EQUANIMITY

Towards a more Humane Society.  Contemplating  one line each day. #MentalHealth. This month is EQUANIMITY 

Equanimity

-Hari Srinivasan

Equanimity is the calm at the center of the storm.

Equanimity is the balance that allows us to move forward.

Equanimity is the anchor that keeps us grounded.

Equanimity is the serenity that comes from within.

Equanimity is the clarity that helps us see things as they are.

Equanimity is the inner strength that allows us to face life's challenges.

Equanimity is the acceptance that all things pass in due time.

Equanimity is the non-judgmental awareness of our thoughts and emotions.

Equanimity is the gentle acceptance of ourselves and others.

Equanimity is the ability to maintain our inner peace in the face of adversity.

Equanimity is the steady hand that guides us through life's ups and downs.

Equanimity is the stillness that allows us to listen to our hearts.

Equanimity is the wisdom that sees through the illusion of our fears.

Equanimity is the patience to wait for the right moment.

Equanimity is the trust that life will unfold as it should.

Equanimity is the surrender to what is and what we cannot change.

Equanimity is the gratitude for all that life has to offer.

Equanimity is the self-awareness that allows us to grow and learn.

Equanimity is the forgiveness that frees us from the past.

Equanimity is the openness to new experiences and perspectives.

Equanimity is the presence of mind that allows us to live in the moment.

Equanimity is the inner peace that radiates outwards.

Equanimity is the self-love that allows us to love others.

Equanimity is the self-compassion that allows us to heal our wounds.

Equanimity is the stillness that allows us to find our inner voice.

See posts for other months. 

Jan [JOY] Feb [EQUANIMITY] March [EMPATHY] April [KINDNESS]

Atmospheric Rivers

 https://youtu.be/cdhEwAZP-gI

An explanation of the crazy weather pattern this winter in California

Delta Notch Numb: Neurogenesis Society

A humorous science skit. 

Delta Notch Numb: Neurogenesis Society

Delta: Hey guys, have you ever wondered why we have such unusual names? I mean, put together, we sound like a Notched-up college Greek Society; a bunch of undergrads that go totally Numb after an exhausting Rush.

SWAN - Strengths and Weaknesses of ADHD Symptoms and Normal Behavior

Lexicon [Measures]- SWAN

The SWAN is more for ADHD and not designed specifically for autism. 

The SWAN (Strengths and Weaknesses of ADHD Symptoms and Normal Behavior) Rating Scale is a tool to assess ADHD symptoms in children and adolescents. 

The SWAN Rating Scale consists of 18 items that capture various domains of ADHD symptoms, including inattention, hyperactivity, and impulsivity. It uses a Likert-type scale ranging from 0 (far below average) to 3 (far above average) to rate the presence and severity of each symptom. The scale can be completed by parents, teachers, or other caregivers who have regular contact with the child.

Scoring of the SWAN involves summing the ratings for each item to obtain a total score. Higher scores indicate greater ADHD symptomatology. The scale also allows for the calculation of subscale scores for inattention and hyperactivity/impulsivity. 

Limitations with its use in autism. 

• Lack of specificity: The SWAN focuses on ADHD symptoms and may not capture the full range of challenges and behaviors associated with autism. Autistics may exhibit ADHD symptoms as part of their broader autism profile, but there may be additional symptoms and impairments not assessed by the SWAN.
• Difficulty differentiating symptoms: Some symptoms of ADHD, such as inattention, can overlap with symptoms of autism, making it challenging to disentangle the two conditions based solely on the SWAN. 

The SWAN Rating Scale was developed by Dr. Stephen J. Kupper in 2006. 

Constant Overload

Being bombarded by the sensory system

A constant overload, it never ends
Sensory overwhelmed, a feeling of prison
Trapped in my own mind, with no friends.

Poor somatosensory body mapping
A constant confusion, a foggy haze
I struggle to understand my own body
A feeling of being lost, in a daze

Words get stuck, inside my head
Apraxic, struggles to speak
A feeling of frustration, so very unique
As talking eludes me, instead

It can be a struggle, to navigate
This world that's full of sensation

I need to find a way
… with determination

Equanimity is the self-love that allows us to love others

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

Chilling on a houseboat

 

This is where I would like to be today on my birthday. 

