Month: July 2015


Jul
2015

After School

categories: Education, Family

What do you do after school?child playing a video game

Deciding what to do after a long day at school can be difficult for any child or young adult.  Do you do your homework, hang out with friends, watch TV or play video games? Parents are often very involved in making sure their children have something to do.  Questions about activities for after school become even more difficult when you have a child or young adult with a disability.  Parents have to consider the supports that are needed in order to make sure their child has a structured and supervised afternoon. While some parents are home when their children get home from school in the early afternoon, many parents are working. Most families these days rely on two incomes to support their household.  Therefore, parents must look for supports from the school or community for after school care.

Unfortunately, finding after school programs poses several barriers for families with children with disabilities.  For one, many after school programs are for younger children. This is a major challenge for families with transitioning young adults who still require a supervised and supported afternoon.  Not only are these programs for younger children, but they are for children that do not have disabilities and high needs for support.  Generally, the after school programs have an adult to child ratio that cannot support young adults or children who cannot be independent.  Another barrier for after school programs is that they usually are not free. The expense for after school care is another challenge for families to figure out a structured afternoon.

Schools can be a great resource for families with children and young adults with disabilities, but often close the doors after the school day is over.  Schools need to rethink how the value of after-school activities could be used to help children and young adults work on many of the social, emotional, leisure and everyday-life skills. With additional supports after school, we could see many gains in student success during the school day.  Resources and staff time would be a limitation for schools to implement after school programs. However, community organizations that support individuals with disabilities could collaborate with schools to create after-school programs that would address a huge gap in the system of care. It’s time for schools and organizations to think outside of the box and partner with families to meet student needs.


Jul
2015

ADHD and Risk of Substance Use Disorders

categories: Health

cartoon head with squiggly arrows radiating from itDid you know that children with Attention Deficit Hyperactivity Disorder (ADHD) are more likely to develop a substance use disorder? It’s true! According to a recent article called Attention-Deficit/Hyperactivity Disorder and Substance Abuse in the journal Pediatrics, there is increased risk. This blog will review the connection and give tips to keep children substance free over the years to come.

What is ADHD?

Children with ADHD are often fidgety, somewhat hyper, and have trouble paying attention and following through on tasks. These children can be impulsive – acting before thinking. They can be distracted easily. Many children with ADHD are highly creative and quite talented. Not all distracted, fidgety, creative children have ADHD.  A diagnosis will only be made if behaviors cause a child to have significant trouble in 2 or more settings. Ask a pediatrician if you are concerned about your child or want more information.

What is Known about the Risk of Substance Use Disorders?

The above-mentioned article in Pediatrics highlights a study showing that children with ADHD are over twice as likely as children without ADHD to develop a substance use disorder in their lifetimes.  These children are more likely to eventually become dependent upon nicotine, alcohol, marijuana, and cocaine. Children with ADHD are more likely to start using substances earlier and to try more types of substances.

The reason for the increased risk is not known. One theory is that people who are more impulsive are more likely to try substances. Perhaps school and other areas of life are often more difficult for people with ADHD, and substances might be used to self-medicate. Another theory is that people with ADHD might more easily develop physical addictions. Perhaps one day more will be known about why these children are at increased risk. In the meantime, let’s look at what can be done to try to reduce the risk.

What Can be Done to Prevent Problems?

Experts agree that treatment will likely reduce the risk of developing substance abuse disorders. Some suggestions include the following:

    • Ask your pediatrician or specialist about treating ADHD symptoms with prescription medication – and start young.
    • Don’t use medication only. Get behavioral treatment from a therapist for children at any age – even as young as 4.
    • Get other conditions such as depression, low self-esteem, anxiety and conduct disorder diagnosed and treated.
    • As your child ages, keep the lines of communication open. Talk to your child about substance use amongst their friends and in their school.
    • Teach your child the importance of taking good care of their bodies.
    • When it comes to substance use, what you do might have more of an impact on your child than what you say. Lead by example.

In my opinion, children with ADHD are some of the most creative, fun, and engaging people. They are at an unfortunately high risk for developing a substance use problem. Early intervention is a key approach to reducing this risk, and will help keep them healthy.

For more information:

See this article from The American Academy of Pediatrics:
Clinical Report: Attention-Deficit/Hyperactivity Disorder and Substance Abuse
Elizabeth Harstad, Sharon Levy, and COMMITTEE ON SUBSTANCE ABUSE
Pediatrics 2014; 134:1 e293-e301; published ahead of print June 30, 2014, doi:10.1542/peds.2014-0992


Jul
2015

Cultural Understanding in Health Care

categories: Health

Multiracial hands making a circle together around the world glob

What is Culture?

Culture refers to a group of people with shared beliefs, knowledge, ideas, experiences, and maybe language. Culture is not limited to racial and ethnic groups. There can be professional, political, religious, organizational, and social groups. Culture is complex with many layers. It brings together every part of one’s life.

Why is Cultural Understanding Important in Health Care?

Culturally-informed care should be the standard and not the exception in the health-care field. For many minority groups (Asians, African Americans, Hispanics/Latinos), language and cultural differences are difficulties in the health care system. Cultural understanding is important in helping families gain access to quality health care services. It is important then that health care providers deliver care that knows, respects, and welcomes these cultural differences (National Institute of Health, 2014).

How is Cultural Understanding Related to Quality Speech-Language Services?

People from different cultures may speak different languages and dialects. As a speech-language pathologist (SLP), I am interested in working with children who grow up in a bilingual home. Language is more than the words that come out of one’s mouth. It includes facial cues; social aspects; word meaning; hand and body movements; tones and rhythm. These are all highly influenced by one’s culture. For example, Asian children are told that it is rude to make eye-contact with an adult. But Americans think eye contact is a sign of attention and respect (Cheng, 1991). It is important that SLPs understand their client’s background in order to make correct diagnoses, and to provide appropriate treatment.

How Can We Be Culturally and Linguistically Sensitive?

  1. Learn more about the local community that you serve. Cultural understanding does not mean that you need to be a fluent speaker of the language. Research the local community’s religions, beliefs, lifestyles, languages, traditions, etc. This knowledge will help you provide culturally informed care.
  2. Use simple terms. Even if the person appears to speak and understand English well, it is always best to use simple language. Unclear or high-level words are hard to translate and the meaning can get lost. For example, instead of “his scores are low compared to the norm” you can simply and clearly say “his scores are low compared to other kids his age”.
  3. Work with interpreters to translate your websites, pamphlets and flyers. You will have great visual aids to use and refer to when counseling individuals. Most importantly, your patients and clients will now have easy access to these educational resources!

Helpful Resources