Thursday, 26 September 2013

UNWRITTEN: Application Denied

Your Name: Elyssa D. Durant
Position Desired: YOURS

What are you seeking in a job at this point in your life?
An advocacy position working with children that would allow me to combine my academic training and educational background with my passion for grassroots policy planning and program development. I have been working at the grassroots level with a number of organizations for many years, and I enjoy seeing the public realize how effective they can be in advocating for themselves. I have witnessed many people take off personally and professionally once they experience how gratifying it can be to become empowered through expressing their views and making their voices heard. I enjoy leading people on this path of empowerment.
Why do you want to work with children?
Having participated in the head start program as a small child, I was fortunate enough to be given additional resources that allowed me to be on a level playing field when I started Kindergarten at 4 ½ years-old. I believe working with Stand for Children will allow me to give a voice to small children and some of the disenfranchised families who have the greatest need for strong, well-organized representation.

How would you explain community or grassroots organizing and what about it appeals to you as opposed to other ways to improve the lives of children?
Grassroots advocacy would allow me to work directly with stakeholders on critical policy initiatives and budget priorities. I enjoy helping the public have their opinions heard and consider myself empathetic to the needs of my target audience and population. I enjoy working towards a stated goal and seeing that programs be properly designed, planned, and implemented to allow for effective program development and policy implementation. In addition, working sat the grassroots level allows you to interact with those who are directly affected by the programs and policy reform initiatives. I enjoy listening to people and helping to empower the disenfranchised populations. Grassroots work allows you to see change happen and letting people know how important each and every voice is on the political spectrum. By establishing a positive network of community alliances and establishing a good rapport with the general public, they will feel that they had a direct role in creating the new programs and policies, and they are much more likely to remain active in their child's education and community programs long after I am gone.

What adjectives would people who know you generally use to describe you? Name specific work situations in which these attributes have served you.
People often comment on my dedication: I do not take on causes that I do not believe in. I will do "whatever it takes" to see that I achieve results that are beneficial to the community I live in, the organization I represent, and the children who need my voice.
I am sincere and not easily swayed from my viewpoints. I am very true to my clients, and believe in what I say. I am outspoken. I am not easily intimidated and believe that I have a right to be heard, as do the children, families, and communities I represent. I am eloquent, logical, and persuasive. I can usually find a way to relate to my clients, and give them a reason to participate in the legislative process. I help them understand that they are a crucial in seeing effective programs implemented in a way that will best serve the needs of their children and communities. I help my clients feel empowered by showing them how their direct participation can improve their circumstances and the lives of their children. I try to demonstrate how easy it is to participate in developing effective policy and public programs. I encourage them to become more active in their own lives by showing them how important it is to be heard by their legislators, congressional representatives, and their community leaders.
I am effective because I get things done!

What would your former employers say about you? What areas would they suggest you work on?
  • "Her involvement with the class, her interaction with the students and teachers alike, and her willingness to listen while offering fresh insight of her own made working with Elyssa a very enjoyable experience."
  • "Her energy for the work and the educational process showcased both her abilities for problem solving and her well-developed communication skills."
  • "Elyssa's enthusiasm for knowledge and the process of learning impressed me a great deal. She has an active curiosity about education and the learning process."
  • Some employers have not been quite as enthusiastic regarding my level of personal involvement with my work... they may suggest I work on my objectivity in the workplace. I tend to take my work very seriously.


Please list your top five achievements at your last position.
  1. My clients still call me from school in the morning to let me know they made it there safely. None have dropped out and five will be graduating this May!
  2. One former client is no longer abusing small animals after we took a day trip to the animal shelter. He now demonstrates empathy towards animals and treats them with a gentle hand.
  3. Mental health parity has received considerable more attention from the press after the NBCNightly News picked up an article I wrote. NBC requested on camera interview, but my schedule was not the least bit forgiving at the time.
  4. New York State passed a bill for Medicaid buy-in the day after I had organized a trip to Albany for members of my community who were at-risk for losing their benefits.
  5. My persistence locating subjects (participants in a long-term study of children with severe emotional disorders) allowed for more reliable and valid results since a larger, more representative sample was achieved for the third and final wave of interviews. The methods and study results were discussed recently in a prestigious journal of public policy.


Describe an interpersonal challenge you faced with a co-worker and how you resolved it.
I learned that my supervisor had altered some of my case notes for a client file that was scheduled to be audited. After confronting him with my original documentation and the new paperwork that was in the child's file, he told me that it was critical not to reflect abuse in my client files since it would cause the company to loose referrals from the Department of Children's services. After speaking with my sister (an attorney) I decided to make copies and forwarded them anonymously to a child rights organization.

