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February 2016 Archives

Lincoln Center Education (LCE) has received a gift of $500,000 from the Estate of Jean Dubinsky Appleton, arranged by Jonathan D. Thier, Executor of the Estate.  With this gift, LCE--which is celebrating its 40th year--will be able to expand and enhance two of its middle school outreach programs, Arts in the Middle and Middle School Arts Audition Boot Camp, assisting hundreds of underserved children in New York City.

Launched in fall 2013, Arts in the Middle is a five-year pilot program providing arts education and teacher training in underserved New York City middle schools that serves as a catalyst for improved student engagement and success, teaching practice, and school and community culture. The program, designed in partnership with the New York City Department of Education as part of a larger middle school reform effort and community engagement initiative, is currently in place in 14 middle schools in the Bronx, Brooklyn, Manhattan, and Queens.

Middle School Arts Audition Boot Camp is a free, annual two-week program designed to prepare rising eighth graders who attend city public schools in low-income communities to audition for competitive high school arts programs and to encourage parent involvement in that process.

The 2014 inaugural Middle School Arts Audition Boot Camp had 98 students pursuing high school placements for dance, music (vocal and instrumental), theater, and visual arts.  As part of the intensive training, students received group and one-on-one coaching from teaching artists, classroom teachers and performing artists, and participated in mock auditions.  Boot Camp participants were also given the opportunity to take master classes and view work by professional artists. Students and their parents were introduced to the high school application and audition process and given advice about next steps in college and career readiness. Support continued through the fall, with "brush-up" sessions offered just prior to the actual auditions, which were held in November and December.  An impressive 90% of the tracked students who completed Boot Camp 2014 received an offer to their high school of choice throughout the five boroughs of New York City; sixty-four percent were offered placement in elite arts programs.  Boot Camp 2015 served 149 students.

With the help of the funds from the Jean D. Appleton Estate, Lincoln Center Education is expanding its commitment to Boot Camp participants with Mentor-Linc, a free mentoring program available to Boot Camp alumni throughout the school year that will support their success through four years of high school and through the college admission process. The newly established $5,000 annual Jean Dubinsky Appleton Scholarship will be given to one Mentor-Linc rising senior who has completed the full program.

 By Roslyn Haber and Marlyn Press

Roslyn A. Haber, Ed.D and Marlyn Press, Ed.D are Associate Professors at Touro College Graduate School of Education 

Getting your child ready for success in school is a joint project of parents and professionals.  Here are some simple, helpful suggestions to jump start your child's learning.

Having a good vocabulary and speaking correctly are important skills for school success.  Research has documented that the larger one's vocabulary, the better one understands what s/he reads and this impacts children's academic success throughout their school career.   How can you help your child?  Here are some suggestions.

  1. Even before your child can speak, speak to your child.  Let him/her hear the sounds of the language and be exposed to words.  As your child develops language, encourage him/her to use new words that are heard, and to speak in longer and more complex sentences.  This can be done in any language spoken at home.  Research shows that whatever the language spoken at home, if your child has a well-developed vocabulary and good grammar, these skills transfer to English.
  2. Play word games with your child.  Read rhyming poetry and encourage your child to come up with his/her own rhymes. 
  3. Visit libraries.  Attend any children's programs that are available.  Ask librarians for suggestions of books to be read to and with children.  Use the library programs as a model for your own reading to children.
  4. Read to your child daily.  Make it a special time together.  Use humor and expression in your voice.  Change your voice as you read different characters.
  5. Make sure your child has listening skills.  Good listening skills increase learning and help the child understand correct routines in school.  Read a story and ask your child questions relating to the story.  Start developing your child's ability to sequence and follow directions by giving one step directions and moving to two to three step directions.  Be specific as to what you want the child to do.  For example, say, "Please get the red pencil," not just "Get the pencil."
  6. Help your child develop good speech habits.  Have him/her repeat words and phrases so that they are clear.  Have your child learn and say nursery rhymes and songs to develop oral fluency and appropriate voice volume. 
  7. Use any and all daily activities as an opportunity to increase language skills.  For example, take your child food shopping and discuss the names of different foods, their characteristics and how they are served.  When taking a walk, look at and discuss the different people and buildings you pass.  Have children help sort laundry to develop categorization skills.  Have children describe what they see when they travel.  Discuss different types of transportation and use the word "transportation".

