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Offline Inculcated

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Bradley Children's home / Bradley Children's Hospital
« on: August 27, 2009, 02:44:29 AM »
Stimulating a normal adjustment: misbehavior, amphetamines, and the electroencephalogram at the Bradley Home for children. -Bromley E.
Department of Anthropology, University of California, Los Angeles, USA
This article uses an historical case study to describe the influence of social and contextual factors on the adoption of somatic approaches to children's misbehavior. The child guidance movement and the emergence of medicalized residential treatment facilities for children influenced the theoretical orientations of physicians treating children's behavior disorders in the United States in the 1930s. Charles Bradley and his colleagues at the Bradley Home in Rhode Island defined behavior disorders in social terms but investigated and treated misbehavior with somatic tools. The use of amphetamines and the electroencephalogram reorganized concepts of maladjustment along neurological lines, even as the research relied on the Home's social priorities. Electroencephalographic investigations especially shaped an organic concept of misbehavior. Ultimately, the somatic orientation obscured the central role of local context in Bradley Home physicians' research. (c) 2006 Wiley Periodicals, Inc. ... 0C%5BPS%5D
« Last Edit: August 27, 2009, 04:01:32 AM by Inculcated »
“A person needs a little madness, or else they never dare cut the rope and be free”  Nikos Kazantzakis

Offline Inculcated

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Re: Bradley Children's home / Bradley Children's Hospital
« Reply #1 on: August 27, 2009, 02:47:03 AM »
Charles Bradley, M.D., 1902–1979
I n 1937, Charles Bradley noted that 14 of 30 children with behavior
problems showed a “spectacular change in behavior . . . remarkably
improved school performance” during 1 week of treatment
with benzedrine (1, p. 582). His subsequent research and that of others
established the benefit of psychostimulants in the treatment of
attention deficit hyperactivity disorder (ADHD). Bradley’s 1937 observation
now stands among the most important psychiatric treatment
Charles Bradley made this discovery while serving as Medical Director
of the Emma Pendleton Bradley Home—now Bradley Hospital—
in East Providence, R.I. The Bradley Home—founded by George
Bradley, Charles’s great-uncle, and named for George Bradley’s
neurologically impaired daughter, Emma—opened in 1931 to treat
children with nervous disorders. A year later, Charles Bradley, fresh
out of his residency at Babies Hospital in New York, joined its staff.
The benzedrine discovery was a byproduct of the thorough neurological
evaluations carried out under Bradley’s direction, which included
pneumoencephalography. Bradley began treating children
who suffered postpneumoencephalography headaches, presumably
due to spinal fluid loss, with benzedrine, speculating that because
benzedrine is a stimulant it would stimulate the choroid plexus to
produce spinal fluid.
The benzedrine did not do much for the headaches, but teachers
noticed that some of the children taking benzedrine experienced a
striking improvement in their schoolwork. The children themselves
noticed the improvement and dubbed the medicine “arithmetic pills.”
Bradley pursued the discovery in a controlled trial that showed benzedrine’s
beneficial effect on school performance.
Bradley’s pursuit of this chance observation is of particular note in
the light of psychiatric practice at the time. Psychological interventions
were regarded as the obvious treatments for behavior disorders. Although
Bradley and his colleagues published their observations in
prominent journals and they were reported in the media as well, 25
years passed before anyone attempted to replicate his observations,
and more than 25 years passed before stimulants became widely used
for ADHD.
Charles Bradley had more than one string in his bow—he invented
a chair to make pneumoencephalography in children easier, pioneered
the residential treatment of children with behavior disorders,
wrote extensively about childhood schizophrenia, and established the
Bradley Home as a center for treatment, research, and education in
child psychiatry.
Painfully aware that most of the psychological afflictions of children
had no effective treatment, Bradley felt that in order for progress
to occur in the treatment of disturbed children, more people needed
to be educated in child psychiatry. Although he was the scion of a
prominent Rhode Island family—Roger Williams was an ancestor—
and had lived in Rhode Island almost all his life, in 1948 Bradley went
to the University of Oregon Medical School to found and direct a
department of child psychiatry.
1. Bradley C: The behavior of children receiving benzedrine. Am J Psychiatry
1937; 94:577–585
968 Am J Psychiatry 155:7, July 1998 ... /7/968.pdf
« Last Edit: August 27, 2009, 04:02:08 AM by Inculcated »
“A person needs a little madness, or else they never dare cut the rope and be free”  Nikos Kazantzakis

