The Effects Of Violence On Youth And More - 898 Words

The Effect of Violence In Media on Youth and More For many years there have been links to how violence in media has been glorified as something harmless and normal especially dealing with music, video games, and social media. Often the disbelief of how violence in media cannot affect the brain is under looked but studies have shown otherwise. Indiana University School of medicine has linked visible alterations MRI brain scans for those who have played violent video games for about a week. In this case it has been shown that there has been an activation of the prefrontal portion of the brain otherwise know as the amygdala which activates the emotion center, but can also trigger, anger, aggression, and impulse behavior (Dale). Other interesting studies from Virginia Tech have shown several of their students violent and non-violent with an obvious increase in hostile behavior. The University of Alabama have conveyed coincidental results stating that the aggression did not just occur after but stayed with the students for quite sometime . Macquarie University for children’s health have researched that children who view violent movies were most likely going to view the world as unsympathetic or scary which could provoke aggression. Furthermore, the video game industry has collect around $66 billion dollars globally in 2012 with amongst 85% of those video games contributing to violence. Parental skills may have some effect on child behavior it ultimately depends on what you allowShow MoreRelatedViolence in Youth1171 Words   |  5 PagesIntroduction Youth violence is defined as violent behaviour that begins early in life and continues throughout subsequent stages of life. Youth violence may include physical and emotional harm, and minor crimes, escalating to murder (Centers for Disease Control and Prevention, 2013). Youth are recognized as being between the ages of twelve and twenty-four however, teens are the most affected by violence than any other group of youths as they are habitually perceived as the most violent age groupRead MoreMedia s Influence On The Youth Of America1454 Words   |  6 Pagesrole on the youth of America. A majority of children and young adults have access to internet, television, radio, newspapers, and video games practically any time they want. The violence in media, along with the availability of media are increasing, however the most predominant form of media for children is video games. Because of this, many are concerned with the effects on the youth. The violence in video games is a cause for a ggressive emotions, thoughts, and behaviors in the youth of America.Read MoreEssay about Media Violence1541 Words   |  7 PagesViolence has been a contributing negative factor to society throughout history. Many researchers believe that the use of violent media, particularly video games, play a huge role in the downward trend of behavior and attitude of youth, and that this behavior continues to spiral out of control. However, other researchers believe that since violence has been occurring since the beginning of time, that adolescence are as capable today of violence, as they were a thousand years ago. ResearchRead MoreMedia Violence And Its Effects1057 Words   |  5 Pages Media violence exposure has been investigated as a risk factor for aggression behavior for years. The impact of exposure to violence in the media the long term development and short term development of aggressive behavior has been documented. Aggression is caused by several factors, of which media violence is one. Research investigating the effects of media violence in conjunction with other predictors of aggression such as; environmental factors and dysfunction within the family household,Read MoreDo Violent Video Games Cause Violence in Childen1049 Words   |  5 PagesDo Violent Video Games Influence Youth Violence Noel Averruz EN1420 ITT-Technical Institute Ever Since Violent Video Games were invented People have been trying to prove that they influence Violence in Juveniles. Although many prospective studies have been done on video game violence and the affect they have on the youth, none have been able to completely validate the claim that violent video games do influence the youth to become violent in their everyday lives. Out of the many studies thatRead More effects of tv violence on children Essay719 Words   |  3 Pages Effects of Television Violence on Children In our society today, it is extremely important to pay attention to what influences children. One of the biggest influences America’s youth may have is the television. It is possible for children to be pulled into the television’s realistic world of violence with sometimes devastating results. The impact of television violence on youth behavior has been an issue for many years. Violent programs on television lead to negative behavior by children and teenagersRead MoreAdolescents And War : How Youth Deal With Political Violence1523 Words   |  7 Pages‘Adolescents and War: How Youth deal with Political Violence’. Political violence, the focus of this study – is difficult to define – primarily because it such a broad term which incorporates different levels of ideology surrounding the nature of violence, its causes, structures and objectives. Barber takes an interesting and unique stance in his literature, as he touches upon the rarely (but advancing) topic of youth and more specifically adolescents; in relation to political violence. Centralising on theRead MoreTelevision Is Destroying Todays Youth, but