to cry, yell, and would be just short of a major catastrophe in my little world. I know somewhere in my rational mind that this is just something very minor that is occured, but I am basically without any control over my body and functions to control how I react to the situation. Everything I say and do at this time is overexaggerated.

If this save event were to happen when I was in the middle of an up-swing in my manic cycle, there could be a hundred different ways that I would react to this very same glass being spilled. I could laugh and just tidy it up; I could get a microscopic mad that it was spilled, but shipshape it up anyway; sometimes when in the grip of an intense euphoria I could even find this small even so hysterically funny that I would fall on the couch laughing at how clumsy I am and forget about even cleaning up the spill for hours or until I stepped on the soggy mess and therefor later send myself into a downward spiral again.

After finally running through a couple of different medications that did nothing for me, or did way to much for me. I did not like feeling like a zombie walking through my day. My doctor and I agreed on Effexor XR for my Bipolar Disorder. This medication treats the Seratonin in your body and helps your body to acquire more of it. It helps with the rapid mood swings and helps with the depression side of the Bipolar Disorder also. So with this medication I finally found something that levels out the moods, but does deafen them. The only bad thing with Effexor is that once you start taking this medication it is almost impossible, if not dangerous, to derive back off of it. Your body will protest so vigorously that you will wonder if it isn’t going in 5 different directions at once. I for one get that it is worth the pill everyday to have the of mind.

The ADHD aspect of my personality does not make back me cope with myself any easier. I perpetually have to be doing something with my hands or my feet. My brain seems like it is constantly on a oval track that never stops to refuel. I have over the years suffered with severe insomnia from time to time. The older that I grow in age the harder it seems to keep my attention focused on one main task.

I have to picture the word SLEEP to actually force my mind to shut down for the night so that I can get some sleep. If I had not learned this expend when I was 15 years outmoded from a counselor that was clever enough to see through the tough rebellious exterior to the frightened runt girl lurking underneath, I would probably mild be struggling with nightly insomnia, instead of occassion insomnia. Visual techniques work wonders for all sorts of different ailments that I have battled over the years and seem to work very aggressively for both my Bipolar and ADHD symptoms.

Migraine headaches have always been the bain of my existence in between all of the rest of my days that I have not been battling Bipolar and ADHD. I cannot name any other thing in the world that will disrupt your life more than a migraine will. I am not talking about a headache that lingers with you and nags at you even for a couple of days. I am talking about the type of migraines that require IV Fluids, medications, hospital visits, and that feel like someone is driving a wedge the size of the Grand Canyon through your forehead, that will literally last for the span of two weeks time without relenting.

When a migraine with this intensity is upon you there is no respite, you do not eat, you do not consider, and when the medication does not work, you lay there and hope to die. It hurts that bad and there is nothing to do for it. All you wish is for it to end. When it finally does you want to get down on the ground and kiss it. But, there is a constant dismay that it will come attend and seize hold of you again. Your life is governed by your migraines. I tried several different medications along with over the counter ibuprofen until my doctor told me that I was slowly eating away the lining of my stomach, because I was taking to many of them to fight off my headaches.

I finally found a medication that seems to take the edge off of most of my migraines and prevents the worst of them and I will never quite taking it as long as it works for me. It is called Topomax. It is the only medication that has actually prevented the migraines in the first residence. That is something that I can’t say thank you enough for. I just wish they had made it a few years earlier.

I have run the course of several different drug therapies and counselors and have found that Effexor XR and Topomax combined seems to be the best solution for me. I have tried other medications in between these and with them, but find that I don’t really like taking medication if I don’t have to. I like to concentrate more on trying to used more physical means of controlling my various microscopic ‘quirks’ as I like to call my Bipolar and ADHD. The medications make it possible to control the worst of the symptoms and to make it possible to take hold of the smaller symptoms to make the patient, myself, more able to handle dealing with the other little ‘quirks’ in my system.

I don’t recommend that anyone just go out and take Effexor, Effexor XR, or Topomax without the approval of your Liscensed Physicians approval. These drugs are very powerful and should not be taken unless you actually need them. The brain and your body and very delicately balanced machine and when you deliberately put them out of balance you are just asking for disaster. Don’t make it even harder for those of us that actually have a medical condition to get the medications that we need by abusing the ones that you don’t.

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As a stimulant composition of the drug, dextroamphetamine, lisdexamfetamine is becoming increasingly more common as the prescription of choice for children with ADHD – children between ages six and 12 years. Because of the toxicity and complications with enzyme hydrolysis of some ADHD medications, lisdexamfetamine has shown to reduce these risks and, therefore, is a choice for many doctors and parents of children with Attention Deficit Hyperactivity Disorder.

The method by which lisdexamfetamine may prove effective for your child’s ADHD is through a process known as “pro-drug” reaction. With this type of biochemical reaction, your child’s dopamine levels and norepinephrine levels are increased in the pre-frontal cortex of the brain. It is this set of the brain that is believed to be associated with the symptoms that are so often associated with ADHD – hyperactivity, lack of focus and attention, and a large and expansive tendency to engage in impulsive activity. By using a drug that is classified as a “pro-drug”, the prefrontal cortex is giving the added support to place these behaviors under better control.

When speaking with your child’s doctor about the options for treating ADHD with medication, you will want to ask about the use of lisdexamfetamine. With the right combination of therapy and medications, many symptoms of ADHD can be well controlled in early childhood, allowing for psychotherapy to engage the pre-frontal cortex in a more controlled behavior and response pattern. Ultimately, by using this type of medication, your child may be able to eliminate medications for ADHD into early adulthood when they begin to expand out into more independence and begin a career and family of their own.

Sources: American Journal of Health Systems Pharmacology, vol. 66, Nov, 15, 1999

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For the best results, occupy this quiz a few times over a week. There are times when we all would answer “yes” to most of these. But, if you’re continually answering “yes,” you may be depressed. Answer this test truthfully and honestly with yourself.