Chilling on a houseboat in the Kerala backwaters

(photo taken a few years back)

Chilling on a houseboat in Kerala's backwaters
Coconut trees sway along the shore
The sun dips low, painting the sky with colors
A serene moment, that I'll forever adore.

A moment of peace

Two deer in my yard

Wandering from woods at the back 

Gentle, graceful steps 

Moment of peace, nature's gift

The gentle creatures graze

Unfazed by noise and haste

Their presence brings me ease

In this tranquil, natural space.

And Thank You to everyone who sent me wishes today (Feb 22) - for taking that one breath and one moment to send "happy" positive vibes my way, on my birthday.

Equanimity is the inner peace that radiates outwards

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

Hints of green

On brown trees, hints of green 

A herald of spring
Softly appears, shy and demure,
A promise of new life, fresh and pure

The brain is a Giant Prediction Machine

Poem follows Prof Mark Wallace's comment in class "The Brain is a giant prediction machine" after a discussion on the growing popularity of Bayesian Statistical Models in research. 

The brain is a giant prediction machine

Bayesian model-like, it constantly schemes

Past experiences and memories in its grasp

Current sensory input, processed in a flash.

 

A bundle of irrational worry

I am a bundle of irrational worry
Each day i wake up with dread and hurry
Fears and doubts consume, a constant flurry
Hope still flickers in internal jury

STAT: Screening Tool for Autism in Toddlers and Young Children

The Screening Tool for Autism in Toddlers and Young Children (STAT) is a play-based screening measure designed to identify early signs of autism  in toddlers and young children. It t assesses social communication and play behaviors associated with ASD in children between 24 and 36 months of age.

Limitations

The STAT is a screening tool and not a diagnostic instrument. A comprehensive evaluation by a qualified professional is necessary for a definitive autism diagnosis.

Scoring and Interpretation
The STAT includes a series of play-based activities and social interactions between the child and the examiner. The examiner observes and scores the child's behaviors in different domains, such as joint attention, pretend play, and social responsiveness.

The STAT scoring involves rating specific behaviors observed during the play-based interactions. The scoring criteria may vary depending on the specific version or adaptation of the STAT being used. There are established cutoff scores that help identify children who may be at risk for ASD and require further evaluation by a qualified professional.

History and Revisions:
The STAT was developed by Wendy Stone, Barry L. Prizant, and Samuel P. Openden in 2008. 

Citation:
Stone, W. L., Prizant, B. M., & Openden, S. (2008). The Screening Tool for Autism in Toddlers and Young Children (STAT). Retrieved from https://www.researchgate.net/publication/228625486_STAT_Screening_Tool_for_Autism_in_Toddlers_and_Young_Children

See posts on Screening/Diagnostic Measures

WISC - Wechsler Intelligence Scale for Children

Lexicon [Measures] - WISC

WISC-V (Wechsler Intelligence Scale for Children) is an IQ test used in children (age 6-16 yrs 11 mo) and takes approximately 60-85 minutes. It was developed by David Wechsler (5th Ed 2014).

Limitations wrt Autism
Autistic children may have specific challenges related to social communication, sensory sensitivities, and executive functioning, which can impact their performance on certain subtests. [Also see post on Why IQ Testing especially problematic in the Autistic Population]

WISC has 10 Subtests that fall under 5 index score categories

1. Verbal Comprehension Index (VCI): 
• Similarities: verbal reasoning and concept formation by assessing the ability to identify how two words or concepts are similar.
• Vocab: language development and word knowledge by asking the child to define or explain the meaning of various words
• Information: general knowledge and comprehension of factual information by asking questions about a wide range of topics.
2. Visual Spatial Index (VSI)
• Block Design: Assesses spatial perception, visual-motor integration, and problem-solving abilities through block imitation
3. Fluid Reasoning Index (FRI): 
• Matrix Reasoning: nonverbal reasoning & fluid intelligence by asking child to identify patterns and complete visual matrices. 
• Picture Concepts 

• Picture Concepts: analyze visual stimuli, recognize relationships, and form abstract concepts by asking the child to identify common features and group pictures based on concepts.

4. Working Memory Index (WMI): 
• Digit Span: attention and working memory through ability to repeat a series of digits forwards and backward.
• Picture Span: working memory through recall of sequence of pictures in correct order
5. Processing Speed Index (PSI)
• Coding: measure visual-motor speed and attention by child copying symbols paired with numbers within a specified time limit
• Symbol Search: visual scanning and processing speed by asking the child to identify target symbols within a specified time limit.

