Avoidant Personality Disorder: Boundaries of a Diagnosis
|
|
- Quentin Wilkins
- 6 years ago
- Views:
Transcription
1 July 01, 2006 By David C. Rettew, MD [1] A discussion of the epidemiology, assessment, diagnostic dilemmas, and treatment of avoidant personality. Avoidant personality (APD) is characterized by a general tendency to fear and avoid interactions even interactions with persons who are well known to the individual. In addition to deserving our clinical and research attention in its own right, APD highlights some of the key controversies with our current classification system. These debates include the "horizontal" boundaries between different Axis I and Axis II conditions as well as the "vertical" boundaries between a clinical and certain personality or temperamental traits. In pediatric psychiatry, use of the diagnosis underscores the conflict between the motivation to avoid Axis II diagnoses in children and adolescents and the motivation toward early identification and early intervention of psychiatric illness. In this article, I will briefly summarize some of the key components of APD, with a focus on epidemiology, assessment, diagnostic dilemmas, and treatment. Background and epidemiology DSM-IV defines APD as "a pervasive pattern of inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation that begins by early adulthood and is present in a variety of contexts." In persons with APD, the avoidance of, and restraint during, contact is the result of fears of rejection and humiliation. APD is one of the cluster C personality s, along with dependent and obsessive-compulsive personality s. The level of impairment associated with APD is high; employment, interpersonal relationships, and global functioning are all negatively affected. The morbidity associated with APD rivals and even exceeds that associated with such Axis I s as major depressive.1 APD is relatively common; the prevalence is about 5% in the community2 and nearly 15% among psychiatric outpatients.3 As such, APD is one of the most if not the most prevalent personality s. APD occurs about equally between males and females. Clinical course The symptoms of APD often appear early and the can be distinguished from other personality s by elementary school or even earlier. Adults with APD reported less involvement in extracurricular activities and sports, and were less popular than adults with another personality or major depression.4 Kagan5 and Hirshfeld and colleagues6 have characterized a temperamental trait labeled behavioral inhibition that applies to children who have a strong tendency to be shy and restrained in novel situations. Behavioral inhibition a potential precursor to later anxiety and avoidance has been reliably assessed in children 2 years old and perhaps even younger.5,7 Longitudinal research has demonstrated detectable, although certainly not inevitable, links between behavioral inhibition and many s in childhood and adolescence. These include anxiety and avoidant (as defined in DSM-III-R).7,8 Emotional s, such as anxiety, depression, and eating s, in adolescence predict cluster C personality s in adulthood in women.9 While there appears to be at least some continuity between adult APD and childhood symptoms, accumulating research is beginning to demonstrate a more waxing and waning course of APD symptoms through adulthood than had originally been expected. A 2-year prospective study from the Collaborative Longitudinal Personality Disorders Study found that over time, feelings of inadequacy and ineptness and the need to be certain of being liked before entering into situations were more stable than worries about shame and risks of exposure in one's employment.10 Page 1 of 5
2 Considerably less is known about APD as affected persons age. The is scarcely studied in geriatric psychiatry. Diagnosis in children and adolescents The finding in APD and other personality s that there is an onset of symptoms in childhood and adolescence represents a dilemma for many clinicians. On one hand, our training dictates the general principal of early identification and intervention to help avoid or reduce long-term suffering. At the same time, clinicians tend to avoid diagnosing personality s in children and adolescents.11 While the reasons for this practice are not entirely clear, the tendency may be based in part on the notion that a child's personality is still "in progress" and thus he or she should not be labeled as "ed" for fear of stigmatization. While this concept has some merit, it is also flawed. Symptoms of Axis I s, such as attention-deficit/hyperactivity, also tend to undergo change through the course of the person's development, yet this does not prevent clinicians from making a diagnosis at a particular point to allow for the amelioration of impairing symptoms. Furthermore, personality development does not stop when a patient reaches age 18. As for stigmatization, it is not intuitively obvious why a diagnosis of APD carries a higher burden than many other conditions that can be diagnosed before adulthood, such as anxiety. A final obstacle to diagnosing APD in children is the criterion that a cause for avoidance be identified (eg, fear or shame or embarrassment). Such a cause may be difficult to detect in younger children, whose self-consciousness is still developing. Etiology and neurobiology There has been little research into the cause and pathophysiology of APD per se, although much literature exists about related Axis I conditions or traits, such as shyness. Behavioral inhibition and other temperament traits like it (eg, harm avoidance) are thought to be related to overactivity of regions of the brain that are involved in the fear response. One recent study found evidence that high