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Hi! My name is Ava and I read the book Wonder by R.J. Palacio. Wonder is a story about a 10-year-old named August Pullman who has a craniofacial disorder. He has gone through 27 surgeries to try and make his face look normal, but no matter what he does, the physical disability lingers. He goes to an upscale preparatory school in Manhattan called Beecher Prep. During his time at school, Auggie never feels comfortable due to his peers bullying him for his looks on a daily basis. We get to know his mom, dad, and sister Via throughout the story which allows us to see his disorder from an outside perspective. The book teaches its readers about kindness, acceptance, and much more that is very worth reading. Wonder is an award-winning book due to its outstanding wording and the lessons that are taught within.

My driving question is “How do disabilities and mental health disorders affect children? Even after treatment, how do these disorders linger?” This question matters to me because there is a clear correlation between mental and physical disorders, and it’s important that we educate ourselves on them. I was also really curious about the lasting effects it may have on people even after some sort of treatment has been done.

During my research, I came across a lot of very interesting sources which helped me to come closer to answering my driving question. I learned about the Newman family who are known as the “real-life wonder family.” Nathaniel Newman was born with Treacher Collins Syndrome which causes him to look different in his face. His syndrome is very similar to the one Auggie has in the book Wonder, which is what allowed Nathaniel to stand out. This disorder is extremely rare as it only affects 1 in 50,000 people. After learning about Nathaniel and his story, it helped me to realize that Auggie is not just a made-up character with a made-up disorder, he can relate to individuals just like Nathaniel. Another source that I came across during my research allowed me to see the connection between physical disabilities and the impact that it may have on one’s mental health. People with physical disabilities may experience societal constraints, loneliness and isolation, barriers to mental health care, lack of integrated care, high incidence of unemployment and poverty, communication barriers, and so much more. All of these factors can create much anxiety and pain for an individual who is already struggling so much due to their physical setbacks. Lastly, another source that I think is worth mentioning is the depression art piece. I love this piece because it shows how someone can really be struggling no matter who they are and what their story is. I chose this piece of art because I think it's very important when we think about these physical disorders such as the one Auggie and Nathaniel have. This connects to my book because it is evident that individuals with physical disorders are more likely to experience mental health disorders such as depression. This art matters because it can show what someone is going through and can maybe give us ideas on how to help them. This elevates the conversation about the book as it brings light to the things that go unnoticed such as the mental health of someone with a physical disability or disorder.

During my research, I learned so much about mental health and physical disorders. I was able to see the connection between the two and how it may affect an individual. I’m really glad I got to learn more about this topic and deepen my understanding because I think it’s really important to be aware of what people are going through and how it may affect them, so we are able to offer them help when needed. I learned a lot about craniofacial disorders and what types of mental and physical pain they may cause, which is something I’m very glad that I learned about. This research project opened my eyes to many things and I’m grateful that my curiosity led me here. Thank you for listening!

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This was one of my favorite articles that I had found about R.J. Palacio. I find this article extremely interesting because it gives us insight into her life outside of being an author, while also focusing on her work as an author. Due to the message of kindness portrayed throughout the book, the "Choose Kind Movement" was started, which has been embraced by readers worldwide. This movement encourages people to create and spread more kindness in the world. Palacio has encouraged such a fantastic thing due to the art she expressed in her best seller "Wonder." Palacio also has many other books that she has published which have also been very successful including "365 Days of Wonder: Mr. Browne's Book of Precepts, Auggie & Me, The Julian Chapter, Pluto, and Shingaling, and We're All Wonders." Her impact has been so great that a movie based on Wonder came out in 2017. This movie had major success, just like the book itself. Not only is wonder an interesting read, it's also very emotional and real, which is why it has been so successful and impactful. In this article, we also learn some innocent facts about Palacio. She has 2 dogs named Bear and Beau and 2 children named Caleb and Joseph!

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An unforgettable story of kindness and unrelenting courage.

Sara Blum lives an idyllic life with her adoring parents in Vichy France. But her world comes crashing down when the Nazi occupation separates the family and forces the young Jewish girl into hiding. Her classmate Julien and his family will risk everything to ensure her survival, and, together, Sara and Julien manage to find beauty in a secret world of their creation.

First a graphic novel, now read the novelized version of the celebrated New York Times bestselling story of kindness and unrelenting courage in a time of war-inspired by the blockbuster phenomenon Wonder.

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Celebrate the Power of Kindness with WONDER - Penguin Random House

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Celebrate the power of kindness with WONDER by R.J. Palacio-the worldwide bestseller that launched the Choose Kind movement.

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The book Wonder by R.J. Palacio is fiction. It tells the story of 10 year old Auggie Pullman who is a fictional character with facial abnormalities. Although the people in Wonder aren't real, Palacio was inspired by real-life events to write this book. The contents of Wonder are ones we may see in our lives, which is why the book is so impactful. It's not technically true, but it definitely isn't farfetched and is something we could see throughout our lifetime. This book takes place in the year 2012 in a suburb of Manhattan called North River Heights. There are also many scenes in Auggie's new school which is Beecher Prep, an upscale preparatory school. This setting can influence our understanding of the book by maybe making it more relatable for teens or even for parents. School is something that every child and parent has to experience, and we can all relate to when times at school get tough. Auggie has a hard time fitting in at Beecher Prep to begin with, but his facial abnormalities make it that much harder. This aspect of the book may be relatable for readers, which can deeper our understanding of the impacts and outcomes that may come about. Wonder can relate to today as bullying is still very prevalent and is something that should not be taken lightly. Children with disabilities in school will always be something that is not easy due to certain people who just make it that much harder for them. In today's day in age, we are experiencing a lot of bullying and racism, which can go hand in hand with how Auggie was treated and how he was feeling throughout the book. It's very important to take note of how these types of children are feeling and how we can help them.

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This article is about the Newman family, who have a similar experience to the fictional family, the Pullmans. With the Newman family expecting their first child, they were very excited waiting in the delivery room for their new baby boy. When they saw their son Nathaniel for the first time, he was nothing like they had expected. Nathaniel was born with Treacher Collins syndrome, a rare craniofacial disorder that's caused by mutations in a specific gene. This disorder is extremely rare as it only affects 1 in 50,000 people. When the Newmans saw their son, they were horrified. This family is known as the real-life 'Wonder' family. There is a very strong connection between the Newman family and the book wonder as Auggie and Nathaniel have very similar syndromes and have to both navigate life with their rare disorders. This connection matters because it shows the world that Auggie is not just a made-up character with a made-up disorder, he can relate to individuals just like Nathaniel. The book Wonder may also help Nathaniel navigate his life and help him to deal with his disorder and all the obstacles and struggles it may bring him. This does connect to my question about the world. My question is: "How do disabilities and mental health disorders affect children? Even after treatment, how do these disorders linger?" This article connects to my question because it can show how a rare disorder such as Treacher Collins syndrome can affect a child like Nathaniel and how he can cope and live with it on a daily basis. We can also see after many surgeries to try to fix this disorder, it still lingers and is still very obvious when looking at Nathaniel. I am very happy that I found this article because it definitely helped me to understand these types of disorders more and made the storyline of Wonder feel more real.

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R.J. Palacio's 2012 book, " Wonder," tells the story of 10-year-old Auggie Pullman, a fictional boy with facial differences, and his experiences in everyday life dealing with the condition.

