Environmental FactorsEnvironmental FactorsAffecting Affecting

Children with DisabilitiesChildren with Disabilities

Researched, Written, and Created by: Lee PoeRio

For: Dr. Levy OQ 602

Definition of Environmental factor: An event, circumstance, influence, or element that plays a part in bringing about a result.

Environmental factors:

•Socio-economics •Drug companies and media•Parental involvement•Toxins in foods and drugs•Nutrition, and diet •Health Care•Pollution•Societal changes

•Definition of Attention Deficit Hyperactivity Disorder (ADHD): A condition characterized by hyperactivity, impulsivity, and inattention; included in the “other health impairments” category.

•Definition of Emotional and Behavioral Disorder: A disability characterized by behavioral or emotional responses that are very different from all norms and referent groups and have adverse effects on educational performance.

Environmental factors that I will Environmental factors that I will cover:cover:

•Socio-Economics Socio-Economics •Drug Companies and MediaDrug Companies and Media•Parental InvolvementParental Involvement

Center for Disease Control website:

•13.7 million Children have a mental disorder

•Only one-third of children get help

•45 million Children 5-17 years of age have been diagnosed with ADHD as of 2006.

•Diagnosis of ADHD increased an average of 3% per year from 1997

•Boys (9.5%) are more likely than girls (5.9%) to have been diagnosed with ADHD

•Almost one in 10 children in the United States has a mental disorder that causes some type of impairment.

•Nearly half (46 percent) of the U.S. adult population suffers from some form mental illness.

Socio-EconomicsSocio-Economics ADHD diagnosis among males was reported ADHD diagnosis among males was reported

significantly more often in families significantly more often in families with incomes with incomes below the poverty thresholdbelow the poverty threshold

Children of parents with an education of 12th grade or Children of parents with an education of 12th grade or HigherHigher

Emotional Disorder and Behavioral Disorders were twice Emotional Disorder and Behavioral Disorders were twice as likely to be diagnosed with families with as likely to be diagnosed with families with incomes incomes below the poverty thresholdbelow the poverty threshold 12.1% compared to 6.1% 12.1% compared to 6.1%

Boys (11.4%) and girls (5.9%) with Medicaid or other Boys (11.4%) and girls (5.9%) with Medicaid or other public health insurance coverage were about twice as public health insurance coverage were about twice as likely to have disorders likely to have disorders

Boys (4.6%) and girls (2.3%) with private Insurance Boys (4.6%) and girls (2.3%) with private Insurance Insured ChildrenInsured Children

What can we conclude from What can we conclude from the data?the data?

Can we relieve economic stress? Can we relieve economic stress? Then Focus on other variables:Then Focus on other variables:

Genetics, and parental Genetics, and parental involvement/relationships?involvement/relationships?

Can we easily distribute truths in front of Can we easily distribute truths in front of the world and our country so the working the world and our country so the working class and families in poverty understand? class and families in poverty understand?

Can we help the children, and the parents Can we help the children, and the parents of these children, and adults who suffer of these children, and adults who suffer from these disorders in an appropriate way?from these disorders in an appropriate way?

Can we end the cycle?Can we end the cycle?

Drug Companies and Drug Companies and MediaMedia

Families USA Has specific data on Drug Company Spending:

Among the nine pharmaceutical companies examined in the report

Merck Pfizer Bristol-Myers Squibb Pharmacia Abbott Laboratories American Home Products Eli Lilly Schering-Plough Allergan *Companies spent more than twice as much on marketing, advertising, and administration than they did on research and development.

* Eli Lilly spent more than 1 ½ as much

National Institute of Mental Health

accused of:

The Consumer/Survivor Movement organization Mind Freedom International accused The National Institute of Mental Health of focusing on basic brain research that won't help in the immediate future, if at all, and

of only seeking new drugs rather other kinds of assistance and therapy being a promotional tool by pharmaceutical companies

Several Psychiatrists were reported having financial links with Pharmaceutical companies.

National Alliance of Mental Health

accused of:

Funding by pharmaceutical companies

Eli Lilly & company executive working from a NAMI headquarter office

Senator Charles E. Grassley led an investigation uncovering 66% of NAMI funding came from pharmaceutical companies

Drug companies provide lavish compensation packages including stock options to top executives.