Dont Blame T.V., Blame the Parents.1302 Words   |  6 PagesAmericas favorite source of entertainment. As society has changed, violence and sexual content have been added ever so increasingly over the years. After all, isnt that what makes T.V. shows interesting? Isnt that why we all want to go see that new movie that came out which is rated R instead of that movie rated PG? Although this violence and sexual content on television and in movies is having devastating effects on Americas youth, you cannot blame television. Instead, we must blame our parentsRead MoreVideo Games And Violent Violence1345 Words   |  6 Pagessociety have an obligation to monitor every type of video game children and adults play simply because they believe it may lead to acts of violence? Psychologists, Sociologists, Anthropologist, Schools, and Law Enforcement not only in the United States but across the world, have been seeking out a correlation between violent video games and violence in youth. They are desperately trying to find an answer for the increase in violent attacks in many venues such as malls, churches, random shootingsRead MoreThe Rate For Youth Committing Extremely Violent Crime1140 Words   |  5 PagesAlthough the rate for youth committing extremely violent crimes have been low, it is still a disturbing deed that happens in Canada. Violent crimes are described by the Province of Ontario as: â€Å"...a composite measure that includes homicide, attempted homicide, assaults, sexual assaults and robbery.† (Ontario Ministry of Children and Youth Services, 2013). There are many different reasons why these type of crimes could occur before adulthood. Some factors that could cause this type of behaviour are:

Description of Ambulatory Care and Hospitalization Care Essay

As early as the 1990’s, outpatient care only made up for 10 to 15% of a hospital’s total profits, compared to inpatient care. Since the start of the twenty-first century, this figure has increased to approximately 60%. This shift in healthcare has been occurring in different medical organizations such as university medical centers, local hospitals, for-profit chains, and not-for-profit suppliers. The increase in outpatient services compared to inpatient has been showing no indication of slowing down. The main reason for the development in outpatient care is because of all the medical advancements in techniques and technology that allow for patients to be treated less invasively. Health care organizations are now being compensated in a†¦show more content†¦The development of walk-in clinics at the local CVS Pharmacy or Wal-Mart are part of the freestanding facilities that provide people in communities easier access to treatment without going to a hospital ED. Additionally, the evident convenience aspect of bringing full emergency services to communities, freestanding centers may be less likely to resort to hospital admissions as an outlet to drive throughput. The incentive for ASCs is to emphasize volume and higher rates, while hospitals are considered to regulate utilization. Looking closely, the main purpose originates from ASCs lower cost profile compared to hospitals with the additional benefit of the likely to evade inpatient expenditure. Within ambulatory clinics, there are three levels of service that are preformed based on the type of diagnosis and treatment recommendations. Level one ambulatory service is considered an option to inpatient care with both patient and service parts that corresponds with the point of intensity. The role of this level is to offer alleviation from acute symptom reducing mechanisms such as less severe residential constituents such as the family treatment home for children. Level two ambulatory services are set apart by effective treatment; regularly with a rehab or transitional process that is built-in to the care plan. This process is complete in a staff-supported setting that expands past the care setting into the important sections of the patient’s districtShow MoreRelatedFacility Planning Part 11004 Words   |  5 Pagesgreat need for an ambulatory care center exists in my community. As of now most services that can be offered in such a setting are done at the hospital as a n outpatient service. That service takes up valuable resources that could be used for the inpatient population if an ambulatory care center existed. The community would be well served by an ambulatory care center that provides much needed services without the hassle of hospital registration and waiting times. The ambulatory care center that wouldRead MoreA Short Note On Failure And Emergency Department1214 Words   |  5 PagesCongestive heart failure (CHF) as a disease which nearly five million Americans suffer from and this number is expected to double in prevalence by the year 2030. CHF is the most common reason for hospitalization and emergency department (ED) visits by those 65 years and older in the United States (American Heart Association, 2002). Horowitz, Rein, and Leventhal (2004) wanted to conduct research on problems with self-managing CHF and whether patient had the adequate tools for self-management. TheRead MoreHealth Care Reform : The United States Essay1087 Wor ds   |  5 PagesKevin Kelley Week 3-Discussion I feel heath care reform was necessary, health care costs affect the economy, the federal budget, and virtually every American’s family’s financial well-being. According to Obama, â€Å"In 2008, the United States devoted 16% of the economy to health care, an increase of almost one-quarter since 1998 (when 13% of the economy was spent on