Monday, August 01, 2016

Tourette's Syndrome - Tic Disorders

What is a tic?
A tic is an involuntary movement. A muscle or group of muscles move - tic - when you don't want them to or you make a noise or grunt rather like the throat-clearing some people do when they get nervous.
 
Tics can be divided into four categories. You can have:
 
1) A transient tic, which can be a movement or making a noise that lasts for more than four weeks but less than twelve. 
2) A chronic tic, which is either a movement or sound (but not both) that is present for more than a year.
3) Tourette's syndrome, which is movement and sounds together for more than a year.
4) A tic disorder (not otherwise specified) that does not fit into any of the other categories.
 
The classic picture of Tourette's syndrome often seen portrayed in films is the exception rather than the rule. The vast majority of children and adults have a variety of minor motor (movement) tics and/or vocal tics.

Although these motor and vocal tics are described as involuntary movements (you can't control them), they can to a certain extent be held back. Some sufferers can stop the tics for a period of time and release them when they are in the privacy of their own home. Therefore, it can come as something of a surprise for a teacher or employer to learn that a child or employee has a tic disorder. Some sufferers can disguise their tics by building them into what might be considered to be normal movements. However, holding back tics comes at a cost. Often when the child gets home his or her behaviour can become very disturbed or they suffer terrible guilt when they finally have to give in to the overwhelming urge.

History 
Tourette's Syndrome was originally described by Gilles de la Tourette as 'maladie des tics convulsifs avec coprolalie' (an illness of convulsive tics with the involuntary use of obscene words). The early documented cases of Tourette's syndrome were of adult patients and it was not until the 1930s that the tics were described in normal children. However, Tourette did note that as well as the involuntary movement tics, vocal tics and swearing, the disorder began in childhood, (usually between the ages of seven and ten), affected males more than females and was, in his opinion, hereditary. He also noted that the tics usually started in the face or upper extremities and that the symptoms waxed and waned and were made worse by stress. 


Disorders associated with Tourette's Syndrome
Some common signs of Tourette's are:
- excessive blinking
- head turning
- throat-clearing
- grimacing
- grunting
- squeaking
- one-sided facial tics
- eyes rolling up

The cause of Tourette's
The exact cause of Tourette's syndrome is unknown, but it appears to be linked to the gene or genes that control certain neurotransmitters, notably dopamine and serotonin. Where these symptoms begin not only goes a long way towards explaining the underlying cause but also presents an opportunity to provide effective treatment. About a third of people with the disorder have relatives with Tourette's syndrome, while another third have family members with milder tic disorders. There is also more obsessive-compulsive disorder and attention deficit hyperactivity disorder in families of people with Tourette's syndrome. Further, because Tourette's is much more frequent in men, the role of hormones has been considered and it has been suggested that the male foetus might be vulnerable to a spike in the female hormone oestrogen from the mother, during a specific stage during pregnancy.

What makes tics worse?
- Just talking about a person's tics - or habits as they are often called - in front of them can set off motor (movement) tics in seconds.
- Being overtired can make a big difference to the occurrence of tics. Children are often worse at the end of term.
- Lack of sleep can cause an upsurge in symptoms.
- Drinking alcohol can make symptoms worse the next day.
- Stress is certainly a big factor. In children the build-up to exams or in adults the period leading up to a big presentation can see an increase in symptoms.
- Diet has also been implicated on numerous occasions. The Mental Health Foundation has suggested that food additives and insufficient omega-3 can play a role in the generation of anxiety and signs of ADHD.

What helps reduce tics?
- Being distracted by something enjoyable or engaging in an activity (e.g. playing piano) can see a complete cessation of tics.
- Getting enough sleep and taking exercise in the fresh air can help prevent a build-up.
- Taking alcohol in moderation.
- A healthy diet as free from artificial sweeteners and additives as possible has been shown to help.
- Supplementing your diet with omega-3 can also provide significant benefits.
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~ The above is from Pauc, R. (2008) Could It Be You? , a well worth reading book for anyone interested in the area of learning difficulties. It's written in a very reader friendly format, detailed but not too taxing on the mind, and covers a range of issues from dyslexia, dyspraxia, ADHD, OCD, Tourette's syndrome, and autism. Recommended.  

Sunday, July 03, 2016

Farming in rural Ireland

In Ireland it is common for rates of depression to be highly prevalent in rural areas of the country. One population that are vulnerable are men, particularly farmers who may spend much of their time in isolation tending to their lands and livestock. A tough job to be involved in especially considering the long hours involving little human interaction.
 
Many middle-age men living in rural Ireland who spend the majority of their time farming may often have inherited the farm from their parents. Consequently, they may never have got married due to the amount of time they had to invest in the duties of farming life. Although no one is too old to find a partner, bachelors like these may feel that their time has passed and that there is little chance or time to pursue meeting someone.
 
The 'pickings' may be slimmer if a farmers only dealings with other people are other local farmers, employees in cattle marts and creameries, or vets making visits to the farm to check on animals and so forth. So much so has this combination of depression and isolation been recognised that some veterinarians are even being trained to spot the signs of depression in people they deal with. 
 