The book was inspired by a real-life encounter Palacio had with a child who had a craniofacial disorder. After her son saw the child and began crying, she quickly turned his stroller around and pushed him away to protect the girl from his reaction.

"It was terrible, and I was so mad at myself for the way that I handled it," Palacio told "20/20" in a 2017 interview. "For the rest of the day, I just kept thinking about all the things I wished I'd said and done."

Palacio decided to write "Wonder" in hopes that it would inspire children and parents.

After the book came out, she met Magda and Russel Newman, whose son Nathaniel was born with Treacher Collins syndrome, a rare craniofacial disorder that's caused by mutations in a specific gene.

Nathaniel's family and Palacio spoke to "20/20" in 2017 about the similarities between Nathaniel's life and Palacio's book. Russel Newman said, "When she saw Nathaniel, you could just see this look in her face."

"I remember thinking, 'Oh my goodness, this is Auggie Pullman come to life,'" Palacio said.

Now, just over two years later, Magda and Nathaniel Newman have their own companion books, " NORMAL: One Kid's Extraordinary Journey" and "NORMAL: A Mother and Her Beautiful Son," coming out in January.

Here's what they had to say about life as it is now, written in their own words. Watch the full story on special Saturday airing of "20/20," Dec. 28 at 10 p.m. ET.

From Nathaniel Newman:

It's hard to believe that more than two years have passed since our episode of "20/20" aired on ABC. Quite a bit has happened since then.

I am now a sophomore at Skyline High School in Sammamish, Washington. I am heavily back into Star Wars these days; I love the new game on my Playstation and I'm hoping the movie lives up to the hype.

I have picked up some new interests along the way. In particular, I love to play Dungeons and Dragons. I have a great group of friends and we often play [Dungeons and Dragons], Minecraft, some Fortnight and even some [Grand Theft Auto] from time to time. But the biggest news over the past two years was working with my mother on a book about my life, called "Normal."

We'd gotten to know R.J. Palacio, the author of "Wonder," and she encouraged us to write a book. Once our life settled down a bit we were able to make it happen. "Normal" details the events of my life starting from my birth (definitely needed help from my parents on that part) up until my early teen years, covering all the critical events that shaped my life. It was fun writing the book. We worked with a writer, Hilary Liftin, and I would talk to her while playing with her dog, Zeus. While my mom worked on her portion of her book, I would chill in the pool and hang out with Hilary's kids.

One great thing that has happened since the show aired is that I rarely have to go to the hospital now. The doctors at Seattle Children's did a great job and I really enjoy not having a tracheostomy [tube] anymore. I can swim whenever I want, I am taking taekwondo and, basically, I get to just be like my friends and classmates.

School is good, some classes are easy (language arts) some are quite difficult (geometry). I just got my learner's permit, and to be honest I'm not the worst driver in the world. For the most part, I'm just your average, everyday teen. After 70-plus surgeries it's pretty nice to be able to say that.

From Magda Newman:

It's hard to believe that more than two years have passed since our episode of "20/20" aired on ABC.

Our life has been pretty ordinary since Nathaniel's tracheostomy came out. I am happy to report that he doesn't have to go to the doctors nearly as often as he used to -- maybe once a year. I have been cancer-free and healthy, and just like Nathaniel, I visit my doctors once a year for routine check-ups.

Jacob is our younger son, now age 13, and he is loving school and enjoying playing lacrosse. While he hasn't had the significant health issues that either Nathaniel or I have had, the past few years haven't been easy on him. As the "unaffected child," he has had to learn how to deal with teen anxiety and depression. Much of the past two years has been spent giving Jacob the time and attention he so richly deserves.

Like any mom, I am busy chaperoning Jacob and Nathaniel to their myriad of activities, like Lacrosse, Taekwondo, tutoring, etc. Nathaniel's life has changed the most since we wrapped up filming for our initial "20/20" show. He got his learner's permit and started driving. Like any "normal" parent, this was a nerve wracking experience. I often find myself hyperventilating when I sit in the passenger seat and watch my son practice driving. But let me assure you that it gets better with every drive.

Now that he is tracheostomy-free, Nathaniel gets to enjoy physical activities just like every other kid. He loves Tae Kwon Do, which he started practicing about two years ago and is about to start his training for a black belt. He is very proud of himself and what he has accomplished so far. He can now swim independently and even got to swim with dolphins and go snorkeling in Hawaii! Before his tracheostomy came out, he wouldn't be able to participate in these activities. Over the past two years, it has brought my husband and I great joy watching Nathaniel grow and thrive as a "normal" teenager.

The most exciting thing that has happened for our family in the past two years has been the writing of our memoirs. Nathaniel and I have penned two books, both titled "Normal." One is targeted at young readers (teens) and the other, in my voice, is targeted at the adult reader. I had been thinking about writing our story for quite some time and became even more encouraged after the popularity and success of "Wonder."

In fact, following the release of the film and our "20/20" special, R.J. Palacio further encouraged me to write these memoirs and helped point us in the right direction. We spent much of the past two years working with our amazing collaborators and publishers to make this dream a reality.

Our goal in writing these memoirs was to go beyond what was told in "Wonder." We wanted to dive deeper into explaining the physical challenges of being born with facial differences and how they impact more than your social interactions. I wanted to share how, as a mom, I overcame my own immense challenges to raise my children as "normal" as possible.

Our Message: Live your normal! Don't let your life circumstances or how others perceive you determine how you choose to live your life. "Normal" is how you choose to define it!!!

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Real-life 'Wonder' family: Nathaniel, Magda Newman on how they're doing

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R.J. Palacio's 2012 book, " Wonder," tells the story of 10-year-old Auggie Pullman, a fictional boy with facial differences, and his experiences in everyday life dealing with the condition. The book was inspired by a real-life encounter Palacio had with a child who had a craniofacial disorder.

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This piece of art is one in which the artist wanted to show what depression looks like. I chose this piece of art because I think it's very important when we think about these physical disorders such as the one Auggie and Nathaniel have. This connects to my book because it is evident that individuals with physical disorders are more likely to experience mental health disorders such as depression. This art matters because it can show what someone is going through and can maybe give us ideas on how to help them. This elevates the conversation about the book as it brings light to the things that go unnoticed such as the mental health of someone with a physical disability or disorder.

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art piece about depression - Google Search

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beautiful meaningful famous drawings deep meaning illustration mental mental health bipolar disorder symbolism

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How Do Mental Health Disorders Affect Children?

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How Do Mental Health Disorders Affect Children?

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This link shows how mental health disorders affect children and why they should be treated early on. Failure to diagnose and treat a disorder in a child can cause implications in their home, school, and social lives pretty early on. This can alter their quality of life which can ultimately cause their physical health to decline. This is an important aspect of my research because again, it shows how mental and physical health go hand in hand, and if one is left untreated, then it can cause the other to deteriorate. Treating disorders early on is important because if not, it can carry on into adulthood and cause an individual to do scary things like harm others or even themselves. It's important to provide support to those who may be showing signs of mental or physical illness, and let them know that they always have someone to talk to.

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Centers for Disease Control and Prevention

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Being mentally healthy during childhood means reaching developmental and emotional milestones and learning healthy social skills and how to cope when there are problems. Mentally healthy children have a positive quality of life and can function well at home, in school, and in their communities.