By Roslyn Haber and Marlyn Press

Roslyn A. Haber, Ed.D and Marlyn Press, Ed.D  are Associate Professors at Touro College Graduate School of Education 

The ability to write legibly and rapidly improves the writing skills of students in later school grades.  Teachers form judgments about the quality of children's ideas based on the legibility of their writing.  Handwriting is linked to other aspects of literacy and content area learning. The better your child's writing skills, the better s/he will learn and demonstrate what s/he knows. For young children, handwriting is a difficult task.  In order to improve handwriting skills, children need practice.  Even with the use of computers, children who can write fluently, legibly and correctly can type better.  The following are some suggestions to help your child develop an interest in writing and increase the skills needed for writing.

  1. Provide your child with a variety of tools and surfaces to write on.  Have various sizes and colors of markers, pens, pencils, and crayons.  Encourage him/her to experiment with them.  Have children express ideas in pictures and tell stories about the drawings.
  2. Teach your child the names of shapes and how to make each shape using various materials.  Teach the basic handwriting lines of down-up, up-down, left-right, right-left, slanted lines, and clockwise and counterclockwise circles.   Children can trace, copy and color shapes. 
  3. Use blocks, stamp pads, songs and computer games to teach your child the name, sound and an associated word for each letter of the alphabet.  At the same time, teach your child to write the letter.  Have your child write it in the air and on your back.  Write the letter on her/his back and see if she/he can tell you what letter it is.  Have the child make letters out of clay, water and other materials around the house. Have them write the letter in the sand box as you say it.
  4. Teach your child to dress him/herself.  Working with buttons, snaps, hooks and eyes, and zippers will improve fine motor skills.  Teach your child to tie his/her shoes correctly.  Do not always use Velcro closures. 
  5.  Arts and crafts projects improve hand-eye coordination and fine motor skills.  Cutting and pasting art projects are an example.  Let your child help you with paper work.  Children can cut out articles and recipes for you.  They can collate papers and staple them together. 
  6. Various finger play activities will help children develop the muscles of the fingers and lower arms and are fun.  Among the titles of these finger plays are Five Little Squirrels, The Beehive, My Hands, Where is Thumbkin, and Eensy Weensy Spider.  You can make up movements for any song or poem you like.  Some websites with finger play activities are: www.wccls.org/rhymes, www.rif.org/kids/learning, www.preschoolrainbow.org
  7. Let your child help with daily routines such as setting the table, pouring juice, wiping the table, opening and closing containers, and stirring, shaking and mixing while cooking.





Handwriting Matters


by Roslyn Haber and Marlyn Press

Roslyn A. Haber, Ed.D and Marlyn Press, Ed.D  are  Associate Professors at Touro College Graduate School of Education

The ability to write legibly and rapidly improves the writing skills of students in later school grades. Teachers form judgments about the quality of children's ideas based on the legibility of their writing. Handwriting is linked to other aspects of literacy and content area learning.  The better your child's writing skills, the better s/he will learn and demonstrate what s/he knows. For young children, handwriting is a difficult task.  In order to improve handwriting skills, children need to integrate eye-hand coordination and repetitive practice. Even with the use of computers, children who can write fluently, legibly and correctly can type better. The following are some suggestions to help your child develop and sustain an interest in writing as well as increase skills needed for writing:

1-Provide your child with a variety of tools in various sizes and colors (e.g. markers, pens, pencils, and crayons) and surfaces to write on.  Encourage him/her to experiment with them.  Have children express ideas in pictures and tell stories about the drawings.

2-Teach your child the names of shapes and how to make each shape using various materials. Teach the basic handwriting directions of down-up, up-down, left--right, right-left, slanted lines, and clockwise and counterclockwise circles.  Children can trace, copy, and color shapes.

3-Use blocks, stamp pads, songs, and computer games to teach your child the name, sound and an associated word for each letter of the alphabet.  At the same time, teach your child to write the letter. Have your child write it in the air and on your back. Write the letter on her/his back and see if s/he can tell you what letter it is. Have the child make the letters out of clay, water and other materials around the house. Have them write the letter in the sand box as you say it aloud.

4-Teach your child to dress him/herself.  Working with buttons, snaps, hooks, and eyes and zippers will improve fine motor skills. Teach your child to tie his/her shoes correctly. Do not always use Velcro closures.

5-Arts and crafts projects improve eye-hand coordination and fine motor skills. Cutting and pasting art projects are an example.  Let your child help you with paper work (e.g. cutting out articles and recipes for you). They can collate papers and staple them together.

6-Various finger play activities will help children develop the muscles of the fingers and lower arms and can be fun as well . Among the titles of these finger plays are Five Little Squirrels, The Beehive, My Hands, Where is Thumbkin? and Eensy Weensy Spider. You can make up movements for any song or poem you like.  Some websites with finger play activities are: www.wccls.org/rhymes, www.rif,org/kids/learning,www.preschoolrainbow.org.

