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- June 15, 2010
- 07:46 PM
- 2,041 views
Facilitated Communication: A Review of the Literature (with a new introduction)
by KWombles in Countering...
Three months ago, I ran the post that appears below. This post got lots of comments, and there were a fair number of misunderstandings, so let me up-front here make clear what I mean by facilitated communication in the hopes these misunderstandings do not occur again. We teach our children many skills by using hand-over-hand techniques. I'm not talking about teaching your child how to type, how to hold a pencil, how to do things. I'm talking specifically about the facilitated communication as Bilken and Crossley set out, as the research literature has examined.If you're guiding your child's communication (as in facilitated communication) and are certain it's all the child, let me suggest to you that you try this trick: try to intentionally guide the communication. I got my daughters to play along, to see just how easy it would be to intentionally co-opt what they typed, quickly moving from hand-over-hand on up the arm. If you've got a passive child, you can, with little practice you can get all the way up the arm to right under the shoulder and type whatever message you like. Now, picture you desperately want communication with a nonverbal child, you've been promised this works, reveals the true nature of your child's powerful intellect hidden within, and one of the first things your child types with the facilitator's help is "I love you." There are powerful emotional incentives to believe that a facilitator is merely helping your child's true self break free of the imprisonment you believe severe autism to be, your belief that there's another child, your real child, locked inside autism.That's what I'm writing about here. There are people using facilitated communication on children with speech and asserting that when FC is used, a real conversation is being had, finally. I've watched a video of a child being facilitated (not so passively) who yells out "stop."Imagine being voiceless and having someone else pretend to be your voice, while insisting the words being typed are your words. You know they are not your words, but you are powerless to do anything about it (unless you're like the child I wrote about above, who was able to vocalize "stop" although that did no good).We must take safeguards to protect our most vulnerable. The co-opting of their voices is one of those things we must safeguard against....“The false and exaggerated claims associated with facilitated communication have been exposed.” (Miles and Simpson, 1996)Facilitated communication is an issue of contention in some areas of the autism community. Part of the problem is what is meant by facilitated communication. There is little doubt that most people rely on authorities and various heuristics to ascertain the validity of claims rather than taking the time to investigate the research findings for themselves. Even when individuals are willing to take the time and make the effort to wade through research findings, a dizzying array of possible sources awaits them in most subject fields.As such, even dedicated and skeptical show-me parents are faced with an all but impossible task: how to decide on treatment and therapy modalities for their children. Which experts do you rely on? Is being the dean at a university enough to convey authority and legitimacy (Bilken, major proponent of FC)? Is being a tenured instructor at universities and a scientist who publishes research enough (Boyd Haley and Richard Deth)? What about being a medical doctor and researcher (Wakefield and Krigsman)?How do parents decide what autism is and what the best way to move forward is to help our children succeed? It is a difficult decision and I empathize with parents who work to do just that and find themselves inundated with people insisting that autistic children are sick, terribly sick, vaccine-damaged and mercury poisoned (buy our products, our way of thinking, and we will recover your child!) or who have a nonverbal, cognitively impaired and noncommunicative child and are sold the idea that inside is a child who is as smart as their non-impaired peers, if only you’ll help at the keyboard (and already knows how to read and the rules of grammar and all that--no need to teach it).I don’t have any easy answers, but I personally prefer to rely on scientific consensus and a careful reading of the literature before making decisions. Because I’ve read the research on the faultiness of human memory and the unreliability of testimonials and anecdotes, moving stories are insufficient evidence. Looking at the big picture, what studies looking at hundreds and thousands of individuals have found, is the best way to get at the objective truth. It’s still flawed, still imprecise, and so even it must be held with a lack of complete certainty and a willingness to entertain new evidence.... Read more »
Finn, P. (2005) Science and Pseudoscience in Communication Disorders: Criteria and Applications. American Journal of Speech-Language Pathology, 14(3), 172-186. DOI: 10.1044/1058-0360(2005/018)
Wegner, D., Fuller, V., & Sparrow, B. (2003) Clever hands: Uncontrolled intelligence in facilitated communication. Journal of Personality and Social Psychology, 85(1), 5-19. DOI: 10.1037/0022-3514.85.1.5
Ziring, P., Brazdziunas, D., Cooley, W., Kastner, T., Kummer, M., De Pijem, L., & et al. (1998) Auditory integration training and facilitated communication for autism. American Academy of Pediatrics. Committee on Children with Disabilities. Pediatrics, 102(2 Pt 1), 431-3. PMID: 9685446
- June 16, 2010
- 07:43 PM
- 396 views
The Use of Terms When Discussing Autism, Intelligence, Impairment, and Disability
by KWombles in Countering...
