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September 2003 Issue


    Articles include:

    PROGRAM DESCRIPTION

    SPIN is co-sponsored by the Disability & Communication Access Board and the Special Education Section of the Department of Education. Services include a phone line for information referral and support, a quarterly newsletter, an annual conference and community workshops. SPIN is guided by an Advisory Committee made up of parents, teachers and people with disabilities.

    SPIN
    919 Ala Moana Blvd., # 101
    Honolulu, Hawaii 96814

    PHONE
    586-8126
    Neighbor Islands dial the following exchange then 6-8126: Kauai -274-3141; Hawai'i-974-4000; Maui-984-2400; Molokai & Lanai - 1-800-468-4644

    FAX
    586-8129

    E-MAIL
    accesshi@aloha.net

    WEB
    www.spinhawaii.org

    CAN-DO: MAKING IT ON OUR OWN

    "Can-Do: Making It On Our Own", the 3rd Annual conference on Self-Determination, will be held on October 24-25, 2003 at the Hilton Hawaiian Village Hotel. This inspirational conference is aimed at helping folks with developmental disabilities live rich, satisfying lives. Leaders in the self-determination movement, including self-advocates, will be featured in the presentations. Workshops will be offered in the areas of self-advocacy, family support, community inclusion and opportunities, life planning and neurotrauma (brain injury).
    Registration fees for Self Advocate/Family - one day ($40), both days ($75); Professionals - one day ($100), both days ($155). Limited scholarships are available for family members and persons with disabilities. A program flyer will be distributed in early September. For more information, contact Mike Tamanaha at the Developmental Disabilities Division at 453-6255 or e-mail to mitamana@mail.health.state.hi.us.

    IDEA

    That's the slogan parents and advocates have been using to express concern about the reauthorization of the Individuals with Disabilities Edcucation Act. On June 25th, the Senate Health, Education Labor and Pensions (HELP) Committee passed S. 1248, the Individuals with Disabilities Education Improvement Act of 2003. It is expected to go up for a vote by the full Senate any day now. S. 1248 has been received by families, advocates and educators much more favorably than the House of Representative's bill (H.R. 1350) which passed the House floor the end of April. The Senate version maintains most of the current protections of IDEA,
    but some of its provisions still concern disability groups (like removing short term objectives and benchmarks from IEPs). To keep up to date on the reauthorization of IDEA call or visit our website.

    EBS FOR AGGRESSIVE AND DISRUPTIVE BEHAVIORS

    This article, the fourth in our series*, is about two
    disruptive mental health disorders in children and teens --Oppositional Defiant Disorder and Conduct Disorder. After describing these disorders, we'll talk about the evidence based services (EBS) or interventions that have been scientifically proven to have a positive effect in their treatment.
    The section on 'what works' has been taken from the "Summary of Effective Interventions for Youth with Behavioral and Emotional Needs", by Hawaii's Evidence Based Services Committee. A complete copy of this 2002 report is available on the Internet
    at www.state.hi.us/doh/camhd.
    Of course, no intervention or medication is 100% effective with all kids, and a number of promising practices in the field of children's mental health have not been studied thoroughly enough to receive an EBS rating. If you are a parent of a child whom you suspect may have one of these disruptive disorders, or if you are that child's teacher, we hope this
    information can be the starting point for discussing where to look for help.
    The category of disruptive disorders includes Attention-Deficit/Hyperactivity Disorder (AD/HD) which was discussed in our May issue. Oppositional Defiant Disorder and Conduct Disorder are both characterized by aggressiveness, antisocial behavior, and a tendency to bother and irritate others on purpose. There are, however, differences in the diagnoses.

    Oppositional Defiant Disorder - ODD

    To be diagnosed with ODD a child or teen would have to show a pattern of negative, hostile and defiant behavior lasting at least 6 months during which four or more of the following symptoms are present:

    ® often loses temper
    ® often argues with adults
    ® often actively defies or refuses to comply with an
    adults's requests or rules
    ® often deliberately annoys people
    ® often blames others for his or her mistakes or
    behavior
    ® often is touchy or easily annoyed by others
    ® often is angry and resentful
    ® often is spiteful and vindictive

    Symptoms usually begin to surface by the preschool years. The estimates of how many kids under 17 have ODD range from 3% - 15%. Other disorders that commonly occur with ODD are ADHD (30-40%), and depression or anxiety (20% or more). Sometimes children with ODD will develop a Conduct Disorder.

