The document outlines the schedule and content for a presentation on treating autism spectrum disorders from a systemic perspective. Part I defines autism and common non-systemic treatment approaches, including applied behavioral analysis and social skills training. Part II examines the systemic context of autism's effects on families. Part III discusses systemic treatment approaches like family therapy and generating stronger family structures.
Biomedical Autism Treatment - Yes, it Could Help Your Autistic Child!NP Karthikeyen
DOAST (Doctrine Oriented Art of Symbiotic Treatment), an integrated therapy centre for autism, Chennai is one of the best autism treatment centre in India, provides best solution for autistic children by improving their behaviour and cognition through integrated therapy. For more details,visit: http://www.autism-ent-specialist-chennai.com
Box 13-7 Family Assessment GuideI Identifying DataName ______.docxbartholomeocoombs
Box 13-7 Family Assessment Guide
I Identifying Data
Name: ___________________________________________________________________________________________________
Address: __________________________________________________________________________________________________
Phone number(s):_____________________________________________________________________________________________
Household members (relationship, gender, age, occupation, education):____________________________________________________
Financial data (sources of income, financial assistance, medical care; expenditures):___________________________________________
Ethnicity: __________________________________________________________________________________________________
Religion: __________________________________________________________________________________________________
Identified client(s):______________________________________________________________________________________________
Source of referral and reason: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
II Genogram
Include household members, extended family, and significant others
Age or date of birth, occupation, geographical location, illnesses, health problems, major events
Triangles and characteristics of relationships
III Individual Health Needs (for each household family member)
Identified health problems or concerns: ________________________________________________________________________________
Medical diagnoses: _____________________________________________________________________________________________
Recent surgery or hospitalizations: _________________________________________________________________________________
Medications and immunizations: _________________________________________________________________________________
Physical assessment data: ______________________________________________________________________________________
Emotional and cognitive functioning: _______________________________________________________________________________
Coping: _____________________________________________________________________________________________________
Sources of medical and dental care: ____________________________________________________________________________
Health screening practices: ____________________________________________________________________________________
IV Interpersonal Needs
Identified subsystems and dyads:________________________________________________________________________________
Prenatal care needed: _________________________________________________________________________________________
Parent–child interactions:__.
Biomedical Autism Treatment - Yes, it Could Help Your Autistic Child!NP Karthikeyen
DOAST (Doctrine Oriented Art of Symbiotic Treatment), an integrated therapy centre for autism, Chennai is one of the best autism treatment centre in India, provides best solution for autistic children by improving their behaviour and cognition through integrated therapy. For more details,visit: http://www.autism-ent-specialist-chennai.com
Box 13-7 Family Assessment GuideI Identifying DataName ______.docxbartholomeocoombs
Box 13-7 Family Assessment Guide
I Identifying Data
Name: ___________________________________________________________________________________________________
Address: __________________________________________________________________________________________________
Phone number(s):_____________________________________________________________________________________________
Household members (relationship, gender, age, occupation, education):____________________________________________________
Financial data (sources of income, financial assistance, medical care; expenditures):___________________________________________
Ethnicity: __________________________________________________________________________________________________
Religion: __________________________________________________________________________________________________
Identified client(s):______________________________________________________________________________________________
Source of referral and reason: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
II Genogram
Include household members, extended family, and significant others
Age or date of birth, occupation, geographical location, illnesses, health problems, major events
Triangles and characteristics of relationships
III Individual Health Needs (for each household family member)
Identified health problems or concerns: ________________________________________________________________________________
Medical diagnoses: _____________________________________________________________________________________________
Recent surgery or hospitalizations: _________________________________________________________________________________
Medications and immunizations: _________________________________________________________________________________
Physical assessment data: ______________________________________________________________________________________
Emotional and cognitive functioning: _______________________________________________________________________________
Coping: _____________________________________________________________________________________________________
Sources of medical and dental care: ____________________________________________________________________________
Health screening practices: ____________________________________________________________________________________
IV Interpersonal Needs
Identified subsystems and dyads:________________________________________________________________________________
Prenatal care needed: _________________________________________________________________________________________
Parent–child interactions:__.