Does it seem like you have recently lost interest in doing things that you stale to enjoy?

Do you suddenly feel sunless, peevish or enraged?

Do you get tired for no reason?

Do you cry (or feel like crying) for no reason?

Has your weight or appearance changed rapidly recently?

Have you suddenly lost your energy and feel fatigued all the time?

Has your sleeping pattern changed?

Have you wished you were dead or had thoughts of suicide?

Do you feel like others would be better off if you were insensible?

Have others notice that you haven’t been as active as you once were?

Do you have sudden, unexplained feelings of guilt about anything?

Do you wake up in the morning and feel like there is nothing to look forward to?

Do you see yourself as not useful and not needed to people?

Do you blame yourself for your problems and feel like you “deserve” your residence?

Are you having anguish remembering things, concentrating or making important decisions?

Do you experience unexplained restlessness (restlessness without a real reason)?

Do you have feelings of worthless or hopelessness? Do you feel like your situation will never change?

Has a conclude, blood relative of yours suffered from depression?

The National Mental Health Association, says that if you answered yes to more than half of these questions (more than nine), you have the symptoms of suffering from depression. This depression test does not substitute though, for an actual clinical depression test, it’s only a question meant to give you a starting point if you feel like you are suffering. If you do have these signs, please contact a medical provider so you can bag the assistance you need. Remember – it’s okay to ask for help. It’s not your fault, you didn’t cause it and you don’t deserve it. You deserve the real you – a happy, healthy, thriving you. So please, get the help you need.

Now, your first reaction when you answered this test may be to assume “See, I knew I was depressed. I’m “officially” worthless now.” Blaming yourself is a very spacious part of depression. But, know this – it is not your fault. Depression can’t be “caused” by your actions and it can’t be “fixed” by yourself. You need someone to talk to. After this test, you may even feel like you “deserve” depression. I’ve heard people claim that they haven’t lived a good life, so depression is their punishment and they’re going to stop that plan. They almost feel like they “need” depression because it’s who they are. But nobody “needs” depression and it’s not who anyone is. We’re not supposed to be that blueprint.

Even if you don’t seek medical help, talk to a friend or family member about what you’re feeling. You may feel like you can’t or that nobody would care, but again, that’s a natural feeling in depression. People will care about you if you seek them. You have plenty more people around you that love you than you’re aware of. Remember – depression is NOT the real you!

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1. Applied Behavior Analysis (ABA) Applied Behavior Analysis is a very widely broken-down therapy in which complex skills are broken down systematically into a series of simpler tasks. Positive reinforcement is used to teach children complex skills like language.

2. Dietary Interventions. Many children with autism are on one or several of various choices for special dietary interventions. These special diets often entail gluten- free, casein- free or specific carbohydrates. For more information contact the Autism Network for Dietary Intervention (ANDI.)

3..Augmentative Communication. Some children who are nonverbal or only limited verbal can be taught to use augmentative communication devices such as the DynaWrite. DynaWrite is a keyboard with a language engine inside it that can voice what is typed- a kind of “talking computer.” Some nonverbal autistic people have gone to universities and colleges with these enormously top-notch devices. For more information on obtaining the DynaWrite contact www.mayer-johnson.com

4.. Floor Time Therapy. The Floor Time model of therapy emphasizes development of receptive and expressive language and relationships. It was developed by Stanley I. Greenspan, MD. For more information contact the Interdisciplinary Council on Developmental and Learning Disorders.

5. Son Rise Program. The Son Rise program at the Autism Treatment Center of America Option Institute teaches families how to implement a home based child centered program based on acceptance and “joining.” Parents are taught to recruit and train a support team. For more information www.son-rise.org

6. DAN! (Defeat Autism Now) Conference. The DAN! Conference is an annual conference at which the DAN! protocol for treatment of autism is discussed by parents and professionals. The conference is place on by the Autism Research Institute. For more information contact www.autism.com/ari/

7. Fast ForWord. Some parents and speech language pathologists have used a software program called Quickly ForWord with their children. Fleet ForWord generally slows speech sounds down and then gradually speeds them up again so that children can learn to process them. For more information contact www.scientificlearning.com

8. Auditory Integration Training. Some children with autism experience hyperacute (painful) hearing. This does not have to do with deafness at all, rather the sounds are heard at distorted pitches which causes pain for the child. Some children build their hands over their ears. Auditory Integration Training attempts to address this.

Those are eight of the best therapies for children with autism. Hopefully one approach if not some combination of approaches will produce improvement for a child over time.

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Since autism is extremely multifaceted, its very definition is often misunderstood. So, what is autism? Basically, autism is a collection of brain disorders. Those who have it suffer from impaired speech, restricted interests, a delay in social skills, and sometimes a development of self-stimulating behaviors. Actually, the severity varies so widely among those diagnosed that autism is only one of five separate conditions, known as the Autism Spectrum Disorders. Boys are four times as likely to be diagnosed with autism as girls, although girls with autism tend to have more severe cases (Quinn 6-7).

Another common disorder on the Autism Spectrum is Asperger Syndrome. Asperger’s is a milder form of autism, sometimes called “high-functioning autism.” Those with Asperger’s may have an incredibly large vocabulary and are able to speak very well. However, they seem unable to fully grasp the give-and-take nature of conversation, and which leaves their social and communicational skills very lacking. They are often very literal, much like those with classic autistic disorder (Quinn 11).

Both Rett Syndrome and Childhood Disintegrative Disorder are very rare. Rett Syndrome is found almost exclusively in girls, and while it shares many symptoms with autism, it is actually a nervous system disorder. The first noticeable symptom of Rett Syndrome is hypotonia, which is a loss of muscle tone. It sometimes proves to be fatal, although years of developments have decreased this risk (Quinn 17). Childhood Disintegrative Disorder, or CDD, is very similar to autism, although the pattern of onset, course, and outcome are very different. Eventually the child’s condition will resemble autism, but first he or she will go through an extensive loss of motor skills, and the decrease in vocabulary is far worse with CDD than with regressive cases of autism. Children with CDD usually have very low IQs and are mostly unable to care for themselves (Quinn 19-20).

