Peter H Brown Clinical Psychologist

Psychology News & Resources

Sally Thibault: Author Of ‘David’s Gift’ On Tips For Parents Of Children With Aspergers Syndrome

For More Information Click Image Or Visit davidsgift.com

On April 2nd, World Autism Day, I blogged this post about the amazing new book “David’s Gift” by author, speaker and mother Sally Thibault. On Friday 16th, Sally was interviewed on the Nine Network Show ‘Today’,During the 4 minute interview she  provided a number of practical tips for parents. Here’s the Video. Make sure you visit http://www.davidsgift.com !

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April 19, 2010 Posted by | Aspergers, Aspergers Syndrome, Autism, Biography, Books, Child Behavior, diagnosis, Education, Parenting, video | , , , , , , , , , , , , , , , , | 3 Comments

Anxiety & Depression: Self-Help Internet Interventions Work!

A little while ago I posted a list of free interactive self-help web sites, all research based, which have been shown to effective in the treatment of anxiety & depression. A recent study adds to the body of evidence which supports web based intervention as a viable treatment option or adjunct.

Cognitive behaviour therapy (CBT) via the internet is just as effective in treating panic disorder (recurring panic attacks) as traditional group-based CBT. It is also efficacious in the treatment of mild and moderate depression. This according to a new doctoral thesis soon to be presented at Karolinska Institutet.

Read the original research thesis here (PDF)

“Internet-based CBT is also more cost-effective than group therapy,” says Jan Bergström, psychologist and doctoral student at the Center for Psychiatry Research. “The results therefore support the introduction of Internet treatment into regular psychiatry, which is also what the National Board of Health and Welfare recommends in its new guidelines for the treatment of depression and anxiety.”

It is estimated that depression affects some 15 per cent and panic disorder 4 per cent of all people during their lifetime. Depression can include a number of symptoms, such as low mood, lack of joy, guilt, lethargy, concentration difficulties, insomnia and a low zest for life. Panic disorder involves debilitating panic attacks that deter a person from entering places or situations previously associated with panic. Common symptoms include palpitations, shaking, nausea and a sense that something dangerous is about to happen (e.g. a heart attack or that one is going mad).

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It is known from previous studies that CBT is an effective treatment for both panic disorder and depression. However, there is a lack of psychologists and psychotherapists that use CBT methods, and access to them varies greatly in Sweden as well as in many other countries. Internet-based CBT has therefore been developed, in which the patient undergoes an Internet-based self-help programme and has contact with a therapist by email.

The present doctoral thesis includes a randomised clinical trial of 104 patients with panic disorder and compares the effectiveness of Internet-based CBT and group CBT within a regular healthcare service. The study shows that both treatments worked very well and that there was no significant difference between them, either immediately after treatment or at a six-month follow-up. Analyses of the results for the treatment of depression show that Internet-based CBT is most effective if it is administered as early as possible. Patients with a higher severity of depression and/or a history of more frequent depressive episodes benefited less well from the Internet treatment.

Jan Bergström works as a clinical psychologist at the Anxiety Disorders Unit of the Psychiatry Northwest division of the Stockholm County Council. This research was also financed by the Stockholm County Council.

“Thanks to our research, Internet treatment is now implemented within regular healthcare in Stockholm, at the unit Internetpsykiatri.se of Psychiatry Southwest, which probably makes the Stockholm County Council the first in the world to offer such treatment in its regular psychiatric services,” says Jan Bergström.

Read the original research thesis here (PDF)

Credit: Adapted from materials provided by Karolinska Institutet.

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April 18, 2010 Posted by | anxiety, Books, Cognitive Behavior Therapy, depression, diagnosis, Education, Internet, research, stress, Technology, therapy | , , , , , , , , , , , , , , , , , , , | 10 Comments

Sticks & Stones AND Words Can Hurt You: How Words Can Cause Physical Pain

“Watch out, it’ll hurt for a second.” Not only children but also many adults get uneasy when they hear those words from their doctor. And, as soon as the needle touches their skin the piercing pain can be felt very clearly. “After such an experience it is enough to simply imagine a needle at the next vaccination appointment to activate our pain memory,” knows Prof. Dr. Thomas Weiss from the Friedrich-Schiller-University Jena.

