Tips for Meeting with School Officials about possible IEP's

Tips for Meeting with School Officials about Individualized

Education Plans

I was recently invited to speak at a national convention devoted to the care of children with a very rare metabolic disorder, but at the convention, a neuropsychologist from Denver, Colorado, Dr. Kendra Bjoraker, offered a series of tips to help parents in meetings with school officials.

These tips each were so insightful, so helpful, I wanted to make them available to you all.  Each really help put  you, the parent, in a better position to get the best educational plan for your child possible.

Keep in mind, these tips were designed for meetings with officials who have the power and authority to decide what help your family and your child will receive from their school.  As such these tips could be helpful for any such meeting, school or otherwise:


Your overall goal is to get the organization to help you and your child

• Be sure to sit next to the most senior decision-maker at the meeting.
• Dress formally, make sure you look like you take their time seriously
• Bring food, fruit or cookies, it is harder to say no to someone who feeds you.
• Print the Rules and Regulations of the State of Ohio on the subject you are discussing, for example, IEP services, and place them in a binder with the title Rules and Regulations of the State of Ohio on the spine of the binder.  Place the binder with the spine facing towards meeting participants.
• If an administrator states that the law forbids or does not allow them to help you in the way you request, ask them to point to the statute, in your binder.
• Take notes.
• Before you leave, insist on getting copy of the administrator's notes.  Often promises made at the meeting don't make it into the final report.
• Tape record the meeting and leave it on as everyone is saying their goodbyes.  Often promise are made as a friendly parting gesture.
• Be sure to go after the problem, not the people.  The challenge is to get help, not to go after individuals.  If you are getting angry at someone, the focus is off center.

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*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Time to Rethink the use of Acetaminophen (aka Tylenol)

Time to Rethink the use of Acetaminophen (aka Tylenol)

On August 16, 2010, The New York Times published a brief account of a research study looking at the association of asthma and use of acetaminophen (the medication in Tylenol, known in Europe as paracetamol).

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http://www.nytimes.com/2010/08/17/health/research/17risk.html?_r=1&ref=health&pagewanted=print

This study, looked at hundreds of thousands of children across 50 countries and found that if kids took Tylenol, the chance of them having asthma, hay fever, or itchy eyes increased.

There have been some indicators that acetaminophen could increase the chance of developing allergic problems like asthma, runny nose, and itchy eyes, but now the evidence is strong enough for we at Advanced Pediatrics to issue the following recommendation, particularly since ibuprofen works just as well:

Advanced Pediatrics recommends that pregnant women, infants, children, and adolescents no longer use acetaminophen (Tylenol).

Why?  Sufficient evidence now exists to be concerned that use of acetaminophen during pregnancy, infancy, childhood, and/or adolescence can increase the chance of developing asthma, hay fever, and/or allergic itchy eyes.

What about fever, pain, inflammation?  It turns out ibuprofen (Advil, Motrin) works as well or better than acetaminophen, so stopping the use of acetaminophen still allows you to give something for fever, pain, and/or inflammations.

What about high fevers and alternating meds?  It also turns out that if you use ibuprofen to control fever, adding an alternating dosage of acetaminophen does not lower the fever any further.  So stopping the use of acetaminophen will not cause the fever to go higher.

See below for abstracts on the NYT quoted study, and a recent survey of the biologic plausability of acetaminophen really causing asthma to develop.

Dr. Arthur Lavin

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Published ahead of print on August 13, 2010
Am. J. Respir. Crit. Care Med. 2010, doi:10.1164/rccm.201005-0757OC

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Submitted on May 12, 2010
Accepted on August 13, 2010

Acetaminophen Use and Risk of Asthma, Rhinoconjunctivitis and Eczema in Adolescents: ISAAC Phase Three

Richard W Beasley^1*, Tadd O Clayton², Julian Crane³, Christopher K.W. Lai⁴, Stephen R Montefort⁵, Erika von Mutius⁶, Alistair W Stewart², and the ISAAC Phase Three Study Group¹ Medical Research Institute of New Zealand, Wellington, New Zealand, ²Faculty of Medical & Health Sciences, The University of Auckland, Auckland, New Zealand, ³ Otago University Wellington, Wellington, New Zealand, ⁴Chinese University of Hong Kong, Hong Kong, China, ⁵ University of Malta, Malta, Malta, ⁶ Dr von Haunersches University Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
^* To whom correspondence should be addressed. E-mail: richard.beasley@mrinz.ac.nz.