The terms we use, how we define them, are important things. Often times, we use similar terminology interchangeably. We're discussing nebulously defined disorders (autism and intellectual disability) that change over time and depending on the criteria being used. What do I mean about interchangeability and criteria? The official umbrella in the DSM-IV is not autism spectrum disorders, but is instead pervasive developmental disorders. However, the NIH uses autism spectrum disorders, as do many people in the autism community. The clinical and research usages change faster than the official bible (and lets not forget some disorders, despite ample research, valid checklists, etc., aren't in the DSM-IV and are not slated to go into the DSM-V). High functioning and low functioning autism are used, both amongst the community and in some research, yet don't exist in the DSM-IV. Many terms over the decades have been used to discuss individuals with what many now call intellectual disability (some textbooks still use mental retardation, as does the DSM, which has no intention of replacing the term, but the use of it within the specific field is on the decline). Mental retardation is in the DSM-IV: "A. Significantly subaverage intellectual functioning: an IQ of approximately 70 or below on an individually administered IQ test (for infants, a clinical judgment of significantly subaverage intellectual functioning).B. Concurrent deficits or impairments in present adaptive functioning (i.e.. the person's effectiveness in meeting the standards expected for his or her age by his or her cultural group) in at least two of the following areas: communication. self-care, home living, social/interpersonal skills, use of community resources, self-direction, functional academic skills, work, leisure, health, and safety.C. The onset is before age 18 years.Code based on degree of severity reflecting level of intellectual impairment" The Merck Manuals Online Medical Library defines intellectual disability thusly:"Intellectual disability (previously called mental retardation) is characterized by significantly subaverage intellectual functioning (often expressed as an intelligence quotient < 70 to 75) combined with limitations of > 2 of the following: communication, self-direction, social skills, self-care, use of community resources, and maintenance of personal safety. Management consists of education, family counseling, and social support."There's a reason that there is considerable overlap between autism and ID: many of the functional life skills are impaired in an individual with autism, just as they are in individuals with an intellectual disability. There's a tendency, though, I think, in the public discourse about ID to ignore the functional domains and focus on the IQ score. If functional life skills are high, but academic ability low, as long as the basic functions of living independently can be carried out, individuals with mild to moderate ID have a good chance of independent lives, while autistic individuals with high IQs but impaired functional life skills may require lifelong care. Despite the commonality in some of the additional impairments necessary to diagnose ID (mental retardation in the DSM-IV) between ID and autism, there is no accompanying requirement that there be ID in order to be diagnosed with autistic disorder. An interesting difference proposed between autistic individuals with low IQs and those with ID is offered by Anderson (2008): "In the case of autism it is argued that the low-IQ scores of people with autism are not likely to be due to a deficit in the cognitive process that is arguably the major cause of mental retardation—namely, speed of processing—but rather low IQ reflects the pervasive and cascading effects of thedeficit in the information-processing module that causes autism."Used interchangeably at times is cognitive impairment (often by me on this blog). I do so, in part, because we can look at specific areas of cognitive impairments that contribute to an overall diagnosis of intellectual disability. The other reason is because after my son's stroke, he was diagnosed with 294.0 Cognitive Disorder NOS. Cognitive impairment may be caused by diseases or accidents and are usually not present from birth. The DSM-IV explains the Cognitive Disorder in this way (note that cognitive disorder/cognitive impairments are not mutually inclusive):"This category is for disorders that are characterized by cognitive dysfunction presumed to be due to the direct physiological effect of a general medical condition that do not meet criteria for any of the specific deliriums, dementias, or amnestic disorders listed in this section and that are not better classified as Delirium Not Otherwise Specified, Dementia Not Otherwise Specified, or Amnestic Disorder Not Otherwise Specified. For cognitive dysfunction due to a specific or unknown substance, the specific Substance-Related Disorder Not Otherwise Specified category ... Read more »
Marrie, R., Chelune, G., Miller, D., & Cohen, J. (2005) Subjective cognitive complaints relate to mild impairment of cognition in multiple sclerosis. Multiple Sclerosis, 11(1), 69-75. DOI: 10.1191/1352458505ms1110oa
Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund LO, Nordberg A, Bäckman L, Albert M, Almkvist O.... (2004) Mild cognitive impairment--beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. Journal of internal medicine, 256(3), 240-6. PMID: 15324367
- July 22, 2010
- 04:49 PM
- 308 views
When Parents Kill: Filicide Usually Accompanied by mental illness
by KWombles in Countering...
