Sleepless and Sleepy Children with Autistic Spectrum Disorders

Size: px
Start display at page:

Download "Sleepless and Sleepy Children with Autistic Spectrum Disorders"

Transcription

1 Sleepless and Sleepy Children with Autistic Spectrum Disorders Dr Paul Gringras Consultant in Paediatric Neurodisability Director Paediatric Sleep Clinic Paediatric Neurosciences Guys and St Thomas s NHS Foundation Trust

2 Topics Why children need sleep Measuring sleep and impact of poor sleep Sleep problems in Autism Some behavioural treatments Some medication treatments What happens to childhood sleep problems in adults

3 Why bother with sleep?

4 Slumber parties Impaired verbal creativity Specific working memory tasks Increased aggressive and social problems Even loss of one hours sleep per night

5 Impact of sleep problems: Physical Growth: disruption of normal growth hormone release during sleep Immune function: sleep deprivation impairs host defenses; infection induces somnogenic cytokines Endocrine system regulation: cortisol, prolactin thyroid Metabolic regulation: obesity/metabolic syndrome linked to sleep deprivation Injuries more common in sleepy children

6 Measuring sleep and its effects in children

7 Investigations Consider Paediatric sleep questionnaire Diary Home video Home actigraphy Home oximetry plus actigraphy PSG-still ideally home based

8 Why do children with autism sleep particularly badly? 20% of our referrals have autism (n=300) A range of sleep phenotypes Studies report sleep problems in 44-83% Sleep onset insomnia Sleep fragmentation REM Sleep Behaviour Disorders Parasomnias Sleep disordered breathing Circadian rhythm disorders Periodic limb movement disorder Melatonin ligand/receptor problems All have different causes, and require different interventions

9 Behavioral Sleep Disorders: Management Extinction: cry it out, limited parental acceptance but most effective Graduated extinction: Use of timed checks Scheduled awakenings Systematic desensitization for fears Preventative education for parents

10 Evidence for behavioural interventions >420 children in 4 studies that showed extinction or graduated extinction works Evidence in children with learning difficulties that an information booklet can be as effective as therapy In most studies, across most conditions, behavioural input achieves an effect size of >0.6 Mindell JA. J Pediatr Psychol Kuhn BR, Elliott AJ. J Psychosomatic Res Weiss 2005 ACAP conference proceedings Montgomery 2004 Child neurology and disability

11 Behavioural Interventions Are addressing behavioural components, not sleep physiology Interventions that actually change the child s sleep. Interventions that do not actually change the child s sleep, but result in the child no longer disrupting the parents Positive changes most likely if extinction used, with potential for temporary extreme deteriorations.

12 Response to behavioural interventions Usually Pre-sleep disruptions Falling asleep alone Disturbing night wakings Co-sleeping Rarely Sleep latency Sleep duration Early morning wakening Night rocking

13 Light, sleep phase and genes

14 Delayed sleep phase -listening to the children I m just not tired when they want me to go to bed I always work best at night when its dark Once I fall asleep I sleep really well I love a long sleep in on the weekend Holidays are fine

15 Sleep diary for at least two weeks Actigraphy for at least two weeks Delayed Sleep Phase Dim light melatonin onset measurement Diagnosis

16 Treatments No Naps! Anchor morning wake-up time Chronotherapy Light therapy Melatonin (phase advance, not as a soperific)

17 Paediatric non 24 hr PER3 This gene is a member of the Period family of genes and is expressed in a circadian pattern in the suprachiasmatic nucleus, the primary circadian pacemaker in the mammalian brain Within UK population:10% have a long version (lark) 45% have a short version (owl) 45% are a mixture

18 Paediatric non 24 hr ASMT ASMT encodes the last enzyme of melatonin synthesis and is often absent or mutated in ASD Low melatonin levels often reported in ASD however: Low melatonin not diagnostic of ASD direct role of melatonin on modulation of neuronal networks unknown Could explain the high prevalence of sleep disturbance in ASD

19 Genetics of melatonin Highly heritable Mutations in ASMT lead to low levels of melatonin and sleep disorders Increased in populations with learning disability and autism Enzyme synthesising genes TPH2, AA-NAT, ASMT Melatonin receptor genes MTNR1A, MTNR1B, GPR50 ASD and Learning Difficulty Genes NLGN, MAOA, MAOB, COMT, SLC6A4, GABAR Melke J, et al. Abnormal Melatonin Synthesis in Autism and Hyperactivity. Molecular Psychiatry 2007

20 Pre and post Treatment 6yr old girl with autistic spectrum disorder Presented with difficulties initiating and maintaining sleep Behavioural intervention and Melatonin (liquid 6mg) have improved sleep initiation? Awakenings still a problem

21 Survey of UK Melatonin Experience 142 respondents each with an average of eight children on melatonin Total number of children ~1900 Dose 0.5 mg-24 mg Maintenance 6-9mg (25-75 interquartile range) Age range 1-21 years 50% sleep onset problems, 10% sleep maintenance Most had tried sleep hygiene, antihistamines or chloral hydrate first -Gringras Waldron,Bramble,Gringras 2005

22 Presenting Disorder Percentage Autism ADHD LD Visual I

23 Clinical impression of response Never Rarely Usually Always Percentage

24 12 UK Centres and the Pasteur Institute 350 Children (200 Autism) 170 RCT melatonin 0.5mg-12mg Actigraphy and sleep diaries Daytime measures behaviour and cognition Salivary melatonin and DNA analysis

25 Contact: Southern centres :Northern centres Nottingham Liverpool Manchester Bristol Oxford Derby/ Chesterfield Birmingham London Guys and St Thomas/St Georges/Great Ormond Street/Royal Free hospital

26 Long-term outcomes

27 Why do people think sleep problems disappear? In conclusion our study indicates that objective sleep disturbances are still present in adolescents and young adults with autistic disorder or Asperger Syndrome, although sleep problems are less frequently reported by parents or caretakers after childhood. The main finding of the present study is that adults with ASD who do not have spontaneous sleep complaints nevertheless show subjectively and objectively measured sleep disturbance.