Formulating a Family Care PlanI Identifying Data· Name ______JeanmarieColbert3
Formulating a Family Care Plan
I Identifying Data
· Name: __________________________________________________________________________________________________
· Address: __________________________________________________________________________________________________
· Phone number(s):_____________________________________________________________________________________________
· Household members (relationship, gender, age, occupation, education):____________________________________________________
· Financial data (sources of income, financial assistance, medical care; expenditures):___________________________________________
· Ethnicity: __________________________________________________________________________________________________
· Religion: __________________________________________________________________________________________________
· Identified client(s):______________________________________________________________________________________________
· Source of referral and reason: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
II Genogram
· Include household members, extended family, and significant others
· Age or date of birth, occupation, geographical location, illnesses, health problems, major events
· Triangles and characteristics of relationships
III Individual Health Needs (for each household family member)
· Identified health problems or concerns: ________________________________________________________________________________
· Medical diagnoses: _____________________________________________________________________________________________
· Recent surgery or hospitalizations: _________________________________________________________________________________
· Medications and immunizations: _________________________________________________________________________________
· Physical assessment data: ______________________________________________________________________________________
· Emotional and cognitive functioning: _______________________________________________________________________________
· Coping: _____________________________________________________________________________________________________
· Sources of medical and dental care: ____________________________________________________________________________
· Health screening practices: ____________________________________________________________________________________
IV Interpersonal Needs
· Identified subsystems and dyads:________________________________________________________________________________
· Prenatal care needed: __________________________________________________________________________ ...
Box 13-7 Family Assessment GuideI Identifying Data· Name ____VannaSchrader3
Box 13-7 Family Assessment Guide
I Identifying Data
· Name: ___________________________________________________________________________________________________
· Address: __________________________________________________________________________________________________
· Phone number(s):_____________________________________________________________________________________________
· Household members (relationship, gender, age, occupation, education):____________________________________________________
· Financial data (sources of income, financial assistance, medical care; expenditures):___________________________________________
· Ethnicity: __________________________________________________________________________________________________
· Religion: __________________________________________________________________________________________________
· Identified client(s):______________________________________________________________________________________________
· Source of referral and reason: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
II Genogram
· Include household members, extended family, and significant others
· Age or date of birth, occupation, geographical location, illnesses, health problems, major events
· Triangles and characteristics of relationships
III Individual Health Needs (for each household family member)
· Identified health problems or concerns: ________________________________________________________________________________
· Medical diagnoses: _____________________________________________________________________________________________
· Recent surgery or hospitalizations: _________________________________________________________________________________
· Medications and immunizations: _________________________________________________________________________________
· Physical assessment data: ______________________________________________________________________________________
· Emotional and cognitive functioning: _______________________________________________________________________________
· Coping: _____________________________________________________________________________________________________
· Sources of medical and dental care: ____________________________________________________________________________
· Health screening practices: ____________________________________________________________________________________
IV Interpersonal Needs
· Identified subsystems and dyads:________________________________________________________________________________
· Prenatal care needed: ________________________________________________________________________ ...
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Formulating a Family Care PlanI Identifying Data· Name ______JeanmarieColbert3
Formulating a Family Care Plan
I Identifying Data
· Name: __________________________________________________________________________________________________
· Address: __________________________________________________________________________________________________
· Phone number(s):_____________________________________________________________________________________________
· Household members (relationship, gender, age, occupation, education):____________________________________________________
· Financial data (sources of income, financial assistance, medical care; expenditures):___________________________________________
· Ethnicity: __________________________________________________________________________________________________
· Religion: __________________________________________________________________________________________________
· Identified client(s):______________________________________________________________________________________________
· Source of referral and reason: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
II Genogram
· Include household members, extended family, and significant others
· Age or date of birth, occupation, geographical location, illnesses, health problems, major events
· Triangles and characteristics of relationships
III Individual Health Needs (for each household family member)
· Identified health problems or concerns: ________________________________________________________________________________
· Medical diagnoses: _____________________________________________________________________________________________
· Recent surgery or hospitalizations: _________________________________________________________________________________
· Medications and immunizations: _________________________________________________________________________________
· Physical assessment data: ______________________________________________________________________________________
· Emotional and cognitive functioning: _______________________________________________________________________________
· Coping: _____________________________________________________________________________________________________
· Sources of medical and dental care: ____________________________________________________________________________
· Health screening practices: ____________________________________________________________________________________
IV Interpersonal Needs
· Identified subsystems and dyads:________________________________________________________________________________
· Prenatal care needed: __________________________________________________________________________ ...