There are some commonalities that almost everyone in the autism community can get solidly behind and that is the issue of filicide. Too many children in this country are killed by their parents. One such murder alone is too many. Of course, our attention is brought to bear when we hear autism in conjunction with a child murder.A Dallas woman murdered her two young children because, according to her 911 call, they were autistic. While our attention is focused on this case, as parents in the online community argue that media attention is on this case because of autism, and speculation amongst some parents runs to the paranoid ("Make autism parents look crazy and that's why they have autistic children. This all feels like one big CIA human experiment."), it's important to consider larger societal issues regarding filicide.What kind of people kill their children? Is this really about the autism, the disability, and an inability to cope because of the situation? Or is there something else at work here?Farooque and Ernst (2003) examined filicide and some of the conditions that appear to be involved in cases. They note that the US Justice Department reported that in 1999 there were over "1000 children died as a result of maltreatment where the alleged perpetrator was the child's parent."The literature on filicide actually goes back a ways; Farooque and Ernst point out that Resnick in 1969 set out a classification system for why parents kill their children and note that intellectual impairment of the perpetrator was not part of the classification system. Indeed, they note "Nearly forty years later, it is apparent thatthese constructs have added little to the understanding of the etiology of filicide and, more importantly, have often distracted investigators from more mundane and practical factors such as intellectual capacity and/or substance abuse of the perpetrator." If categorizing why parents say they do despicable acts isn't adequate as explanation, examining the mental health of the perpetrators can at least provide a window into the act.According to Farooque and Ernst, "Maternal mental illness has been found to be especially important in the incidence of filicide." Faroouque and Ernst summarize the current state of knowledge on filicide thusly: "mental illnesses, including psychotic symptomatology and affective illnesses,were frequently found in both male and female perpetrators of filicide."Farooque and Ernst expanded their study to also examine the intellecutal capacity of individuals who committed filicide during an eight year period. Their findings are interesting: Only one of the 19 cases revealed an Antisocial Personality Disorder while 10 of the 19 cases satisfied the diagnostic criteria for substance abuse/dependence. Two of these were intoxicated at the time of the crime. Only five subjects were psychotic at the time of the crime. On the other hand, eight of the 19 had some level of mental retardation. Of these, four scored in the borderline range (70-84) and four were in the range of mild mental retardation (55-70) based on DSM-IV criteria (American Psychiatric Association, 2001).1 We also found a positive relationship between borderline or mild mental retardation and evidence of child neglect by the perpetrator prior to the filicide event. Eight subjects revealed evidence of having perpetrated child neglect/abuse and, of these, seven satisfied the criteria for borderline or mild mental retardation. These subjects were significantly younger than those with normal intelligence.Hatters Friedman et al. (2005) found that "Over three-fourths of our filicide-suicide offenders had evidence of mental illness. Less than two-thirds of those with mental illness had been in mental health treatment." It would be convenient to twist this most recent filicide as an indictment of particular ideologies within the autistic community (indeed, this has already begun). The blame for these two children's murders does not rest in the autism community or in one particular faction of it. It does not rest with the public service announcements created by Autism Speaks (as some at Age of Autism would like to suggest). It doesn't rest with neurodiversity advocates. It doesn't rest with those who would cure autism at any cost. The blame rests squarely on the mother's shoulders.There isn't enough information about this mother, her exposure to the autism community, her mental health, her level of support, period to answer why she did this act, what led her to that monstrous act. Is it more than likely, based on the research that has been done on filicide, that she is mentally ill? Yes. Does her lack of affect in the 911 call suggest mental illness? Yes. Can you be mentally ill and intentionally premeditate the murder of your children? Yes. Should she be held legally responsible? Yes, one way or another, she should be held accountable for her actions. They are reprehensible and without defense. Looking for other people to blame to further one's own ideology is irresponsible.We do, as a society, need to do a better job of providing support to families, at providing education, and appropriate mediations. Was this a family in need of better support? What access to services were there? Was there a history of mental health issues? Speculation is pointless. Waiting for the facts in the case make sense here. What does seem clear is that the mother did do this. What is clear is that this is an unacceptable act. So, leaving that aside, what do we know about parents of autistic children, coping-wise? Pottie and Ingram (2008) found that the severity of autistic symptoms was not correlated with parental daily mood. They found that in "terms of significant predictors of daily positive mood, on average, 10 coping responses were found to predict daily pos... Read more »
Farooque R, & Ernst FA. (2003) Filicide: a review of eight years of clinical experience. Journal of the National Medical Association, 95(1), 90-4. PMID: 12656455
Hatters Friedman S, Hrouda DR, Holden CE, Noffsinger SG, & Resnick PJ. (2005) Filicide-suicide: common factors in parents who kill their children and themselves. The journal of the American Academy of Psychiatry and the Law, 33(4), 496-504. PMID: 16394226
Pottie, C., & Ingram, K. (2008) Daily stress, coping, and well-being in parents of children with autism: A multilevel modeling approach. Journal of Family Psychology, 22(6), 855-864. DOI: 10.1037/a0013604
- June 14, 2010
- 08:22 PM
- 305 views
So if Facilitated Communication has been shown to be Pseudoscience, What's a Parent to Do with a Nonverbal Child?
by KWombles in Countering...