What did you learn from it?
I ultimately resigned since I felt I did not want to be part of an organization that would place financial incentives above a child's welfare.

What experience do you have working directly with children? Concerns for children?
For my undergraduate practicum, I worked as a social skills counselor in a school-based intervention program designed for high-risk youth. After working with various groups of children, I began to notice significant differences in their levels of self-esteem. This made me increasingly concerned about policy issues involved in special education, assessment, and placement. I think it is critical to explore alternative program options that would allow children to receive the special attention they need without jeopardizing their emotional development.

Have you ever been involved in an effort to change a policy or a budget priority? Please describe.
Yes-several years ago, I had the opportunity to participate in the Governor's Roundtable on TennCare. The new CEO had implemented cuts to the program without providing members (or providers) with adequate time or information prior to implementing a major change to the prescription formulary (the list of approved medications.) Because I had witnessed the fallout at my local pharmacy that weekend, my supervisor requested that I draft a written statement to the committee regarding the impact of these changes for beneficiaries. After the newly appointed CEO of TennCare denied receiving any negative feedback on his rapid budget cuts, my boss asked me if I would be willing to speak before the committee and call his bluff. Ultimately, this lead to the passage of the Grier Amendment. Grier provides beneficiaries with a formal procedure that must be followed prior to cutting off any medications prior to receiving a formal appeal. Grier provides beneficiaries with a form of "due-process" protection granting them access to an adequate supply of medication while their physician can has the opportunity to obtain the necessary authorization for medically necessary treatment.
I recently ran into the former CEO that implemented the poorly planned budget cuts. He now works at my local gas station in the mini-mart; however, he claims they offer excellent health insurance with unlimited pharmacy benefits.

Why, in your opinion, do schools, early childhood education, and other programs that give children a fair chance in life receive so much less funding than they need and deserve?
I believe there are several reasons that contribute towards the pattern of under-funding educational programs. First, I believe that the "war on terror" has misrepresented our budget priorities to the general public. Second, I believe that there is a hesitation to re-distribute funds so that they can be used in the communities that would benefit the most from additional sources of funding. Third, I think that the people designing the budget are not sympathetic to the needs of the underprivileged, and they are reluctant to offend wealthier constituents by allocating funds towards impoverished districts. Fourth, I believe that the general public is quite comfortable believing that all is well in American schools, and if we keep adjusting the SAT's to reflect this myth, the true state of education will most likely be ignored. As a society, we must decide that education is a top priority and fund education in the same way we fund the military. I could go on, but I will not!

What specifically can be done to ensure that more public funding goes to schools, early childhood education and other programs that give children a fair chance in life?
We need to think of educational policy reform initiatives and programs in terms of equity rather than equality. Equality is a myth. Some children, schools, communities, and parents simply need more if they are to benefit from the large number of pre-k programs soon to become available to young Tennesseans. We must meet their needs by matching them with appropriate programs and opportunities by virtue of their parent's financial resources. We must reframe the educational model in terms of equity not equality; all homes and all schools are sadly not equal.
I was a head start child myself, and I am proud of my academic achievements. With the new lottery in place, many children will have a new source of opportunity: scholarship money can provide a completely new funding source beyond the standard K-12 public education. We need to reframe the educational model so that we can improve the system for children who are "at-risk" of falling behind so that they have true equal opportunity. There are many new opportunities to be had in the state of Tennessee. Not only can children now benefit from the new pre-K programs being developed, but they can also benefit from educational funding that has become available in the form of Hope scholarships that the lottery program offers for college.
We need to give children a fair shot at actualizing their inherent capabilities and help them to develop a love of learning before they have an opportunity to be lost in the "system."

Share experiences you've had in forming or building an organization.
As the director of special programs for NAMI, I had the opportunity to work with consumers and their families by planning special events and programs. I made frequent trips to the local psychiatric hospital to talk to consumers about how they need to take an active role in planning new programs-especially if they were unhappy with the current programs in place for SPMI (severe and persistent mentally ill) populations. I was amazed at how much you can accomplish on a long road trip by providing a school bus and free lunch for all who were willing to participate and make their voice (and their votes) count!


ESSAY SELECTED FOR PUBLICATION IN "GUIDE TO WRITING GRADUATE SCHOOL ESSAYS FOR THE HEALTH SCIENCES"


STATUS: APPLICATION DENIED


 IRONY: PRICELESS



Recruitment and Retention Rates in Public Education Incentives Needed to Improve Performance

Recruitment and Retention Rates in Public Education

Incentives Needed to Improve Performance 

Elyssa D. Durant, Ed.M.


The high rate of student mobility is compounded by the constant shifting of school personnel. Many schools may just lose the few experienced, dedicated teachers they still have left to surrounding districts, cities, and states.