7-Let your child help with daily routines such as setting the table, pouring the juice, wiping the table, opening and closing containers, stirring, shaking and mixing while cooking.

Students, faculty, administrators and support staff from the Touro College Graduate School of Social Work  (GSSW) braved freezing temperatures after midnight Monday to help New York City with its annual count of the numbers of homeless living on the streets, and offer to take them to shelters.

Since 2008 the graduate school has participated in the count, which draws thousands of volunteers from throughout the boroughs to canvass parks, subways and other public spaces as part of the New York City Department of Homeless Services (DHS) Homeless Outreach Population Estimate (HOPE).  Over 3,000 volunteers turned out for the federally-mandated survey.

"Homelessness is a complex, 300-year-old social problem. The approximately 60,000 people who sleep in city shelters each night and the 3,000 more who make their homes on subways and public thoroughfares are the most vulnerable members of society," said Professor Elhanan Marvit, MSW, director of administrative services at the GSSW, who leads the graduate school's team every year on the HOPE count.

He continued: "Homelessness stems from a confluence of multiple factors, social structures and community circumstances.  This annual count is critical to helping overcome homelessness, and is aligned with Touro's mission - which is to train clinical social work practitioners to help individuals, families and communities meet their needs and enhance well-being."

Georgia Van Cooten, a GSSW student on the count Monday for the second year in a row, said she encountered multiple homeless veterans and individuals and offered them transportation to a shelter or drop-in center, but many refused.   She attributed the response to "past experiences of assault, unhealthy conditions and an overall sense of fear surrounding the city's shelter system."

In spite of the cold, Ms. Van Cooten said she'd like to participate again next year as an alumna, "remembering how great it was to be surrounded by alumni during my first year, able to see how it's done and realize that it's not just a survey filled with questions but a conversation between people living in a city plagued with homelessness."

The City announced that to help boost the efficiency and productivity of HOPE this year, the count piloted a new HOPE mobile app, allowing one team in each borough to use GPS-powered maps of their assigned routes and submit digital questionnaires. The digital capabilities, the City said, would increase efficiency, accuracy and accountability in the data collection process, as well as improve analytic efforts.

About the Touro College and University System

Touro is a system of non-profit institutions of higher and professional education. Touro College was chartered in 1970 primarily to enrich the Jewish heritage, and to serve the larger American and global community. Approximately 18,000 students are currently enrolled in its various schools and divisions. Touro College has branch campuses, locations and instructional sites in the New York area, as well as branch campuses and programs in Berlin, Jerusalem and Moscow. New York Medical College, Touro University California and its Nevada branch campus, as well as Touro University Worldwide and its Touro College Los Angeles division are separately accredited institutions within the Touro College and University System. #

Hunter College Graduation




Formerly Homeless Students, a 71-Year-Old Granddad, Immigrant "Dreamers" Among Graduates

104-Year-Old Teacher Helen Posner Fried to Receive Alumni of the Year Award; Ford Foundation President Darren Walker to Deliver Commencement Address


More than 1500 students will received their degrees at the Hunter College Winter Commencement, led by President Jennifer J. Raab, in January.


Graduates include three class valedictorians. Among them, Deena Chanowitz, who left a large Hasidic household as a young teen and emerged from homelessness to become a restaurateur and chef, then pursued a secular education as a Hunter pre-med student. 


Other graduates in the limelight will be Ayesha Jones, who became homeless after a fire destroyed her family's apartment, and who will receive her degree in Nursing; Mariano Laboy, who put his family through college then got an education himself and at the age of 71 will graduate with a degree in Africana, Puerto Rican and Latin Studies; Trinidadian born Amrika Ballyram, a Silicon Valley-bound Economics major who also emerged from poverty and homelessness; and Grace Couch, a student from South Korea who is the first Dream US National Scholar to graduate from Hunter.


Ford Foundation President Darren Walker will deliver the commencement address and receive the President's Medal. Like so many Hunter College students, Walker came from humble beginnings and, with his intelligence and determination, overcame obstacles to achieve academic and professional success.


Special honoree at the Hunter Commencement: Helen Posner Fried, a 104-year-old Hunter College grad (Class of '31), who put her Education degree to use as an elementary school teacher in Harlem and Brooklyn for decades, will receive the Alumni of the Year Award.  