Box 13-7 Family Assessment GuideI Identifying Data· Name ____VannaSchrader3
Box 13-7 Family Assessment Guide
I Identifying Data
· Name: ___________________________________________________________________________________________________
· Address: __________________________________________________________________________________________________
· Phone number(s):_____________________________________________________________________________________________
· Household members (relationship, gender, age, occupation, education):____________________________________________________
· Financial data (sources of income, financial assistance, medical care; expenditures):___________________________________________
· Ethnicity: __________________________________________________________________________________________________
· Religion: __________________________________________________________________________________________________
· Identified client(s):______________________________________________________________________________________________
· Source of referral and reason: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
II Genogram
· Include household members, extended family, and significant others
· Age or date of birth, occupation, geographical location, illnesses, health problems, major events
· Triangles and characteristics of relationships
III Individual Health Needs (for each household family member)
· Identified health problems or concerns: ________________________________________________________________________________
· Medical diagnoses: _____________________________________________________________________________________________
· Recent surgery or hospitalizations: _________________________________________________________________________________
· Medications and immunizations: _________________________________________________________________________________
· Physical assessment data: ______________________________________________________________________________________
· Emotional and cognitive functioning: _______________________________________________________________________________
· Coping: _____________________________________________________________________________________________________
· Sources of medical and dental care: ____________________________________________________________________________
· Health screening practices: ____________________________________________________________________________________
IV Interpersonal Needs
· Identified subsystems and dyads:________________________________________________________________________________
· Prenatal care needed: ________________________________________________________________________ ...
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
Autism Spectrum Disorders
1. A Systemic Approach to the Treatment of the Autism Spectrum Disorders
Greater Washington Society for Clinical Social Work
Jonah Green, MSW
January 18, 2009
Schedule:
10-10:15-Introduction/Overview
10:15-11:00-Part I
11:00-11:15—Break
11:15-11:45—Video of individual with ASD
11:45-12:30—Part II/Video
12:30-12:45—Break
12: 45-1:30—Part III
1:30-:45--Discussion
1:45-2:00-Evaluations
1
2. Introduction
___________________
Part I ___________________
Defining Autism, ___________________
Symptoms, Etiology, ___________________
Screening/Diagnostic ___________________
Process, Differential ___________________
Diagnosis, Co-Morbidity, ___________________
Effects on Functioning, ___________________
Epidemiology, Non- ___________________
Systemic Approaches to ___________________
Treatment ___________________
___________________
2
3. Part II ___________________
___________________
The Systemic Context— ___________________
Effects on Overall Family ___________________
System/Interactions ___________________
Outside of the Family, ___________________
Effects at Particular Life ___________________
Stages, Effects on ___________________
Specific Family ___________________
Relationships ___________________
___________________
___________________
3
4. Part III ________________________
________________________
Systemic Approaches to ________________________
Treatment ________________________
Support and Problem- ________________________
Solving: the “Family Focus” ________________________
Approach ________________________
Generating a Stronger ________________________
Family Structure:The ________________________
Contemporary Structural
________________________
Framework
________________________
Couples therapy when one
________________________
partner has Asperger’s
4
5. Part I:
Understanding Autism and Non-
Systemic Approaches to Treatment ___________________________
___________________________
Definition of Autism and the Autism ___________________________
Spectrum ___________________________
“The Triad” of symptoms: impaired ___________________________
