First Published Tuesday, 13 January 2009

Daniel Tammet (Image: Toby Madden/Eyevine)

07 January 2009 by Celeste Biever

Autistic savant Daniel Tammet shot to fame when he set a European record for the number of digits of pi he recited from memory (22,514). For afters, he learned Icelandic in a week. But unlike many savants, he’s able to tell us how he does it. We could all unleash extraordinary mental abilities by getting inside the savant mind, he tells Celeste Biever

Do you think savants have been misunderstood – and perhaps dehumanised – in the past?

Very often the analogy has been that a savant is like a computer, but what I do is about as far from what a computer does as you can imagine. This distinction hasn’t been made before, because savants haven’t been able to articulate how their minds work. I am lucky that the autism I have is mild, and that I was born into a large family and had to learn social skills, so I am able to speak up.

When did you first realise you had special talents?

At the age of 8 or 9. I was being taught maths at school and realised I could do the sums quickly, intuitively and in my own way – not using the techniques we were taught. I got so far ahead of the other children that I ran out of textbooks. I was aware already that I was different, because of my autism, but at that point I realised that the relationship I had with numbers was different.

To most people, the things you can do with your memory seem like magic. How do you do it?

The response that people often have to what I can do is one of “gee whiz”, but I want to push back against that. One of the purposes of the book I’ve just written, Embracing the Wide Sky, is to demystify this, to show the hidden processes behind my number skills.

I have a relationship with numbers that is similar to the relationship that most people have with language. When people think of words, they don’t think of them as separate items, atomised in their head, they understand them intuitively and subconsciously as belonging to an interconnected web of other words.

Can you give an example?

You wouldn’t use a word like “giraffe” without understanding what the words “neck” or “tall” or “animal” mean. Words only make sense when they are in this web of interconnected meaning and I have the same thing with numbers. Numbers belong to a web. When somebody gives me a number, I immediately visualise it and how it relates to other numbers. I also see the patterns those relationships produce and manipulate them in my head to arrive at a solution, if it’s a sum, or to identify if there is a prime.

But how do you visualise a number? In the same way that I visualise a giraffe?

Every number has a texture. If it is a “lumpy” number, then immediately my mind will relate it to other numbers which are lumpy – the lumpiness will tell me there is a relationship, there is a common divisor, or a pattern between the digits.

Can you give an example of a “lumpy” number?

For me, the ideal lumpy number is 37. It’s like porridge. So 111, a very pretty number, which is 3 times 37, is lumpy but it is also round. It takes on the properties of both 37 and 3, which is round. It’s an intuitive and visual way of doing maths and thinking about numbers.

Why do you think you treat numbers this way?

When I was growing up, because of my autism, I didn’t make friends. Numbers filled that gap. The numbers came alive. My mind was able to pick out patterns and to make sense of them. It was similar to how a child would acquire his first language.

Do you make mistakes?

Absolutely. All the time, because of my intuitive approach. In the book I give an example of how another autistic savant thought that 10,511 was a prime number. That’s the kind of mistake I could make, because it looks prime. However, it is divisible by 23 and 457. It’s a forgivable error and not a rookie mistake.

What can we learn from the way your mind works?

The differences between savant and non-savant ability have been exaggerated. Savants are not freaks, cut off from the rest of humanity. The thinking of savants is an extreme form of the kind that everyone has. The aim of my book is to show that minds that function differently, such as mine, are not so strange, and that anyone can learn from them. I also hope to clear up some misconceptions about savant abilities and what it means to be intelligent or gifted.

There is immense potential, and instincts for language and numbers, in everyone. We could train these intuitions – especially at an early age, but also at any age – and learn how to break down preconceptions about how numbers should be thought about or how language works. Then, though people might not necessarily be able to do all the things I can do, they will be more comfortable with language and mathematics, and learning and education in general.

You also excel at learning languages. How do you pick them up so quickly?

I have synaesthesia, which helps. When there is an overlap between how I visualise a word and its meaning, that helps me remember it. For example, if a word that means “fire” in a new language happens to appear orange to me, that will help me remember it. But more significant is my memory and ability to spot patterns and find relationships between words. Fundamentally, languages are clusters of meaning – that is what grammar is about. This is also why languages interest me so much. My mind is interested in breaking things down and understanding complex relationships.

You have created your own language. Why?

My language – called Mänti – is about my love of words. If you have that relationship with words, you will always want to express yourself but not be able to find the word in your native language. I speak many languages and I still can’t always find the right sentence in any language. Mänti is about having that freedom to play with language, to see what would happen if I had a word for this or that.

What can you say in Mänti that you can’t say in any other language?

I like the word “kellokult”, which means “clock debt”. It’s a way of emphasising that when you are late for something, it incurs a debt, you owe someone that time. There is also “rupuaigu”, which means “bread time”. It’s a period of time, roughly an hour, that is the time it would take for bread to bake in an oven. What I like is that it is the same for everyone in the world. It’s a more intuitive way of thinking about an hour.

Do you have a bone to pick with the neurologist Oliver Sacks, who wrote about autistic savants?