President Raab with Ford Foundation President Darren Walker


From Hunter College

Professor Emily Braun Brings the Leonard A. Lauder Collection to the Metropolitan Museum of Art

Distinguished Professor Emily Braun

Distinguished Professor Emily Braun, leading art historian and curator of the extraordinary Leonard A. Lauder Collection of Cubist art, has organized the collection's first exhibition at the Metropolitan Museum of Art. Braun worked with Met Co-Curator Rebecca Rabinow on the exhibition, which will run from October 20, 2014 to February 16, 2015.

The billion-dollar assemblage of works by Picasso, Braque, Léger and Gris--amassed by Lauder over four decades and now a promised gift to the Museum--is described by The New York Times as "one of the world's greatest collections of Cubist art."

Braun, deputy chair of the Department of Art and Art History, has been Lauder's art advisor for 27 years. In an interview published last spring in At Hunter magazine, she noted that Lauder encouraged her to use the collection in her teaching. As a result, she said, Hunter's art history students "get to see the works first-hand as they become experts in the field of provenance." Braun also noted that Lauder has hired Hunter students and graduates to work on the collection.

Leonard Lauder was married to devoted Hunter alumna Evelyn H. Lauder '58, who died in 2011.

From the NY Times: "As a professor and scholar, Ms. Braun has gravitated toward more fractured, less bucolic art, like the Italian artist Alberto Burri's wounded assemblages of discarded burlap sacks or scorched industrial plastics, which will appear in a retrospective she is organizing for the Guggenheim Museum this October, and the Cubist works in Mr. Lauder's collection, which she has helped him build over 28 years and which he has promised to the Metropolitan Museum of Art.

The birds, in their tiny portraits, are more straightforward charmers. Ms. Braun noted the "illusionistic textures" in their plumage and how "each has a personality": a red grouse with an aristocratically stretched neck, a wistful black grouse with a tail like a lyre, a woodcock criminally intent on dinner, a portly English partridge caught midwaddle. Dinner guests try to identify them; no one has named all four."

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Rein Ulijn, the Albert Einstein Professor of Chemistry at Hunter College and director of nanoscience at CUNY's Advanced Science Research Center, has made a major discovery through collaborative research with Scottish scientists. Their findings are published in the latest issue of the leading scientific journal Nature Chemistry.

Because peptides (sequences of amino acids) are the building blocks of living systems, biological gels made of peptides have significant potential for use in nutrition, cosmetics and biomedicine. But until now, there was no way to reliably predict whether a particular peptide sequence could form a useful gel. The discovery of functional gels relied largely on chance discoveries.

Professor Ulijn says that to streamline the discovery process, he and his colleagues at the University of Strathclyde sought "to design structures based on peptides that are inspired by biology but are much simpler - making them scalable, tunable, robust and functional."  As a result of their joint research, he said, "We now have predictive methods to achieve this."

Now that they have found a way to greatly simplify the peptide-testing process, it will be much easier to develop materials with useful properties.

Christopher Gilbert, Assistant Professor of Anthropology, was the lead author on an article entitled Papio Cranium from the Hominin-Bearing Site of Malapa: Implications for the Evolution of Modern Baboon Cranial Morphology and South African Plio-Pleistocene Biochronology.  The study details findings surrounding the discovery in South Africa of a fossil monkey specimen representing the earliest baboon ever found, dating back more than 2 million years.   The study, which received international attention, including in the Daily Mail, illustrates that humans and baboons co-existed prior to taking different evolutionary paths.

Hunter College and DREAM


 On Tuesday, August 25, 2015, Hunter welcomed its second cohort of TheDream.US Scholars to the college.  TheDream.US is a scholarship fund dedicated to providing a low-cost, high quality education to immigrant youth students who want to give back to their communities. With 21 new Dream Scholars, Hunter doubles its cohort of Dreamers; Hunter is proud to host one of the largest contingents of Dream Scholars in the country.

By Melanie Grayce West

To celebrate her 80th birthday, Eva Kastan Grove's family wanted to give a gift to Hunter College students.

The donation of $9 million to Hunter, part of the City University of New York, will honor Mrs. Grove's lifelong interest in promoting the rights of immigrants. It follows several other smaller gifts to the school made from the family's foundation. Mrs. Grove is the wife of Andrew Grove, the former chairman of Intel.

Mrs. Grove graduated from Hunter in 1958 with a degree in pre-social work. Born in Vienna, she was 3 years old when her family fled the Nazis. She was raised in Bolivia.

Mrs. Grove arrived in New York City at the age of 18 and found Hunter to be an enlightening, diverse place, she said. She was a member of the Spanish club and a sorority, Alpha Gamma Delta. She worked in the book room and relished the apples from the vending machine.

