Thursday, February 16, 2017

--People with attention-deficit hyperactivity disorder have distinct differences in their brain structure, a new study finds, suggesting the disorder should be considered a neurological condition and not simply a behavioural problem.-------The researchers found those with ADHD had smaller brain volume in five subcortical regions, as well as an overall smaller brain volume. The phenomenon was greatest in children and less notable in adults. The most noteworthy findings relate to the smaller amygdala and hippocampus in patients with ADHD, as those regions haven't previously been conclusively linked to the disorder.--------"Both of those brain regions are associated with emotional processing. And those types of emotional symptoms [such as impulsivity] are very common in ADHD, but aren't given as much attention or focus as the cognitive symptoms that we see in the disorder," says Dr. Jonathan Posner, an associate professor of psychiatry at New York's Columbia University Medical Center.----------Now that we have scientific proof of the anatomical differences of children with ADHD we should be considering coding for these children in the education system. For far too long children with neurodevelopmental disorders like ADHD and Auditory Processing disorder have been disregarded and their difficulties trivialised. The problems with such neurodevelopmental disorders are real but without proper education coding and money applied to supporting these children we will have adults with difficulties as well as anxiety problems. We can do better in Alberta. We should do better. So far I have yet to receive any information from Alberta Education on even the small matter of how the heck they are diagnosing kids with auditory processing disorder when AHS is not doing auditory assessments on these kids. How can such children be diagnosed if auditory assessments are not being done? And where are the auditory processing disorder guidelines at Alberta Education? No response from Alberta Education to my e-mail; there needs to be action taken by the GOA. We need diagnostic requirements, guidelines, and coding in place. When will the GOA take action for our children with neurodevelopmental disorders? I'd say when we all yap endlessly about this matter.



http://www.cbc.ca/news/health/adhd-brain-structures-1.3983919

Children with ADHD have some smaller brain regions, study shows

Researchers suggest disorder should be considered a neurological condition and not simply a behavioural one

By Vik Adhopia, CBC News Posted: Feb 16, 2017 5:00 AM ET Last Updated: Feb 16, 2017 9:38 AM ET
Study finds more evidence children with ADHD have abnormalities in brain structures.
Study finds more evidence children with ADHD have abnormalities in brain structures. (Laura Meader/CBC)
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Vik Adhopia
Vik Adhopia is a senior reporter with the Health Unit at CBC News. He joined CBC National Radio News in Toronto in 1995 and then began his coast-to-coast-to-coast journalistic odyssey, reporting from Iqaluit, Prince George, B.C., Vancouver, St. John's, N.L., and finally back to Toronto again.

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People with attention-deficit hyperactivity disorder have distinct differences in their brain structure, a new study finds, suggesting the disorder should be considered a neurological condition and not simply a behavioural problem.

The research — published Wednesday in Lancet Psychiatry — was described by its authors as the largest-ever review of ADHD patient brain scans.
The scientists evaluated MRI scans and other data from more than 3,200 people, comparing 1,713 patients who had been diagnosed with ADHD to a control group. The patients ranged in age from four to 63.
'It is a bit distressing that kids are still getting feedback that they are misbehaving or that [ADHD] is not real.'- Dr. Evdokia Anagnostou, pediatric neurologist
The researchers found those with ADHD had smaller brain volume in five subcortical regions, as well as an overall smaller brain volume.
The phenomenon was greatest in children and less notable in adults.
The most noteworthy findings relate to the smaller amygdala and hippocampus in patients with ADHD, as those regions haven't previously been conclusively linked to the disorder.
"Both of those brain regions are associated with emotional processing. And those types of emotional symptoms [such as impulsivity] are very common in ADHD, but aren't given as much attention or focus as the cognitive symptoms that we see in the disorder," says Dr. Jonathan Posner, an associate professor of psychiatry at New York's Columbia University Medical Center.
Michigan Daily Life
ADHD causes inattention, hyperactivity and impulsivity — and at least one in 20 children in Canada are estimated to have the disorder. (Jake May/Flint Journal/Associated Press)
Posner wasn't involved in the study, though he did publish a commentary in the same edition of Lancet Psychiatry based on the research.
The findings are important, he adds, because they verify the results of earlier studies considered too small to be conclusive.
And while the findings can't conclude whether brain abnormality is a cause of ADHD or the result of it, Posner says they suggest the behavioural problems in children with ADHD are actually neurological.