Oliver Sacks wrote a famous account of autistic savant twins who counted 111 matches in an instant, as they spilled to the floor. Because he is famous, this has gained a lot of traction. People have devised theories to explain how savants might do this. But the likeliest explanation is that savants don’t instantly discern large quantities of objects at all. This ability has never been demonstrated scientifically, nor has it ever been reported in another savant. I think Sacks’s account – which has been so influential – is totally wrong.

Why is it so important to get this right?

The abilities of savants have been pigeon-holed as somehow supernatural, almost inexplicable and certainly not as part of the natural continuum of human talent. This has deformed how the public and, crucially, scientists, view the brain and human potential. It is insulting and potentially dehumanising. The future is an immensely scary place, full of all kinds of challenges. We will need every kind of mind, so why not bring along every kind of intelligence?

First Published Tuesday, 13 January 2009

Making Room for Miss Manners Is a Parenting Basic

For years, I took care of a very rude child. When he was 3, I called him rambunctious — and I talked to his mother about “setting limits.” At 4, I called him “demanding.” At 5, he was still screaming at his mother if she didn’t do what he wanted, he still swatted me whenever I tried to examine him, and his mother asked me worriedly if I thought he was ready for kindergarten.

I could go on (he didn’t have an easy time in school), but it would sound like a Victorian tale: The Rude Boy. I never used the word “rude” or even “manners” when I spoke to his mother. I don’t describe my patients as rude or polite in the medical record. But I do pass judgment, and so does every pediatrician I know.

It’s always popular — and easy — to bewail the deterioration of manners; there is an often quoted (and often disputed) story about Socrates’ complaining that the young Athenians have “bad manners, contempt for authority.” Sure, certain social rubrics have broken down or blurred, and sure, electronic communication seems to have given adults as well as children new ways to be rude. But the age-old parental job remains.

And that job is to start with a being who has no thought for the feelings of others, no code of behavior beyond its own needs and comforts — and, guided by love and duty, to do your best to transform that being into what your grandmother (or Socrates) might call a mensch. To use a term that has fallen out of favor, your assignment is to “civilize” the object of your affections.

My favorite child-rearing book is “Miss Manners’ Guide to Rearing Perfect Children,” by Judith Martin, who takes the view that manners are at the heart of the whole parental enterprise. I called her to ask why.

“Every infant is born adorable but selfish and the center of the universe,” she replied. It’s a parent’s job to teach that “there are other people, and other people have feelings.”

The conversations that every pediatrician has, over and over, about “limit setting” and “consistently praising good behavior” are conversations about manners. And when you are in the exam room with a child who seems to have none, you begin to wonder what is going on at home and at school, and questions of family dysfunction or neurodevelopmental problems begin to cross your mind.

Dr. Barbara Howard, an assistant professor of pediatrics at the Johns Hopkins School of Medicine and an expert on behavior and development, told me that a child’s manners were a perfectly appropriate topic to raise at a pediatric visit.

“It has a huge impact on people’s lives — why wouldn’t you bring it up?” she said. “Do they look you in the eye? If you stick your hand out do they shake it? How do they interact with the parents; do they interrupt, do they ask for things, do they open Mommy’s purse and take things out?”

Dr. Howard suggested that the whole “manners” concept might seem a little out of date — until you recast it as “social skills,” a very hot term these days. Social skills are necessary for school success, she pointed out; they affect how you do on the playground, in the classroom, in the workplace.

We also think of social skills as a profound set of challenges that complicate the lives of children — and adults — on what is now called the autism spectrum. Children with autism, whether mild or severe, have great difficulty learning social codes, deciphering subtle body language or tone of voice, and catching on to the rules of the game.

Therapy for these children can include systematic training in social skills, sometimes using scripts for common human interactions. And one lesson, Dr. Howard said, “is that you can teach this stuff, and we maybe aren’t teaching it as well as we should be to children who are developing normally.”

And of course, one of the long-term consequences of being a rude child is being a rude adult — even a rude doctor. There are bullies on the playground and bullies in the workplace; it can be quite disconcerting to encounter a mature adult with 20 or so years of education under his belt who still sees the world only in terms of his own wants, needs and emotions: I want that so give it to me; I am angry so I need to hit; I am wounded so I must howl.

I like Miss Manners’ approach because it lets a parent respect a child’s intellectual and emotional privacy: I’m not telling you to like your teacher; I’m telling you to treat her with courtesy. I’m not telling you that you can’t hate Tommy; I’m telling you that you can’t hit Tommy. Your feelings are your own private business; your behavior is public.

But that first big counterintuitive lesson — that there are other people out there whose feelings must be considered — affects a child’s most basic moral development. For a child, as for an adult, manners represent a strategy for getting along in life, but also a successful intellectual engagement with the business of being human.

I did not enjoy visits with my rude patient. Despite his generally good health and his normal developmental milestones, I couldn’t help feeling that the adult world had failed to guide and protect him. He was loud and demanding and insistent, but one of his basic needs had not been met: no one had taught him manners.

As a pediatrician, I worry about the trajectories of children’s growth and development: measuring a baby’s head size, weighing a toddler, asking about the language skills of a preschooler. Manners are another side of the journey every child makes from helplessness to autonomy. And a child who learns to manage a little courtesy, even under the pressure of a visit to the doctor, is a child who is operating well in the world, a child with a positive prognosis.