"Hunter opened the doors to America for me," she said.

As Mrs. Grove's daughters considered how to honor their mother, said daughter Robie Spector, they repeatedly came back to their mother's commitments to advocacy and social service, as well as a commitment to immigrants' rights and dignity. Both Mrs. Grove and her husband are immigrants; he emigrated to the U.S. from Hungary in 1957.

As for the size of the gift, the daughters thought they should give the college "a bit more" than usual for the milestone birthday, said Ms. Spector. "My father said, 'Let's give them a lot more.' "

Part of the grant, $4 million, will establish a scholars program at Hunter's Roosevelt House and support a variety of student activities and programs in public policy and human rights. Roosevelt House is a place where Mrs. Grove spent many hours as an undergraduate, but now serves as a hub for students with an interest in social justice and human rights.

The remainder of the grant, $5 million, will go toward scholarships and funding internships. Preference will primarily go to students who are, among other things, immigrants or children of immigrants, or who are undocumented.

The internship grants to students are especially important because they allow for many students to take on an unpaid position at a nongovernmental organization or nonprofit, a critical step in getting a foot in the door to a career, said Hunter's president, Jennifer J. Raab.

Mrs. Grove's time at Hunter had one other serendipitous moment--at the job-placement center.

It was there that Mrs. Grove was given a lead on a summer job at a hotel in the Catskills. Mr. Grove, a student at City College, also part of the City University of New York, was given the same referral. She was a waitress and he a busboy. They married shortly after graduating from college.

According to their daughter, Ms. Spector, Mr. Grove still carries in his wallet a portrait of Mrs. Grove taken while she was a student at Hunter.

Write to Melanie Grayce West at melanie.west@wsj.com

If you are a Hunter College student interested in applying for the Eva Grove Scholarship for Immigrant Rights, please visit bit.ly/grovescholarship. If you have questions regarding the scholarship, please contact Chris Aviles by email at CA748@hunter.cuny.edu or by phone at 212-396-6846.

by Dr. Allen Frances

My first experience with antipsychotic medication was in the early 1960's, shortly after they were introduced. As is usual with new treatments, benefits were appreciated before harms were realized. Delusions and hallucinations improved, but patients developed many very unpleasant side effects- a strange fixed stare, muscle rigidity, uncontrollable movements, agitation, sedation, and lots of others.

I and others hoped that "expectant treatment" with antipsychotics could provide patients with benefits, while minimizing harms. The idea was to reduce the lifetime burden of side effects by limiting meds to episodes of relapse. Medication would gradually be tapered once the patient was stabilized, to be restarted promptly only if, and when, symptoms later returned.

I led one of the research teams doing controlled studies of expectant treatment. About one-third of patients taken off meds did fine, but two thirds had relapses, sometimes terrible ones- while the group kept on antipsychotics had only half their rate of relapse. I learned the painful lesson that, for people with severe and chronic mental illness, going off meds is a risky gamble, one that is usually not worth taking. This was confirmed by hundreds of clinical experiences working in emergency rooms and hospitals.  By far the most common cause of psychotic relapse is going off antipsychotic medicine.

In the 1990's, a new generation of antipsychotics was introduced that initially showed great promise. The new meds were no more effective than the old. But they were much better tolerated because they usually didn't cause the muscle rigidity or agitated restlessness that had made patients feel so uncomfortable and look so strange .

The honeymoon didn't last long. Too often, the new meds caused massive weight gain, increasing the risks of diabetes, cardiovascular disease, and shortened life expectancy. And because their side effect profile was less overt, the new antipsychotics lent themselves to careless over-prescription for phoney indications: ordinary anxiety or insomnia; conduct problems in poor kids or those in foster homes; and "agitation" in elderly residents of understaffed nursing homes. Antipsychotics were also prescribed for unnecessarily long periods--sometimes many years--for people who had experienced only a brief, first-time psychotic episode. I and many others have fought vigorously against these dangerous misuses of antipsychotic medication.

The weight gain and consequent risk of diabetes should, by themselves, provide sufficient warning against the reckless over-prescription of antipsychotics and sufficient encouragement to limit their use only for clearly defined and narrow indications.

But in recent years,  critics of psychiatry have added an additional, counter-intuitive argument against antipsychotics- that they actually cause or worsen psychotic symptoms and should not be used on a long term basis.

Not surprisingly, this bold claim has quickly gained currency among those who have had a bad experience with antipsychotic  medication. For them, it was indeed more harmful than helpful and they generalize from their own personal experience to assume antipsychotics are equally harmful for everyone else. This generalyzing, and the proselytizing that often comes with it, has dangers for others who go on to have a very different lived experience.   Influenced by popular books and blogs,  people who truly need antipsychotic medications discontinue them-sometimes with disastrous consequences.