levels of harm avoidance were related to decreased coupling between the amygdala and the anterior cingulate gyrus which, in turn, may be related to genes involved in serotonin transmission.12 The heritability of behavioral inhibition ranges from 25% to 44%, as measured in toddlers.13 Interestingly, there is some evidence to support stronger genetic associations with the personality dimensions that may underlie APD than with the specific APD symptoms themselves.14 Assessment The differential diagnosis of APD (or its "horizontal" boundaries) includes mainly other psychiatric s. While there may be theoretical distinctions between APD and related diagnoses, these differences can be very difficult to untangle in practice, especially if one takes a developmental perspective of the patient. The Table lists some features that may distinguish other traits and s from APD. The main theoretical distinction between APD and both schizoid personality and an autistic spectrum is the notion that persons with APD very much want contact but are afraid to seek it out, while those with schizoid personality or an autistic spectrum are less intrinsically interested in contact. However, many individuals with an autistic spectrum do seek out human contact but struggle with how to achieve it. It is thus advisable to obtain a good developmental history if both of these s are being considered as alternatives to APD. Developmentally, it is also possible that over time a person with APD who initially craves contact will begin to settle into a pattern in which this contact is no longer sought. Another point of divergence between APD and an autistic relates to cues. Children with an autistic spectrum tend to ignore these cues, while those with APD are hypersensitive to them. Perhaps the greatest diagnostic dilemma pertains to the boundaries between APD and the general subtype of anxiety (GSAD). The diagnostic criteria overlap considerably. Attempts to find distinguishing characteristics in the epidemiology, physiology, and response to treatment have yielded little in the way of qualitative differences.15 Indeed, there may be more differentiation between the specific and generalized form of GSAD than between generalized GSAD and APD, despite their existence on different axes. Researchers have similarly been interested in the "vertical" boundaries between APD and established personality or temperamental traits, such as shyness. There certainly appears to be Page 2 of 5
3 significant overlap between certain s, such as APD, and specific personality dimensions. Nevertheless, the increasingly popular hypothesis that APD simply represents the extreme end of a normally distributed trait such as shyness appears to be overly simplistic. Studies of the relationship between shyness and generalized phobia show that many people with very high levels of shyness do not meet criteria for GSAD.16 This lack of continuity has stimulated researchers to begin looking for other features that could moderate the relationship between shyness and psychiatric s. These include other personality or temperament traits (such as emotion regulation) or specific cognitive factors that may exacerbate shyness into full-fledged APD. Assessment for APD is part of a general psychiatric evaluation; the condition should be suspected in patients in whom avoidance, fear of embarrassment, and intimacy difficulties are uncovered. Instruments to aid in the diagnosis of APD and other personality s continue to be refined, although their use in routine practice remains limited.17 As with most personality s, most patients who meet criteria for APD will meet criteria for other Axis I and Axis II conditions. Notable among these are Axis I anxiety and affective s, other cluster C s, and substance abuse. Treatment Treatment of APD involves psychotherapy and/or medication. Unfortunately, treatment studies rarely focus primarily on APD and instead analyze patients with APD as a subset of those with GSAD or other personality s.18 Given this limitation, multiple types of psychotherapy have been shown to be effective in adult APD, including cognitive- behavioral, psychodynamic, and supportive-expressive therapy No medications have been specifically approved for the management of APD. However, research has documented improvement in patients who meet criteria for both APD and anxiety when treated with selected serotonin reuptake inhibitors and benzodiazepines.22,23 Current recommendations include consideration of pharmacotherapy in APD, regardless of whether a patient meets criteria for a comorbid Axis I,24,25 although additional research in this area is sorely needed. Given the risk of substance use in APD, physicians should be cautious in prescribing benzodiazepines. Regardless of treatment modality, however, one of the keys to treatment success (as with other anxiety conditions) is exposure. Patients who simply take a medication or who speak with a therapist are not likely to report symptom relief before they take the risk of confronting their feared situations. Greater success can be anticipated if the therapist supports patients and encourages them to confront their fears. This can take the shape of a specific homework assignment within a cognitive-behavioral format or therapist support of the patient's willingness to risk intimacy and no longer be the "perfect patient" within a psychodynamically oriented framework. The bottom line APD is a relatively common condition that is associated with significant impairment in multiple domains. The boundaries of the both horizontally with other psychiatric diagnoses and vertically with personality dimensions such as shyness continue to be blurry and not well established. In particular, there seems to be little to qualitatively distinguish APD from the generalized type of anxiety. Research into the course of APD demonstrates the 's origin in early temperamental traits. Increasing data exist to suggest that during adulthood APD may be more changeable over time than originally thought. These data suggest that positive responses can occur with psychotherapy and/or medications. Table Avoidant personality : Comparative features of other psychiatric diagnoses Trait or Category Distinguishi ng features Page 3 of 5
