Helping young people battle an eating disorder is one of the toughest challenges ChildLine's counsellors face, according to a study of calls to the charity about the issue. Now a new report, I'm in Control - Calls to ChildLine about eating disorders, offers fresh insights into these life-threatening problems - revealing that friends are often the first to be told about a young person's eating disorder, and that family members have a vital part to play if a young sufferer is to recover from an eatin disorder. The report (based on analysis of calls to ChildLine between April 2001 and March 2002) also found that an eating disorder is almost always part of an 'intertwined knot of problems' - including family breakdown, bullying, bereavement, and in some cases child abuse - which must be unravelled one by one before the process of recovery can begin. (For extensive information on child abuse, visit HealthyPlace Abuse Community.)

Each year ChildLine helps around 1,000 children and young people suffering from eating disorders and last year almost 300 additional children spoke to the charity to seek advice about how to help a friend with an eating disorder. The report, sponsored by Next and written by award-winning journalist Brigid McConville, examines the gruelling and compelling testimony of young sufferers and demonstrates that there is rarely a single cause for an eating disorder.

ChildLine's Chief Executive, Carole Easton, says: 'This report makes a significant contribution to the debate on this difficult subject because it gives a voice to the young people whose lives are being destroyed by these debilitating conditions. We hope that it will form a springboard to greater understanding and offer fresh hope for young sufferers, as well as their friends and families. The pictures painted by this report are of intelligent, successful, high-achieving and determined young people who may seem unlikely to be vulnerable to destructive behaviours like anorexia and bulimia.

However, a closer look often reveals a "knot of problems" out of which an eating disorder develops. Eating disorders may develop from a need for young people to feel a sense of control, to communicate feelings, and to block out painful emotions. All too often young people get a sense of self-worth from controlling their intake of food and this is what makes it so challenging for others to help break the iron grip of an eating disorder.

'Children and young people in their thousands turn to ChildLine's experienced counsellors every day of the year to talk about every problem imaginable - including those as harrowing as abuse, and attempted suicide. Yet our counsellors say that, of all the problems they help young people with, eating disorders are among the most challenging. This report shows that ChildLine's counsellors can help to cut through the confusion of denial and distortion facing loved ones when they try to help. When children call ChildLine and talk to a counsellor about an eating disorder they have already taken the first step along the difficult road to recovery - - acknowledging that there is a problem. ChildLine is empowering for young people as they are in charge of the process and can call or write when they choose. The relationship can take on a special resonance as their counsellor can't see them and therefore can't "judge" them on their appearance.'

The report reveals that:

• Friends are enormously influential and have an important part to play in coping with an eating disorder. A significantly higher number of callers said they had told a friend (31%) rather than their mother (16%) or their GP (9%) about their illness. Friends are crucial in supporting each other, and are often extremely distressed by what their friend is going through - many call ChildLine to speak to a counsellor about the effect of an eating disorder on a friend.
• For family and friends, helping a young person with an eating disorder can be incredibly difficult - - yet young sufferers tell ChildLine that the support of people around them is indispensable. More than any other issue, family tensions are mentioned in conversations with young people about eating problems. A quarter of those who call ChildLine to talk primarily about an eating disorder also discuss family difficulties, including conflict between parents, resentment about siblings and an atmosphere of unhappiness and tension at home. However, in many cases it is unclear whether these difficulties were a precursor to the eating disorders or had arisen as a result. The report also shows that parents are extremely supportive and a crucial source of help to their children.
• Adolescence and the accompanying emergence of an adult sexual identity is often the time when a young person is most vulnerable to the onset of an eating disorder. Of callers who mentioned their age, three-quarters (74%) in ChildLine's sample were between the ages of 13 and 16. It is clear from the calls that children as young as 11 have a vocabulary that includes the words anorexia and bulimia. Children in the younger age group frequently talk about the physical symptoms of their eating disorder, while older callers are often the veterans of hospitals and clinics and have a deeper understanding of what they're going through.
• Young people tell ChildLine about a wide range of factors that they believe triggered their problem. These usually include a situation or event that threatens their self-identity or security or lowers their self-esteem. The circumstances most often mentioned by callers include family problems, bullying, school pressures, loss of a friend or family member, illness and abuse.
• Calls to ChildLine demonstrate a range of reasons for the progression of an eating disorder, once it has been triggered off. Among these is an increasingly distorted perception of body image and a sense that they are helpless to stem the progress of the eating disorder as it is 'out of control'. Pervasive social and media pressures to be thin influence the determination of many to control their body shape, as does the continued sensation that feeling thin equates with feeling good.
• A small minority of calls in the sample were from boys - only 50 of the 1,067 total. The experiences boys have in developing eating disorders appear similar to those of girls but there are significant differences in the way boys and girls talk about their eating problems and some of the triggers setting them off. These appear to be centred on the roles and behaviours considered acceptable to boys in society. The report discloses that boys are twice as likely to say that bullying is part of their problem and are far more likely to confide in their doctor or their mother about an eating problem - - perhaps due to fear of being bullied by their peers. Calls to ChildLine also portray boys as feeling an additional sense of shame about having what is seen as a 'girl's problem'.
• Boys talk about their eating disorders in a more factual, straightforward way, unlike girls who tend to start by saying they're worried about their weight, and then to gradually unravel their 'bundle of problems'. Boys focus on the health or medical reasons for being thin, rather than the aesthetic explanations girls give. Girls often tell ChildLine that they feel judged, and judge themselves, on how they look and they generally express more self-hatred than boys, which is mirrored in the way they speak about their bodies. In contrast to boys, the report's author found that some girls also appear to be in a kind of 'anorexic club' where they all diet and starve themselves to be thin.