Patients with chronic psychotic symptoms usually do quite well on meds and quite badly off them. The decision to stay on or go off antipsychotics has tremendous significance in a person's life--and is sometimes a matter of life and death.

I have asked Dr. Ronald Pies, Professor of Psychiatry at SUNY Upstate Medical University and Tufts University, to set the record straight on what the literature does and does not say about long-term use of antipsychotics.

Dr. Pies writes: 
"We need to make modest claims, not sweeping generalizations, about the literature on long-term use of antipsychotic medication. "Gold-standard,"  randomized, placebo-controlled studies are fewer than we would like, and existing studies are always subject to different interpretations.

Most randomized, long-term studies of schizophrenia support the net benefit of antipsychotics in preventing relapse of the illness. Some data also show better "quality of life" with maintenance antipsychotic treatment, compared with drug discontinuation. There is no convincing evidence that maintenance treatment causes worsening of schizophrenia or related psychotic illnesses, or leads to poorer outcomes, when compared with discontinuation of the antipsychotic.

That said, data from Dr. Lex Wunderink suggest that for some people experiencing their first psychotic episode, "less is more"; that is, lower doses of antipsychotics may lead to better long-term recovery rates and social functioning than higher doses.

It's important to understand that only a portion of people with a first psychotic episode have schizophrenia, which is usually a very chronic illness. Many have quite brief bouts of psychosis that never return, making long-term antipsychotic treatment unnecessary.

But when we look at relapse rates in patients with schizophrenia, we see a different picture. Prof. Stefan Leucht and colleagues examined relapse rates in persons with schizophrenia or schizophrenia-like psychoses, comparing those maintained on antipsychotic medication vs those given a placebo. Leucht reviewed 65 randomized controlled trials (RCTs) involving 6493 participants, covering studies from 1959 to 2011.

The authors concluded that '...the efficacy of antipsychotic drugs for maintenance treatment in schizophrenia was clear. Antipsychotic drugs were significantly more effective than placebo in preventing relapse at seven to 12 months.'

About 27% relapsed while taking medication, versus 64% taking placebo. Quality of life was also better in participants staying on medication.

Of course, the authors noted that 'This [benefit] must be weighed against the side effects of antipsychotic drugs," which include sedation, weight gain, and movement disorders.

Recently, researchers in China (Ran et al) carried out a 14-year prospective study of outcome in people with schizophrenia (N=510) who had never been treated with antipsychotic medication, and compared outcome with those who were treated. Consistent with the Leucht's findings, the Chinese investigators found that partial and complete remission rates in treated patients were significantly higher than that in the never-treated group--57.3% vs. 29.8%. Moreover, the authors concluded that, '..never-treated/remaining untreated patients may have a poorer long-term outcome (for example higher rates of death and homelessness) than treated patients.'

Critics sometimes charge that apparent relapse among persons with schizophrenia does not represent a bona fide recurrence of the original illness. Rather, they claim, it is simply a 'withdrawal effect' causing a flare-up of 'super-sensitized' brain cells. Yet when we look at the time course of psychotic relapse, it usually occurs several months after discontinuation of the antipsychotic. This is not consistent with what we know about most drug withdrawal syndromes, which usually occur days to a few weeks after a drug is stopped. Thus, the 'withdrawal psychosis' or 'supersensitivity psychosis' notions remain, at best, highly speculative.

Some studies also raise the possibility that antipsychotic medication can cause structural changes in certain brain regions, leading some to raise the alarm about 'brain damage' from these drugs. Yet schizophrenia itself is linked with numerous brain abnormalities, including progressive loss of brain cells, even in persons never exposed to antipsychotic medication. We need more research to sort out this issue, while always weighing the neurological risks of treatment, including movement disorders, against the very real benefits.

Critics of long-term antipsychotic use often cite studies done by Dr. Martin Harrow and colleagues. Harrow looked at 139 patients with schizophrenia who were either on or off antipsychotic medications, over a 20-year study period. Harrow found that those not on antipsychotics had a lower severity of psychosis and significantly greater rates of recovery compared to those taking antipsychotics. This led Harrow to suggest a 'recovery paradox' in which antipsychotics help in the short-term, but lose effectiveness in the long-term.

However, as UCLA schizophrenia expert Dr. Joseph M. Pierre has pointed out, patients in the Harrow studies were not randomized. Patients themselves were allowed to decide whether or not to continue medication. This means that those with milder symptoms likely self-selected to discontinue medication, whereas those with more severe illness--who would be expected to have a poorer outcome--elected to stay on medication.

