Blog Archives

neurodiversity & Accomodation

11/29/2020

There are more and more neurally diverse people in the workforce
Most people with executive functioning differences have never been formally identified.
As more and more challenges mount up, some of those folks find themselves involved with substances (legal and/or illegal)
And some find themselves Homeless or involved with the Criminal Justice System.

It seems that Executive Functioning Differences are the COMMON DENOMINATOR that cuts across cognitive disabilities and is a COMMON DENOMINATOR in INCARCERATED POPULATIONS.

Executive Functioning Differences are COMPLICATED and they are NOT all bad -- Leonardo da Vinci and Einstein are speculated to have had ADHD.

It is worth noting that both da Vinci and Einstein went to great lengths to TAILOR their WORK ENVIRONMENTS to suit themselves.

I would submit there are a lot of people in the criminal justice system who need TAILORED WORK ENVIRONMENTS.

There is more TALENT in jails and prisons and homeless shelters than we realize -- but some people will need SUPPORT with EXECUTIVE FUNCTIONING DIFFERENCES.

We haven't been good at Executive Functioning SUPPORTS, WORKAROUNDS and ACCOMODATIONS -- we need to get a lot better -- and start complying with the Americans with Disabilities Act (ADA).

Most ACCOMMODATIONS and WORK AROUNDS are NOT an "UNDUE HARDSHIP."

On the other hand, if we haven't been doing them -- it is going to be awhile before it gets "EASY."

The ADA largely places the BURDEN on people with COGNITIVE DISABILITIES to know about these ACCOMODATIONS -- when most of their Service Providers don't know about them.

THIS IS NOT WORKING IN A BIG WAY.

We must get PROVIDERS up to speed on ACCOMODATIONS AND WORKAROUNDS FOR EXECUTIVE FUNTIONING DIFFERENCES, and at the very least make appropriate referrals.

Employment Index

THANKSGIVING 2020 ---- WHAT WE'RE THANKFUL FOR

11/28/2020

[This was first posted Thanksgiving Day 2020 -- Nov. 26.]

We are very THANKFUL for the CORONA VIRUS VACCINES.

Maybe we will be more back to "normal" next year.

This INTERIM time before the vaccine has been very difficult -- many people have lost their lives.

For many people with different serious diseases or syndromes -- that INTERIM time may be most of their lives.

Cognitive Disability/Difference whether Brain Injury, Mental Illness, Trauma, Developmental Disability and/or Substance Use is COMPLICATED and we are starting to really address these problems that affect millions of people in the US and all over the world.

Those problems are INTEGRATED and they do involve BIOLOGY, ENVIRONMENT and SOCIAL SYSTEMS.

For our perspective we're very thankful for BLACK LIVES MATTER -- that was not afraid to make the case that RESOURCES NEED TO BE ALLOCATED to the SERVICES our COMMUNITIES NEED.

MAD IN AMERICA & THE AMERICAN PSYCHIATRIC ASSOCIATION ---CLOSER THAN YOU THINK

11/28/2020

WE NEED TO GET BOTH OF THEM CLOSER TO THE NATIONAL INSTITUTE OF MENTAL HEALTH

One of the issues that can really get people going is whether Mental Illness is Biologically Based or Psycho-Socially Based.
My take on the relative positions is:

Mad In America sees things as psycho-socially based because they are against MEDICATION. [I would argue that one could just as easily say MEDICATION is problematic because the BIOLOGY is so COMPLICATED.]
The American Psychiatric Association seems to take a Middle Ground -- BUT they have failed to address a scientifically invalid diagnostic manual in large part -- because some of them are INVESTED in a PSYCHO-SOCIAL MODEL that is somehow divorced from BIOLOGY.
The National Institute of Mental Health does recognize that it is the INTERACTION of BIOLOGY and ENVIRONMENT. NIMH focuses a lot on the BIOLOGY because that is what we really need right now.
WHY DO WE REALLY NEED THE BIOLOGY RIGHT NOW?
A lot of those SOFT FACTORS included in ENVIRONMENT are already CORROBORATED in the BIOLOGY --- and we have a lot of REASON to believe others will be as well.
THE LANGUAGE OF FEELING is IMPORTANT and it is far from IRRELEVANT --- and if it is all you've got --- it is definitely better than nothing. BUT we do need a LANGUAGE that can provide more PRECISION --- and can be compared and contrasted with the LANGUAGE of FEELING.
I'm definitely a BELIEVER in: If somebody says it's NOT WORKING --- it's probably NOT WORKING.
On the other hand -- NIMH is right --- we have to get beyond talking about the "QUALITY of FEELING" as our MEASURE and get to those BIOMARKERS where we can find them.
Those biomarkers are being found -- SLOWLY -- and some of this isn't exactly what we thought -- mental illness has a lot more to do with the IMMUNE SYSTEM and the MICROBIOME than we realized just a few years ago. [And the Endocrine System is in there, too.]