'It is a bit distressing'

Toronto pediatric neurologist Dr. Evdokia Anagnostou agrees, saying she hopes this research will help dispel misconceptions about children with the disorder.
"It is a bit distressing that kids are still getting feedback that they are misbehaving or that [ADHD] is not real. If anything comes out of this very large study, it's that this is a brain disorder," she says.
Diagnoses of ADHD have become increasingly common — at least one in 20 children in Canada are estimated to have the disorder.
Still, the behavioural problems that accompany ADHD are often dismissed as "just lazy parenting, too much sugar, too many video games, undisciplined kids, lazy kids, et cetera," says Heidi Bernhardt, executive director of the Centre for ADHD Awareness Canada.
For those who live and work in the field, she says the study's findings could assist in erasing some of the stigma and misinformation surrounding the disorder.
As far as using MRIs or brain scans to diagnose ADHD, Posner says it's too early to consider that.
The research was conducted by the ENIGMA ADHD working group, a consortium of scientists from some of the world's most prestigious universities, hospitals and research institutes.



With files from Melanie Glanz
************************

Now that we have scientific proof of the anatomical differences of children with ADHD we should be considering coding for these children in the education system.
For far too long children with neurodevelopmental disorders like ADHD and Auditory Processing disorder have been disregarded and their difficulties trivialised. The problems with such neurodevelopmental disorders are real but without proper education coding and money applied to supporting these children we will have adults with difficulties as well as anxiety problems.
We can do better in Alberta.
We should do better.
So far I have yet to receive any information from Alberta Education on even the small matter of how the heck they are diagnosing kids with auditory processing disorder when AHS is not doing auditory assessments on these kids. How can such children be diagnosed if auditory assessments are not being done?  And where are the auditory processing disorder guidelines at Alberta Education?

No response from Alberta Education to my e-mail on January 15, 2017; there needs to be action taken by the GOA. We need diagnostic requirements, guidelines, and coding in place. When will the GOA take action for our children with neurodevelopmental disorders? I'd say when we all yap endlessly about this matter.


From: Julie Ali Date: Sun, Jan 15, 2017 at 1:50 PM
Subject: Auditory Processing Disorder Evaluation, Testing, Supports and Services in Alberta(ACR-419764)------Mother says school did 'absolutely nothing to help him'---
To: education.minister@gov.ab.ca, Edmonton Calder <edmonton.calder@assembly.ab.ca>, Office of the Premier <premier@gov.ab.ca>, edmonton whitemud <edmonton.whitemud@assembly.ab.ca>, "Danette Andersen, Supervisor" <danette.andersen@epsb.ca>, "Michael Janz, Chairman" <Michael.Janz@epsb.ca>, Cheryl.Johner@epsb.ca, Michelle.Draper@epsb.ca, Orville.Chubb@epsb.ca, Ray.Martin@epsb.ca, Ken.Gibson@epsb.ca, bridget.stirling@epsb.ca, Nathan.Ip@epsb.ca, Sherry.Adams@epsb.ca, info@ecsd.net, health.minister@gov.ab.ca, Health.Deputy-Minister@gov.ab.ca, jane.philpott@canada.ca, Bob Turner <Bob.Turner@assembly.ab.ca>, Matt.Jeneroux@parl.gc.ca


Dear Mr. Eggen,

Recently I wrote to the GOA (Alberta Connects) for specific information and was given a formula recipe response that does not answer my questions.
I therefore will direct my questions at you and the Premier of Alberta

As a parent of a child who was not diagnosed with ADHD, hypothyroidism and Auditory Processing Disorder by the Edmonton School system nor provided with supports until I complained to the then board chair Mr.Dave Colburn and the then Minister of Education, Mr. Dave Hancock,  I am concerned that the current testing protocols for determining auditory processing disorder (APD) are not adequate.

In my son's case, he got an auditory assessment to determine his condition very late in the day.
This auditory assessment was essential in order to diagnose his condition. 

Recently, I learned from AHS that there is currently no audiological assessment being done for APD.
What then is the test that is being done to diagnose APD?
Without an auditory assessment --how therefore will the school boards in Alberta determine if a child had APD? 

