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February 2003 Issue


"SEAS THE OPPORTUNITY"

Ahoy matey! SPIN is taking on provisions for a cruise into the sea of opportunities for children and teens with disabilities and their families. It's our 18th Annual SPIN Conference, and we set sail on Saturday, April 12th from the University of Hawaii Campus Center.
At the helm of our cruise ship is Dr. Richard Radtke, famous oceanographer and founder of the Sea of Dreams Foundation. After you get your sea legs listening to Rich, we'll steer you to a choice of 18 excursions over the course of the day. We'll also have prizes and a number of agency tables to learn about their services for families and youth. You can find an agenda of the conference on page 7, along with a registration form. For a more complete conference flyer, call or e-mail us at SPIN.
Last year's conference netted 400 folks from across the state, and we expect another crowd this year, so make your cruise reservations early. There are a number of airfare scholarships available to parents from the Neighbor Islands. We'll be using coupons, so it is very important to make your reservations early. Hope to see you all there.

HFAA CONFERENCE

Hawaii Families as Allies (HFAA) is also putting out the call to families and youth with emotional and behavioral challenges to attend their Annual Conference. The Youth Conference will be on June 14 and the Family Conference on June 21--both at the UH Campus Center. This is a popular conference, so call early for an application at 487-8785 or toll-free at 1-866-361-8825.

EVIDENCED BASED SERVICES AND ANXIETY

Evidence based services or interventions (EBS) are those that have been scientifically proven to have a positive effect in the treatment of a particular disorder. In our last issue we began sharing information from an important Hawaii report* about EBS for children and teens with mental health disorders that was released in December, 2002.
We continue in this issue to share the report's findings on what works in treating anxiety disorders in children and teens, so that families can make informed choices about intervention options. As you read these findings on effective practices keep in mind the following:
* no intervention or medication is 100% effective with all kids,
* only those studies that met scientific research standards (for example, randomized control and experimental groups) were reviewed,
* a number of promising practices in the field of children's mental health have not been studied thoroughly enough to receive an EBS rating, and
* if your child is receiving an intervention that is not listed in the report, but that seems to be giving real benefit, then it may be the best option available for him or her.
The important thing with any intervention is to have some way to measure its effectiveness.

*The "Summary of Effective Interventions for Youth with Behavioral and Emotional Needs", by the EvidenceBased Services Committee is available on-line at www.state.hi.us/doh/camhd).

What are Anxiety Disorders?

Anxiety is a natural part of every child's life. It normal for infants and toddlers to be distressed when they have to leave their parents, or for young children to be afraid of the dark. Teens worry about how they appear to others and about speaking up in class. Anxiety only becomes a mental health problem when it is persistent and severe enough to interfere with the child's normal functioning.
More children and teens suffer from anxiety disorders than any other mental health disorder. Of children age 9-17, roughly 13% will experience some form of anxiety disorder within the year. Here are some of the more common disorders:

Separation Anxiety Disorder involves fear of being away from parents or other caretakers. Often the child will be afraid of something bad happening to a parent and be reluctant to go to school, stay at friend's houses or sleep alone. Stomachaches and headaches are common.

Generalized Anxiety Disorder causes children to worry excessively about all sorts of things--upcoming events, grades, friends, family, being on time, even natural disasters. Other symptoms can include trembling, dizziness, stomach upsets, trouble sleeping and irritability.

Phobias are extreme fears of things or situations (such as spiders, heights, getting a shot, dogs, and flying). The level of fear is usually inappropriate to the situation and can lead the child to avoid common, everyday situations.

Social Phobia is the most common anxiety disorder in teens. It involves an ongoing fear of being embarrassed in social situations or in class. This anxiety can cause the teen to have trouble talking in class, taking tests or meeting new people.

Obsessive Compulsive Disorder causes frequent and uncontrollable thoughts or impulses (obsessions) about bad things happening. These thoughts lead the child to perform a ritual or routine (compulsion) like hand-washing or checking locks to relieve the anxiety caused by the obsession.