28 Study Ref Age Range (mean) Sleep Latency (mins) Total Sleep Time Sleep Efficiency (%) Night Wakings Elia Reduced by 1hr 15 minutes in ASD Diomedi (18) 81% ASD vs 92% controls 11.4 ASD vs 4.2 controls Oyane % Tani ASD vs 31 controls 84.4 ASD vs 91.5 controls Limoges years (21.1) vs ns

29 Medications that disrupt sleep Anticonvulsants Phenytoin/lamotrigine Beta-blockers SSRI Decongestants Antihistamines Corticosteroids Theophylline Sulfasalazine

30 Insomnia medications with poor evidence base in children Clonidine Tricyclics Trazodone Benzodiazepines Zolpidem/zopiclone Zalepon

31

A Healthy Life RETT SYNDROME AND SLEEP. Exercise. Sleep. Diet 1. WHY SLEEP? 4. ARE SLEEP PROBLEMS A COMMON PARENT COMPLAINT?

A Healthy Life RETT SYNDROME AND SLEEP. Exercise. Sleep. Diet 1. WHY SLEEP? 4. ARE SLEEP PROBLEMS A COMMON PARENT COMPLAINT? Diet Sleep Exercise RETT SYNDROME AND SLEEP DR. DANIEL GLAZE, MEDICAL DIRECTOR THE BLUE BIRD CIRCLE RETT CENTER A good night s sleep promotes learning, improved mood, general good health, and a better

More information

SLEEP DISTURBANCE AND PSYCHIATRIC DISORDERS

SLEEP DISTURBANCE AND PSYCHIATRIC DISORDERS E-Resource December, 2013 SLEEP DISTURBANCE AND PSYCHIATRIC DISORDERS Between 10-18% of adults in the general population and up to 50% of adults in the primary care setting have difficulty sleeping. Sleep

More information

Effective Treatment of Sleep Problems for Children with ASD

Effective Treatment of Sleep Problems for Children with ASD Effective Treatment of Sleep Problems for Children with ASD Dennis R Dixon, Ph.D. Center for Autism & Related Disorders, Inc. Normal Sleep What is Sleep? Sleep is a brain process Yet effected by environmental

More information

Primary Care Management of Sleep Complaints in Adults

Primary Care Management of Sleep Complaints in Adults Scope Primary Care Management of Sleep Complaints in Adults (Revised 2004) This guideline is for the primary care management of non-respiratory sleep disorders in adults and follows the DSM-IV-TR classification

More information

Neurological causes of excessive daytime sleepiness. Professor Adam Zeman Royal Devon and Exeter Hospital University of Exeter Medical School

Neurological causes of excessive daytime sleepiness. Professor Adam Zeman Royal Devon and Exeter Hospital University of Exeter Medical School Neurological causes of excessive daytime sleepiness Professor Adam Zeman Royal Devon and Exeter Hospital University of Exeter Medical School Excessive daytime sleepiness Physiological sleep deprivation,

More information

Sleep Medicine. Maintenance of Certification Examination Blueprint. Purpose of the exam

Sleep Medicine. Maintenance of Certification Examination Blueprint. Purpose of the exam Sleep Medicine Maintenance of Certification Examination Blueprint Purpose of the exam The exam is designed to evaluate the knowledge, diagnostic reasoning, and clinical judgment skills expected of the

More information

Medical Information to Support the Decisions of TUECs INTRINSIC SLEEP DISORDERS

Medical Information to Support the Decisions of TUECs INTRINSIC SLEEP DISORDERS Introduction Excessive daytime sleepiness (EDS) is a common complaint. Causes of EDS are numerous and include: o Intrinsic sleep disorders (e.g. narcolepsy, obstructive sleep apnoea/hypopnea syndrome (OSAHS)

More information

Nursing Interventions for Sleep Disorders Following TBI

Nursing Interventions for Sleep Disorders Following TBI Nursing Interventions for Sleep Disorders Following TBI Kadesha Clark, RN BSN When you sleep, your body rests and restores its energy levels. A good night's sleep is often the best way to help you cope

More information

Headache and Sleep Disorders 屏 東 基 督 教 醫 院 沈 秀 祝

Headache and Sleep Disorders 屏 東 基 督 教 醫 院 沈 秀 祝 Headache and Sleep Disorders 屏 東 基 督 教 醫 院 沈 秀 祝 Sleep Sleeping later Sleep deprivation Excessive Sleep Sleep Migraine Physiology of sleep Headache Clinical, Anatomical, and Physiologic Relationship Between

More information

Consequences of Excessive Daytime Sleepiness

Consequences of Excessive Daytime Sleepiness Transcript Details This is a transcript of an educational program accessible on the ReachMD network. Details about the program and additional media formats for the program are accessible by visiting: https://reachmd.com/programs/clinicians-roundtable/consequences-of-excessive-daytimesleepiness/1904/

More information

Poor sleep/sleepiness in teenagers

Poor sleep/sleepiness in teenagers Poor sleep/sleepiness in teenagers what causes it how to assess it what can be done to help Dorothy Bruck Professor of Psychology 1 My aim today. Help you know what to ask make differential assessments

More information

Recognizing and Treating Depression in Children and Adolescents.