4 Shyness Personality trait Less severity of features and lack of marked distress or impairment Generalized anxiety Axis I Almost none Autistic spectrum s Axis I Restricted interests; de velopmental delays; may be less interested in contact; und er-reading of cues rather than over-re ading Schizoid personality s Axis II Lack of interest in encounters; less worthle ssness and feelings of inadequacy Dr Rettew is assistant professor of psychiatry and pediatrics at the University of Vermont College of Medicine in Burlington. References 1. Skodol AE, Gunderson JG, McGlashan TH, et al. Functional impairment in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality. Am J Psychiatry. 2002;159: Torgersen S, Kringlen E, Cramer V. The prevalence of personality s in a community sample. Arch Gen Psychiatry. 2001;58: Zimmerman M, Rothschild L, Chelminski I. The prevalence of DSM-IV personality s in psychiatric outpatients. Am J Psychiatry. 2005;162: Rettew DC, Zanarini MC, Yen S, et al. Childhood antecedents of avoidant personality : a retrospective study. J Am Acad Child Adolesc Psychiatry. 2003;42: Kagan J. Galens Prophecy. Boulder, Colo: Westview Press; Hirshfeld DR, Rosenbaum JF, Biederman J, et al. Stable behavioral inhibition and its association with anxiety. J Am Acad Child Adolesc Psychiatry. 1992;31: Biederman J, Rosenbaum JF, Bolduc-Murphy EA, et al. A 3-year follow-up of children with and without behavioral inhibition. J Am Acad Child Adolesc Psychiatry. 1993;32: Schwartz CE, Snidman N, Kagan J. Adolescent anxiety as an outcome of inhibited temperament in childhood. J Am Acad Child Adolesc Psychiatry. 1999;38: Helgeland MI, Kjelsberg E, Torgersen S. Continuities between emotional and disruptive behavior s in adolescence and personality s in adulthood. Am J Psychiatry. 2005;162: Page 4 of 5
5 10. McGlashan TH, Grilo CM, Sanislow CA, et al. Two-year prevalence and stability of individual DSMIV criteria for schizotypal, borderline, avoidant, and obsessive-compulsive personality s: toward a hybrid model of axis II s. Am J Psychiatry. 2005;162: Kernberg PF, Weiner AS, Bardenstein KK. Personality Disorders in Children and Adolescents. New York: Basic Books; Pezawas L, Meyer-Lindenberg A, Drabant EM, et al. 5-HTTLPR polymorphism impacts human cingulate-amygdala interactions: a genetic susceptibility mechanism for depression. Nat Neurosci. 2005;8: Saudino KJ, Cherny SS. Sources of continuity and change in observed temperament. In: Emde RN, Hewitt JK, eds. Infancy to Early Childhood: Genetic and Environmental Influences on Developmental Change. New York: Oxford University Press; 2001: Jacob CP, Strobel A, Hohenberger K, et al. Association between allelic variation of serotonin transporter function and neuroticism in anxious cluster C personality s. Am J Psychiatry. 2004;161: Rettew DC. Avoidant personality, generalized phobia, and shyness: putting the personality back into personality s. Harv Rev Psychiatry. 2000;8: Chavira DA, Stein MB, Malcarne VL. Scrutinizing the relationship between shyness and phobia. J Anxiety Disord. 2002;16: Spitzer R, Williams JMG, Fyer AJ, et al. Structured Clinical Interview for DSM-III-R Personality Disorders. Washington, DC: American Psychiatric Press; Hofmann S, Newman M, Becker E, et al. Social phobia with and without avoidant personality : preliminary behavior therapy outcome findings. J Anxiety Disord. 1995;9: Svartberg M, Stiles TC, Seltzer MH. Randomized, controlled trial of the effectiveness of short-term dynamic psychotherapy and cognitive therapy for cluster C personality s. Am J Psychiatry. 2004;161: Leichsenring F, Leibing E. The effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality s: a metaanalysis. Am J Psychiatry. 2003;160: Vinnars B, Barber JP, Noren K, et al. Manualized supportive-expressive psychotherapy versus nonmanualized community-delivered psychodynamic therapy for patients with personality s: bridging efficacy and effectiveness. Am J Psychiatry. 2005; 162: Reich J, Noyes R Jr, Yates W. Alprazolam treatment of avoidant personality traits in phobic patients. J Clin Psychiatry. 1989;50: Seedat S, Stein MB. Double-blind, placebocontrolled assessment of combined clonazepam with paroxetine compared with paroxetine monotherapy for generalized anxiety. J Clin Psychiatry. 2004;65: Kapfhammer HP, Hippius H. Special feature: pharmacotherapy in personality s. J Personal Disord. 1998;12: Deltito JA, Stam M. Psychopharmacological treatment of avoidant personality. Compr Psychiatry. 1989;30: Source URL: Links: [1] Page 5 of 5
PROGRAM REQUIREMENTS FOR RESIDENCY EDUCATION IN DEVELOPMENTAL-BEHAVIORAL PEDIATRICS
In addition to complying with the Program Requirements for Residency Education in the Subspecialties of Pediatrics, programs in developmental-behavioral pediatrics also must comply with the following requirements,
More informationSTAFF DEVELOPMENT in SPECIAL EDUCATION
STAFF DEVELOPMENT in SPECIAL EDUCATION Factors Affecting Curriculum for Students with Special Needs AASEP s Staff Development Course FACTORS AFFECTING CURRICULUM Copyright AASEP (2006) 1 of 10 After taking
More informationMaximizing Learning Through Course Alignment and Experience with Different Types of Knowledge