Repost from March 26, 2010.I recently wrote a research-based blog on facilitated communication. It was a rather long article, I'll admit, but I thought it important to provide as much information about facilitated communication and what the overwhelming majority of studies and meta-analyses showed regarding it. It has, despite its popularity in some sectors of the autism community and its fervent supporters, been shown that the communication comes not from the individual who is nonverbal but from the facilitator instead.What is a parent and what are educators to do? We want to help nonverbal individuals find a way to express themselves, to communicate their needs, wants, and desires.There are other modalities that do not have the potentiality of being co-opted subconsciously by the facilitator.According to Schlosser and Wendt (2008):"Approximately 25%–61% of learners with autism present with little or no functional speech (Weitz, Dexter, & Moore, 1997) and may be candidates for augmentative and alternative communication (AAC) approaches to replace or supplement natural speech and or handwriting (Lloyd, Fuller, & Arvidson, 1997). Unaided AAC approaches include gestures, manual signing, and finger spelling. Aided AAC approaches include selection-based methods, such as graphic symbols, nonelectronic communication boards,speech-generating devices with synthesized and/or digitized speech output, and exchange-based approaches, such as the Picture Exchange Communication System (e.g., Mirenda, 2003)."Perhaps some of the confusion in the wider community with what is meant by facilitated communication is the use of facilitation in the context of augmentative and alternative communication:"It is understood that the primary aim of AAC intervention is to facilitate a child’s communicative competence through the use of multiple communication modalities that are by their very nature supplementing (“augmentative”) or replacing (“alternative”) natural speech (Light, Beukelman, & Reichle, 2003)" (Schlosser and Wendt, 2008).Son et al. (2005) note that there are many available choices for AAC interventions and that there may be benefit in the nonverbal individual having a role in the decision of which intervention device to use, while noting the difficulty in determining which AAC will be the most effective for the individual.There are problems, as others more illustrious than myself have noted, with autism treatments not being well vetted in the scientific literature before being implemented. FC is an example of this, but it is only one of many.I understand the need, the desire, the impetus to do something, anything, to help children with autism improve their functional skills. I understand parents, educators, support personnel, and physicians employing a kitchen sink approach, while I might not agree with that approach.We need to work better at coordinating researchers' efforts with the actual clinicians, practitioners, educators, and parents so that what is done boots on the ground is looked at in well-designed studies that can evaluate the effectiveness of the approaches being taken.Even some widely used systems like PECS have not received sufficient research to validate them: "Results of this study reveal that the PECS is widely implemented with individuals having ASDs but without a strong empirical base" (Ostryn et al., 2008).Does this mean we stop cold? No, it means that while we work to help our children, we look to what current research has to say and where there is clear empirical evidence that treatment modalities are not effective or cause greater harm, we steer clear of them. Where the research has not been done, but no harm has been substantiated, we proceed cautiously, and we advocate for getting that research done. We make sure that the treatments are plausible, as well. If it's too good to be true, well, come on, folks, it is. We educate ourselves about the scientific method, about critical thinking, about the body and how it works, about the brain and how it works. We read the scientific literature and we examine everything with skepticism. We also proceed knowing the fallibility of our perceptions, our incredible ability to see what we wish to see, and to attribute causes inaccurately. As long as we proceed open-minded and willing to be proven wrong, we safeguard against falling into the woo and losing our way and in the process harming our children.References Ostryn, C., Wolfe, P., & Rusch, F. (2008). A Review and Analysis of the Picture Exchange Communication System (PECS) for Individuals With Autism Spectrum Disorders Using a Paradigm of Communication Competence. Research & Practice for Persons with Severe Disabilities, 33(1/2), 13-24. Retrieved from Academic Search Complete database. Son, S., Sigafoos, J., O'Reilly, M., & Lancioni, G. (2006). Comparing two types of augmentative and alternative communication systems for children with autism. Pediatric Rehabilitation, 9(4),... Read more »
Schlosser, R., & Wendt, O. (2008) Effects of Augmentative and Alternative Communication Intervention on Speech Production in Children With Autism: A Systematic Review. American Journal of Speech-Language Pathology, 17(3), 212-230. DOI: 10.1044/1058-0360(2008/021)
- August 11, 2010
- 01:10 PM
- 301 views
Playing the Blame Game: People Don't Kill Their Children Because of Autism
by KWombles in Countering...