Recognizing and Treating Depression in Children and Adolescents. Recognizing and Treating Depression in Children and Adolescents. KAREN KANDO, MD Division of Child and Adolescent Psychiatry Center for Neuroscience and Behavioral Medicine Phoenix Children s Hospital

More information

Clinical Practice Guidelines: Attention Deficit/Hyperactivity Disorder

Clinical Practice Guidelines: Attention Deficit/Hyperactivity Disorder Clinical Practice Guidelines: Attention Deficit/Hyperactivity Disorder AACAP Official Action: OUTLINE OF PRACTICE PARAMETERS FOR THE ASSESSMENT AND TREATMENT OF CHILDREN, ADOLESCENTS, AND ADULTS WITH ADHD

More information

Sleep Difficulties. Insomnia. By Thomas Freedom, MD and Johan Samanta, MD

Sleep Difficulties. Insomnia. By Thomas Freedom, MD and Johan Samanta, MD Sleep Difficulties By Thomas Freedom, MD and Johan Samanta, MD For most people, night is a time of rest and renewal; however, for many people with Parkinson s disease nighttime is a struggle to get the

More information

SLEEP AND PARKINSON S DISEASE

SLEEP AND PARKINSON S DISEASE A Practical Guide on SLEEP AND PARKINSON S DISEASE MICHAELJFOX.ORG Introduction Many people with Parkinson s disease (PD) have trouble falling asleep or staying asleep at night. Some sleep problems are

More information

Dosage (total number of sessions) Delivered to

Dosage (total number of sessions) Delivered to Population Authors & year Design Intervention (I) and Comparison (C) Mean age (SD) 1 Gender (%) Delivered to Dosage (total number of sessions) Primary Outcome domain (Measure(s)) Secondary Outcome domain

More information

Behavioral Approaches To The Treatment Of Sleep Problems In Children with Developmental Disorders: What Is The State Of The Art?

Behavioral Approaches To The Treatment Of Sleep Problems In Children with Developmental Disorders: What Is The State Of The Art? Behavioral Approaches To The Treatment Of Sleep Problems In Children with Developmental Disorders: What Is The State Of The Art? Amanda Richdale & Luci Wiggs This paper reviews behavioral treatments for

More information

Attention, memory and learning and acquired brain injury. Vicki Anderson. Jamie M. Attention & learning: an information processing model

Attention, memory and learning and acquired brain injury. Vicki Anderson. Jamie M. Attention & learning: an information processing model Attention, memory and learning and acquired brain injury Vicki Anderson Jamie M. Childhood acquired amnesia Attention & learning: an information processing model MANAGEMENT Organising, problem solving

More information

ASSESSMENT AND TREATMENT OF PEDIATRIC INSOMNIA

ASSESSMENT AND TREATMENT OF PEDIATRIC INSOMNIA ASSESSMENT AND TREATMENT OF PEDIATRIC INSOMNIA David Camenisch, MD/MPH PAL Conference Sheridan, WY Disclosure Statement No relevant financial relationships with the manufacturer(s) of any commercial product(s)

More information

Obsessive Compulsive Disorder: a pharmacological treatment approach

Obsessive Compulsive Disorder: a pharmacological treatment approach Obsessive Compulsive Disorder: a pharmacological treatment approach Professor Alasdair Vance Head, Academic Child Psychiatry Department of Paediatrics University of Melbourne Royal Children s Hospital

More information

Neuropsychological assessment clinic

Neuropsychological assessment clinic Neuropsychological assessment clinic Information for families and professionals Ealing child and adolescent mental health service Learning disabilities (CAMHS-LD) August 2014 What is a neuropsychological

More information

General Information about Sleep Studies and What to Expect

General Information about Sleep Studies and What to Expect General Information about Sleep Studies and What to Expect Why do I need a sleep study? Your doctor has ordered a sleep study because your doctor is concerned you may have a sleep disorder that is impacting

More information

UNMH Sleep Medicine Clinical Privileges

UNMH Sleep Medicine Clinical Privileges o Initial privileges (initial appointment) o Renewal of privileges (reappointment) o Expansion of privileges (modification) All new applicants must meet the following requirements as approved by the UNMH

More information

Sleep Medicine and Psychiatry. Roobal Sekhon, D.O.

Sleep Medicine and Psychiatry. Roobal Sekhon, D.O. Sleep Medicine and Psychiatry Roobal Sekhon, D.O. Common Diagnoses Mood Disorders: Depression Bipolar Disorder Anxiety Disorders PTSD and other traumatic disorders Schizophrenia Depression and Sleep: Overview

More information

Supplements in Psychiatry: N-Acetylcysteine, Omega-3 Fatty Acids & Melatonin. March 19, 2004 David A. Graeber, MD UNM Department of Psychiatry

Supplements in Psychiatry: N-Acetylcysteine, Omega-3 Fatty Acids & Melatonin. March 19, 2004 David A. Graeber, MD UNM Department of Psychiatry Supplements in Psychiatry: N-Acetylcysteine, Omega-3 Fatty Acids & Melatonin March 19, 2004 David A. Graeber, MD UNM Department of Psychiatry 1 N-Acetylcysteine = NAC NAC modulates Neurotransmitters: 1.

More information

Neuroscience and Biobehavioral Reviews

Neuroscience and Biobehavioral Reviews Neuroscience and Biobehavioral Reviews 34 (2010) 755 768 Contents lists available at ScienceDirect Neuroscience and Biobehavioral Reviews journal homepage: www.elsevier.com/locate/neubiorev Review Circadian

More information

Systemic Pesticides as a Causal Factor of Developmental Brain Disorders (ADHD, autism, etc.)

