How Do Dyslexia Schools Teach Their Students?

In dyslexia schools, special educators teach individuals with this developmental reading disorder how to properly approach text and comprehend writing. These institutions have given children and adults of all ages the ability to succeed in their education.

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Dyspraxia Symptoms and Treatment

There are no clear answers to what causes the disorder, Dyspraxia. However, enough research has been done by medical and neurological professionals to make a positive diagnosis of Dyspraxia and there are a number of therapies already available to treat this disorder mainly found among children in early childhood.

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Premature Baby Has Congenital Torticollis? Try These Simple Stretches

Congenital Torticollis is a condition that causes a baby’s head to tilt to one side, while the baby’s face is turned to the opposite side. If left untreated this condition can have serious side effects such as Plagiocephaly. Use the recommended stretches daily to help correct this condition.

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Prader-Willi Syndrome And Its Characteristics

Prader-Willi syndrome is the rare genetic disorder that can cause a lot of serious health problems. Despite the fact that there is no treatment for this disorder, there are some ways that can help to improve the condition of the patient. The earlier the treatment is started the better results can be achieved.

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Brain Fitness From Injuries

After a brain injury, we must take charge and work toward brain-fitness. The holistic approach is one of the best therapeutic methods that helps you to rebuild cognitive function. It will help you gain back your quality of life.

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Teratogens and the Damage They Do

This paper explores teratogens and how they affect the embryo and fetus. The study of teratogens logically evolved from the study of bacteria. A teratogen is an agent that can cause birth defects. The abnormalities produced, range from the slight to severe. Some anomalies are observable at birth while others don’t show up until later in childhood, adolescence or even adulthood. While there is little control over one’s environment, there are things that can be done – or not done to minimize the damage to the embryo and fetus.

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Crawling: The Benefits Are More Important Than You Think!

My daughter and my nephew were born two weeks apart. Thankfully both of them are developing normally. They both held their heads up, smoked and roled over within days of each other. However, my daughter crawled on her hands and knees for several months, while my nephew only crawled for about two weeks and then started walking. Should my sister have worried that her son skipped this stone?

Many health care professionals believe that if a baby skips crawling, it's no big deal and that at some point in the future he will end up crawling and reap the benefits. On the other hand, there are other health care professionals who believe in the theory that if an infant skips crawling, there is a possibility that the Symmetrical Tonic Neck Reflex (STNR) will not fully mature and integrate like it is provided to. This can cause long term problems such as Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD). According to the book, “Stopping ADHD” by Dr. Miriam Bender who studied infants and toddlers as part of her research. Dr Miriam found that at least 75% of the kids with a learning disability had an immature STNR. When an infant with an immature STNR moves their chin down towards their chest, the reflex causes their legs to extend or straighten. At the same time, their arms flex or curl upwards. As a typically developing baby matures and grows, the STNR should integrate and mature so that neck movement would no longer have any influence over the movement of the arms and legs. In other words, as a baby matures, the movement of their necks should be completely independent from the movement of their limbs. The argument that crawling is crucial and should not be skipped at all costs goes something like this: Crawling stimuli brain development by fosting communication between the right and left sides of the brain as baby moves around on the floor with her arms and legs moving in a reciprocal pattern. In addition, when a baby is on the floor on hands and knees, she is able to lift her head and look across the room at toys or other objects of interest. This type of activity helps to develop early binocular vision. As she begins to crawl to reach the toys she will also develop early hand-eye coordination. These skills are needed later on in a child's life during sporting activities, reading and writing. Crawling also strengthens the arms, chest, trunk, shoulders and upper thigh muscles.

With all of the confounding variables involved in studying infant development and gross motor skill acquisition, it's difficult if not impossible to say with absolute certyty, that if your baby skips crawling they will have a developmental delay or a learning disability. But with all of the benefits that crawling provides if I were you, I would definitely help my baby crawl around on the floor daily. Just remember that your baby will crawl when she is ready, so be patient and do not rush her. But when you feel that she is ready to begin crawling, jump in, encourage her and make it as much fun as possible. Place your baby on her hands and knees and gently rock her front to back. When she is able to maintain her balance on her hands and knees, kneel in front of her and you rock front to back and show her how much fun this type of rocking on hands and knees can be. Encourage her to play on the floor on her stomach and help her reach for toys just out of reach. Buy a play tunnel or tent, and crank up the crawling fun!

