Patterns of verbal interaction in an interdisciplinary team in a special education school in Israel : an ethnographic case study

This study deals with the description and analysis of patterns of verbal interaction in an interdisciplinary team in a special school, the aim being to discover the ongoing processes that occur in the work of the team. The research examines the team members' perceptions of their role and of the pupils and explores key concepts that are specific to the various experts in relating to the pupils and to the roles in an interdisciplinary team. Characteristic patterns of communication in meetings of the Individual Education Plan team and the administrative team are investigated. This research is the first of its kind in investigating interactions in an interdisciplinary team in the Israeli educational system. The research was conducted as a case study in a special school during the years 1997-1998. The research population comprised 65 members of the interdisciplinary team, consisting of educators, doctors and para-medical professionals. The research tools employed Included observations, Interviews and collection of documents. Using the interpretive method, meaningful processes in the everyday life of the team and its functioning vis-a-vis the pupils are revealed and analysed. The work of an interdisciplinary team in the school requires considerable attention in terms of organisation, since the mere fact of bringing diverse professionals to work together does not guarantee effective collaboration, and the question arises as to how the joint work of the experts is performed in practice, and what are its results and meanings for the participants. The aims of the research are to reveal knowledge and arrive at a thorough description of the organisational culture of an interdisciplinary team. The knowledge revealed can serve as the basis for construction of a cognitive framework for the development of an explanatory theory, the construction of practical tools for the work of an interdisciplinary team in the field and the formulation of questions for future research. The main findings are that the members of the interdisciplinary team working from various areas of specialisation, such as education, therapy and medicine, differ in their role perceptions, definitions of situation and perceptions of the pupils. Moreover, the concepts used by the team members indicate the existence in the interdisciplinary team of three worlds of semantic content, between which there is transferability. Collaboration and communication in the interdisciplinary team is complex and takes place on several levels, reflecting the professional knowledge basis of the team members. The collaboration revolves around the special knowledge of the different experts. The research identified various categories of knowledge that serve in the interdisciplinary discourse; for instance, knowledge from personal experience and knowledge based on professional experience. In the interaction verbal two levels operate concurrently: the overt organisational level, and the hidden social level. Work in a special school is rife with potential crisis situations which may lead to feelings of discontent that are liable to overshadow the work of the professionals in the school. The findings in this work demonstrate the complexity of the working relations among various professionals working together as a team. The main conclusions of the research are that work in an interdisciplinary team demands a wide range of skills, broad knowledge and extensive resources. Therefore it is important that the team members receive training for interdisciplinary team work, as well as ongoing in-service training of professionals in the skills of professional teamwork

Risk of attention-deficit/hyperactivity disorder in children with atopic dermatitis

Atopic dermatitis (AD) is a common, chronic, inflammatory, pruritic skin disorder that affects up to 20% of the children in Western countries. Attention-Deficit/Hyperactivity disorder (ADHD) has been reported to be more frequent in children with AD. The purpose of this study was to explore the risk for ADHD in our population of patients with AD. A population-based case-control study, using the medical database of Clalit Health Services (CHS), the largest healthcare provider organization in Israel. The study included 840 patients with AD between the age of 0-18 years and 900 age and gender frequency-matched patients without AD. The proportion of ADHD in patients with AD was 7.1% as compared to 4.1% in controls. ADHD was more frequent in boys with AD (9.6% vs. 5.2%, odds ratio (OR) 1.9, 95% confidence interval (CI) 1.1-3.2) but not in girls with AD (4.6% vs. 2.9% OR 1.5). In multivariate analyses, AD was associated with ADHD (OR 2.1, 95% CI 1.3-3.4). The current study demonstrated an association between AD and ADHD. This report and earlier observations emphasize the need for detection and treatment of ADHD in atopic patients.  </p

Reaction time performance in ADHD: improvement under fast-incentive condition and familial effects