Systemic Pesticides as a Causal Factor of Developmental Brain Disorders (ADHD, autism, etc.) 2012 9 2 浸 透 性 農 薬 フォーラム 脳 の 発 達 障 害 (ADHD 自 閉 症 など) の 原 因 としての 浸 透 性 農 薬 : ネオニコチノイド Systemic Pesticides as a Causal Factor of Developmental Brain Disorders (ADHD, autism, etc.) 環 境 脳 神 経 科 学 情 報 センター

More information

Disordered sleep at night has long been

Disordered sleep at night has long been Neurology 59 Excessive daytime sleepiness in PD Excessive Daytime Sleepiness (EDS) in Parkinson s disease (PD) is an important issue that warrants serious attention because it can have adverse effects

More information

A practical approach to circadian rhythm sleep disorders

A practical approach to circadian rhythm sleep disorders Sleep Medicine Reviews (2008) -, -ewww.elsevier.com/locate/smrv Clinical review A practical approach to circadian rhythm sleep disorders Bjørn Bjorvatn a,b,c, *, Ståle Pallesen b,c,d a Department of Public

More information

SLEEPINESS AND THE HEALTH AND PERFORMANCE OF ADOLESCENT STUDENTS

SLEEPINESS AND THE HEALTH AND PERFORMANCE OF ADOLESCENT STUDENTS SLEEPINESS AND THE HEALTH AND PERFORMANCE OF ADOLESCENT STUDENTS A WORKSHOP FUNDED BY THE INSTITUTE OF POPULATION AND PUBLIC HEALTH THE CANADIAN INSTITUTES OF HEALTH RESEARCH HAMILTON, ONTARIO. 9, 10 NOVEMBER

More information

SLEEP DIFFICULTIES AND PARKINSON S DISEASE Julie H. Carter, R.N., M.S., A.N.P.

SLEEP DIFFICULTIES AND PARKINSON S DISEASE Julie H. Carter, R.N., M.S., A.N.P. SLEEP DIFFICULTIES AND PARKINSON S DISEASE Julie H. Carter, R.N., M.S., A.N.P. Problems with sleep are common in Parkinson s disease. They can sometimes interfere with quality of life. It is helpful to

More information

REHABILITATION MEDICINE by PROFESSOR ANTHONY WARD

REHABILITATION MEDICINE by PROFESSOR ANTHONY WARD REHABILITATION MEDICINE by PROFESSOR ANTHONY WARD What is Rehabilitation Medicine? Rehabilitation Medicine (RM) is the medical specialty with rehabilitation as its primary strategy. It provides services

More information

Autism Spectrum Disorders and Comorbid Behavioral Health Symptoms

Autism Spectrum Disorders and Comorbid Behavioral Health Symptoms Autism Spectrum Disorders and Comorbid Behavioral Health Symptoms Cynthia King, MD Child and Adolescent Psychiatrist Associate Professor of Psychiatry UNMSOM Psychopharmacologic and Alternative Medicine

More information

Preparation guidelines for your Child s Sleep Study

Preparation guidelines for your Child s Sleep Study Preparation guidelines for your Child s Sleep Study Patient Sticker here Maintain your child s regular night sleeping and nap schedule for several days before the study. On the day of the study, do not

More information

Diagnosis and Treatment

Diagnosis and Treatment Sleep Apnea: Diagnosis and Treatment Sleep Apnea Sleep Apnea is Common Dangerous Easily recognized Treatable Types of Sleep Disordered Breathing Apnea Cessation of airflow > 10 seconds Hypopnea Decreased

More information

SLEEP QUESTIONNAIRE. Name: Today s Date: Age (years): Your Sex (M or F): Height: Weight: Collar/Neck Size (inches) Medications you are taking:

SLEEP QUESTIONNAIRE. Name: Today s Date: Age (years): Your Sex (M or F): Height: Weight: Collar/Neck Size (inches) Medications you are taking: SLEEP QUESTIONNAIRE Name: Today s Date: Age (years): Your Sex (M or F): Height: Weight: Collar/Neck Size (inches) Medications you are taking: Medical conditions: High blood pressure Heart Disease Diabetes

More information

Changes in the Evaluation and Treatment of Sleep Apnea

Changes in the Evaluation and Treatment of Sleep Apnea Changes in the Evaluation and Treatment of Sleep Apnea Joseph DellaValla, MD FACP Medical Director Center for Sleep Medicine At Androscoggin Valley Hospital Sleep Related Breathing Problems Obstructive

More information

SLEEP, RECOVERY, AND HUMAN PERFORMANCE A Comprehensive Strategy for Long-Term Athlete Development

SLEEP, RECOVERY, AND HUMAN PERFORMANCE A Comprehensive Strategy for Long-Term Athlete Development SLEEP, RECOVERY, AND HUMAN PERFORMANCE A Comprehensive Strategy for Long-Term Athlete Development Post-exercise recovery and regeneration (PERR) is as important as the training regimen to the complex adaptive

More information

Shining a light on the future

Shining a light on the future Complex Neurodevelopmental Disorder Service (CNDS) for Children and Young People The Complex Neurodevelopmental Disorder Service (CNDS) is a specialist tertiary service working in collaboration with local

More information

Cognitive Behavioral Therapy for Insomnia (CBT-I)

Cognitive Behavioral Therapy for Insomnia (CBT-I) Cognitive Behavioral Therapy for Insomnia (CBT-I) Virginia Runko, PhD, CBSM Behavioral Sleep Medicine Specialist Licensed Psychologist The Ross Center for Anxiety and Related Disorders, Washington DC Workshop

More information

Treatments for Major Depression. Drug Treatments The two (2) classes of drugs that are typical antidepressants are:

Treatments for Major Depression. Drug Treatments The two (2) classes of drugs that are typical antidepressants are: Treatments for Major Depression Drug Treatments The two (2) classes of drugs that are typical antidepressants are: 1. 2. These 2 classes of drugs increase the amount of monoamine neurotransmitters through

More information

Sleep-Wake Patterns in Brain Injury Patients in an Acute Inpatient Rehabilitation Hospital Setting

Sleep-Wake Patterns in Brain Injury Patients in an Acute Inpatient Rehabilitation Hospital Setting Sleep-Wake Patterns in Brain Injury Patients in an Acute Inpatient Rehabilitation Hospital Setting David T. Burke, MD * Mrugeshkumar K. Shah, MD * Jeffrey C. Schneider, MD * Brian Ahangar, MD Samir-Al-Aladai,