Source:   http://www.nytimes.com/2009/01/13/health/13klas.html?em

First Published Wednesday, 14 January 2009

14 January 2009 by Jessica Marshall

WHY be miserable? OK, so it’s January and you’re feeling fat and broke after the excesses of the holiday season, but there’s really no need. Misery is inconvenient, unpleasant, and in a society where personal happiness is prized above all else, there is little tolerance for wallowing in despair. Especially now we’ve got drugs for it.

Antidepressants can help banish sad feelings – not just the life-sapping black dog of clinical depression, but the rough patches that most people go through sometimes, whether it’s after losing a job, the break-up of a relationship or the death of a loved one. So it’s no surprise that more and more people are taking them (see graph).

But is this really such a good idea? A growing number of cautionary voices from the world of mental health research are saying it isn’t. They fear that the increasing tendency to treat normal sadness as if it were a disease is playing fast and loose with a crucial part of our biology. Sadness, they argue, serves an evolutionary purpose – and if we lose it, we lose out.

“When you find something this deeply in us biologically, you presume that it was selected because it had some advantage, otherwise we wouldn’t have been burdened with it,” says Jerome Wakefield, a clinical social worker at New York University and co-author of The Loss of Sadness: How psychiatry transformed normal sorrow into depressive disorder (with Allan Horwitz, Oxford University Press, 2007). “We’re fooling around with part of our biological make-up.”

Perhaps, then, it is time to embrace our miserable side. Yet many psychiatrists insist not. Sadness has a nasty habit of turning into depression, they warn. Even when people are sad for good reason, they should be allowed to take drugs to make themselves feel better if that’s what they want.

So who is right? Is sadness something we can live without or is it a crucial part of the human condition?

Hard evidence for the importance of sadness in humans is difficult to come by, but there are lots of ideas about why our propensity to feel sad might have evolved. It may be a self-protection strategy, as it seems to be among other primates that show signs of sadness. An ape that doesn’t obviously slink off after it loses status may be seen as continuing to challenge the dominant ape – and that could be fatal.

Wakefield believes that in humans sadness has a further function: it helps us learn from our mistakes. “I think that one of the functions of intense negative emotions is to stop our normal functioning, to make us focus on something else for a while,” he says. It might act as a psychological deterrent to prevent us from making those mistakes in the first place. The risk of sadness may deter us from being too cavalier in relationships or with other things we value, for example.

What’s more, says Paul Keedwell, a psychiatrist at Cardiff University in the UK, even full-blown depression may save us from the effects of long-term stress. Without taking time out to reflect, he says, “you might stay in a state of chronic stress until you’re exhausted or dead”. He also thinks that we may have evolved to display sadness as a form of communication. By acting sad, we tell other community members that we need support.

Then there is the notion that creativity is connected to dark moods. There is no shortage of great artists, writers and musicians who have suffered from depression or bipolar disorder. It would be difficult to find enough recognised geniuses to test the idea in a large, controlled study, but more run-of-the-mill creativity does seem to be associated with mood disorders. Modupe Akinola and Wendy Berry Mendes of Harvard University found that people with signs of depression performed better at a creative task, especially after receiving feedback that was designed to reinforce their low mood. The researchers suggest that such negative feedback makes people ruminate on the unhappy experience, which allows subconscious creative processes to come to the fore, or that it pushes depression-prone people to work harder to avoid feeling bad in the future (Personality and Social Psychology Bulletin, vol 34, p 1677).

Don’t be happy, worry

There is also evidence that too much happiness can be bad for your career. Ed Diener, a psychologist at the University of Illinois in Urbana-Champaign, and his colleagues found that people who scored 8 out of 10 on a happiness scale were more successful in terms of income and education than 9s or 10s – although the 9s and 10s seemed to have more successful close relationships (Perspectives on Psychological Science, vol 2, p 346).

This could simply demonstrate that the happiest people are those who cherish close relationships over power and success, but it could also signal that people who are “too happy” lose their willingness to make changes to their lives that may benefit them. Medicating sadness, Keedwell suggests, could do the same – blunting the consequences of unfortunate situations and removing people’s motivation to improve their lives. Giving antidepressants to people whose real problem is something else – a bad relationship, for instance – may allow the person to continue in an unhealthy situation instead of addressing the underlying problem.

Whether or not a little sadness is useful, everyone agrees that clinical depression is not. Unfortunately it’s not clear exactly where to draw the line between the two (see “Sad or depressed?”). So which is more dangerous: to over-medicate normal sadness, a feeling which may lead us to re-evaluate our lives after the loss of a job or the end of a relationship, or under-medicate clinical depression?

Ian Hickie of the Brain and Mind Research Institute at the University of Sydney, Australia, insists that depression is not overdiagnosed but would rather it were than see seriously depressed people left out in the cold. He points out that there is evidence to suggest that the number of suicides has declined as more cases of depression have been diagnosed. It’s important to take borderline diagnoses of depression seriously, he says, because “most of the suicides do not occur in the most severely depressed”.

Wakefield, however is uneasy about prescribing pills where there is no certainty that they are needed. After all, he points out, antidepressants have side effects, some of them serious.