Pervasive Developmental Disorder’”Not Otherwise Specified (PDD-NOS) is the most commonly diagnosed condition within the Autism Spectrum Disorders, and it is sometimes called “atypical autism”. Those with PDD-NOS have great difficulties with speech, gestures, and eye contact. They also have problems with play and social interaction, but are decidedly too social to be considered totally autistic (Quinn 15).

These conditions are not to be confused with Sensory Processing Disorder. Those with SPD may have some symptoms similar to autism, but these symptoms are attributed to the brain’s inability to process sensory information (Wallis 62). Another common misconception is that all people with autism also have savant syndrome. A savant, as defined by Robledo, is “a person who possesses enormous intellectual abilities or talents even as they try to manage a disability.” Only ten percent of autistic people also have savant syndrome (Robledo 12).

What causes autism? It seems as though there have always been cases of autism, though it was not until 1943 when Professor Leo Kenner’s paper was published that autism was thought of as a disorder definite from various conditions of mental retardation. The first recorded case of autism appears to be a boy named Victor the “Wild Boy of Aveyron” in 1799 (Wing 16-17). Still, the cause or causes of autism are yet to be determined. A recent study states that, “Scientists have discovered the strongest link yet between specific chromosomal abnormalities and an increased risk of autism.” However, the abnormalities could only be linked to 1% of autism cases with certainty (Arnst 4). It is also suggested that while autism may have some causes related to genetics, it is very unlikely that autism is caused by purely genetic abnormalities (Tinbergen 116). In fact, some say that strong genetic components, along with many metabolic, environmental, and immunologic factors could be the culprits (eMedicineHealth 1).

The symptoms of autism, if one knows what to observe for, are fairly recognizable. Communication delays are the most commonly recognized characteristic of autism. Those with autism do not impartial have problems with language, but they also seem to be unable to understand the process of communication at all. They do not realize that there are other ways to ask for support and convey their needs other than screaming and crying. They have disaster making eye contact and nonverbal gestures such as nodding or waving (Stone 14). Children with autism have difficulty speaking, if they do at all. They can sometimes imitate others perfectly, but when attempting to express themselves, their pronunciation becomes very poor. They may confuse similar sounding words or consonants, and they may have a mechanical, toneless sound to their grunt. Still others may effect emphasis in the wrong places. Wing says, “Normal people spend many more words than are strictly necessary, while autistic children are more economical.” (Fly 32-33)

While some children with autism never speak or have erratic speech patterns, others develop echolalia. Children who suffer from echolalia will repeat all or fragment of a phrase spoken by another person, sometimes right after they hear it. Other times, in what is called “delayed echolalia,” they will repeat these phrases days, weeks, or even months after hearing them, usually without understanding what they are saying. Occasionally they will echo if they can understand, but are unable to use the proper grammar to formulate a response (Koegel 39).

Children with autism also have difficulty initiating social interactions, as well as responding to them. They may not pay attention or respond at all to others who smile, call their name, or wave goodbye. They may not participate in turn-taking games or show interest in other children (Stone 12-13). Children with autism generally do not show a great deal of empathy in their interactions, which may lead others to believe they are not paying attention to what is being said. However, they can be taught to make empathic responses, so that the person they are speaking with realizes that they are, in face, interested in what they have to say (Koegel 158). Autistic children are also unable to read faces for information, a technique that is called “social referencing” (Cohen 35-36).

Often, children with autism have problems with disruptive behavior and aggression. This usually occurs for one of two reasons: either the child is attempting to communicate but does not know how, or the disruptive behavior is actually a self-stimulatory one. As for the former case, it has been found that 75-85% of disruptive behaviors occur because the child is trying to communicate. Either way, children with autism are highly unlikely to cause a scene or afflict themselves for no reason (Koegel 102-103).

The other definitive symptoms of autism are restricted interests and self-stimulatory behaviors. Those with autism have very rigid thinking patterns, and may not play with a variety of toys, use toys how they are designed to be used, arrange toys how they are meant to be arranged, show functional play or create play sequences (Stone 16-17). Self-stimulatory behaviors, or stims, are repetitive and seemingly pointless behaviors that children with autism often engage in for various reasons. Some view stims as obsessive-compulsive behaviors, while others believe that autistic children are unable to get stimulation from other people, so they create it themselves. Popular examples include rocking, flapping of hands, waving of fingers, tapping, humming, and singing. While these stims may be irritating and socially stigmatizing, they are relatively harmless. Children with autism can, however, learn to curb the urges to stim and may even learn to redirect those urges into more appropriate activities, usually a more socially acceptable variation of the fresh stim (Koegel 113-114).

In some cases, children with autism suffer from hypo- or hypersensitivities. These include tactile dysfunction, which is the hyper- or hyposensitivity to touch or sensation. This means that children may either be incredibly sensitive to touch, or their senses may be dulled to a point where they barely feel much at all. Others suffer from proprioceptive dysfunction, which interferes with the body’s ability to know where our body parts are in relation to one another. This keeps autistic children from moving fluidly and naturally, and may cause them to constantly invade the personal space of others. Some autistic kids may suffer from vestibular dysfunction, which interferes with the body’s equilibrium and sense of balance. Children with vestibular dysfunction may either constantly feel unsteady. On the other hand, if this system is underdeveloped, they may feel the need to twirl around either to gain a sense of balance or because they never feel dizzy (Robledo 38-39). Many children suffer from hyper- or hyposensitive hearing, sight, and smell.

