You are not covered!

Usually this is an information blog, however, when I look back what happened to me today I decided I needed to write about this experience.

When I did my doctorate thesis, I did it on the difference in special education in the US vs Oman. This unfortunately is another slap in the face for Omani parents with special needs children or children with learning problems.

My son had an appointment this morning with Dr. Laura Do Vale, one of the leading psychologists in Muscat for children with learning disabilities and for children with other handicaps.  While I am a Dr. in educational psychology, I choose not to assess my own children. So my son’s pediatrician had recommended Dr. Laura.

We are covered by one of the largest insurance company in Oman- however when I went into the clinic they informed me that educational testing, IQ testing and behavior therapy are not covered under his medical insurance. Needless to say, I was shocked.

Then I started to think about the autistic children, children with ADHD and other conditions that need these services. Most children with autism as well as children with severe ADHD need bi-weekly behavior therapies. I was wondering if other parents were having the same problem with their insurance companies.  I asked some parents at the center, they said absolutely these services are not covered with their insurance plan. Either they have to take them to government hospitals or pay large sums of money at private hospitals and clinics.

In the United States, most HMOs or insurance companies are paying for psychological services for children that have been diagnosed with a learning difficulty or a handicap?  It is very frustrating to parents in Oman that this service is not being covered by insurance companies in the Sultanate. It is another step backwards for special education in Oman.

The insurance companies here need to look at the situation for special education students and cover this part of their medical. This is a very imperative part of the success of a child with learning disabilities and most important for an autistic child. The child needs mass sessions of behavior therapy and the parents need the guidance of a experience child psychologist.

Activites for special education children

Here's some good and fun activities suggestions for autistic children, However, most of these activities can be used for all special education children.

1. You could play with him in a swimming pool. Make a splashing game or a kick game. Get some simple pool toys or beach toys like beach ball, floating rings, etc. Sing a song so he could swim with the beat and feel relax. Remember to keep a good eye on the child while in a pool.

2. In a class, you could print out some pictures of eating, sports, going to the bathroom, sleep and everything that may happen in his daily life. Let him make a schedule for himself, he should like this activity, because children with autism take constant schedules very seriously. And if the schedule they followed everyday is broken, it will ruin their day badly.

3. Big tupperware items filled with rice or beans will be fun, you can put little toys in them and have the autistic child put his hand into the rice or beans to find them. The game could make a mess, but they would love it.

4. Sensory play is widely suggested, too. You could take the child to a children's museum if there's one nearby. Commonly, there will be something that could interests the child.

5. Structured activities with a clear start, middle and end are always good for children with autism because they like rules, organization and structure. Gymanasitics is a common game that autistic children do well at since there is less reliance on language(children with autism often have little communication skills) but a lot of motor movement and imitation.

6. If music can calm the child down, you can introduce different instruments to him, with some music playing gently in the background. You can let him beat a drum and learn different rhythms.

7. There are some therapeutic horse riding groups that you can participate in, children can learn to feed and take care of horses in their lessons.

8. Every child with autism is different, you should find out his likes and dislikes and continue to do the things he seems to enjoy.

Learning difficulties vs Mental retardation

To be considered mentally retarded (MR), a person's general intellectual functioning is well below average. People with this diagnosis have an intelligence quotient (IQ) of around 70 or less. People with mental retardation also have a significant impairment in the ability to handle the demands of daily living. This condition clearly has an impact on learning, communication, self-help skills, and social skills, during play or in a work setting. The degree of difficulty can range from mild to moderate to profound. According to federal government statistics, about 1 out of every 100 people is mentally retarded, although some place this figure as high as 3 percent. Mental retardation is slightly more common in males than in females. It occurs in people of all racial, ethnic, educational, and economic backgrounds.

In contrast, a learning disability (LD) is regarded as a disorder in one or more of the processes involved in understanding and using spoken or written language. Learning disabilities show up in different ways in different individuals. They can have problems with visual perception (understanding or remembering what they see), which can make activities like reading letters or copying shapes very difficult. Or they can have problems with auditory perception (understanding or remembering what they hear) or using language to tell or write a story. A learning disability can cause difficulties in math, reading, writing, or spelling. Some people with a learning disability have organizational problems that can affect school or work.