My sister is still not convinced that crawling is that important, nor is she in the least bit concerned that my nephew skipped it. So when I play with him, I chase him through the tunnel I bought for him, and yes we are both on our hands and knees crawling.

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Isn’t ADHD Just An Excuse For Lack Of Discipline?

ADHD or Attention Deficit Hyperactivity Disorder is a disorder that commonly affects children by making them hyperactive with low attention span, it has been seen that boys are inflicted more than the girls. The typical symptoms include difficulty in controlled behavior, low focus and attention span and hyperactivity. But considering the increasing levels of behavioral issues plaguing schools and homes, isn’t ADHD just an excuse for a lack of discipline?

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Infant Torticollis – These Stretching And Positioning Exercises Can Help!

Infant Torticollis is fairly common and presents itself as a tilt of the baby’s head toward one side or the other. This condition affects boys and girls equally, is usually painless and can be treated with simple exercises and positioning. However, if left untreated it can have significant side effects such as flat head syndrome (Plagiocephaly) to one side of your baby’s head.

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Aging Out of EPSDT – Part IV: States of Disarray

The Early and Periodic Screening, Diagnostic, and Treatment program (EPSDT) forces states to extend Medicaid coverage to low-income children for almost every medical service – but adults are a different story. There are genuinely consequential restrictions on Medicaid benefits offered to adults, as many if not most of the services that enable a person with disabilities to maintain their function within their community have very limited coverage options. These include prescription drugs (Adderall for ADHD), respiratory care (inhalers for severe asthma), and therapeutic services (speech therapy for autism-spectrum disorders), as a few common examples.

While every state offers some degree of these optional services, none of them offer coverage for all of the optional services used by people with disabilities. For example, as of 2012:

• Only 23 states offered private nursing service benefits (used by any person with a disability that precedes them from cleaning themselves)
• Only 26 states fully cover speech, hearing, and language disorders,
• Only 32 states fully cover eyeglasses,
• Only 25 states fully cover psychiatric services, and
• There are still 3 states that offer absolutely no mental health coverage!

Restricted Access

The other side of this horrible coin is that there's no guarantee a disabled young adult will be able to get coverage even provided the state offers a Medicaid program relevant to their needs. That's because states are given broad leave to limit the scope, duration, and amount of benefits offered to adults. For example, some states' prescription drug coverage restricts any given individual to receiving just 3 different prescriptions per month. Any parent of a child with severe ADHD can tell you that 3 prescriptions will just cover someone who needs a daily, a school-time, and a 'booster' dose of Concerta to be able to function effectively across the day. Heaven forbid that same child also be diabetic and require insulin!

Similarly, many states that offer therapy services such as occupational, speech, or physical therapies only cover a specific number of sessions each year, which is totally acceptable if you're someone with an injury they're trying to recover from. For someone with ongoing special needs for whatever the exercises acts as maintenance rather than recovery, who needs a therapy session every week or more for all of the foreseeable future, it's a complete disaster.

Waivering Support

Finally, many states are trying to reduce health care burdens by offering less-expensive Home- and Community-Based Services (HCBS), by obtaining a special waiver from Medicaid enabling them to create a location-based program. These HCBS waivers are good in a way, because many states would not offer some services at all without them – but they're also very bad, because anyone who can not qualify under a waiver is put on a waiting list and receives no Medicaid services unless they have a genuine medical emergency.

How Bad Is It Really?

Genuinely bad: one recent study demonstrated that, of the roughly three million Americans who need daily assistance to perform the most basic activities (toileting, eating, getting dressed, etc.), fully one million of them were not able to get the assistance they needed regularly. Specifically:

• 80% said they regularly go one or more day each month with no clothes on.
• 30% said they had soiled themselves at least once in the last month because they had no other option.
• 10% said they had gone to bed hungry at least once in the last month because they had the help they needed to eat.