Living with autism is difficult for everyone involved. Many accounts from autistic people seem to boil down to one thing: fear. The autistic child constantly fears saying and doing the wrong things, undoing all of his or her progress, and the world itself. Change is the enemy (Cohen 22-23). Parents of autistic children often waver between sadness and hope, disappointment and perseverance, which are perfectly natural things to feel. However, autism is not a death sentence, and it must not be treated that way. Parents are urged to have an emotional outlet in this time of crisis (Robledo 44-45). Siblings of autistic children have varying reactions to the diagnosis. Their responses are based on several factors, such as the severity of the diagnosis, their own personalities, and the attitudes of their parents. They will often receive less attention, and personal possessions may be destroyed in the wake of a fit of aggression by an autistic sibling. Some may even worry about their bear potential for autism, and still some may flourish, and even indulge in helping their handicapped brother or sister (Wing 148-149).

Autism is considered a devastating disorder by many, and so it is only natural that a parent may want to wait on treatment, hoping that their child is only going through a phase. However, waiting will not change the diagnosis; it will only prevent the child from receiving early intervention (Quinn 60-61). Screening tools are available to pediatricians to test for autism. These tools evaluate the child’s skill development in relation to their age in what is essentially a check list containing certain abilities and behaviors (Quinn 46-47). The Checklist for Autism in Toddlers (CHAT), the Modified Checklist for Autism in Toddlers (M-CHAT), and the Screening Tool for Autism in Two-Year-Olds (STAT) are a few tools used to test children for autism (Quinn 48-49).

There are many kinds of interventions and therapies available for autistic children. It is suggested that children receive thirty to forty hours a week, in-house and pre-school, of one-on-one therapy. It is also recommended by some that parents implement an Individualized Education Program (Arranga 1).

To enhance speech development, some therapies allow children to slowly build up a vocabulary of fifty words or more using modeling and positive reinforcement, and then learn to string the words together to form short phrases, such as “no lettuce” and “more Elmo” (Koegel 51). Replacement behaviors must be taught in order to teach the child the appropriate response to an action, because once they can communicate properly, they will no longer have to revert back to the disruptive behaviors caused by frustration or inability to express themselves (Koegel 89-90).

One of the most popular and arguably most effective programs of intervention is called Applied Behavioral Analysis (ABA). ABA works on the theory that appropriate behaviors that are rewarded are more likely to be repeated than the inappropriate behaviors that are ignored or punished (Quinn 84-85). Sensory Integration therapies are also available. Art and music therapies have been known to be very helpful in improving sensory integration as well. Both can provide auditory, visual, and tactile stimulation, and through these therapies children can improve their hand-eye coordination, language comprehension, and focus. Animal therapies are conventional to focus a child’s attention and better their ability to listen and learn (Quinn 97-98).

There are no prescription medications specifically for autism, but antiseizure medications have been proven effective in treating behavioral problems in autistic patients (Quinn 107). Most dietary interventions are based on the idea that either food allergies cause the symptoms of autism, or that autism is caused by a deficiency of a specific vitamin or mineral. Both are unproven theories. Diets include gluten-free casein-free diets, dietary supplements, and dietary yeast control (Quinn 121-122). However, these are not recommended, nor are any other unproven treatments on the market. Most unproven treatments prove to be expensive, time consuming, and very disappointing (Quinn 116-117).

In truth, for all the information available to the public, there is very little known about autism. The causes still elude researchers today, and treatment options are few and far between. Nevertheless, scientists are working every day to catch clues for this highly complex disorder, in hopes of one day finding a cure.

Works Cited

Arnst, Catherine. “Chromosomal Abnormality Linked to Autism.” Business Week Online January 2008: 4.

Arranga, Ed. National Autism Association. 30 January 2008
.

Cohen, Shirley. Targeting Autism. Berkely: U of California P, 1998. eMedicineHealth. 30 January 2008

Koegel, Lynn Kern. Overcoming Autism. London: Penguin, 2004.

Quinn, Campion. 100 Questions and Answers About Autism. Sudbury: Jones, 2006.

Robledo, S. Jhoanna. The Autism Book. New York: Penguin, 2005.

Stone, Wendy L. Does My Child Have Autism? San Francisco: Jossey, 2006.

Tinbergen, Niko. ‘Autistic’ Children. London: Allen, 1983.

Wallis, Claudia. “Is This Disorder For Real? ” Time December 2007: 62-66.

Fly, Lorna. Autistic Children: A Guide for Parents and Professionals. Unique York: Brunner, 1985.

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The altar sits exactly in the center of the circle facing east, the direction of beginnings and of the rising sun. The altar should be covered with an altar cloth. The color depends on the type of spellwork you are performing. White and black are best and can be used for most any type of spellwork. A soilable altar cloth is best as you will likely be accidentally spilling things onto it such as oils, herbs, ashes, wine and candle wax.

The altar can be set up indoors or outdoors. A working altar for a circle is carefully put away when your working is done, unless it is out of doors. A decorative shrine type altar dedicated to one or more Gods or Goddesses can be set up anywhere and left up at all times.

the athame – a double-bladed knife, usually no longer than 9″ in length. This knife is the sacred ritual knife used in all Wiccan rituals. It is never used to cut anything on the material plane. If an athame has been used to slit something, a new athame must be sought. In the dwelling between the worlds, however, it can be used as a defensive tool. The knife must be virgin, meaning that it has never been used to cut anything. It must be cleansed and consecrated and as all other tools, must be stored in a soft, opaque cloth of either black or white. It is used to draw the magic circle and is used in many spells. This blade can be of any length, but for many Pagan practices, the handle must be black and the blade must be roughly as long as the hand.

dish of salt – represents the Earth and the Goddess. The salt is a symbol of purity and is broken-down to cleanse and consecrate objects. Placing objects in salt or in salt water under the fat moonlight cleanses and charges them. Salt, as a symbol of earth, is also a symbol of the mother or Goddess. For your altar, you will need a dish of sacred salt. Sacred salt must be cleansed and consecrated especially for use in your ritual. Any kind of salt can be used but most agree that sea salt is best.