Innov High Educ (2009) 34:93 103 DOI 10.1007/s10755-009-9095-2 Maximizing Learning Through Course Alignment and Experience with Different Types of Knowledge Phyllis Blumberg Published online: 3 February
More informationCurriculum Vitae of. JOHN W. LIEDEL, M.D. Developmental-Behavioral Pediatrician
Updated July 07, 2009 of JOHN W. LIEDEL, M.D. Developmental-Behavioral Pediatrician EDUCATIONAL AND PROFESSIONAL EXPERIENCE: Children's Program 7707 SW Capitol Hwy. 97219 August 1987 - Present The Children's
More informationGlobal Health Kitwe, Zambia Elective Curriculum
Global Health Kitwe, Zambia Elective Curriculum Title of Clerkship: Global Health Zambia Elective Clerkship Elective Type: Department(s): Clerkship Site: Course Number: Fourth-Year Elective Clerkship Psychiatry,
More informationChildren and Adults with Attention-Deficit/Hyperactivity Disorder Public Policy Agenda for Children
Children and Adults with Attention-Deficit/Hyperactivity Disorder Public Policy Agenda for Children 2008 2009 Accepted by the Board of Directors October 31, 2008 Introduction CHADD (Children and Adults
More informationGUIDELINES FOR COMBINED TRAINING IN PEDIATRICS AND MEDICAL GENETICS LEADING TO DUAL CERTIFICATION
GUIDELINES FOR COMBINED TRAINING IN PEDIATRICS AND MEDICAL GENETICS LEADING TO DUAL CERTIFICATION PREAMBLE This document is intended to provide educational guidance to program directors in pediatrics and
More informationNo Parent Left Behind
No Parent Left Behind Navigating the Special Education Universe SUSAN M. BREFACH, Ed.D. Page i Introduction How To Know If This Book Is For You Parents have become so convinced that educators know what
More informationImproving recruitment, hiring, and retention practices for VA psychologists: An analysis of the benefits of Title 38
Improving recruitment, hiring, and retention practices for VA psychologists: An analysis of the benefits of Title 38 Introduction / Summary Recent attention to Veterans mental health services has again
More informationDeveloping needs led child and adolescent mental health services: issues and prospects
European Child & Adolescent Psychiatry 8:1±10 (1999) Ó Steinkop Verlag 1999 REVIEW ARTICLE FOR DEBATE R.C. Harrington M. Kerfoot C. Verduyn Developing needs led child and adolescent mental health services:
More informationBayley scales of Infant and Toddler Development Third edition
Bayley scales of Infant and Toddler Development Third edition Carol Andrew, EdD,, OTR Assistant Professor of Pediatrics Dartmouth Hitchcock Medical Center Lebanon, New Hampshire, USA Revision goals Update
More informationN NEW YORK CITY COLLEGE OF TECHNOLOGY The City University of New York School of Arts & Sciences Department of Social Science Course Outline
Course code: PSY 2403 Course title: Abnormal Psychology Class hours/credits: 3 class hours, 3 credits Prerequisite: PSY 1101 Pathways: Individual and Society N NEW YORK CITY COLLEGE OF TECHNOLOGY The City
More informationIntroduction to Psychology
Course Title Introduction to Psychology Course Number PSYCH-UA.9001001 SAMPLE SYLLABUS Instructor Contact Information André Weinreich aw111@nyu.edu Course Details Wednesdays, 1:30pm to 4:15pm Location
More informationRecommended Guidelines for the Diagnosis of Children with Learning Disabilities
Recommended Guidelines for the Diagnosis of Children with Learning Disabilities Bill Colvin, Mary Sue Crawford, Oliver Foese, Tim Hogan, Stephen James, Jack Kamrad, Maria Kokai, Carolyn Lennox, David Schwartzbein
More informationLeprosy case detection using schoolchildren
Lepr Rev (2004) 75, 34±39 Leprosy case detection using schoolchildren G. NORMAN, G. A. JOSEPH, P. UDAYASURIYAN, P. SAMUEL & M. VENUGOPAL Schieffelin Leprosy Research and Training Center, Karigiri, Vellore
More informationBIOH : Principles of Medical Physiology
University of Montana ScholarWorks at University of Montana Syllabi Course Syllabi Spring 2--207 BIOH 462.0: Principles of Medical Physiology Laurie A. Minns University of Montana - Missoula, laurie.minns@umontana.edu
More informationClinical Review Criteria Related to Speech Therapy 1
Clinical Review Criteria Related to Speech Therapy 1 I. Definition Speech therapy is covered for restoration or improved speech in members who have a speechlanguage disorder as a result of a non-chronic
More information- COURSE DESCRIPTIONS - (*From Online Graduate Catalog )
DEPARTMENT OF COUNSELOR EDUCATION AND FAMILY STUDIES PH.D. COUNSELOR EDUCATION & SUPERVISION - COURSE DESCRIPTIONS - (*From Online Graduate Catalog 2015-2016) 2015-2016 Page 1 of 5 PH.D. COUNSELOR EDUCATION
More informationThe Complete Brain Exercise Book: Train Your Brain - Improve Memory, Language, Motor Skills And More By Fraser Smith
The Complete Brain Exercise Book: Train Your Brain - Improve Memory, Language, Motor Skills And More By Fraser Smith If searched for the ebook The Complete Brain Exercise Book: Train Your Brain - Improve
More informationMatthew Taylor Morris, Ph.D.
Matthew Taylor Morris, Ph.D. Home: 203 Prospect St. Blacksburg, VA 24060 (540) 922-2763 mmorris1@vt.edu MMorris@nrvcs.state.va.us ACADEMIC PREPARATION: Doctorate of Philosophy, Human Development, December
More informationSoaring With Strengths
chapter3 Soaring With Strengths I like being the way I am, being more reserved and quiet than most. I feel like I can think more clearly than many of my friends. Blake, Age 17 The last two chapters outlined
More informationProgram Alignment CARF Child and Youth Services Standards. Nonviolent Crisis Intervention Training Program
Program Alignment 2009 CARF Child and Youth Services Standards Manual: Section 2.G Nonviolent Practices & The goal is to eliminate the use of seclusion and restraint in child and youth services, as the
More informationSpecialists in Child and Adolescent Psychiatry