health care), yet much of that spending did not translate into better outcomes for patients† (Obama, 2016, p.526). In 2008, 1 inRead Morephase of perioperative care beginning with the decision to perform surgery and continuing until the700 Words   |  3 Pagesphase of perioperative care beginning with the decision to perform surgery and continuing until the client reaches the operating area. Starts off whether the patient wants to perform the surgery then continues until the patient reaches the operating area. When a patient is admitted into ambulatory surgery or short before surgery the time for preoperative assessment, nursing diagnoses, and evaluation of the nursing management may be limited. It’s important to recognize the patient’s immediate preoperativeRead MoreRotator Cuff Surgery: Case Study Questions1706 Words   |  7 Pagesthis case, the subjects emotional well-being is at stake due to the fear of lost income, financial security and earning capacity related to surgery. In Adams case, one of the biggest flaws in his treatment plan appears to be the failure of attending care providers to match the subject with a proper intervention. The result is a poor management of the psychosocial implications of his otherwise simple procedure. According to the research by Ruiz-Suarez Barber (2008), one of the best ways to positivelyRead MoreCase Analysis : Blount Senior Care Partners2618 Words   |  11 PagesProposal â€Å"Blount Senior Care Partners uses a team based approach that focuses on continuity, patient independence, and clinical excellence† (Blount Senior Care Partners, 2014). Blount Senior Care Partners provides care in an outpatient geriatric clinic, several assisted living facilities, rehabilitation and long term facilities within the community and during acute inpatient hospital admissions at Blount Memorial Hospital. Currently, the care of inpatient hospitalizations is exclusively managed byRead MoreThe World s First Professional Organization For Informatics1138 Words   |  5 Pagescommunication, and optimal use of health related data, information, and knowledge. The discipline utilizes the methods and technologies of the information sciences for the purpose of problem solving, decision-making and assuring highest quality health care in all basic care and applies areas of biomedical sciences.† In 1949 Germany’s Doctor Gustav Wagner established the German Socie ty for Medical Documentation, Computer Science and Statistics. This was the world’s first professional organization for informaticsRead MoreRole Of A Family Nurse Practitioner2244 Words   |  9 Pagesphysician’s clinic within a rural area. Due to the increased demand for primary care providers, it is important to discuss the FNP role within the healthcare system. The Association of American Medical Colleges estimates a shortage of 46,000 primary care physicians by the year 2025 (AAMC, 2015). The increased provider shortage and gaps within the rural areas provide a promising future for FNPs with the ability to provide primary care for the underserved. In America’s ever changing healthcare industry, FNPsRead MoreThe comparison of quality of life in Hemodialysis and peritoneal patients with a socioeconomics and demographic evidence in Iran1420 Words   |  6 Pageset al., Chronic kidney disease as a global public health problem: Approaches and initiatives - a position statement from Kidney Disease Improving Global Outcomes. Kidney Int, 2007. 72(3): p. 247-259. 7. Alarabi, S., Quality of life: Subjective descriptions of challenges to patients with end stage renal disease. Nephrology Nursing Journal, 2006. 33(3): p. 14. 8. Olsen, J., et al., Economic consequences of an increased number of patients on outgoing dialysis. Scandinavian Journal of Urology and NephrologyRead MoreInterdisciplinary Education3785 Words   |  16 Pagesthis project will help them work better within the health care team (82% and 87%, respectively) and that they should have more participation in interdisciplinary projects (83% and 76%, respectively). At the end of the project, these students reported positive attitudes concerning working on interdisciplinary health care education initiatives. T he benefits of interdisciplinary health care have been demonstrated throughout the health care system. Patients with chronic conditions such as obesity

Global Knowledge Management Framework †MyAssignmenthelp.com

Question: Discuss about the Global Knowledge Management Framework. Answer: Introduction: The process of Taylorism denotes to the application of the scientific model of management in various types of the process of work that would assist in fragmenting a specific task or action into a various number of categorized tasks so as to increase the output of the production. In the current business scenario, the section of the worker in Australia, America, and Europe would not desire to adapt the methodology of Taylorism as there have been evolving changes in the behavioral and technical aspects of the processes of industrial work. The model by Taylor doe s not happen to add value for the regular workers as it does not enhance the level of skills and there is no outcome regarding wisdom included in accepting this old theory of work (Axelrod VanDeveer, 2014). As knowledge and skills associated with work do not happen to be enhanced by the Taylorism model, the regular workers would not be pleased to be involved in the mechanical process that does not include any type of transfer o f knowledge and skills. Application of Taylorism model can be fruitful to a specific extent in the structuring aspect