Sunday, March 11, 2018

Special Education Report about HISD from AIR American Institutes for Research (AIR)

The AIR American Institutes for Research (AIR) report of HISD special education is accessible.


This report poses fundamental and even spiritual questions about how our community treats our most vulnerable children. 

Special education should not just be "integrated".  SPED should lead. 

Biology has diversity. Our kids are not McNuggets. SPED is the advanced course in educational theory and application.   If we fail SPED we are failing all children. 

And, I hope its translated to Spanish.

Offer feedback to your trustee or to Trustee at Large @annesung.

Dr. Rotenberg

Here is my summary of the report(my personal opinion, representing no one):  

For the most vulnerable of our children...

In a state that actively discourages identification and treatment of the approximately 15% of children with developmental disorders....

HISD has decent people, trying their best. 

But, HISD also:

  • Under-identifies children while not really communicating/ understanding the process for identification.
  • Places children without data ("sorting hat" vs data based approach?)
  • Inequitably deprives children of resources (e.g resource room).
  • Pokes the "I" out of the IEP.
  • Supports no accountability.
  • Does not adequately communicate.
  • Does not adequately train.
  • Suffers instructional / outcomes failure for SPED.
  • Has no idea a) what happens in transition or after graduation nor attends to this on its report.

Saturday, February 17, 2018

low-THC Cannabis & Epilepsy in Texas on Texas Public Radio

 ... Doctor Joshua Rotenberg, of Houston Specialty Clinic, agrees with Newmark. Rotenberg, who is also registered in the CURT, notes he senses “a lot of hesitation” and “fear” among physicians regarding the low-THC cannabis treatment in Texas, partly because of doubts about the legal aspects surrounding it, and partly because of what is still a lack of knowledge about the treatment itself by those not specialized in epilepsy or not familiar with the research yet. 

Cannabis Treatment Raises Hope For Parents Of Epileptic Children; But Costs, Side Effects Are A Matter Of Concern 

Full Article Here

Dr. Joshua Rotenberg, who works at Houston Specialty Clinic, is one of the 21 physicians that have so far been approved by the Texas Department of Public Safety to prescribe low-THC cannabis treatments for intractable epilepsy.
Rotenberg says the discussion about low-THC cannabis treatments for epilepsy has increased over the last five years and adds that “this medicine is helping a group of people that are really suffering and are really impaired from their epilepsy.” There are over 20 other states in the country where cannabis has been legalized for medical purposes. 
An impactful illness
Rotenberg underlines an illness as impactful as epilepsy typically affects more than just the patient. “It’s not just them, it’s their whole families, these are kids that are having many, many dozens of seizures a day and they have no life, or they have very little quality of life and, so, most of the parents that I see are running towards it as an option to help their children,” explains the physician about the treatment. 
Rotenberg also notes several parents of children with epilepsy have gone to other states to buy low-THC cannabis treatments.
Buying the treatment in other states up until now is something Donna Stahlhut, CEO of the Houston office for the Epilepsy Foundation in Texas, is familiar with.....

Tuesday, February 13, 2018

Coughing? Wheezing? Asthma? Airway is FIRST ...then watch for developmental problems!

Could sleep apnea cause the developmental problems? Yes. Could reflux cause both asthma, and 
disrupted sleep? Yes. 

Regardless see your physician or a  pediatric pulmonary specialist to ask about asthma treatment. 


 2016;53(3):277-81. doi: 10.3109/02770903.2015.1089277. Epub 2015 Oct 30.

The association of childhood asthma with mental health 

and developmental comorbidities in low-income families.



The objective of the study was to determine 
the relationship of childhood asthma with mental health 
and developmental indicators in low-income families.


Parents/guardians of approximately 400 children, 
aged 2-14 years, were recruited from a charity hospital 
serving low income neighborhoods in the outskirts of Karachi, 
Pakistan. Mothers of children were interviewed in their 
local language by a trained nurse. Eight self-reported 
comorbidities were grouped into two constructs based 
on factor analysis and conveniently labeled as mental health 
(anxiety, attention and behavioral problems) and developmental 
problems (learning, developmental delay, hearing impairment, 
sleep and speech problems). 
Data were analyzed using multiple logistic regression, 
adjusted for age, sex, presence of older siblings, 
number of people in the household, child birth weight, p
resence of mold, and family history of asthma or hay fever.