Mental disorders among children are described as serious changes in the way children typically learn, behave, or handle their emotions, which cause distress and problems getting through the day. Many children occasionally experience fears and worries or display disruptive behaviors. If symptoms are serious and persistent and interfere with school, home, or play activities, the child may be diagnosed with a mental disorder.

Mental health is not simply the absence of a mental disorder. Children who don't have a mental disorder might differ in how well they are doing, and children who have the same diagnosed mental disorder might differ in their strengths and weaknesses in how they are developing and coping, and in their quality of life. Mental health as a continuum and the identification of specific mental disorders are both ways to understand how well children are doing.

What are common childhood mental disorders?

Among the more common mental disorders that can be diagnosed in childhood are attention-deficit/hyperactivity disorder (ADHD), anxiety (fears or worries), and behavior disorders.

Learn more about childhood mental disorders, symptoms, and treatment.

Other childhood disorders and concerns that affect how children learn, behave, or handle their emotions can include learning and developmental disabilities, autism, and risk factors like substance use and self-harm.

Read more about related conditions.

What are the symptoms of childhood mental disorders?

Symptoms of mental disorders change over time as a child grows, and may include difficulties with how a child plays, learns, speaks, and acts, or how the child handles their emotions. Symptoms often start in early childhood, although some disorders may develop during the teenage years. The diagnosis is often made in the school years and sometimes earlier; however, some children with a mental disorder may not be recognized or diagnosed as having one.

Can childhood mental disorders be treated?

Childhood mental disorders can be treated and managed. There are many treatment options based on the best and most current medical evidence. Parents and doctors should work closely with everyone involved in the child's treatment-teachers, coaches, therapists, and other family members. Taking advantage of all the resources available will help parents, health professionals, and educators guide the child towards success. Early diagnosis and appropriate services for children and their families can make a difference in the lives of children with mental disorders.

Get help finding treatment

If you have concerns about a child, you can use these resources to help you find a healthcare provider familiar with treatment options.

Who is affected?

Childhood mental disorders affect many children and families. Boys and girls of all ages and ethnic/racial backgrounds and living in all regions of the United States experience mental disorders. Based on the National Research Council and Institute of Medicine reportexternal icon , which gathered findings from previous studies, it is estimated that in 2007, 13-20% of children living in the United States (up to 1 out of 5 children) experienced a mental disorder in a given year, costing individuals, families, and society an estimated $247 billion per year.

What is the impact of mental disorders in children?

Mental health is important to overall health. Mental disorders are chronic health conditions-conditions that last a long time and often don't go away completely-that can continue through the lifespan. Without early diagnosis and treatment, children with mental disorders can have problems at home, in school, and in forming friendships. Mental disorders can also interfere with a child's healthy development, causing problems that can continue into adulthood.

Public health includes mental health

Supporting children's mental health also includes making sure children meet developmental milestones, understanding what to do when there is a concern, supporting positive parenting strategies, and improving access to care.

CDC works with partner agencies to better understand mental health and mental disorders and the impact they have on children.
Read more about research on children's mental health.
What you can do

Parents: You know your child best. Talk to your child's healthcare professional if you have concerns about the way your child behaves at home, in school, or with friends.

Youth: It is just as important to take care of your mental health as it is to take care of your physical health. If you are angry, worried or sad, don't be afraid to talk about your feelings and reach out to a trusted friend or adult.

Healthcare professionals: Early diagnosis and appropriate treatment based on updated guidelines are very important. There are resources available to help diagnose and treat children's mental disorders.

Teachers/school administrators: Early identification is important so that children can get the help they need. Work with families and healthcare professionals if you have concerns about the mental health of a child in your school.

Resources

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Being mentally healthy during childhood means reaching developmental and emotional milestones and learning healthy social skills and how to cope when there are problems. Mentally healthy children have a positive quality of life and can function well at home, in school, and in their communities.

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Treatment Options For Craniofacial Disorders

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Treatment Options For Craniofacial Disorders

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This link shows the treatment options that are available to those who have a craniofacial disorder. This is important because it is one of the main points of my research and it is directly related to my anchor text which is the book Wonder by R.J. Palacio. This is also related to my guiding question which was "Even after treatment, how do these disorders linger?" We can see through this link and even the real-life experience of Nathaniel Newman that even after numerous surgeries, it is possible that the craniofacial disorders won't just go away, and will most likely be present for the rest of one's life. This may cause a lot of mental health issues for someone who does not feel comfortable in their own skin.

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Plastic and Craniofacial Surgery for Infants and Children

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At Plastic and Craniofacial Surgery for Infants and Children, we offer advanced treatment options for common craniofacial disorders. If you are the parent of a child with one of these challenging conditions, request a consultation online or call us at (469) 375-3838 to schedule a time to meet with our skilled team. You can also review online resources about:

Distraction Osteogenesis

The purpose of the distraction device to treat children with certain craniofacial conditions affecting the growth of the jaw is to gradually lengthen the space between the two cut ends so that new bone is formed to fill in the gap. During the surgical procedure, a cut is made in the jawbone. A small incision is made in the skin for pin placement, and the distraction or expansion rod is connected to the pins on the outside of the child's jaw.

The area is allowed to heal for about one week before "turning," or lengthening, is begun. The turning is done by the surgeon for the first time, and parents are then taught the technique so that they may continue expansion at home. Pin turning lasts for about 3 to 4 weeks, or until the desired length is achieved. The appliance then remains in place for an additional 6 to 8 weeks to ensure that the gap is filled-in with stable new bone. It is removed in the operating room under sedation.

Parents report that their children tolerate the pin turning without pain. Children may go to school and participate in their regular activities; however they may not swim or play contact sports. They should also be kept on a soft, mushy diet during this time.

Advantages of Procedure

In the past, surgery to lengthen the jaw involved a longer procedure that required bone grafts from the rib or hip. This distraction procedure is simpler, does not require a blood transfusion, and obtains very good results. There is also less chance of relapse. There is a small scar on the jawline, and the child may receive some curious looks or questions while wearing the device, however these drawbacks are minor compared with the long-term benefits of this procedure.

Crouzon and Apert Syndrome

As with any craniofacial disorder, treatment by a multidisciplinary team working together with the family provides the best results. In the newborn period some potential problems that may need to be addressed include respiratory difficulties, feeding problems, neurologic complications such as hydrocephalus, and the potential risk of developmental delay.

If a cleft palate is present, this could cause some feeding difficulty. Techniques described in the section on feeding may be used.

The infant's shallow midface and/or small or partially obstructed nasal passages can cause respiratory problems and also contribute to feeding difficulty. Evaluations by the ENT specialists are important and a tracheostomy may be necessary to relieve the airway problems.

In Crouzon and Apert syndromes synostosis of 2 or more cranial sutures may be involved; therefore there can be a risk for increased intracranial pressure. There is also a greater chance of hydrocephalus in these infants than those with single suture fusion and evaluation and close monitoring by the team neurosurgeon is important.

The reported incidence of mental retardation in patients with Crouzon syndrome is between 0% and 20% while a higher incidence (approximately 20 to 30%) has been reported with Apert syndrome. Referral to an infant stimulation program may be helpful.