goblet of wine – the libation. This can also be of juice if you do not drink alcohol. The libation is used in ritual when it is time to partake of the earth or in celebration. After ritual, the unused wine or juice is poured out over the earth as libation to the earth and its spirits. Any type of wine or juice can be used, preferably of grapes or apples.

goblet of water – symbol of water and of the Goddess. During ritual, salt is sprinkled into the water and taken into the body to symbolize the imbibing of the Goddess and her elements. The water is also archaic in cleansing rituals for tools and for the home and sacred space. The water on the altar must be consecrated holy water, for which you will find a recipe later in this website.

the wand – Many witches use wands to direct their power and focus it for use in one area. Wands are not entirely magickal by themselves. They must be used by someone who knows what they are doing. Most wands are made for general purpose, but you can find wands made specifically for certain task such as healing. Many witches argue over the desired length of a wand. If you are making your own it should be roughly the length of your forearm. Wands must be made by hand out of natural materials during a certain phase of the moon. Wands created during the full moon are infused with power.

While this can be very useful, the power is unruly and can easily procure out of hand if not dilapidated by a practiced magician. Wands that are made during the unique moon are like blank pages. The owner of the wand can infuse it with their own power, making it more predictable and easy to use. It is probably best to get a wand created during the unusual moon. Wands can be made from a variety of natural materials. According to Bried Foxsong, there are two types of wands stemming from two different traditions: the metal wands represent the South and the element fire. These are broken-down for ceremonial magick, controlling spirits, and conducting energy. Wooden wands are associated with the East and with air. They are used for natural magick and to tune into and utilize the surrounding natural forces.

“Traditionally,” says Foxsong, “most all-purpose wands are made from willow or hazel.” Copper is highly conductive and is commonly used to create powerful wands. Other conductive metals can also be used, gold being the second strongest and silver being the most conductive metal for use. These metals are often too costly to use in creating a wand. Gold or silver wire wrapped around a wooden wand can be quite powerful, however. Wooden wands befriend in nature magick and bring the force of life into your working. Certain woods, such as yew create very powerful wands. Branches that grow twining around each other pack an extra punch and are highly sought after. An ideal wand is on of twisted yew or other wood wrapped in silver wire and adorned with the proper gemstones.

Gemstones are not significant for wands, but most witches add them for added strength or other specific purposes. If you are creating a healing wand, you may want to incorporate healing stones, such as rose quartz. Most wands are tipped with quartz crystal. A popular create is a wand with a sure crystal sphere at one ruin and a quartz crystal point at the other. Safe stones for any wand are quartz crystals and amber gemstones. Wands are always held in the power hand. If there is a crystal point, it should be at the ruin farthest from you. Always use your wand pointing in the same direction. Do not alternate using different ends as the tip.

Ceremonial wands are often plain. Women’s wands are tipped with a crescent moon (often incorporating a crystal) and men’s wands are tipped with a pinecone. After a wand is made or purchased, it should be cleaned with all four elements n a cleansing ritual and left for one night under the light of a elephantine moon. Wands are easily charged by practicing with them. Practice sending your energy through the wand. Hold the base wit your sending hand and hold the tip with your receiving hand. Practice sending power out of your lawful hand, through the wand and into your left hand, wait on into your body. Wands are a masculine symbol and a representation of the element air and of the God. They are extinct for directing power, greeting, and as a symbol of the God. They can be used as a tool in ritual in position of the athame, sword or hand.

Making a wand: Wands can be made from felled tree branches or cut from trees. You may wish to make your wand out of a specific type of tree. Research the trees that are found in your area and learn what they look like. Try to remember if you have seen any of that type of tree around in your yard or in the park. Decide what type of wood you want for your wand and go look for it. Here is a short list of some properties of woods commonly used for wands:
Apple – wealth, money, care for, fertility
Ash – healing
Birch – cleansing, new beginnings, dawn, purity
Elder – Witchcraft, banishment, magical art, waters of life
Hawthorn – protection, fairy magick, wishes
Hazel – divination and wisdom
Holly – Holiness, consecration, material glean, physical revenge, beauty. strength, will to survive
Oak – power, strength, protection
Pine – Strength, life and immortality, rejuvenation
Rowan – protection, magick
Willow – Moon magic, psychic energy, healing, inspiration, fertility

If you chop a branch from a tree, you must be sure to ask the tree first. If you get a bad feeling when you take hold of the branch ten it is not for you and you must move on. Thank the tree after you have removed the branch that you want and leave some fertilizer late.

Prepare your wand any way that feels right to you. You may wish to sand it down and give it a nice silky sheen. If you remove the bark, coat your branch with some fine beeswax or linseed oil to protect it. Decorating your wand is very personal and may be a minute difficult. Do only what appeals to you and increases the power of your wand. Many witches inscribe their wands with symbols, runes, or spells stating exactly what the wand is to do. These can be inscribed with a knife, carving tool, wood burner or with paint. You can attach a crystal or other symbol to the tip of the wand. Metal wire or beads can also be used to decorate it – it’s entirely up to you. Just remember to keep the materials natural and, if you must use glue, use it sparingly. Bless and consecrate your wand after you have finished.

incense – symbol of air and fire. Symbol of the God. Incense is used in most spells. Later, you will learn which incenses to use for which spells and purposes. The smoke from the incense and candle flame are used along with water and salt in cleansing objects and sacred spaces. Make sure that you ONLY utilize stick incense or the preferred charcoal incense. NEVER use barbecue charcoal as it is hazardous and toxic to your spellwork. Only use the charcoal disks made especially for incense. To use this charcoal, purchase an incense burner which has a long foot or one which hangs. The burner will get very hot very quickly and you will need something to carry it with. Plot the disk of charcoal in the center and light it. You will know it has been lit because it will turn a limited grey all over very quickly. It should not occupy a flame. Place your herbs (dry or moist) on the charcoal and allow it to smoke. You will have to replace more herbs every once and awhile. Only use a little bit of the incense if you are working indoors.

