
Dr. Jay Tarnow and Dr. Ron Swatzyna continue to be on the leading edge of mental health treatment with their newest publication. In November 2016, the Journal of Clinical Neurophysiology accepted the article “Integration of EEG into Psychiatric Practice: A Step Toward Precision Medicine for Autism Spectrum Disorder.”
Following the National Institute of Mental Health’s (NIMH) Research Domain Criteria (RDoC) project, the study sought to further research on evidence-based interventions in psychiatry and step away from medication recommendations based on trial and error. Specifically, Drs. Tarnow and Swatzyna wanted to prove that integrating the EEG into psychiatric practice can provide valuable information for treatment and medication selection.
Although it is not common for the EEG to be used by psychiatrists, past research has found that EEG abnormalities are more prevalent in psychiatric patients when compared to the general population. In particular isolated epileptiform discharges (IEDs) are found to be more prevalent in those diagnosed with Autism Spectrum Disorder (ASD), ADHD, and Tourette’s syndrome.
ASD often presents a treatment challenge, due to the variety of symptoms that make each case unique. Many medications prescribed to manage associated symptoms such as attention issues, anxiety, depression, poor reality, testing, and behavioral problems fail to alleviate symptoms and produce undesirable side effects. In addition, these medications lower seizure threshold, and result in increased epileptiform activity. Therefore, it may be prudent to order an EEG prior to treatment in order to screen for EEG abnormalities that may otherwise go undetected.
The study was comprised of 140 nonepileptic subjects diagnosed with ASD, ages 4-25. The majority of the subjects were referred for treatment after failing multiple attempts with different medications. Visual inspection of each of the subject’s EEGs was performed in order to search for abnormalities.
Of the 140 subjects with ASD, the EEG data identified 36% of the subjects had IEDs. There were no significant differences found between genders or age. These findings indicate that there is a high prevalence of IEDs among individuals with ASD.
In conclusion, the results show that compared to a healthy population, a large number of patients with ASD have IEDs. These findings suggest that an EEG should be utilized with children, adolescents, and young adults with ASD, regardless of gender or age. This is particularly true for those who exhibit aggressive behaviors or those who have failed prior medication attempts with stimulants, antidepressants, and antipsychotics. Utilizing the EEG for refractory cases in a psychiatric practice allows for more individualized and precise medication selection.
For more information, the article abstract can be found on PubMed, or you can download the full article PDF here.

Dr. Julie Jones specializes in the treatment of AD/HD and autism. In addition, she has a long history of helping individuals manage extreme anxiety. She has advocated for and treated children with selective mutism for almost two decades. As a former school counselor and dean, she appreciates collaborating with schools to help provide appropriate treatment and supportive services for her clients.
Dr. Jones is a published researcher. She is currently engaged in several research projects including a multiyear study on the impact of fitness on academic learning for adolescents with Autism (with UTMB). She also speaks to local and national audiences on the outcomes of her research. She is committed to sharing credible information individuals can directly apply in their respective roles. She speaks to schools, professional groups, and parents on topics related to anxiety, AD/HD, autism, executive functioning, and ethics.
As an adjunct professor at the University of Houston-Clear Lake, she teaches master's level students in the programs for marriage and family therapy and clinical psychology. Additionally, she offers private supervision for licensed marriage and family therapy interns and licensed professional counselor interns.
It’s getting ugly out there. Just go to the comments section of any news story online, and you’ll see what I’m talking about. People are just angry, and it doesn’t take much to start a fight. A lot of times, it seems to come out of nowhere. I just read a tragic story the other day about a New York couple who were killed in a hit-and-run accident on their way to the hospital, to deliver their first child. Scroll down to the comments section, and…. there it is. Somebody blaming Obama for the accident. Then just as quickly, somebody else blaming the Republicans. Then somebody else talking about how it was God’s way of punishing those who don’t follow Him (the couple was Haredi, which is a conservative sect of Judaism). Seriously? Whether it’s the election, gun control, gay marriage, abortion, or the legalization of marijuana, it’s easy to see that we’re as divided a nation as we’ve ever been.
Or are we?
We’ve always been divided. Heck, our country was founded on division. Many early colonists to America were escaping what they saw as religious persecution by the Church of England. They wanted the right to practice Christianity free of interference. They wanted to “purify” the church, and hence, were called Puritans. But once settled in Plymouth, there were those within this sect who believed that the Puritans weren’t separated enough from the Church of England, and they split off to form the Providence Settlement. Eventually, members of the Providence sect became dissatisfied and moved on to form their own group. And so on, and so on…
William Golding’s Lord of the Flies is the penultimate example of our inherent separatist nature and also how it can go horribly wrong if unchallenged. In the book, a group of British private school students find themselves marooned on an island with no adult supervision. Initially, they work together to establish some sort of structure in order to survive. But after the initial crisis passes, the boys become restless and begin to develop paranoid fantasies about a mythical “beast” that prowls the island. This beast, and the disagreements about how to best handle the threat, eventually results in the boys splintering into two separate groups. One group, the “Hunters,” sets off to hunt the beast, and they begin to color their faces with charcoal and carry sharp wooden spears. Animosity grows as the boys take sides, and the hunters’ camouflage makes them unrecognizable from the students they had been. Eventually the hunters turn their aggression on the remaining boys, with disastrous consequences.