A Competency Based Curriculum for Specialist Training in Psychiatry Specialists in Child and Adolescent Psychiatry Royal College of Psychiatrists Approved 14 May 2013 (update approved 2 October 2014, revised
More informationStrategy for teaching communication skills in dentistry
Strategy for teaching communication in dentistry SADJ July 2010, Vol 65 No 6 p260 - p265 Prof. JG White: Head: Department of Dental Management Sciences, School of Dentistry, University of Pretoria, E-mail:
More informationSample Iep Goals For Anxiety
Sample Iep Goals For Anxiety Free PDF ebook Download: Sample Iep Goals For Anxiety Download or Read Online ebook sample iep goals for anxiety in PDF Format From The Best User Guide Database student have
More informationPh.D. in Behavior Analysis Ph.d. i atferdsanalyse
Program Description Ph.D. in Behavior Analysis Ph.d. i atferdsanalyse 180 ECTS credits Approval Approved by the Norwegian Agency for Quality Assurance in Education (NOKUT) on the 23rd April 2010 Approved
More informationGreek Teachers Attitudes toward the Inclusion of Students with Special Educational Needs
American Journal of Educational Research, 2014, Vol. 2, No. 4, 208-218 Available online at http://pubs.sciepub.com/education/2/4/6 Science and Education Publishing DOI:10.12691/education-2-4-6 Greek Teachers
More informationSpecial Education Services Program/Service Descriptions
Special Education Services Program/Service Descriptions SES Program/Service Characteristics Specially Designed Instruction Level Class Size Autism (AU) A developmental disability significantly affecting
More informationSpecial Educational Needs and Disability (SEND) Policy. November 2016
Special Educational Needs and Disability (SEND) Policy November 2016 This Policy complies with the statutory requirement laid out in the SEND Code of Practice 0 25 (January 2015) and has been written with
More informationTHE UNIVERSITY OF WESTERN ONTARIO. Department of Psychology
THE UNIVERSITY OF WESTERN ONTARIO LONDON CANADA Department of Psychology 2011-2012 Psychology 2301A (formerly 260A) Section 001 Introduction to Clinical Psychology 1.0 CALENDAR DESCRIPTION This course
More informationINTRODUCTION TO PSYCHOLOGY
INTRODUCTION TO PSYCHOLOGY General Information: Instructor: Email: Required Books: Supplemental Novels: Mr. Robert W. Dill rdill@fhrangers.org Spencer A. Rathus, Psychology: Principles in Practice. Austin,
More informationSpecial Educational Needs and Disabilities Policy Taverham and Drayton Cluster
Special Educational Needs and Disabilities Policy Taverham and Drayton Cluster Drayton Infant School Drayton CE Junior School Ghost Hill Infant School & Nursery Nightingale First School Taverham VC CE
More informationTomball College and Community Library Occupational Therapy Journals
Tomball College and Community Library Journals Reference Desk 832-559-4211 Reserve/Circulation Desk 832-559-4206 http://tclibrary.nhmccd.edu Updated 08/06 Activities, Adaptations 1990-1994 and Aging Adolescence
More informationAdvances in Assessment The Wright Institute*
3 2 1 Advances in Assessment Training @ The Wright Institute* Child Assessment The Wright Institute Assessment Clinic WI Sanctuary Project 2nd Year Assessment Program *Contact and Referral information
More informationEntrepreneurial Discovery and the Demmert/Klein Experiment: Additional Evidence from Germany
Entrepreneurial Discovery and the Demmert/Klein Experiment: Additional Evidence from Germany Jana Kitzmann and Dirk Schiereck, Endowed Chair for Banking and Finance, EUROPEAN BUSINESS SCHOOL, International
More informationGlenn County Special Education Local Plan Area. SELPA Agreement
Page 1 of 10 Educational Mental Health Related Services, A Tiered Approach Draft Final March 21, 2012 Introduction Until 6-30-10, special education students with severe socio-emotional problems who did
More informationYou said we did. Report on improvements being made to Children s and Adolescent Mental Health Services. December 2014
You said we did Report on improvements being made to Children s and Adolescent Mental Health Services December 2014 Bracknell and Ascot Clinical Commissioning Group Newbury and Community Clinical Commissioning
More informationFort Lauderdale Conference
Our Mission At Social Thinking, our mission is to help people develop their social competencies to better connect with others and live happier, more meaningful lives. We create unique treatment frameworks
More informationPost-intervention multi-informant survey on knowledge, attitudes and practices (KAP) on disability and inclusive education
Leonard Cheshire Disability and Inclusive Development Centre University College London Promoting the provision of inclusive primary education for children with disabilities in Mashonaland, West Province,
More informationMENTAL HEALTH FACILITATION SKILLS FOR EDUCATORS. Dr. Lindsey Nichols, LCPC, NCC
MENTAL HEALTH FACILITATION SKILLS FOR EDUCATORS Dr. Lindsey Nichols, LCPC, NCC Session Overview Introductions Understanding connection between mental health needs and academic success Common types of mental
More informationUNIVERSITY OF SOUTHERN MISSISSIPPI Department of Speech and Hearing Sciences SHS 726 Auditory Processing Disorders Spring 2016
UNIVERSITY OF SOUTHERN MISSISSIPPI Department of Speech and Hearing Sciences SHS 726 Auditory Processing Disorders Spring 2016 Class 10902, Section H001-LEC Regular, Credit Hours: 3, Room: JBG 202 Meeting
More information2. CONTINUUM OF SUPPORTS AND SERVICES
Continuum of Supports and Services 2. CONTINUUM OF SUPPORTS AND SERVICES This section will review a five-step process for accessing supports and services examine each step to determine who is involved
More informationLongitudinal family-risk studies of dyslexia: why. develop dyslexia and others don t.
