May I make a suggestion, when you read the following, wherever you see the word 'Disorder' consider reading the remark again and replacing 'Disorder' with 'Different' and see what else you might notice.
Extracted from:
Journal of the American Academy of Audiology/Volume 11, Number 9,
October 2000
James Jerger*
"A team approach to assessment provides further
validation of the differential diagnosis.
Moreover, it is important for management
planning. At a minimum, the team should
include an audiologist and speech-language
pathologist along with parents and teachers .
Other specialists can be consulted as needed.
The .following assumptions are basic to the
differential diagnosis of APD:
differential diagnosis of APD:
- Auditory processing problems can occur independently
or can coexist with other, nonauditory
disorders in the following combinations :
(a) A pure auditory processing disorder,
(b) An auditory processing disorder and a
disorder or disorders in other modalities
(i.e ., multisensory),
(c) A disorder that initially appears to be
auditory, but actually is nonauditory, or
(d) A disorder that initially appears to be
nonauditory but is actually auditory.
Auditory processing and methods of assessing
auditory processing can be influenced by
deficits in other disorders that impact auditory
function, including
(a) ADHD,
(b) Language impairment,
(c) Reading disability,
(d) Learning disability,
(e) Autistic spectrum disorder, and
(f) Reduced intellectual functioning.
(page) 469
Journal of the American Academy of Audiology/Volume 11, Number 9, October 2000
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Extract: Journal of the American Academy of Audiology/Volume 12, Number 10, 2001
Clinical Forum: A Search for Evidence of a Direct Relationship between Tinnitus and Suicide
Gary P. Jacobson, Devin L. McCaslin
"Among the most pressing professional issues is the lack of intensive treatment provided in schools. Ironically, although large numbers of individuals with (C)APD are children in schools, current school policies and caseloads do not support the intensive training required for cortical reorganization and behavioral change. Because (C)APD is often a multifaceted problem, a team approach is needed to best serve the individual and his/her family. (C)APD must be diagnosed by an audiologist; however, other professionals can and should be involved in the broad assessment of the functional deficits experienced by the individual with (C)APD and in planning the intervention activities needed to minimize those deficits.
Reimbursement is another pressing professional issue. Despite improved reimbursement rates for some diagnostic services, the rates remain inadequate, and clinicians cannot use some current procedural terminology (CPT) codes with certain third party payers (e.g., Medicare) to secure reimbursement for their intervention efforts. The AAA and other professional associations representing audiologists must continue their efforts to educate physicians, teachers, parents, and legislators and their staffers to the level of education, training, instrumentation, and clinical time needed for the accurate and early diagnosis and multidisciplinary assessment of (CAPD) and its intervention. The support and advocacy of these professional associations may lead to smaller caseloads and more therapy time per child in schools, as well as positive changes in reimbursement rates.
These guidelines are not exhaustive and are not intended to serve as the sole source of guidance for the clinician, nor are they intended to replace clinical judgment. Rather these guidelines reflect the best evidence-based practices in this area at this time as judged by the members of this task force. They should be used as a framework to guide the clinician in decision-making and best clinical practices as they relate to the diagnosis and treatment of (C)APD in various clinical populations presenting with this disorder.
-----------------------------------------------------
Then I recently read:
"This study is the first to find direct evidence that ADHD is a genetic disorder". One of the authors, Professor (Named) is quoted as saying: "Now we can say with confidence that ADHD is a genetic disease and that the brains of children with this condition develop differently to those of other children".
They analysed stretches of DNA from 366 children who had been diagnosed with the disorder.
(How do they know that they Don't have the condition? - What if it's 'different' ?)
- At least 2% of children in the UK are thought to have attention-deficit hyperactivity disorder (ADHD).
(Compared to what? What does this actually tell us?)- Affected children are restless and impulsive.
(Would anything else explain the presenting symptoms?)
- They may also have destructive tendencies,
(Would any alternative explain this?)
- and experience serious problems at school
(Is this where the problem was first noticed?_ Did it pre-exist, and if it did, in what way?)
- and within family life.
(Wait, is this BAD?... Not 'normal' ? - and Who said? How does this present? What does that tell us about the client/patient environment?)
The researchers compared genetic samples from ADHD children, with DNA from 1,047 people without the condition.
(How do they know that they Don't have the condition? Is it possible they found 'something else' ?)
They found that 15% of the ADHD group had large and rare variations in their DNA - compared with 7% in the control group.
(What condition?)
Professor (Named) said:
"We found that, compared with the control group, the children with ADHD have a much higher rate of chunks of DNA that are either duplicated or missing."
(Where's the conclusive evidence to associates these factors?)
"This is really exciting - because it gives us the first direct genetic link to ADHD. "
(Does it, are you sure?)
"We have looked at lots of potential risk factors in the environment - such as parenting or what happens before birth - but there isn't the evidence to say they're linked to ADHD."
(What condition? Wait, wouldn't the fact that there's a problem with the child - if their parents present them as such - be an indicator of parental ability? Are you sure there's no Potential evidence linking these things?Do you wear dark glasses a lot?)
"There's a lot of public misunderstanding about ADHD. Some people say it's not a real disorder, or that it's the result of bad parenting."
(Who's saying this? - Ah.... the Psychologist... oh wait, isn't this contradictory to clinical psychological best practice guidance? There's a lot of inference, it's all negative and... lacks evidence.)
"Finding this direct link should address the issue of stigma."
(Oh, the one you've just implied and associated with the 'disorder' you've described on lack of evidence and professional accountability?)
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