This past June, we sent many cards to students who graduated from high school. We extend heartiest congratulations to these students whose high school experience may not have included sports teams or school plays, but rather such high school placements as alternative schools, non-public schools, residential centers, home and hospital instruction or possibly even in a detention center. Congratulations to the family members, as well, who worked equally hard to make sure their children got to school and received the appropriate services to enable them to succeed.
We also turn our thoughts to families whose children should have graduated this year, but did not. For those family members whose children have dropped out of school or have been expelled from school, we honor you as well for your efforts! Please know you are not alone! You have valiantly tried to help your child get through school, yet it wasn't to be. We admire your courage in not giving up and hope that in time your child will return to school or earn a GED.
In the coming year, the Coalition will be working in partnership with the Maryland State Department of Education to improve outcomes for students in special education who are coded ED. We will keep you posted on these efforts and will solicit your input in the process.
- Jane A. Walker
Executive Director
Diagnosing and Treating Bipolar Disorder in Children
Research papers and studies published over the past year have documented what is said to be a 40-fold increase in the rate of diagnosing bipolar disorder in children and youth over the past decade.
Indeed, in 1994–1995, there were 25 bipolar diagnoses per 100,000 children recorded by the National Center for Health Statistics. Most recently, that rate was found to be 1,003 bipolar diagnoses per 100,000 children. For comparison purposes, the most recent adult rate was reported to be 1,679 bipolar diagnoses per 100,000 people.
Questions remain whether bipolar disorder was undiagnosed in the past, is being overdiagnosed in the present or whether more children are developing behavioral disorders now. Most researchers are concluding the answer lies in a mix of those three possibilities.
Physicians currently follow the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria in diagnosing children with bipolar disorder—criteria based on how the disorder typically appears in adults, and that has changed little since the early 1990s. (The next DSM revision isn't expected until 2012.) While many children exhibit symptoms that clearly meet the diagnosis criteria, such as clearly defined cycles of mania and depression with periods of normalcy in between, far more show some but not all symptoms, leading to disagreement over whether their excessive irritability and impulsivity are bipolar disorder symptoms or those of a broader spectrum of mood disturbances.
According to the Child and Adolescent Bipolar Foundation, the following are some behaviors children with bipolar disorder may exhibit:
- an expansive or irritable mood;
- extreme sadness or lack of interest in play;
- rapidly changing moods lasting a few hours to a few days;
- explosive, lengthy and often destructive rages;
- separation anxiety;
- defiance of authority;
- hyperactivity, agitation and distractibility;
- sleeping little or, alternatively, sleeping too much;
- bed wetting and night terrors;
- strong and frequent cravings, often for carbohydrates and sweets;
- excessive involvement in multiple projects and activities;
- impaired judgment, impulsivity, racing thoughts and pressure to keep talking;
- daredevil behaviors (such as jumping out of moving cars or off roofs);
- inappropriate or precocious sexual behavior;
- delusions and hallucinations; and
- grandiose belief in own abilities that defy the laws of logic (ability to fly, for example).
Children may experience other disorders along with bipolar disorder, complicating the diagnostic process for each one. Many children diagnosed with bipolar disorder, for instance, also have attention deficit disorder (ADD) or ADD with hyperactivity (ADHD). Other disorders that may occur with bipolar disorder include conduct disorder, oppositional-defiant disorder, obsessive-compulsive disorder and reactive attachment disorder.
Research also is beginning to document that many adult mental disorders begin in childhood and go unrecognized. National Institute of Mental Health (NIMH) research has found that about 65 percent of adults with bipolar disorder describe the onset of symptoms before age 19, lending credence to the suggestion that bipolar disorder in children previously was underdiagnosed.
NIMH is working to develop biological tests to help validate the diagnosis of childhood bipolar disorder, using such tools as EEGs and MRIs. Genetic studies also are under way.
Based on information from the National Institute of Mental Health, the Child and Adolescent Bipolar Foundation and the Archives of General Psychiatry.