Read the original research paper (PDF)

As the scientist and his team from the Dept. of Biological and Clinical Psychology could show in a study for the first time it is not only the painful memories and associations that set our pain memory on the alert. “Even verbal stimuli lead to reactions in certain areas of the brain,” claims Prof. Weiss. As soon as we hear words like “tormenting,” “gruelling” or “plaguing,” exactly those areas in the brain are being activated which process the corresponding pain. The psychologists from Jena University were able to examine this phenomenon using functional magnetic resonance tomography (fMRT). In their study they investigated how healthy subjects process words associated with experiencing pain. In order to prevent reactions based on a plain negative affect the subjects were also confronted with negatively connotated words like “terrifying,” “horrible” or “disgusting” besides the proper pain words.

“Subjects performed two tasks,” explains Maria Richter, doctoral candidate in Weiss’s team. “In a first task, subjects were supposed to imagine situations which correspond to the words,” the Jena psychologist says. In a second task, subjects were also reading the words but they were distracted by a brain-teaser. “In both cases we could observe a clear activation of the pain matrix in the brain by pain-associated words,” Maria Richter states. Other negatively connotated words, however, do not activate those regions. Neither for neutrally nor for positively connotated words comparable activity patterns could be examined.

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Can words intensify chronic pain?

“These findings show that words alone are capable of activating our pain matrix,” underlines Prof. Weiss. To save painful experiences is of biological advantage since it allows us to avoid painful situations in the future which might be dangerous for our lives. “However, our results suggest as well that verbal stimuli have a more important meaning than we have thought so far.” For the Jena psychologist the question remains open which role the verbal confrontation with pain plays for chronic pain patients. “They tend to speak a lot about their experiencing of pain to their physician or physiotherapist,” Maria Richter says. It is possible that those conversations intensify the activity of the pain matrix in the brain and therefore intensify the pain experience. This is what the Jena psychologists want to clarify in another study.

And so far it won’t do any harm not to talk too much about pain. Maybe then the next injection will be only half as painful.

Read the original research paper (PDF)

Adapted from ScienceDaily March 31 2010

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April 14, 2010 Posted by | Age & Ageing, anxiety, Cognition, Pain, research, Technology | , , , , , , , , , , , , , , , , | 5 Comments

Teen Myths Busted: New Science Reveals That Common Assumptions Are Wrong

A new book, The Teen Years Explained: A Guide to Healthy Adolescent Development, dispels many common myths about adolescence with the latest scientific findings on the physical, emotional, cognitive, sexual and spiritual development of teens. [Book is available for download through the Center of Adolescent Health website at Johns Hopkins Center for Adolescent Health (CURRENTLY FREE).] Authors Clea McNeely and Jayne Blanchard from the Center for Adolescent Health at the Johns Hopkins Bloomberg School of Public Health, provide useful tips and strategies for real-life situations and experiences from bullying, to nutrition and sexuality.

Created in partnership with an alliance of youth-serving professionals, The Teen Years Explained is science-based and accessible. The practical and colorful guide to healthy adolescent development is an essential resource for parents and all people who work with young people.

“Whether you have five minutes or five hours, you will find something useful in the guide,” said McNeely. “We want both adults and young people to understand the changes – what is happening and why – so everyone can enjoy this second decade of life.”

Popular Myths about Teenagers:

Myth: Teens are bigger risk-takers and thrill-seekers than adults. Fact: Teens perceive more risk than adults do in certain areas, such as the chance of getting into an accident if they drive with a drunk driver.

Myth: Young people only listen to their friends. Fact: Young people report that their parents or a caring adult are their greatest influence – especially when it comes to sexual behavior.

Myth: Adolescents live to push your buttons. Fact: Adolescents may view conflict as a way of expressing themselves, while adults take arguments personally.

Myth: When you’re a teenager, you can eat whatever you want and burn it off. Fact: Obesity rates have tripled for adolescents since 1980.

Myth: Teens don’t need sleep. Fact: Teens need as much sleep or more than they got as children – 9 to 10 hours is optimum.

Three years in the making, the guide came about initially at the request of two of the Center’s partners, the Maryland Mentoring Partnership and the Maryland Department of Health and Mental Hygiene, who felt there was a need in the community for an easily navigated and engaging look at adolescent development.