So the Harrow studies did not prove that long-term antipsychotic treatment per se worsened outcome. It is far more likely that the severity of patients' symptoms determined whether or not they and their doctors decided to continue medication. In interpreting the Harrow studies, non-medical critics of antipsychotic treatment have misperceived direction of the arrow of causality."

Thanks so much, Dr Pies, for this illuminating review.

Beyond the scientific literature, there are also two huge, naturalistic experiments illustrating that psychosis was, and is, an enormous problem, without invoking antipsychotics as its cause.

As Dr. E. Fuller Torrey has pointed out, in 1955, there were about 600,000 people living in state mental hospitals. Not all of these had severe and chronic psychotic symptoms, but hospital records indicate that the majority did. Chronic psychosis before the 1950's can't possibly have been caused by antipsychotics, because the medication did not then exist. This is an uncontrolled, but compelling refutation of the cart-before-the-horse assumption that meds cause the symptoms.

The lifetime course of chronic psychosis in the pre-medication era also helps explain the misinterpretation that meds are unnecessary to treat chronic psychosis, or even make it worse. Twenty to thirty percent of patients recovered more or less completely before medication was available-  exactly as happens now. These 'spontaneous recoverers' are often the people most opposed to medication and are used to justify claims that meds are actually harmful in chronic psychosis.

But we mustn't forget the remaining seventy to eighty percent who did poorly without meds. Their chronic, psychotic symptoms could not have been caused by antipsychotics, because they had never taken them. In those days, such people were warehoused in state hospitals; now they often wind up in jail or homeless.

The second "natural experiment" began in the 1950's when hundreds of thousands of the severely ill were discharged from hospital, often without access to medication. The result: we now have about 250,000 homeless people and about 350,000 of the mentally ill in jail or prisons for nuisance crimes--avoidable, had their psychiatric symptoms been treated. The quality of life for the majority of people with untreated severe mental illness is abysmal.https://www.psychologytoday.com/blog/saving-normal/201512/worlds-best-and-worst-places-be-mentally-ill.

As Dr. Torrey points out, "...on any given day in the United States, half of all individuals with schizophrenia, or about one million people, are not being treated. This is a huge natural experiment...Many of these individuals are found in public shelters, sleeping under bridges, in jails, and in prisons."

There is no 'one size fits all' approach to psychiatric care. Medications are not all good or all bad. Misapplied to people who don't really need them, they are bad. Prescribed properly to people who do, they are good. Meds that are harmful for someone who doesn't need them are essential for someone who does.

The misleading idea that antipsychotic medications cause or worsen psychosis legitimizes the incorrect view that long term medication is bad for everyone. A minority of people with chronic, severely impairing psychotic symptoms may eventually do fine off meds, but the majority will have relapses that are always disruptive and often dangerous.

Even factoring in all the side effects, going off antipsychotic medication is usually a bad bet for the severe and chronically ill. The consequences of relapse can be unpredictable and sometimes horrible. Patients, families, and prescribers need to understand both the real benefits and the very real risks of antipsychotic medications. The mistaken idea that antipsychotics cause psychosis is an unnecessary and dangerous distraction from what is already a tough enough risk/benefit calculation.

References and links

Wunderink et al study: http://www.ncbi.nlm.nih.gov/pubmed/23824214

Leucht et al study: http://www.ncbi.nlm.nih.gov/pubmed/?term=Cochrane+Database+Syst+Rev.+2012+May+16%3B5%3ACD008016.+doi%3A+10.1002%2F14651858.CD008016.pub2.

Ran et al study: 

Harrow et al study: http://www.ncbi.nlm.nih.gov/pubmed/25066792

Joe Pierre's website: https://www.psychologytoday.com/blog/psych-unseen/201408/do-antipsychotics-worsen-schizophrenia-in-the-long-run

Fuller Torrey website: http://www.treatmentadvocacycenter.org/component/content/article/2085-anatomy-of-a-non-epidemic-a-review-by-dr-torre

This Week on ChildMind.org

Children have a whole arsenal of tactics for evading things they don't want to do, from ignoring instructions to whining and wheedling to active defiance. Your average parent is familiar with most of them. But some kids are definitely harder to manage than others, and almost every day we hear from parents who feel that they're losing the battle.

Last week one frustrated mom wrote to us about her 10-year-old daughter who, when asked to do something not to her liking, says "No," folds her arms angrily, and disobeys. None of the discipline strategies she's tried have gotten results, the mom wrote, ending her email with "Help!!!"