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Re: Bradley Children's home / Bradley Children's Hospital
« Reply #2 on: August 27, 2009, 03:02:07 AM »
'and the funding...
New Legislation Would Increase Funds for Bradley Residency Program
Whitehouse/Kennedy Bill Closes Loophole Excluding Children’s Psychiatric Hospitals from Graduate Medical Education Payments
April 15, 2009
Providence, RI - U.S. Senator Sheldon Whitehouse (D-RI) and U.S. Congressman Patrick Kennedy (D-RI) are introducing legislation to help Bradley Hospital get its fair share of federal funding designated for teaching hospitals.
Bradley is one of the few children's psychiatric hospitals that trains physicians in residencies in child and adolescent psychiatry, pediatrics, and general psychiatry. Most pediatric teaching hospitals receive payments to cover the extra costs associated with taking on residents, but current law excludes Bradley and other children's hospitals that focus on psychiatric care.
During a roundtable discussion with Bradley residents and medical faculty today, Whitehouse announced legislation to close that loophole. If enacted, the Children's Hospitals Education Equity Act could provide hundreds of thousands of federal funding to support Bradley's residency programs. Kennedy will introduce companion legislation in the House of Representatives.
"Teaching hospitals offer new doctors invaluable experience working with patients, and the federal government has long recognized that additional funding helps make these residency programs possible. At a time when we're facing a shortage of psychiatrists trained to work with children and young people, we can't afford to let programs like Bradley's fall through the cracks," Whitehouse said.
"I'm proud to be introducing legislation to ensure that children's psychiatric hospitals are eligible for Graduate Medical Education payments through the Children's Hospital pool, and specifically, that would help children in Rhode Island get the services they need. Our nation is experiencing a critical shortage of child and adolescent psychiatrists, and we need to take steps to increase the pool of trained child psychiatrists so that our nation's children can get the services they need. This bill aims to increase the supply of child and adolescent psychiatrists, thereby increasing both access to services and the quality of the services provided to our nation's children," said Kennedy.
Health care providers trained in child psychiatry are in severe demand across the country. According to the Annapolis Coalition's 2007 Action Plan on Behavioral Health Workforce Development, citing a report by the American Academy of Child and Adolescent Psychiatry [AACAP] Task Force, "the federal government has projected the need for 12,624 child and adolescent psychiatrists by 2020, far exceeding the projected supply of 8,312. Currently there are only 6,300 such psychiatrists nationwide, and relatively few are located in rural and low-income areas."
Bradley trains 10 psychiatry residents per year through a partnership with the Hasbro Children's Hospital and the Alpert Medical School at Brown University. The hospital supports a residency program in child and adolescent psychiatry; a "Triple Board" program that trains residents in pediatrics, general psychiatry, and child and adolescent psychiatry; and postdoctoral fellowships in clinical psychology and a National Institutes of Health-funded research training program. According to its web site, Bradley is "one of only four hospital-based programs in the United States that is affiliated with a medical school and that specializes in serving children with both psychiatric disorders and developmental disabilities."
Most teaching hospitals receive Medicare funds called graduate medical education (GME) payments to cover the expense of educating residents, including time attending doctors spend training residents, space and other administrative costs, and equipment use. Children's hospitals, however, which serve few or no Medicare beneficiaries, receive their GME payments from a separate pool called the Children's Hospitals Graduate Medical Education Payment Program (CHGME). This pool was created in 1999 and includes roughly 75 hospitals. In Fiscal Year 2008, $301.6 million was available for CHGME payments.
To qualify for CHGME, hospitals must meet the Social Security Act's definition of a "children's hospital," which is "a hospital whose inpatients are predominantly individuals under 18 years of age," among other qualifications. For years, however, Bradley has been unable to qualify for CHGME payments because it is licensed as a psychiatric hospital, and thus did not fit the description of a children's hospital.
The Children's Hospitals Education Equity Act would expand the definition of a "children's hospital" to include "a freestanding psychiatric hospital with 90 percent or more inpatients under the age of 18, that has its own Medicare provider number as of December 6, 1999, and that has an accredited residency program." While specific appropriations for the CHGME fund vary from year to year, Bradley has estimated that if it had been eligible for these payments in Fiscal Year 2008, it could have received as much as $390,000 in additional funds.
"We are grateful that Senator Whitehouse and Congressman Kennedy have taken the lead to help correct this glaring example of unintentional but serious stigmatizing of children with psychiatric disorders," said Gregory K. Fritz, M.D., Academic Director at Bradley Hospital. "Freestanding children's psychiatric hospitals with a major commitment to residency education, like Bradley, will no longer be ‘second class citizens' in the world of academic medicine. We will use the GME monies to enhance our training programs in an effort to increase the access to high quality children's mental health services, both locally and nationwide."
The bill has been endorsed by the American Academy of Child & Adolescent Psychiatry, the Association for Behavioral Health and Wellness, the National Alliance on Mental Illness, the National Association for Children's Behavioral Health, and the National Association of Psychiatric Health Systems.

All group home or other residential facility "beds" located or associated with Bradley
 Hospital shall be reimbursed to the local city or town or the legal education authority at the rate of
 thirty-two thousand dollars ($32,000) per "bed. "

Whitehouse to announce legislation for Bradley Hospital
9:23 AM Wed, Apr 15, 2009 | ... enc-1.html

And more...$
E. Providence students recruited for program with Bradley

01:00 AM EDT on Monday, July 27, 2009

By Alisha A. Pina

Journal Staff Writer

EAST PROVIDENCE — Parents of special-needs students who are taught outside the city’s borders will meet with school officials over the next two weeks to decide whether their child is a match for the new in-district program with Bradley Hospital.