Scoring and Interpretation

Index scores are derived from specific combinations of subtests and provide an overall assessment of an child's cognitive strengths and weaknesses in those domains.

The Full-Scale IQ (FSIQ) is the combination of the index scores. It represents overall intellectual functioning and is calculated based on the combined performance across all subtests.

Interpretation involves comparing an individual's performance to normative data (percentile ranks, confidence intervals, and descriptive categories), considering the person's age and the index and subtest scores obtained. 

Citation

Wechsler, D. (2014). Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V). San Antonio, TX: Pearson.

Feb 17 is Random Act of Kindness Day

 Saw this on Canva. Did not know that there was a day. But a good thought nonetheless. 

Loneliness

The room is empty

Loneliness creeps in slowly
Empty walls surround

Silence echoes all around

DNA Repair

Pollina et al. 2023 
The paper describes a new method called sBLISS-seq for identifying DNA damage sites in cells. The authors used this method to study the role of a protein called Ep400 in repairing DNA damage.

The paper suggests that the link between neuronal activity and DNA repair mediated by NPAS4-NuA4 may be relevant to NDD like autism. This is because damage at activity-dependent regulatory elements may be a source of neuronal dysfunction in these disabilities.

Key Takeaways & Contributions.

- Discovery of a specialized chromatin regulatory mechanism in the brain that couples synaptic activity to genome preservation. 

- Identification of a link between neuronal activity and DNA repair mediated by NPAS4-NuA4, which suggests that damage at activity-dependent regulatory elements may be a source of neuronal dysfunction in NDD and autism . 

- Potential role of NPAS4-NuA4 in sustaining neuronal vitality over time and contributing to cellular and organismal longevity. 

- Development of a new method called sBLISS-seq for identifying DNA damage sites in cells

Methods

• The development of a new method called sBLISS-seq for identifying DNA damage sites in cells. 
• The use of 
• chromatin immunoprecipitation (ChIP) to study the binding of proteins to DNA. 
• CRISPR-Cas9 genome editing to create knockout cell lines. 
• RNA sequencing (RNA-seq) to study gene expression. 
• immunofluorescence to study protein localization in cells. 
• comet assays to measure DNA damage.

Questions raised

• What is the full extent of the role of NPAS4-NuA4 in sustaining neuronal vitality over time and contributing to cellular and organismal longevity? 
• How does the link between neuronal activity and DNA repair mediated by NPAS4
• NuA4 contribute to NDD & autism, and can this mechanism be targeted for therapeutic purposes?  
• What other proteins and pathways are involved in the regulation of DNA repair in response to neuronal activity, and how do they interact with NPAS4-NuA4? 
• How can the sBLISS-seq method be further optimized and applied to other cell types and experimental conditions? 
• Findings implications in understanding relationship between neuronal activity and genome preservation in the brain?

Haikus for the love of spring

  Its feb 14 and spring is upon us. I see flowers bloom on my neighbor's tree. 

In the midst of bloom, 

Petals entwine, a sweet embrace, 

Love's essence inhaled.

TBI Regressive Autism

Ameliorating Hemianopia with Multisensory Training (Rowland et al., 2023)

Quick Summary of paper . An  visual-auditory stimulation therapy was used on two older males  who has loss of vision in the left hemifield (hemianopia). The cause was brain trauma (TBI) rather than lesion.  Prior to joining the study both had been referred to PT and OT as rehabilitation measures. 

• 64 year old JM joined the study 14 months after stroke  (2 infracts)
• 74 year old CW joined the study ~18 months after 1 infract (better sighted field compared to JM). 
• Therapy took place over 8 months /10 sessions 

The results were dramatic. Both patients recovered the ability to detect and describe visual stimuli throughout their formerly blind field within a few weeks. They could also localize these stimuli, identify some features, and perceive multiple visuals simultaneously in both fields. (more detail on paper here link)

Relating all this back to Autism

So impressive about being able to restore sight in a matter of 8 months, given therapy was started 14-18 months after infract and not immediately and it was in older adults. 

Why is regressive autism not thought to be TBI at 18 mo, where there is a sudden loss of learned skills. 