Children with asthma had 18 times greater odds 
of mental health problems 
(adjusted OR = 18.0, 95% CI: 9.2, 35.1) as compared to 
children without asthma. 
The odds of developmental problems were more than 
14 times greater for children with asthma 
(adjusted OR = 14.3, 95% CI: 7.8, 26.1) 
as compared to children without asthma.


This study found mental and developmental
 adverse consequences of childhood asthma in low-income 
families. Identifying and treating asthma at an early age 
could reduce the burden of comorbidities in this population.


Asthma; attention problems; children; developmental delay
[Indexed for MEDLINE]

Saturday, February 10, 2018

Cannabis Treatment for Epilepsy: Where is the evidence?

Is there good evidence for cannabis efficacy and safety in treating epilepsy?  Yes.  - JR

Cannabinoids in the Treatment of Epilepsy: Hard Evidence at Last?

Evidence for cannabidiol / CBD superiority over placebo in treating
refractory epilepsy syndromes. 
The interest in cannabis-based products for the treatment of refractory epilepsy has skyrocketed in recent years. Marijuana and other cannabis products with high content in Δ(9) - tetrahydrocannabinol (THC), utilized primarily for recreational purposes, are generally unsuitable for this indication, primarily because THC is associated with many undesired effects. Compared with THC, cannabidiol (CBD) shows a better defined anticonvulsant profile in animal models and is largely devoid of adverse psychoactive effects and abuse liability. Over the years, this has led to an increasing use of CBD-enriched extracts in seizure disorders, particularly in children. Although improvement in seizure control and other benefits on sleep and behavior have been often reported, interpretation of the data is made difficult by the uncontrolled nature of these observations. Evidence concerning the potential anti-seizure efficacy of cannabinoids reached a turning point in the last 12 months, with the completion of three high-quality placebo-controlled adjunctive-therapy trials of a purified CBD product in patients with Dravet syndrome and Lennox-Gastaut syndrome. In these studies, CBD was found to be superior to placebo in reducing the frequency of convulsive (tonic-clonic, tonic, clonic, and atonic) seizures in patients with Dravet syndrome, and the frequency of drop seizures in patients with Lennox-Gastaut syndrome. For the first time, there is now class 1 evidence that adjunctive use of CBD improves seizure control in patients with specific epilepsy syndromes.
J Epilepsy Res > Volume 7(2); 2017 > Article

Friday, February 02, 2018

CBD & Epilepsy: Medical cannabis delivered in Texas - Interview with Epilepsy Specialist Dr. Joshua Rotenberg

Interesting times. - JR

Report on KHOU HERE
For those latter cases—known as intractable epilepsy—Rotenberg, a Houston pediatric neurologist, and 17 other statewide neurologists have a new treatment tool at their disposal: low-THC medical cannabis.
“It’s incredible for them, I think, to reduce the burden of seizures and increase quality of life,” Rotenberg said. “It changes the whole world.”
The cannabis comes in the form of oil with low amounts of tetrahydrocannabinol, the main ingredient in marijuana that causes a high. Instead, the oil contains high amounts of cannabidiol (CBD) that doesn't come with a high and is used to treat epilepsy and other medical conditions.
CBD Oil For Epilepsy Now dispensed in Texas
It was legalized in 2016 when Gov. Greg Abbott signed the Compassionate Use Act into law. Not only did it authorize the legal use of cannabis oil for patients who suffer from intractable epilepsy, but it created a state registry of neurologists to prescribe the oil and for the creation of three dispensaries to cultivate marijuana to be processed into cannabis oil and dispensed statewide.
A 6-year-old girl in Central Texas, who wasn’t identified, was the first recipient of legal medical cannabis after an order was delivered to her home Thursday.
“This is a great day for patients in Texas,” said State Rep. Stephanie Klick (R-Fort Worth), in a conference call Friday. Klick authored the Compassionate Use Act. “Many of these patients have exhausted all options—brain surgery, multiple pharmaceutical products—and their seizures are not controlled.”
Knox Medical, a Florida-based company with a dispensary in Schulenburg, made Thursday’s delivery. The company declined to release more details about the girl, citing patient privacy, but a spokesperson said the company is honored to make the “first delivery of medical cannabis to a patient in Texas.” 