The Image above is surprisingly from the Social Work Podcast --- we really like it.

When Mad In America or some Professionals or others object to BIOMARKERS --- sometimes what they are arguing for is the legitimacy of a particular dimension or way of viewing the world.

Those ways are valid (basically if they can be integrated -- there are no known CONTRADICTIONS that can't be worked around by viewing the issue in another respect so that there is NO CONTRADICTION).

HUMAN KNOWLEDGE needs to be INTEGRATED -- INTEGRATION of KNOWLEDGE is NOT just a BUZZWORD -- and at the end of the day it is a lot of HARD WORK.

Conversation & Dialogue: Integrating Science, Reason and Faith/Religion

Mental Health Must Change A Whole Lot to be Effective -- & A Big Part of that is Appreciating the Large Role of the Immune System in Mental & Brain Disorders

[This blog looks at a broad range of scientific evidence regarding "mental illness" and the "immune system."

Importantly, from a Psycho-Social Perspective -- Childhood Trauma can damage the Immune System.

Additionally, there is Elevated Risk for Autoimmune Disorders in Iraq and Afghanistan Veterans with Post-Traumatic Stress Disorder.

Of course, it unfortunately turns out that there are A LOT OF THINGS that can DAMAGE the IMMUNE SYSTEM.]

The Anna Karenina Principle:

After realizing how unpredictably each individual's gut microbiome communities responded during "unhappy" stressful situations, the research team coined their discovery the "Anna Karenina principle" in honor of Tolstoy's dictum. In the study abstract, the authors write:

"The result is an ‘Anna Karenina principle’ for animal microbiomes, in which dysbiotic individuals vary more in microbial community composition than healthy individuals—paralleling Leo Tolstoy's dictum that “all happy families look alike; each unhappy family is unhappy in its own way."

The Crying Need for Individualized, Precision Medicine in Psychiatry -- It's Hard To See How You Get There Without BIOMARKERS

Greta Garbo in "Anna Karenina" (1935)

Ohio State's Anna Karenina Principle

ALIVE: A STORY OF SURVIVAL

11/26/2020

I think most "gifted" people are Twice Exceptional on some level.

Further, I think there are more individuals who are Twice Exceptional than the .5% that are currently estimated.

This is a lot about DIVERSITY & DIFFERENCE and "TRADITIONAL INTELLIGENCE" being a lot different than we thought.

The emotional overexcitabilities of "gifted" people seem to have been a driving factor in the "Emotional Intelligence" movement.

We're living in a time in which gender and sexual orientation diversity are more and more recognized and accepted.

But for the person with Executive Functioning Differences -- that is NOT ACCEPTED and very few professionals know how to ACCOMMODATE and WORK AROUND differences in Executive Functioning.

Twice Exceptional Children: Brain Development
Research shows that the 2e brain, not accounting for any particular condition, is meta-physiologically different from a neurotypical brain.

Twice exceptional brains generally tend to:

*be physically larger

*have more connectivity – the white matter within the brain is denser, meaning more connections and storing of information.

*Sensory intake capacity is also greater.

*be “over-excitable” – emotions are more intense because the limbic system, the part of the brain thought to be responsible for emotion and other processes, is overloaded by increased sensory input (as a result of denser white matter) and the development of intense epigenetics, or sensory prints, as the brain builds knowledge based on various environmental stimuli.

The increased demands on the limbic system may explain why many 2e children have the same struggles and asynchronous development paths – their social-emotional growth is typically delayed, but their intellectual growth is accelerated.

-----ADDITUDE: What Does Twice Exceptional Mean? Identifying and Nurturing Gifted Children with ADHD

"The confusion over where the plane went down led to what Canessa, who was one of two that hiked to find help, called one of his greatest regrets.

"The group's strategic planning centered around the premise they were in Chile when they were in Argentina."

Val's Note: I picked this book because one of the tragedies of the Andes plane crash was the pilots gave the survivors the wrong directions to safety.

I think that is what the Mental Health Profession is doing in some respects.

It "seems" that some people are outside of traditional human "Homeostasis" for sensory intake and this can impact them in a number of positive and negative ways.

Various Mental Disorder Categories such as ADHD, AUTISM, BIPOLAR DISORDER, DEPRESSION and SCHIZOPHRENIA are BLURRED according to the National Institute of Mental Health --- and at least on some level there are common mechanisms-- such as Calcium Channel disruptions.

Aspects of intelligence are NOT what we think -- and "traditional intelligence" is related to GREATER SENSORY INTAKE.