More information

Register of Students with Severe Disabilities

Register of Students with Severe Disabilities Department of Education Learners first, connected and inspired Register of Students with Severe Disabilities Department of Education Register of Students with Severe Disabilities 1. Eligibility Criteria

More information

ValueOptions Autism Care Management Product. Bryan Davey, PhD, BCBA-D Christopher Dennis, MD, MBA, ValueOptions Chief Medical Officer

ValueOptions Autism Care Management Product. Bryan Davey, PhD, BCBA-D Christopher Dennis, MD, MBA, ValueOptions Chief Medical Officer ValueOptions Autism Care Management Product Bryan Davey, PhD, BCBA-D Christopher Dennis, MD, MBA, ValueOptions Chief Medical Officer Autism Spectrum Disorders Background 2 Autism Spectrum Disorders within

More information

Seminar/Talk Calendar

Seminar/Talk Calendar Seminar/Talk Calendar Tuesday, February 3rd Dr. John Neumaier, Professor of Psychiatry and Pharmacology, University of Washington DREADDing Addiction Dr. Neumaier s laboratory is studying stress and addiction

More information

INSOMNIA SELF-CARE GUIDE

INSOMNIA SELF-CARE GUIDE INSOMNIA SELF-CARE GUIDE University of California, Berkeley 2222 Bancroft Way Berkeley, CA 94720 Appointments 510/642-2000 Online Appointment www.uhs.berkeley.edu All of us have trouble sleeping from time

More information

Skate Australia Concussion Guidelines

Skate Australia Concussion Guidelines Skate Australia Concussion Guidelines Introduction Forces strong enough to cause concussion are common in all roller sports. Even though helmets are worn in most disciplines, the risk of concussion is

More information

Nocturnal Enuresis Clinical Management Tool (CMT)

Nocturnal Enuresis Clinical Management Tool (CMT) Nocturnal Enuresis Clinical Management Tool (CMT) Nocturnal Enuresis Clinical Management Tool Why this management tool? 1. The aim of this tool is to use a simple questionnaire and non-invasive screening,

More information

Nocturnal Enuresis Clinical Management Tool (CMT)

Nocturnal Enuresis Clinical Management Tool (CMT) Nocturnal Enuresis Clinical Management Tool (CMT) This tool and additional educational resources can be found at www.stopbedwetting.org Zinc Code: DN/360/2010/UKe(1)a Date of Preparation of website: August

More information

Headaches in Children

Headaches in Children Children s s Hospital Headaches in Children Manikum Moodley, MD, FRCP Section of Pediatric Neurology The Cleveland Clinic Foundation Introduction Headaches are common in children Most headaches are benign

More information

News on sleep apnea for the commercial trucking industry. Support system leads to CPAP success

News on sleep apnea for the commercial trucking industry. Support system leads to CPAP success PPD Protecting Professional Drivers SM Driver edition Summer 2011 Volume 4, Issue 3 News on sleep apnea for the commercial trucking industry Visit PPD s new driver blog for OSA support Support system leads

More information

The core symptoms of ADHD, as the name implies, are inattentiveness, hyperactivity and impulsivity. These are excessive and long-term and

The core symptoms of ADHD, as the name implies, are inattentiveness, hyperactivity and impulsivity. These are excessive and long-term and Attention Deficit Hyperactivity Disorder What is Attention Deficit Hyperactivity Disorder? The core symptoms of ADHD, as the name implies, are inattentiveness, hyperactivity and impulsivity. These are

More information

ADHD AND ANXIETY AND DEPRESSION AN OVERVIEW

ADHD AND ANXIETY AND DEPRESSION AN OVERVIEW ADHD AND ANXIETY AND DEPRESSION AN OVERVIEW A/Professor Alasdair Vance Head, Academic Child Psychiatry Department of Paediatrics University of Melbourne Telephone: 9345 4666 Facsimile: 9345 6002 Email:

More information

Epilepsy12 National Audit Round 2 Final Unit Report for: University Hospital of North Tees and Hartlepool

Epilepsy12 National Audit Round 2 Final Unit Report for: University Hospital of North Tees and Hartlepool United Kingdom collaberative clinical audit of health care for children and young people with suspected epileptic seizures Epilepsy12 National Audit Round 2 Final Unit Report for: University Hospital of

More information

Feeling Moody? Major Depressive. Disorder. Is it just a bad mood or is it a disorder? Mood Disorders. www.seclairer.com S Eclairer 724-468-3999

Feeling Moody? Major Depressive. Disorder. Is it just a bad mood or is it a disorder? Mood Disorders. www.seclairer.com S Eclairer 724-468-3999 Feeling Moody? Is it just a bad mood or is it a disorder? Major Depressive Disorder Prevalence: 7%; 18-29 years old; Female>Male DDx: Manic episodes with irritable mood or mixed episodes, mood disorder

More information

A Guide for Enabling Scouts with Cognitive Impairments

A Guide for Enabling Scouts with Cognitive Impairments A Guide for Enabling Scouts with Cognitive Impairments What cognitive impairments are discussed in this manual? Autism Spectrum Disorder Attention Deficit Hyper Activity Disorder Depression Down Syndrome

More information

Children with Down Syndrome Attending Mainstream Schools

Children with Down Syndrome Attending Mainstream Schools Children with Down Syndrome Attending Mainstream Schools Background Down syndrome is a chromosomal anomaly caused by the presence of all or part of an extra 21st chromosome. It is a complex, low incidence

More information

Memorial Hospital Sleep Center. Rock Springs, Wyoming 82901. Sleep lab Phone: 307-352- 8229 (Mon - Wed 5:00 pm 7:00 am)

Memorial Hospital Sleep Center. Rock Springs, Wyoming 82901. Sleep lab Phone: 307-352- 8229 (Mon - Wed 5:00 pm 7:00 am) Memorial Hospital Sleep Center Rock Springs, Wyoming 82901 Sleep lab Phone: 307-352- 8229 (Mon - Wed 5:00 pm 7:00 am) Office Phone: 307-352- 8390 (Mon Fri 8:00 am 4:00 pm ) Patient Name: Sex Age Date Occupation:

More information

DSM 5 AND DISRUPTIVE MOOD DYSREGULATION DISORDER Gail Fernandez, M.D.