You may be thinking of senior citizens at this point, but remember – roughly 10% of those three million people are between the ages of 19 and 35. That means that, in the last month, there are thirty thousand American adults who went to bed hungry because they could not feed themselves, and the programs that got them to age 19 vanished out from under them.

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Aging Out of EPSDT – Part III: Losing Coverage

In Part I in this series, we discussed the state of Medicaid and the EPSDT – the Early and Periodic Screening, Diagnosis, and Treatment benefit – which covers most American children with disabilities from birth until 19 (21 in some states) years of age. Since 1989, the EPSDT has required that each state of the Union provide every child with “all medically necessary services” that were available under the Federal government's Medicaid program, even if that state did not offer that service to adults. This coverage is expansive enough that it dwarfs most private insurance.

What is 'Medically Necessary'?
One major difference is that most states adopt a definition of “medically necessary” that only includes those services that “improve or eliminate a condition,” at least for adults. But the EPSDT's definition of includes services that “correct or ameliorate defects and physical and mental illnesses and conditions.” That might not sound like a big difference, but it's huge.

That's because 'correct or ameliorate' includes services that stabilize someone who is medically unstable (ie vital signs are not consistently within the defined safe range). So if you're 20 years and 262 days old and your epilepsy lands you in the hospital because you severely injured yourself, the EPSDT kicks in and whatever services it takes to stabilize you are paid for. If you're 21 years old by seven hours when you land in the hospital, that (usually quite massive) bill gets sent to your parent's insurance, and suddenly significant co-pays and discounts apply.

Similarly, 'correct or ameliorate' includes services that maintain function in someone who would normally not function without a specific ingoing intervention. (Maintenance is not 'improving or eliminating'). By far and away the most common example is ADHD medication, which is covered by the EPSDT until 21 years of age, and then, depending on your prescription prescription, the cost can jump as high as $ 300 / month with no assistance available regardless of your income level.

A State of Exposure
States have quite broad discretion when it comes to designing the benefit packages that they offer adults enrolled in Medicaid. They are obliged to provide coverage for a specific list of services, including (but not limited to):

• The Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program,
• Inpatient and Outpatient hospital care,
• Physician services,
• Health Center, Rural Health Clinic, and Nursing Home use,
• Nurse Midwife, Certified Pediatric and Family Care Nurse, and Freestanding Birth Center services,
• Lab and X-ray use, and
• Transportation services (for medical reasons only).

This means that they are not obliged to provide Medicaid programs covering:
• Prescription drugs,
• Clinic services (ie any non-hospital medical facility)
• Therapy services, including physical, occupational, behavioral, and so on,
• Dental, vision, speech, hearing, and language services,
• Respiratory care,
• Podiatry,
• Prosthetics, and
• Private duty nursing services.

As you can see, if you're an adult on Medicaid, you might be very well-cared-for if you live in the right state … or you may be almost completely without coverage for the services you use most, even if your state accepted the Medicaid expansion. Remember in the first post in the series, we stated that the majority of children using the EPSDT were using it for developmental, mental, or emotional disabilities? Notice that all of those fall under “optional” services within this rubric? We'll talk about what this means in more detail in the next post.

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Aging Out of EPSDT – Part II: Losing Medicaid

One of the primary questions for any disabled youth that is turning 19 (21 in some states) is “Will I still be eligible for Medicaid when I age out of the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program?” The answer to that question depends largely on whether or not the state you live in has accepted the Medicaid Expansion that came along with the Affordable Care Act.

If Your State Accepted the Medicaid Expansion

Children turning adult in states that took the Medicaid Expansion (32 out of the 51 counting the District of Columbia) continue to receive the same coverage they did before provided their individual income remains 138% of the Federal Poverty Level or lower. Furthermore, newly-adult folks who were ineligible for Medicaid due to their family's income now become eligible as long as their income remains low (as above.)

These extended forms of coverage end at age 26, at which point many will be right back in this same hellish scenario, only slightly older – the exception is those adults with disabilities who remain legal dependents of their parents; they are covered for as long as their parents are employed. Again, the transition will still occur, but it is delayed until their parents retire. Furthermore, see the next post for reasons why you might lose the coverage you need even if you retain Medicaid coverage in the broad sense.