About 160,000 Texans suffer from intractable epilepsy, according to Knox Medical, though Rotenberg estimates the number to be around 130,000.
Texas has long taken a hard stance against marijuana, even for medical purposes. Meanwhile 28 states  have legalized the use of medical marijuana, while nine states plus the District of Columbia have outright legalized the recreational use of marijuana.
There’s a growing trend among Texans who support marijuana’s legalization, too. Eighty-three percent of Texans support legalizing marijuana for some use, according to a 2017 University of Texas/Texas Tribune Poll. 
Rotenberg said he’s aware of people who have traveled to states like Colorado, where recreational marijuana use is legal, to purchase cannabis oil to help combat intractable epilepsy. It’s long travel for families who swear by its benefits. Rotenberg said in some cases cannabis oil has cut a person’s seizures in half.
“If it helps in that way, that’s great,” he said.

Monday, December 11, 2017

Epilepsy Surgery: Insurance Company Blocks Minimally Invasive Brain Surgery

Image result for laser ablation epilepsy
Laser ablation surgery burns otherwise inaccessible target areas to stop seizures. 
I have had a refractory patient cured by laser ablation for epilepsy. This is outrageous.
I fear that the notion of "experimental is often abused to block care". JR

Girl has blunt message for Aetna after her brain surgery request was denied

The author of the story has a family member with an uncontrolled seizure disorder who does not medically qualify for either type of brain surgery mentioned in the piece nor has the family member been denied care by an insurance provider.

(CNN)Cara Pressman sobbed in the big red chair in her living room. The 15-year-old tried to absorb the devastating news relayed by her parents: that their insurance company, Aetna, denied her for a minimally invasive brain surgery that could end the seizures that have haunted her since she was 9 years old.

"When my parents told me, I went kind of blank and started crying," she said. "I cried for like an hour."

Her friends had been lined up to visit her in the hospital for the surgery three days away, on Monday, October 23. Between tears, she texted them that the whole thing was off.

It was supposed to be a joyous weekend. Cara's grandparents had come to town to celebrate their 90th birthdays, a jubilant party with more than 100 family and friends crowding her home. The party did go on -- just with a lot more stress.

Cara had multiple complex partial seizures that weekend. When the seizures strike, her body gets cold and shakes, and she zones out for anywhere from 20 seconds to two minutes, typically still aware of her surroundings. Her seizures can be triggered by stress, by being happy, by exerting herself -- almost anything. "It's like having a nightmare but while you're awake," she said.
In the six weeks since the denial, Cara has had more than two dozen seizures affecting her everyday life....



Friday, December 01, 2017

TEA selling Special Education IEP data? What is the connection between ISD and SPEDX?

Do parents have recourse? More to follow... JR

Texas Education Association 

Firing leaves Texas without a special education director at a critical time

Updated 5:56 pm, Wednesday, November 29, 2017

AUSTIN - After just over three months on the job, the state's special education director was fired last week after she filed a federal complaint against the Texas Education Agency for awarding a multi-million dollar, no-bid contract to a company that is mining data on disabled students......

A few months before she was hired, TEA signed a $2 million contract with SPEDx, a Georgia-based data company, to analyze students' Individualized Education Program, or IEP. An IEP lays out a student's disability, their education needs and how a school intends to meet those needs.
In a presentation to school districts, TEA said SPEDx will analyze IEPs to "detect hidden patterns and insights" that can help the department better serve students. In September, TEA amended SPEDx's contract to $4.4 million dollars. TEA says it did not put the contract out for bid because data project requires specialized software that only SPEDx can provide.