People with learning disabilities generally have average or above-average intelligence. Their learning disability, however, creates a gap between ability and performance. They tend not to do well in environments that aren't suited to their learning style, but they can learn very well when taught appropriately. Learning disabilities often run in families. Fifteen percent of the U.S. population, or some 39 million Americans, have some form of learning disability. About 50 percent of all public-school students in special education have learning disabilities.


LD and MR are two distinctly separate conditions, and the terms are absolutely not interchangeable. If tests scores suggest that your son has a verbal IQ (that is, his ability to use and understand language) of 105, that's right in the middle of the average range. You say, "in all other areas his IQ is a 66." This might mean that his non-verbal skills, (that is, his eye-hand coordination and his visual perception) are extremely weak. This much of gap between verbal and performance IQs (the two major parts of an IQ test) suggests that at some point your son experienced a trauma to his brain that affected the centers that control non-verbal skills. So "by the numbers" he functions like someone with mental retardation in the visual perceptual areas. His verbal intelligence is clearly in the average range. If you blend these two scores together, you would get an overall IQ that would be in or close to the cut-off for mental retardation.

What is Cerbral Palsy

Cerebral palsy (CP) is a disorder that affects muscle tone, movement, and motor skills (the ability to move in a coordinated and purposeful way). Cerebral palsy can also lead to other health issues, including vision, hearing, and speech problems, and learning disabilities.

CP is usually caused by brain damage that occurs before or during a child's birth, or during the first 3 to 5 years of a child's life. There is no cure for CP, but treatment, therapy, special equipment, and, in some cases, surgery can help a child who is living with the condition.

About Cerebral Palsy

Cerebral palsy is one of the most common congenital (existing before birth or at birth) disorders of childhood.
The three types of CP are:

1. spastic cerebral palsy — causes stiffness and movement difficulties
2. athetoid cerebral palsy — leads to involuntary and uncontrolled movements
3. ataxic cerebral palsy — causes a disturbed sense of balance and depth perception

Cerebral palsy affects muscle control and coordination, so even simple movements — like standing still — are difficult. Other vital functions that also involve motor skills and muscles — such as breathing, bladder and bowel control, eating, and learning — may also be affected when a child has CP. Cerebral palsy does not get worse over time.

Causes of Cerebral Palsy

The exact causes of most cases of CP are unknown, but many are the result of problems during pregnancy in which the brain is either damaged or doesn't develop normally. This can be due to infections, maternal health problems, or something else that interferes with normal brain development. Problems during labor and delivery can cause CP in some cases.

Premature babies — particularly those who weigh less than 3.3 pounds (1,510 grams) — have a higher risk of CP than babies that are carried full-term, as are other low birth weight babies and multiple births, such as twins and triplets.

Brain damage in infancy or early childhood can also lead to CP. A baby or toddler might suffer this damage because of lead poisoning, bacterial meningitis, malnutrition, being shaken as an infant (shaken baby syndrome), or being in a car accident while not properly restrained.

Diagnosing Cerebral Palsy

CP may be diagnosed very early in an infant known to be at risk for developing the condition because of premature birth or other health problems. Doctors, such as pediatricians and developmental and neurological specialists, usually follow these kids closely from birth so that they can identify and address any developmental delays or problems with muscle function that might indicate CP.

In a baby carried to term with no other obvious risk factors for CP, it may be difficult to diagnose the disorder in the first year of life. Often doctors aren't able to diagnose CP until they see a delay in normal developmental milestones (such as reaching for toys by 4 months or sitting up by 7 months), which can be a sign of CP.
Abnormal muscle tone, poorly coordinated movements, and the persistence of infant reflexes beyond the age at which they are expected to disappear also can be signs. If these developmental milestones are only mildly delayed, the diagnosis of CP may not be made until the child is a toddler.

Preventing Cerebral Palsy

In many cases the causes of CP are unknown, so there's no way to prevent it. But if you're having a baby, you can take steps to ensure a healthy pregnancy and carry the baby to term, thus lowering the risk that your baby will have CP.

Before becoming pregnant, it's important to maintain a healthy diet and make sure that any medical problems are managed properly. As soon as you know you're pregnant, proper prenatal medical care is vital. If you are taking any medications, review these with your doctor and clarify if there are any side effects that can cause birth defects.