The Tennessean released data on July 5, 2008 reporting disparities in teacher salaries for Metro employees. The article, "Poor kids' teachers earn less in Metro: Hiring bonuses, other incentives target inequities" raises questions about the hiring practices in Metro Nashville Public Schools, and reports that teachers earn less in schools that are not meeting the No Child Left Behind benchmarks. This article glossed over the magnitude of this desperate situation in Metro schools.

The basic fact that students are not making adequate progress is a reflection of the top-down policy failure by MNPS and the Board of Ed. Students are not making adequate progress, and teachers are being shuffled around in a desperate attempt to fix a problem that they do not fully understand. In order to fix our broken schools, we need to look at schools that work. There are, in fact, public schools in urban neighborhoods that are successfully educating the students despite limited budgets, supplies, and adequate funding. So what is it about these schools that allows them to successfully educate disadvantaged, at-risk students and how can we replicate their success?
Unfortunately, this article does not offer any new insights into the inner-workings of our neighborhood schools. MNPS does not have the answers, nor does our newly elected Mayor who recently launched an aggressive media campaign to recruit new teachers willing to work within the constraints our over-regulated, under-funded public schools. Teachers, administrators and the community are strangely unfamiliar with the political process, and teachers are expected to implement and carry out policies that were designed by academic professionals or educational consultants.
As an educator and a Metro employee, I earn $10.46 / hour (without benefits) teaching at-risk students, I am offended by the way teachers are treated in the schools, in the community, and by the press. The state Department of Education could not offer any realistic solution to the simple fact that I cannot afford to pay the fees associated with the application fees certification requirements. If the Mayor really needs applicants, perhaps the city should comp the application fees necessary to be considered for employment. I find it difficult to believe that a city so desperate for teachers is not willing to bend the rules just a little or waive the application fee for anyone who is willing to work in such a hostile environment.
My graduate degree in education is from the very same university that Mayor Dean attended in New York City. When I called HR and the "Certificated Office" to inquire about obtaining a provisional teaching license and alternative certification, I was simply told that I was not eligible for alternative certification and without additional coursework, and tuition and fees, I was not deemed qualified to teach in Metro.
I am not qualified to teach in Metro since, apparently, Metro "does not teach education." What a joke! To make matters worse- I had to pay them to find out that I was not even qualified to work with Head Start. I went to Head Start! Shouldn't that be enough? If MNPS truly wants a better-qualified staff, then the Mayor, the Board of Education, and school administrators need to take a closer look at the methods used to recruit, retain, and reward qualified individuals willing to sacrifice their financial stability for a career in public service. Now that I realize my education was a complete waste of time and money, is it any wonder that I am ready to give up on teaching and maybe even ready to leave Nashville for good. The local hardware store has more to offer including benefits!
The high rate of student mobility is compounded by the constant shifting of school personnel. Many schools may just lose the few experienced, dedicated teachers they still have left to surrounding districts, cities, and states. Such instability in the system may even prompt the younger set to leave the profession all together and discourage future teachers from applying for jobs in Metro.
Everything we know about the positive outcomes in neighborhood schools is their strong reliance upon community buy-in and parental involvement. One thing that makes magnet, lottery, charter schools, parochial, and private schools so good is the fact that parents, teachers, students, and administrators fight to get in, and fight to stay there. The act of choosing, in effect, leads to an enhanced sense of community and builds a supportive, consistent, and structured environment. Calling this project "Fresh Start" is ridiculous-- it would be more accurate to call it a very bad ending!


  • Teacher salaries are only part of the problem.
  • Teacher mobility contributes to the instability of urban schools.
  • Metro is trying to fix a problem they do not fully understand.

Elyssa D. Durant © 1995-2013

PREVIOUSLY PUBLISHED IN NEWS Nashville News

Equity in Education Are Minorities to Blame for Failure to Meet No Child Left Behind Benchmarks?

Equity in Education: Are Minorities to Blame for Failure to Meet No Child Left Behind Benchmarks?  by Elyssa D. Durant, Ed.M.


The Nashville City Paper previously reported that African-American students were out-performed by their white counterparts on the ACT (Metro ACT scores drop; Tennessee reaches new high, 2007).