incense burner or censer – The censer can be of any size and shape and can be made of most any material except wood, but must have feet on it or chains with which to hang it so that the heat of the burning incense does not reach the altar.

cauldron – symbol of water and rebirth as well as the womb Goddess. This tool can also symbolize death and the return to the earth as well as birth from the earth. Symbol of fertility and harvest. Used in many rituals and for scrying which you will learn about in a later lesson. This tool is unique as it is often used to decorate the home, much like the broom and is often left in a place where it will be seen.

the pentacle – symbol of earth, used in consecration and is the most important tool. The pentacle should be a tile of sorts that sits flat in the center of the altar. It can be made of any material (except probably iron as some believe that cold iron is not permitting to spellwork). Usually they are made from wood or ceramic and is about five to seven inches in diameter. You can make your own by painting a pentacle onto a tile or round disk of wood. They can also be drawn on fabric, such as a placemat. This symbol of the five elements represents all that is sacred and is always used in ritual to consecrate objects. This item should be wrapped up and stored away safely when not in use.

altar cloth – cloth draped over the altar. It can be of any color, but it is best to use colors that coincide with your working. A white altar cloth is best as it reflects all colors. Black altar cloths are most approved and absorb all colors.

statues and pictures of deities – if you choose to work with deities, then you may want to attach statues, pictures or icons of your deities (or angels or Jesus if you are a Christian witch) on the altar to help invoke them in your spellwork or rituals. These are not necessary, but are popular. This practice is popular in all religions and is traditional even today in voodoo.

illumination candles – one on either side of the altar is good. They should be white, but can be colored to suit your spell requirements. These candles are only for supplying light in darkness and should not be in the way of what you are doing.

burning dish – this is required in some spells for the burning of papers, wishes, questions and spells. It should have some sort of foot so that no heat reaches the altar. The dish can be made of any material so long as it is not flammable and can be shaped like a bowl or a plate.

silver bell - a silver bell is used to call the quarters and is also necessary in some spells. Many stores will sell cheaper bells of brass, but the bell should be made of silver. If a silver bell cannot be obtained then it is acceptable to use a bell of brass. It is a standard ritual tool, but is not mandatory. Ritual can be done without using a bell. The bell is used to call sure spirits and deities or to begin and end spells and prayers (much like an “amen”).

sword – this tool is also not absolutely necessary. It can retract the place of the athame and the wand in some cases such as drawing the magic circle or be used in defense while in the astral realm. I have never used a sword in any of my rituals and many people find them too cumbersome or expensive.

boline – this is a sickle-shaped curved-bladed knife with a white handle. The boline was a tool passe by ancient Druids for ritual. Today, we use the boline for making sacred cuttings. Because the athame cannot be used to cut materials on the physical plane, we use the boline instead. This tool is mostly used for cutting herbs and other plants for magical purposes. The crescent shape is symbolic of the moon and the color of the handle is symbolic of purity. A boline does not have to be crescent-shaped. It can be any puny knife with a white handle.

To learn more about Wicca and other Pagan beliefs and practices, check out my website at Witch-Crafted.com

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MR is defined in children as three components that assess intellectual functioning, functional strengths and weaknesses, and age at time of diagnosis. Intellectual functioning is measured by the intelligence quotient (IQ), which is found to be 70-75 or below. Deficits in functional behaviors are defined by strength and weaknesses in 10 different adaptive skill areas: communication, self care, home living, social skills leisure, health and safety, self direction, functional academics, functional use and work. Finally MR must be diagnosed by 18 years of age (Wong, Hockenberry-Eaton, 2005). 

Mild retardation (50-55 to 70 IQ) in the preschool child is not noticed as often by the casual observer, but is slower to walk, feed self, and talk. The school age child can glean practical skills, reading and arithmetic to a 3rd-6th grade level. As adults they can achieve social and vocational skills, may need occasional guidance and relieve when under social and economic stress. 

Moderate retardation (35-40 to 50 -55) in the preschool child has more noticeable motor delays especially in speech. The school age child can learn simple communication, elementary, health and safety habits and simple manual skills. This child has a mental age of 3 to 7. The adult can perform simple tasks, participate in simple recreation, and is usually incapable of self maintenance. 

Severe retardation (23-25 to 35-40 IQ) in the preschool child has marked delay in motore development, little or no communication skills and may respond to training in elemtary self care. The school age child usually walks barring specific disability, has some understanding of speech and achieves a mental age of a toddler. The adult can conform to dialy routines and repetitive activities, needs continuous direction and supervision. 

Profound retardation (below 20-25 IQ) in the preschool child has cross retardation, minimum capacity for functioning in sensorimotor areas and needs total care. The school age child has delays in all area of development, shows basic emotional responses, may respond to skillful training in utilize of legs, hands, and jaw. This child achieves a mental age of a young infant. The adult may fling, needs complete custodial care and has primitive speech (Wong, Hockenberry-Eaton, 2001). 

The change and increasing opportunities for children with MR have arrive about within the last 30 years. Many states now offer Early Intervention Programs (EIP) in the school system. The EIP accommodates special needs for children with MR from birth to three years of age; it also offers special classes to children between ages 3-5 years who have special needs (Donovan, Noreen, nurse at Wing Lake, 2004). These changes and opportunities have resulted because of the public law 94-142 (The Education for all Handicapped Children Act of 1975). This act was passed to provide free appropriate public education for all handicapped children from 3-21 years of age and to provide for supportive services that ensure the benefit of special education (Wong, Hockenberry-Eaton, 2001). This act also provides safeguards for parents of handicapped children when special education decisions are made by the schools. These safeguards ensure the rights of handicapped children are protected (Mitchell, Espin, 1990). 