Given the reports of another murder of an autistic child, and the angry place's unbelievable need to suggest, both through an article and a tweet, that it is the lack of support causing parents to kill their children, I'm revamping my filicide post from last month and adding additional information. The reality is that filicide is far more common than people would like to admit ("7.31 in female and 6.54 in male children younger than 1 year per 100,000 live births" in Finland, according to Kauppi et al., 2010). In all likelihood, these parents didn't need the stressor of autism to commit these unspeakable acts; they were also dealing with other stressors and mental illness as well. For individuals to use these murders to further their agendas is heinous. Even where one could argue that the attempt is to gain better support, it is still irresponsible, as it represents an inaccurate portrait of both the parents who overwhelmingly cope well as well as allowing for the potential demonization of the disabled. "Oh, well, that would never have happened if the mom hadn't been dealing with a disabled child" is complete and utter rubbish.While there should be some commonalities that everyone in the autism community can get solidly behind, like the issue of filicide, not even here can we achieve any kind of real unity.Too many children in this country are killed by their parents, but far too often those deaths receive no nationwide attention. One such murder alone is too many. Of course, our attention is brought to bear when we hear autism in conjunction with a child murder, and we try to make sense of it. It doesn't mean we can, though, and the need to use these deaths to push one's agenda is wrong. It's wrong to suggest that parents kill their children because the autism was too hard to deal with and the support too inadequate. Ultimately, this works to put the blame on the autistic individuals and society at large while excusing the person who actually committed the crime. Should we have better supports in place? Yes. We should. Should we use these filicides to argue that without it there will be a rash of these murders? No. No. And again, no. Why? Because if these homicides are an accurate picture of the number of children with autism who have been killed over the last ninety days by parents, then the filicide of autistic individuals is not occurring the US at a greater rate than the prevalence of autistic individuals. What, how can that be?Three to five children a day are murdered by their parents in the US. So over the course of this summer, some 450 children will have been killed by their parents. 450 kids. Where is the outrage over this? I suspect that just as certain places ignore the reality that ADHD is found in 6% of the population compared to the 1% that autism appears to affect, that this is irrelevant to them because it doesn't advance their agenda. What doesn't promote their view of reality is ignored, both intentionally and through disconfirmation biases in place. Acording to Bourget et al. (2007), "Results of numerous studies indicate an association between filicide and parental psychiatric illness, with major depression with psychotic features most common.2,5,9,12,28–30,50–56... Read more »
Hatters Friedman S, Hrouda DR, Holden CE, Noffsinger SG, & Resnick PJ. (2005) Filicide-suicide: common factors in parents who kill their children and themselves. The journal of the American Academy of Psychiatry and the Law, 33(4), 496-504. PMID: 16394226
Kauppi A, Kumpulainen K, Karkola K, Vanamo T, & Merikanto J. (2010) Maternal and paternal filicides: a retrospective review of filicides in Finland. The journal of the American Academy of Psychiatry and the Law, 38(2), 229-38. PMID: 20542944
Pottie, C., & Ingram, K. (2008) Daily stress, coping, and well-being in parents of children with autism: A multilevel modeling approach. Journal of Family Psychology, 22(6), 855-864. DOI: 10.1037/a0013604
- June 16, 2010
- 10:17 AM
- 286 views
Once More into the Breach of Autism and Intellectual Disability (tweaked)
by KWombles in Countering...
Written before the important Nature study by Pinto et al. (2010), this post takes several posts I've done in the past on autism and intellectual disability, as well as responses to an individual who is positing an 80% rate of ID in autistic disorder, and synthesizes them into one large post while hopefully streamlining it some slight bit.Citing Berkel et al. (2010) as proof that ID is present in autistic disorder 80% of the time is not an accurate use of the research by bloggers. Researchers have been examining the connection between genetic variants in intellectual disability and autism for some time now. The latest study, Berkel et al. (2010) offers further corroboration that genetic differences can manifest as a wide variety of phenotypes. What we learn with each additional study is that autism (and as we've known for some time now, intellectual disability) is amazingly complex much of the time.“An overall cognitive deficit is not a defining feature of autism. “ –Amiet et al. (2008)…“Another difference between past and present autism diagnosis involves the presence of intellectual disabilities, adds Yeargin-Allsopp. During the 1960s and 1970s, the vast majority of those diagnosed with autism had an intellectual disability but today, only about 40% have one.” –from CMAJThis does not equate to an 80% figure of ID for those with autistic disorder, no matter how one parses the numbers. In fact Yeargin-Allsop’s 2003 study disconfirms the idea that most individuals with the AD diagnosis have ID. Some individuals are fond of the 80% number for ID and autism comorbidity (like others are so fond of the 80% divorce rate, also untrue).The CDC’s press briefing on the latest autism findings offer this:“Catherine Rice: So in terms of mental retardation, it’s now more commonly referred to as intellectual disability. We know there’s quite an overlap in intellectual disability and autism spectrum disorders. For many years, the best statistics and disorders told us 75% or three-quarters of children with autism also had an intellectual disability. Now the numbers that we’re identifying in our study shows us it’s more about 40% or more specifically 41% of children with autism having an intellectual disability. So overall, this is a population with less intellectual impairment, sometimes referring to as more a higher functional population. So there are many theories out there in terms of this diagnostic shifting and how we look at things or are we really seeing a more high functioning population? That is challenging to sort out.”In 2009, Rice wrote: “Data on cognitive functioning are reported for sites having IQ test scores available on at least 70% of children who met the ASD case definition. The proportion of children with ASDs who had test scores indicating cognitive impairment (IQ ≤70) ranged from 29.3% in Colorado to 51.2% in South Carolina (average: 41%). In four of the six sites (Alabama, Arizona, North Carolina, and South Carolina), a higher proportion of females with ASDs had cognitive impairment compared with males (Figure 3), although Arizona was the only site for which the proportions differed significantly (0.05).”In discussing autism and intellectual disability, Rice wrote: “Children identified with an ASD in 2006 reflect a group with less co-occurring cognitive impairment than the population identified ≥20 years ago, when autism was conceptualized in a more severe and singular form compared with the spectrum of disorders identified today (2,34... Read more »