Given what is currently at stake in Metro Nashville Public Schools (MNPS), such casual reporting of racial discrepancy in test scores is irresponsible at best: Does this mean that white children are better students than their black and Hispanic classmates?
What's next for Nashville? Are minorities to blame for our failure to meet the benchmarks set forth in the No Child Left Behind legislation? High-stakes, standardized entrance exams are not only culturally biased, but also politically motivated in their agenda to help bring back a return to basics type of core-curriculum.
Studies in both the sociology and politics of educational evaluation have consistently shown that standardized entrance exams such as the SAT and ACT do not accurately predict academic performance at the college level.
Given the official release of performance data by MNPS officials, I am concerned that less curious readers may place too much attention to such details and misconstrue this information making voluntary, de-facto desegregation less attractive to schools that did not quite make the grade last academic term.
If, as stated in Wednesday's article, the ACT is a curriculum-based measure of readiness in English, mathematics, reading and science, then all these scores show us is that we have failed in our mission to provide an adequate education for all our citizens.
I am not sure exactly what readiness is, but I am certain that our schools are failing miserably at educating those children who need us the most. Let's level the playing field for a change and start talking about equity in education if we truly expect teachers to leave no child behind, we must first give them the tools they need to move forward.

Elyssa D. Durant © 1995-2013


PREVIOUSLY CROSS PUBLISHED Nashville News

Wednesday, 25 September 2013

Reorganization or Disorganization: Metro Nashville Public Schools Undermines Teacher Autonomy and Professionalism

Reorganization or Disorganization: Metro Nashville Public Schools Undermines Teacher Autonomy and Professionalism

The Restructuring of Metro Schools Disrupts Community Program 

Elyssa D. Durant, Ed.M.



If I didn't know better, I would think that the local media is supporting the ridiculous decision to transfer MNPS principals from one failing metro school to the next after reading "State reorganization moves on to school principal assignments," (Nashville City Paper, July 9, 2008.)

I find it deeply disturbing that the media (and the community) have failed to recognize this for what it is: a desperate attempt to convince the community that we are actively working to improve the quality of education in our public schools. This last minute attempt to restructure neighborhood schools will most likely do more harm than good to the community at large.
The high rate of student mobility in Metro (approximately 40% per year) is compounded by the constant shifting of district-wide changes to school personnel by transferring teachers, administrators, and support staff on a regular basis. Everything we know about the sociology of education in urban schools shows us that there is a strong correlation between parental involvement and student performance.
One thing that makes magnet, lottery, charter, parochial, and private schools so good is the fact that parents, teachers, students and administrators fight to get in, and fight to stay there. The act of choosing, in effect, leads to an enhanced sense of community and builds a supportive, consistent, and structured environment. Good schools are a place where all members of the community, including school administrators, teachers, parents, and community leaders create a sub-culture with a common set of goals and expectations that are reinforced both in and out of the classroom environment.
Successful schools are an extension of the community at large, where everyone works together to create a common set of experiences; creating an environment that encourages parental involvement and community participation. If Metro continues to alienate educators by disemboweling the organizational structure within public schools, we may just lose the few experienced and dedicated teachers we still have left to surrounding districts, cities, and states.
By failing to examine the issue in further detail, the press and our community leaders are failing in their mission to provide the community with the information they need to participate in the political process that is MNPS. The media have a responsibility to examine and provide the community with the information they need to make informed policy decisions.

Top Down Policy Failure in Public Education

Top Down Policy Failure in Public Education
by Elyssa D. Durant, Ed.M.

Metro Nashville Public Schools (MNPS) does not have the answers, nor does our newly elected Mayor who recently launched an aggressive media campaign to recruit new teachers willing to work within the constraints our over-regulated, under-funded public schools. This article MNPS News glossed over the magnitude of the desperate situation in Metro Nashville Public Schools (MNPS).