The need for sad

So where does this leave the notion of human sadness? Should we accept that major life events may make us so sad that we are temporarily disabled? Or should we run to the doctor in the hope that pills will speed up our emotional journey back to happiness?

Ken Kendler, a psychiatrist at the Virginia Commonwealth University in Richmond, points out that for some people, sadness is definitely something they are better off without. He recalls a mother in her late 20s who came to him because she had an inoperable defect in her aorta that would rupture at some undeterminable time in the future, killing her instantly. This knowledge had made her depressed – certainly with reasonable cause – but she did not want to live the rest of her days that way, unable to function for her family.

“That seemed to me to be an irreproachable logic on her part,” Kendler says. “I started her on antidepressants. She came back much brighter. The idea that I was depriving this woman of the proper grieving experience and preventing her from experiencing deeply the meaning of this rang very hollow in this particular case.”

For those of us not faced with such an extreme problem, Terence Ketter, a psychiatrist at Stanford University in California, is more cautious. “The cost of happiness is complacency,” he says. Sadness is still something useful: “Discontent can drive change. Certainly, you don’t want to stifle or blunt emotion – emotion is information.”

Keedwell agrees. “Clearly, if we didn’t feel sad when we were unsuccessful at achieving certain goals, we would not stand back from that goal and introspect and perhaps try to change our strategies,” he says, echoing Wakefield and the Harvard creativity study. “Being enthusiastic and jubilant we would probably go blindly on.”

So is there some middle ground? Both sides agree that there are ways to lift the gloom without pills. “An alternative would be thinking about what is making you unhappy,” says Wakefield. “Another possibility is watchful waiting. A more nuanced view of the situation will help people think about their options better.”

Diener also suggests we stop obsessing about being happy all the time (see “A pill for every ill”). “One of the things we want to do is disabuse people of the notion that they’re not happy enough,” he says. He cites a study that used emotion-recognition software to work out the Mona Lisa’s inner feelings (New Scientist, 17 December 2005, p 25). It concluded that she is 83 per cent happy. The rest is a mix of negative emotions like fear and anger. That, it seems, is just about right.

Read our related editorial

Jessica Marshall is a freelance science writer based in St Paul, Minnesota

Source:   http://www.newscientist.com/article/mg20126911.600-is-it-really-bad-to-be-sad.html?full=true

First Published Friday, 16 January 2009

People who are depressed are literally sick at heart: they have a significantly increased risk for cardiovascular disease, and no one knows exactly why. Now three new studies have tried to explain this, and they arrive at subtly different conclusions.

The first, led by Dr. Mary A. Whooley of the Veterans Affairs Medical Center in San Francisco, studied 1,017 patients with coronary artery disease for an average of more than four years. Although the study found an association of depression with heart disease, when researchers statistically corrected for other medical conditions, disease severity and physical inactivity, the association disappeared.

They concluded with a relatively straightforward explanation: depression leads to physical inactivity, and lack of exercise increases the risk for heart disease. The study appears in the Nov. 26 issue of The Journal of the American Medical Association.

A second study, published Tuesday in The Journal of the American College of Cardiology, provides a different perspective. It included more than 6,500 healthy men and women with an average age of 51. Researchers tested them for depressive symptoms and followed them for an average of more than seven years.

This study, too, found that behavioral issues like smoking and inactivity were the strongest factors in the increased risk for heart disease among people who are depressed or anxious, accounting for 65 percent of the difference in risk. But they also found that depressed people had higher rates of hypertension and higher levels of C-reactive protein, and that these two physiological factors together accounted for about 19 percent of the increased risk. Mark Hamer, a senior researcher at University College London, was the lead author.

While these two studies suggest that the mechanism by which depression exerts its effect is mostly or entirely through poor health behaviors, a third study, in the December issue of The Archives of General Psychiatry, found that something else might be even more important.

This paper, whose senior author was Dr. Brenda Penninx, a professor of psychiatry at VU University in Amsterdam, studied 2,088 well-functioning adults ages 70 to 79. It found no difference in physical activity between those who were depressed and those who were not.

But it did find that depressive symptoms were associated with an increase in visceral fat accumulation — the pot belly that is a known risk factor for cardiovascular illness. This suggests that there is a biological mechanism that links depression with physiological changes independent of how much a person exercises.

To further complicate matters, Dr. Penninx suggested that her physically healthy subjects might have a different kind of depression. “There is now quite a lot of evidence that among heart attack patients, the physical symptoms of depression are more prevalent,” she said, “which suggests that their depression is different from that seen in an otherwise healthy sample.”

For now, Dr. Hamer, of London, offered what might be the last word on the complicated relationship between depression and heart disease.

“It’s really quite difficult to understand,” he said.

Source:   http://www.nytimes.com/2008/12/16/health/research/16depr.html?ref=research

Hypertension and Stroke Health Alert

Call 911 — Not a Healthline — for Suspected Stroke

Much more publicity is given to the symptoms of a heart attack than a stroke. Yet like a heart attack, a stroke is an emergency that requires immediate medical attention. It’s essential to get to the hospital as soon as symptoms start, since drug therapy is most likely to be effective within the first three hours of stroke onset.