Carole Easton says: 'Eating disorders are a minefield for everyone affected by them. One of the saddest revelations in ChildLine's report is the sense among some sufferers that their eating disorder is a coping mechanism that stops them from ""doing something worse" - and ""as an alternative to suicide, is a familiar friend that keeps them alive" The cycle of denial and deceit, and frequently withdrawn and angry behaviour of a young person with an eating disorder, can almost seem designed to drive away those who care about them, leaving parents and friends utterly bewildered and at a loss as to how to move forward.

'But our report also brings home the fact that friends and family must not give up - - their love and support is essential in building up a young person's self esteem and bringing them back to health. Although there is no single solution to the tortuous situation an eating disorder can provoke, families and friends are the best allies a young person has, and the most effective remedy is when everyone - - friends, family, school, professionals, and ChildLine counsellors - works together to ensure there is always someone to turn to.'

Case Studies:

All identifying details have been changed

Becky, 14, called ChildLine because she wanted to know more about the symptoms of anorexia and bulimia. 'I've lost a lot of weight recently', she said. 'I only eat one meal a day and often I throw it up.' Becky told her counsellor that she enjoyed swimming at school but often felt faint when she did it. 'I've no energy so I've stopped doing exercise', she said. 'I haven't told my mum - we argue a lot.' Becky said she often felt fat - even though really she knew she wasn't.

Rhiannon, 13, was very upset when she called ChildLine. 'I got a swimsuit for my birthday but when I tried it on I realised I'm too fat to wear it', she said. 'I know I'm fat because my friends at school tease me about it.' Rhiannon paused and then she said, 'I've started making myself sick. It's been a few months now.' She said she had done this in the past and had lost weight - but she had ended up in hospital. 'I liked being thin - but I didn't have any energy so I couldn't play out with my friends.' Rhiannon said that her mum always tried to make sure she ate regularly.

When Ian, 13, called ChildLine he said he had recently started a special diet to help him lose weight. Ian told ChildLine that he had been 'really overweight' so his GP had given him a course of medicine to suppress his appetite. 'They worked and I lost weight which made me happy', he said. Now that he had finished the course Ian told the counsellor that he felt 'very alone' without the back-up of the drugs. 'Now I'm scared that if I start eating again I'll put the weight back on.' Since stopping taking the tablets he had only been 'snacking now and then'.

'My boyfriend is really annoying me', said 16-year-old Emma when she called ChildLine. 'He keeps asking me what I've had to eat - I always read the information on food to check I am eating well'. Emma told ChildLine that she was feeling pressured about her eating habits by several people in her life. 'My friends at school like pointing out who in the group has put weight on and where on their body. And sometimes my dad says to me watch what you eat or you'll end up as big as your auntie.'

When Natalie, 15, called ChildLine she said, 'I want to talk about food. I can't stand the thought of it inside me - so I throw it up.' Natalie said she was very unhappy about her weight but couldn't talk to her family. 'I'm being picked on at school 'cause I'm fat. If my folks find out I may as well just run away - I think they're embarrassed to know me anyhow'. She said that she had always had a problem with her weight. 'I'm so big it's unreal', Natalie said. 'I feel like food is destroying me - making me feel bigger - but then I feel so hungry'.

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Professional Guidelines Recommend The Use of Proven Psychological Methods Along With or Without Medication In The Treatment of Attention Deficit Disorder:

The prescribing information provided by CIBA ( the manufacturers of Ritalin) states "Ritalin is indicated as an integral part of a total treatment program which typically includes other remedial measures (psychological, educational, social) for a stabilizing effect in children with a behavioral syndrome characterized by the following group of developmentally inappropriate symptoms: moderate-to severe distractibility, short attention span, hyperactivity, emotional ability, and impulsivity."

The same literature also states, "Drug treatment is not indicated for all children with this syndrome..... Appropriate educational placement is essential and psychosocial intervention is generally necessary. When remedial measures alone are insufficient, the decision to prescribe stimulant medication will depend upon the physician's assessment...."(1)-Physicians' Desk Reference 1998

Dr. William Barbaresi notes that "Comprehensive treatment, including both medication and nonmedical intervention, should be coordinated by the primary-care provider."(2)-Mayo Clinical Proceedings 1996

Similarly Dr. Michael Taylor concludes, "The most successful management of children with attention deficit disorder involves a coordinated team approach, with parents, school officials, mental health specialists and the physician using a combination of behavior management techniques at home and at school, educational placement and medication therapy."(3)-American Family Physician 1997

Research and Clinical Practice Has Shown Well Constructed Behavior Modification Programs To Be Very Useful In The Management of ADD/ADHD:

Behavior modification programs emphasizing positive reinforcement of appropriate behavior have been useful in reducing maladaptive behavior at home and at school. Research has shown that behavior modification can improve impulse control and adaptive behavior in children of various ages (4)-Perceptual Motor Skills 1995, and (5)-Abnormal Child Psychology 1992.

The use of positive reinforcement related to daily reports from school has been found to be useful in improving task completion and reducing disruptive behavior in the classroom (6)-Behavior Modification 1995.

Some parents have been found to prefer behavioral to medical treatment (7)-Strategic Interventions for Hyperactive Children 1985.

Families are often able to succeed with their behavior modification efforts through the use of written materials only (8)-Journal of Pediatric Health Care 1993.

Teaching children with attention deficit disorder how to relax can be effective in reducing hyperactivity and disruptive behavior while increasing attention span and task completion:

Relaxation training conducted by parents in the home has been found not only to be effective in improving behavior and other symptoms but also improves over all relaxation when measured by biofeedback equipment (9, 10)-Journal of Behavior Therapy & Experimental Psychiatry1985 & 1989.

A review of a number of studies related to relaxation training with children concluded, "Findings suggest that relaxation training is at least as effective as other treatment approaches for a variety of learning, behavioral, and physiological disorders . . ."
(11)-Journal of Abnormal Child Psychology 1985.