The Dyslexia Handbook 2013 69 Aryan van der Leij, Elsje van Bergen and Peter de Jong Longitudinal family-risk studies of dyslexia: why some children develop dyslexia and others don t. Longitudinal family-risk
More informationBiomedical Sciences (BC98)
Be one of the first to experience the new undergraduate science programme at a university leading the way in biomedical teaching and research Biomedical Sciences (BC98) BA in Cell and Systems Biology BA
More informationThesis-Proposal Outline/Template
Thesis-Proposal Outline/Template Kevin McGee 1 Overview This document provides a description of the parts of a thesis outline and an example of such an outline. It also indicates which parts should be
More informationPREP S SPEAKER LISTENER TECHNIQUE COACHING MANUAL
1 PREP S SPEAKER LISTENER TECHNIQUE COACHING MANUAL IMPORTANCE OF THE SPEAKER LISTENER TECHNIQUE The Speaker Listener Technique (SLT) is a structured communication strategy that promotes clarity, understanding,
More informationDevelopmental coordination disorder DCD. Overview. Gross & fine motor skill. Elisabeth Hill The importance of motor development
Developmental coordination disorder Overview The importance of motor development Elisabeth Hill e.hill@gold.ac.uk DCD Developmental coordination disorder: Diagnosis Behaviour, brain & Intervention Gross
More informationA Game-based Assessment of Children s Choices to Seek Feedback and to Revise
A Game-based Assessment of Children s Choices to Seek Feedback and to Revise Maria Cutumisu, Kristen P. Blair, Daniel L. Schwartz, Doris B. Chin Stanford Graduate School of Education Please address all
More informationNCEO Technical Report 27
Home About Publications Special Topics Presentations State Policies Accommodations Bibliography Teleconferences Tools Related Sites Interpreting Trends in the Performance of Special Education Students
More informationShyness and Technology Use in High School Students. Lynne Henderson, Ph. D., Visiting Scholar, Stanford
Shyness and Technology Use in High School Students Lynne Henderson, Ph. D., Visiting Scholar, Stanford University Philip Zimbardo, Ph.D., Professor, Psychology Department Charlotte Smith, M.S., Graduate
More informationTHE USE OF TINTED LENSES AND COLORED OVERLAYS FOR THE TREATMENT OF DYSLEXIA AND OTHER RELATED READING AND LEARNING DISORDERS
FC-B204-040 THE USE OF TINTED LENSES AND COLORED OVERLAYS FOR THE TREATMENT OF DYSLEXIA AND OTHER RELATED READING AND LEARNING DISORDERS Over the past two decades the use of tinted lenses and colored overlays
More informationED 294 EDUCATIONAL PSYCHOLOGY
ED 294 EDUCATIONAL PSYCHOLOGY Readings and Website Information Required Text: Moreno, R. (2010). Educational Psychology. Hoboken, NJ: John Wiley & Sons Inc. Course Materials/Grades: Syllabus, Daily Outlines,
More informationEarly Warning System Implementation Guide
Linking Research and Resources for Better High Schools betterhighschools.org September 2010 Early Warning System Implementation Guide For use with the National High School Center s Early Warning System
More informationUniversity of Arkansas at Little Rock Graduate Social Work Program Course Outline Spring 2014
University of Arkansas at Little Rock Graduate Social Work Program Course Outline Spring 2014 Number and Title: Semester Credits: 3 Prerequisite: SOWK 8390, Advanced Direct Practice III: Social Work Practice
More informationDisability Resource Center (DRC)
DISABILITY RESOURCE CENTER & DEAF AND HARD OF HEARING SERVICES College of Southern Nevada Disability Resource Center (DRC) Prospective Student General Information Packet NORTH LAS VEGAS OFFICE SORT CODE
More informationLongitudinal Integrated Clerkship Program Frequently Asked Questions
Longitudinal Integrated Clerkship Program Frequently Asked Questions The University of Vermont Larner College of Medicine offers a rural longitudinal integrated clerkship (LIC) at the Hudson Headwaters
More informationM.Ed. (1996) Arizona State University (APA & NASP Accredited) Tempe, Arizona (Main Campus) Educational Psychology Major GPA: 3.9 / 4.
Education: Sipsas-Herrmann - 1 Curriculum Vitae Sia Sipsas-Herrmann Licensed Psychologist Certified School Psychologist 10210 N. 32 nd Street, Building C / Suite # 213, Phoenix, AZ 85028 (602) 824-8804
More informationSpecial Educational Needs & Disabilities (SEND) Policy
Thamesmead School Special Educational Needs & Disabilities (SEND) Policy 2016-2017 Person Responsible Governors Committee Review Period P.Rodin Standards & Performance Annually Date of Review July 2016
More informationExaminee Information. Assessment Information
A WPS TEST REPORT by Patti L. Harrison, Ph.D., and Thomas Oakland, Ph.D. Copyright 2010 by Western Psychological Services www.wpspublish.com Version 1.210 Examinee Information ID Number: Sample-02 Name:
More informationExecutive Summary. Abraxas Naperville Bridge. Eileen Roberts, Program Manager th St Woodridge, IL
Eileen Roberts, Program Manager 2221 64th St Woodridge, IL 60517-2180 Document Generated On January 18, 2017 TABLE OF CONTENTS Introduction 1 Description of the School 2 School's Purpose 4 Notable Achievements
More informationParamedic Science Program
Paramedic Science Program Paramedic Science Program Faculty Chair Michael Mikitish Chair, Emergency Services Department Emergency Medical Services (EMS) An Associate of Science degree in Paramedic Science
More informationUnderstanding and Changing Habits
Understanding and Changing Habits We are what we repeatedly do. Excellence, then, is not an act, but a habit. Aristotle Have you ever stopped to think about your habits or how they impact your daily life?
More informationHierarchical Linear Models I: Introduction ICPSR 2015
Hierarchical Linear Models I: Introduction ICPSR 2015 Instructor: Teaching Assistant: Aline G. Sayer, University of Massachusetts Amherst sayer@psych.umass.edu Holly Laws, Yale University holly.laws@yale.edu
More informationDeveloped by Dr. Carl A. Ferreri & Additional Concepts by Dr. Charles Krebs. Expanded by
Name Date Advanced I Workshop Manual Language Processing and Brain Integration Developed by Dr. Carl A. Ferreri & Additional Concepts by Dr. Charles Krebs Expanded by Dr. Mitchell Corwin 2914 Domingo Ave
More informationCoping with Crisis Helping Children With Special Needs
Traumatic Loss Coalitions for Youth Phone: 732-235-2810 Fax: 732-235-9861 http://ubhc.rutgers.edu/tlc Coping with Crisis Helping Children With Special Needs Tips for School Personnel and Parents * National
More informationEarl of March SS Physical and Health Education Grade 11 Summative Project (15%)
Earl of March SS Physical and Health Education Grade 11 Summative Project (15%) Student Name: PPL 3OQ/P - Summative Project (8%) Task 1 - Time and Stress Management Assignment Objective: To understand,
More informationDyslexia/LD Attention Deficit Disorders
and Dyslexia/LD Attention Deficit Disorders Groundbreaking Understanding, Diagnosis and Treatment Harold N. Levinson, M.D. V i s i t u s o n l i n e a t w w w. d y s l e x i a o n l i n e. c o m The Breakthrough!