“Add The Teen Years Explained to the ‘must-read’ list,” said Karen Pittman, director of the Forum for Youth Investment. “In plain English, the book explains the science behind adolescent development and challenges and empowers adults to invest more attention and more time to young people.”

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The Teen Years Explained: A Guide to Healthy Adolescent Development will be available for purchase on April 10 through Amazon.com. Electronic copies will also be available for download through the Center of Adolescent Health website atJohns Hopkins Center for Adolescent Health (CURRENTLY FREE).

The Center for Adolescent Health is a Prevention Research Center at the Bloomberg School of Public Health funded by the Centers for Disease Control and Prevention (CDC) that is committed to assisting urban youth in becoming healthy and productive adults. Together with community partners, the Center conducts research to identify the needs and strengths of young people, and evaluates and assists programs to promote their health and well-being. The Center’s mission is to work in partnership with youth, people who work with youth, public policymakers and program administrators to help urban adolescents develop healthy adult lifestyles.

Source:
Johns Hopkins University Bloomberg School of Public Health

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April 13, 2010 Posted by | Adolescence, Books, Child Behavior, Girls, Health Psychology, Internet, Intimate Relationshps, research, Resilience, Sex & Sexuality | , , , , , , , , , , , , , , , | 1 Comment

Compulsive Collecting: Finding Hope In The Misunderstood Mess of Hoarding

Compulsive collecting or Hoarding is a misunderstood and debilitating mental health issue. Many psychologists and counsellors never see someone with this condition as they very rarely present for help. This article from an Australian newspaper provides an excellent overview of the condition and issues underlying hoarding, and I have included links to two brilliant books co-authored by the researchers discussed in the article, who have developed a wholistic and novel approach to it’s treatment.

Credit: Kate Benson, Sydney Morning Herald April 8 2010

They may dress well or hold down a good job. But hoarders are unhappy people who suffer from a debilitating condition.

Every suburb has one. The elderly woman weaving through an overgrown backyard full of cardboard boxes, old tyres and discarded furniture. Cats perch on every surface; kittens roll about among the rusted drums and long grass.

Inside, behind closed curtains, the rooms are piled high with papers, cups, plates and bottles. Broken toys, old clothes and shopping bags spill across kitchen benches and floor, smothering the stove and filling the sink, neither of which has been used in years.

The stench of cat faeces, urine and food scraps fill the house.

To her neighbours, she is an oddity. Or a pest, bringing down house values and encouraging vermin.

But to therapists she is one of a growing band across Australia suffering from a debilitating condition known as compulsive hoarding, where people feel a need to collect and store items that seem useless to others.

Their homes become havens of insurmountable clutter and junk, often leaving them unable to sleep in their beds or use appliances. Many end up with electricity or gas supplies disconnected or their fridge and washing machines unusable because they fear their lifestyle will be revealed if they contact a tradesmen to make repairs.

This secrecy and shame make it difficult to know exactly how many people have the disorder.

Some experts think between 200,000 and 500,000 Australians compulsively hoard, but others put the figure closer to 800,000.

“It’s a sleeping giant,” Chris Mogan, a clinical psychologist and expert on hoarding, says. “There is no systematic estimate of how many hoarders there are in any Australian setting. I suspect there are many, many more out there than we are aware of.”

Louise Newman, the president of the Royal Australian and New Zealand College of Psychiatrists, agrees.

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“I’ve only seen one case in my career [because] these people usually only come to light when the council steps in and orders a clean-up. Hoarders desperately want to keep hoarding. They don’t want to be stopped.”

There is little research on the condition in Australia and not much in the way of funding or treatment programs, but experts are hopeful hoarding will be included in the next (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders, the bible used by mental health experts to diagnose psychiatric conditions.

Many sufferers fall between the cracks because hoarding is not a clinical diagnosis in its own right, but is seen more as an offshoot of obsessive compulsive disorder, muddled with depression, anxiety, panic disorder and low self-esteem.

“But it is different to OCD and once we get it in the DSM-V, therapists, psychiatrists, psychologists and social workers can then be trained in the management of it [and] we can attract funding for research,” Mogan says.

Jessica Grisham, a clinical psychologist who specialises in obsessive compulsive disorder, also believes compulsive hoarding should be included in the next edition as it requires specialised treatment.