Help for Developmental Delay or Disability
Each jurisdiction in Maryland has offices that can help you if you think your child might have a developmental delay or disability. Disability includes young children with mental health or behavioral needs. The listing below can help you find the right place to start your search for information and assistance.
| JURISDICTION |
AGE |
|
|
Birth to Age 3
Infants and Toddlers |
Age 3–21
Public Schools |
| |
| |
Allegany
|
301-689-0466 |
301-759-2066 |
Anne Arundel |
410-222-6911 |
410-766-6662 |
Baltimore City |
410-396-1666 |
443-642-3032 |
Baltimore County |
410-887-2169 |
410-887-3017 |
Calvert County |
410-535-7381 |
410-535-7380 |
Caroline County |
410-479-3246 |
410-479-3246 |
Carroll County |
410-876-4437 ext. 277 |
410-876-4437 or 410-751-3033 |
Cecil County |
410-996-5444 |
410-996-5444 |
Charles County |
301-609-6808 |
301-934-3884 or 301-753-1745 |
Dorchester County |
410-221-5207 |
410-221-1111 ext. 1023 |
Frederick County |
301-600-1612 |
301-644-5276 or 301-644-5301 |
Garrett County |
301-334-1189 |
301-344-7655 |
Harford County |
410-638-3823 |
410-638-4386 or 410-638-4387 |
Howard County |
410-313-7017 |
410-313-7046 |
Kent County |
410-778-7919 |
410-778-1350 ext.7038 |
Montgomery County |
240-777-3997 |
301-929-2224 |
Prince George 's County |
301-265-8415 |
301-808-2722 or 301-567-8642 |
Queen Anne's County |
410-758-0720 ext. 4456 |
410-758-2403 ext. 182 |
Somerset County |
410-651-1485 |
410-651-1616 |
St. Mary's County |
301-475-4393 |
301-475-5511 ext. 213 |
Talbot County |
410-820-0319 |
410-820-8263 |
Washington County |
301-766-8217 |
301-766-2970 or 301-766-2971 |
Wicomico County |
410-677-5250 |
410-677-5250 |
Worcester County |
410-632-5033 |
410-632-5033 |
MSDE
Division of Special Education/Early Intervention Services
200 West Baltimore Street
Baltimore, MD 21202
1-800-535-0182
Health Care Grants Available
The UnitedHealthcare Children's Foundation announced the availability of new grants to help children who need critical health care treatment, services or equipment not covered or not fully covered by their parents' health benefit plans. Grants of up to $5,000 are available to help families pay for such services as speech therapy, physical therapy, occupational therapy sessions and prescriptions and such medical equipment as wheelchairs, orthotics and eyeglasses. Parents and legal guardians, including grandparents raising grandchildren, may apply for these grants online by visiting www.uhccf.org.
Help for Kids in Military Families
The continuing military actions in the Middle East take their toll on those left behind—often in ways not easily visible. Children don't always understand where their parents are and why they left; they just know they're not at home, tucking them in every night.
A new program focusing on multiple deployments and family adjustments when a parent returns stars the furry folks from "Sesame Street." The workshop "Talk, Listen, Connect: Deployment, Homecoming, Changes" helps children understand and untangle their complex emotions around this subject, and even takes on dealing with a parent's debilitating injuries. Visit the Military OneSource website for a DVD kit or downloadable video, and the Sesame Workshop website for more information and more downloadable materials.
Military pediatricians and youth professionals also have developed videos and DVDs specifically on deployment. The video "Military Youth Coping with Separation: When Family Members Deploy" addresses a variety of deployment-related concerns for teens. For elementary-aged children, there is a "Mr. Poe and Friends Discuss Reunion After Deployment" DVD. Both videos are available for online viewing on the American Academy of Pediatrics Deployment Support website or they may be ordered at the Military One Source website.
For more family resources, visit the Military Spouse Network.
Kennedy Center Internships
The John F. Kennedy Center for the Performing Arts long has sponsored the Career in the Arts Initiative to support opportunities for individuals with disabilities to successfully pursue a career in the arts.
The Kennedy Center offers "OPENING STAGES," a free, quarterly newsletter for people with disabilities pursuing careers in the forming arts. It also offers the Experiential Education Initiative (EEI) Internship in the fall, designed to offer meaningful instruction and cultural arts experiences for individuals with developmental disabilities. Individuals between the ages of 19 and 30 are eligible for the EEI program, which helps participants build professional development skills and social skills while enjoying exposure to the performing arts.
For more information, contact Catharine McNally, accessibility programs assistant, at 202.416.8883 or TTY 202.416.8728.
Upcoming Events
Maryland Youth Leadership Forum, July 28–Aug. 1, Bowie State University. Rising high school juniors and seniors with disabilities are eligible to apply for this weekend of activities and events to teach self-advocacy skills. For more information, contact DaRue Doakes at 240-898-2185 and visit www.md-ylf.org to access the application form.