As it is there seems to be plenty of confusion in the school system about what a disability is. This lack of knowledge is astonishing. Parents have to be the ones to do the investigation and bring forth the diagnosis of APD to the school system. This is unacceptable. It is also not reasonable as per the requirements of Alberta Education and legislation for the disabled student. As you are fully aware the province has the legal responsibility to ensure that students with disabilities receive the supports and services they require to meet their full potential in the educational system. Failures to meet these requirements sets up the GOA for legal challenge and further pressures on the public purse in payouts. Recent lawsuits have affirmed the rights of students to receive safe and proper instruction as noted in this case where the family sued over bullying of their child. 

Ottawa student wins precedent-setting bullying case against school board

What is true for bullying is also true for failing to provide appropriate testing, supports and services to disabled students in the system. This includes both the education and health care system please note, as per the human rights legislation of Alberta. Hopefully families do not have to go to the human rights commission of Alberta or to the justice system to get the GOA to do its job with reference to the handicapped citizens of Alberta in both the education and health care systems.  


I encourage you to ensure that audiological assessment  is in place for diagnosis of APD. I also encourage you to ensure that testing is not difficult to obtain as it was for my son. Without testing, there are no allocations of cash and care in the system as you well know.

In my son's case there were the problems of accessing testing in the Edmonton School System that pinpointed the problems; it appears to me at least that the education system lacks knowledgeable personnel who are familiar with neurodevelopmental disorders. When delay occurs in the diagnosis these children are stigmatised as being lazy and incapable resulting in self image problems and anxiety disorders. With the onset of anxiety disorders there are further problems for the disabled student that have to be addressed by the Minister. Recently there has been public attention on the lack of mental health supports in the system that the Health Minister has yet to address in any coherent fashion. 

I would like to know simply from you if audiological assessments are being done for these children after initial psychological assessments and academic testing indicates that neurodevelopmental testing might be useful.

Can you provide also the generic decision making tree that Alberta Education has provided to ensure that such children are evaluated in a consistent and productive fashion?

Can you tell me what supports are available for children with APD in the school system?

I do not want to be fobbed off with generic responses of the sort I was given below.
As you may or may not know I am not allowed to ask the current school board these questions directly and so I am going to ask for the province wide strategy that is in place for the diagnosis of APD specifically.
While ADHD is diagnosed reliably there appears to be no consistent method of diagnosis of APD nor  any guidelines in place for supports and services other than the usual chatter of "Schools are expected to provide an educational program with addition supports and services for students who have been diagnosed with this category of learning disability."

As my son's case affirms this sort of responsive treatment of children is not in place according to our family's experiences and should be in place so that children are not missed in terms of their disability.

Sincerely,

Julie Ali




From: <AlbertaConnects@gov.ab.ca>
Date: Mon, Oct 31, 2016 at 2:06 PM
Subject: RE:Auditory Processing Disorder Evaluation, Testing, Supports and Services in Alberta(ACR-419764)
To:


**********please do not reply THIS EMAIL ADDRESS IS NOT MONITORED **********

Thank you for visiting the Alberta Government feedback web site. Following is the response to your question prepared by Education :

Thank you for your inquiry about educational programming for students who have been diagnosed with an auditory processing disorder. Schools are expected to provide an educational program with addition supports and services for students who have been diagnosed with this category of learning disability.

The school team, that includes the parent and when appropriate the student, are in the best position to determine the type and frequency of additional assessments to be performed by qualified professionals. When needed, a school can make a referral to its Regional Collaborative Services Team for assistance coordinating further assessments and/or diagnosis.

Thanks again for taking the time to write and for using Alberta Connects.

On 2016-10-25 20:38:00.0 you wrote:

Hi,




I recently found out that AHS is not doing Auditory Processing Testing for children through their
audiologists. I am interested in how parents will find out if their children have auditory processing
disorder in Alberta in the interim if they can't get their kids tested through the system.


If audiologists are not being used to identify children who have auditory processing disorder, this leaves
me frankly puzzled.
Who then-- is doing the determination for this disability in Alberta?
How is the disability being identified if audiology testing is not being done?




I asked this question of the Edmonton Public School Board folks and I have not received a response to
date.