    Conduct Disorder

    While kids with ODD can be annoying, a child with a conduct disorder can be a threat to the safety of himself or others. To receive a diagnosis of CD, a child or teen must have shown a repetitive and persistent pattern of behavior in which the basic rights of others or major society rules are violated. At least three of the following must be present for a year, and one for at least six months:

    Aggression to people and animals
    ® often bullies, threatens or intimidates others
    ® often initiates physical fights
    ® has used a weapon that can cause serious physical harm to others (a bat, brick, knife, gun, etc.)
    ® is physically cruel to animals
    ® is physically cruel to people
    ® has stolen while confronting a victim

    Destruction of property
    ® has deliberately engaged in fire setting with the intention of causing serious damage
    ® has deliberately destroyed other's property other than by fire setting
    Deceitfulness or theft
    ® has broken into someone else's house or car
    ® often lies to get goods or favors or to avoid work
    ® has stolen items of value without confronting a victim (shoplifting, forgery)

    Serious violation of rules
    ® often stays out at night despite parent's prohibitions, beginning before age 13
    ® has run away from home overnight at least twice without returning home for a long period
    ® often skips school before age 13.

    Like ODD, conduct disorders commonly occur with other disorders. 30-50% of kids with conduct disorder also have ADHD. Other combinations with conduct disorder include depression, anxiety, learning disabilities, bipolar disorder, Tourette Syndrome and drug or alcohol abuse.

    What works with ODD and CD?
    THERAPY
    When the Evidence Based Committee reviewed the many studies around treatments for ODD and conduct disorders, they found that parent and teacher training in behavior management provided the best support or evidence that it was effective in reducing the symptoms. Good support was found for anger coping therapy, assertiveness training, problem solving skills training and rational emotive therapy. Multisystemic Therapy (MST) provided good support to students who had gotten in trouble with the law.
    Several school-based programs also have shown good support. Anger Coping-Self Instruction Training (AC-SIT) and the Fast Track program helped reduce disruptive and aggressive behavior. The Promoting Alternative Thinking Strategies (PATHS) program helped increase students' ability to identify and manage emotions.
    MEDICATION
    The EBS committee reviewed studies on three medications that are known to help steady moods.
    Carbamazepine (Tegretol ") and Valproate (Depakote" and Depakene") have shown mixed results in treating aggression and conduct disorder. The third drug, Lithium, was shown to be helpful in reducing symptoms in the short term. Unfortunately, all of these drugs can cause serious side effects and must be monitored closely. If a child has a diagnosis besides ODD or conduct disorder (for example, ADHD) doctors advise trying the drugs for that condition first.

    When should I get help?

    Early intervention is extremely important in helping children with ODD and conduct disorders succeed in school and community life. Parents need support, too. These kids can be a big challenge, and the more information and training families have, the better they are able to avoid World War III at the breakfast table.
    If you suspect your child of having ODD or a conduct disorder, ask your child's teacher or principal for help. All schools have school based behavioral health services and can help steer you toward evaluation and services to meet your child's needs.

    Services that work:
    For ODD and Conduct Disorders:
    Parent and teacher training in behavior management, anger coping therapy, assertiveness training, problem solving skills training, rational emotive therapy, MST, AC-SIT, Fast Track and PATHS

    Medications that work:
    Lithium provides short term relief of symptoms for aggressive disorders
    ________________
    * For copies of past articles on ADHD, depression and anxiety, call or e-mail SPIN.

    CHOOSING WHAT WORDS TO USE

    We have all heard about the power of the spoken word. And books on parenting talk about framing your message in ways that will be easily understood by your children. The difficult part of communication is taking the time to really choose words that encourage cooperation. Either our ego or old habits get in the way of positive communication. Given all that, here are some gentle reminders of encouraging words you can substitute for those that back us and our children into a corner.
    "and" instead of "but" When you use but in a sentence, you tend to negate everything that came before the but. ("I like the way you cleaned up the kitchen tonight, but I wish you would take out the trash.") Substitute and for but, and your child (or husband) will hear the compliment that came first.
    "next time" instead of "should" If the milk is spilt, and there's no way to go back in time, try the phrase "next time you can carry your milk with both hands" rather than "you should have used both hands, and now look what happened."
    "would you?" instead of "you'll have to" "Would you please turn off the TV and get ready for bed?" tends to avoid the argument that often follows "You'll have to..."
    "Sure, as soon as.." instead of "can't because" Your 10-year old just asked for an ice cream bar and it's twenty minutes to dinner. Rather than, "no, you can't because we're about to eat," try "sure you can have ice cream as soon as we finish dinner."
    "I wish I could" instead of "there's no way" Many of our kids' reasonable requests can't be filled for one reason or another. I wish I could buy you karate lessons helps lessen the sting more than there's no way I'm going to buy you karate lessons.
    And remember, the quickest way to end an argument is with the words, "you're right!"