People who call a hospital’s medical-advice healthline instead of 911 for a suspected stroke can lose critical time due to delays or misinformation, according to a study published in the journal Stroke (Volume 38, page 2376) .

The researchers called 46 U.S. hospital healthlines and presented operators with a typical scenario of stroke symptoms. The operators were then asked which of four responses they would give: wait and see if symptoms subside; call your primary care doctor; drive to your local urgent-care center; or call 911 for an ambulance. While 78% of the healthline operators gave the correct response — call 911 — 22% recommended that the caller contact his or her primary care doctor, including 32% of the operators who worked for healthlines at certified stroke centers. Moreover, 39% of the healthline calls were transferred at least once (usually to the emergency department), and one quarter of the operators couldn’t identify even one sign or symptom of a stroke.

A stroke is a medical emergency and time is of the essence, so if you suspect that you or someone else is having a stroke, immediately call 911, not a medical-advice healthline. Emergency-room doctors are the ones who should make the decision whether symptoms are of a stroke or not.

Listed below are the symptoms of a stroke, as well as what to do in the event of a stroke.

Symptoms of Stroke:

• *Sudden weakness or numbness in the face, arm, or leg on one side of the body.
• *Sudden loss, blurring, or dimness of vision.
• *Mental confusion, loss of memory, or sudden loss of consciousness.
• *Slurred speech, loss of speech, or problems understanding others.
• *Sudden, severe headache with no apparent cause.
• *Unexplained dizziness, drowsiness, loss of coordination, or falls.
• *Nausea and vomiting, especially when accompanied by any of the above symptoms.

Actions To Take in the Event of a Stroke:

• *Stay calm. Ignore any tendency to downplay a stroke symptom; it’s common for people to deny the possibility of something as serious as a stroke. Don’t hesitate to take prompt action.
• *Call or have someone call an ambulance. (Dial 911 in most parts of the United States.) Be sure to give your name, telephone number, and exact whereabouts.
• *While waiting for the ambulance, the person suffering the stroke should be made as comfortable as possible and should not eat or drink anything other than water.
• *If an ambulance cannot arrive for an extended period of time, a family member or neighbor should drive the stroke patient to the hospital. Under no circumstances should the person experiencing the stroke symptoms attempt to drive.
• *Notify the stroke patient’s doctor. He or she can provide the hospital with the patient’s medical history, which may be important for determining the best type of treatment for the stroke.

First Published Friday, 16 January 2009

Fwd:

Disability Groups Send Recommendations to Obama

Dear President-elect Obama,

Congratulations on capturing the hearts, minds, and hopes of our nation! As
grassroots, community-based, consumer-controlled disability organizations,
which collectively represent over 50 million Americans with the full
spectrum of disabilities, we look forward to working with you and your
administration to make cost-effective policy changes to enhance the lives of
and restore the civil liberties Americans with disabilities.

Attached you will find nine summaries of the top policy issues facing
Americans with disabilities. Taking action on your commitment and these
policy measures will not only benefit citizens with disabilities, our
nation’s wounded warriors, and the ever-growing aging population, it will
benefit all Americans and save our government millions of dollars as
individuals with disabilities become full participants in society.

They include:

· * **Employment<http://jfactivist. typepad.com/ jfactivist/ 2009/01/disabili ty-groups- send-transition- team-education- policy-recommend ations.html>
:* Reversing the persistently high percentages of people with disabilities
who are not working but are ready, willing and able to work;

<http://jfactivist. typepad.com/ jfactivist/ 2009/01/disabili ty-groups- send-transition- team-education- policy-recommend ations.html>
*Education:<http://jfactivist. typepad.com/ jfactivist/ 2009/01/disabili ty-groups- send-transition- team-education- policy-recommend ations-1. html>
*Increasing access and opportunities for physical activity, and improving
quality;

· *Health
Care<http://jfactivist. typepad.com/ jfactivist/ 2009/01/disabili ty-groups- send-transition- team-healthcare- policy-recommend ations.html>
:* Improving access and decreasing disparities and inequities;

· * **Home and Community-based Services
(HCBS):<http://jfactivist. typepad.com/ jfactivist/ 2009/01/disabili ty-groups- send-transition- team-hcbs- policy-recommend ations.html>
*Promoting effective community-based services as alternatives to costly
nursing homes and other institutions and increase the FMAP to states;

· *Disability
Research<http://jfactivist. typepad.com/ jfactivist/ 2009/01/disabili ty-groups- send-transition- team-disability- research- policy-recommend ations.html>
: *Promoting a quality of life and participation- based research agenda;

· *Civil
Rights<http://jfactivist. typepad.com/ jfactivist/ 2009/01/disabili ty-groups- send-transition- team-civil- rights-recommend ations.html>
*: Reinvigorating civil rights enforcement, extending access requirements to
new technologies, and continuing to restore protections stripped away by
hostile courts;

· *Human
Rights<http://jfactivist. typepad.com/ jfactivist/ 2009/01/disabili ty-groups- send-transition- team-human- rights-recommend ations.html>
:* Protecting human rights of individuals with disabilities at home and
abroad;

· *Emergency Preparedness, Response and Recovery
Needs:<http://jfactivist. typepad.com/ jfactivist/ 2009/01/disabili ty-groups- send-transition- team-emergency- preparedness- recommendations. html>
*Planning, coordinating, and providing resources to support people with
disabilities before, during, and after a crisis; and**

· *Genetic Science and
Technology:<http://jfactivist. typepad.com/ jfactivist/ 2009/01/disabili ty-groups- send-transition- team-genetic- science-and- technology- policy-recommend ations.html>
*Promoting ethical use of new technologies.