Cognitive Behavioral Therapy Can Help ADD Children Improve Problem Solving and Coping Skills:

Cognitive Behavioral Therapy (CBT) consists of teaching children to change their thought patterns from ones that lead to maladaptive behavior to ones that produce adaptive behavior and positive feelings. This technique can be used to help children to improve their self-esteem. It can also be used to help them improve coping skills, problem solving skills and social skills.

In one study CBT was found to be helpful in helping hyperactive boys develop anger control. The findings indicated that "Methylphenidate (Ritalin) reduced the intensity of the hyperactive boys' behavior but did not significantly increase either global or specific measures of self-control. Cognitive-behavioral treatment, when compared to control training, was more successful in enhancing both general self-control and the use of specific coping strategies." (12) Journal of Abnormal Child Psychology 1984. (It should be noted that CBT has not proven to be successful in all studies. The problem may be related to the fact that each study uses different strategies and measures of success).

Cognitive Rehabilitation Exercises (Brain Training) Can Improve Attention & Concentration Well As Other Intellectual and Self-Control Functions:

Victims of strokes or head injury may have significant impairments in attention and concentration. Cognitive Rehabilitation exercises are often used to help these people to improve their ability to concentrate and pay attention. This approach has been applied to children with attention deficit disorder with some success. The repeated use of simple (attentional training) exercises can help children to train their brains to concentrate and pay attention for longer periods of time. (13)-Behavior Modification 1996

Focus is a multi-media psychoeducational program that combines all of the above methods in a package that can be easily and effectively implemented at home by parents:

The training manual provides a behavior modification program using the daily report card to improve performance at school.

A token economy program is provided to improve behavior at home and foster a positive parent/child relationship.

The manual also provides a series of Cognitive Rehabilitation exercises that are fun and easy to implement to improve attention and concentration while also helping to reduce hyperactivity and improve impulse control.

The manual along with audio tapes help not only teach how to improve their ability to relax but also how to apply this skill to home, school, social and sport activities.

A temperature biofeedback card is supplied as an additional aide for relaxation training.

Audio tapes provide Cognitive Behavioral Therapy to help improve motivation, self-control and self-esteem.

The program is organized in a way to provide materials appropriate for two different age levels (6-11 and 10-14).

The program also provides additional parent education material related to attention deficit disorder as well as a set of forms for recording progress.

next: Tips for Helping Kids and Teens with Homework and Study Habits
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References

(1) Physicians' Desk Reference. 52nd ed. Montavle (NJ): Medical Economics Data Production Company, 1998

(2) Barbaresi, W Primary-care Approach to the Diagnosis and Management of Attention-Deficit Hyperactivity Disorder. Mayo Clin Proc 1996: 71; 463-471

(3) Taylor, M Evaluation and Management of Attention-Deficit Hyperactivity Disorder. American Family Physician 1997: 55 (3); 887-894

(4) Cociarella A, Wood R, Low KG Brief Behavioral Treatment for Attention-Deficit Hyperactivity Disorder. Percept Mot Skills 1995: 81 (1); 225-226

(5) Carlson CL, Pelham WE Jr, Milich R, Dixon J Single and Combined Effects of Methylphenidate and Behavior Therapy on the Classroom Performance of Children with Attention-Deficit Hyperactivity Disorder. J Abnorm Child Psychol 1992: 20 (2); 213-232

(6) Kelly ML, McCain AP Promoting Academic Performance in Inattentive Children: The Relative Efficacy of School-Home Notes With and Without Response Cost. Behavior Modif 1995: 19; 76-85

(7) Thurston, LP Comparison of the Effects of Parent Training and of Ritalin in Treating Hyperactive Children In: Strategic Interventions for Hyperactive Children , Gittlemen M, ed New York: ME Sharpe, 1985 pp 178-185

(8) Long N, Rickert VI, Aschraft EW Bibliotherapy as an Adjunct to Stimulant Medication in the Treatment of Attention-Deficit Hyperactivity Disorder. J Pediatric Health Care 1993: 7; 82-88

(9) Donney VK, Poppen R Teaching Parents to Conduct Behavioral Relaxation Training With Their Hyperactive Children J Behav Ther Exp Psychiatry 1989: 20 (4); 319-325

(10) Raymer R, Poppen R Behavioral Relaxation Training With Hyperactive Children J Behav Ther Exp Psychiatry 1985: 16 (4); 309-316

(11) Richter NC The Efficacy of Relaxation Training With Children J Abnorm Child Psychol 1984: 12 (2); 319-344

(12) Hinswaw SP, Henker B, Whalen CK Self-control in Hyperactive Boys in Anger-Inducing Situations: Effects of Cognitive-Behavioral Training and Methylphenidate. J Abnorm Child Psychol 1984: (12); 55-77

(13) Rapport MD Methylphenidate and Attentional Training. Comparative Effects on Behavior and Neurocognitive Effects on Behavior and Neuorcognitive Performance in Twin Girls With Attention-Deficit/Hyperactivity Disorder Behav Modif 1996: 20 (4) 428-430

(14) Myers, R Focus: A Comprehensive Psychoeducational Program For Children 6 to 14 Years of Age To Improve Attention, Concentration, Academic Achievement, Self- Control and Self-Esteem Villa Park (CA): Child Development Institute 1998

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A comprehensive overview of personality disorders; what they are, types and causes, and treatment of personality disorders.

Definition of Personality Disorders

Up to 30 percent of people who require mental health services have at least one personality disorder--characterized by abnormal and maladaptive inner experience and behavior.

Personality disorders are patterns of perceiving, reacting, and relating to other people and events that are relatively inflexible and that impair a person's ability to function socially.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) specifies that these dysfunctional patterns must be regarded as nonconforming or deviant by the person's culture, and cause significant emotional pain and/or difficulties in relationships and occupational performance. In addition, the patient usually sees the disorder as being consistent with his or her self-image and may blame others for his or her social, educational, or work-related problems.