Rationale: There is epidemiological evidence that the use of acetaminophen may increase the risk of developing asthma. Objective: To investigate the risk of asthma and other allergic disorders associated with the current use of acetaminophen in 13 to 14 year old children in different populations worldwide. Methods: As part of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three, 13 to 14 year old children completed written and video questionnaires, obtaining data on current symptoms of asthma, rhinoconjunctivitis and eczema, and a written environmental questionnaire obtaining data on putative risk factors including acetaminophen use in the past 12 months. Measurements: The primary outcome measure was the odds ratio (OR) of current asthma symptoms associated withacetaminophen use calculated by logistic regression. Main results: A total of 322,959 adolescent children from 113 centres in 50 countries participated. In the multivariate analyses the recent use of acetaminophen was associated with an exposure-dependent increased risk of current asthma symptoms [OR 1.43 (95% CI 1.33 to 1.53) and 2.51 (95% CI 2.33 to 2.70) for medium and high versus no use respectively]. Acetaminophen use was also associated with an exposure-dependent increased risk of current symptoms of rhinoconjunctivitis and eczema. Conclusions: Acetaminophenuse may represent an important risk factor for the development and/or maintenance of asthma, rhinoconjunctivitis and eczema in adolescent children.

Clin Exp Allergy. 2010 Jan;40(1):32-41.

The role of paracetamol in the pathogenesis of asthma.

Farquhar H, Stewart A, Mitchell E, Crane J, Eyers S, Weatherall M, Beasley R.

Medical Research Institute of New Zealand, Wellington, New Zealand.

Abstract

Paracetamol use represents a putative risk factor for the development of asthma. There is convincing epidemiological evidence that the risk of asthma may be increased with exposure to paracetamol in the intrauterine environment, infancy, later childhood and adult life. A dose-dependent association has also been observed in these different age groups in different populations world-wide. An association has also been shown between paracetamol use in both rhinoconjunctivitis and eczema. There is biological plausibility with paracetamol use leading to decreased glutathione levels resulting in increased oxidant-induced inflammation and potentially enhanced T-helper type 2 responses. At the population level, patterns of paracetamol use might explain, to some extent, the world-wide variation in the prevalence of asthma and related disorders, particularly the high rates in English-speaking countries, which have high per capita prescription and over-the-counter use of paracetamol. A temporal association also exists between the international trends of increasing paracetamol use and increasing prevalence of asthma over recent decades. Further research is urgently required, in particular randomized-controlled trials (RCTs) into the long-term effects of frequent paracetamol use in childhood, to determine the magnitude and characteristics of any such risk. Importantly, RCTs will also enable evidence-based guidelines for the recommended use of paracetamol to be developed.

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*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Concerns about the New Meningitis Vaccine- Menactra- Now Resolved

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Concerns about the New Meningitis Vaccine- Menactra- 

Now Resolved

Several years ago, improvements to the meningococcal meningitis vaccine led to the licensure of Menactra.

Menactra offers the advantage of a longer duration of coverage.

However, soon after it was licensed, a group of 6 people who got the vaccine developed a syndrome of temporary paralysis called Guillan-Barre Syndrome.  The FDA launched a study to see if the vaccine was at fault.  We have held off recommending this vaccine until this issue was settled.  Note that our stance was never that the Menactra vaccine was dangerous, we just wanted to ensure its safety before recommending it.

Two important studies have now been published and establish that the Menactra vaccine does not cause Guillan-Barre syndrome and we now recommend its use to prevent meningococcal meningitis, the type of meningitis seen in college.

One of the studies looked at the experience of 1.4 million children who got the Menactra shot, in Boston.  There were no cases of Guillan-Barre syndrome associated with the shot.

The other study was from the CDC showing no increased risk of developing Guillan Barre syndrome after being immunized with Menactra.

Bottom Line:

Advanced Pediatrics, on the basis of recent evidence that Menactra has no connection to Guillan-Barre syndrome, is now recommending the routine use of Menactra in all children, starting at age 11-12.

Dr. Arthur Lavin

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*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.