Friends Reunion in CHICAGO

Just spent a long weekend catching up with Madeline and Rose in Chicago. We had an amazing time. Here's a link to my facebook album...

http://www.facebook.com/p.php?i=7207520&k=Z5G6Z4VRQ6ZAUCDHR162QQY

Summing it all Up.

I finished my last day of work at Munroe Meyer today...300 hours of clinical work and research. It has been a wonderful experience. Although I came most interested in neuropsychology, much of what I saw here falls in the category of behavioral pediatrics... which is basically how to change behavior in children. I saw over 70 kids during my time here! Here's a list of the types of things we worked to fix: Aggression (biting, hitting, screaming), Lying, Tics, Speech and Language Delays, Developmental Delays, Self-Injurious Behavior, Depression, Memory Problems, Sleep Disruptions, Feeding Problems, etc. Munroe Meyer is extremely behaviorally-based, so problem-solving was done from a behaviorist standpoint. It was awesome to be able to jump into such in-depth clinical work. I'm definitely going to miss it here!

I'm flying out of Omaha tomorrow to head to Chicago for the weekend! I'll leave you with my favorite part of Nebraska... their motto.

Refreshing...

Here's the story: http://www.msnbc.msn.com/id/32223159/ns/world_news-wonderful_world/

National Loan Repayment...

Some of the interns that I've met here are doing this. There is a national program called National Health Service Corps that will repay up to $50,000 in student loans if you choose to work two years in an area that is lacking in health related professionals (psychologists included). Here's the site that tells about it:

http://nhsc.hrsa.gov/loanrepayment/

And here's the place you can go and browse States for openings (There are places in Wake County and all over the US).

http://hpsafind.hrsa.gov/

Genetics Clinic in Scottsbluff

This past weekend the two other summer interns (Katie and Carl) and I traveled to Scottsbluff, Nebraska for a genetics outreach clinic. We were in the car for 8 hours each way, allowing me to see the entire state of Nebraska! Fun at first, then got a little redundant. It was very flat and you could see for miles. Here are some pics from the drive:

We observed the clinic all day on Friday and Saturday. I didn't have any idea of what to expect, and was thinking it would be more of a lab setting. It turns out that it was a very interdisciplinary clinic where parents/kids could come to get a lot of information at one time. So instead of making separate appointments with a geneticist, psychologist, nurse, doctor, physical therapist, occupational therapist, etc., a family could get them all out of the way at once. It was a great way to do things, and I hope that one day I work in a setting like that. These were not super long appointments, but acted more as screenings. Recommendations were given to parents after the sessions. For example, if a child showed physical/developmental signs of fragile x syndrome, the geneticist would set up an appointment for the child to be genetically tested, while the psychologist would set up an appointment for a psychoeducational evaluation as well as give recommendations for managing behavior. Many of the kids in the clinic actually came with foster parents and were being evaluated because of possible exposure to drugs/alcohol during pregnancy. If there were signs of these exposures, the doctor would write a note to the court system to establish a pre-existing condition so that medicare would cover these children later in life. If anything was reiterated to me on the trip, it was how much respect and admiration that I have for foster parents. I met so many truly selfless people.

After finishing with the clinic we decided to climb Scott's Bluff, which actually turned into driving to the top and walking around a little :) It was beautiful, though, and very different from the rest of the landscape in Nebraska. Here are some pics...

All in all it was an awesome trip :)

Jenny Lewis at The Slowdown

Wow, what an amazing concert! Jenny Lewis has been my favorite singer since she was in the band, Rilo Kiley. She calls Omaha her second home, so it was awesome to see her in a place that's the topic of a lot of her songs. Jonathan Rice sang backup/male vocals with her... he's the guy that played Roy Orbison in the movie Walk the Line. So, it was cool that he was there, too.

Here's a link to her songs GODSPEED and YOU ARE WHAT YOU LOVE

kids with concussions, settlers of catan, and baseball

So, my first week in Omaha was fantastic.

Starting with my internship... I have to complete 300 internship hours while I'm here, including hours spent with clients, observing labs, and doing research. My advisor here is Dr. Bill Warzak, who does neuropsych assessments, among other things, and I'll be working with him on a project related to the assessment of kids that have had concussions. We're trying to develop a new protocol for assessment, including something called the ImPact Test, a balance assessment (in cooperation with the physical therapy department), and typical neuropsych tests that would normally be given. Using the combination of these things, we will have a good amount of info that helps to determine when a child is "ok" to return to normal physical activity. So, I've been doing lots of reading on things like that lately.

I'm also participating in this mini-program that allows me to observe all of the different labs here at Munroe Meyer. Here's a list of them all:

• Audiology

• Developmental Medicine

• Diabetology and Endocrinology

• Education and Child Development

• Genetic Medicine

• Health Policy and Planning

• Human Genetics Laboratories

• Molecular Genetics

• Nursing

• Nutrition

• Occupational Therapy

• Pediatric Dentistry

• Physical Therapy

• Psychology

• Recreation Therapy

• Social Work

• Speech-Language Pathology

I can't wait! I'm observing the autism clinic tomorrow. It's an awesome opportunity to see what I might be interested in doing in the future. Is it too late for pediatric dentistry?