Like you, we stand and sit on the shoulders of so many who have come before
us. As our nation approaches the 20th anniversary of the Americans with
Disabilities Act in 2010, we embrace the disability rights principle,
“Nothing About Us, Without Us.” For too long others claimed the need to
speak for us, but no other group – professionals or relatives – speak for *
us*.

Additionally, we urge you to embrace the fundamental principles for
sustainable change, which are essential elements to building healthy,
resilient, empowered communities. As you move forward with deliberate speed
and consideration, we urge your administration to:

· Provide oversight of federal agency public policy, regulatory, and
enforcement actions, and collaborate with consumer and community-based
disability organizations as partners to better serve the ever-expanding
population of more than 50 million Americans with disabilities;

· Hire qualified professionals with disabilities, who have expertise
in policy areas, throughout the administration, including a Special
Assistant to the President on Disability Policy;

· Include individuals with disabilities in policy formation in all
areas addressed by the administration, and integrate representatives of our
community on all advisory boards of all major agencies;

· Provide services that serve people with disabilities across the
life span, from cradle to grave, and all those with increased needs for
health care, health promotion, and long-term services and community-based
supports;

· Incorporate consumer-directed services and include consumers in
policy development;

· Embrace the disability experience as part of culturally competent
policy and diversity at all levels of planning, policy formulation,
implementation, and evaluation; and

· Focus on “universal design” as a cost-effective innovative way to
enhance the quality of life and level of participation of all Americans in
community life and incorporate it into infrastructure changes in the
economic stimulus package so we upgrade the infrastructure for all to use;

Thank you for your support of the need for the federal government to be
“diligent about making sure the states enforce the rights affirmed by the
Olmstead decision.” Enabling people with disabilities to live independently
in their own homes and communities, rather than being forced into costly
Medicaid-funded nursing homes and other institutions will ensure civil
liberties, enhance the quality of life and full participation of all
Americans by creating stronger, sustainable communities of inclusion and
acceptance to honor the 10th Anniversary of the Olmstead decision.

As a community of individuals with disabilities, we ask for nothing more
than what other Americans expect and already have. We seek inclusion. We
seek a voice for the disability rights message in the change you create. As
you create more jobs for Americans, include jobs for Americans with
disabilities. As you improve education for America’s students, include
students with disabilities. As you improve the healthcare system, include
the healthcare needs of individuals with disabilities. As you restore civil
rights to Americans, include the civil rights of individuals with
disabilities. To paraphrase your now immortal words, – We are not a nation
of disabled and non-disabled Americans. We are the United States of America.

We stand ready to work with you and look forward to an opportunity to
discuss our priorities with you personally in the coming months.

Sincerely,

American Association of People with Disabilities (AAPD)

Access Living

American Disabled for Attendant Programs Today (ADAPT)

Autistic Self Advocacy Network

Boston Center for Independent Living (BCIL)

California Foundation for Independent Living Centers (CFILC)

Disability Rights Education and Defense Fund (DREDF)

Generations Ahead

Little People of America

Metro-West Center for Independent Living (MWCIL)

National Association of the Deaf (NAD)

National Coalition for Disability Rights (NCDR)

National Coalition of Mental Health Consumer Survivor Organizations

National Council on Independent Living (NCIL)

National Empowerment Center* *

*National Federation of the Blind (NFB)*

Self Advocates Becoming Empowered (SABE)

Special Olympics

Texas State Independent Living Council (TX SILC)

World Institute on Disability (WID)

For Policy Recommendations on each policy issue click links above

—
Ari Ne’eman
President
The Autistic Self Advocacy Network
1660 L Street, NW, Suite 700
Washington, DC 20036
http://www.autistic advocacy. org
732.763.5530

First Published Tuesday, 20 January 2009

Harvard Women’s Health Watch

Understanding and treating anxiety can often improve the outcome of chronic disease.

With headlines warning us of international terrorism, global warming, and economic slowdown, we’re all likely to be a little more anxious these days. As an everyday emotion, anxiety — the “fight or flight” response — can be a good thing, prompting us to take extra precautions. But when anxiety persists in the absence of a need to fight or flee, it can not only interfere with our daily lives but also undermine our physical health. Evidence suggests that people with anxiety disorders are at greater risk for developing a number of chronic medical conditions. They may also have more severe symptoms and a greater risk of death when they become ill.

The anatomy of anxiety

Anxiety is a reaction to stress that has both psychological and physical features. The feeling is thought to arise in the amygdala, a brain region that governs many intense emotional responses. As neurotransmitters carry the impulse to the sympathetic nervous system, heart and breathing rates increase, muscles tense, and blood flow is diverted from the abdominal organs to the brain. In the short term, anxiety prepares us to confront a crisis by putting the body on alert. But its physical effects can be counterproductive, causing light-headedness, nausea, diarrhea, and frequent urination. And when it persists, anxiety can take a toll on our mental and physical health.