Personality Traits of Someone with a Personality Disorder

Everyone has characteristic patterns of perceiving and relating to other people and events (personality traits). That is, people tend to cope with stresses in an individual but consistent way. For example, some people respond to a troubling situation by seeking someone else's help; others prefer to deal with problems on their own. Some people minimize problems; others exaggerate them. Regardless of their usual style, however, mentally healthy people are likely to try an alternative approach if their first response is ineffective.

In contrast, people with a personality disorder are rigid and tend to respond inappropriately to problems, to the point that relationships with family members, friends, and coworkers are affected. These maladaptive responses usually begin in adolescence or early adulthood and do not change over time. Personality disorders vary in severity. They are usually mild and rarely severe.

Most people with a personality disorder are distressed about their life and have problems with relationships at work or in social situations. Many people also have mood, anxiety, substance abuse, or eating disorders.

People with a personality disorder are unaware that their thought or behavior patterns are inappropriate; thus, they tend not to seek help on their own. Instead, they may be referred by their friends, family members, or a social agency because their behavior is causing difficulty for others. When they seek help on their own, usually because of the life stresses created by their personality disorder, or troubling symptoms (for example, anxiety, depression, or substance abuse), they tend to believe their problems are caused by other people or by circumstances beyond their control.

Until fairly recently, many psychiatrists and psychologists felt that treatment did not help people with a personality disorder. However, specific types of psychotherapy (talk therapy), sometimes with drugs, have now been shown to help many people. Choosing an experienced, understanding therapist is essential.

Sasha is 5 years old. A physically healthy child of normal weight and size, she is so frightened of becoming fat that she spends every recess period at school running back and forth across the schoolyard in an effort to work off calories. She is a worried and sad little girl. Her mother is worried and sad as well, consumed with questions about why this is happening to her daughter. Could she be doing anything to inadvertently contribute to her child's problem?

Except in cases where there may have been some form of child abuse, parents needn't feel guilty or responsible for having caused this type of extreme eating-related problem that occurs so early in a child's life. In most such cases, these children are born with genetic predispositions towards such behaviors and a temperamen

t that sustains them. Enlightened parents, however, can do a great deal to counteract inherited tendencies as well as the destructive forces of peers and the media, by proactively shaping a child's healthy attitudes towards food, eating and body image.

Sasha's mom tries to be the best role model she can be for her daughter. She believes that she is a healthy eater and tries to do "everything right." She consults nutritional labels in an effort to limit her fat intake, keeps no junk foods in the house, has only coffee for breakfast, and Slimfast for lunch most days. She exercises regularly and is careful about the foods she eats in an effort to lose weight and keep it off.

What Parents Need to Know in order to be Positive Role Models for their Children

• Parents need to know what healthy eating is. Healthy eating is moderate, varied and balanced eating; it is eating without restriction and without excess. Parents provide a healthy eating lifestyle for their children by preparing three nutritious meals a day that contain all the food groups, and by sitting down to eat these meals together with family as often as possible. Healthy eating is not about weight control. Fat-free eating is unhealthy eating for the young child.
• Parents need to be aware of their own personal attitudes and behaviors towards food, eating and body image; they need to become aware of the messages they send to their child, purposefully or inadvertently, about eating and body image. When parents struggle with their own fears or issues in this regard, it is difficult for them to become impartial observers and positive role models for their child.
• Parents are their child's most effective teachers. The young child is not born knowing that the body is a precious machine that needs fueling, nurturance and care in order to grow optimally, feel good, learn, play, and remain healthy. Children need to recognize that their body is the only vessel they will ever have to take them through the journey of life.

The Best Laid Plans.....

Sasha's mom's intentions are about as good as any parent's can be. She can rest assured that Sasha does not have an eating disorder, though her daughter's misguided notions about food and exercise could possibly put her at high risk to develop one in the future. Sasha is most likely learning life lessons from her mother that are not at all what her mother intended to convey.

Through watching her mother's behaviors, in her confusion, Sasha has come to believe that:

• Food is fattening.
• Fat is unhealthy for the body.
• Dieting and restricting food is a healthy way to keep one's weight down.
• It's okay to skip meals.
• Food substitutes can take the place of meals.
• Meals are served, not eaten, by parents.
• Exercise can keep a person slim. The more exercise you do, the thinner you get.
• Being fat is about being unhealthy, unhappy and unattractive. It must be avoided at all costs.

QUIZ: Are you Teaching your Child Healthy Messages about Eating and Body Image?

1. Do you have a cupboard that is continuously stocked with nutritious foods?

2. Do you eat three meals a day? Does your spouse or partner?

3. Do you serve three meals a day to your young child?

4. Do you expect your child to eat them?

5. Do you sit down to eat them together with him or her?

6. Do you serve varied foods?

7. Are mealtimes happy, stress free times in your home?

8. Do you eat at mealtime, even if you are not particularly hungry?

9. Are you careful not to complain about your weight in front of your child?

10. Do you attempt to avoid being critical of how your child looks?

11. Does your child know that the body is a machine that needs fueling? That the brain is a muscle that needs feeding in order to remain alert?

12. Do you know that dieting is the worst way to lose weight and keep it off?

Parents need to understand that their actions speak more loudly to their children than do words, wishes, or intentions. The child who is raised with healthy eating behaviors is bound to develop into an adolescent and young adult with positive attitudes towards food and the self. Such attitudes are the best immunity a child can develop to the eventual onset of some type of an eating disorder.

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Learning disabilities are present in at least 10 percent of the population. By following the links on this page you will discover many interesting facts about learning disabilities as well as well as uncover some of the myths. You will also be provided with practical solutions to help children and adolescents with learning disabilities greatly improve their academic achievement as well as their self-esteem.

• What is a learning disability?
• How prevalent are learning disabilities?
• What causes learning disabilities?
• What are the "early warning signs" of learning disabilities?
• What should a parent do if it is suspected that a child has a learning disability?
• How does a learning disability affect the parents of the child?
• Pointers for parents of children with learning disabilities.