DSM 5 AND DISRUPTIVE MOOD DYSREGULATION DISORDER Gail Fernandez, M.D. DSM 5 AND DISRUPTIVE MOOD DYSREGULATION DISORDER Gail Fernandez, M.D. GOALS Learn DSM 5 criteria for DMDD Understand the theoretical background of DMDD Discuss background, pathophysiology and treatment

More information

Recovery. Shona Halson, PhD AIS Recovery

Recovery. Shona Halson, PhD AIS Recovery Recovery Shona Halson, PhD AIS Recovery What is Recovery? Process by which the athletes physiological and psychological function is restored Recovery can result in an enhanced performance by increasing

More information

ADEPT Glossary of Key Terms

ADEPT Glossary of Key Terms ADEPT Glossary of Key Terms A-B-C (Antecedent-Behavior-Consequence) The three-part equation for success in teaching. Antecedents (A) Anything that occurs before a behavior or a skill. When teaching a skill,

More information

Sleep Seekers has been sponsored by an educational grant from Eli Lilly and Company Limited. Sleep Seekers. Living with ADHD 24/7

Sleep Seekers has been sponsored by an educational grant from Eli Lilly and Company Limited. Sleep Seekers. Living with ADHD 24/7 Sleep Seekers has been sponsored by an educational grant from Eli Lilly and Company Limited Sleep Seekers Living with ADHD 24/7 Contents Introduction 1 Are you a Sleep Seeker? 2 Family Stress Points: Bedtime

More information

The following product has been developed by the. American Academy of Sleep Medicine

The following product has been developed by the. American Academy of Sleep Medicine The following product has been developed by the American Academy of Sleep Medicine Copyright 2003 American Academy of Sleep Medicine One Westbrook Corporate Center, Ste. 920, Westchester, IL 60154 Telephone:

More information

Epilepsy 101: Getting Started

Epilepsy 101: Getting Started American Epilepsy Society 1 Epilepsy 101 for nurses has been developed by the American Epilepsy Society to prepare professional nurses to understand the general issues, concerns and needs of people with

More information

Al Ahliyya Amman University Faculty of Arts Department of Psychology Course Description Special Education

Al Ahliyya Amman University Faculty of Arts Department of Psychology Course Description Special Education Al Ahliyya Amman University Faculty of Arts Department of Psychology Course Description Special Education 0731111 Psychology and life {3} [3-3] Defining humans behavior; Essential life skills: problem

More information

Child & Adolescent Anxiety: Psychopathology and Neuroscience

Child & Adolescent Anxiety: Psychopathology and Neuroscience bbrfoundation.org Child & Adolescent Anxiety: Psychopathology and Neuroscience Daniel S. Pine, M.D. Chief, Child & Adolescent Research Mood & Anxiety Disorders Program National Institute of Mental Health

More information

University at Buffalo School of Pharmacy and Pharmaceutical Sciences Drug Information Response Documentation. Module Dates:

University at Buffalo School of Pharmacy and Pharmaceutical Sciences Drug Information Response Documentation. Module Dates: University at Buffalo School of Pharmacy and Pharmaceutical Sciences Drug Information Response Documentation Module Dates: 10/24/05-11/30/05 Preceptor Name: Dr. Tammie Lee Demler Name of Clerkship: Applied

More information

EXPECTATIONS OF PHYSICIANS INTENDING TO PRACTISE SLEEP MEDICINE CHANGING SCOPE OF PRACTICE PROCESS BACKGROUND

EXPECTATIONS OF PHYSICIANS INTENDING TO PRACTISE SLEEP MEDICINE CHANGING SCOPE OF PRACTICE PROCESS BACKGROUND EXPECTATIONS OF PHYSICIANS INTENDING TO PRACTISE SLEEP MEDICINE CHANGING SCOPE OF PRACTICE PROCESS BACKGROUND The College is gradually moving toward a system of performance measurement by focusing on a

More information

Sleepiness, Drug Effects, and Driving Impairment. Thomas Roth Henry Ford Hospital Sleep Center

Sleepiness, Drug Effects, and Driving Impairment. Thomas Roth Henry Ford Hospital Sleep Center Sleepiness, Drug Effects, and Driving Impairment Thomas Roth Henry Ford Hospital Sleep Center OUTLINE Scope of Sleepiness Related Accidents Causes of Sleepiness Other Causes of Accidents How to Measure

More information

Parent-Based Sleep Education for Children with Autism Spectrum Disorders

Parent-Based Sleep Education for Children with Autism Spectrum Disorders DOI 10.1007/s10803-013-1866-z ORIGINAL PAPER Parent-Based Sleep Education for Children with Autism Spectrum Disorders Beth A. Malow Karen W. Adkins Ann Reynolds Shelly K. Weiss Alvin Loh Diane Fawkes Terry

More information

Irritability and DSM-5 Disruptive Mood Dysregulation Disorder (DMDD): Correlates, predictors, and outcome in children

Irritability and DSM-5 Disruptive Mood Dysregulation Disorder (DMDD): Correlates, predictors, and outcome in children Irritability and DSM-5 Disruptive Mood Dysregulation Disorder (DMDD): Correlates, predictors, and outcome in children Ellen Leibenluft, M.D. Chief, Section on Bipolar Spectrum Disorders National Institute

More information

Objectives. Cortical thickness over time. Cortical thickness over time. ADHD neurobiology

Objectives. Cortical thickness over time. Cortical thickness over time. ADHD neurobiology The Neuroscience of Attention Deficit Hyperactivity Disorder: Implications for Treatment Steven R., M.D. Professor and Chief Division of Child and Adolescent Psychiatry UTHSCSA Source Purdue Disclosures

More information

Sleepy Students: How can we help?