It's an extremely relevant issue in Ireland today and has been for a long time. The topic was recently examined in a 2013 film called Pilgrim Hill . It depicts the life of an Irish cattle farmer, living alone with his invalided father in a remote Irish location.

I'd highly recommend a viewing. It captures the forgotten side of rural Ireland and the tragic sense of what is often involved for some men working in the Irish farming industry today.


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The Irish Times (in a four-star review): "Barrett's debut feature is a quietly stunning slice of rural naturalism. A masterful debut."


Monday, June 13, 2016

Compassion Fatigue in Funeral Directors

“The funeral director operates in a market with a seemingly endless source of supply – death will always occur and this service will always be required” (Parsons, 2003, p. 70).

This "endless source of supply" gave me the idea of examining the possibility that some funeral directors in Ireland may be susceptible to compassion fatigue. Thus formed the main hypothesis around my undergraduate psychology dissertation.
 
"One of the primary caregivers to the newly bereaved is the funeral director (Parsons, 2003). In their work with the bereaved and through body handling, they are among a group of occupations that witness death on a regular basis (Harrawood, White, & Benshoff, 2008). It is estimated that there are 600 funeral service providers in Ireland (Irish Hospice Foundation, 2011), who are responsible for the burial or cremation of up to 30,000 people a year. Some undertaking for the funeral director may be simply about guiding a family through proceedings and ensuring everything runs smoothly (Holloway et al., 2013), however more difficult situations may also present. Individuals who are bereaved by homicide can experience overwhelming emotions and intense suffering beyond the imagination of some (Malone, 2007). In organising funeral arrangements for these mourners, what is presented to the funeral director is most certainly a negotiation with a traumatised population. As Ireland has one of the highest rates of homicide in Europe (O’Keefe, 2014), and with 83 recorded cases in 2013 alone (Central Statistics Office, 2014), it is reasonable to suggest that some funeral directors are operating in an environment at risk of secondary traumatic stress."
It managed to get published in the Student Psychology Journal of Ireland and additionally received the best submission award. So all a whirlwind and proud venture for me. Aside from the results of the study, I think what I learned most is the actual arduous process that goes into research work and I tip my hat to those who work in research positions on a daily basis. So with a Masters dissertation about to begin, all I can do is sweat the thoughts of it. But it'll be fun...right?
I attached the link to the complete manuscript below if this is your cup of tea / can't sleep etc.
 
 
 
 
 
 



Link to full manuscript here

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''The very act of being compassionate and empathic extracts a cost under most circumstances. In our effort to view the world from the perspective of the suffering we suffer. The meaning of compassion is to bear suffering. Compassion fatigue, like any other kind of fatigue, reduces our capacity or our interest in bearing the suffering of others.''
                                                                         ~ Charles Figley, ''Compassion Fatigue: Psychotherapists’ Chronic Lack of Self-Care'' (2002)

Friday, May 20, 2016

Applied Behaviour Analysis

Applied Behaviour Analysis (ABA) is an effective behavioural treatment programme widely used with children with autism to improve socially significant behaviours.
 

ABA makes meaningful changes in people's lives through the use of procedures that have been demonstrated to work. The goal of an ABA teaching environment is to build socially significant behaviours in a meaningful way and to a meaningful degree. Generalisation, spontaneity and fun are essential components of successful intervention.
  
A few years ago, Ireland was in the fortunate position of having 12 ABA schools that had been set up and staffed in a way that made possible comprehensive programmes for children with autism (Leslie, 2013). However, the changes implemented from 2010 mean this is far from being the case now. Members of the Division of Behaviour Analysis are either in or in close touch with these schools. They are now termed special schools and, because of the rules they operate under none of them can meet the specifications for an ABA school.

ABA aspires to help with serious behavioural problems. A serious behavioural problem is one that impairs the quality of life of the person to a significant degree, impacts negatively on the lives of others, is persistent (thus rarely goes away of its own accord), and is not readily removed by some simple or brief treatment or intervention.

Some of the problems of many children with autism meet these criteria. If help is not provided or not adequate, their behavioural problems may leave them trailing far behind their peers of the same age in personal, social and educational development.
 
For more information see the following links:
 
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''If they can't learn the way we teach, we teach the way they learn''  ~   O. Ivar Lovaas

Saturday, April 02, 2016

The McGurk effect

A phenomenon that occurs when a speech sound does not match the shape of the lips producing it, as when the sound corresponding to the usual pronunciation of the word gay is dubbed on to a video image of a person uttering the word bay, causing the listener to hear a word intermediate between the two (day).

The effect shows that the visual channel conveys important information not just to deaf people but also to listeners with normal hearing. For those with minor hearing loss, speech reading can be a very valuable way to maximize the hearing they still do have. Also, this reveals more about why watching the mouth is so important in intense language learning.

The phenomenon is named after the Scottish psychologist Harry McGurk (1936-98) who co-authored the first article on it, entitled 'Hearing Lips and Seeing Voices' in the journal Nature in 1976.


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