What is a learning disability?

Interestingly, there is no clear and widely accepted definition of "learning disabilities." Because of the multidisciplinary nature of the field, there is ongoing debate on the issue of definition, and there are currently at least 12 definitions that appear in the professional literature. These disparate definitions do agree on certain factors:

1. The learning disabled have difficulties with academic achievement and progress. Discrepancies exist between a person's potential for learning and what he actually learns.
2. The learning disabled show an uneven pattern of development (language development, physical development, academic development and/or perceptual development).
3. Learning problems are not due to environmental disadvantage.
4. Learning problems are not due to mental retardation or emotional disturbance.

How Prevalent are Learning Disabilities?

Experts estimate that 6 to 10 percent of the school-aged population in the United States is learning disabled. Nearly 40 percent of the children enrolled in the nation's special education classes suffer from a learning disability. The Foundation for Children With Learning Disabilities estimates that there are 6 million adults with learning disabilities as well.

What causes learning disabilities?

Little is currently known about the causes of learning disabilities. However, some general observations can be made:

• Some children develop and mature at a slower rate than others in the same age group. As a result, they may not be able to do the expected school work. This kind of learning disability is called "maturational lag."
• Some children with normal vision and hearing may misinterpret everyday sights and sounds because of some unexplained disorder of the nervous system.
• Injuries before birth or in early childhood probably account for some later learning problems.
• Children born prematurely and children who had medical problems soon after birth sometimes have learning disabilities.
• Learning disabilities tend to run in families, so some learning disabilities may be inherited.
• Learning disabilities are more common in boys than girls, possibly because boys tend to mature more slowly.
• Some learning disabilities appear to be linked to the irregular spelling, pronunciation, and structure of the English language. The incidence of learning disabilities is lower in Spanish or Italian speaking countries.

What are the early Warning Signs of Learning Disabilities?

Children with learning disabilities exhibit a wide range of symptoms. These include problems with reading, mathematics, comprehension, writing, spoken language, or reasoning abilities. Hyperactivity, inattention and perceptual coordination may also be associated with learning disabilities but are not learning disabilities themselves. The primary characteristic of a learning disability is a significant difference between a child's achievement in some areas and his or her overall intelligence. Learning disabilities typically affect five general areas:

1. Spoken language: delays, disorders, and deviations in listening and speaking.
2. Written language: difficulties with reading, writing and spelling.
3. Arithmetic: difficulty in performing arithmetic operations or in understanding basic concepts.
4. Reasoning: difficulty in organizing and integrating thoughts.
5. Memory: difficulty in remembering information and instructions.

Among the symptoms commonly related to learning disabilities are:

• poor performance on group tests
• difficulty discriminating size, shape, color
• difficulty with temporal (time) concepts
• distorted concept of body image
• reversals in writing and reading
• general awkwardness
• poor visual-motor coordination
• hyperactivity
• difficulty copying accurately from a model
• slowness in completing work
• poor organizational skills
• easily confused by instructions
• difficulty with abstract reasoning and/or problem solving
• disorganized thinking
• often obsesses on one topic or idea
• poor short-term or long-term memory
• impulsive behavior; lack of reflective thought prior to action
• low tolerance for frustration
• excessive movement during sleep
• poor peer relationships
• overly excitable during group play
• poor social judgment
• inappropriate, unselective, and often excessive display of affection
• lags in developmental milestones (e.g. motor, language)
• behavior often inappropriate for situation
• failure to see consequences for his actions
• overly gullible; easily led by peers
• excessive variation in mood and responsiveness
• poor adjustment to environmental changes
• overly distractible; difficulty concentrating
• difficulty making decisions
• lack of hand preference or mixed dominance
• difficulty with tasks requiring sequencing

When considering these symptoms, it is important to remain mindful of the following:

1. No one will have all these symptoms.
2. Among LD populations, some symptoms are more common than others.
3. All people have at least two or three of these problems to some degree.
4. The number of symptoms seen in a particular child does not give an indication as whether the disability is mild or severe. It is important to consider if the behaviors are chronic and appear in clusters.

What should a parent do if it is suspected that a child has a learning disability?

The parent should contact the child's school and arrange for testing and evaluation. Federal law requires that public school districts provide special education and related services to children who need them. If these tests indicate that the child requires special educational services, the school evaluation team (planning and placement team) will meet to develop an individual educational plan (IEP) geared to the child's needs. The IEP describes in detail an educational plan designed to remediate and compensate for the child's difficulties.

Simultaneously, the parent should take the child to the family pediatrician for a complete physical examination. The child should be examined for correctable problems (e.g. poor vision or hearing loss) that may cause difficulty in school.

How does a learning disability affect the parents of the child?

Research indicates that parental reaction to the diagnosis of learning disability is more pronounced than in any other area of exceptionality. Consider: if a child is severely retarded or physically handicapped, the parent becomes aware of the problem in the first few weeks of the child's life. However, the pre-school development of the learning disabled child is often uneventful and the parent does not suspect that a problem exists. When informed of the problem by elementary school personnel, a parent's first reaction is generally to deny the existence of a disability. This denial is, of course, unproductive. The father tends to remain in this stage for a prolonged period because he is not exposed to the child's day-to-day frustrations and failures.

Research conducted by Eleanor Whitehead suggests that the parent of an LD child goes through a series of emotions before truly accepting the child and his problem. These "stages" are totally unpredictable. A parent may move from stage-to-stage in random. Some parents skip over stages while others remain in one stage for an extended period. These stages are as follows:

DENIAL: "There is really nothing wrong!" "That's the way I was as a child--not to worry!" "He'll grow out of it!"

BLAME: "You baby him!" "You expect too much of him." "It's not from my side of the family."

FEAR: "Maybe they're not telling me the real problem!" "Is it worse than they say?" "Will he ever marry? go to college? graduate?"