relationships, difficulty with ___________________________
communication, restricted ___________________________
interests/behaviors ___________________________
The 5 discrete diagnoses: Autistic D/O, ___________________________
Asperger’s, PDD-NOS, Rett’s, ___________________________
Disintegrative D/O ___________________________
The three primary diagnoses and their ___________________________
different symptoms; Asperger’s lacks ___________________________
delay in verbal IQ, PDD-NOS lacks full ___________________________
symptomatology
___________________________
Additional symptoms/challenges for
people on the spectrum: sensory ___________________________
processing, sleep, gi issues,
Effects on Functioning throughout the Life
Span
The drive for comfort and stimulation
Common Strengths for people with
ASDs:visual abilities, memory, splinter
skills 5
6. The Question of Etiology
Medical Screening: Modified
Checklist for Autism ________________________
________________________
Making the Diagnosis: Team
of psychologist, OT SPLP, ________________________
educator, social worker ________________________
The Various Rating Scales: ________________________
Gilliam, Autism Rating Scale ________________________
Resources for making the ________________________
Diagnosis: DDA/School ________________________
System/Private providers ________________________
Differential Diagnosis: OCD, ________________________
ADHD, Social Anxiety
Co-Morbidity: OCD, ADHD,
mood issues
Epidemiology: 1 in 150 6
7. Common Non-Systemic
Approaches to Treatment _________________________________
_________________________________
_________________________________
Characteristics of Successful _________________________________
Approaches: begins early, intensive, _________________________________
involves family, structured, utilizes _________________________________
behavioral principles _________________________________
“Normalization”, or helping kids to “feel _________________________________
normal” vs. “Treatment” _________________________________
Applied Behavioral Analysis; intense, _________________________________
specific skill-building _________________________________
_________________________________
TEACHH:visual structure and _________________________________
organization _________________________________
LEAP: educational inclusion _________________________________
Picture-Exchange Communication _________________________________
Systems: communicating with pictures _________________________________
Greenspan/Denver/DIR Model: play _________________________________
which develops reciprocity _________________________________
_________________________________
Social Skills Groups: teaching specific _________________________________
skills
Educational Supports (504s, IEPs,
accommodations/special programs,
FastForward, Cogmed, Kurzweil)
7
8. Language-Communication Therapy: _________________________________
intense teaching of pragmatic language _________________________________
Functional Behavioral Analysis; _________________________________
addressing the function of behaviors _________________________________
_________________________________
Medication: anti-depressants, stimulants, _________________________________
anti-psychotics _________________________________
Collaborative-Problem Solving: relating _________________________________
more flexibly _________________________________
Relationship Development Intervention _________________________________
(RDI): making use of ‘productive _________________________________
uncertainty’ _________________________________
Sensory Integration Therapy: modulating _________________________________
sensitivities and increasing awareness _________________________________
_________________________________
Dietary Interventions: reducing gluten and _________________________________
casein, adding Omega-3s _________________________________
Emphasizing Strengths; memory, visual _________________________________
abilities, etc. _________________________________
Individualized sports: karate, tennis, etc. _________________________________
Mentor programs _________________________________
Play Dates/Controlled social events
Social Stories: improving behavior and
teaching skills
The battle against screen time
8
9. Individual therapy: ________________________
Make concepts concrete: ________________________
play-dough, rubber bands, ________________________
Offer specific guidance: ask ________________________
when, where, with whom, use ________________________
cartoons and role plays
developing the ‘theory of
________________________
mind’ using speech bubbles ________________________
Using sociograms or ________________________
“closeness circles” to identify ________________________
and improve relationships ________________________
using the relationshipL “I ________________________
wonder if you do this when?”