Later the amendment to the Education of Handicapped Act of 1986 was passed to allow comprehensive community services to infants and toddlers with disabilities and their families. This law requires a timely comprehensive multidisciplinary evaluation including assessment activities related to the child and the child’s family (Fewell, 1991). In 1990 another amendment was passed (The Individual with Disabilities Educational Act). This act encouraged states to provide educational opportunities for all children with disabilities from birth to 21 years of age. All these changes led to changes in trends which include; family centered care (the family is the constant in the child’s life), normalization (child and family live their life as normal as possible), mainstreaming (to integrate children with special needs into regular classrooms) (Wong,Hockenberry-Eaton, 2001). 

Personal attitudes, beliefs and feelings regarding children with MR can affect care provided to the child. It was once believed that children with MR were better off in institutions ti be forgotten about. They were treated as outcasts, seen as different and many people were afraid of children with MR. This affected the care given. Now they receive the services, assessment and treatments that lead to better education (Wong, Hockenberry-Eaton, 2001) 

There are many that make up the multidisciplinary team responsible for people with MR. This team consists of a physical therapist, occupational therapist, social worker, the educational teacher, the family and the nurse. This team working together provides the student with their gain “Individualized Education Plan”. There are yearly team meetings that allow this team to share information insights, perspectives and concerns about the student. Nurses in these programs develop care plans, pass medication, and make clear the overall wellbeing of the child is being met (Donovan, nurse at Fly Lake, 2004). Also the nurse is keen in programs in which ways to prevent MR are discussed. There are social and environmental factors that are preventable which can cause MR. These factors are poor nutrition, cigarette smoking, chemical abuse, terrible parental care, and lead poising. Major interventions regarding educating the mother of he dangers of alcohol use. Other indispensable preventions that play a role are genetic counseling and prenatal screening, especially regarding Downs Syndrome or Fragile X syndrome. The use of folic acid supplements during pregnancy to decrease neaural tube defects, optimal medical care of high risk newborns, and rubella immunizations. Newborn screening for treatable inborn errors of metabolism such as congenital hypothyroidism, phenyketonuria, galactosemia, and early appropriate therapies and rehabilitation services for children with developmental disability can help in prevention (Wong, Hockenberry-Eaton, 2001). 

The students at Wing Lake Developmental Center attend for educational programs. The program at this center is set up to teach many skills of daily living and self care as possible. Each child has their have Individual Education Plan specifically written to meet that child’s needs. The educational team evaluates the student’s abilities in areas of fine motor, gross motor, socialization and self care skills. Evaluations are done on the student’s birthday each year and then a complete evaluation is done every 3 years. Fly Lake provides these education programs for severe mental impairments (SCI) and severe multiple impairments (SXI) for students from birth to 25 years of age. 

In order to provide better outcome and enhance IEP ( individualized education concept), the nurse is required to use strategies adapted to the needs of the individual and family, as evidence by: nurse has to be sensitive to cultural nuances of role, touch, and space. Consider child’s safety, security, family preference, privacy, and equipment on which child is dependent. Have available a supply of toys that are colorful, nonbreakable, easily cleaned, and that have no removable parts. Be direct, confident, and positive in approach. Effect and maintain trust. Explain clearly and simply what will be done. Keep child in position of comfort. Use smooth, efficient movement. Incorporate play and games. Proceed in an orderly, unrushed manner. CC is a nineteen-year old student in an adult SXI program at Cruise Lake Developmental Center. She is at the developmental age of 6 month. CC was born May 11th 1986. Her medical diagnosis is Rett Syndrom and seizure disorder. Her weight at present time 149.4 lb and height 5 ft 51/2in. Her present medication is Depakene liquid 4 tsp (250 mg /5ml) bid and Keppra 250mg ½ tablet daily every pm. By approximately age 3 years, CC loss of her previously acquired skills. Purposeful expend of the hand has been lost as well as mosts spoken language, such as previously learned words or word combinations. Cass (2003) states that “the regression is characterized by deterioration in babble or speech and functional hand use, social withdrawal, unexplained screaming, and sleep disturbance” (p.325). CC has a history of fractures and sprains to both upper and lower extremities including: fracture to right foot 10/91, fractured left ankle 12/91 and fractured left hip 6/95. She is monitored closely both at home and school to avoid any injury to her extremities. CC lives at home with her mom and dad. On May 28th student is alert, eyes open spontaneously, oriented-incomprehensible sounds, using vocalizations, facial expressions, recognizes her name, familiar people and familiar objects in her immediate environment (spoon, plate, straw).Compliance with assistance with scream to move body part (rolling on the changing table). Invent autistic-like behaviors. Eye contact and attention span very limited. Psychosocial Development Trust versus Mistrust) stage. 

Development of sense of trust with primary caretaker. Socialization behavior : Prefers caretaker figures to other adults. ”Freezes” in presence of strangers (time for diaper change).Hearing and vision are functional. No wearing glasses or using hearing help. Continue informal hearing and vision screening outlined by the Oakland County Health Department. Mouth condition is good. Mucous membrane pink and moist. CC eats a regular school lunch and is able to chew, tolerate different texture of food. Language development: Makes vowel-like sounds. Smiles in response to adult speech. At this time speech therapy is discontinued because of the decline in verbal participation. Horrible Motor Development: can sit for long periods with firm support. Rolls from back to side and from side to back with assistance. Fine Motor Development: CC requires assistance with scooping her food but is able to bring the spoon to her mouth independently. CC is also able to drink independently with a straw. CC participates in grooming activities such as face and hand washing. CC required assistance for all ADL. CC makes purposeful attempts to grab objects and able to maintain objects in both hands (spoon).Conscious control of the hands and fingers is gradually replaced by uncontrolled, stereotypic movements. No ability to consciously coordinate purposeful movements (apraxia). CC is receiving physical therapy with emphasis upon activities to believe ROM and gross motor skills. CC sits up in a “Gillette seating chair” especially made for her. It has special chest, arm and leg straps which holds her in. She has minimal participation with activities. CC enjoys music and being read to most of the day. CC respirations and heart rate are within normal limits, and there are no coughs, Wheezes or abnormal breathing sounds heard with interaction. CC skin is white/pink in appearance and is warm to the touch. CC continues to experience ongoing swelling in both feet with the left foot more swollen than the lawful. Left foot is very dry with black color scab region 0.5 cm in diameter noted. Her primary care doctor is aware of these problems. No itching in, inflammation, tearing, bleeding is noted. CC is incontinent to bowel and bladder. CC is wearing briefs. No abdominal distention, ascites, herniation, lesion is noted. Urine is light amber color .No odor noted. 