Dawson, M., Soulieres, I., Ann Gernsbacher, M., & Mottron, L. (2007) The Level and Nature of Autistic Intelligence. Psychological Science, 18(8), 657-662. DOI: 10.1111/j.1467-9280.2007.01954.x
Fombonne, E. (2002) Epidemiological trends in rates of autism. Molecular Psychiatry, 7(s2). DOI: 10.1038/sj.mp.4001162
Yeargin-Allsopp, M. (2003) Prevalence of Autism in a US Metropolitan Area. JAMA: The Journal of the American Medical Association, 289(1), 49-55. DOI: 10.1001/jama.289.1.49
- August 16, 2010
- 09:32 AM
- 280 views
Musical Accompaniment
by KWombles in Countering...
I have a soundtrack playing in my head, nearly 24/7. It beats the hell out of my tinnitus, but it can be distracting at times. I wake up in the middle of the night to the music playing in my head. I have conversations while it phantom plays; I type and it's there, playing in the background. Call it the ultimate in multitasking and totally easier than walking around with an MP3 player and earbuds. It's exclusively in my head, though; thankfully it hasn't branched out to musical hallucinations, where people hear music that isn't there. No, this is just my mind playing on. The last week or so it's been the Court Yard Hounds; I've listened to the cd often enough that it's cycling in my head in an endless loop.If my soundtrack appeared to be originating outside my head, in that I was hearing music no one else was, then it would perhaps be more troublesome. However, as long as the music plays in my head, it does seem to effectively dampen the ringing. Also, as long it's music I want to be listening to, it's hardly a problem. I wonder if this particular perseveration, hearing the Court Yard Hounds in my mind (right now it's "Gracefully"), is simply an extension of my perseveration of listening to the cd each time I get in the car since the cd was released. In other words, I'm hooked on the album, and my brain generates the music for me.The question is, since my mind always turns to what scientists know about a topic, is has this been studied? What kind of variation are there for phantom music? So we know that people have auditory hallucinations, hear voices that register as external, and it appears that people can hear music as external. Some people believe the music to be real, while others know it is not. Mocellin, Walterfang, and Velakoulis (2008) explain the difference between hallucinations and hallucinosis: "Hallucinations attributed to structural CNS disease are often differentiated by the term hallucinosis’. In general, hallucinosis and hallucinations are usually separated by the nature of the associated insight. Hallucinations in psychiatric disorders are defined by the absence of insight in which the person experiencing the phenomena does not understand it as morbid. In general, those describing hallucinosis have some degree of insight, often being able to comprehend their experiences as tricks of the mind’."I try to imagine how it would feel to actually hear the music outside my head. I've had the ringing in my ears for over seven years. It was incredibly frustrating until I learned to work around it with white noise machines and fans in every room of the house running around the clock. The constant music is relatively new in comparison; most of us have had the experience of having a song stuck in our head; we either jam along with it or get incredibly frustrated. Last year, for a week or so I had the song my son danced to at his concert at the day center, "Another One Bites the Dust." Kathleen would send me links to songs on you tube in an attempt to knock it out.Okay, neither of these (musical hallucinations or musical hallucinosis) really fit. According to the American Tinnitus Association, music is one of the sounds that individuals with tinnitus may hear. So, is the soundtrack playing in my head (that has my head shaking in time to the beat) simply a change in how my tinnitus manifests? Maybe, except the bzzzz from the tinnitus is experienced as a real sound, while the music in my head is internal.Access to a good database and a boundless curiousity allows the opportunity to keep asking questions and to find all sorts of goodies. Perhaps it's a pseudohallucination? Hah, no seriously, there's an article that has a case study of a patient with OCD and musical obsessions: "The musical symptoms in the present patient were experienced as produced in his own mind and not imposed from outside. The music was experienced as repetitive, intrusive and inappropriate, which caused marked anxiety, distress and impairment of social–occupational functioning. It was not simply associated with excessive worries about life problems. The musical symptoms were accompanied by full insight into the senselessness and excessiveness of the symptoms, and the patient attempted to suppress the music or neutralize it with other thoughts. Thus, the musical symptoms observed in the present case are consistent with the psychopathological characteristics of obsessions" (Praharaj et al., 2009).Oh, hell. Hee. I jest. I don't think this is an issue unless I want it to be. And it would be kind of silly, wouldn't it? It is what it is. And the soundtrack can be silenced by playing music; it just resumes when the music is off. Must mean I've got a song in my heart, right?... Read more »
Mocellin, R., Walterfang, M., & Velakoulis, D. (2008) Musical hallucinosis: case reports and possible neurobiological models. Acta Neuropsychiatrica, 20(2), 91-95. DOI: 10.1111/j.1601-5215.2007.00255.x
Praharaj, S., Goyal, N., Sarkar, S., Bagati, D., Sinha, P., & Sinha, V. (2009) Musical obsession or pseudohallucination: Electrophysiological standpoint. Psychiatry and Clinical Neurosciences, 63(2), 230-234. DOI: 10.1111/j.1440-1819.2009.01926.x
- July 6, 2010
- 02:54 PM
- 253 views
Mercola: Truer Words Were Never Written?