She cites recent neural imaging studies in the US that showed that different parts of the brain were activated in hoarders than in obsessive compulsive disorder patients.

Mogan and Grisham agree that cognitive behaviour therapy, where sufferers are slowly taught to change their thought patterns, is more effective than medication alone.

But hoarders responded better to a specially adapted version of the therapy, developed by the American hoarding experts Gail Steketee and Randy Frost. It had been achieving success with about 60 per cent of hoarders – far more than standard cognitive behaviour therapy.

“But it has to be a long-term project. You don’t go in to someone’s place and do a sudden excavation against their will,” Grisham says.

“That’s a violation and it’s very traumatic for them. It might make great TV, but it’s not good clinically.”

Mogan agrees. A pay TV show, Hoarders, was damaging to the public’s understanding of the illness, because it focused on forcefully cleaning houses in three days.

“Within six to 12 months that house will be recluttered because it is a compulsion … they suffer a lot of grief after things are taken away.”

Mogan makes weekly home visits to hoarders, and focuses on getting them to reduce the associated dangers by ensuring their home has two exits for safety, and working appliances and smoke alarms.

“Just as we do with drugs and alcohol, we’re into harm minimisation. Once the house is safe, we gradually set more goals. If they are comfortable with that, they will continue to stay in touch and not reject us.”

Sometimes the problem extends beyond mounds of paperwork and clothes. Mogan and Grisham know patients who hoarded urine or fingernail clippings. Some stored their own faeces or collected one particular item, such as bicycles. One sufferer was hoarding so much junk, the only access to the house was a 30-centimetre gap at the top of the front door.

But for Allie Jalbert, of the RSPCA, the most distressing hoarders are those who keep scores of cats and dogs, all battling for attention and food on a crowded suburban block.

She has been calling for years to have hoarding classified as an illness in its own right to allow more people to receive treatment and put an end to the 100 per cent recidivism rate.

“Often, we find that hoarders might be treated for peripheral symptoms such as anxiety or depression, but their core problem, the hoarding, is not addressed. So once we have cleaned out the house, they reoffend, which is very, very frustrating for everyone involved,” Jalbert says.

Some people threatened suicide and had to be removed by police when faced with the prospect of giving up their animals or clutter.

“There’s a mixed bag of emotion when you deal with hoarders. Firstly, there is the concern for your personal safety but there is also a degree of empathy because often these people are quite emotional and attached to the animals. But it’s quite frustrating to see animals living in such horrific situations,” she says.

“I’ve seen bathtubs full of faeces and rubbish, sinks that no longer work, homes with no heating or cooling. Sometimes it’s quite an overwhelming experience.”

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Who develops the condition and why?

Some studies have shown that many hoarders have been brought up in households where chaos reigned. Some were neglected as children and witnessed pets being treated poorly.

Mogan accepts the aetiology is mostly unknown, but cites an Australian study that found sufferers reported failing to connect with their parents or growing up in households lacking emotional warmth.

“The lack of attachment causes them to become ambivalent about their identity and about other people. As a compensatory mechanism, they link with things, which they find more compelling, more predictable and dependable and less rejecting.”

But Grisham believes there is no real trigger, apart from children of hoarders being rewarded for saving things and getting punished for discarding. “Sometimes there is a traumatic head injury but those cases are very rare.”

The condition affects slightly more women than men but is found across all occupations, age groups and ethnicities. “And they are in relationships,” Mogan says. “Albeit strained ones.

“Some are going out to work, but they make sure no one comes to their house. They’re not agoraphobic. On the contrary, many hoarders go out a lot to escape. But their children’s lives can’t be normalised because they can never sit down for a meal or find space to do homework. It’s a real impost on the family experience.”

Mogan runs group therapy sessions in Melbourne and says that many patients do want to be cured.

“This condition is a disability and the source of quite a lot of human suffering and neglect. A lot of these people are quite relieved to get help.”

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April 10, 2010 Posted by | anxiety, Books, Cognitive Behavior Therapy, diagnosis, Identity, research, Resources, therapy | , , , , , , , , , , , , | 9 Comments

Video: A Conversation With Temple Grandin

Not long ago I posted a video of a lecture by Temple Grandin. Temple is autistic,  a designer of livestock handling facilities and a Professor of Animal Science at Colorado State University. She is an icon in the Autistic Community. Her life has been a beacon and an inspirational story and recently her story was told in a biopic produced by HBO. She is the author of several books on autism and the autistic spectrum.