Does Alberta Education have guidelines in place for testing for this disability and provision of
accommodations/supports and services for children with Auditory Processing Disorder? Why is this
disability not associated with a code to ensure that these children receive proper supports?




Since this disability appears to be difficult for the system to diagnose based on our experience as a
family in the past, I am curious how the system has evolved to meet its obligations to children with
auditory processing disorder. What test is being used? How is this disability reviewed on an ongoing
basis by the medical system as the child matures in the school system? How is the child prepared for
post secondary education?


I also note that parents of children with Auditory Processing Disorder are not informed of their ability
to request the Disability Tax Credit to help them for out of pocket expenses. This information should be
provided to parents on diagnosis by AHS. I only found out about my younger son's eligibility for the DTC
when we met with the advisor at SSD (Services for Students with Disabilities) at NAIT. This is far too late
to find out this information.


http://www.cra-arc.gc.ca/tx/ndvdls/sgmnts/dsblts/dtc/menu-eng.html


The disability tax credit (DTC) is a non-refundable tax credit that
helps persons with disabilities or their supporting persons reduce the
amount of income tax they may have to pay. An individual may claim
the disability amount once they are eligible for the DTC. This amount
includes a supplement for persons under 18 years of age at the end
of the year.


The purpose of the DTC is to provide for greater tax equity by allowing some relief for disability costs,
since these are unavoidable additional expenses that other taxpayers don’t have to face.


Being eligible for the DTC can open the door to other federal, provincial, or territorial programs such as
the registered disability savings plan, the working income tax benefit, and the child disability benefit.


******
It is important that diagnosis of this disability is not left too late as children develop anxiety disorders
trying to cope with their disability by themselves. I believe all children with Auditory Processing
Disorder need audiology as well as psychologist/ child psychiatrist support.


Sincerely,


Julie Ali


P.S.
I refer you to the Canadian Guidelines from Speech-Language and Audiology Canada for 2012. It
specifically indicates the need for audiology presence for these children.





http://www.metronews.ca/news/ottawa/2016/07/22/ottawa-student-wins-bullying-case-against-school-board.html

Ottawa student wins precedent-setting bullying case against school board

Winston Karam and his mom were awarded $3,000 by the court, marking the first time in North America a school board has been found negligent in a bullying case.