by KWombles in Countering...
Mercola, webster of woo, he of the get your vitamin D through our tanning bed fame, has a new post up at Huffington Post. I tell you, I find it endlessly comforting to know that these medically-related articles are reviewed by Ornish, you know? Okay, not.Can Huffington Post put up a health related piece that isn't woo? I mean, can they?Mercola's latest is on aspartame. I won't go into all the details relating to his assertion that aspartame is more evil than the devil. Aspartame has received a fair amount of attention from people who think it is at the root of a lot of health issues.No, what really gets me is this sentence, and Mercola's never written truer words: "This is deception at its finest: begin with a shred of truth, and then spin it to fit your own agenda." It's what Mercola does, time and time again, so it's fascinating to read him accuse the manufacturer of aspartame of the same thing. The rest of Mercola's article is designed to scare the shit out of you concerning aspartame and make you go on over to his site, so you can learn all about his plan to free you from your sugar and sugar-free habits through the incredibly odd Meridian Tapping Technique. The American Council on Science and Health writes concerning aspartame: "The American Council on Science and Health (ACSH) is now receiving daily inquiries regarding one such health hoax about aspartame (see below).The hoax links the sweetener to multiple sclerosis-like symptoms and systemic lupus using quasi-medical jargon. Like most of its kind, this Web scare appears to be credible, pointing to impressive-sounding names like the Multiple Sclerosis Foundation, the "World Environmental Conference" and the mysterious "Dr. Espisto." Also like its compadres, this article is packed with misinformation that could frighten those, such as diabetics, who rely on aspartame.In fact, aspartame, known as "NutraSweet" and "Equal," is safe. Aspartame is one of the most thoroughly tested substances in the U.S. food supply. Numerous authorities, including the Food and Drug Administration, the Joint Expert Committee on Food Additives of the FAO/WHO, the European Community, and the American Medical Association have concluded that aspartame is a safe product, except in the rare cases of phenylketonuria. For more information on aspartame, please refer to ACSH's peer-reviewed booklet Low Calorie Sweeteners. And beware of Internet health hoaxes." Should one see just how much aspartame one can consume in a day? Probably not. But, for the overwhelming majority of people, aspartame causes no adverse effects:"Even when aspartame is consumed in unusually large (but physically possible) amounts, adverse health effects do not occur. Aspartame has been tested in human volunteers in single doses four times the acceptable daily intake (the amount considered safe for daily consumption for a lifetime) and in studies where volunteers consumed aspartame daily at a level 50% higher than the acceptable daily intake for several months. Even at these high doses, the levels of all three of aspartame’s components in the volunteers’ blood remained within safe ranges, and no adverse effects occurred." ACSHThe ADI (acceptable daily intake) of aspartame is 50 mg/kg/d. Acute toxicity symptoms include: "Headache, dry mouth, dizziness, mood change, nausea, vomiting, reduced seizure threshold, thrombocytopenia" (Whitehouse, et al., 2008). Note that the ACSH reports that individuals have taken 4 times that and had none of these adverse events.No, what seems apparent, upon reading Mercola's article (devoid of even this bare minimum of research), is that Mercola is interested, primarily, in scaring people, driving them to his website, and even where he's not trying to explicitly sell them something, make them susceptible to looking at his products and buying them.There's no doubt that Mercola is big, big, big business. He's got lots of followers, lots willing to listen to him as if he had all the answers. It'd be a wise thing to take a minute and remember that scientists and science-based doctors are always willing to admit they don't have all the answers. They have informed opinions based on the weight of the scientific evidence.Whitehouse, C., Boullata, J., & Mccauley, L. (2008). The Potential Toxicity of Artificial Sweeteners AAOHN Journal, 56 (6), 251-259 DOI: ... Read more »
Whitehouse, C., Boullata, J., & Mccauley, L. (2008) The Potential Toxicity of Artificial Sweeteners. AAOHN Journal, 56(6), 251-259. DOI: 10.3928/08910162-20080601-02
- June 27, 2010
- 12:35 PM
- 233 views
Monkeys and Mice: A Literature Review the Anti-Vaccine Folks Should Embrace But Won't
by KWombles in Countering...