But it does raise questions about the hiring and retention practices by the Board of Ed. The basic fact that students are not making adequate progress is a reflection of the top-down policy failure by MNPS and the Board of Ed. Students are not making adequate progress, and teachers are being shuffled around in a desperate attempt to fix a problem that they do not fully understand.
This data seems to support the need for performance based incentives such as the study on performance incentives at the National Center for Performance Incentives on the Peabody Campus at Vanderbilt University. Teachers in the experimental group receive a $15,000 bonus if their students demonstrate a pre-determined level of achievement and demonstrate proficiency. In conjunction with the RAND corporation, data will be collected twice a year: at the beginning of the academic term to establishing the baseline level of competency for each student. Data is then collecting at the end of the year to measure achievement. Several waves of data will be collected and evaluated over the next several years will be evaluated in conjunction with the RAND Corporation.
In order to fix our broken schools, we need to look at schools that work. There are in fact public schools in urban neighborhoods that are successfully educating the students despite limited budgets, supplies, and adequate funding. So what is it about these schools that allows them to successfully educate disadvantaged, at-risk students and how can we replicate their success?
As an educator employed by MNPS, I earn $10.46 / hour (without benefits) teaching at-risk students. What does this say about the fiscal priorities of our community? My graduate degree in education is from the very same university that Mayor Karl Dean attended in New York City. What does that say about our values as a society? What does that say about the value of a graduate degree from the Ivy League?
I called HR and the "Certificated Office" to inquire about obtaining a provisional teaching license and alternative certification, I was simply told that I was not eligible for alternative certification and without additional coursework, and tuition and fees, I was not deemed qualified to teach in Metro. I am not qualified to teach in Metro since, apparently, Metro "does not teach education." What a joke. To make matters worse- I had to pay them to find out that I was not even qualified to work with Head Start. I went to Head Start! Shouldn't that be enough? I find it difficult to believe that a city so desperate for teachers is not willing to bend the rules just a little or waive the application fee for anyone who is willing to work in such a hostile environment.
The state Department of Education could not offer any realistic solution to the simple fact that I cannot afford to pay the fees associated with the application fees certification requirements. If the Mayor really needs applicants, perhaps the city should comp the application fees necessary to be considered for employment. They are strangely unfamiliar with the political process, and teachers are expected to implement and carry out policies that were designed by academic professionals or educational consultants. If MNPS truly wants a better-qualified staff, then the Mayor, the Board of Education, and school administrators need to take a closer look at the methods used to recruit, retain, and reward qualified individuals willing to sacrifice their financial stability for a career in public service.
The high rate of student mobility is compounded by the constant shifting of school personnel. Many schools may just lose the few experienced, dedicated teachers they still have left have, to surrounding districts, cities, and states. Such instability in the system may even prompt the younger set to leave the profession all together and discourage future teachers from applying for jobs in Metro. Now that I realize my education was a complete waste of time and money, is it any wonder that I am ready to give up on teaching and maybe even ready to leave Nashville for good. The local hardware store has more to offer including benefits!
Everything we know about the positive outcomes in neighborhood schools is their strong reliance upon community buy-in and parental involvement. One thing that makes magnet, lottery, charter schools, parochial, and private schools so good is the fact that parents, teachers, students, and administrators fight to get in, and fight to stay there. The act of choosing, in effect, leads to an enhanced sense of community and builds a supportive, consistent, and structured environment.  Calling rezoning and teacher shuffling in Metro "Project Fresh Start" is ridiculous-- it would be more accurate.


  • The state Department of Education could not offer any realistic solution.
  • The high rate of student mobility is compounded by the constant shifting of school personnel
  • The Board need to take a closer look at the methods used to recruit, retain qualified educators.

  • Elyssa D. Durant © 2009-2013 

    Unwritten: A Letter to Myself


    From: Elyssa Durant 
    Date: September 5, 2008, 2:20:16 PM EDT
    To: ed70
    Subject: letter to catherine from AC

    my god -- this could not have come at a better time!

    i just spent the last 4 hours composing a letter only to realize i have no one to send it to.

    i have so many things i need to say-- and it huts so much to realize that my carefully chosen words have been ignored, ridiculed or twisted by some egomaniac who seems to get off on making me feel like a piece of shit.

    i spent hours writing a press release for a committee i joined believing it would lead to other opportunities (which it did) but apparently it is good to use so long as I don't put my name on it.

    So after putting my entire soul into a volunteer project for the last two weeks, i am at a loss for words.  i only have tears.  

    this world is breaking me, and i just don't get it...  

    i don't understand why i do so much for others only to find myself completely abandoned by the very same people and organizations i helped build.  

    all i can think right now is just sending a very simple one word reply: "FURB!"

    hope is a terrible thing.  so is post traumatic stress. just as i begin to think i'm on the verge of breaking the cycle; the slightest trigger can set me back to the exact same place i was 13 years ago.

    i'm sorry for babbling at your expense, but i actually may send it (to you exclusively) on the off chance that you may be able to see through my fragmented, disconnected words that keep me from participating in this so-called life.

    thank you so very much-- if you don't mind, i may just send the letter to myself. 

    i worked on for so long, [FIVE YEARS] because even if you don't read it, at least i'll know that i had enough courage to say what some people really need to hear!  

    unfortunately, the people who need to hear what i'm saying are so far removed from the incredible pain they have caused me, they would not even realize i am directing my anger, fear, sadness and feelings of helplessness, hopelessness, and worthlessness that are a direct result of their depraved indifference.

    this is a very sad day for me.  

    i hope you don't mind me sharing too much-- it kind of comes with the territory!