• If TBI --> can those lost skills not be regained through targeted therapy. If you can restore skills in 60-70 yr old, should be able to, in a younger more plastic brain. 
• If TBI -->  is this related to CW & JM having practice with vision for 60-70+ years vs toddlers who only have practice with the skills for 18 mo.

Rethink Traditional Therapies

• CW & JM  had PT/OT for 14-18 mo before joining study; implication these therapies not that useful for regaining lost skills. 
• Autistics kids are in insane amounts of therapy (childhood stuffed with ABA/speech/OT every waking hr with little advances to show for it other than the $$$ spent and lots of career advancement for therapists). 
•  Maybe we need rethink early childhood therapy to be more targeted to restore lost skills. Even regaining that level of lost skills improves quality of life, let alone moving beyond.

One big vagary

Vagaries ubiquitous in autism.
Nothing standard, fractured light in a prism.
Can we conclude then, so far…..
… no evidence in any evidence really
….no clues. What’s going on in this gallery.
inexplicable me. I continue to be one big vagary.

Cellular neuroscience is tough.

Cellular neuroscience  is tough. 

=====

I'm like a library book, overdue
My brain's so full, it's about to bust in two
I feel like I'm stuck in a never-ending test
Studying so much, I'm starting to feel depressed!
Will it bring success to my quest?



This was the response from my friend in my neuroscience cohort. Thank you for the encouragement and empathy. 

Will it bring success to my quest?
Simply stated, my answer is yes

Battling through the constant stress, through days, months, years of duress
Though now life may seem like a mess, the quest is not to be the best,
Prioritize self-care, remember to rest

Is it worth it, when all I see, are cloudy skies up over me?
Yes I say, the world will see, what's possible with a degree,
The journey to a PhD is sprinkled serendipity,
But even more importantly, be free to show YOU empathy!

Hari,
Above all you are my friend, one that will be there 'til the end,
Remember I am here for you, day in, day out, through and through.

WAIS - Wechsler Adult Intelligence Scale

Lexicon [Measures] - WAIS 

The Wechsler Adult Intelligence Scale (WAIS-IV) is an IQ test used in adults (ages 16-90) to assess cognitive abilities across different domains. It can take around 60-90 minutes to complete

Limitations in the context of autism:

• Language and communication challenges can impact performance on subtests that heavily rely on language abilities.
• Sensory sensitivities and attentional difficulties affect their performance on tasks requiring sustained attention or visual processing.
• Social and contextual factors/aspects of intelligence relevant to autism not considered as the test focuses on cognitive abilities.
• [Also see post on why IQ tests problematic in autistics] 

WAIS-IV has 10 core subtests which are organized into four index scores.

1. Verbal Comprehension Index (VCI):
• Similarities: verbal reasoning and concept formation.
• Vocabulary: ability to define words and understand their meaning.
2. Perceptual Reasoning Index (PRI):
• Block Design: visual-motor coordination and spatial perception.
• Matrix Reasoning: non-verbal reasoning and problem-solving skills.
• Visual Puzzles: ability to analyze and synthesize visual information.
• Picture Completion: visual perception and attention to detail. Presented with incomplete pictures and are required to identify the missing part or detail.
3. Working Memory Index (WMI):
• Digit Span: attention, concentration, and working memory by assessing the ability to repeat a series of digits forward and backward.
• Arithmetic: mental arithmetic skills and working memory.
4. Processing Speed Index (PSI):
• Symbol Search: visual scanning speed and processing speed.
• Coding:motor speed, attention, and visual-motor coordination.

Scoring and interpretation

Index scores are derived from specific combinations of subtests and provide an overall assessment of an individual's cognitive strengths and weaknesses in those domains.

The Full-Scale IQ (FSIQ) is the combination of the index scores. It represents overall intellectual functioning and is calculated based on the combined performance across all subtests.

Interpretation involves comparing an individual's performance to normative data (percentile ranks, confidence intervals, and descriptive categories), considering the person's age and the index and subtest scores obtained. 

History
WAIS was first developed by David Wechsler as an adaptation of his earlier intelligence tests, the Wechsler-Bellevue Intelligence Scale (1st Ed 1955, 4th Ed 2008).

Equanimity is the steady hand that guides us through life's ups and downs

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

The Neurotransmitter Showdown: GABA v Glutamate in the Courtroom.

The Neurotransmitter Showdown: GABA v Glutamate in the Courtroom.