That greater sensory intake can have a number of challenges the SOCIETY isn't prepared for and the INDIVIDUAL certainly isn't prepared for.

COMING TO TERMS WITH BURDEN OF PROOF

11/25/2020

There are some "ANSWERS" that are DEEPLY ENTRENCHED in our Society -- which appear to be WRONG at least in part, and maybe in large part.
This becomes particularly problematic when addressing evolving scientific concepts of "MENTAL ILLNESS" and legal concepts of "INSANITY" and "INCOMPETENT TO PROCEED."
The COMPLEXITY just multiplies when one realizes --- "MENTAL ILLNESS" isn't the only cognitive disability represented in the Criminal Justice System.
Next -- we're at EXTREME EXPONENTIAL COMPLEXITY --- many people within the Criminal Justice System have MORE THAN ONE cognitive issue whether it's a COMBINATION of:
- Brain Injury,
- Mental Illness
- Trauma
- Developmental Disabilities such as High IQ ADHD or Autism, or other Intellectual Disabilities, and/or
- Disability as a result of Substance Use
When SCIENTISTS look at a problem regarding EVIDENCE and PROOF --- by and large the BURDEN of PROOF is always on them -- so they don't even think about that issue.
For the LAWYER --- who has the BURDEN of PROOF --- is OFTEN AN ISSUE. It is certainly often a central issue in CRIMINAL JUSTICE.
So far we haven't been willing to address the BURDEN of PROOF issues wrapped in EVOLVING SCIENCE on "MENTAL ILLNESS" and other cognitive disabilities -- this is all more COMPLICATED than we thought -- and maybe some of these disorders are not only brain disorders, but immune disorders and disorders of the microbiome.
RIGHT NOW --- our attitude seems to be -- as soon as all that gets figured out -- we'll address it.
Really? -- That's our IDEA of JUSTICE?
In fairness, we have some other DEEPLY ENTRENCHED IDEAS -- that are making it hard for us to address the evolving science on Mental Illness and Cognitive Disability RATIONALLY.
The reality is we could have GREATER SAFETY if we moved even more strongly to a PUBLIC HEALTH APPROACH to CRIMINAL JUSTICE.
The NEEDS of a lot of people in the CRIMINAL JUSTICE SYSTEM --- FAR OUTSTRIP what their FAMILIES can provide.
This is NOT an EASY PROBLEM.
Whether through Olmstead Planning or something else, we need an ON-GOING PROCESS to provide Housing, Placements, Intensive Services, and Supported Employment that includes:
- Measurable Goals
- Reasonable Time Frames, and
- Funding to Support the Plan

"The Strange Order of things"

11/24/2020

For Neuroscientist Antonio Damasio, the Strange Order of Things is the origin of feelings not in big-brained primates but in the beginnings of LIFE ITSELF -- single-celled animals, even bacteria.

The "STRANGE ORDER of THINGS" also seems related to our notions of FREE WILL --- it is not running from the FUTURE to the PAST --- it is running from the PAST to the FUTURE.

In a lot of ways, the PROGRESSION of our UNDERSTANDING is what you would expect --- it EXPANDS and DEEPENS over Time.

We latched onto "INTENT" as the "PROOF" of "FREE WILL" and justification for "PUNISHMENT" largely out of NECESSITY to protect ourselves and others and to provide for SAFETY.

There is plenty of "BAD INTENT" out in the World.

More and more people around the world are asking very provocative questions:

What's behind the "BAD INTENT?"
If it's "EMOTIONAL DYSREGULATION" what's behind the "EMOTIONAL DYSREGULATION?"
- Brain Injury?
- Mental Illness?
- Trauma?
- Developmental Disability/ Difference?
- Substance Use?
- Often some combination?
THE IRONY --- taking into account the ROOT CAUSES of Emotional Dysregulation mean --- Justice/CARE involvement could be quite lengthy.
ANOTHER IRONY --- a PUBLIC HEALTH APPROACH to CRIMINAL JUSTICE gets us on an EVIDENCED-BASED PATH to provide for SAFETY and HUMANE TREATMENT -- rather than the current ARBITRARY Sentencing Schemes.

Antonio Damasio: "The Strange Order of Things --- Life, Feeling and the Making of Cultures"

COMEDY & DRAMA BOTH RELY ON INTENSE SENSITIVITY

11/23/2020

There is a lot to be said for being a highly sensitive, emotional person --- but it takes time to process all that emotion.
I would submit that the Humanities and the Arts are very much --- "When Life Gives You Lemons, Make Lemonade" for the intensely sensitive/emotional person.
Exploring the many dimensions of intense emotionality reveals not only much about ourselves but others as well.
There is enormous INFORMATION & FUEL packed into emotion. Emotion is NOT Reason's opposite.
But it takes real time and energy to tease that information out --- and it is really the work of a lifetime.