More informationSummary / Response. Karl Smith, Accelerations Educational Software. Page 1 of 8
Summary / Response This is a study of 2 autistic students to see if they can generalize what they learn on the DT Trainer to their physical world. One student did automatically generalize and the other
More informationCORRELATION FLORIDA DEPARTMENT OF EDUCATION INSTRUCTIONAL MATERIALS CORRELATION COURSE STANDARDS / BENCHMARKS. 1 of 16
SUBJECT: Career and Technical Education GRADE LEVEL: 9, 10, 11, 12 COURSE TITLE: COURSE CODE: 8909010 Introduction to the Teaching Profession CORRELATION FLORIDA DEPARTMENT OF EDUCATION INSTRUCTIONAL MATERIALS
More informationDISABILITY RESOURCE CENTER STUDENT HANDBOOK DRAFT
DISABILITY RESOURCE CENTER STUDENT HANDBOOK DRAFT Rev. 8/2014 TABLE OF CONTENTS UNIVERSITY OF THE DISTRICT OF COLUMBIA DISABILITY RESOURCE CENTER... 1 UNIVERSITY COMMITMENT... 1 RIGHTS AND RESPONSIBILITIES
More informationClinical Child Psychology Postdoctoral Fellowship
The Clinical Child Psychology Postdoctoral Fellowship Children s Hospital Los Angeles University Center for Excellence in Developmental Disabilities Clinical Child Psychology Postdoctoral Fellowship 2014-2015
More informationSection on Pediatrics, APTA
Section on Pediatrics, APTA Pediatric Residency and Fellowship Development Resource Manual Section on Pediatrics, APTA 1111 North Fairfax Street Alexandria, VA 22314-1488 Phone 800/999-2782, ext 3254 E-mail:
More information(2) GRANT FOR RESIDENTIAL AND REINTEGRATION SERVICES.
Code: IDDF (18) 160-4-7-.18 GRANTS FOR SERVICES. (1) AUTHORIZATION. (a) The State Board shall have authority to provide grant funds for the implementation of other educational programs or additional personnel
More informationThe Journey to Vowelerria VOWEL ERRORS: THE LOST WORLD OF SPEECH INTERVENTION. Preparation: Education. Preparation: Education. Preparation: Education
VOWEL ERRORS: THE LOST WORLD OF SPEECH INTERVENTION The Journey to Vowelerria An adventure across familiar territory child speech intervention leading to uncommon terrain vowel errors, Ph.D., CCC-SLP 03-15-14
More informationAll Kinds of Minds. Web-site: To Contact NY Student Success Center. or
All Kinds of Minds Web-site: www.allkindsofminds.org To Contact NY Student Success Center sspny@allkindsofminds.org or 646.775.6677 To Contact Schools Attuned mdahm@allkindsofminds.org or 646.775.6663
More informationjpr / report Learning Disabilities: Understanding their prevalence in the British Jewish community L. Daniel Staetsky
jpr / report Institute for Jewish Policy Research February 2017 Learning Disabilities: Understanding their prevalence in the British Jewish community L. Daniel Staetsky The Institute for Jewish Policy
More informationAssessing Student Learning in the Major
Assessing Student Learning in the Major Bob Smallwood University of North Florida 7 th Annual Texas A&M University Assessment Conference February 22-23, 2007 Presentation Objectives I. Steps in Developing
More informationFurther, Robert W. Lissitz, University of Maryland Huynh Huynh, University of South Carolina ADEQUATE YEARLY PROGRESS
A peer-reviewed electronic journal. Copyright is retained by the first or sole author, who grants right of first publication to Practical Assessment, Research & Evaluation. Permission is granted to distribute
More informationSchool Inspection in Hesse/Germany
Hessisches Kultusministerium School Inspection in Hesse/Germany Contents 1. Introduction...2 2. School inspection as a Procedure for Quality Assurance and Quality Enhancement...2 3. The Hessian framework
More informationReviewed December 2015 Next Review December 2017 SEN and Disabilities POLICY SEND
Reviewed December 2015 Next Review December 2017 SEN and Disabilities POLICY SEND Bewdley Primary School is committed to safeguarding and promoting the welfare of children and young people and expects
More information1. Introduction. Keywords Positive Behavioural Support, Fostering, Desirable Behaviour, Adolescent, Emotional Behavioural Disorder
International Journal of Psychology and Behavioral Sciences 2014, 4(3): 98-105 DOI: 10.5923/j.ijpbs.20140403.03 Fostering Desirable Behaviour among Secondary School Adolescents with Emotional and Behavioural
More informationTun your everyday simulation activity into research
Tun your everyday simulation activity into research Chaoyan Dong, PhD, Sengkang Health, SingHealth Md Khairulamin Sungkai, UBD Pre-conference workshop presented at the inaugual conference Pan Asia Simulation
More informationConsultation skills teaching in primary care TEACHING CONSULTING SKILLS * * * * INTRODUCTION
Education for Primary Care (2013) 24: 206 18 2013 Radcliffe Publishing Limited Teaching exchange We start this time with the last of Paul Silverston s articles about undergraduate teaching in primary care.