Post-Traumatic Stress Disorder can occur when children experience a physical or emotional trauma such as witnessing a disaster (like 9/11), being sexually or physically abused or being in a car accident. The child "re-lives" the trauma through nightmares or flashbacks, may be irritable, and have trouble eating, concentrating and sleeping.

What works in anxiety disorders?

THERAPY. In reviewing the most current studies, the Evidence Based Services Committee found the BEST SUPPORT for treating anxiety through Cognitive Behavior Therapy (CBT), exposure and modeling. Studies using CBT with parents included and Educational Support met the criteria for GOOD SUPPORT.
Cognitive Behavioral Therapy teaches the anxious child or teen skills to help them manage their fearful thoughts, so they can see that they do not always need to be afraid. Then, the child or teen participates in guided practice to get comfortable being around the things they are afraid of.
"In vivo" exposure, or real-life exposure, involves practicing approaching and confronting a feared situation or object.
Modeling involves demonstrating non-fearful behavior in a feared situation and showing the child or teen a more appropriate response for dealing with a feared object or event.

MEDICATION. The majority of the medication studies reviewed by the EBS Committee for use in treating anxiety disorders of childhood and adolescence did not have randomized controls, and so earned the rating of "C" which indicates minimal or no support. However, Selective serotonin reuptake inhibitors (SSRIs) were found to be effective and safe in the short term in treating Obsessive Compulsive Disorder (OCD). Common brand names include Zoloft, Paxil and Prozac.

Services that work:
For anxiety, phobias and avoidance behavior:
Cognitive Behavior Therapy (with or without parents), Exposure, Modeling and Educational Supports

Medications that work:
For obsessive compulsive disorder:
Selective serotonin reuptake inhibitors

Where do I go for help?

If you are concerned that your child may have an anxiety disorder you should check with your family physician or ask the school for help in evaluating whether school based behavioral health services are needed. Early intervention can prevent future difficulties, such as a loss of friendships, failure to reach social and academic promise and feelings of low self-esteem.

Thanks to Dr. Bruce Chorpita for his help with definitions for this article.

ASSISTIVE TECHNOLOGY FAIR

The Aloha Special Technology Access Center (Aloha STAC) will be holding it's annual assistive technology fair on May 3, 2003 at Shriners Hospital. Hands-on workshops, speakers, vendors, and numerous organizations will focus on technology that can enhance the lives of persons with disabilities. Registration is required. Call 523-5547 for more information.

SUPPORT GROUPS NEWS

The AUTISM SOCIETY OF HAWAII presents "Basic Autism Training: Is There Mental Health in Autism?"
Date: Saturday, February 8, 2003
Time: 9:00 a.m. - 4:30 p.m.
Place: Hawaii State Capitol, Chambers Auditorium
To reserve your seat, contact Naomi Grossman at 595-3672 or 228-0122.
Next Autism of Hawaii support group meeting is February 18, 2003.

MILITARY FAMILY INFORMATION & SUPPORT GROUPS
The Exceptional Family Member Program (EFMP) provides information and support groups for military parents. This is an opportunity to learn from other parents and from speakers from the medical center, school and community.
Autism Spectrum Disorders Support Group
(Usually meets the second Monday of the month)
Cerebral Palsy Support Group
(Usually meets the fourth Monday of the month)
Both groups meet from 6:30 p.m. - 8:00 p.m. at the Tripler Army Medical Center, Pediatric Clinic Waiting Room, Wing 4F. Call Alan Gamble, EFMP at 433-6205/4441 or e-mail to alan.gamble@haw.tamc.amedd.army.mil.

ANNUAL FAMILY CAMP

The Therapeutic Recreation Unit of the Department of Parks and Recreation will be holding the 7th Annual Family Camp on March 21-23 at Kualoa Regional Park. The purpose of the camp is to provide an opportunity for individuals and their families and friends to have an enjoyable camping experience. Costs of the camp are only $20 for 13 years to adults, $15 for 8-12 years, and $10 for 3-7 years (2 & under are free). Deadline for registration is February 14! For more information and a registration form contact Colleen Casey at 692-5750.