Accusations toward National Institute of Mental Health and National Alliance of Mental Health

• A pediatrician experienced in development and behavior, examines in his book, The Last Normal Child: Essays on the Intersection of Kids, Culture, and Psychiatric Drugs:

• The trends of drug companies and doctors who are quickly diagnosing ADHD and other disorders.

• These diagnoses are leading to quick prescriptions of a stimulant drug. prescription meds used as needed, but only as a part of comprehensive management program and behavior plan.

• Believes that ADHD is being over diagnosed

• Individuals with Disability Education Act of 1990 accelerated pharmacological treatment as well as the ADHD diagnosis

• Because its amendment in 1991 included ADHD as a diagnosis

• That makes a child eligible for special services and accommodations in public schools.

• Schools get funding when the child has an IEP, and is classified with a disability.

Dr. Lawrence H. Diller

Dr. Diller’s Research:Dr. Diller’s Research:

Over the last 15 years brand name stimulant Over the last 15 years brand name stimulant production has increased by 1700% andproduction has increased by 1700% and

Generic stimulants by more than 3000%Generic stimulants by more than 3000%

The number of U.S. children taking The number of U.S. children taking psychotropic drugs has doubled over the last psychotropic drugs has doubled over the last ten years. We currently have more than 4.5 ten years. We currently have more than 4.5 million children under 18 taking psychotropic million children under 18 taking psychotropic drugs that are mostly stimulants. drugs that are mostly stimulants.

Over 3 billion Dollars are put towards Over 3 billion Dollars are put towards advertisingadvertising

The percentages of children with ADHD being reported by the (CDC):The percentages of children with ADHD being reported by the (CDC):State-based Prevalence Data of ADHD DiagnosisState-based Prevalence Data of ADHD DiagnosisPercent of Youth 4-17 ever diagnosed with Percent of Youth 4-17 ever diagnosed with

Attention-Deficit/Hyperactivity Disorder: National Survey of Attention-Deficit/Hyperactivity Disorder: National Survey of 20032003

State-based Prevalence Data of State-based Prevalence Data of ADHD Medication ADHD Medication TreatmentTreatment

Percent of Youth 4-17 ever diagnosed with Percent of Youth 4-17 ever diagnosed with Attention-Deficit/Hyperactivity Disorder: National Survey of Attention-Deficit/Hyperactivity Disorder: National Survey of

Children's Health, 2003Children's Health, 2003

Medication treatment high in East

Dr. Michael Valentine Behavioral Therapist

1. Finds no concrete medical evidence for ADHD

2. No valid assessment for ADHD

3. Pharmaceutical companies have spent a lot of money underwriting and promoting Children and Adults with Attention Deficit Disorder (C.H.A.D.D.)

4. Funding the organization and supporting this disease model.

5. Pharmaceutical companies and well paid national researchers in this field have petitioned the Drug Enforcement Agency (DEA) to change Ritalin (ADHD medication) from a Class II drug to a Class III drug so they can produce more Ritalin without government restrictions.

Have Parents diagnosed their Have Parents diagnosed their kids based on advertising kids based on advertising

campaigns?campaigns?

Dr. Diller suggests that many parents Dr. Diller suggests that many parents welcomed a brain–focused diagnosis welcomed a brain–focused diagnosis that relieved them of responsibility that relieved them of responsibility for problem behavior.for problem behavior.

ControversialControversial

Parental Involvement

German Research Team published

in Developmental Neurobiology

• Studied the rodents Degus (chinchilla family) wiring is almost the same in the human and degus brain

• Reared by two parents both taking part in caring for young

• Degus reared without father differed

Neuronal Development between two Neuronal Development between two sets of pups showed significant sets of pups showed significant

differencesdifferencesFatherless Pups Reared By Mother AloneFatherless Pups Reared By Mother Alone

Significantly different growth patterns in parts of their Significantly different growth patterns in parts of their brains thatbrains that

Control:Control:

Decision makingDecision making RewardReward ControlControl Also: Also: Less interaction with mother Less interaction with mother Poor impulse controlPoor impulse control More play fighting with siblingsMore play fighting with siblings Displayed aggressionDisplayed aggression

Children From The Former Soviet Children From The Former Soviet UnionUnion

A swarm of children received very little A swarm of children received very little touch in some orphanagestouch in some orphanages

Slight StimulationSlight StimulationNo HugsNo HugsLittle PlayLittle PlayLittle Communication Little Communication Many children stayed in cribs for long periods of timeMany children stayed in cribs for long periods of time

Frequently Became Developmentally Frequently Became Developmentally ImpairedImpaired

Not GeneticNot Genetic

Surgeon General Website

Boys and girls living in single-mother families were about twice as likely to have had “difficulties”

Boys (9.6%) Girls (4.7%)

Boys and girls living in two-parent families:

Boys (5.4%) Girls (2.6%)

Training parents of high-risk children how to Training parents of high-risk children how to deal with the children’s demands may deal with the children’s demands may help. help.