This week we've rounded up pieces on childmind.org that address the most effective ways to manage behavior. If kids are seriously out of control, parent training can be a lifesaver; we've seen it many times. But parents who apply the principles on their own can also see good results both at home and at school. The biggest beneficiaries are the kids themselves, because when children are able to cooperate and follow rules, they can enjoy more positive relationships not only with parents but with teachers and friends and all the other important people in their lives.

 --Caroline Miller, Editorial Director

making fun  
Managing Problem Behavior at Home
A guide to more confident, consistent and effective parenting (and happier, better-behaved kids).  

Stop Yelling! Calm Parenting Makes Calmer Kids
It can be hard to keep your cool, but less yelling means better communication. Some tips on avoiding explosive situations from professionals and parents alike.

parenting traps  
Three Common Parenting Traps
Tips for avoiding those interactions that, despite your best intentions, end up teaching your children exactly the wrong thing.

How to Make Time Outs Work
If time outs aren't working for your child, it may be time to revisit how you're doing them.

How to Give Kids Effective Instructions
The first step to harmony at home is making sure kids understand what they're being told to do.

The Dwight Schools brought together 220 students from around the world to perform in a global concert on February 6th at a sold-out Carnegie Hall. This concert, an annual Dwight tradition, exemplifies the school's work since 1972 to bridge boundaries, break ground in international education, and prepare students to thrive in today's globalized world.

With campuses in New York, London, Seoul, Shanghai, and on Vancouver Island, The Dwight Schools are leading International Baccalaureate (IB) World Schools providing students with invaluable opportunities to participate in cross-campus cultural and curricular collaborations, and exchange programs. Dwight offers these same opportunities to students around the world who take courses online or in a blended learning environment through Dwight's Open World School, including students in the ICL Academy for Film and Performing Arts in Los Angeles, who joined their peers to perform at Carnegie Hall.

"No matter where in the world a Dwight student lives, we personalize the educational journey for each one based on individual passions, which we call 'igniting the spark of genius in every child.' We are equally committed to preparing students to be global leaders who can solve global challenges in innovative ways," said Stephen Spahn, Chancellor of The Dwight Schools, the longest-serving head of school in New York City.

"This year, our concert entitled 'Music for Dance' brought the Dwight cross-campus collaborative process to life in every way," reported Music Director Alistair Hamilton. "It included music and dance orchestrated, choreographed, and composed by faculty and students from around the world. Students auditioned virtually, and music directors shared ideas and cultural traditions the same way, before meeting in New York to rehearse and perform as one family. This process illustrates the benefits of being part of an active global network of schools that values the arts and provides students with unprecedented opportunities, such as performing together at Carnegie Hall."

Two New York students who demonstrated their musical spark of genius at Carnegie Hall are:

• Elli Choi '20, who began violin studies at age three and only a year later was invited to the Suzuki Method World Convention. A soloist at age five, and student in the Pre-College Division of The Julliard School by age seven, she is a seasoned performer with world-renowned youth and professional orchestras; and winner of numerous honors, including first prize in the Senior Division of the 2015 Lipinski and Wieniawski International Competition for Young Violinists in Poland; the Grand Prize at the 11th Young Virtuoso competition in Sofia, Bulgaria in 2015; and is invited to the Menuhin Competition 2016 in London. Ms. Choi, who performed Bach's Violin Concerto No. 2 in E Major, said, "I am very honored and excited to have participated in an event at one of the most famous venues in the world with my peers and new friends from Dwight campuses all over the world."

• Zachary Fobert '16, who began playing the piano at age four, performed two jazz ensemble pieces. A student in the Dwight Music Conservatory, Zachary's interests span music technology and composition, classical piano, and rock. "Last year, I was privileged to fulfill a childhood dream previously thought unattainable of performing in Carnegie Hall. It was a powerful experience of camaraderie with my fellow performers and a phenomenal learning experience. This year, I wanted to further improve my ability to work with others by playing challenging pieces alongside another student on the same piano and presenting an entertaining performance."

More about Dwight School

Founded in 1872, Dwight is a leading international school located on Manhattan's Upper West Side. It is the first school in the Americas to offer all four IB programs for students from preschool through grade 12. A Dwight world-class education rests on three pillars: personalized learning, community, and global vision. Graduates attend such leading colleges and universities worldwide as Harvard, Yale, Princeton, MIT, Stanford, NYU, Brown, Columbia, Oxford, and the University of Edinburgh.

Watch the video below of Dwight global students preparing for Carnegie Hall.

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