Anxiety as illness

Research on the physiology of anxiety-related illness is still young, but there’s growing evidence of mutual influence between emotions and physical functioning. Yet anxiety often goes unidentified as a source of other disorders, such as substance abuse or physical addiction, that can result from attempts to quell feelings of anxiety. And it’s often overlooked in the myriad symptoms of chronic conditions like irritable bowel syndrome (IBS) or migraine headache.

Nearly two-thirds of the estimated 57 million adults with anxiety disorders are women. What people with these disorders have in common is unwarranted fear or distress that interferes with daily life (see chart). Anxiety also plays a role in somatoform disorders, which are characterized by physical symptoms such as pain, nausea, weakness, or dizziness that have no apparent physical cause. Somatoform disorders include hypochondriasis, body dysmorphic disorder, pain disorder, and conversion disorder.

Anxiety has now been implicated in several chronic physical illnesses, including heart disease, chronic respiratory disorders, and gastrointestinal conditions. When people with these disorders have untreated anxiety, the disease itself is more difficult to treat, their physical symptoms often become worse, and in some cases they die sooner.

Anxiety and gastrointestinal disorders

About 10 percent to 20 percent of Americans suffer from the two most common functional digestive disorders — IBS and functional dyspepsia (upset stomach). In these disorders, the nerves regulating digestion appear to be hypersensitive to stimulation. Because these conditions don’t produce lesions like ulcers or tumors, they aren’t considered life-threatening. But their symptoms — abdominal pain, bloating, and diarrhea or constipation in IBS; and pain, nausea, and vomiting in functional dyspepsia — can be chronic and difficult to tolerate.

There are no firm data on the prevalence of anxiety disorders in people with functional digestive disorders, but a 2007 New Zealand study of subjects with gastroenteritis (inflammation of the digestive tract) found an association between high anxiety levels and the development of IBS following a bowel infection.

Chronic respiratory disorders

In asthma, inflamed airways constrict spasmodically, reducing the flow of air through the lungs. In chronic obstructive pulmonary disease (COPD), inflammation of the airways is exacerbated by a loss of elasticity in the lungs: not only is it more difficult for air to reach the lungs, but the lungs neither fill nor expel air completely.

Although results vary, most studies have found a high rate of anxiety symptoms and panic attacks in patients who have chronic respiratory disease, with women at greater risk than men. In several studies involving COPD patients, anxiety has been associated with more frequent hospitalization and with more severe distress at every level of lung function. So even if anxiety doesn’t affect the progress of the disease, it takes a substantial toll on quality of life.

Anxiety and heart disease

Anxiety disorders have also been linked to the development of heart disease and to coronary events in people who already have heart disease. In the Nurses’ Health Study, women with the highest levels of phobic anxiety were 59 percent more likely to have a heart attack, and 31 percent more likely to die from one, than women with the lowest anxiety levels. Data from 3,300 postmenopausal women in the Women’s Health Initiative showed that a history of full-blown panic attacks tripled the risk of a coronary event or stroke.

Two studies — one involving Harvard Medical School and the Lown Cardiovascular Research Institute; the other, several Canadian medical colleges — concluded that among both men and women with established heart disease, those suffering from an anxiety disorder were twice as likely to have a heart attack as those with no history of anxiety disorders.

Physical benefits of treating anxiety

Therapies that have been successful in treating anxiety disorders are now being used to ease the symptoms of chronic gastrointestinal and respiratory diseases. These therapies may have an important role in preventing and treating heart disease. These are the best-studied approaches:

Cognitive-behavioral therapy. The cognitive component helps people identify and avoid thoughts that generate anxiety, and the behavioral part helps them learn how to react differently to anxiety-provoking situations. The specifics of the treatment depend on the type of anxiety. For example, patients with generalized anxiety disorder or panic disorder may be asked to examine their lives for habits and patterns that foster a sense of dread. They may also be taught relaxation techniques to diminish anxiety. Patients with OCD characterized by excessive washing may be asked to dirty their hands and wait with a therapist for increasingly longer intervals before cleaning up.

Psychodynamic psychotherapy. Anxiety is often triggered by a deep-seated emotional conflict or a traumatic experience that can sometimes be explored and resolved through psychotherapy. In the first randomized controlled clinical trial comparing relaxation therapy to psychodynamic psychotherapy (focused talk therapy), clinician-researchers at Columbia University in New York found that panic-disorder patients treated with psychodynamic therapy had significantly fewer symptoms and functioned better socially than those who underwent relaxation therapy (American Journal of Psychiatry, February 2007). Nearly three-quarters of the psychotherapy group responded to treatment compared with only 39 percent of the relaxation-therapy group.