of various scripts for the application in Webhelp which is a UK based call centre. The functions and operations that are involved in the scenario of Webhelp are mostly categorized in different categories that are based on different sectors which specialize in specific departments (Fabricius et al., 2013). There is a possibility for dividing the model of work in Webhelp based on the particular area of knowledge, expertise and role or job of authorities and respectively the job can be allotted to the employees in Webhelp by incorporating the Taylor scientific management model. However, a variety of cases that involve a completely new or varying situation, this specific method of work will not be productive as it needs a very different type of resolution (Hill, Jones Schilling, 2014). Clip is presenting the history from past 100 ago- Some would say that the world has moved on and these ideas are out of date. However, need of Taylorism process in some parts of the world today. The Taylorism process is very old; however, there will be some industries and processes of the business around the world which can apply these methods of work in a very productive and effective manner (Laudon Laudon, 2016). The underlying rules and principles which are adopted can relate to the effective application of Taylorism methods to obtain profitable outcomes. Corporate culture instilled in HRM practices and customer satisfaction Zappos has integrated a very unconventional strategy in its process of recruitment which is paying the newly hired employees right after the first training week post joining in the company to quit. The newly recruited employees who would opt to quit the company the very moment would be awarded an extra $ 1000. This kind of unconventional and unique employee retention strategy has been fruitful for the online shoe retail company in gaining deep commitment level from its current employees, mostly for checking and keeping the newly recruited employees who are willing to actually work for the company. The work culture of human adapted by Zappos has been productive for the company in keeping the human resources, irrespective of the fact that they are old or new, to be enthusiastic and proactive for working in the company which helps the company in providing best customer service (Mangan Lalwani, 2016). The employees working in this company have the liberty of making a decision regarding the work culture each year. The objective of the company is to have retention of the new employees by the approach of paying them for layering out the most interested and best employees so that the company can provide best services to the customers. This is also materialized by paying the employees that have the possibility of engaging very less in engaging to provide service to Zappos. The CEO of Zappos, Toney Hsieh, very strongly believes in inculcating a great culture of work in the company. A flexible culture of work facilitates a way for inviting increased sales generation and better service to the customers. Structuring an excellent image of the brand becomes very convenient when the company has a great culture of organizations. An enhanced culture of organization would result in generating better revenue and increasing optimizing profits for a longer term. An innovative and flexible culture in the company would result in giving the employees satisfied and more interested in working for the company even during the market crisis (Pawlowski Bick, 2015). A very flexible and open culture of work also assists in enhancing the creativity and innovation pool of the company that results in the generation of many qualitative and quantitative ideas. The online shoe retail company, having a variable number of creative ideas would lead to the innovation in both the produ cts and services along with the entire company that would be very much productive for the online retail company for a very long term (Stark, 2015). Conclusion From the first activity in the assignment, the benefits of using scientific management model in various processes of work could be obtained. It could be obtained that using the approach of categorizing the major task into various sub-task would help in increasing the output in regards to productivity in any business organization. In the second activity, the effectiveness of using unconventional employee retention methods could be learned. It was also comprehended that the innovative approach of retaining and awarding the newly hired employees only after few days of appointment could also result in an enhanced dedication of the employees for the company on a longer term. References Axelrod, R.S. and VanDeveer, S.D. eds., 2014. The global environment: institutions, law, and policy. CQ Press. Fabricius, C., Koch, E., Turner, S. and Magome, H. eds., 2013. Rights resources and rural development: Community-based natural resource management in Southern Africa. Routledge. Hill, C.W., Jones, G.R. and Schilling, M.A., 2014. Strategic management: theory: an integrated approach. Cengage Learning. Laudon, K.C. and Laudon, J.P., 2016. Management information system. Pearson Education India. Mangan, J. and Lalwani, C., 2016. Global logistics and supply chain management. John Wiley Sons. Pawlowski, J.M. and Bick, M., 2015. The global knowledge management framework: Towards a theory for knowledge management in globally distributed settings. Lead. Issues Knowl. Manag. Vol. Two, 2, p.134. Stark, J., 2015. Product lifecycle management. In Product Lifecycle Management (Volume 1) (pp. 1-29). Springer International Publishing.