Sleepy Students: How can we help? Sleepy Students: How can we help? 1. Identify keys factors which contribute to late bedtimes and insufficient sleep among college students. 2. Discuss how sleep deprivation impairs academic performance,

More information

June 20, 2012. Testimony of. Vera F. Tait MD, FAAP. On behalf of the. American Academy of Pediatrics. Before the

June 20, 2012. Testimony of. Vera F. Tait MD, FAAP. On behalf of the. American Academy of Pediatrics. Before the Testimony of Vera F. Tait MD, FAAP On behalf of the Before the Subcommittee on Personnel, Senate Armed Services Committee Department of Federal Affairs 601 13th Street NW, Suite 400 North Washington, DC

More information

Information about sleep

Information about sleep About this resource Getting a good night s sleep is important for children, young people and adults. If you have concerns about your child s sleeping habits you will find this booklet useful. You will

More information

Sleep, Circadian Rhythms: Implications for Pediatric Epilepsy Phyllis C. Zee, MD, PhD

Sleep, Circadian Rhythms: Implications for Pediatric Epilepsy Phyllis C. Zee, MD, PhD Sleep, Circadian Rhythms: Implications for Pediatric Epilepsy Phyllis C. Zee, MD, PhD Benjamin and Virginia T. Boshes Professor in Neurology Professor of Neurobiology Director Center for Circadian and

More information

SLEEP DISTURBANCE AND MULTIPLE SCLEROSIS Abbey J. Hughes, PhD Department of Rehabilitation Medicine University of Washington School of Medicine

SLEEP DISTURBANCE AND MULTIPLE SCLEROSIS Abbey J. Hughes, PhD Department of Rehabilitation Medicine University of Washington School of Medicine SLEEP DISTURBANCE AND MULTIPLE SCLEROSIS Abbey J. Hughes, PhD Department of Rehabilitation Medicine University of Washington School of Medicine Table of Contents Introduction... 2 Summary of MS Sleep Research...

More information

MODULE MULTIPLE SLEEP LATENCY TEST (MSLT) AND MAINTENANCE OF WAKEFULNESS TEST (MWT)

MODULE MULTIPLE SLEEP LATENCY TEST (MSLT) AND MAINTENANCE OF WAKEFULNESS TEST (MWT) MODULE MULTIPLE SLEEP LATENCY TEST AND MAINTENANCE OF WAKEFULNESS TEST (MWT) MULTIPLE SLEEP LATENCY TEST AND MAINTENANCE OF WAKEFULNESS TEST (MWT) OBJECTIVES: At the end of this module the student must

More information

A comprehensive firefighter fatigue management program Operation Stay Alert

A comprehensive firefighter fatigue management program Operation Stay Alert A comprehensive firefighter fatigue management program Operation Stay Alert Steven W. Lockley, Ph.D. Harvard Work Hours, Health and Safety Group slockley@hms.harvard.edu Division of Sleep Medicine, Harvard

More information

Draft revised statutory guidance to implement the strategy for adults with autism in England

Draft revised statutory guidance to implement the strategy for adults with autism in England Draft revised statutory guidance to implement the strategy for adults with autism in England Consultation on new statutory guidance for local authorities and NHS organisations to support implementation

More information

Applied Behavior Analysis for Autism Spectrum Disorders

Applied Behavior Analysis for Autism Spectrum Disorders Applied Behavior Analysis for Autism Spectrum Disorders I. Policy University Health Alliance (UHA) will reimburse for Applied Behavioral Analysis (ABA), as required in relevant State of Hawaii mandates,

More information

INDEX. and side effects of light therapy, 73 Bulimia nervosa See Eating disorders Bupropion, in treatment of SAD, 91

INDEX. and side effects of light therapy, 73 Bulimia nervosa See Eating disorders Bupropion, in treatment of SAD, 91 INDEX 5-hydroxytryptophan, and neuroendocrine responses in SAD patients, 46 Alcoholism, and light therapy, 78 Alzheimer s disease, and light therapy, 78, 79 American Sleep Disorders Association, 78 Anorexia

More information

Billy. Austin 8/27/2013. ADHD & Bipolar Disorder: Differentiating the Behavioral Presentation in Children

Billy. Austin 8/27/2013. ADHD & Bipolar Disorder: Differentiating the Behavioral Presentation in Children ADHD & Bipolar Disorder: Differentiating the Behavioral Presentation in Children Judy Goodwin, MSN, CNS Meadows Psychiatric Associates Billy Austin 1 Introduction Distinguishing between ADHD and Bipolar

More information

Pervasive Developmental Disorders: Understanding the Spectrum and Long Term Prognosis

Pervasive Developmental Disorders: Understanding the Spectrum and Long Term Prognosis Pervasive Developmental Disorders: Understanding the Spectrum and Long Term Prognosis ACLI Medical Section Annual Meeting 2010 Nhung T. Tran, MD, FAAP UTHSCSA Developmental-Behavioral Pediatrics Objectives

More information

Diagnostic Criteria. Diagnostic Criteria 9/25/2013. What is ADHD? A Fresh Perspective on ADHD: Attention Deficit or Regulation?