Drug therapy

Medications alone are less effective than psychotherapy over the long term; they may also have unpleasant side effects and interact with other medications. Still, they can be helpful when used in combination with psychotherapy. The most commonly used types of drugs include these:

Anti-anxiety drugs. Benzodiazepines — clonazepam(Klonopin) and alprazolam(Xanax) — were developed to relieve anxiety. They act rapidly and have few side effects except occasional drowsiness. But they’re not recommended for long-term use, because patients develop tolerance and require increasing doses. A newer drug, buspirone (BuSpar), needs two weeks to take effect but can be taken for longer periods than benzodiazepines.

Antidepressants. Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) such as sertraline (Zoloft), have been replacing benzodiazepines in the long-term treatment of panic disorder and generalized anxiety. Antidepressants have the advantage of relieving depression as well as anxiety, and they are believed to create less risk of dependence and abuse. However, patients sometimes prefer benzodiazepines to antidepressants because they act more quickly (antidepressants take two weeks to work) and don’t cause weight gain or sexual problems.

Beta Blockers. These drugs can relieve acute anxiety by slowing the heart rate and reducing blood pressure; they are often used, for example, to treat stage fright.

Seeking help

About 30 percent of people with anxiety disorders go through life untreated. If you think you might fall into this category — or if you have IBS, asthma, COPD, or heart disease and haven’t been evaluated for anxiety — you may want to consult your primary care clinician. You may also want to talk to your clinician if you have pain, dizziness, insomnia, or other symptoms that persist after physical causes have been ruled out. Keep in mind that all symptoms are real — and treatable — whether they originate in the body or the brain. If you’re just feeling a little more anxious than you once did, you might want to consider trying some relaxation techniques (for some examples, visit www.health.harvard.edu/womenextra)

ANXIETY DISORDERS AND THEIR SYMPTOMS

GENERALIZED ANXIETY DISORDER: Exaggerated worry about health, safety, money, and other aspects of daily life that lasts six months or more. Often accompanied by muscle pain, fatigue, headaches, nausea, breathlessness, and insomnia.

PHOBIAS: Irrational fear of specific things or situations, such as spiders (arachnophobia), being in crowds (agoraphobia), or being in enclosed spaces (claustrophobia).

SOCIAL ANXIETY DISORDER: Overwhelming self-consciousness in ordinary social encounters, heightened by a sense of being watched and judged by others and a fear of embarrassment.

POST-TRAUMATIC STRESS DISORDER (PTSD): Reliving an intense physical or emotional threat or injury (for example, childhood abuse, combat, or an earthquake) in vivid dreams, flashbacks, or tormented memories. Other symptoms include difficulty sleeping or concentrating, angry outbursts, emotional withdrawal, and a heightened startle response.

OBSESSIVE/COMPULSIVE DISORDER: Obsessive thoughts, such as an irrational fear of contamination, accompanied by compulsive acts, such as repetitive hand washing, that are undertaken to alleviate the anxiety generated by the thoughts.

PANIC DISORDER: Recurrent episodes of unprovoked feelings of terror or impending doom, accompanied by rapid heartbeat, sweating, dizziness, or weakness.

DISTRIBUTED BY TRIBUNE MEDIA SERVICES, INC.

First Published Tuesday, 20 January 2009

We merely aimed to understand what causes differences in autistic traits

First Published Tuesday, 20 January 2009

Prospects, The National Autistic Society’s employment service, is running three employment training courses in February about communication skills, personal management skills, and dealing with anxiety at work. These are open to adults with autism or Asperger syndrome who are already in employment. All the courses last for one day.

The courses are:

• *communication skills at work (takes place on 5 February)
• *dealing with anxiety in the workplace (takes place on 12 February)
• *personal management skills for the workplace (takes place on 19 February).

More information is on the course flyers, which you can download from the bottom of this page. Each course costs £130, including lunch and a certificate, and takes place in Ladbroke Grove. (Please note that this is a different address from that given on the flyers.)

To book a place, complete the booking form, which you can also download at the bottom of this page, and return it to Prospects.

Contact Andrew Graham or Daniel Aherne at Prospects if you have any questions about the three courses. Email andrew.graham@nas.org.uk or daniel.aherne@nas.org.uk, or telephone 020 7704 7450.

Related resources

Relevant documents for downloading

• Communication skills at work (PDF)
• Personal management skills for the workplace (PDF)
• Prospects Employment Service – training booking form (PDF)

First Published Tuesday, 20 January 2009

A new play, Peas, written by a person with Asperger syndrome, is being staged in Liverpool in February.

The play deals with the relationship between Bunny, a 30-year-old with Asperger syndrome and his mother, Mrs Kemp.

Dhanil Ali, the play’s writer, was diagnosed with Asperger syndrome in his 40s. He describes the play as a dark comedy, and explains that when things get too much for the main character, Bunny, he retreats into his own world which is filled with the voices of the Christopher Eccleston Doctor Who, Stephen Hawking and Alan Bennett.

Dhanil has previously written the plays Hancock: The Lost Half Hours, A Play In The Life Of Alan Bennett and The Hylda Baker Show.

Peas is on from 4-7 February at:

The Unity Theatre
1 Hope Place
Liverpool L1 9BG

The play starts at 8pm each night. To book tickets contact the theatre on 0151 709 4988. Tickets cost £9.00 (£7.00 concession).

Related resources

External links

• Unity Theatre Liverpool

Source:  http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=253&a=18515