"The brain is a servant of the body" - celebrated neuroscientist and author Antonio Damasio on feelings as the origin of the brain

So we are talking about feelings and emotions as something intrinsically biological that often can be all over the map from ethereal to hellish to hilarious.

Damasio's pick for greatest neuroscientist of all time: Shakespeare.

Warning: Some disturbing images.

Jesse JR's incredible montage: "There is something inside me" which validates the intensely emotional person.

The Bachelor & the Bobby Soxer (1947)

Shirley Temple's comedic portrayal of a 1940s teenage girl who appears equal parts sensitivity and arrogance.

Those who know me, know there are some ways in which I resemble this character --- that's part of the fun of it, too --- finding something you can identify with.

STRENGTH BASED APPROACH + WORK AROUNDS FOR EXECUTIVE FUNCTIONING

11/22/2020

FOR THOSE INVISIBLE ABILITIES & DISABILITIES

For some time the law has struggled with the concept of "Insanity" --- and recognizing a "Defense" when someone doesn't understand the nature or consequences of their actions.
That's not most people.
We're starting to address those people with "mental illness" who are caught in this system.
A lot of foundation is being laid around the world to deal with the large prevalence of BRAIN INJURY in jails and prisons --- which seems to be more prevalent than classic Mental Illness.
Dealing with Developmental or Acquired Deficits or Differences in Executive Functioning is a BIG ISSUE for EDUCATION, EMPLOYMENT/ENTREPRENEURSHIP and for CRIMINAL JUSTICE.
Our focus on the Humanities and the Arts is meant to CAPITALIZE on the often INTENSE EMOTIONS of people with Developmental or Acquired Differences and the need to communicate those emotions and insights.
Further, this Arts and Humanities focus can and maybe should be integrated with STEM.
So in this sense we see INTENSE EMOTIONALITY as a STRENGTH.
With respect to Executive Functioning Deficits or Differences, the temptation to try and change the person into a NEURO-TYPICAL largely needs to be RESISTED --- if nothing else, it is UNLIKELY TO WORK.
On the other hand, WORK-AROUNDS, RE-STRUCTURING, and ACCOMMODATIONS may all be needed to address challenges in:

Initiation / Activation
Planning & Organizing
Attention
Self-Monitoring
Working Memory
Effort, and
Emotional Regulation

judicial & state recognition of the importance of support over criminal justice involvment

11/21/2020

Jagruti Rai Shah, Forensics Services Director at the Colorado Department of Human Services

Colorado Forensics Services Director Jagruti Rai Shah posted this information from the CSG Justice Center and highlighted the quote from Judge Waller in Oregon.

There is a lot of work to do --- BUT as more and more Judges and State Officials around the country recognize the importance of funding SUPPORT over criminal justice involvement -- REAL TRANSFORMATION seems not only possible but probable.

Getting this FOUNDATIONAL UNDERSTANDING is so important if we're to move on to the COMPLICATED FINANCING CHALLENGES facing States across the country.

We greatly appreciate the leadership of Colorado Forensic Services Director Jagruti Shah.

It has cost us more than $300,000 to try to restore competency to a young woman on my docket.

And yet, when her charges are dismissed, she will have no housing and no community supports or services.

The community and this young woman would have been far better off if we diverted her out of the criminal justice system at the beginning and invested the money spent on restoration on services and housing that would support her for the long run.

-------HONORABLE NAN WALLER, CIRCUIT COURT JUDGE, MULTNOMAH COUNTY, OREGON

Just & Well: Rethinking How States Approach Competency to Stand Trial

HINDSIGHT IS 20/20 ----- COVID, MENTAL HEALTH & ECONOMICS

11/19/2020

Several months into the pandemic --- that's also turned into a Mental Health Pandemic and an Economic Disaster--- the US response is NOT what we want for the future.

A lot more thought must be put into the Mental Health Ramifications of shutdowns and restrictions.

I'm sympathetic to the pleas of medical professionals --- but they are basically saying the same thing they have been saying for several months, BUT

they are NOT adequately addressing the mental health aspects of this, and
they are NOT adequately addressing the economic aspects.

Just re-iterating ad nauseam mask wearing and social distancing isn't good enough.

Now maybe that epidemiologist isn't the right person to address mental health and the economics of restrictions.

Further, just reporting how bad mental health is -- isn't good enough either. We need new innovative strategies to deal with such restrictions.

It appears the vaccine(s) is imminent --- and that is going to be the ultimate answer for COVID-19.

But this hasn't been handled well -- and just re-iterating medical precautions without addressing mental health and economics SUBSTANTIVELY is a bad joke.

Kaiser Family Foundation

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