    Sincerely yours,

    Elyssa Durant


    -- 
    Elyssa D. Durant, Ed.M.

    http://labs.daylife.com/journalist/elyssa_durant

    http://www.associatedcontent.com/user/145691/elyssa_durant.html


    "The paradox of education is precisely this-- that as one begins tobecome educated, one begins to examine the society in which he [orshe] is being educated."   - Baldwin


    Elyssa D. Durant © 2008-2013


    POST SCRIPT: This is a happy day for me because not only am I finally posting this "UNWRITTEN" letter, I no longer suffer with PTSD and after living in silence for more than a decade, I am finally finding my voice and my self. 

    Autism, OCD and Anxiety

    Autism, OCD and Anxiety Associated with PANDAS and PANS

    For years physicians who treat children with autism and other DSM diagnosis have stated that there is a link between these conditions and PANDAS (Pediatric Autoimmune Neuropsychiatric Diagnosis Associated with Streptococcal Infections). The patients they treat with biomedical interventions have experienced improvements and up until recently, mainstream medicine was not on board. This all changed when the Director of the National Institute of Mental Health stated that PANDAS is indeed a real medical illness.

    The NIMH states that PANDAS is used to describe a subset of children and adolescents who have Obsessive Compulsive Disorders and/or tic disorders whose conditions worsen following strep infections such as Strep throat and Scarlet Fever.  

    PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) is a newer term used to describe the larger class of acute-onset OCD cases and includes all cases of abrupt onset – not just those associated with strep infections. Lyme disease, staph infections, mycoplasma infections such as walking pneumonia and rheumatic fever have been linked with PANS.

    PANDAS/PANDS leads to autoimmune-mediated inflammation of the brain and attacks parts of the brain known as the basal ganglia and the anterior cingulated gyrus resulting in serious changes in behavior, movement control, obsessive thoughts and extreme emotional ups and downs.

    The following symptoms are usually seen in children diagnosed with PANDAS/PANS:

    • Severe separation anxiety
    • Generalized anxiety. which may progress to episodes of panic and a ‘terror-stricken look’
    • Hyperactivity, abnormal movements, and a sense of restlessness
    • Sensory abnormalities, including hyper-sensitivity to light or sounds, distortions of visual perceptions, and occasionally, visual or auditory hallucinations
    • Concentration difficulties, and loss of academic abilities, particularly in math and visual-spatial areas
    • Increased urinary frequency and a new onset of bed-wetting
    • Irritability and emotional lability. Abrupt onset of depression can also occur, with thoughts about suicide.
    • Developmental regression, including temper tantrums, "baby talk" and handwriting deterioration

    How Does This Relate to Autism?

    It is estimated that more than 30% of children with autism also have PANDAS/PANS. In children diagnosed with autism, the extreme pain from brain swelling may lead to head-banging behavior.  Unfortunately, medical professionals view head-banging as stimming and are not likely to do the lab tests necessary to determine if the child’s brain is inflamed due to a severe bacterial infection. It is important to advocate for your child as many children on the spectrum make dramatic improvements with several documented cases of complete recovery once properly diagnosed and treated.

    Testing for PANDAS/PANS

    The diagnosis of PANDAS is a clinical diagnosis, which means that lab tests alone are not enough to qualify for the diagnosis. Instead clinicians use diagnostic criteria for the diagnosis of PANDAS that includes some lab work. Recommended lab work includes:

    • Measuring anti-streptococcal antibody titers to determine whether there is immunologic evidence of a previous strep infection.
    • Throat swab or 48-hour strep test
    • Check family members to see if someone is a strep carrier. Carriers are often asymptomatic, but will test positive for strep.

    Diagnostic Criteria for PANDAS/PAN are:

    • Presence of obsessive-compulsive disorder and/or a tic disorder
    • Pediatric onset of symptoms (age 3 years to puberty)
    • Episodic course of symptom severity
    • Association with group A Beta-hemolytic streptococcal infection (a positive throat culture for strep or history of Scarlet Fever)
    • Association with neurological abnormalities (motoric hyperactivity, or adventitious movements, such as choreiform movements).

    Treatment Options

    Traditional treatment includes Cognitive Behavior Therapy, antibiotic treatment and immune based treatment such as IVIG or Prednisone.

    At Healing 4 Soul, we recognize other treatment approaches that have been effective throughout the world. Many homeopaths are seeing success treating PANDAS/PANS using Pleo Sanum remedies and supplements. The Healing 4 Soul PANDAS/PANS treatment plan will sometimes include the following:

    1. Pleo San Strep

    2. Pleo Not

    3. Quinton Isotonic

    4. GcMAF

    5. Pleo San Staph

    6. Pleo Quent

    Scheduling an appointment with Sima Ash will allow her to look at the specifics in your child’s case and also utilize other modalities such as CEASE Therapy to provide further benefit. Please phone our office at 714-939-9355 to schedule an appointment in our office, over the phone or via skype.