GABA: Good day, Glutamate. How do you plead today?

Glutamate: Not guilty Your Honor. My actions were justified.

GABA: Oh, please. You know that you always overexcite the receptors and cause chaos in the brain.

Glutamate: That's simply untrue. I only activate the NMDA, AMPA, and kainate receptors as needed.

GABA: Needed? 

Your excessive activation of those receptors leads to seizures and neurotoxicity and not to mention hyperactivity, mood swings, social communication challenges, and sensory dysfunction in autistics. 

You are totally implicated in the Excitatory-Inhibition Imbalance theory in autism.

Hari: You Said It, GABA!! Tell it like it is. 

Judge (pounding table with mallet): Order in the court! The audience is not allowed to speak. 

Hari: Your Honor, I was not speaking out loud. It was all in my mind. 

Judge: But we are in your mind so everyone here can hear you. 

Hari: Oh, Ok. Then I'll go off and take a nap. 

Judge. Thank you Hari. 

(Pounding with mallet) Order! Order!I call order in the courtroom!

Executive and Contextual Control Theory (ECCT)

 

While no single theory fully explains all aspects of autism, each attempts to provide insights into different cognitive and behavioral characteristics.

• ECCT posits that individuals with autism have difficulties with contextual control, which is the ability to modulate behavior based on the context. This can be related to challenges in executive function and flexibility.
• Implications: Difficulty in adjusting behavior to suit different social contexts, rigidity in thought processes, and a tendency toward repetitive behaviors.

Read more on [ECCT Theory]

Posts on other [Theories of Autism]

27 Genetic Variants Linked to ADHD

 https://neurosciencenews.com/genetics-adhd-22476/

"imbalance in dopamine in the brains of people with ADHD is partly attributable to genetic risk factors"

"7,300 common genetic variants that increase the risk of ADHD. It is particularly interesting that the vast majority of these variants—84-98 percent—also have an influence on other mental disorders, e.g. autism, depression and schizophrenia"

Serenity is the harmony that comes with being in balance.

Informal Removals

This is so deja vu for me. 

Never mind even the struggles involved in getting access to general ed classrooms, 

even special education classrooms only want the Good Patients. 

=================

https://www.nytimes.com/2023/02/09/us/students-disabilities-informal-removal.html?fbclid=IwAR36fyuIXrWPV7QZMxdeHt_HPxYJy9___BwxYS0k7YIEKBarCdHdrxEAW4U


"During her son’s elementary years, Ms. LaVigne was called almost daily to pick him up hours early because he was having “a bad day.” By middle school, he was only attending an hour a day..."

"...tactic that schools... use to remove challenging students with disabilities from class. The removals — which can include repeated dismissals in the middle of the day or shortening students’ education to a few hours a week."

"In a report last year, the National Disability Rights Network, a national nonprofit established by Congress more than four decades ago, found informal removals occurring hundreds and perhaps thousands of times per year as “off-the-book suspensions.” The report said the removals also included “transfers to nowhere,” when students are involuntarily sent to programs that do not exist."

"The removals largely escape scrutiny because schools are not required to report them in the same manner as formal suspensions and expulsions, making them difficult to track and their impact hard to measure."

"continuation of the practice sends a terrible message to students and to school communities about which students deserve an education.”

Cellular Neuroscience

Last semester was systems neuroscience, this semester is cellular neuroscience. 

What's interesting is the way the course is organized. It's very different from what I'm used to. Every week we get a different professor teaching the class on a different topic followed by a Friday quiz on that topic. Of course the other parts are there like a midterm, final and a class presentation. While the class feels a bit disjointed with a new professor this week (autism & change are not the best of bedfellows), its also kinda cool to be taught a topic by a someone researching that area specifically. They know the topic absolutely inside out. But the quizzes are tough!!

Wk 5: Synaptic Plasticity with Prof Roger Colbran (Molecular Physiology and Biophysics)

Wk4:  Voltage Gated Ion Channels and Presynaptic Calcium Channels. If last week was glutamate receptors, this week its GABA receptors with Prof David Jacobson (Molecular Physiology & Biophysics). 