If Your State Declined the Medicaid Expansion

Children becoming adults in the remaining 19 states (Alabama, Florida, Georgia, Idaho, Kansas, Maine, Mississippi, Missouri, Nebraska, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming ) have a very different struggle ahead of them.

For them, there is exactly one pathway to Medicaid eligibility: they must qualify as low-income (75% or less of the federal poverty level, roughly $ 7250 / year in 2015), and they must be receiving Supplemental Security Income (SSI, aka 'disability' benefits). While it's trivial for many young adults with disabilities to meet the income requirements, it's startingling how many of them can not qualify for SSI as adults – about 3 out of 4 lose their Medicaid access due to SSI's strict disability standards.

That means that every year, thousands of young adults with severe medical conditions that are often disabling – cystic fibrosis, diabetes, severe asthma, HIV, and even cancer! – and who easily meet the income requirements are denied Medicaid and SSI in the same stroke of a pen.

Different Standards for Adults and Children

This is because the Social Security Administration (the government agency responsible for SSI benefits) applies a much more stringent set of criteria to adults than they do children. Of course, they also issue a re-determination on issues of disability whenever a person turned 18, at which point an estimated 30% of all enrolled children lose their SSI benefits, which means they lose Medicaid coverage as well.

More than half of those who lose SSI and Medicaid simultaneously end up completely without any form of medical coverage. This is due to the fact that the ACA was written anticipating a mandatory Medicaid Expansion (which the Supreme Court ruled unconventional and made optional). The ACA's subsidies of health insurance were specifically written to leave out people who made less than 100% of the Federal Poverty Level on the assumption they would be 'caught' by the Medicaid Expansion. When some states declared that program, they forced thousands of Americans into a situation where there is no way they can afford medical care, no matter how disabled they are.

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Aging Out of EPSDT – Part I: What Is EPSDT?

Medicaid is a joint program financed by both the US Federal government and several states; it provides health coverage for low-income Americans. Both critical health services and long-term care are available to roughly 52 million Americans (about 1 in 7 US Citizens) through this powerful program, including over a million disabled youths of 21 years of age or under. Over 20% of the population of disabled youth are receiving Medicaid, including 7 out of 10 low-income children with disabilities.

These disabilities run a wide gamut, including both physical conditions such as cerebral palsy or congenital blindness, and mental conditions such as dyslexia or autism-spectrum disorders. The major channel of coverage for disabled children, Supplemental Security Income (SSI 'disability' payments), primarily goes to children with a primary mental disability such as a developmental disability or an emotional disorder.

Because Medicaid is forged between the Federal and state Governments, both have a say in how it works. The Federal government establishes basic eligibility requirements and broad benefit guidelines, but each state defines precisely what income ranges qualify in their territory, and what services they will offer. However, in an effort to support children's health, the Federal Government is much stricter about children's benefits, forcing states to accept children in at a much higher income threshold than most choose to accept adults, and to offer them a much wider scope and higher quality set of services than they offer adults.

The first and most important service mandated by the Federal government for disabled children is called the Early and Periodic Screening, Diagnostic, and Treatment benefit (EPSDT). This benefit begins at birth, and is responsible for paying for all of the hearing, vision, dental, mental / emotional, and physical exams your child receives at no cost from your school and medical provider, as well as paying for immunizations. If a child is discovered to have a genuine medical issue and is low-income, the 'treatment' part of the program kicks in to pay for whatever form of standardized treatment that state affords them.

… And Introducing 'Aging Out'

All of which is absolutely awesome … right up until the child turns 19 (21 in some states). The moment a person with a disability is no longer a 'youth,' they suddenly find themselves with absolutely nothing in terms of Medicaid benefits unless they qualify for one of the disability programs. Even those who do qualify for an adult-oriented Medicaid disability program often find that their new program (no longer subject to the federal pro-child rules) is substantially lacking in support compared to their old one.

This sudden decrease in support and benefits is known as “Aging Out,” and it is the single most difficult problem many American parents of children with disabilities will contend with during their child's transition to adulthood. Over the next several posts, we're going to explore the effects of aging out of EPSDT and into 'normal' Medicaid, and offer some of our best advice about how to deal with the transition if you're a parent with a disabled child .

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