    Words to Lose

    But - Should - You'll have to... - Can't because... - There's no way - I don't know

    Words to Use

    And - Next time... - Would you... - Sure, as soon as... - I wish I could - That's a good question

     

    KEEP AN EYE OUT FOR THESE EVENTS

    BRAIN INJURY WORKSHOP AND MINI CONFERENCE

    The Rehab Hospital of the Pacific and the Brain Injury Association of Hawaii are sponsoring a workshop on "Financial Resources After a Disabillity" on September 17, 2003 from 7 p.m. - 8:30 p.m. at the Rehab Hospital of the Pacific. Mary Wilson-Isley, R.N., is the speaker for this presentation.
    As part of Brain Injury Awareness month, a mini conference,"I Am Brainy, Are You?" - How to Prevent Brain Injury Among the Very Young, is scheduled for October 18, 2003 from 9 a.m. - 12 noon. For the location and more information, contact the Brain Injury Association of Hawaii at 524-9399.
    In addition, support group meetings are held on the 2nd Wednesdays of the month (9/10, 10/8, 11/12) at the Rehab Hospital of the Pacific.

    AUTISM/ASPERGER'S 2003 - HAWAII

    Future Horizons presents the "Autism/Asperger's 2003 - Hawaii" conference at the Hawaii Prince Hotel Waikiki on September 29-30, 2003 . Keynote speakers and national experts include Carol Gray and Dr. Kenneth Rubin (Factoring Friendship into the Lives of Children with Asperger's and Autism) and Dr. Jeanie McAfee and Amelia Davies (Social Skills Workshop).
    Registration fees: Parents/Family Members/Students ($160); Person with Autism ($125); Professional ($180). One day and group rates are available. Register early, seating is limited.
    For more information call 1-800-489-0727 or
    e-mail to info@futurehorizons-autism.com.

    AWARE WORKSHOPS

    Schedule of AWARE (Assisting with Appropriate Rights in Education) trainings:
    Chapter 56
    9/9 Kaneohe - Jodie at 586-5363
    9/10 Makalapa - Jo at 851-7738
    9/30 Schofield - Janet at 655-2303
    10/3 Foster Parent Conference - Call 536-9684, ext. 25
    10/7 Fort Shafter - Janet at 655-2303 Advocacy
    10/4 Foster Parent Conference - Call 536-9684, ext. 25
    Understanding Evaluations
    9/17 Makalapa - Jo at 851-7738
    10/2 Schofield - Janet at 655-2303
    10/9 Fort Shafter - Janet at 655-2303
    IEP Development
    9/10 Hilo - Call Phyllis at 968-7544 or Suzanne at 961-5166
    9/24 Makalapa - Jo at 851-7738
    10/1 Schofield - Janet at 655-2303
    10/8 Fort Shafter - Janet at 655-2303
    Rules Regarding Discipline
    11/12 Hilo - Phyllis at 968-7544 or Suzanne at 961-5166
    Section 504
    12/10 Hilo - Phyllis at 968-7544

    For more information contact the AWARE Education & Training Coordinator at 536-9684, ext. 25 or
    toll-free (800) 533-9684, ext. 25.

    HAWAII FAMILIES AS ALLIES

    Hawaii Families As Allies (HFAA) offers workshops in your community on several topics (ADHD/ODD, record keeping,,the impact of severe emotional disabilities on families) and much more. Please contact Linda Machado at 692-8232 or 487-8785. Neighbor islands can call toll free 1-866-361-8825.
    HFAA will also be sponsoring a Youth & Family Conference in the summer of 2004.