ENVY: "Why can't he be like his sister or his cousins?"

MOURNING: "He could have been such a success, if not for the learning disability!"

BARGAINING: "Wait 'till next year!" "Maybe the problem will improve if we move! (or he goes to camp, etc.)."

ANGER: "The teachers don't know anything." "I hate this neighborhood, this school...this teacher."

GUILT: "My mother was right; I should have used cloth diapers when he was a baby." "I shouldn't have worked during his first year." "I am being punished for something and my child is suffering as a result."

ISOLATION: "Nobody else knows or cares about my child." "You and I against the world. No one else understands."

FLIGHT: "Let's try this new therapy--Donahue says it works!" "We are going to go from clinic to clinic until somebody tells me what I want to hear.!"

Again, the pattern of these reactions is totally unpredictable. This situation is worsened by the fact that frequently the mother and father may be involved in different and conflicting stages at the same time (e.g., blame vs. denial; anger vs. guilt). This can make communication very difficult.

The good news is that with proper help, most LD children can make excellent progress. There are many successful adults such as attorneys, business executives, physicians, teachers, etc. who had learning disabilities but overcame them and became successful. Now with special education and many special materials, LD children can be helped early. The list of celebrities with learning disabilities includes: Cher, Thomas Edison, Albert Einstein, Mozart, Bruce Jenner to name a few.

Pointers for parents of children with learning disabilities.

1. Take the time to listen to your children as much as you can (really try to get their "Message").
2. Love them by touching them, hugging them, tickling them, wrestling with them (they need lots of physical contact).
3. Look for and encourage their strengths, interests, and abilities. Help them to use these as compensations for any limitations or disabilities.
4. Reward them with praise, good words, smiles, and pat on the back as often as you can.
5. Accept them for what they are and for their human potential for growth and development. Be realistic in your expectations and demands.
6. Involve them in establishing rules and regulations, schedules, and family activities.
7. Tell them when they misbehave and explain how you feel about their behavior; then have them propose other more acceptable ways of behaving.
8. Help them to correct their errors and mistakes by showing or demonstrating what they should do. Don't nag!
9. Give them reasonable chores and a regular family work responsibility whenever possible.
10. Give them an allowance as early as possible and then help them plan to spend within it.
11. Provide toys, games, motor activities and opportunities that will stimulate them in their development.
12. Read enjoyable stories to them and with them. Encourage them to ask questions, discuss stories, tell the story, and to reread stories.
13. Further their ability to concentrate by reducing distracting aspects of their environment as much as possible (provide them with a place to work, study and play).
14. Don't get hung up on traditional school grades! It is important that they progress at their own rates and be rewarded for doing so.
15. Take them to libraries and encourage them to select and check out books of interest. Have them share their books with you. Provide stimulating books and reading material around the house.
16. Help them to develop self-esteem and to compete with self rather than with others.
17. Insist that they cooperate socially by playing, helping, and serving others in the family and the community.
18. Serve as a model to them by reading and discussing material of personal interest. Share with them some of the things you are reading and doing.
19. Don't hesitate to consult with teachers or other specialists whenever you feel it to be necessary in order to better understand what might be done to help your child learn.

next: Attention Deficit Disorder ADD / ADHD Educational Material
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You want to get better but this is some yellow brick road

The road to recovery is often a long and frustrating one but it can also be a time of great hope and great relief. You probably have thought on and off about trying to "quit" your eating disorder. As you begin this process, you may experience a wide range of emotions: fear, impatience or frustration on the one hand, and determination, confidence and empowerment on the other.

Not sure about taking the first step?

Deep down you may have known for a long time that you needed to stop binge eating and purging or starving yourself. But maybe you were too afraid you would get really fat or that something the eating disorder gives you would be too much to lose. Maybe you have tried so many times before and your efforts only lasted a day or a few hours, and you have been afraid you could never really beat it. Or maybe you do not know how to begin a recovery process. The most important thing is that you have decided to try to make some changes in your life.

Is it worth it?

Ultimately you are choosing to get back your physical and emotional health. Sometimes it may not seem apparent to you that this eating disorder is taking a toll on your physical health - but it truly is. You may notice that the bingeing and purging leave you feeling tired, edgy and irritable. You may feel like you are on an emotional roller coaster. Be aware that you are not instantaneously going to feel healthy and energetic. It will take time. But getting your health back and getting your life back is worth your time and patience.

Losing your way

You can expect that there will be good days and not-so-good days and maybe even some terrible days. Despite the best intentions, most people in recovery will have "slips" where they fall back into disordered eating habits. A variety of situations may trigger a slip. Avoid being hard on yourself when you slip or fail. Criticizing yourself for a slip can actually further discourage you and lead to more steps backward. What is far more important than your slip is whether you are willing to try again. Remember, no one says change is easy but change will happen if you keep trying. Research on relapses actually indicates that the more times you try to quit a behavior, the better chance you will eventually succeed.

You shouldn't have to do this alone

Most people find it helpful to see a mental health professional (a psychologist, psychiatrist, social worker or counselor, with a state license in their field) to assist in this process. Individual and/or group therapy for eating disorders, medical monitoring, psychiatric medication (eating disorders medications) and nutritional counseling are the most common elements of eating disorders treatment or intervention that are helpful (or even essential!) for individuals with eating disorders. One or more of these processes could be used at any given time; and many of them may be part of a person's recovery process over time. This will take time, so you should be sure to credit yourself for every single step you take, and know that your goal is not an easy one.

next: Getting Help for Anorexia and Bulimia
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"If one can actually revert to the truth, then a great deal of one's suffering can be erased - because a great deal of one's suffering is based on sheer lies."
- R. D. Laing

1) Responsibility
2) Deliberate Intent
3) Acceptance
4) Beliefs
5) Gratitude
6) This Moment
7) Honesty
8) Perspective

7) Honesty With Yourself & Others

Dishonesty is a major contributor to allot of unhappiness and problems. Do this experiment and you'll see what I mean. Next time you sit down to watch your favorite sitcom, movie or drama series on television, notice how many of the problems are caused by someone being dishonest. Whether it's a lie of omission, a little lie, a big lie, doesn't matter. Just look for the lie and watch what results from it. I was amazed when I did this myself. I'm starting to think dramas wouldn't be possible if there were no lies.