Parents may need to be taught to reinforce Parents may need to be taught to reinforce appropriate behaviors and not harshly appropriate behaviors and not harshly punish transgressing ones.punish transgressing ones.

Encouraged to find ways to increase the Encouraged to find ways to increase the strength of the emotional ties between strength of the emotional ties between parent and child.parent and child.

Improving parenting skills through training Improving parenting skills through training can substantially reduce antisocial can substantially reduce antisocial behavior in children.behavior in children.

Childhood Maltreatment Childhood Maltreatment (Surgeon General Website)(Surgeon General Website)

It is estimated that over 3 million children are It is estimated that over 3 million children are maltreated every year in the United States maltreated every year in the United States (National Committee to Prevent Child Abuse, 1995).(National Committee to Prevent Child Abuse, 1995).

Physical abuse is associated withPhysical abuse is associated with::

insecure attachment insecure attachment psychiatric disorderspsychiatric disorders such as post-traumatic stress disordersuch as post-traumatic stress disorder Conduct DisorderConduct Disorder ADHDADHD Depression Depression Impaired social functioning with peersImpaired social functioning with peers

Family EnvironmentFamily Environment learningdisabilties.orglearningdisabilties.org

Some learning difficulties may actually Some learning difficulties may actually stem from the family environment stem from the family environment

For example: For example:

Parents who have expressive language Parents who have expressive language disorders might talk less to their childrendisorders might talk less to their children

or the language they use may be distorted.or the language they use may be distorted.

In such cases, the child lacks a good In such cases, the child lacks a good model for acquiring language and model for acquiring language and therefore, may seem to be learning therefore, may seem to be learning disabled. disabled.

There is a big risk that this labeling and medicating of children will eventually become a social control issue for lower Socio Economic Students and minority students.

Politicians and drug companies tried to “prove” racial intelligence in the past, and some still flirting with it.

Genetic racism led a team of researchers in performing numerous experiments, partly funded by federal dollars, on children as young as six years of age.

In one "study" at the New York State Psychiatric Institute, 34 healthy boys, aged 6 to 10, were administered the drug fenfluramine, the primary ingredient in the diet drug Fen-Phen which has been banned by the US government.

1.1. The boys were all from impoverished familiesThe boys were all from impoverished families

2.2. 44% were African-American 44% were African-American

3.3. and 56% were Hispanic. and 56% were Hispanic.

4.4. The boys were made to fast for 12 hours prior to beginning and The boys were made to fast for 12 hours prior to beginning and during the test were allowed only water. during the test were allowed only water.

5.5. An intravenous catheter was inserted and designed to remain in An intravenous catheter was inserted and designed to remain in place for 5 1/2 hours. place for 5 1/2 hours.

6.6. During that period an oral dose of the drug fenfluramine hydroxide During that period an oral dose of the drug fenfluramine hydroxide was administered (10mg/kg). was administered (10mg/kg).

7.7. Blood was drawn hourly. Blood was drawn hourly.

8.8. Their results were inconclusive, and actually disproved their theory. Their results were inconclusive, and actually disproved their theory.

9.9. So, So, They changed their theoryThey changed their theory that extra serotonin as a child that extra serotonin as a child could could leadlead to the to the decreasedecrease in serotonin as and adult, in serotonin as and adult,

10.10. and therefore the children grow up to have disorders as adults.and therefore the children grow up to have disorders as adults.

What Next?What Next?

We aren’t seeing a decrease We aren’t seeing a decrease of disorders, and ADHD but of disorders, and ADHD but only the oppositeonly the opposite, AN , AN INCREASE! DRASTICALLY INCREASE! DRASTICALLY BECOMING WORSE!BECOMING WORSE!

Having people get the skills they need Having people get the skills they need in life in life may work.may work. There is no big There is no big

business behind this approach. business behind this approach. There There is no money to be made by doing this.is no money to be made by doing this.

Drug companies and their influence Drug companies and their influence would not be very happy.would not be very happy.