    Aspergers and OCD

    3 thoughts on “Asperger’s and OCD – Obsessional Behaviours, Diagnosis and Treatment Options”

    June 21st 2013

    Today we are very happy to have a guest blog post on Asperger’s and OCD from Carol Edwards. Carol is a Cognitive Behavioral Therapist who specializes in the area of OCD. She became interested in the area after one of her family member became misdiagnosed with Asperger’s Syndrome when in fact they actually had OCD. We hope you enjoy this posts which illustrates that while the two conditions have overlaps, they are not always the same.

    Asperger’s and OCD – Obsessional Behaviours, Diagnosis and Treatment Options

     Copyright 2012 by Carol Edwards

    CBT DipHE (D) Dip.ocd (D) ASD credits – CRB Checked

    Asperger’s Syndrome

    Asperger’s Syndrome, often referred to as Asperger’s or AS, comes under the umbrella for Autistic Spectrum Disorders which is a complex developmental disability that affects the way a person communicates and relates to the people around them. The term autistic spectrum is often used because the condition varies from person to person. For example, some individuals who have accompanying learning disabilities are usually placed at the less able end of the spectrum, while others who have average or above intelligence are placed at the more able end of the spectrum (Asperger’s).

    Despite the various differences, everyone with the disorder has difficulty with what is known as the ‘triad of impairments’. These are:

    • social interaction and social skills
    • social communication
    • social imagination

    Obsessive Compulsive Disorder

    Obsessive Compulsive Disorder, or OCD, is characterised by intrusive thoughts, ideas and images which often follow compulsive behaviours. These can be overt and also covert. For example, an individual whose OCD variation revolves around contamination fears may openly display an urge to repeatedly wash her hands (overt); whereas a person who suffers from disturbing thoughts and images may try to cancel these intrusions out by using a counter phrase or praying ritual in his mind (covert). Both behaviours serve to reduce the anxiety brought on by these intrusions, but only momentarily.

    Unless there is an autistic overlap or other pervasive developmental disorder, a person with OCD usually does not present with problems associated with the triad of impairments.

    Social imagination

    In this article, we’ll be looking at the triad to distinguish what the driving force behind obsessional behaviours mean and whether the findings suggest if a person has developed social imagination or not. Observing how a person reacts in response to his compulsions or rituals can provide us with clues; therefore, let’s consider two individuals with obsessive behaviours:

    Jack has an obsessive compulsion where he feels compelled to line up food items in order of size in the kitchen cupboard while Jill repeats a ritual which involves lining up a collection of ornaments in a cabinet in the family’s lounge.

    While Jack is generally an honest person, he has none-the-less learned to use deception to manage his OCD. In other words when he is prevented from doing a ritual he uses his imagination to find ways to figure out how to complete the act. For instance, while watching TV, Jack’s wife often prevents him from repeatedly checking that there isn’t a tin, bottle or packet out of place in the kitchen cupboard. This increases Jack’s anxiety but he wants to avoid conflict; therefore, he uses every trick up his sleeve so that he can fulfil his compelling need to check. Using deception provides him with the opportunity to relieve himself of anxiety, e.g. making up the excuse that he’s ‘just nipping through to the kitchen for a snack’.

    Now let’s consider Jill’s obsessional behaviour. Basically, the imagination is in the act itself which is part of her daily routine. When Jill lines up the ornaments she experiences organised satisfaction, rather than anxiety relief. When Jill’s mother tries to stop her, explaining that they have to leave for Jill’s scheduled appointment, Jill feels extreme annoyance to the point of anger, just like any person might if they were for example prevented from finishing their housework or something else and in the order they do it. The confused interaction between mother and daughter causes such distress that the appointment has to be cancelled.

    What does this mean?

    First, Jack can work around his compulsion because he understands that his thoughts affect his feelings and thus behaviours. Thethought is ‘A bottle is out of place in the kitchen cupboard’ which follows with thefeeling ‘When I’m prevented from checking, my anxiety rises’, which leads to deceptive behaviour, e.g.‘I’ll pretend I need a snack’. To add to this, Jack is not only able to understand the connection between his own thoughts, feelings and behaviours, he is also capable of grasping the thoughts, feelings and behaviours of others, hence the deception towards his wife. This tells us that he has developed social understanding which fits neatly with the ‘theory of mind’ (Baron-Cohen et al 1985*). What’s sad however is that while Jack goes to ridiculous lengths to perform his compulsions, he knows the behaviours are attributed to OCD, not him, and he wants to stop.