Controlling diabetes, anemia, hypertension, seizures, and nutritional deficiencies during pregnancy can help prevent some premature births and, as a result, some cases of cerebral palsy.
Once your baby is born you can lower the risk of brain damage, which could lead to CP. Never shake an infant, as this can lead to shaken baby syndrome and brain damage. If you're riding in a car, make sure your baby is properly strapped into an infant car seat that's correctly installed — if an accident occurs, the baby will be as protected as possible.

Be aware of lead exposure in your house, as lead poisoning can lead to brain damage. Remember to have your child get his or her immunizations on time — these shots protect against serious infections, some of which can cause brain damage resulting in CP.

How Cerebral Palsy Affects Development

Kids with CP have varying degrees of physical disability. Some have only mild impairment, while others are severely affected.

Associated medical problems may include visual impairment or blindness, hearing loss, food aspiration (the sucking of food or fluid into the lungs), gastroesophageal reflux (spitting up), speech problems, drooling, tooth decay, sleep disorders, osteoporosis (weak, brittle bones), and behavior problems.

Seizures, speech and communication problems, and mental retardation are also common among kids with the severe form of CP. Many have problems that may require ongoing therapy and devices such as braces or wheelchairs.

Treatment of Cerebral Palsy

Currently there's no cure for cerebral palsy, but a variety of resources and therapies can provide help and improve the quality of life for kids with CP.

Different kinds of therapy can help them achieve maximum potential in growth and development. As soon as CP is diagnosed, a child can begin therapy for movement, learning, speech, hearing, and social and emotional development.

In addition, medication, surgery, or braces can help improve muscle function. Surgery can help repair dislocated hips and scoliosis (curvature of the spine), which are common problems associated with CP. Severe muscle spasticity can sometimes be helped with medication taken by mouth or administered via a pump (the baclofen pump) implanted under the skin.

A team of professionals will be needed to work with you to meet your child's medical needs. That team may include therapists, psychologists, educators, nurses, and social workers..

Listen

How Cerebral Palsy Affects Development

Kids with CP have varying degrees of physical disability. Some have only mild impairment, while others are severely affected.
Associated medical problems may include visual impairment or blindness, hearing loss, food aspiration (the sucking of food or fluid into the lungs), gastroesophageal reflux (spitting up), speech problems, drooling, tooth decay, sleep disorders, osteoporosis (weak, brittle bones), and behavior problems.
Seizures, speech and communication problems, and mental retardation are also common among kids with the severe form of CP. Many have problems that may require ongoing therapy and devices such as braces or wheelchairs.

Treatment of Cerebral Palsy

Currently there's no cure for cerebral palsy, but a variety of resources and therapies can provide help and improve the quality of life for kids with CP.
Different kinds of therapy can help them achieve maximum potential in growth and development. As soon as CP is diagnosed, a child can begin therapy for movement, learning, speech, hearing, and social and emotional development.
In addition, medication, surgery, or braces can help improve muscle function. Surgery can help repair dislocated hips and scoliosis (curvature of the spine), which are common problems associated with CP. Severe muscle spasticity can sometimes be helped with medication taken by mouth or administered via a pump (the baclofen pump) implanted under the skin.
A team of professionals will work with you to meet your child's medical needs. That team may include therapists, psychologists, educators, nurses, and social workers.
Many resources are available to help and support you in caring for your child. Talk to your doctor about finding those in your area.
Reviewed by: Steven J. Bachrach, MD
Date reviewed: April 2009

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What is meant by the term "Mental Retardation""?

Mental retardation is a term that was once commonly used to describe someone who learns and develops more slowly than other kids. But it’s not used as much anymore. (However unfortunately,  it is still widely used in the Middle East)
Instead, you might hear terms like “intellectual disability” or “developmental delay.” But all these words mean basically the same thing. Someone who has this kind of problem will have trouble learning and functioning in everyday life. This person could be 10 years old, but might not talk or write as well as a typical 10-year-old. He or she also is usually slower to learn other skills, like how to get dressed or how to act around other people.
But having an intellectual disability doesn’t mean a person can’t learn. Ask anyone who knows and loves a person with an intellectual disability! Some kids with autism, Down syndrome, or cerebral palsy may be described as having an intellectual disability, yet they often have a great capacity to learn and become quite capable kids.
Just like other health problems, an intellectual disability can be mild (smaller) or major (bigger). The bigger the disability the more trouble someone will have learning and becoming an independent person.