Wk2-3 Presynaptic & Postsynaptic specialization: Prof Ege Kavalali (Pharmacology) and Prof Teru Nakagawa (Molecular Physiology and Biophysics)

Wk1:  Electrophysiology : This week was Bioelectricity of Neurons with Jerod Denton (Anesthesiology). After all, electrophysiology forms the basis of how the nervous system works, it determines how we interact with our environment, how we process that information in the nervous system and how we respond (hopefully appropriately?). And I loved how he said we should be so comfortable with it that we can strike up a casual conversation on the topic at the next VBI (Vanderbilt Brain Institute) meet. 

A lot of material is covered in each class. Interesting, a maze and tough all at once. 

Some poems being inspired by the neuroscience I'm learning. 

Woody Vine Dance

Woody Vine Dance

Gale tosses the woody vines of tall trees.

Strong wind and rustling leaves.

Nature roars, unrelenting crescendo 

Rustic music and Woody Vine dance.

Equanimity is the gentle acceptance of ourselves and others

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

Equanimity is the non-judgmental awareness of our thoughts and emotions

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

16 of 118

 16 of the 118 elements. Go Bears!! I have the Berkelium t-shirt. 

I laughed when i saw the last hashtag. Cal and Stanford have this friendly rivalry going on which is most evident at Big Game (annual football game). Like a former therapist (had been a student at Stanford when working with me), was overjoyed that I got into Cal, with the caveat of "except during Big Game."

Seatbelt? What is that

Seatbelts? What is that. 

This is the way to ride to school. Students in school uniform on the back of an auto. Carefree joy!! 

Photo taken during a 2018 India trip in North India. 

Equanimity is the acceptance that all things pass in due time

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

Equanimity is the inner strength that allows us to face life's challenges

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

Equanimity is the clarity that helps us see things as they are.

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

Twinkling Tree Canopy

Glass trees sweat in the winter sun

Refraction bends with ice melts.

Twinkling treetops in a blue sky

Canopy of stars in the daytime light.

The photo does not capture it but the tops of the trees were twinkling as the melting frost was refracted by the sunlight. It was like seeing stars in daytime. 

Research and the Testable Autistic

A fundamental issue in autism research is that again and again we are testing only a narrow band of "testable autistics." 

Essentially past and current research on Autism is oversampling the same ~30% of autistics, the testable autistics. Then we assume the results apply to all, when they do no. 

I was in a research stakeholder meeting last week where another autistic talked about the variety of different research studies she had participated in over the years. 

I was thinking of how many autism research studies where I've been a participant - it was ZERO, literally!! It was not that I did not want to, I was always in the exclusion criteria zone even in autism research. 

Growing up, I used to hear about what autistics are supposed to be thinking/doing, all based on the hundreds of studies that had already been done. And the thought was -  the results don't reflect me. Do I have the wrong dx?

We badly need to RETHINK RESEARCH METHODOLOGY along with new NEW TECHNOLOGY , so that we can expand this ZONE OF TESTABLE AUTISTICS so it's more representative of even those with high support needs like me. 

We can expand the range of testable autistics only if we use methods that don’t need fluent oral communication or fluent motor manipulation or expect a person to sit absolutely still. 

We need every neurodiverse/neurotypical mind thinking about this!!

So, what kind of methods can we use to extend the range of testable autistics.

We need to find answers and solutions for all autistics. THIS IS URGENT. 

M-CHAT Modified Checklist for Autism in Toddlers

Lexicon [Measures] - M-CHAT 

The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) is a screening tool to identify early signs of autism  in toddlers. The M-CHAT-R is a caregiver-reported questionnaire that assesses the presence of behaviors associated with ASD in toddlers aged 16 to 30 months. It is intended to screen for potential developmental concerns and determine the need for further evaluation.

Limitations

The M-CHAT-R has some limitations, including the potential for false positives or false negatives, as it is a screening tool rather than a diagnostic instrument. It relies on caregiver-reported information, which may be subject to biases or inaccuracies.

Measure, Scoring & Interpretation
The M-CHAT-R is typically administered by a clinician or early intervention specialist.  It consists of 20  items that cover different areas of development, including social communication, joint attention, play, and repetitive behaviors. Caregivers indicate whether the behaviors are observed in their child or not (scored as 1 for Yes and 0 for No). The total score is calculated by summing the scores across all items. 

The M-CHAT-R also includes a follow-up interview with additional questions to further explore areas of concern. Scoring and interpretation guidelines are provided with specific cutoff scores to identify children who may be at risk for ASD and require further evaluation.