I had always thought myself to be a fairly honest person, and by society's standards I was. But what society considers honest and what true honesty really is, are two separate things. We've been systematically taught in our culture to make lying a part of our lives. We lie so often that we don't even notice it anymore.

Honesty is telling "the truth, the whole truth, and nothing but the truth." Society's definition of the truth telling is to tell the truth ONLY...

1. if it doesn't make anyone uncomfortable,
2. doesn't cause a conflict
3. and/or doesn't make you look bad.

I'm not talking about the big lies, but more about the consistent, persistent "lies of omission" and "white lies" we tell people almost everyday. For me, I didn't even consider these small untruths to be lies until I experienced the exact opposite.

Up until about five years ago, I had always considered myself a fairly honesty person. Then I attended a month-long program where total honesty was a major intention for the class. It was kinda like we were experimenting on what it would be like to live in a world where you said everything you thought and felt. This included what you thought about the program, the teacher, and the other students. It was a mind blowing experience. I hadn't realized how much I had been holding back. It was a wonderful and absolutely terrifying experience.

Terrifying? Yes. When you are honest with someone they get to see all of you, including the parts of yourself you wish were not there. The judgmental parts, the catty parts, the criticizing and untrusting parts of yourself. But you know what, even those people I thought I was being mean to, came to be some of my closest friends. I don't think that's a coincidence.

As a person who has lived in both worlds (the land of lies and the land of speaking your truth), I'm here to tell you they are very different worlds. If you're like me, most of your lies aren't big and blatant but lies of omission. Not saying what you really think and feel. You wouldn't think getting rid of these lies would make much difference, but it really does.

Intention Behind Honesty

I'm not talking about using honesty as an excuse for being abusive to others. Your intention behind your honest will guide you in determining what you say and to whom you say it. If my intention is to have a close relationship, I will be considerably more honest with that person than I would, say, the checkout girl at the grocery store.

What would be the purpose of sharing what I'm really thinking and feeling with the checkout girl? What would be my intention? She wouldn't understand why I was sharing with her and we would have no time to talk about it. But, in the case of a close friend or spouse, there is no reason NOT to be totally revealing. And if I want to have intimacy (that's the intention) then honesty must rule in the relationship.

"It is necessary to the happiness of man that he be mentally faithful to himself."

- Thomas Paine

The best place to begin becoming more honest is with yourself. Start a journal and gradually being to write about your thoughts and feelings. Let the honesty begin with yourself. Write about how you feel. Write about what you think of the people in your life. Write about what you want. What you fear. Don't hold anything back. Then later, as you become more and more comfortable with your honesty, you can begin carrying that truthfulness over into your relationships.

next: 8 Ways To Happiness: Perspective

Paediatrician and ADHD expert, Dr. Billy Levin, argues there shouldn't be any confusion about ADHD and it's the misinformation that's hurting widespread, successful treatment of ADHD.

There is an urgent need to overcome conflicting views surrounding the diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD). This can only be achieved if doctors, parents and teachers take heed of information from reliable and authoritative sources, instead of succumbing to the false and often sensational messages that arise out of ignorance and a failure to consider all the facts.There is a world of accurate and scientific information, written by experts in the field of ADHD. There is equally as much, if not more, misinformation made public which, it would appear, is read more readily than the facts - with distressing and sometimes tragic results.

The Debate Over Ritalin

Perhaps the biggest area of debate around ADHD is medication, particularly with regard to Ritalin. It has been suggested that more has been written about Ritalin and ADHD than any other medical condition. I would go further to say there is probably more misinformation written than genuine information, something not apparent in other fields of medicine. A possible explanation is that certain organisations are underdernmining the evidence supporting Ritalin by confusing the public and medical professionals and distorting the facts.

In spite of Nobel Prize winner, Roger Sperry's elucidation of the neurology of ADHD, parents bow to pressure arising from unsound and misleading information and so stop medicating their children. Teachers respond to the same information by persuading parents to stop Ritalin treatment or simply refuse to accept that the condition exists, labelling the child as lazy, naughty or stupid, without appreciating that correct timing, correct dosage and regular re-evaluation lead to effective treatment and a stepping stone to remediation. "you can't teach a child before you reach the child!" You cannot reach them with out Ritalin.

Instead, children are often given programs that are not beneficial or, even worse, detrimental. These programs, which have been condemned by the experts, are being peddled to unsuspecting parents, only to aggravate these children's suffering. It is negative influences like these that hamper progress.

Highly emotive arguments surrounding the use of Ritalin and the diagnosis of ADHD have been going on for at least 30 years, without consensus. Yet throughout, expert opinion has been constant, that Ritalin is safe and effective - provided it is used correctly and for the right type of patient.

Ritalin Is Not the Miracle Cureall

However, and this is where many people make a mistake, Ritalin should not be seen as the be-all and end-all, because treatment of ADHD requires an holistic approach that demands commitment from parents, teachers and patients. Whether it is a behavioural problem, a learning problem, or both, ADHD children need motivation, especially from their parents, as well as educational help from their teachers. Children have a vital role to play in overcoming their own problems -dedication. While their condition is being treated, they might still have to cope with the negativity and ignorance that abounds.

In addition, the experts have laid down clear guidelines, methods and systems that have been found to be effective time and again. It is not so much a question of whether too much Ritalin is being used as has been suggested in the lay press, but whether it being used correctly and for those who really need it. One should not confuse misuse, abuse or addiction. There appears to be substantial misuse (because of misdiagnosis, incorrect dosage or incorrect management), some abuse, no addiction - but gross confusion.