After the newborn period, the multidisciplinary team continues to evaluate the child's needs. Audiology (hearing) and speech evaluations are important to ensure good speech and language development. Assessment by the opthalmologist is important, especially if the eyelids are not protecting the eyes completely or if there are eye muscle problems.

Orthodontic Concerns

Orthodontic evaluation should begin at age 3 to 4 in these children. The upper jaw is usually set back and small in all dimensions. This results in severe crowding of the permanent teeth, as well as a significant "underbite," a condition where the top teeth meet inside of the bottom teeth. The palate is constricted and high.

Delayed dental eruption is common, and extra or missing teeth have been noted on occasion. Treatment requires extraction of some permanent teeth to alleviate the crowding, as well as expansion of the maxilla, either surgically or through the use of orthodontic devices.

Treatment in infancy is directed at correction of the suture fusion and resultant misshapen head.

Surgical treatment of the midface deformity is usually done during the preschool period (age 4 to 6 years).

Conventional surgical advancement of the midface requires numerous cuts of the facial bones and advancing the midface region to a predetermined level. This usually requires bone grafts. Plates and screws are used to stabilize the new position.

The past several years have seen a significant increase in treatment using a technique called osteogenic distraction. The same surgical boney cuts are performed and an expansion device is inserted, where by gradual advancement of the midface region can be obtained. Research has indicated this may provide a more stable correction.

Craniosynostosis

Treatment is aimed at restoring the normal shape and relationship of the forehead and orbital rims. While the deformity may vary from very mild to severe, the psychological effect of a noticeably misshapen forehead and face can cause great problems and is a very important reason for seeking treatment. The child must also be evaluated for any signs of increased intracranial pressure due to restricted skull growth.

The type and timing of surgery varies with the child and diagnosis. However, there are some common elements.

The surgeons make an incision or opening in the skull behind the hairline so that afterwards the scar is covered by the hair. The head is not shaved. The bone in the area of the defect is reshaped or replaced with bone from another area of the skull. The surgery is usually very successful, and most children go on to lead normal lives with no residual effects of their craniosynostosis.

There is a chance that your child may need blood during surgery or the recovery period. There is a Designated Donor Program available whereby family members or friends can donate blood in advance. We can help you with these arrangements before surgery.

The total hospital stay is usually 3 to 4 days. Your child will have a preoperative workup in the Day Surgery Unit the day before surgery. This involves completing the necessary paperwork, a physical examination by a nurse practitioner, and lab work. A tour of the operating room and hospital by a Child Life Specialist can also be arranged. On the morning of surgery you will report back to the Day Surgery Area. There is a Family Waiting Room nearby where you can wait during the operation and receive progress reports from the OR nurses.

After surgery your child will spend the night in the Intensive Care Unit in order to be closely watched. Parents are able to visit as much as possible. While in the ICU, your child will have several IV lines and monitors, as well as a dressing covering the head. Most of these will be removed before your child leaves the ICU.

There will be some swelling of the forehead and eyes after the operation. This usually increases after the drain is removed, and the eyes will swell shut for a few days.

The day after surgery, your child will be able to start having liquids and will gradually progress back to a regular diet.

You are probably worried about the amount of pain your child may experience during this time. Every effort is made to keep them comfortable and pain medication is available to ease their irritability. All in all you will be surprised at how well your child tolerates the operation and recovery.

Your child will not require any special care after discharge except for common sense safety precautions. The hair may be washed and the stitches are dissolvable. A follow-up visit is scheduled for approximately 2 weeks after discharge.

Office visits, hospitalization and surgery can be emotionally and financially difficult for the family. We realize this and have professionals such as Child Life Specialists, Financial Counselors, and Social Workers available to help. There is also a parent support network that provides an opportunity for parents to meet and talk with other families in the same situation.

Deformational Plagiocephaly

What is the treatment for deformational plagiocephaly?

After your health care provider has determined the severity of the deformational plagiocephaly, a specific treatment plan will be made. This may include frequent position changes of your baby's head, alternating sleep positions, keeping your baby off of the flat areas of the head as much as possible, and not putting your baby on his back when he is awake. Tummy time is also important. If torticollis is diagnosed, a referral for physical therapy will be made. Depending on the severity of the head shape, a cranial remolding band or helmet or orthosis (these are the same) may be prescribed to reshape the head.

How does a cranial remolding band or helmet or orthosis work?

Cranial remolding bands or helmets are custom-made orthotic devices, fabricated out of a hard outer shell with an inner foam lining. These orthotic devices work by providing mild constant pressure to the prominent parts of the skull and allowing the natural growth of the baby's head to fill in the flat areas. There is no pain. Adjustments to the helmet or band need to be made every 1 to 2 weeks as the baby's head grows very quickly. Average length of wear is 3 to 6 months, depending on the baby's age, the growth of the baby, and the severity of the deformational plagiocephaly. Sometimes a second helmet or band may be necessary if the baby grows out of his first one prior to completion of treatment. Cranial remolding therapy is most effective when started by about 6 months of age; however, older babies also benefit from treatment.

Recommended Resources

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Craniofacial Surgery: Treatment Options for Craniofacial Disorders

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At Plastic and Craniofacial Surgery for Infants and Children, we offer advanced treatment options for common craniofacial disorders. If you are the parent of a child with one of these challenging conditions, request a consultation online or call us at (469) 375-3838 to schedule a time to meet with our skilled team.

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The Correlation between Mental and Physical Health

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The Correlation between Mental and Physical Health

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This is a longitudinal study in which individuals ranging from the ages of 9 to 18 were sampled to examine the relationship between mental and physical health. The results showed that "mood and disruptive behavior disorders were related to cumulative health problem incidence, as well as aggregate measures of health problems and severe health problems." This is important to my research because part of my guiding question and the intention of my research was to find out how mental and physical health are related and if there is a correlation between the two? I wanted to know if someone with a physical problem, such as a disability was at a higher risk to experience mental health issues than someone who wasn't and vice versa. After extensive research on this topic, it is evident that there is a strong correlation between the two.

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J Adolesc Health. Author manuscript; available in PMC 2009 Oct 27.

Published in final edited form as:

Gregory A. Aarons, Ph.D., 1, ² Amy R. Monn, B.A., 1, ⁵ Laurel K. Leslie, M.D., 1, ³ Ann Garland, Ph.D., 1, ² Lindsay Lugo, B.A., ¹ Richard L. Hough, Ph.D, 1, ⁴ and Sandra A. Brown, Ph.D. 1, ²

Abstract

Purpose

This longitudinal study examined the relationship between mental and physical health problems in a sample of high-risk youth served in the public sector.

Methods

Participants included youth ages 9 to 18 at baseline, randomly sampled from one of five public service sectors in San Diego County, California and youths may have been active to more than one sector. Diagnoses for mood, anxiety, and disruptive disorders based on structured diagnostic interviews were determined at baseline and data regarding health-related problems were collected two years post-baseline.

Results

Mood and disruptive behavior disorders were related to cumulative health problem incidence, as well as aggregate measures of health problems and severe health problems. Additionally, mood disorder diagnosis was associated with higher rates of infectious diseases, respiratory problems, and weight problems. Disruptive disorder diagnosis was related to higher rates of risk-behavior related health problems.