ABSTRACT Background Reaction time (RT) variability is one of the strongest findings to emerge in cognitive-experimental research of attention deficit hyperactivity disorder (ADHD). We set out to confirm the association between ADHD and slow and variable RTs and investigate the degree to which RT performance improves under fast event rate and incentives. Using a group familial correlation approach, we tested the hypothesis that there are shared familial effects on RT performance and ADHD. Method A total of 144 ADHD combined-type probands, 125 siblings of the ADHD probands and 60 control participants, ages 6-18, performed a four-choice RT task with baseline and fast-incentive conditions. Results ADHD was associated with slow and variable RTs, and with greater improvement in speed and RT variability from baseline to fast-incentive condition. RT performance showed shared familial influences with ADHD. Under the assumption that the familial effects represent genetic influences, the proportion of the phenotypic correlation due to shared familial influences was estimated as 60-70%. Conclusions The data are inconsistent with models that consider RT variability as reflecting a stable cognitive deficit in ADHD, but instead emphasize the extent to which energetic or motivational factors can have a greater effect on RT performance in ADHD. The findings support the role of RT variability as an endophenotype mediating the link between genes and ADH

Confirmation that a specific haplotype of the dopamine transporter gene is associated with Combined-Type ADHD

Objective: The primary purpose of this study was to confirm the association of a specific haplotype of the dopamine transporter gene and attention deficit hyperactivity disorder (ADHD), which could be one source of the heterogeneity seen across published studies. Method: The authors previously reported the association of ADHD with a subgroup of chromosomes containing specific alleles of two variable-number tandem repeat polymorphisms within the 3' untranslated region and intron 8 of the dopamine transporter gene. They now report on this association in a sample of ADHD combined-type probands. Results: The original observations were confirmed, with an overall odds ratio of 1.4 across samples. Conclusions: These data challenge results of meta-analyses suggesting that dopamine transporter variation does not have an effect on the risk for ADHD, and they indicate that further investigation of functional variation in the gene is required. <br/

The World Federation of ADHD International Consensus Statement:208 Evidence-based conclusions about the disorder

Background: Misconceptions about ADHD stigmatize affected people, reduce credibility of providers, and prevent/delay treatment. To challenge misconceptions, we curated findings with strong evidence base. Methods: We reviewed studies with more than 2000 participants or meta-analyses from five or more studies or 2000 or more participants. We excluded meta-analyses that did not assess publication bias, except for meta-analyses of prevalence. For network meta-analyses we required comparison adjusted funnel plots. We excluded treatment studies with waiting-list or treatment as usual controls. From this literature, we extracted evidence-based assertions about the disorder. Results: We generated 208 empirically supported statements about ADHD. The status of the included statements as empirically supported is approved by 80 authors from 27 countries and 6 continents. The contents of the manuscript are endorsed by 366 people who have read this document and agree with its contents. Conclusions: Many findings in ADHD are supported by meta-analysis. These allow for firm statements about the nature, course, outcome causes, and treatments for disorders that are useful for reducing misconceptions and stigma.</p

European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that persists into adulthood in the majority of cases. The evidence on persistence poses several difficulties for adult psychiatry considering the lack of expertise for diagnostic assessment, limited treatment options and patient facilities across Europe. METHODS: The European Network Adult ADHD, founded in 2003, aims to increase awareness of this disorder and improve knowledge and patient care for adults with ADHD across Europe. This Consensus Statement is one of the actions taken by the European Network Adult ADHD in order to support the clinician with research evidence and clinical experience from 18 European countries in which ADHD in adults is recognised and treated. RESULTS: Besides information on the genetics and neurobiology of ADHD, three major questions are addressed in this statement: (1) What is the clinical picture of ADHD in adults? (2) How can ADHD in adults be properly diagnosed? (3) How should ADHD in adults be effectively treated? CONCLUSIONS: ADHD often presents as an impairing lifelong condition in adults, yet it is currently underdiagnosed and treated in many European countries, leading to ineffective treatment and higher costs of illness. Expertise in diagnostic assessment and treatment of ADHD in adults must increase in psychiatry. Instruments for screening and diagnosis of ADHD in adults are available and appropriate treatments exist, although more research is needed in this age group

Patterns of verbal interaction in an interdisciplinary team in a special education school in Israel An ethnographic case study

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