Treatment of ADHD demands a knowledge of developmental norms in children, clinical criteria for diagnosis, systems for evaluation monitored titrated dosages a knowledge of pharmacology and counciling. Parent and teacher education plays an important role in the treatment of children with ADHD who are placed on Ritalin or alternate medication. Initially it should be on a trial basis, not to establish if it is safe (it is safe), but to establish whether the child benefits.

However, as long as deception and misinformation continue, the chances of achieving widespread success in treating ADHD will be diminished.

About the author: Dr. Billy Levin (MB.ChB) has spent the last 28 years treating patients with ADHD. He has researched, developed and modified a diagnostic rating scale of which he has evaluated over tens of thousands of case studies. He has been a speaker at several national and international symposiums on ADHD and has had articles published in various teaching, medical and educational journals and on the Internet. He has written a chapter in a textbook (Pharmacotherapy edited by Prof. .C.P. Venter) and received nominations by his local branch of SAMA for a National award (Excelsior award) on two occasions."

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Self-Therapy For People Who ENJOY Learning About Themselves

All personal and interpersonal problems CAN be solved. We've looked at the roadblocks (#1) and how to identify a problem (#2). Now, in #3 and #4, we'll learn about the six aspects of all problems. This topic focuses on My Part of the Problem, Your Part of the Problem, and the Situation.

THE PART I PLAY IN THE PROBLEM

When we pretend we don't have any responsibility for a problem, we say things like: "It's Not My Problem!" - "I Didn't Do Anything Wrong." - "It's All Your Fault." - "You'll Have To Fix It!"

How Do We Know That We ARE Part Of The Problem? We ALWAYS play a part in any problem that exists between us and other people. But it's important to realize that we don't have to DO anything to be a big part of a problem!

If your partner says "I have a problem with the way you do dishes" you might say "It's not my problem. It's your problem that you want me to do them differently."

SAYING that you don't have a part in the problem, doesn't make it so! In this example, the part you play in this problem might be: - That you drop every third dish(!).

• That you say you'll do them but don't.
• That you refuse to discuss the dishes at all.

If you drop every third dish, you probably admit that you are at least part of the problem! But if you don't keep your word about when you'll do them or if you simply refuse to discuss the dishes, then your part of the problem is a PASSIVE part.

Your part of the problem isn't about what you do, but about what you do NOT do. When little kids get blamed for something, they love to respond with: "But I didn't DO anything!!" Many adults live their lives as if this is their only defense: To be able to say "I didn't DO anything!"

Many problems have both an ACTIVE and a PASSIVE participant. The active person is at least putting their beliefs "out there" to be seen. The passive person is staying hidden, and their role may be overlooked.

The worst example of passivity in problem solving is in abusive relationships. The person who is being abused keeps saying "I didn't DO anything!" but they DID do something very, very important! They TOOK the abuse, passively, even after they KNEW it was going to happen again. Their passivity is an extremely important part of the problem!

How To Handle It When You Want To Deny That You Are Part Of The Problem

Tell Yourself: "I am part of this problem. Something I DID or DID NOT DO contributes to it!"

THE PART THE OTHER PERSON PLAYS IN THE PROBLEM

When we pretend the other person doesn't have any responsibility in a problem, we say things like:

"It's Not Your Problem!" - "You Didn't Do Anything Wrong." "It's All My Fault." - "I'll Fix It By Myself."

How Do We Know The Other Person IS A Part Of The Problem? (See "How We Know WE Are Part of the Problem".... Just reverse the pronouns....)

How To Handle It When You Want To Deny That The Other Person Is Part Of The Problem

This can be pretty serious stuff. It may be based on self-hate, intense fearfulness, or both.

Tell Yourself: "The other person IS responsible for what they do or don't do. It is NOT all my fault or entirely my responsibility to fix this." (If necessary, add: "I will not take being mistreated!"...)

THE ROLE OF THE SITUATION: "Are There Other Important Factors?"

Sometimes the situation really doesn't matter. If the "situation" in our example is only "the kitchen," there isn't much we need to say about it.

But what if one partner's parents are taking a side in the dispute? What if someone's religious beliefs are involved? What if someone believes that the only way to do dishes is the way they think "everyone" does them (and this is defined by what they've seen on TV)?

How Much Does The Situation Matter? Each person determines the amount they let these elements influence their decisions.

What matters is whether we take responsibility for making our own decisions or we blame outside factors for "making us" do what we choose to do.

Saying you "have to" do something the way your parents or your religion or your culture says, is a cop out. You make your own decisions, regardless of the amount of pressure around you.

Saying you LEARNED FROM your parents, religion, or culture and you picked out the good stuff and threw away the bad from each source is being responsible.

next: Finding Purpose

Overview of inositol supplements as a natural remedy for depression and whether inositol works in treating depression.

What is Inositol?

Inositol is a type of sugar related to glucose. It occurs naturally in the body and is present in many foods. Inositol can also be taken as a dietary supplement.

How does Inositol work?

Low levels of inositol have been found in the spinal fluid of people who are depressed and in the brains of people who have committed suicide. These findings have raised the possibility that taking inositol might be a useful treatment.

Is Inositol effective ?

There have been several small studies on inositol. It is unclear from this evidence whether inositol is effective.

Are there any disadvantages?

None known.

Where do you get Inositol?

Inositol powder can be bought as a dietary supplement at some health food shops or over the internet.

Recommendation

It is unclear whether inositol helps depression. More research is needed.

Key references

Taylor MJ, Wilder H, Bhagwagar Z, Geddes J. Inositol for depressive disorders (Cochrane Review). In: The Cochrane Library, Issue 3, 2004. Chichester, UK: John Wiley & Sons, Ltd.

back to: Alternative Treatments for Depression