More informationCOUNSELING PSYCHOLOGY 748 ADVANCED THEORY OF GROUP COUNSELING WINTER, 2016
Instructor: Robert L. Gleave, Ph.D. Office Phone: 422-3035 COUNSELING PSYCHOLOGY 748 ADVANCED THEORY OF GROUP COUNSELING WINTER, 2016 Required Reading: Yalom, I.D. (2005). The Theory and Practice of Group
More informationSecond Step Suite and the Whole School, Whole Community, Whole Child (WSCC) Model
Second Step Suite and the Whole School, Whole Community, Whole Child (WSCC) Model suite The Second Step Suite and the WSCC model share the common goals of supporting the safety, well-being, and success
More informationGlobal Health Interprofessional Program Summer Zambia
Global Health Interprofessional Program Summer 2018 - Zambia Title of Proposed Project School Faculty name Appointed department(s) Assessment of medical and pharmacy student knowledge of antimicrobial
More informationSUPPORTING AND EDUCATING TRAUMATIZED STUDENTS. CSSP Conference 2014 Barb Bieber
SUPPORTING AND EDUCATING TRAUMATIZED STUDENTS CSSP Conference 2014 Barb Bieber IS TRAUMA AN EPIDEMIC? It s widespread - affecting more than 20% of the population It s effects are far-reaching It s influences
More informationBIOGRAPHICAL SKETCH. DEGREE (if applicable)
BIOGRAPHICAL SKETCH Provide the following information for the Senior/key personnel and other significant contributors in the order listed on Form Page 2. Follow this format for each person. DO NOT EXCEED
More informationPost Test Attendance Record for online program and evaluation (2 pages) Complete the payment portion of the Attendance Record and enclose payment
Thank you for choosing MSU School of Social Work for your continuing education needs. You are only a few steps away from earning online continuing education credit! Step 1. Download the Understanding the
More informationCognitive Apprenticeship Statewide Campus System, Michigan State School of Osteopathic Medicine 2011
Statewide Campus System, Michigan State School of Osteopathic Medicine 2011 Gloria Kuhn, DO, PhD Wayne State University, School of Medicine The is a method of teaching aimed primarily at teaching the thought
More informationLaurie Mercado Gauger, Ph.D., CCC-SLP
CONTACT INFORMATION Laurie Mercado Gauger, Ph.D., CCC-SLP Curriculum Vitae Address University of Florida College of Public Health and Health Professions Department of Speech, Language, and Hearing Sciences
More informationEDF 6211: Educational Psychology: Applied Foundations Classroom GC (Graham Center 287-B)
EDF 6211: Educational Psychology: Applied Foundations Classroom GC (Graham Center 287-B) Professor: Dr. Martha Peláez Office Number: 348-2090; COE 242-B Spring 2009 Class Hrs: Thursdays 5:00 7:40 pm Web
More informationPrevalence of Oral Reading Problems in Thai Students with Cleft Palate, Grades 3-5
Prevalence of Oral Reading Problems in Thai Students with Cleft Palate, Grades 3-5 Prajima Ingkapak BA*, Benjamas Prathanee PhD** * Curriculum and Instruction in Special Education, Faculty of Education,
More informationCURRICULUM VITAE. COLLEEN M. SANDOR, Ph.D.
CURRICULUM VITAE COLLEEN M. SANDOR, Ph.D. Department of Psychology, Westminster College 1840 South 1300 East Salt Lake City, UT 84105 csandor@westminstercollege.edu Academic Positions 2014-Present Professor
More informationExamining the Use of Play Activities to Increase Appropriate Classroom Behaviors
Examining the Use of Play Activities to Increase Appropriate Classroom Behaviors Kallie B. Allen and Catherine R. Barber University of St. Thomas This 1-group pretest posttest quasi-experimental study
More informationThe Effect of Extensive Reading on Developing the Grammatical. Accuracy of the EFL Freshmen at Al Al-Bayt University
The Effect of Extensive Reading on Developing the Grammatical Accuracy of the EFL Freshmen at Al Al-Bayt University Kifah Rakan Alqadi Al Al-Bayt University Faculty of Arts Department of English Language
More informationOpen Dialogues in social networks: professional identity and transdisciplinary collaboration
International Journal of Integrated Care ISSN 1568-4156 Volume 10, 16 September 2010 URL:http://www.ijic.org URN:NBN:NL:UI:10-1-100956 Publisher: Igitur, Utrecht Publishing & Archiving Services Copyright:
More informationReviewed by Florina Erbeli
reviews c e p s Journal Vol.2 N o 3 Year 2012 181 Kormos, J. and Smith, A. M. (2012). Teaching Languages to Students with Specific Learning Differences. Bristol: Multilingual Matters. 232 p., ISBN 978-1-84769-620-5.
More informationLife Span Development HDCN 6320 Section 775
Life Span Development HDCN 6320 Section 775 August 4, 2015 October 9, 2015 Thursday 6:00 PM 10:15 PM Lecturer: Terrie L. Naramor, Ph.D. Email: ; tnaramor@smu.edu Phone: or Office Hours: By appointment
More informationWELCOME! Of Social Competency. Using Social Thinking and. Social Thinking and. the UCLA PEERS Program 5/1/2017. My Background/ Who Am I?
Social Thinking and the UCLA PEERS Program Joan Storey Gorsuch, M.Ed. Social Champaign Champaign, Illinois j.s.gorsuch@gmail.com WELCOME! THE And Using Social Thinking and the UCLA PEERS Program Of Social
More information