Dr. Breggin has shown that many failing inner city schools have children who are

much more active, aggressive and impulsive than most children currently diagnosed or

labeled as ADHD.

Staff trained in this discipline approach has had success in turning these schools around for the most part without having to medicate

these children.

The majority of lower social economic inner city students typically are minorities and they are at risk of becoming a psychiatric disorder or disease that might need to be

socially and politically controlled by drugging them.

This is already a reality in some psychiatric hospitals and prison systems and is close

to becoming a reality in schools.

In a housing development or in “the projects” they are not considered ADHD to one another, they are like all of their peers, but if you place that child into

another living situation, and into another neighborhood they would have ADHD, or

ODD, or another form of a disorder

When the child in When the child in government housing, government housing,

impoverished, they are impoverished, they are at risk as our jail systems at risk as our jail systems shows us. Will we start shows us. Will we start

drugging the kids in drugging the kids in projects? projects?

We are.

The U.S. Justice Department statisticsThe U.S. Justice Department statistics::

• A record 7 million people -- or one in every 32 American adults -- were behind bars, on probation or on parole.

• Of the total, 2.2 million were in prison or jail.

• More people are behind bars in the United States than in any other country.

• The U.S. incarceration rate is 737 per 100,000 people

• In contrast, the incarceration rates in many Western industrial nations range around 100 per 100,000 people.

Immigration and Culture

This documents the existence of several disparities.

Affecting mental health care of racial and ethnic minorities compared with whites:

Minorities have less access to, and availability of, mental health services.

Minorities are less likely to receive needed mental health services.

Minorities in treatment often receive a poorer quality of mental health care.

Minorities are underrepresented in mental health research.

But additional barriers deter racial and ethnic minorities; mistrust and fear of treatment, racism and discrimination, and differences in language and communication. The ability for consumers and providers to communicate with one another is essential for all aspects of health care, yet it carries special significance in the area of mental health because mental disorders affect thoughts, moods, and the highest integrative aspects of behavior. The diagnosis and treatment of mental disorders greatly depend on verbal communication and trust between patient and clinician. More broadly, mental health care disparities may also stem from minorities’ historical and present day struggles with racism and discrimination, which affect their mental health and contribute to their lower economic, social, and political status.

Ethnic and racial minorities in the United States face a social and economic environment of inequality that includes greater exposure to racism, discrimination, violence, and poverty.

Living In poverty has the most measurable effect on the rates of mental Illness.

People in the lowest strata of income, education, and Occupation (known as socioeconomic status) is about two to three times more likely than those in the highest strata to have a Mental disorder.

White non-Hispanic White non-Hispanic (6.6%)(6.6%)

Black non-Hispanic boys Black non-Hispanic boys (8.3%) (8.3%)

Hispanic boys (4.7%). Hispanic boys (4.7%).

• Mental illnesses including anxiety disorders and depression are common and under-treated in many developed and developing countries, with the highest rate found in the United States, according to a study of 14 countries.

• We need to help our children, and the parents of all children. We need to have information become common knowledge and funding for information not coming from companies that will make money on results as to not have skewed information. We need to know how many kids are ODD, ADHD, and other disorders winding up in our institutions.

National Joint Committee on Learning Disabilities

High quality learning opportunities Exposure to rich and varied vocabulary, syntax,

and discourse patterns Responsive learning environments sensitive to

all cultural and linguistic backgrounds Involvement in structured and unstructured

individual/group play interactions and conversations

Engagement in gross and fine motor activities

201102.wmv

References Adhd-report.com breggin.com cdc.gov chadd.org Developmental Psychobiology Volume 42 Issue 3, Pages 237 - 245 Published Online: 26 Feb 2003 Copyright © 2010 Wiley Periodicals, Inc., A

Wiley Company dldcec.org/default.cfm Empowering parents.org greens.org/s-r/19/19-07.html Ldonline.org Learningdisabilties.org Linksforlearning.com michael-valentine.com/adhd.html mindfreedom.org/kb/psych-drug-corp/nimh-draft/ Nami.org pbs.org/wgbh/pages/frontline/shows/medicating/interviews/jensen.html playattention.com Richard Gosden and Sharon Beder Pharmaceutical Industry Agenda Setting in

Mental Health Policies Ethical Human Sciences and Services 3(3) Fall/Winter 2001, pp. 147-159.

Surgeongeneral.gov