The country’s oldest hospital for children with mental illness joined with the School Department to expand its services and help the district cope with its more than $4.2-million deficit. East Providence has roughly 185 special-needs students taught outside the city at a total annual cost of $8.7 million, or 11.2 percent of the department’s operating budget.

District officials estimate the “world class” program could save the district more than a half-million dollars. The committee will vote on the nearly finished contract Aug. 11.

“We’re hoping they [the parents] will recognize the value of this great opportunity,” district chief operating officer Lonnie Barham said. “It truly is the first step to getting them back into the mainstream.”

Said Schools Supt. Mario Cirillo, “The fluidity of this program is the beauty of it.”

Participants will be educated in separate classrooms within three city schools — Silver Spring Elementary and Martin and Riverside Middle schools. Each classroom will have fewer than 10 students who are similar in age and cognitive skills. If they make enough progress, the final step is to integrate them back fully into regular classrooms. Similarly, if they regress, the student can return to Bradley Hospital until the teachers and staff believe the child is ready to return to the public schools.

A total of 66 students –– who represent $3.4 million of this year’s tuition costs –– have already been identified as students to come back in September. The district is reexamining its out-of-district students to see whether it can add another 15 to 30 students.

Parents who disagree can request a stay-put order with the state Department of Education. A hearing then occurs and school officials must prove the district can meet the student’s individual education plan and provide the same services as the student’s last placement.

Barham and Cirillo said the district tends to win those hearings ... ab55f.html
« Last Edit: August 27, 2009, 04:02:40 AM by Inculcated »
“A person needs a little madness, or else they never dare cut the rope and be free”  Nikos Kazantzakis

Offline Inculcated

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Re: Bradley Children's home / Bradley Children's Hospital
« Reply #3 on: August 27, 2009, 03:32:26 AM »
Founded in 1931, Bradley Hospital in East Providence is the nation's first psychiatric hospital devoted to children and adolescents.
Exerpts from Hospitals have wealth of history-By Phyllis Hanlon
Noted for its historic medical, academic and financial institutions as well as for prominent names in retail, business and manufacturing, New England is also home to several venerable psychiatric facilities. In the early days, far-sighted individuals foresaw the importance of such institutions. Three of those hospitals are briefly described below.


Unable to find quality medical care for his beloved daughter who suffered from cerebral palsy, epilepsy and retardation as a result of probable encephalitis, George Lothrop, astute businessman and colleague of Alexander Graham Bell, established a charity to fund a hospital specifically for children. The Emma Pendleton Bradley Home in Rhode Island was founded out of sorrow and anguish "…and the hope that from the affliction of this one life may come comfort and blessing to many suffering in like manner," Bradley wrote in his will.

In 1931, 25 years after Bradley's death, construction was completed and the doors of the country's first children's psychiatric hospital opened to the public. From its inception, the institution gained acclaim as an important research institute out of which many significant discoveries flowed. A number of pharmacological breakthroughs for schizoid and convulsive disorders in children were discovered. The use of advanced technological tools, such as electroencephalography, was first implemented at this facility. Additionally, the hospital gained a reputation for providing free care to those in need of services but without financial means.

During the ensuing years, Bradley became incorporated as a hospital (1957); formalized an affiliation with Brown University (1973); joined LifeSpan (1996) and implemented several innovative outpatient and community programs. According to Daniel J. Wall, hospital president, Bradley offers a variety of services - from inpatient and residential to outpatient and special education programs - to more than 300 children. He notes that, in addition to enhancing patient services, the expansion of operations has improved the hospital's overall fiscal health.

« Last Edit: August 27, 2009, 04:03:25 AM by Inculcated »
“A person needs a little madness, or else they never dare cut the rope and be free”  Nikos Kazantzakis

Offline Inculcated

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Re: Bradley Children's home / Bradley Children's Hospital
« Reply #4 on: August 27, 2009, 03:36:13 AM »
Integration of a behavior modification program into a traditionally oriented residential treatment center for children -Anthony Davids and Jon K. Berenson
Abstract:   The historical background and early contributions of the Emma Pendleton Bradley Hospital, the first psychiatric hospital for children in the United States, are described. The focus of this report is on the incorporation of the treatment modality of behavior modification into this traditional psychoanalytically oriented program. Beginning with exploratory studies in the mid-1960s, in recent years within the residential center there has been a separate Autistic Unit, in which the major treatment strategy is consistent application of behavior modification principles and programs. Changes that have occurred in the course of developing the behavior modification program are discussed to show some of the positive and negative aspects of introducing such a radical change into a traditional setting. Case studies are included to reveal both the failures and the successes that have been encountered in treating psychotic children with either psychotherapy or behavior therapy. Description of the current status of the program shows that treatment is comprehensive, including psychodynamic and behavioral approaches, medication when warranted, and special education. The role of parents in the program is now very different from that ascribed to them in traditional psychoanalytically guided treatment.

Group Psychotherapy with Children on an Inpatient Unit: The MEGA Group Model ... n17188706/
« Last Edit: December 31, 1969, 07:00:00 PM by Guest »
“A person needs a little madness, or else they never dare cut the rope and be free”  Nikos Kazantzakis