    ANNUAL BUDDY WALK

    The Hawaii Down Syndrome Congress and the National Down Syndrome Society presents the 5th Annual Buddy Walk to promote awareness and acceptance of children and adults with Down Syndrome. This event will be held on Saturday, October 4, 2003 from 10 a.m. - 2 p.m. at the Kakaako Waterfront Park (second section back from Ala Moana across from the Children's Discovery Museum).
    There will be lots of entertainment, food and plenty of free parking. For more information contact Connie at 949-1999 or Cheryl at 672-6444.

    SELF ADVOCACY FOR LIFE-LONG LEARNING

    Many students obtain the basic skills necessary to get a job while they are in high school. However, education and training after high school (postsecondary) are the means to get the high-skilled jobs of the 21st Century. This education and training comes mainly through vocational or technical schools and two or four year colleges.

    Although students with disabilities are entering college in greater numbers, the majority leave before completing their program or degree. One major reason for this is that many youth with disabilities lack the necessary self advocacy skills to speak for themselves and to communicate with others to acquire information and recruit help in meeting personal needs and goals. These skills will help them decide what supports or adjustments they need to be successful in college or vocational school. These adjustments are called accommodations in Section 504 of the Rehabilitation Act. An adjustment could mean making a classroom more accessible for wheelchairs, Braille labeling in elevators, someone to take notes for the student, or maybe having the class notes printed in a larger font for easier reading.

    It is important to understand that responsibility shifts from the IEP team to the student when asking for accommodations in postsecondary education and employment settings. This switch is an about face from secondary education where it is the responsibility of the school and IEP team to identify and deliver an appropriate education. Self Advocacy is key to a student getting his needs met. Without the necessary accommodations, students can become discouraged with their lack of success and even drop out of their program.

    One possible explanation for limited development of self-determination (see definition below) is that many educators are unaware of how to help students determine their own needs. In addition, educators and parents traditionally exercise control for the students with disabilities in school and home environments. Limited opportunities to make choices that will help them increase their ability to act more independently results in students with disabilities exiting high school with little experience in self advocacy, Self advocacy is one of the important self-determination skills for negotiating new adult and legal responsibilities in postsecondary education and the workplace.

    These are some strategies an IEP team should consider when preparing a student with disabilities for postsecondary education:
    1. Provide choices early in life and help them process the consequences.
    2. Teach them to make decisions by considering past solutions and new possibilities, and choosing the best option to make a plan.
    3. Teach students what their disability is and the accommodations they need to succeed
    4. Teach them skills to know how to negotiate in moments of conflict and how to attain their goals.
    5. Empower them to decide where they want to go to work or live in their community.
    6. Teach students with disabilities to establish career goals through self-directed career planning and learn to monitor their own progress through the use of time management strategies.

    Submitted by
    Sheila Leder
    Dissemination Coordinator
    Center on Disability Studies, University of Hawai'i at Manoa

    Self-determination is defined as the combination of skills, knowledge, and beliefs that enable a person to engage in goal-oriented self-regulated behavior. Seven characteristics have been described as part of self-determination: self-awareness, self-advocacy, self-efficacy, decision making, independent performances, self-evaluation and adjustment.

    LIFE'S IMPORTANT WORDS

    The six most important words in our language are:
    I admit I made a mistake.

    The five most imortant words:
    What is your opinion?

    The three most important words:
    If you please.

    The two most important words:
    Thank you.

    The single most improtant word:
    We.

    The least important word:
    I.

    --Norton Nockridge

    MARK YOUR CALENDAR

    8/23 Special Olympics Conference
    & 24 Ala Moana Hotel - Call Nip Ho at 943-8808, x23

    9/13 "On the Waterbed" The Impact of Learning Disabilities"
    9-ll:30 a.m., Kapiolani Community College
    Contact HIDA at 538-7007 or info@hibida.org

    9/29 Future Horizons Conference Autism/Asperger's 2003-Hawaii

    10/3 Foster Parent Care Conference Sheraton Waikiki
    & 4 Special Feature: Concurrent Teen Track on 10/4
    Call 263-0920, toll-free 877-775-4400

    10/3 2003 Annual Leadership Symposium & Early Childhood Conference
    & 4 Hawaii Convention Center - Call Kathy Murphy at 942-4708

    10/24 Can-Do: Making It On Our Own
    & 25 (A conference on self-determination)

    10/4 Hawaii Down Syndrome 'Buddy Walk'

    3/29 PAC Rim Conference on Disabilities 2004 - Sheraton Waikiki
    & 30 www.pacrim.hawaii.edu/ or 956-9810 or cds@hawaii.edu