Diagnostic Criteria. Diagnostic Criteria 9/25/2013. What is ADHD? A Fresh Perspective on ADHD: Attention Deficit or Regulation? What is ADHD? A Fresh Perspective on ADHD: Attention Deficit or Regulation? The Transition from Disorder to Traits Thor Bergersen M.D. Founder, ADHD Boston www.adhdboston.com Attention Deficit/Hyperactivity

More information

Adolescent Depression and Sleep. Bi-Directional Mutual Maintenance

Adolescent Depression and Sleep. Bi-Directional Mutual Maintenance Adolescent Depression and Sleep Allison G. Harvey, PhD Professor, Clinical Psychology University of California, Berkeley SPONSORED BY THE Center for Applied Research and Educational Improvement in the

More information

Smart Isn t Everything: The Importance of Neuropsychological Evaluation for Students and Individuals on the Autism Spectrum

Smart Isn t Everything: The Importance of Neuropsychological Evaluation for Students and Individuals on the Autism Spectrum Smart Isn t Everything: The Importance of Neuropsychological Evaluation for Students and Individuals on the Autism Spectrum Ilene Solomon, Ph.D., Spectrum Services The decision to have a child or adolescent

More information

Diabetes Insipidus. Series N. 12

Diabetes Insipidus. Series N. 12 Diabetes Insipidus Series N. 12 Patient s Guide Average Readability Leaflet Diabetes Insipidus - Series 12 (Revised August 2006) This leaflet was produced by Fernando Vera MSc and Prof Gary Butler at the

More information

Basis for Final Grade. Grading Scale (%) 96-100 Honors 69-95 Pass 0-68 Fail 30% 15% 20% 35% 100%

Basis for Final Grade. Grading Scale (%) 96-100 Honors 69-95 Pass 0-68 Fail 30% 15% 20% 35% 100% Interprofessional Study of Autism Spectrum Disorder (ASD) and Neurodevelopmental (ND) Disabilities 1 &2 A SC LEND Educational Program involving collaboration between: Medical University of South Carolina

More information

Jefferey F. Knox, IES Senior Lighting Designer, Schuler Shook

Jefferey F. Knox, IES Senior Lighting Designer, Schuler Shook Evidence-Based Lighting g for Long-Term Care Jefferey F. Knox, IES Senior Lighting Designer, Schuler Shook Provider Number: A090 Course Number: C21-17 28 September 2013 Credit(s) earned on completion of

More information

Fields of Education. Last updated August 2011

Fields of Education. Last updated August 2011 Fields of Education Last updated August 2011 Monash University is required to report to the Department of Education, Employment and Workplace Relations (DEEWR) the number of higher degree by research (HDR)

More information

NEW! School Psychology start: September 2016

NEW! School Psychology start: September 2016 NEW! School Psychology start: September 2016 Key staff: Michiel Westenberg (coordination), Femke Stad, Niko Steinbeis, Bart Vogelaar Developmental and Educational Psychology Leiden University Chair: Eveline

More information

Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem

Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem Nearly 40 million Americans suffer from sleep disorders Greater in women National Sleep Foundation 2010 Sleep in America Poll 25% reported

More information

ROLE OF SCHOOL PSYCHOLOGIST AS A RELATED SERVICE PROVIDER

ROLE OF SCHOOL PSYCHOLOGIST AS A RELATED SERVICE PROVIDER ROLE OF SCHOOL PSYCHOLOGIST AS A RELATED SERVICE PROVIDER I. Related Services Definition - IDEA According to the Individuals with Disabilities Education Act, psychological services include: Administering

More information

Benzodiazepine & Z drugs withdrawal protocol

Benzodiazepine & Z drugs withdrawal protocol Benzodiazepine & Z drugs withdrawal protocol Rationale The NSF for Older People has highlighted the issues of dependence, sedation and fall in the elderly when taking these types of medications. It has

More information

DSM-5. Presented by CCESC School Psychologist Interns: Kayla Dodson, M.Ed. Ellen Doll, M.S. Rich Marsicano, Ph.D. Elaine Wahl, Ph.D.

DSM-5. Presented by CCESC School Psychologist Interns: Kayla Dodson, M.Ed. Ellen Doll, M.S. Rich Marsicano, Ph.D. Elaine Wahl, Ph.D. DSM-5 Presented by CCESC School Psychologist Interns: Kayla Dodson, M.Ed. Ellen Doll, M.S. Rich Marsicano, Ph.D. Elaine Wahl, Ph.D. Introduction Lifespan approach to diagnosis Diagnoses occurring in children

More information

Therapies for Children With Autism Spectrum Disorders. A Review of the Research for Parents and Caregivers

Therapies for Children With Autism Spectrum Disorders. A Review of the Research for Parents and Caregivers Therapies for Children With Autism Spectrum Disorders A Review of the Research for Parents and Caregivers Is This Guide Right for the Child in My Care? Yes, if: The child you care for is between 2 and

More information

CIRCADIAN RHYTHM SLEEP DISORDERS. An American Academy of Sleep Medicine Review TABLE OF CONTENTS

CIRCADIAN RHYTHM SLEEP DISORDERS. An American Academy of Sleep Medicine Review TABLE OF CONTENTS CIRCADIAN RHYTHM SLEEP DISORDERS Circadian Rhythm Sleep Disorders: Part II, Advanced Sleep Phase Disorder, Delayed Sleep Phase Disorder, Free-Running Disorder, and Irregular Sleep-Wake Rhythm An American

More information

HEADACHES IN CHILDREN AND ADOLESCENTS. Brian D. Ryals, M.D.

HEADACHES IN CHILDREN AND ADOLESCENTS. Brian D. Ryals, M.D. HEADACHES IN CHILDREN AND ADOLESCENTS Brian D. Ryals, M.D. Frequency and Type of Headaches in Schoolchildren 8993 children age 7-15 in Sweden Migraine in 4% Frequent Nonmigrainous in 7% Infrequent Nonmigrainous

More information

Components of an Effective Evaluation for Autism Spectrum Disorder

Components of an Effective Evaluation for Autism Spectrum Disorder Components of an Effective Evaluation for Autism Spectrum Disorder Lara M. Mattox, Ph.D. Clinical Psychologist Tulsa Developmental Pediatrics & Center for Family Psychology Why is Evaluation Important??

More information