Use active empathy but avoid
intrusiveness
The need for patience
Meeting with counselors and
friends
Decision-making analysis
The Reality Principle; getting
9
these guys to look beyond
typical women
10. Part II: The Systemic
Context of Autism _______________________
Common Family Dynamics:
time/resource demands, stigma,isolation, _______________________
behavior issues, guilt/blame, parental _______________________
strife, problems with other siblings
The Stages of Grief Model: shock, denial, _______________________
anger, bargaining,acceptance. Family _______________________
members can be at different stages, need
to grieve again at each developmental _______________________
stage _______________________
Common Ways of Coping: Normalization
(addressing autism within the context of _______________________
other needs), Crusadership (illness as an _______________________
occupation), Altruism (can neglect own
needs), Resignation (can lead to _____________
depression)
Positive Effects of Having An Autistic
Member of the Family: increased
cohesion, empathy among siblings,
personal growth
10
11. Challenges for Families At
Particular Developmental ___________________
Stages
Infant and Toddler Stage: the stress
___________________
of diagnosis, difficulty bonding, ___________________
negotiating different family ___________________
reactions, finding supports
School-Age: Need for advocacy, ___________________
arranging treatments/child care, ___________________
managing behaviors
Adolescence: coping with chronicity,
___________________
isolation/peer rejection, need to ___________________
build functional living skills, facing
dangerous tantrums
___________________
The Transition to Adulthood: ___________________
coordinating services ___________________
Adulthood (Autism vs. Asperger’s):
maximizing independence and
___________
supports/ongoing demands
11
12. Typical Challenges for Particular
Family Relationships (in middle-
class America)
_______________________
Mother-Father: enmeshment vs. _______________________
disengagement _______________________
Mother (typically)-Autistic Child: “doing
for” autistic child, depression/guilt in _______________________
Mother _______________________
Father (typically)-Autistic Child: Father
can be rejecting/withdrawing, focused on _______________________
behavior and achievement, Father’s self- _______________________
esteem effected
Mother or Father—non-autistic child: may _______________________
neglect needs of child, pressure child to _______________________
care for or ‘make up’ for autistic child
Autistic child-non-autistic child: jealousy, _______________________
“survivor’s guilt”, embarrassment _______________________
Grandparents-parents: can be critical and
non-supportive
_______________________
Caveats: these responses are typical
of dominant social group, all families
and relationships are different, and the
presence of the autistic child can also 12
have positive effects
13. Part III: Systemic
Approaches to Addressing ___________________
the Challenge of Autism
___________________
Goals: Maximizing
functioning for all family ___________________
members, increasing ___________________
normalization, increasing ___________________
support, knowledge, and ___________________
capacities of family to ___________________
manage stress, advocate,
and manage the treatment ___________________
The Need for support as well
___________________
as re-structuring ___________________
The need to address ___________________
systems issues beyond the ___________
family
13
14. Initial Systemic Approaches
for Families with Young _______________________
Children _______________________
Initial Engagement: _______________________
Normalizing, reframing, and the _______________________
drawing out of individual _______________________
narratives _______________________
Considerations for segmenting _______________________
sessions _______________________
Assisting in Generating Order, _______________________
Obtaining Resources, and _______________________
trouble-Shooting
_______________________
Empowering the “Treatment _______________________
Managers: Offering Information
and Support
Facilitating Positive Ways of
Coping: Advising them to look at
needs of family, individual
needs, and other relationships
14
15. Systemic Approaches in Working
With Older Adolescents and _______________________________
Adults _______________________________
_______________________________
_______________________________
Navigating systems: Obtaining vocational _______________________________
assistance, education, getting benefits, housing, _______________________________
finding respite care, transportation, peer groups _______________________________
Addressing isolation, overuse of t.v., _______________________________
pornography _______________________________
engaging staff and family: meet both with adults _______________________________
with autism and without, and coordinate with
agencies _______________________________
_______________________________
_______________________________
Strengthening the Family Structure (for _______________________________
Families who Have Autistic _______________________________
Children at Home) _______________________________
_______________________________
Continuing with Normalization, Reframing, and
_______________________________
Supportive Interventions, and developing a _______________________________
systemic worldview via relational questions _______________________________
Applying a Contemporary Structural Approach: _______________________________
What it is and why it works with these families _______________________________
(see handout) _______________________________
_____________
15
16. _______________________________
Goals of Family Therapy And _______________________________
_______________________________
Interventions to Achieve Them: _______________________________
_______________________________
The Strengthening of the _______________________________
Hierarchy _______________________________
_______________________________
Putting parents in charge of _______________________________
discipline _______________________________
Encouraging parents to position _______________________________
_______________________________
themselves as a unit _______________________________
Assisting parents with collaborative _______________________________
problem-solving, limit-setting _______________________________