Conclusions

The present work extends the research on the relationship between mental and physical health problems to adolescents served in the public sector, who are at especially high risk for behavioral and emotional problems. Potential mechanisms by which mental health problems may impact health problems are discussed. We suggest the development of effective interagency cooperation between medical and mental health systems in order to improve the care of youth with comorbid mental and physical disorders.

There is increasing concern and attention to the relation of mental health disorders and physical health problems as evidenced by published studies and by the National Institutes of Health (NIH) support for research addressing this issue. Adults with mental illness are at higher risk for physical health problems than those without mental illness [ 1- 3], but less is known about the prevalence and nature of mental health disorders and physical health problems in adolescents, and particularly in adolescents at high risk for behavioral and emotional problems. Research has shown that the mental disorders most likely to be related to physical disorders in adolescents include depression [ 3- 8], anxiety [ 4, 6, 9, 10], oppositional defiant disorder (ODD), and conduct disorder (CD) [ 4, 11, 12]. However, studies of adolescents tend to be either cross-sectional or conducted in clinical samples focused only on one type of disorder.

Mental illness may have a direct or indirect impact on physical health. For instance, mental disorders, such as depression, may directly lead to physical illness by weakening and/or altering the immune response. There is extensive evidence suggesting that stress can lead to decreased immune functioning [ 13, 14] and depression in particular has been linked to changes in cellular immunity [ 15] often resulting in reduced immune response. These changes may lead to an increase in viral and bacterial infections, including influenza and the common cold [ 8, 16]. By impairing immune response, mood disorders may also increase the severity of allergies and asthma which can be triggered by viral illnesses [ 17- 19].

In addition to directly impacting immune functioning, individuals with mental illness may be more likely to engage in behaviors that lead to physical illness. For instance, depression is associated with poor self-care [ 20], and people with depression often sleep less, exercise less, have poorer diets, smoke more, and use more alcohol and other drugs than those who are not depressed [ 15]. Research has also shown that psychiatric disorders in adolescents are often related to risky behaviors, including substance abuse, unsafe sex, and suicide attempts resulting in health problems [ 4, 11, 12]. Finally, anxiety, depression, and disruptive disorders have been linked to poor eating habits and lack of exercise, leading to elevated weight status that is maintained from childhood into adulthood [ 21, 22]. Given the paucity of longitudinal studies of comorbid mental and physical health problems in adolescents from community populations, we chose to examine the associations of mental and physical health problems in a high-risk sample of youth served in public sector settings. Previous research has confirmed high rates of mental illness and high risk behaviors among these youths [ 23- 25].

Consistent with our earlier work [ 23], we hypothesized that mental health diagnosis (depression, anxiety, or ODD/CD) assessed at baseline, would be associated with health problems assessed two years post-diagnosis. We also specifically examined the relationship between each mental disorder and four categories of health problems: infectious diseases, respiratory problems, health problems stemming from risky behaviors, and weight problems. We hypothesized that infections diseases would be positively associated with mood disorder diagnosis and that respiratory problems would be positively associated with anxiety disorder diagnosis. We also hypothesized that risk-behavior related health problems would be positively associated with disruptive disorder diagnosis and that weight problems would be positively associated with mood disorder diagnosis. We focus on health problems shown to be related both directly and indirectly to mental health problems, by either a direct impact on the immune system or through altered health behaviors. These disorders also tend to be more common in adolescents, as opposed to physical health problems shown to be related to mental health problems in adults, such as cardiovascular disorders or Type II diabetes [ 1- 3].

Method

Participants

The sample for the present study was drawn from youth in a larger study of prevalence of mental health disorders and service utilization in publicly funded youth service sectors in San Diego County, California [ 25]. Youth who received services from one or more of five public service sectors (Alcohol and Drug, Juvenile Justice, Mental Health, school/Serious Emotional Disturbance, Child Welfare) serving youth at risk for mental health or substance use problems and who were between the ages of 6 and 17 years at baseline were eligible for study.

Participants were identified by creating an integrated database from administrative records provided by the five different county sectors of care for youth. After unduplicating records across sectors and agencies, 12,662 youth were identified who received services during the specified time period and were thus eligible to participate in the study. Youth within the sampling frame were stratified based on their service sector involvement during the 1996-1997 fiscal year, highest level of restrictiveness of care, and race/ethnicity. From this pool, 3,402 eligible cases were randomly selected for recruitment. Of these cases, 793 could not be located and 54 could not be recruited for other reasons (e.g., unable to obtain ex-parte order for permission to participate) leaving 2,555 cases available for recruitment. At least one interview was completed (with either the youth or the adult respondent) in 1,715 cases and most of these included both a youth and adult caregiver report.

It was possible to compare study participants along a number of dimensions with the entire population from which individuals were sampled. Characteristics of the sample (e.g., reason for arrest in the Juvenile Justice sector; reason for removal from the home in the Child Welfare sector) were within 2-3 percentage points of data available in administrative records for the entire service system population. We found no differences between participants and non-participants with regard to age or gender. Asian-Americans were somewhat less likely to participate than other ethnic groups; however, analyses are weighted to account for such differences.

The sub-sample for the present study included youth 9 to 18 years of age at baseline (n=1,332, M=14.96, SD=2.38). The sample was ethnically diverse: 38.2% were Caucasian, 27.1% Latino, 19.2% African-American, 7.4% Asian/Pacific-Islander, 5.2% bi-racial, and 2.9% were classified as "other." Two-thirds (67%) of the participants were male. The majority of the parent/caregiver informants were biological parents (73%). Others included close relatives, foster caregivers, adoptive/step parents, and professional caregivers.

Procedure

Youth and their caregivers were interviewed at baseline and two years post-baseline as part of a comprehensive computer assisted interview about their need for and use of mental health services. This study was approved by the appropriate institutional review boards. Informed consent was obtained from caregivers and assent from youth, each being assured of confidentiality verbally and through consent/assent procedures, and with a federal Certificate of Confidentiality for any information reported in the interview. Parent and youth interviews were conducted by different interviewers. Parents received $40 for participation and youth received between $10 and $40 depending on their age, which was related to length of interview.

Interviewers were non-clinicians with an undergraduate college degree who completed approximately 100 hours of training on the specific instruments (including Diagnostic Interview Schedule for Children (DISC) training by a member of the DISC editorial board). Quality assurance mechanisms are described in Garland and colleagues [ 25]. Follow-up at two years was 93%.

Measures

Demographics

Age, gender, and race/ethnicity (i.e., white/non-white) data were obtained from baseline youth interviews. Annual household income was obtained from baseline caregiver interviews.

Mental Health Diagnoses

The computer assisted version of the Diagnostic Interview Schedule for Children - IV (C-DISC-IV) [ 26] was administered to parents and youth during the baseline interview by lay interviewers trained on the instrument by a member of the NIMH DISC Editorial Board (AG). The DISC-IV is a highly structured diagnostic interview designed to yield DSM-IV based diagnoses though computer algorithm scoring. The DISC has demonstrated reliability and validity comparable to that of other diagnostic measures [ 26]. Two-week test-retest reliabilities range from r=.70 to r=.80. Kappa coefficients for combined parent and youth report and clinician diagnosis range from .40-.80 [ 27] and diagnostic sensitivity ranges from .73 to 1.0 [ 28].