At risk for injury R/T uncontrolled movements during seizure (Ackley, 2005). NOC: The student will remain free from any injury from seizure activity throughout the day. The teacher and facility will identify symptoms that indicate risk for injury from seizure every day. NIC: Seizure Precaution and Management: 1. The teacher will remove potentially harmful objects from the environment during the day.2. The facility will have oxygen and suctioning equipment in the room during the day.3. The teacher will discontinue with child during seizure reorient when awake, and allow to rest or sleep after seizure. 4.The teacher will maintain sidelying region with chair padded and provide gentle support to head and arms if harm might result during seizure.5. The teacher will assess skin for color (pallor, flushed or cyanosis), respiratory rate, depth, and for sign of distress.( Provides information about possible obstruction or aspiration of secretion if seizures are prolonged and affect ventilation.) The nurse will administer and evaluate anticonvulsant medication. Diastat rectal gel 10 mg is to be administered prn for seizure activity lasting fifteen minutes or longer. The student was strapped in her chair with proper padding when the tray was not in place,all sharp objects were locked away in closet, and there was always room between each student so the teacher can cease close to the child all the time. 

At risk for injury R/T cognitive and sensory disability (Ackley, 2005).NOC: The student will remain free from any injury throughout the day. The teacher will utilize adequate lighting throughout the day. The teacher and facility will identify symptoms that indicate risks for injury every day. The teacher and faculty will use healthcare services congruent with the needs of the student every day (use of the nurse). NIC: Environmental Management: safety: 1. Identify needs of student, based on level of physical and cognitive function and history of behavior (motor skills, communication, ADL’s, sensory or hearing level).2. Identify safety hazards in the environment (all chemicals locked in closet, clutter removed and put away, sharp objects locked away, distance between each student).3. Use protective devices (straps to keep student secured in chair, trays to help glean student in chair, proper padding in the chair. The student was strapped in her chair when the tray was not in place all chemicals and sharp objects were locked away in closets, and there was always room between each student so no one got hit another students swinging arm. 

At risk for impaired skin integrity R/T mechanical forces(shearing forces, pressure, restraint), decreased physical mobility (Ackley,2005). NOC: Risk Detection: The teaching faculty and nurse will sight symptoms that exhibit risks (restraints, pressure, moist skin from secretions, red areas that are not blanchable). The teaching faculty and nurse will perform examination of skin every 2 hours. The teaching faculty and nurse will use health care services congruent with needs every day .NIC: Skin Surveillance: 1. Observe extremities for color, warmth, swelling, pulses, texture, edema, and ulcerations every day and every 2 hours.2. Monitor skin for areas of redness and breakdown every day and every 2 hours. 3. Monitor for sources of pressure and friction every day. 4. Monitor skin for excessive dryness or moistness every day. 5. Declare family member, caregiver about signs of skin breakdown ( non blanchable redness, infection to a site, open areas to skin, swelling, drainage from an furious area). The restraints were removed during the day and legs were rubbed. Proper repositioning was not always done, because the student had to remain in her chair all day. During diaper changes skin was examined quickly.
Impaired social interaction R/T communication barriers, AEB: inability to order more than one word (Ackley, 2005). NOC: Social Involvement: The student will interact with neighbors every day using non verbal interaction. The student will interact with family members every day using nonverbal interaction. The student will participate in organized activities every day. NIC: Socialization Enhancement: 1. Help student to increase awareness in communicating with others.2.Encourage social activiyies.3. Encourage involvement in unique activities.4.Give positive feedback. The student sometimes demonstrates socialization: she would participate in all group activities with help. 

Self-care deficit R/T impaired ability to perform ADL, AEB: immobility, no functional hand use (Ackley, 2005). NOC: Self –Care: The student will maximize self-care capability with use of aids. NIC: Self care Assistance: 1. Balance activities with rest as needed every day.2. Place needed articles within reach during activities 3. Provide assistive aids or devices to perform ADL, allow choices when possible. ( washing hands in the basin, hold the colm, special spoon). The student sometimes demonstrates self care: she would participate in self feeding activities: scooping her food, bringing the spoon to her mouth independently. 

The experience for the student nurse at Wing Lake was enthralling. Although it was challenging and heartening, the student nurse received a better understanding of children with cognitive impairment. This experience will help during the care of children by being able to see the differences that each child has and the student nurse will feel more comfortable when the care for a cognitively impaired patient arrives. 

Reference

Ackley, E., Ludwig., (2005). Nursing Diagnosis Handbook (6th ed.) St. Louis: C.V. Mosby

Cass, H., Reilly, S., Owen, L., Wisbeach, A., (2003). Finding from a multidisciplinary clinical case series of females with Rett syndrome. Developmental Medicine and Child Neurology 45,( 5), 325.

Mount, R. (2003). Features of Autism in Rett Rett Syndrome and Severe Mental Retardation. Journal of Autism and Developmental Disorders, 33, (4), 435-441.

Wong, D., Hockenberry-Eaton, M., (2005) Essentials of Pediatric Nursing. (6th ed.) St Louis.
C.V. Mosby.

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