Vania and Winston Karam recently won a precedent-setting case against the public school board, after a judge found the board was negligent and breached the duty of care owed to a student when Winston was bullied at Broadview Public School.
MELISSA MURRAY/METROLAND MEDIA
Vania and Winston Karam recently won a precedent-setting case against the public school board, after a judge found the board was negligent and breached the duty of care owed to a student when Winston was bullied at Broadview Public School.
When Winston Karam got on the witness stand, his voice was finally heard.
“It was my first time in a courthouse, so I was nervous,” he said of the 2014 experience.
“I was very nervous since I’m not the best with speaking my mind and words, it was hard to talk about what happened.”
Winston told the judge in small claims court about the bullying he endured at Broadview Public School during the 2011-12 academic year.
He told the judge of being stolen from, shoved around, being put in a chokehold, being called the N-word, A--hole, alongside other insults. On one occasion, when Winston fought back and swore at his peers, he was the only one punished.
“I still said what I could – my truth, my story. It was a huge weight off my chest.”
It led to a precedent-setting case, filed against the public school board. After the initial small claims decision, an appeal and a retrial back in small claims court, a judge found the board was negligent and breached the duty of care owed to a student. The judgement came down on May 24 of this year.
Winston and his mother, Vania, were seeking costs for home schooling, self-defence classes and counselling.
The bullying came to a head in April 2012. After being pinched on the back of the neck, Winston suffered an anxiety attack. The school did not call an ambulance.
“I had kept a lot inside and it got too much for me,” Winston said of that day.
Mother says school did 'absolutely nothing to help him'
Winston had previously sought help from the principal on five or six occasions, and vice-principal and guidance counsellor two or three times to respond to the bullying.
“The school had plenty of policies on how to respond to bullying and Winston reached out for help after almost every incident, but they looked the other way and did absolutely nothing to help him,” Vania said.
According to court documents, the principal told Vania it was just roughhousing.
“It had been escalating and escalating,” Vania said. “He literally couldn’t take it anymore.”
After the panic attack, which was described as seizure like, they sought help from the school board.
When the bullying didn’t stop, Vania had her son home schooled.
Then when she picked up Winston’s report card at the end of the year, a comment caught her eye.
“The rules guiding peer relationships are inappropriate and need to be monitored and corrected. More positive dialogue and interaction between adults and Winston is needed."
Winston was also placed into a class with one of the bullies on the next year’s class list.
“I really felt like these people have no care at all for this. It was the final straw; I felt like I was pushed a bit into this lawsuit,” Vania said of the series of events.
The first trial took two days and 11 witnesses were called, including teachers, administrators, one of the bullies, Winston and Vania. They won, but the board appealed the decision. At the appeal, the judge ordered a retrial to determine the board’s duty of care and when it is breached.
The judge at the retrial, Honourable Rohan Bansie, accepted that Winston was bullied at the hands of two students and the board was liable for the inaction of school staff. Of note, Bansie found the school principal’s testimony to be "obtuse, rote and inconsistent,” which helped form his decision.
Vania spent about $51,000 throughout the three proceedings and in the end was awarded about $3,000.
“I didn’t do this for the money, I did this because it was too awful not to do something about,” Vania said of the entire process.
“My hope is that looking back in time, Winston can say in life sometimes you have to stand up for yourself and stand up for what’s right and my mom did that for me and … I came out of this stronger and better for it.”
Vania said Ottawa's police department has requested a copy of the judgment because of its implication for school resource officers.
“Going forward schools will have to pay attention because there will be financial ramifications,” Vania said, adding she and her son have gone through a lot since 2012, but are better for it.
“Winston’s case is not the only one. This is happening in every school, every classroom and hopefully it opens a dialogue and incites schools to do more and protect the victim.”
Vania and Winston are both still hoping for a written apology from the school board about its role in what happened.
Winston is now about two years away from going to university or college and for now, he’s considering the fire safety engineering program at Carleton University.
Though he didn’t have much success being heard within his school, the advice he gives others who are bullied is to be persistent.
“Try to make an effort to tell others, try to get it to stop,” he said.
“There are people who will listen to you, find those people. Get it off your chest and it gets a lot better.”
School board responds to court ruling
In a statement released on July 20, the public school board is highlighting its commitment to providing “safe and caring learning environments for all students.”
“Across the district, our schools are engaged in a number of initiatives to prevent bullying and discrimination,” the board statement reads. “We believe this work is making a difference.”
The statement says the court decision shows the need for continued growth in the area of bullying and discrimination.
“As a learning organization, we will be reviewing this decision in detail to help identify opportunities to improve our practice and provide further professional development.
“Unfortunately, we cannot undo this experience, but we can learn from it to better support all students and families.”
The Ottawa public school board's insurance provider, Ontario School Boards’ Insurance Exchange, represented the board at small claims court. The statement says the board has followed up with the provider to make sure the Karam family is paid “the pecuniary expenses as provided in the court decision.”





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http://www.sac-oac.ca/sites/default/files/resources/Canadian-Guidelines-on-Auditory-Processing-
Disorder-in-Children-and-Adults-English-2012.pdf








C A N A D I A N G U I D E L I N E S O N AU D I TO RY P R O C E S S I N G
D I S O R D E R I N C H I L D R E N A N D A D U LT S :
ASSESSMENT AND INTERVENTION
December 2012












However,at the school level, speech-language pathologists and educational audiologists need to be
primary point people for these students. The involvement of educational audiologists is crucial where
assistive listening devices, particularly personal listening devices (which are a form of personal
amplification), are provided. Ng, Fernandez, Buckrell and Gregory (2010), for example, describe a
local service delivery model which provides a well-documented process for the evaluation of student
needs, and trial of assistive listening device if appropriate, incorporating information from many
sources, and which provides a clear, consistent and transparent process for parents.




The Alberta feedback site is constantly updated to provide you with important information about Alberta programs and services. We invite you to visit us soon. Your Alberta, a new e-newsletter from the Government of Alberta, will keep you up-to- date on the province’s latest projects and plans.

To sign-up, visit http://www.alberta.ca/contact.cfm

Internet www.Alberta.ca (AC-419764)



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