To reduce interview duration and respondent burden, not all DISC modules were administered, and some modules were administered to only one informant (parent or youth), while others were administered to both informants. Garland and colleagues reported these procedures in greater detail [ 25]. Table 1 identifies which diagnostic modules were administered to each informant, depending on the child's age (i.e., 9-10 vs. 11-18 years). These decisions were based on previous literature indicating that, (a) youth younger than 11 years may have especially low reliability in diagnostic reporting; and (b) youth are generally the most comprehensive reporters of internalizing (mood and anxiety) symptoms [ 29- 32] whereas parents are good reporters of disruptive behavior symptoms [ 29, 31- 33]. Procedures used were based on the most practical and rigorous approach given the population, the ages of the youth involved, and guidelines for use of the diagnostic measure.

Table 1

Diagnosis

Adult Respondent- DISC

Youth Respondent-DISC

Youth 9-10

Youth 11+ yrs

Youth 9-10

Youth 11+ yrs

Health Problems

Our measure of health problems was based on a scale created by Brown and colleagues and applied in a study of the impact of substance use disorders on physical health [ 23]. The validity of the health problem measures is supported by demonstrated associations with gender differences and level of substance use [ 23]. Our previous study using this measure predicted health problems as a function of adolescent substance abuse resulting in bias corrected effect sizes ranging from .46-.80 [ 23].

Thirty-six potentially significant health problems were assessed by structured interview with youth respondents at two years post-baseline. For each identified problem, a chronicity rating (1=acute: less than two weeks duration, or 2= chronic: greater than 2 weeks duration) and severity rating were collected. Severity scores were based on objective anchors as follows: 1) no significant disruption (e.g. did not stay home sick or see a doctor), 2) some disruption (e.g. saw a doctor and/or stayed home), 3) moderate disruption (e.g. stayed home for at least one week), 4) serious disruption but not life threatening (e.g. hospitalization for surgery or accident), and 5) life-threatening. Table 2 provides a list of health problems assessed during the interview and included in the analyses.

Table 2

1. Allergies

2. Flu, throat infection, cold

3. Contagious diseases

4. Cuts, scrapes, bruises

5. Puncture wounds

6. Dental

7. Dermatological

8. Eye problems

9. Neurological

10. Reproductive organs

11. Sexually transmitted diseases (not HIV/AIDS)

12. Respiratory tract (pneumonia, bronchitis)

13. Cardiovascular

14. Other organ problems (kidney, liver, appendix)

15. Pregnancy, childbirth

16. Drug or alcohol overdose

17. Urological

18. Tumor; cysts; cancer

19. Bone damage

20. Joint, muscle, ligament, cartilage (includes trauma injuries)

21. Gastrointestinal problems

22. Elective surgery

23. Rape

24. Blood disorders

25. Other (e.g. medical reaction, thyroid)

26. Suicide attempt

27. Problems due to non-medically necessitated abortion

28. Weight problems

29. Hypertension

30. Emphysema

31. Asthma

32. Ulcers

33. Diabetes

34. Pain (e.g. neck, back, leg, jaw)

35. Hearing or ear

Three summary health problem measures were calculated for each participant. Cumulative Health Problem Incidence was calculated by summing all health problems reported by each participant. Because of the low base-rate of individual health problems reported and to avoid undue influence of single cases in statistical tests, two aggregate measures were also included and are described below. Incidence and the two aggregate measures were used in the present study because they were found in a previous study to be sensitive to differing predictors and levels of psychosocial problems among youths and young adults.

A Health Problem Index (HPI) was calculated as the sum of the 36 potential health problems reported as the product of problem chronicity (1=acute and 2=chronic) and severity (1=least severe to 5=life-threatening or most severe). Thus, the possible range for this index was 0 to 360 (36 × 2 × 5). To assess health problems with greatest impact on functioning, a Severe Health Problem Index (SHPI) was also calculated to represent cumulative severe health problems experienced by youth. This variable was computed as the sum of identified health problems that caused moderate to most severe disruption (severity rating ≥ 2) and weighted for chronicity and severity.

Scales also reflected four categories of health problems, including infectious diseases (e.g. flu, colds, and other contagious diseases), respiratory (e.g. asthma, allergies), risk-behavior related (e.g. sexually transmitted diseases, drug overdose, suicide attempt), and weight problems (e.g. over or under weight). The health problems category variables were computed as the sum of the health problems in each category divided by the total number of the health problems in the category, and weighted for chronicity and severity. Finally, five additional scales were created for severe health problems in each of the categories by computing the sum of the health problems in each category causing moderate to severe disruption (severity rating ≥ 2), dividing by the total number of the health problems in the category, and weighting for chronicity and severity.

Analyses

We conducted 2-step hierarchical regression analyses with summary health problem measures and scales representing categories of health problems as the dependent variables. Demographic variables (age, race/ethnicity, gender, family income, and insurance statuses) were entered at step 1, and mental health diagnosis (mood disorders, disruptive disorders, and anxiety disorders) were entered at step 2. Insurance status was coded as "0" (no insurance) or "1" (had insurance coverage).

Results

The percentage of participants who reported each type of health problem are presented in Table 3 . Results from the final step of the hierarchical regression analyses for the summary health problem variables are presented in Table 4 .

Table 3

Health Problem Index
(%)

Severe Health Problem Index
(%)

Any health problems

73.1

50.9

Infectious diseases

36.8

22.3

Respiratory

23.5

10.9

Risk behavior-related

5.1

3.4

Weight problems

2.6

1.3

Table 4

Cumulative Health Problem Incidence

Health Problem Index

Severe Health Problem Index

B

SE B

β

B

SE B

β

B

SE B

β

Age

-.01

.03

-.01

.07

.09

.03

.06

.08

.02

Anxiety disorder

.16

.22

.02

.10

.76

.00

.02

.68

.00

Health Problem Incidence

We first examined Cumulative Health Problem Incidence. Shown in Table 4 , gender, race/ethnicity, and insurance status were significantly related to Health Problem Incidence, after controlling for other variables in the model; participants who were white, female, and insured reported experiencing a higher number of health problems ( F(8,970) = 16.50, p < .001, R ² = .120). There was also a small but significant negative relationship between household income and Health Problem Incidence. Finally, presence of a mood or disruptive disorder on the DISC at Wave I predicted a higher number of health problems at Wave II.

Infectious Diseases

Table 5 presents the final step of the hierarchical regression analyses for the 5 categories of health and severe health problems. For the HPI for infectious diseases, demographic variables and mental health problem variables accounted for a significant amount of overall variance ( F(8,970) = 5.02, p < .001, R ² = .040), and the mental health problem variables accounted for a significant increase in explained variance ( F(3,970) = 3.04, p = .028, ΔR ² = .009). The regression for the SHPI for infectious diseases accounted for a significant amount of overall variance ( F(8,970) = 4.60, p < .001, R ² = .036). However, the mental health problems variables did not account for a significant increase in explained variance. Participants who were female and Caucasian reported higher scores on both the HPI and the SHPI for infectious diseases. Identification of a mood disorder was related to higher scores on HPI, but not the SHPI.