SPIN AWARDS

Here's your chance to acknowledge some key parents and professionals whose efforts make a positive difference in the lives of children and young adults with disabilities and their families in Hawaii. These outstanding individuals will be honored at our SPIN Conference on April 12, 2003.
We are asking for your help in identifying candidates for SPIN's major awards:
*Parent of the Year
*Professional of the Year
*Family Choice Award
To request a nomination form, please call SPIN at 586-8126 or e-mail accesshi@aloha.net. We want to hear about your "heros and heroines" by March 3, 2003.

"SEAS THE OPPORTUNITY"
Saturday, April 12th, UH Campus Center
8:30 a.m. - 9:00 a.m. Registration/Networking/Displays

9:00 a.m. ­ 10:00 a.m. -Dr. Richard Radtke, Sea of Dreams Foundation
10:00 a.m. ­ 10:15 a.m. Networking Break
Tide Phase 1
10:15 a.m. - 11:30 a.m.

  • Let's Go Fishing-Positive Behavioral Supports - Initial Line of Inquiry
  • Charting the Course- IEP development
  • How to Rock the Boat without Sinking the Ship-Effective negotiation and conflict resolution
  • From Sea to Shining Sea -Transition
  • Maiden Voyage -Planning process for infants & toddlers (IFSP)
  • Coming Out of the Fog - Quality of life through self-determination

11:30 a.m. - 12:45 a.m. Buffet ** Award Presentation **

Tide Phase 2 12:45 p.m. - 2:00 p.m.

  • The Perfect Storm-
  • Fathom This- Standards based education
  • S.O.S.: Save One's Sanity -Techniques to reduce stress
  • Free Will-y -Estate planning
  • Everybody Go Surfing! -Recreation & leisure for the family
  • Diving for Pearls - Evidence based interventions

2:00 p.m. - 2:15 p.m. Networking Break
Tide Phase 3 2:15 p.m. - 3:30 p.m.

The Perfect Storm- The process of positive behavioral supports-Behavior Plans(repeat)

Ports of Call (disability specific workshops)
*Autism - Autism & Natural Supports

*Deafness - Communication & Deaf Culture

*Externalizing Emotional Disorders (ADHD, ODD, etc.)

*Internalizing Emotional Disorders (anxiety, depression, etc.)

*Learning Disabilities

MARK YOUR CALENDAR

2/7 Real Choices Promising Practices Institute
2/9 Real Choices, Employment, and Transitioning Youth Forum
Contact Sumi at 956-4126 or info@realchoices.org

PacRimPre Conference
2/9 Learning & Growing Together with Families:
Strategies for Building Effective Relationships
Sheration Waikiki
2/13 Cameron Center- Maui
2/14 Keauhou Beach Hotel- Big Island
Contact Taletha at 973-9643

2/10 PacRim Conference
&11 Sheraton Waikiki
2/13 CEC/DD (Kauai)
&14 Call 956-9810 or cds@hawaii.edu

2/12 Professional Employment for Individuals with Disabilities: Issues of Preparation &
&13 Transition- FEE, call Velina at 956-5688

2/22 "Every Child Deserves a Medical Home"
Shriners Hospital
Call 800/433-9016 x7081 or mhtraining@aap.org

2/14 '03 Pacific Basin Learning Disabilities Conference
&15 Call 538-7007 (HIDA) or 536-9684 (LDAH)

2/27 Building the Bonds of Attachment (workshop on attachment-resistant disorder)
9 - 4 p.m. - Central Union Church
6:30 p.m. - 8:30 p.m. Maunawili Elementary
2/28 9 - 4 p.m. - Sheraton Waikiki
Call Warren at 521-9531

3/8-9 Family Leadership Conference (co-sponsored by Hawaii Families As Allies & Easter Seals)
Call Nicole at 536-1015 or Yvonne at 487-8785 or toll free at 1-866-361-8825.

4/12 2003 SPIN Conference
UH Campus Center
Keynote: Dr. Richard Radtke

6/14 Hawaii Families As Allies Youth Conference
6/21 Hawaii Families As Allies Family Conference
Contact HFAA at 487-8785