    Second, we’ve already established that Jill’s daily routine involves lining up the ornaments in the family cabinet. Her behaviour when prevented from doing this reveals that social imagination might be lacking, e.g. faking illness to avoid going out so that she can stay home and finish her ritual. Further, the difficult interaction with her mother and her inability to grasp that failing to turn up for an appointment can be problematic for others involved indicates that her obsessional behaviour is stereotyped and therefore characteristic of Asperger’s Syndrome. Jill fights her own corner honestly and has no conscious thoughts about whom and what the obsessional ritual is attributed to, and she doesn’t want to stop. So does this imply a lack of social imagination meaning Jill has not developed a theory of mind? Possibly, but not necessarily as it could be that this area of functioning requires intervention to help tease it into consciousness thus improving social awareness and world perception.

    *Theory of mind

    Baron-Cohen speculates that having a theory of mind is what gives us the unique ability to work together and execute complex interactions. In other words we are able to understand that we and others have minds with knowledge, feelings, beliefs, motivations, intentions, and so on, which includes presuming our own and others mental states and then being able to explain and predict the behaviours arising from this. Humans are able to assess that others may hold false beliefs about themselves and the world around them. Baron-Cohen’s research suggests that individuals on the autistic spectrum lack a theory of mind and therefore do not have the mental capacity to imagine the world from the perspective of others, which includes failing to question beliefs about themselves or others. They apparently live in a state of certainty in terms of what others may think about them; that is, what someone says is what they mean, and so on. You can find more information on this topic at: www.social-science.co.uk/corestudies/titled ‘Does the autistic child have a theory of mind?’

    Treatment for OCD

    Some say anxiety is the source of OCD which suggests a neurobiological condition to which pharmacological treatment in the form of Selective Serotonin Reuptake Inhibitors (SSRIs) is the primary tool. Others suggest it’s the other way round in which case a psychological approach to the problem is favoured. The psychological model is viewed from a social learning perspective, is specific in its approach with its cognitive and behavioural strategies and involves exposure response prevention (real or imagined). Its aim is to target obsessions, compulsions and doubt resulting from three underlying factors that maintain OCD: 1) fear 2) anxiety and 3) threat. Depression may also be a factor, which is often secondary to OCD, a result of the disruption caused in a person’s life. There is some evidence which suggests the cognitive approach is as effective as the medical approach (SSRIs) in terms of this treatment modifying biological parameters (Understanding Obsessive-Compulsive and Related Disorderswww.ocd.stanford.edu). However, the level of OCD severity and secondary depression is not overlooked here in which case medication combined with a biobehavioural approach is often an option.

    A cognitive dilemma for those with Asperger’s

    The cognitive approach casts doubt for those on the high end of the autistic spectrum, which is, since this type of therapy challenges the individual’s belief system and focuses on bringing awareness of the psychological features of OCD, how does this fair when it comes to treating individuals with the disorder if they also have Asperger’s? With regards to Baron-Cohen’s theory and this being correct and in terms of those with AS sharing some features of autism, there is however no delay in language and cognitive development; so the answer in most cases has to be that the prognosis is good.

    Back to choosing the right treatment options for OCD

    The right choice of treatment takes into account many more factors than already discussed, such as whether pharmacotherapy should be considered, for instance, if a client refuses psychological treatment or has poor response to behavioural methods. Likewise, behaviour therapy might be the appropriate choice if the client refuses medication or if drug therapy is ineffective, if the client is pregnant, is a child etc. Further, a combined approach might be considered a better option because it offers the best of both treatments, especially if the client’s condition has become entrenched over a number of years and/or if the person has depression or other overlapping conditions, or another distinguished disorder such as Asperger’s or Bipolar. In extreme cases, hospitalisation may have to be discussed as a treatment option, such as when a client’s condition is so debilitating that the person whose contamination fears for example are so severe that she isolates herself from other people, including family members; and to which her overall health (and her family’s well-being) is clearly at risk.

    What happens when the wrong diagnosis is given?

    A true diagnosis for both Asperger’s and OCD can often be confusing. I have known children and adults diagnosed with AS whose traits include aversions to foods touching each other, social avoidance, touch issues, and so on, only to find these features were associated with contamination fears and other OCD problems. I have also come across people diagnosed with OCD appearing to present with contamination fears associated with food, who have later revealed that they preferred their food placed on their plate in a particular order, not because they feared getting germs from food items touching each other. Some individuals also found social interaction difficult because they were touch-sensitive, not germ obsessed which is more likely to be characteristic of Asperger’s, not OCD. These examples only touch the surface but the bigger picture suggests there might be some ambiguity regarding certain statements/questions when determining diagnosis. Thus it is crucial that the person is clear about what box he is actually ticking during assessment for either (or both) diagnosis. Further, be sure about what questions are being asked and what they mean during an assessment before answering.