Table 5

Health Problem Index

Severe Health Problem Index

B

SE B

β

B

SE B

β

Mood disorder diagnosis

.16

.01

.07*

.14

.08

.06

Race/ethnicity

-.14

.03

-.08*

-.07

.06

-.04

Insurance status

.22

.09

.08*

.16

.09

.06

Anxiety disorder diagnosis

-.17

.10

-.06

-.20

.09

-.07*

Discussion

This longitudinal study investigated the association of mental health problems and physical health of youth sampled from a large public sector community service setting. The main finding in this study is that mood and disruptive behavior disorders were significantly associated with cumulative health problem incidence, as well as our aggregate measures of health problems (i.e. HPI) and severe health problems (i.e. SHPI). In addition, effects were consistent for mood disorder diagnosis association with infectious disease, respiratory problems, and weight problems. The association of mood disorder diagnosis and infections disease is consistent with findings that immune system suppression is found in depressed patients. Also as expected, disruptive behavior disorders were associated with increased risk behavior-related health problems. The negative association of anxiety disorder with respiratory problems is surprising, but is likely a statistical "suppressor effect" [ 34], an artifact of a moderate correlation between mood and anxiety disorders. We expected a positive association between these variables given characteristic symptoms of anxiety and panic attacks and these results warrant further study. Overall, these findings add to the growing literature suggesting a link between mental and physical health problems in adolescents, and extend the finding to a high-risk population.

Limitations

Several limitations of the present study should be noted. First, youth were sampled from a single county and results may not generalize to other geographic areas. Youth came from five different public service sectors and this may have had an influence on outcomes. However, roughly 35% of youths were active to more than one sector at the time of sampling reducing the likelihood of single sector effects. Second, parent corroboration of health problems and some mental health problems was not available. Third, possible unobserved variables not available to the researchers may have an additional influence on the nature of the relationship between mental health and physical health (e.g., living situations that add stress and influence poor nutrition). Finally, a measure of health problems was only available at Wave 2, preventing conclusive evidence of causality or direction of effects. While the longitudinal nature of this study suggests that mental health problems can lead to physical health problems, effects may be bi-directional. For example, it is possible that acute or chronic health problems to lead to mental health problems such as depression or anxiety. It is less likely, however, that disease or injuries sustained through risk behaviors would lead to disruptive behavior disorders. The onset and sequencing of types of mental health and physical health problems should be examined in longer prospective studies in this population.

Implications

The findings in this study that mental health is associated with physical health in high-risk youths suggest the need for a closer look at this population and their risk for health problems. A number of studies have indicated that mental health problems may worsen symptoms of physical health problems and the present study supports this concern. Research also suggests that comorbid physical and mental health problems persist into adulthood [ 8, 22]. Finally, a recent study by Chen and colleagues [ 35] found that teens with both physical and mental health disorders were more likely to have very low quality of life as adults, in comparison with teens who suffered from only one form of disorder. Fortunately, some studies also suggest that childhood and adolescent mental health interventions may improve physical health outcomes. For instance, early treatment of comorbid depressive disorder has been shown to prevent obesity in overweight adolescents [ 21] and to improve outcomes and even reduce mortality in adolescents with asthma [ 36]. Interventions for conduct disorder may reduce the incidence of health problems related to risky behaviors including substance use and STDs [ 4]. Thus, early identification and management of mental health problems has major benefits for both mental and physical well-being.

Managing both mental and physical health problems leads to the need to negotiate multiple healthcare systems, particularly among youth in the often complex community health care system. It is important that youths with co-occurring problems understand the separate systems and linkages between them. However, systems can also enact policies, structures and processes to support service access. For example, a study by Hurlburt and colleagues [ 37] suggests that linkages between child welfare and mental health agencies leads to stronger associations between mental health needs and mental health service use and reduces race/ethnic disparities in service utilization. The study's characterization of linkages was adapted from the Access to Community Care and Effective Services and Supports program [ 38] and was defined as the ties existing between the two agencies at the local level, including co-location of services, interagency client tracking systems, and integrated service-delivery teams. A similar theoretical approach could be applied in the investigation of the impact of linkages between medical and mental health systems on adolescents suffering from comorbid physical and mental health problems seen in community mental health settings.

Consideration of physical health as a consequence of mental health problems will be become especially important as we work to understand the long-term consequences of mental health disorders both on patient quality of life and long-range costs of care across service systems. In order to more comprehensively examine these issues, future studies of mental health problems and treatment in community populations should include measures of physical health in addition to traditional mental health and psychosocial outcome variables.

Finally, it is important for clinicians to be alert to potential co-occurring problems. Such co-occurrence increases the complexity of diagnosis and treatment for high-risk youths. Because a given public sector of care typically focuses on a particular set of issues and problems (e.g. substance use disorders, mental health disorders, or medical problems), attention to co-occurring problems may appear to be less of an imperative. However, such compartmentalization does a disservice to the children and families engaged in services as critical identification and intervention opportunities may be missed, allowing problems to go untreated. It is likely that untreated problems in one domain may exacerbate problems in another domain, and clinicians have the opportunity to help to interrupt such negative cycles.

Acknowledgments

This work was primaryly supported by NIMH grant 5U01MH055282 (PI: Hough) and in part by 5K01MH001695 and 5R01MH072961 (PI: Aarons)

Footnotes

Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Reference List

2. Jones DR, Macias C, Barreira PJ, et al. Prevalence, severity, and co-occurrence of chronic physical health problems of persons with serious mental illness. Psychiatr Serv. 2004;55:1250-1257. [[ PMC free article] [ PubMed] Google Scholar]

12. Delligatti N, Akin-Little A, Little S. Conduct disorder in girls: Diagnostic and intervention issues. Psychology in the Schools. 2003;40:183-192. [ Google Scholar]

34. Tabachnick BG, Fidell LS. Using Multivariate Statistics. 4th. Boston: Allyn and Bacon; 2001. [ Google Scholar]

37. Hurlburt MS, Leslie LK, Landsverk J, et al. Contextual predictors of mental health service use among children open to child welfare. Arch Gen Psychiatry. 2004;61:1217-1224. [[ PMC free article] [ PubMed] Google Scholar]

# data[].attributes.attachment_link.title
The Association of Mental and Physical Health Problems in High-Risk Adolescents: A Longitudinal Study

# data[].attributes.attachment_link.description
This longitudinal study examined the relationship between mental and physical health problems in a sample of high-risk youth served in the public sector.Participants included youth ages 9 to 18 at baseline, randomly sampled from one of five public service ...

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This source explains what craniofacial anomalies are, how they come about, and what the most common types are. I think this article is important because both Auggie and Nathaniel have craniofacial anomalies, making it a very big part of my research. "CFA's (craniofacial anomalies) are a diverse group of deformities in the growth of the head and facial bones." CFA's can be caused by a combination of genes, environmental exposures, and folic acid deficiency. The most common types of CFA's are a cleft lip or a cleft palate, craniosynostosis, hemifacial microsomia, vascular malformation, hemangioma, and informational plagiocephaly. This research is important because it can show what causes this very rare condition. The University of Rochester Medical Center is also a very trusted source, so we know this information isn't inaccurate or false.