Second, my roommate, Crystal, and her friend, Buzz, taught me to play a board game called Settlers of Catan. I was skeptical initially (it looks kind of like something you would play at vacation bible school, not that there's anything wrong with that :).

However, it's actually lots of fun. I looked it up online and there's a huge international following of the game, and you can buy add on's and all kinds of crazy things for it.

We also checked out a Sushi place downtown and a bar called "Nomad" which reminds me of Mosaic in Raleigh.

Also, just some tidbits about my roommates:

1. Caitlin's dad is an actual beekeeper, as his profession. He sells hives to lots of companies to help with pollination.

2. Crystal is vegan, and so I'm learning all about cooking without the use of animal products. Sometimes I think I could do it, but only if dollar double cheeseburgers didn't exist.

3. There are three sewing machines in the basement, and my roommate Julia designs clothes and costumes. There's a Shakespeare festival coming up that she's singing in as well as designing for.

So, not only are my roommates awesome, but the girls at Munroe Meyer are great, too. They were nice enough to invite me to a College World Series game. We saw Southern Mississippi play Texas on Sunday. It was a beautiful day! Here are some pics:

That's it for now! I miss everyone in Raleigh a ton. Hope everyone is having an awesome summer!

Finding my way around Omaha...

So, I set out this morning to find out where I would be working. Here are some pics from the walk. This is the front of the house where I'm staying...

The walk to University of Nebraska Medical Center is .8 miles from my house, so it wasn't bad at all. Here's a park near where I live:

Unfortunately, the walk on Leavenworth St. isn't the prettiest. Here's a pic of the street. You can see UNMC in the background. On the way home I found a much better way with less cars and more trees.

I took this as a promising sign:

I also found a wonderful coffeeshop called Caffeine Dreams that is about a 2 minute walk from where I'll be working. Didn't see quite as many skinny jeans and keds as in Raleigh, thank God :)

On the way home, I realized that I live right beside Omaha's Eckankar Center! Which proved to me that it really is a small world.

I then stopped by the dollar store and bought some stuff for my room. Apparently the dollar store has everything you could ever want. Here are the before and after shots.

Before

After

Also, here are some more pics from the house. I love the corn picture (they are still painting) :)

This afternoon I'm going to find the Old Market area, and I'm starting work tomorrow :)

Arrived in Omaha!

So excited to be here! I flew in tonight around 8:30 and am just finishing unpacking. I'm living with 3 girls, a med student, a nursing student, and a waitress, and they really couldn't be nicer. Here's a pic of my room... don't worry, I'll spice it up shortly. I'm spending my day tomorrow finding my way around the city.

Grand Canyon Trip

The trip down the Grand Canyon was amazing.  I've never seen anything like it.  It was a very powerful reminder of the beauty of the natural world.  On the way to the Grand Canyon, we (my mom and I) stopped in Sedona, which had huge red rocks rising everywhere.  The town has a famous golf course, which made me wish I played golf; I'm sure it would be awesome to have that kind of scenery around you.  Here is a Sedona pic:

We then drove up to the Canyon and checked in for the mule ride (which would start at 7am the next day).  They gave us a water carrier, which I think is called a wine skin, a big rain coat, and some string to tie our cameras, sunglasses, hats, etc. around our neck.  They also weighed us (awesome) because you had to be less than 200 lbs. to ride the mule.  Here's a pic of everything attached to my mule (named Zug Zug) the next day.  

So, we were used to 100 degree weather in Phoenix, and when we arrived at the Canyon it was in the 40s.  So, we then bought very stylish Grand Canyon long-sleeve t-shirts to wear on our ride.  We also discovered that we had left our hats in Phoenix, so we had to frantically buy hats at a gas station at like 11pm the night before our trip.  The hats we bought looked more like gardening hats than cowboy hats, so just overlook that in the pics :)

We woke up the next day and gathered at the corral, haha.  Then we were given our mules.  We were told to keep our mule close to the mule in front of us or else a "mule run" could occur, and we had to use our "motivators" (aka whip) if the mule wasn't going fast enough.  The first step out onto the Canyon literally took my breath away.  At first, I was just terrified of the height and the fact that the mule walked literally ON THE EDGE of the canyon, but that wore off within a few minutes, and I could enjoy the view.  Here are some pics:

We made two stops on the trip.  One at Bright Angel campsite, where we got water, had a bathroom break, and actually got sprayed off with water (it got really hot towards the bottom).  We also stopped at Plateau Point for lunch, and ate overlooking the Colorado River.  We went a total of 6 miles down on the trail.  On the way back up we had to stop every 10 minutes to rest the mules.  When we stopped our guide, Anslen, told us about the history of the trail, the different points along the way, etc.  The whole trip took around 8 hours, and even though I was sore and tired, I really didn't want it to end.  