What Causes Intellectual Disabilities?

Intellectual disabilities happen because the brain gets injured or a problem prevents the brain from developing normally. These problems can happen during pregnancy, during the baby’s birth, or after the baby is born. Many times, though, doctors don’t know the cause.
Here are some problems that can cause intellectual disabilities:

• There’s a problem with the baby’s genes, which are in every cell and determine how the body will develop. (Genes are inherited from both parents, so a baby might receive genes that are abnormal or the genes might change while the baby is developing.)
• There’s a problem during the pregnancy. Sometimes, the mother might get an illness or infection that can harm the baby. Taking certain medicines while pregnant can cause problems for the baby. Drinking alcohol or taking illegal drugs can also damage a baby’s developing brain.
• During childbirth, the baby doesn’t get enough oxygen.
• The baby is born way too early.
• After being born, the baby gets a serious brain infection.
• Any time in life, a serious head injury can hurt the brain and cause intellectual disabilities. Some of these disabilities are temporary and others can be permanent.

Doctors figure out that someone has an intellectual disability by testing how well the person thinks and solves problems. If a problem is spotted, doctors and other professionals can work with the family to decide what type of help is needed.

Schooling

During school, a student with an intellectual disability will probably need help. Some students have aides that stay with them during the school day. They may be in special classes or get other services to help them learn and develop.
Someone with an intellectual disability often gets help in learning “life skills.” Life skills are the skills people need to take care of themselves as they get older, such as how to cook a meal or ride a public bus to get to work. Adults with intellectual disabilities often have jobs and learn to live independently or in a group home.
Students with intellectual disabilities want to develop their skills to the best of their abilities. They want to go to school, play, and feel support from loving families and good friends.
If you can’t think of anything, just say, “hi.” It’s a little word that could make that person’s day.

ADHD Vs Autism

ADHD Vs Autism
Basically, ADHD (completely known as Attention Deficit Hyperactivity Disorder) is when a person indulges in too much activity to the point that he can no longer focus his attention to a given object or task under normal circumstances. There is a recurrent feature of being impulsive, aside from the common inattention to other things. Impulsive and inattention are two of the most identifiable characteristics of ADHD.
Because these individuals are unable to focus on one task for a prolonged period of time, you’ll almost always notice them shifting tasks and frequently moving about. They really can’t stay in a single place for a long time or else they will become anxious or get bored. Nevertheless, you need not worry that much because if ever your child has ADHD, there’s still a big probability of him outgrowing the condition most especially when he reach the age of twenty and above.
Autism is when a person has poor or underdeveloped social skills. In this regard, the autistic person is not able to clearly interpret or distinguish body language. He is also unable to emphatize with other people. These characteristics are said to be attributed to the absence of mirror neurons in the central nervous system.
Autism is a more complex developmental disorder that affects many developmental dimensions of the individual. When at 3 years old, the child demonstrates certain significant restrictions in communication, interaction and behavior (repetitive) then most likely he is autistic. Sometimes autism surfaces at one year old and other cases even manifest early at birth (although you can’t conclude directly that it is autistic behavior unless there are several tests done). Because there are many dimensions and other variables to be considered, autism is usually very difficult to diagnose.

Autistic children have a hard time developing language. Even if they have already learned some new words, there’s still a big chance of losing such knowledge as time passes by. Autistic children practice a sense of ‘social retreat.’ This means that they are mostly introverted and don’t want to interact with other kids even at playtime. Most of them don’t even want to make eye contact at all. They also have sensory issues like when they identify certain stimuli as addictive (e.g. rotating fan blades). They also do repetitive motions like hand flapping.
It is also interesting to note that many autistic kids are found to have high IQs. Although they have this much mental capacity, they actually have built a ‘world’ of their own which is difficult to penetrate from the outside.
All in all, although both conditions are classified as developmental disorders they still differ in the following aspects:
1. Autism is a more complex problem compared to ADHD.
2. Autism has hallmark characteristics of repetitive behavior, language and sensory problems, and social retreat. ADHD is seen when the individual is impulsive, hyperactive, inattentive and easily gets bored.