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Overview of Craniofacial Anomalies - Health Encyclopedia - University of Rochester Medical Center

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TED Talk: Breaking the Stigma and Shame of Mental Illness

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TED Talk: Breaking the Stigma and Shame of Mental Illness

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This TED Talk connects to my book because it talks about mental illnesses and why they should be normalized and not looked down upon. It is very common for someone to see a victim of mental illness as lazy and unmotivated, but that is almost never the case. We need to look past this stigma and realize that those who struggle with mental illnesses are humans too and they shouldn't be treated differently. This TED Talk matters because it brings light to the issue and normalizes those with mental illnesses which is something that is inevitable for some. This talk elevates the conversation about my book because it allows us to more deeply understand what mental illnesses are, who can have them, what the stigma is around them, and why there is so much shame regarding them. This TED talk raises a few questions such as why is there such a stigma? Why is mental illness looked at differently than any other illness such as cancer? How can we break the stigma and shame of mental illness?

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Kitty Westin: Breaking the Stigma and Shame of Mental Illness | TED Talk

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Suicide leads to over 44,000 deaths each year in the U.S. Stigma against people with mental illness is a major contributor to this unacceptably high mortality rate. Kitty uses heartbreaking true stories and scientific facts to help the audience understand ways to challenge their thinking and join th…

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This poem is based on the book Wonder. This poem connects to my book as it talks about August and the struggles he may go through. It relates August to the month, which may allow the readers to understand it a bit more. This poem elevates the conversation about my book because it shows that someone like August has feelings too and he isn't just someone with a physical disability. It's important to remember this aspect when we think about individuals who may struggle with something like a craniofacial disorder because it's something that they can't control and most likely don't want to have to deal with. This poem can help us to think beyond the storyline, and think about the feelings and mental illnesses that are involved in disabilities like these. This poem is one that helped me to understand the book as well as Auggie more, as I was able to look at him from a different perspective, and not just someone with a physical disability.

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Are individuals with physical disabilities known to have more mental health issues? 

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Are individuals with physical disabilities known to have more mental health issues? 

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This article explains the connection between physical disabilities and the impact that it may have on one's mental health. Before researching this topic, I expected that individuals who have physical disabilities are more likely to have more mental health issues due to feeling alone and upset about their appearance. In this article, we learn that around 32.9% of adults with disabilities experience frequent mental distress, which is about 5 times more as compared to adults without disabilities. This shows that just due to a disability, one's mental health is already impacted so much. People with physical disabilities may experience societal constraints, loneliness and isolation, barriers to mental health care, lack of integrated care, high incidence of unemployment and poverty, communication barriers, and so much more. All of these factors can create much anxiety and pain for an individual who is already struggling so much due to their physical setbacks. This can create much strain on their mental health, which can ultimately affect their quality of life and the relationships they have with others and even themselves. This question is important and relevant today because it can bring awareness to all that those with physical disabilities have to deal with. It's something that is often looked past and not given much thought, but it is definitely something that we as a society need to pay more attention to because living with a physical disability and mental health disorders is not easy.

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A physical disability is a much complex issue than most of us believe it to be. A physical disability is not simply an impairment or a restricted ability to do a certain task. That is just one part of the whole picture. Physical disabilities have multifaceted impacts on a person's life that affects almost every aspect of her living. In this article, we will try to assess the impacts of physical disabilities on the mental health of the person inflicted with the disability.

Statistics on Mental Health of Persons with a Disability

Studies and researches have time and again indicated that people with disabilities are at higher risk of mental health issues as compared to their non-disabled counterparts. Interestingly, some of those studies have also shown that people with mental health issues are more likely to develop a physical health problem.

According to a study done in 2018, around 32.9% of adults with disabilities experience frequent mental distress. The frequency is almost 5 times more as compared to adults without disabilities.

Reasons Affecting Mental Health of a Person with Disability

Persons with disabilities often do not distress for the fact that they have certain disabilities. There are various factors that make people with disabilities more prone to mental health issues. Let us see some of the most common reasons behind the mental health issues of a person with a disability.

Societal Constraints

We are living in a time when we focus a lot on individualism but the fact can never be changed that human beings are 'social animals'. Society plays a crucial role in everybody's life, including persons with disabilities. Studies have shown that suicidal thoughts and tendencies in persons with disabilities do not come due to their physical limitations but due to the way, they are treated in their society.

Persons with visible disabilities often face discrimination in public places. General public's 'different attitude' towards persons with disabilities may push them towards life-threatening depression. Of course, different cultures have different norms. Societies that consider people with disabilities relatively at par with non-disabled counterparts will have a lesser number of PwDs with mental health issues and vice versa.

Loneliness and Isolation

Human beings, being social animals, are not designed to live alone or to be left alone. Some people with a severe disability do not have any means to get out of their house and participate in social life. Inaccessible infrastructure forces a lot more to live an isolated life within the four walls of their house. Many people with certain kinds of disabilities are isolated by society due to myths about their disability. Whatever may be the reason, it's difficult to save a person from mental health issues if they remain lonely and isolated for a long time. So, this is one of the factors contributing to the high incidence of mental health issues among persons with disabilities.

Barriers to Mental Health Care

Effective and accessible mental health care is rarely available for persons with disabilities. There is variety of barriers that prevent people with disabilities to see a mental health professional well in time. Sometimes infrastructure is not accessible, sometimes there's no support from the caregiver and sometimes stigmatization restricts persons with disabilities in seeking help when needed.

Sometimes even a mental health practitioner can push a person with a disability towards stress by sharing their own stigmatizing beliefs about the disability of the person. Not all mental health professionals are sensitized towards disability and hence can be an ableist.

Lack of Integrated Care

Many disabilities are painful and require frequent medical attention. The painful medical treatments may cause traumatic stress in many individuals. Long hospitalization periods may break a person's social connections and leave them lonely. People often tend to ignore mental health while they focus on physical comfort and pain relief. Due to a lack of integration in the medical field, persons with disabilities do not get the holistic care they need for their overall well-being.

High Incidence of Unemployment and Poverty

In most countries around the world, the incidence of unemployment is higher in individuals with disabilities. Moreover, the life maintenance cost for persons with disabilities too is higher than those without disabilities. The clubbed effect is poverty. Needless to say, a distressing condition like this, where a person has to deal with physical pain, limitations, and poverty, easily attracts mental health issues like depression. A person in such a condition does not even have the awareness or access to mental health care.

Communication Barriers

Mental health professionals can work best when they can communicate with the person who needs their help. Many disabilities affect a person's communication skills thereby significantly decreasing their chance of getting proper help. Even persons with disabilities with no limitation with communication often find it difficult to communicate their need for help. They do not want to have an extra layer of stigma added to them. A mental health issue coupled with a disability is a dangerous combination that can stigmatize a person to the level of isolating them.

Final Words from WeCapable

Being mentally healthy is important for everyone, including persons with disabilities. Therefore, make sure to take care of your mental health as you try to keep your body healthy. And, if you need the help of a medical health professional, do get it. Don't let the social stigma dictate what you do to keep yourself healthy in all possible ways. Be a self-advocate about your needs.

And, if you are a friend or family of a person with a disability, treat them with love and dignity as you would have treated someone without a disability. Sometimes only a feeling of being valued can keep a person happy and away from stress and loneliness.

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Effects of Physical Disability on Mental Health

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A physical disability is a much complex issue than most of us believe it to be. A physical disability is not simply an impairment or a restricted ability to do a certain task. That is just one part of the whole picture.