Understanding Bipolar Disorder in Children free essay sample

School is often the site where mental health disorders are observed when comparing behaviors with other children. Assessing the emotional, academic, and health needs of a student with a bipolar disorder is a critical step in designing effective interventions and school accommodations. Without appropriate medical, psychological, pharmaceutical, and academic interventions, a child is at risk for uncontrolled mania, depression, substance abuse, or suicide. The school nurse is part of the multidisciplinary team and plays a key role in facilitating case management to potentially reverse this possible negative trajectory. Successful case management provides children with bipolar disorder the opportunity to reach their academic potential. i INTRODUCTION Bipolar disorder (formerly called manic-depressive illness) is an illness of the brain that causes extreme cycles in a person’s mood, energy level, thinking, and behavior. The disorder was first described by French scientist Jules Baillarger in 1854 as â€Å"dual-form mental illness. † Later in the 19th century, German psychiatrist Emil Kraepelin coined the term â€Å"manic-depressive psychosis. We will write a custom essay sample on Understanding Bipolar Disorder in Children or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page By the 1980s, the term bipolar disorder replaced manic-depressive illness as the name psychiatrists use to describe this condition. Bipolar disorder is usually characterized by episodes of mania and depression, as well as a combination of the two at the same time called a mixed state. It is often first diagnosed during adolescence or in young adulthood; however, some people show symptoms of the illness in early childhood. Bipolar disorder in children and adolescents is not an easy or certain diagnosis. This diagnosis is usually made by a mental health clinician who has evaluated and treated many, many children. It requires that the clinician take a detailed medical and psychiatric history and perform a thorough evaluation. Many parents are challenged by a child who has extreme changes in mood, energy, thinking, and behavior. Careful evaluation will find that some of these children are suffering from a mental disorder. Yet, only a very few of those will have bipolar disorder. While systematic data on the frequency of bipolar disorder among children are only now being collected, recent studies by the National Institute of Mental Health indicate that, overall, children have a lower rate of bipolar disorder than adults. However, the rate increases with age, reaching approximately 1 percent (1 in 100) by adolescence. In adults, the rate of people who have some form of the disorder during their lifetime is approximately 4. 4 percent (1 in 20). Even though this illness affects a significant number of children and adolescents, most of the research into the disorder has been conducted in adults. While the number of children and adolescents who are diagnosed with bipolar disorder is increasing, research into bipolar disorder in children and adolescents is limited. New research is now being conducted with children and adolescents to enhance early recognition, to help doctors accurately diagnose the disorder in children, and to evaluate age-specific therapies. The purpose of this report is to help teachers and parents to better recognize the signs of bipolar disorder and to give those children a better chance at being successful in school, in collage and in the work field. 1 Living Daily Life: Helping Your Teen at Home and School Getting the best possible treatment for your adolescent with depression or bipolar disorder is your top priority. After that hurdle has been crossed, however, you may soon realize that there are still many challenges left to overcome. Depression and bipolar disorder affect every aspect of your teen’s functioning at home and school. As a parent, there are steps you can take to help things go more smoothly in these key areas of daily life. By reducing stress this way, you may also help speed your teen’s recovery and reduce the chances of a relapse or recurrence. Adolescence is by definition a time of transition from childhood to adulthood. It’s a period when children naturally start to pull away from their parents and begin to forge independent lives and identities. For both you and your teen, this transition involves major changes in roles and expectations. At times, the changes can be exhilarating, and at other times, they can be rather frightening. For parents of a teen with depression and bipolar disorder, the anxiety may be magnified. However, the push-pull of autonomy versus dependence is something that all parents of adolescents go through. It’s a natural phase in the evolution of your role as a parent. While your relationship with your teen will change, that doesn’t mean it becomes any less significant. In fact, your teen may need the security of your love and support more than ever now. The way you communicate with your adolescent and structure your family life can have a major impact on how your teen functions at home which can influence how your teen functions in other situations. The time and energy you devote to your other children, your significant other, and yourself can help keep the teen’s issues in perspective, a good thing for all of you. And the way you address school issues and advocate for your teenager’s educational needs can have a decisive impact on his or her success in school. All the while, you’ll be slowly but surely working toward one of the most difficult but ultimately gratifying tasks for any parent letting go. As the parents of an adolescent with depression or bipolar disorder, you may have to take things a bit more gradually than other parents, but the ultimate goal of helping your child move toward a healthy, productive, independent life as a young adult is still the same. What can the school do to help my child with bipolar disorder? Teachers often are the first to notice the symptoms of bipolar disorder, and can provide parents, guardians, and doctors with information that may help diagnose and treat the disorder. They also can play an important role in implementing a successful treatment program by using instructional and behavioral strategies in the classroom. Public schools are required to evaluate all students suspected of having a disability and to provide a free appropriate public education (FAPE) to students whose disabilities affect their ability to learn. Families also can request an evaluation to determine if their child qualifies for educational services. 