Yesterday I came across this amazing one-on-one interview with Temple. The video is a re-broadcast of an hour long intimate discussion with Temple about her life, her work and her journey with autism. If you are at all interested in the area of ASD you will want to watch this!

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April 9, 2010 Posted by | Aspergers, Aspergers Syndrome, Autism, Biography, podcast, Technology, video | , , , , , , , , , , , | 2 Comments

Mid Life – What’s The Crisis?: Why Self Esteem Peaks In The Middle-Aged

Credit: LiveScience

Read the original research article HERE (PDF)

Bad vision and other physical ailments aren’t the only things that seem to get worse as people grow old. Self-esteem also declines around the age of retirement, a new study finds.

The study involved 3,617 American men and women ranging in age from 25 to 104. Self-esteem was lowest among young adults, but increased throughout adulthood, peaking at age 60, before it started to decline.

Several factors might explain this trend, the researchers say.

“Midlife is a time of highly stable work, family and romantic relationships. People increasingly occupy positions of power and status, which might promote feelings of self-esteem,” said study author Richard Robins of the University of California, Davis. “In contrast, older adults may be experiencing a change in roles such as an empty nest, retirement and obsolete work skills in addition to declining health.”

Measuring self-esteem

The participants were surveyed four times between 1986 and 2002. They were asked to rate their level of agreement with statements such as: “I take a positive attitude toward myself,” which suggests high self-esteem; “At times I think I am no good at all,” and “All in all, I am inclined to feel that I am a failure,” which both suggest low self-esteem.

Subjects also indicated their demographics, relationship satisfaction, and whether they had experienced stressful life events, including suddenly losing a job, being the victim of a violent crime, or experiencing the death of a parent or child.

On average, women had lower self-esteem than men throughout most of adulthood, but self-esteem levels converged as men and women reached their 80s and 90s. Blacks and whites had similar self-esteem levels throughout young adulthood and middle age. In old age, average self-esteem among blacks dropped much more sharply than self-esteem among whites. This result held even after accounting for differences in income and health.

Future research should further explore these ethnic differences, which might lead to better interventions aimed at improving self-esteem, the study authors say.

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More self-esteem factors

Education, income, health and employment status all had some effect on the self-esteem trajectories, especially as people aged.

“People who have higher incomes and better health in later life tend to maintain their self-esteem as they age,” Orth said.

“We cannot know for certain that more wealth and better health directly lead to higher self-esteem, but it does appear to be linked in some way. For example, it is possible that wealth and health are related to feeling more independent and better able to contribute to one’s family and society, which in turn bolsters self-esteem.”

People of all ages in satisfying and supportive relationships tend to have higher self-esteem, according to the findings.

However, despite maintaining higher self-esteem throughout their lives, people in happy relationships experienced the same drop in self-esteem during old age as people in unhappy relationships.

“Thus, being in a happy relationship does not protect a person against the decline in self-esteem that typically occurs in old age,” said study author Kali H. Trzesniewski of the University of Western Ontario.

With medical advances, the drop in self-esteem might occur later for baby boomers, Orth said. Boomers might be healthier for longer and, therefore, able to work and earn money longer.

Read the original research article HERE (PDF)

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April 6, 2010 Posted by | Age & Ageing, Books, Cognition, depression, Education, Health Psychology, research, Resilience, Resources, Seniors | , , , , , , , , , , , , , , | 1 Comment

Exercise DOES Help Improve Mood! And Just 25 Minutes Worth Will Decrease Stress & Increase Energy

Having an Honors degree in Human Movement Studies and working in gyms in a former life while studying for my Clinical Masters degree, I have seen this to be true.  Of course it seems self evident, but these researchers have used great science with an excellent and now research-proven written program and workbook. These, along with their recent meta-analytic research review, show just how effective exercise can be in improving mood.

Credit: PhysOrg.com) — Exercise is a magic drug for many people with depression and anxiety disorders, according to researchers who analyzed numerous studies, and it should be more widely prescribed by mental health care providers.