Dance and Drama Therapy

Since we are in the process of bringing dance and drama therapist to Oman for our center, we would like the opportunity to explain what it is.
These therapies will help special education students improve in many different ways…
DRAMA THERAPY
Drama therapy applies techniques from theatre to the process of psychotherapeutic healing. It emerged as a field in the late 1970’s from hospital and community programs where it was first used with clients to produce plays and later was integrated with improvisation and process drama methods. The focus in drama therapy is on helping individuals grow and heal by taking on and practicing new roles.
Drama and psychology are both the study of human behavior two sides of the same coin. Psychology is the study of thoughts, emotions and behavior; drama actively analyzes and presents the thoughts, emotions and behavior of characters for an audience to see and understand. Much of dramatic literature addresses the psychological, social, and cultural conditions of humanity and, thus, serves as a natural vehicle for actually helping real people with problems more consciously address their problems.
Just as psychotherapy treats people who have difficulties with their thoughts, emotions and behavior, drama therapy uses drama processes (games, improvisation, storytelling, role play) and products (puppets, masks, plays/performances) to help people understand their thoughts and emotions better or to improve their behavior. However, unlike most types of therapy which rely purely on talking (psychoanalysis was, after all, called “the talking cure”), drama therapy relies on taking action on doing things!
The drama therapist is trained in four general areas: drama/theatre, general and abnormal psychology, psychotherapy, and drama therapy. Each of these categories involves a number of required classes, many of them experiential, where one learns by doing, practicing, getting supervisory feedback, and refining skills. In the end, the drama therapist is able to facilitate the client’s experience in a way that keeps the individual emotionally and physically safe while the individual benefits from the dramatic process.
Because there are so many forms that drama can take, drama therapy can be considered a very broad field. The metaphor we  like to use to explain this is to say there is a very big “Drama Therapy Pie” which can be cut into many smaller slices:

The Drama Therapy Pie

Depending on the goals and needs of the student, the drama therapist chooses a method (or several) that will achieve the desired combination of understanding, emotional release, and learning of new behavior. Some methods, such as drama games, improvisation, role play, developmental transformations, sociodrama and psychodrama are very process-oriented and unscripted. The work is done within the therapy session and not presented to an audience. Other methods, such as Playback Theatre, Theatre of the Oppressed, and the performance of plays are more formal and presentational, involving an audience. Puppets, masks, and rituals can be used as part of performance or as process techniques within a therapy session.
Certain techniques: drama games, improvisation, role play, sociodrama, developmental transformations, rituals, masks, puppets and some types of performances involve fictional work. The student pretends to be a character different from him or herself. This can expand the student’s role repertoire (or the number of types of roles that can be accessed for use in real life) or it can allow the student to explore a similar role to one he or she plays, but under the guise of “not-me-but-someone-like-me.” Other techniques, such as Psychodrama, Therapeutic Spiral Model, Playback Theatre, Theater of the Oppressed and autobiographical performances, allow the client to explore his or her life directly. Students will need to have good ego strength to be able to do this kind of non-fiction work because it requires an honest, searching look at oneself.
DANCE AND MOVEMENT THERAPY
Dance and movement therapy is the psychotherapeutic use of movement to promote emotional, cognitive, physical, and social integration of individual. Dance and movement therapy is practiced in mental health, rehabilitation, medical, special educational,  and in nursing homes, day care centers, disease prevention, and health promotion programs.
The dance and movement therapist focuses on movement behavior as it emerges in the therapeutic relationship. Expressive, communicative, and adaptive behaviors are used for group and individual treatment. This is excellent for therapist to use for aggressive children, it is an excellent way of integrating behavior therapy.
Body movement as the core component of dance simultaneously provides the means of assessment and the mode of intervention for dance/movement therapy. 

Pioneering the Body and Mind

• For over 50 years, Dance/Movement Therapists have pioneered the understanding of how body and mind interact in health and in illness.
• Whether the issue is the will to live, a search for meaning or motility, or the ability to feel love for life, Dance/Movement Therapists mobilize resources from that place within where body and mind are one.