2 However, parents and guardians must give written permission before a school can provide testing or services to a child. Testing and services are confidential and are provided through the public school system at no cost to the family. Students whose bipolar disorder impairs their ability to learn may qualify for special education and related services under the Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act of 1973. Both laws provide assistance to students with disabilities to meet their unique learning and behavioral needs, including accommodations and modifications in the classroom and diagnostic and counseling services. Children with bipolar disorder may be eligible for special education under IDEA in two disability categories: Other Health Impairment and Emotional Disturbance. Children who do not meet IDEA’s stringent requirements may still be eligible for accommodations and services under Section 504 of the Rehabilitation Act of 1973. Because children with bipolar disorder may have coexisting conditions, such as ADHD, anxiety, and learning disabilities, they may qualify for educational services for these conditions as well. Increasing numbers of children with bipolar disorder attend private therapeutic schools, which have an educational and mental health focus. Because public schools may lack the resources or trained staff to teach students with bipolar disorder, some school districts are paying their private school tuition as a way to provide free appropriate public education. A list of educational resources can be found in Appendix III. The American Academy of Child and Adolescent Psychiatry also has online education resources to help parents find services for children with special needs. To access a fact sheet about services in school for children with special needs. How can you work together with your child’s teachers? Teachers are your most important allies at school. They’re the ones who spend an hour or more per day five days a week, with your child. And they’re the ones who control the learning environment, for better or worse. When children are in elementary school, it’s easy to get to know their teachers and perhaps volunteer at the school or help chaperone a field trip, if your schedule permits. As students get older, however, they may have a different teacher for each subject. Your teenage children may also seem considerably less enthusiastic about running into you in the hall at school. Don’t let this discourage you, however, No matter how they act, kids of all ages really want their parents involved, just be sensitive to your child’s growing need for independence, especially in front of his or her friends. Make the extra effort to get acquainted with all your teen’s teachers. After meeting teachers, stay in touch throughout the year. If a problem develops, give the teacher the benefit of the doubt. Most teachers really want to do a good job for every student. Like parents, however, they may sometimes find it difficult to deal with a student whose behavior and learning ability are affected by a mood disorder or medication side effects. Approach the teacher with an attitude that says, â€Å"We’re all in this together,† and you’re much more likely to get a positive response. On the other hand, if you start out with an accusatory tone, the teacher’s defenses will go up, and you’re more likely to end up in an antagonistic posture. Don’t forget to also let the teacher know when things are going right. An occasional thank you note or small token of appreciation can help cement a strong alliance. You can also establish yourself as an asset to th e school by participating in fund-raising efforts or volunteering in the office. Educators are only human; they respond to encouragement and support like anyone else. The more you can do to build a positive working relationship with school personnel, the more effective you’ll be when it comes time to request services for your student. Occasionally, you may run across a teacher who remains unresponsive to your teen’s needs, no matter what your approach. In such cases, it’s perfectly appropriate to go to the principal with a complaint. Once again, though, try to avoid sounding accusatory when you state the problem. Instead, approach the principal with the attitude that this is a problem you can team up to solve together. That may be all it takes to enlist the teacher’s cooperation. If all else fails, though, request a different placement for your student. Your teen has enough challenges in school without also having to cope with a teacher who is unwilling or unable to adapt to individual needs. School amp; the Child with Bipolar Disorder Does bipolar disorder affect a child’s ability to learn? Having bipolar disorder does not affect your child’s intelligence. It can, however, affect his or her ability to learn. Bipolar disorder also has been shown to cause cognitive problems, such as impaired concentration, memory, and thinking. For example, this illness tends to interfere with sleep, which in turn can affect alertness and school attendance. Learning also can be compromised by time spent away from the classroom for disciplinary actions, since children with emotional and behavioral disorders are much more likely than other students to be suspended or expelled from school. How does bipolar disorder affect my child’s ability to form friendships? Children with bipolar disorder often have difficulty with social (peer) relationships, which can cause conflict at home and at school. Poor social skills and problems perceiving emotions of others, coupled with moody, irritable, impulsive, and sometimes aggressive behavior, may cause children with bipolar disorder to act in ways that others think are mean, rude, thoughtless, or weird. Also, children with bipolar disorder are more frequently the targets of bullies or are bullies themselves. Treatment for bipolar disorder can have positive effects on behavior that lead to improved relationships. Parents can help foster friendships for their children by letting teachers, school counselors, and coaches know about problems that might develop, arranging one-on-one play dates, and Encou-raging participation in school activities and peer-group programs. 