Aschner and Ceccatelli (2010) review the relevant data for thimerosal as a cause of autism. They conclude there is "no reliable data indicating that administration of vaccines containing thimerosal is a primary cause ofautism. However, one cannot rule out the possibility that the individual gene profile and/or gene–environmentinteractions may play a role in modulating the response to acquired risk by modifying the individual susceptibility."Aschner and Ceccatelli first discuss all the possible exposures to mercury that occur in the environment. There's a lot of potential exposures to mercury, with fish being the primary exposure to methylmercury.Of interest is this paragraph:"The incidents in Japan and Iraq revealed the particularly devastating neurotoxic effects of MeHg on the developing nervous system. Lately, also exposure to much lower level of MeHg from dietary sources was shown to have unfavorable neurodevelopmental effects as reported by prospective studies of populations in the Faroe Islands and New Zealand (Kjellstrom et al. 1989; Grandjean et al. 1997). Recent studies point to the critical role that maternal diet can play in the onset of MeHg developmental neurotoxicity (Davidson et al. 2008)." (Aschner and Ceccatelli)It makes almost no sense on a practical level for parents to be raging against thimerosal while ignoring the reality that their children's exposure to methylmercury is far more pervasive.Aschner and Ceccatelli note that thimerosal was removed from vaccines under the assumption that toxicity would be similar to methylmercury exposure, but that since that removal, "it has been shown that the kinetics of tissues disposition and metabolism differ from those for MeHg." They continue: "While the scientific literature supports the concept that MeHg is a potent developmental neurotoxin, the assertion that thimerosal leads to developmental disorders in children is hypothetical and unsubstantiated, resting on indirect and incomplete information, primarily from analogies with MeHg."As a purely precautionary action, reducing thimerosal exposure made practical sense while conducting studies to look at the potential for neurotoxicity. Unfortunately, we know that those who latched onto thimerosal as a potential cause of autism, have used this cautionary act as proof that the government and pharma knew it was a problem. It's evident from careful and exhaustive reading of parents who buy into the vaccine causation theory that facts and evidence aren't necessary for this belief system to maintain itself more fervently over time and as each potential theory is shot down.Safety studies on thimerosal have now been conducted. So have studies looking at autism rates as thimerosal was removed from vaccines. Aschner and Ceccatelli conclude from these studies: "Simply stated, MeHg is not a suitable reference for evaluating ethylmercury toxicity. Key observations to substantiate this statement include the following: (1) mercury clears from the body much faster after the administration of ethylmercury than after the administration of MeHg; (2) the brain-to-blood mercury concentration ratio established for MeHg will overestimate mercury in the brain after exposure to ethylmercury; and (3) because ethylmercury decomposes much faster than MeHg, the risk of brain damage is less for ethylmercury than for MeHg."Aschner and Ceccatelli even spend a fair amount of time reviewing Burbacher's study on monkeys that the anti-vaccine folks love to trot out. Hornig's mice study is also reviewed. If the anti-vaccine folks were about scientific evidence, then they'd have to embrace the conclusions that Aschner and Ceccatelli come to, but anyone who's spent time reading those who embrace autism as vaccine injury knows once they're aware of Aschner and Ceccatelli's literature review, they'll be quick to reject it, especially since the conclusion of the literature review on thimerosal and autism is: "Methodologically sound and rigorous epidemiologicalstudies have largely failed in finding a significant correlation between thimerosal-containing vaccines and autism. However, efforts to reduce the exposure of infants, children, and pregnant women to any form of mercury from various sources should continue."Aschner, M., & Ceccatelli, S. (2009). Are Neuropathological Conditions Relevant to Ethylmercury Exposure? Neurotoxicity Research, 18 (1), 59-68 DOI: 10.1007/s12640-009-9113-2... Read more »
Aschner, M., & Ceccatelli, S. (2009) Are Neuropathological Conditions Relevant to Ethylmercury Exposure?. Neurotoxicity Research, 18(1), 59-68. DOI: 10.1007/s12640-009-9113-2
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