“Exercise has been shown to have tremendous benefits for mental health,” says Jasper Smits, director of the Anxiety Research and Treatment Program at Southern Methodist University in Dallas. “The more therapists who are trained in exercise therapy, the better off patients will be.”

The traditional treatments of cognitive behavioral therapy and pharmacotherapy don’t reach everyone who needs them, says Smits, an associate professor of psychology.

“Exercise can fill the gap for people who can’t receive traditional therapies because of cost or lack of access, or who don’t want to because of the perceived social stigma associated with these treatments,” he says. “Exercise also can supplement traditional treatments, helping patients become more focused and engaged.”

The Program used in the study is available from bookstores-Click Image to view description

Smits and Michael Otto, psychology professor at Boston University, presented their findings to researchers and mental health care providers March 6 at the Anxiety Disorder Association of America’s annual conference in Baltimore.

Their workshop was based on their therapist guide “Exercise for Mood and Anxiety Disorders,” with accompanying patient workbook (Oxford University Press, September 2009).

The guide draws on dozens of population-based studies, clinical studies and meta-analytic reviews that demonstrate the efficacy of exercise programs, including the authors’ meta-analysis of exercise interventions for mental health and study on reducing anxiety sensitivity with exercise.

“Individuals who exercise report fewer symptoms of anxiety and depression, and lower levels of stress and anger,” Smits says. “Exercise appears to affect, like an antidepressant, particular neurotransmitter systems in the brain, and it helps patients with depression re-establish positive behaviors. For patients with anxiety disorders, exercise reduces their fears of fear and related bodily sensations such as a racing heart and rapid breathing.”

After patients have passed a health assessment, Smits says, they should work up to the public health dose, which is 150 minutes a week of moderate-intensity activity or 75 minutes a week of vigorous-intensity activity.

At a time when 40 percent of Americans are sedentary, he says, mental health care providers can serve as their patients’ exercise guides and motivators.

The patient workbook which accompanies the program - Click image to view description

“Rather than emphasize the long-term health benefits of an exercise program — which can be difficult to sustain — we urge providers to focus with their patients on the immediate benefits,” he says. “After just 25 minutes, your mood improves, you are less stressed, you have more energy — and you’ll be motivated to exercise again tomorrow. A bad mood is no longer a barrier to exercise; it is the very reason to exercise.”

Smits says health care providers who prescribe exercise also must give their patients the tools they need to succeed, such as the daily schedules, problem-solving strategies and goal-setting featured in his guide for therapists.

“Therapists can help their patients take specific, achievable steps,” he says. “This isn’t about working out five times a week for the next year. It’s about exercising for 20 or 30 minutes and feeling better today.”

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April 5, 2010 Posted by | anxiety, Books, brain, Cognitive Behavior Therapy, depression, Exercise, Health Psychology, Positive Psychology, research, Resilience, Resources, stress, therapy | , , , , , , , , , , , , , , , , , , | 4 Comments

Asperger’s Syndrome on “Arthur”

Here’s a different look at Asperger’s as explained by Brain on the kids show Arthur!

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April 5, 2010 Posted by | Aspergers, Aspergers Syndrome, Autism, Child Behavior, diagnosis, Internet, Resources, Technology, video | , , , , , , , , , , , , | Leave a comment

The Real “Rain Man”: A Fascinating Look At Kim Peek

Kim Peek, diagnosed by Darold Treffert with Sa...

Kim Peek 1951-2009 Image via Wikipedia

Kim Peek was the inspiration for the movie Rain Man starring Dustin Hoffman and Tom Cruise. Peek, who passed away last year at the age of 58, lived with his father Fran. Peek suffered from a brain development disorder known as agenesis of the corpus collosum. Malformation and absence  of the corpus callosum are rare developmental disorders that result in a wide spectrum of symptoms, ranging from severe cerebral palsy, epilepsy and autism to relatively mild learning problems.

While Kim was able to perform extraordinary mental feats, particularly related to memory of historical facts, he struggled with many of the day to day tasks of life. This is a fascinating short video of Kim’s visit to London and his explanation of his condition. Enjoy!Vodpod videos no longer available.

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April 4, 2010 Posted by | Aspergers Syndrome, Autism, Books, brain, Cognition, Resources, video | , , , , , , , , , , , | Leave a comment