4 Peer-group programs focused on successful social interactions (social skills groups) may be offered by school personnel, psychologists, speech pathologists, occupational therapists, licensed counselors, and social workers. Disorders that Can Accompany Bipolar Disorder Research shows that two-thirds of children diagnosed with bipolar disorder have at least one additional mental health or learning disorder. Having more than one condition at a time is called having a coexisting (or comorbid) condition. Coexisting conditions can make diagnosing and treating bipolar disorder more difficult and create more challenges for a child to overcome. According to several studies, the most common coexisting conditions with bipolar disorder in children and adolescents are ADHD, oppositional defiant disorder (ODD), and conduct disorder (CD). In fact, more than half of all children with bipolar disorder also may have ADH Rates of Mental Health Disorders that Can Coexistwith Bipolar Disorder in Childhood and Adolescence| Mental Health Disorder| Rate Coexisting withChildhood BipolarDisorder (%)| Rate Coexisting withAdolescent BipolarDisorder (%)| Attention-Deficit/HyperactivityDisorder (ADHD)| 70-90%| 30-60%| Anxiety Disorders| 20-30%| 30-40%| Conduct Disorders (CD)| 30-40%| 30-60%| Oppositional Defiant Disorder(ODD)| 60-90%| 20-30%| Substance Abuse| 10%| 40-50%| Learning Disabilities| 30-40%| 30-40%| Can my child take medication for bipolar disorder if there is a coexisting condition? If your child’s doctor determines that your child has one or more coexisting conditions, a treatment plan should be developed to address each coexisting condition as well as the bipolar disorder. Treatment plans for children and adolescents with bipolar disorder and a coexisting condition often include one or more medications as well as psychosocial treatment. For example, children with bipolar disorder and ADHD can have as good a response to stimulants as do children who only have ADHD. This is especially true if the symptoms of bipolar disorder are controlled first. 24 However, more frequent monitoring for a reaction to the medication or a dependency on the medication is advised when treating children and adolescents with stimulant medications who have coexisting substance use disorders. 5 Working with the School Your child spends more time at school than anywhere else but home. For teens, school is a place not only to learn about academic matters but also to connect with friends and get involved in extracurricular activities. Those who are successful in this setting acquire the cognitive and social skills they’ll need later for college, work, and adult relationships. Unfortunately, teens with mood disorders are at high risk for poor attendance, academic underachievement, school failure, and dropping out. In the midst of an episode, they can find it very difficult to pay attention, think clearly, solve problems, recall information, sit still, and follow classroom rules. Once stabilized, it’s quite possible for these teens to thrive in school, but they may still need a little extra assistance from parents and teachers. Among other things, certain medications may cause side effects that detract from learning. These effects include drowsiness, fatigue, lack of mental alertness, memory problems, slurred speech, poor coordination, or physical discomforts, such as nausea or excessive thirst. When confronted with a teen who has special needs, some teachers and administrators are quite adaptable and eager to help. Others, however, are inflexible and unsympathetic, based on ignorance or prejudice about mental disorders. Your challenge as a parent is to build an effective partnership with the school. Your goal is to support the positive teachers, educate the uninformed ones, and avoid the few who are unable to understand what you child or teen is experiencing. To help your teen make the most of public school, you need to become aware of the educational opportunities that are available to students with disabilities, including those with mental illnesses. The school system is the equal opportunity mental health provider, because if your child meets the eligibility requirements for IDEA(the Individuals with Disabilities Education Act), your income doesn’t matter,† says Tammy Seltzer, a senior staff attorney at the Bazelon Center for Mental Health Law. The schools are charged with providing a free and appropriate public education to all. For families whose income disqualifies them from Medicaid, the schools may be the best source of publicly funded services. 6 Medications used to treat child and adolescent mental disorders Class: Stimulants Benefits:  Treats the core symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) including, impulsivity, hyperactivity and inattention. There is very little documented difference in the effectiveness between the amphetamine and methylphenidate medicines. However, some children respond to one group better than another. Side Effects:  Loss of appetite, difficulty falling asleep, irritability and /or moodiness. Some children may develop tics while on the medicine while those with a tic disorder may find that the tics worsen. Both growth and weight should be monitored, since weight loss can occur, and there is some evidence that stimulants may cause a slowdown in growth. Very rarely they may cause hallucinations or exacerbate manic symptoms These medications can increase blood pressure and pulse slightly. Please tell your doctor if there are any relatives with a history of heart disease at an early age. | MEDICATION NAME| NOTES| Brand Name| Generic Name**| | Ritalin Focalin Methylin Methylin Chewable Methylin Liquid| methylphenidate| These are short acting—generally lasting about 3–4 hours. Concerta Focalin XR