History, Limitations, and Revisions
The M-CHAT-R is an updated version of the original M-CHAT,. It was developed by Diana Robins, Deborah Fein, and Marianne Barton in 2009. 

Citation:
Robins, D. L., Fein, D., & Barton, M. L. (2009). The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R). Retrieved from https://mchatscreen.com/wp-content/uploads/2021/07/M-CHAT-R.pdf

Kindness is the language that everyone can understand

Equanimity is the serenity that comes from within

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

Winter Thaw

Golden sun swathes the trees
Winter thaw, nature awakes
Twittering birds in flights of awe
Dancing from tree to tree to tree


I woke upto sunshine today though the temperature is still in the 30s. My window view continues to be provide awe for me.

Joy is the light that shine within us

 

Contemplation, one line a day #Mental Health

Equanimity is the anchor that keeps us grounded

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

Hoarfrost and Icicles

glazed ice drape the leafless trees
ice sculptures of neural dendrites
...glistening at 27 degrees

white latticed cobwebs cover the brush.
fine needle crystals, it's hoarfrost.
water vapor turned solid, sublimation.
icicles drip by my windowsill
add to the morning chill

Comorbidity of ADHD puts you at higher risk for Mental Health

This article on ADHD talks about research from Bath University in the UK. 

Essentially it says

• Mental health risk higher in ADHD alone > Mental Health risk in Autism alone
• The risk is higher when there are co-morbidities (ie: Autism+ADHD)

Research confirms what many us have already felt and known about comorbidity of Autism+ADHD. The net effect is not a simple sum, but exponential. 

What makes me sad is for the most part stimulant meds seem to work ADHD like they are supposed to. But when it comes to autism+ADHD, the same meds are still a wild guess and most don't work in autism like they do in the non-autism population with paradoxical effects.

 

Optimism is the lens that allows us to see the world through the eyes of possibility.

Equanimity is the balance that allows us to move forward

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

Black Ice

Thin and clear, hard to see,
Black ice makes roads slippery.
Silent and unseen, it lies ahead,
A slippery trap, ready to paralyze one dead


Zoom classes on schedule today

Postsynaptic receptors will rule the day. 
But no commute is relief!

Moments like Fleet

 Its already month 2 of 2023. Time does rush past. 

Months speed by, moments like fleet

Leaving memories, both sweet and beat. 

Where have the days gone, oh so fast

Never to return, from the past.

Hold tight, each moment's just right

Be supported to joy, day and night. 

Time waits for no one, it's true

Our lives are worth living, cherish it anew

Multilingual and Autism

Multilingual and Autism

Therapists often tell families to only speak English so as to not confuse the autistic child. I think that's not a good idea as it results in a loss of cultural identity. During my elementary years there was so much time spent on teaching me St Patrick's day (what relevance do green men and rainbows have for me) instead of say teaching me about Diwali (more relevant to me). Many of us have extended family who only speak their native tongue. Life exists outside of the special education classroom and therapy. 

Autism loves to get stuck on sameness, so you may be inadvertently encouraging that very thing. For instance, in my early years - I used to watch Thomas the Tank engine pretty obsessively. I would avoid the Ringo Starr narrated version but loved the George Carlin version - the Brit accent felt like an alien foreign language. 

It's good to also be exposed to different accents associated with the different languages for another important reason. We will be be surrounded by caregivers/educators with diff accents. No one thinks about this aspect. 

I had a class aide in elementary who's accent I never understood. She was a new immigrant who was barely learning to speak English herself and I just could not make out her high pitched accent. It was not due to cognition on my part, how could I respond if I have not understood the question/instruction which as far as I was concerned was in an alien language.  Sometimes I would try to watch her lips, trying to synchronize the visual of her lip movements with the audio I was hearing - it was a lot to process and it was often easiest to give up and engage in stimming behaviors (comforting) instead. Rather ironical as she was supposed to be teaching me. No one thinks about this aspect. 

Anyway, I did get over the Ringo Starr thing eventually. Interestingly, the accent thing is not so striking in singing. I love Beatles music (simple lyrics that you can actually get your mouth around) and i did not realize Adele was Brit till i saw her talk at an awards ceremony.

Equanimity is the calm at the center of the storm

Towards a more humane society. #MentalHealth. Contemplation, one line a day.