_______________________________
Applying the “guard rail” technique _______________________________
Cautions/considerations: especially _______________________________
watch for “unbalancing” against the _______________________________
“enmeshed Mom” _______________________________
_______________________________
_______________________________
_______________________________
_____________
16
17. The Development of Caretakers’
Nurturing and Understanding _______________________________________
_______________________________________
Encourage both parents to position _______________________________________
themselves to offer nurturance _______________________________________
Ask children’s opinions of parents’ _______________________________________
_______________________________________
remarks _______________________________________
Maintaining a connection with parents _______________________________________
Scripting parents in “practical empathy” _______________________________________
_______________________________________
(wanting as opposed to feeling) _______________________________________
The Development of “Skill-Building _______________________________________
Skills” by parents _______________________________________
_______________________________________
Showing them how to build a theory of _______________________________________
mind in their children: getting them to ask _______________________________________
kids what others may want or think _______________________________________
Showing parents how to coach kids in _______________________________________
_______________________________________
emotion regulation: getting kids, to slow _______________________________________
down, separate, ask “So what?” _______________________________________
Role-playing (including puppets and _______________________________________
figures) to develop problem-solving skills _______________________________________
_______________________________________
Games such as “Stop, Relax, and Think” _______________________________________
17
18. The Development of _______________________________________
Emotional Bonds Between _______________________________________
Particular Parents and _______________________________________
_______________________________________
Children _______________________________________
_______________________________________
Hold sessions with the “less _______________________________________
close” parent and child(ren) _______________________________________
_______________________________________
Filial Play Therapy, encouraging _______________________________________
_______________________________________
reflection and empathy _______________________________________
Encourage enjoyable activities, _______________________________________
_______________________________________
physical closeness _______________________________________
_______________________________________
Breaking Down Dysfunctional _______________________________________
Coalitions _______________________________________
_______________________________________
Supporting the “less competent” _______________________________________
_______________________________________
parent _______________________________________
_______________________________________
Blocking (and supporting) the _______________________________________
enmeshed parent _______________________________________
Blocking inappropriate cross-
generational alliances
18
19. _______________________________________________
_______________________________________________
Minimizing Scapegoating _______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
Allying with the scapegoat (sitting _______________________________________________
_______________________________________________
next to) _______________________________________________
_______________________________________________
Checking in with the scapegoat _______________________________________________
_______________________________________________
The Alter Ego Technique (“speaking _______________________________________________
_______________________________________________
for”) _______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
Strengthening the parental _______________________________________________
relationship _______________________________________________
___________________________________
“Turning towards”/time for
themselves
Improving communication
Making a safe space for emotions
Generating more equity/more
flexible roles
19
20. Supporting the non-autistic child ____________________________________________
Position them close to you and parents ____________________________________________
____________________________________________
Offer individual sessions and filial ____________________________________________
sessions ____________________________________________
____________________________________________
Strengthening the sibling relationship ____________________________________________
____________________________________________
Sibling sessions—foster fun and problem- ____________________________________________
solving ____________________________________________
____________________________________________
Developing Family Unity ____________________________________________
____________________________________________
Games and exercises—Family Sandtray, ____________________________________________
Life Stories game, play with puppets and ____________________________________________
characters ____________________________________________
____________________________________________
Improving the relationship with ____________________________________________
____________________________________________
grandparents/other family members ____________________________________________
Encourage their support and block ____________________________________________
____________________________________________
criticism/intrusion ____________________________________________
____________________________________________
____________________________________________
The vision: An adaptable and functional family ____________________________________________
____________________________________________
that is supported and supported, supports ____________________________________________
each member’s needs, attends to each ____________________________________________
relationship, and supports and
empowers the person with autism
Addendum: Couples Work when one 20
partner has Asperger’s Disorder