Metadate CD Ritalin LA Daytrana Patch| methylphenidate| These are long acting—generally lasting about 8–12 hours. Each one is formulated somewhat differently but there is generally no way to determine which will last the longest for any individual. Daytrana is the newest and uses a patch to deliver methylphenidate through the skin. The patch may cause some skin irritation . | Dexedrine Dextrostat Adderall| amphetamine| These are short acting—generally lasting about 3–6 hours. Each one is formulated somewhat differently but there is generally no way to determine which will last the longest for any individual. Adderall is a mixture of different forms of amphetamine (amphetamine salts). | Adderall XR| amphetamine salts| Lasts 8–10 hours| Dexedrine Spansules| amphetamine| Lasts 8–10 hours| 7 Psychotherapy In addition to medication, psychotherapy (talk therapy) can be an effective treatment for bipolar disorder. Studies in adults show that it can provide support, education, and guidance to people with bipolar disorder and their families. Psychotherapy may also help children keep taking their medications to stay healthy and prevent relapse. Children and teens may also benefit from therapies that address problems at school, work, or in the community. Some psychotherapy treatments used for bipolar disorder include: Cognitive behavioral therapy  helps young people with bipolar disorder learn to change harmful or negative thought patterns and behaviors. Family-focused therapy  includes a childs family members. It helps enhance family coping strategies, such as recognizing new episodes early and helping their child. This therapy also improves communication and problem-solving. Interpersonal and social rhythm therapy  helps children and teens with bipolar disorder improve their relationships with others and manage their daily routines. Regular daily routines and sleep schedules may help protect against manic episodes. Psych education  teaches young people with bipolar disorder about the illness and its treatment. This treatment helps people recognize signs of relapse so they can seek treatment early, before a full-blown episode occurs. Psych education also may be helpful for family members and caregivers. Other types of therapies may be tried as well, or used along with those mentioned above. The number, frequency, and type of psychotherapy sessions should be based on your childs treatment needs. A licensed psychologist, social worker, or counselor typically provides these therapies. This professional often works with your childs psychiatrist to monitor care. Some may also be licensed to prescribe medications; check the laws in your state. For more information, see the  Substance Abuse and Mental Health Services Administration  web page on choosing a mental health therapist. In addition to getting therapy to reduce symptoms of bipolar disorder, children and teens may also benefit from therapies that address problems at school, work, or in the community. Such therapies may target communication skills, problem-solving skills, or skills for school or work. Other programs, such as those provided by social welfare programs or support and advocacy groups, can help as well. Some children with bipolar disorder may also have learning disorders or language problems. Your childs school may need to make accommodations that reduce the stresses of a school day and provide proper support or interventions. CONCLUSION No one has a bigger stake in ongoing research on the diagnosis, treatment, management, and prevention of mood disorders than you. As the parent or teacher of an adolescent with depression or bipolar disorder, you are directly affected by any new advances that such research might bring. There is an urgency and immediacy to your concern, since the drive to pr otect and nurture your child is a powerful, primal force. You can draw on that energy to become an agent for change, both in the private life of your adolescent and in the public realm of American society. To get momentum started in your community, share information and resources with those who have an impact on young people, such as teachers, primary care physicians, sports coaches, youth group leaders, and directors of local social service organizations. Get involved in support and advocacy groups, and volunteer your time and energy in whatever way seems most appropriate for you. Don’t give up. Parenting and schooling children with depression or bipolar disorder can be a long and arduous task. With time and appropriate treatment, however, there’s an excellent chance your adolescent’s mood will stabilize, and his or her symptoms will improve. As your teen’s prospects brighten, your own life will get easier. There is an end in sight. 9 WORK CITED Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE, Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005 Merikangas KR, Akiskal HS, Angst J, Greenberg PE, Hirschfeld RM, Petukhova M, Kessler RC, Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2007. Wagner M, Marder C, Blackorby J, Cameto R, Newman L, Levine P, DaviesMercier E, The Achievements of Youth With Disabilities During Secondary School. A Report from the National Longitudinal Transition Study-2 (NLTS2). Menlo Park, CA: SRI International, 2003. U. S. Department of Education, Free Appropriate Public Education for Students With Disabilities: Requirements under Section 504 of The Rehabilitation Act of 1973. Washington, DC: U. S. Department of Education, Sept 2007. Available at: http://www. ed. gov/about/offices/list/ocr/docs/edlite-FAPE504. html. U. S. Department of Health and Human Services, Your Rights Under Section 504 of the Rehabilitation Act. Washington, DC: U. S. Department of Health and Human Services, Office for Civil Rights. Available at: http://www. hhs. gov/ ocr/504. html. Wagner M, Cameto R, The characteristics, experiences, and outcomes of youth with emotional disturbances. NLTS2 Data Brief 3, 2004. Available at: http://www. ncset. org. Kiki Chang, M. D. , Dir. , Pediatric Bipolar Disorders Program, Lucile Packard Children’s Hospital at Stanford February 28, 2008. If Your Adolescent Has Depression of Bipolar Disorder Dwight L. Evans, MD, and Linda Wasmer Andrews 2005 10