Once we made it back to the top, we had a beer in the lodge to celebrate the fact that we didn't fall off the canyon, and then we drove back to Phoenix and flew out the next morning.  

Here is a link to an album with all of the pics if you're interested:

http://picasaweb.google.com/rosssg1/SedonaAndTheGrandCanyon?feat=directlink

ABAI in Phoenix

Just got back from the ABAI conference in Phoenix and a trip to the Grand Canyon!  Both were amazing experiences.  I want to write a couple thoughts about the talks that I found interesting so that I don't forget them, and also so that people can share their ideas about the topics (haha, please share, otherwise I feel like I'm just writing to myself :).  Here's a pic of the conference center in Phoenix.  It was hot, dry, and all of the plants were succulents, which makes me want to grow a cactus garden immediately :)

Topic 1:  ABA for Acquired Brain Injury Adults:

This talk discussed the behavioral aspects of treating someone with a seizure disorder. The researcher talked about determining the functional variables that trigger the seizures (e.g., emotional upset triggers, being active in sports, high or low temperatures, etc.), and then training the patient to either avoid those triggers, or to be aware of warning signs that a seizure was about to occur (e.g., dizziness, nausea, etc).  When the patient becomes aware of the warning signs they should implement relaxation techniques, biofeedback, etc. to avoid the onset of the seizure.  The researchers found that with these techniques in place, the patient was able to almost complete stop medication because they had behavioral control over their seizures.  Yay.

Topic 2:  Saving the World with ABA

Unfortunately, this guy didn't really talk about saving the world, but talked about his list of "maladaptive behavior phenomena" that prevent us from saving the world.  Check out Chance (2007) for more info.  Here are a few things that prevent us from making the changes we need to make:

1. immediate consequences outweigh delayed consequences

2. Susceptibility to social reinforcement can incline us to extreme views (He mentioned that with the introduction of the internet to society, we were supposed to become more diverse in our thinking.  Instead people tend to find groups that reinforce them for having their extreme views and never branch out).  

3.  Consequences for the individual outweigh consequences for others.

4. Simple familiar ideas (that are wrong) are often preferred over complex, correct ideas.

ETC....

He then said that everything is politics, and in order to change anything we have to get involved politically.  He also pointed us to a website: Behaviorists for Social Responsibility  (Not the prettiest website, but seems to have some interesting ideas).  

Topic 3: Motivational Interviewing (with Bill Miller, the guy who introduced this idea)

I've always found the whole motivational interviewing idea a little hoaxy, but this guy changed my mind.  His research basically shows (in several different studies) that for alcoholics, a brief, one time encounter with a professional (during which a therapist asks info about history of addiction, talks about goals, and listens) is equally as effective as several sessions of self-control training.  During that one interview, the therapist should try to 1. Listen with empathy, 2. Minimize resistance, 3. Evoke person's own concerns and motivations (e.g., ask them what their life would be like without the addiction), 4. Nurture hope and optimism, 5. Let the person, rather than the therapist, make the arguments for change.  

Motivational Interviewing is embedded in the Humanistic view that people have the wisdom for change within them, and therapists should bring that out versus telling them a lot of information.  

Overall, there have been 200 clinical trials on a variety of problems (addiction, depression, etc.) and effect sizes of .3 to .5 have been found in all studies.  Kind of cool.  Here's the website:

Motivational Interviewing

(again, all of these people should hire a web designer)

Topic 4: Data-Based Decision Making

So, for those of you who know what a pain it is to find interventions on WhatWorksClearinghouse and InterventionCentral (mainly because you have to buy the whole program, etc.) a research group in Hawaii has put together a website that uses the "Common Elements Approach". They've basically gone through all of the intervention manuals that cost hundreds of dollars and pulled out the common elements of the interventions for a specific problem (e.g., anxiety).  They call it the "build-your-own Evidence Based Practice kit".  It's really an awesome idea, and would be even better if it were free, but a subscription costs the same as a subscription to PsycInfo (which I'm pretty sure is a ton).  Sooo, no one can really use it, which puts us back where we started from.  Here's the site: PracticeWise

Topic 5: Autism and Observational Learning

This speaker suggested that instead of teaching autistic kids to do one task at a time, we should instead teach them to attend to social cues in the environment (e.g., look around and follow what their peers are doing).  It's a good idea, but would definitely only work for high functioning students.  Plus, seems a little like we would be taking away any individual personality that the child had, by telling them to go into a room and act exactly as their peers are.... I know that's usually the least of our worries when working with autistic children, though.  This research was done at the Alpine Learning Group.

That's pretty much it.  John, Bomly, Bridget, and myself presented posters while we were there on various reading interventions, and John and I both gave a talk about our research.  So, other than having to walk around in heels most of the time, the whole experience was awesome :)

Welcome :)

Phoenix in just a few days :)  Going to the Applied Behavior Analysis International Conference

http://www.abainternational.org/

and then heading to the Grand Canyon!  We won't technically get to see the skywalk, but it's pretty awesome anyway.