What Golding touched on in 1954 was a basic human instinct to seek the company of those who think, feel, and behave as we do. This is our collective identity; that which identifies “Us” and distinguishes us from “Them.” Thousands of years ago, this type of distinction was necessary for survival. I had to be able to tell, quickly, if you were part of my tribe (safe), or part of their tribe (threat). Nowadays? Not so much. A collective identity can provide a healthy source of comfort or harmless pride so long as we keep our feet grounded in reality. But when we let our group mentality blind us to individual differences, we can get caught up in all the nasty ism’s: Racism, Sexism, Heterosexism, and Bipartisanism. The goal is to recognize this intrinsic drive to separate and then to challenge ourselves not to fall prey to it.
Are we divided as a country? Absolutely. But we’re certainly no more divided now than when Alexander Hamilton and Aaron Burr took (literal) shots at each other over political and personal differences. I think the difference is that in the past, we pretty much stuck with our own. Democrats stuck with Democrats, and Republicans stuck with Republicans. When we did run across one another, we had the good manners not to engage in political discourse, or at least to keep any such discourse civil.
But now, we’re too busy. Job, school, soccer practice, scout meeting… we don’t have time for conversation. And so we tweet. We update our Facebook status. We “like,” re-tweet, and comment. Each of us has his or her own public forum on the internet, and I can easily identify the other Us’s by who likes and who comments on my updates. What happens when the We encounter the Them? Those good manners we used to have in face-to-face discussion have flown the coop. The internet serves the same role as charcoal on a schoolboy’s face; it makes us feel safe and anonymous, but it doesn’t really hide who we are. I will say things to you online that I would never say to your face. What are you going to do, drive over to my house and fight me? Nyah-nyah-nah-nyah-nyah. There’s a term for this, by the way: Trolling. By definition, a Troll is an intentionally inflammatory posting online that is designed to incite anger in others. Consider the story of the Haredi couple above as a great example.
The problem is that most of us are trolling our friends, co-workers, and classmates. That anonymity and distance evaporate when we’re back in face-to-face contact. And the things we say to each other online have serious repercussions in the real world. How many of you have witnessed age-old friendships dissolve overnight as a result of a Facebook fight? It’s not just politics. People argue about the stupidest stuff you can imagine. I’ve seen friendships end over Lebron vs. Kobe, New vs. Old Country Music, and (true story) whether or not Gigli is the worst movie of all time.1
Why do we argue about this stuff? Because we’re bored. When are we online? When we’re bored. Arguing with someone is a sure-fire way to get rid of that boredom. Even though we’re not in any real danger, an argument still activates our fight/flight response and gets the brain humming. For some, that stimulation can be intoxicating. And just like with any other form of intoxication, there’s a hangover effect. With trolling, that hangover is a loss of friends. So if you find yourself wanting to take a shot at somebody online, it’s a sign that you’re trying to inject a little excitement into your day. Get up. Out of the chair. Walk the dog. Go for a run. Do some jumping jacks. Exercise will release some of that adrenaline and help you make better decisions. If you’re still ticked off in ten minutes, you’ll have a clearer mindset to say what you want to say without being a Troll. At least we’re not shooting each other over this stuff.
By the way, if Hamilton and Burr had been Facebook users, I imagine the duel would have gone something like this...
1 It is.

In an age of distraction, sometimes it’s a challenge to talk to your own kids. Competing with a screen and the seemingly lost art of long social conversations are likely contributors to ongoing frustrating silence. Luckily, there are some simple tactics clever parents can try.
I remember years ago after a tough time in our family, I took my kids jet skiing over waves in the ocean. It was rough, exhilarating, and a bit scary. The water rushing over our faces, the taste of the salt water, and the visual scenery provided a lot of interesting sensory stimulation. We were experiencing something new together for the first time. This created natural commentary about what we were doing. Anything that is new for both of you is more likely to spark fresh conversation.
Tip #1: Try a new experience together.
Have you ever noticed guys are often more talkative when they are side-by-side instead of looking at each other directly? Reducing the requirement of direct eye contact sometimes makes it easier for people to talk to each other. Start a commentary on what you are seeing in front of you. Common times you might capture this opportunity are while riding in a car, playing a game, and cooking together. Consider taking a car ride to an unusual place like the Galveston seawall, Brazos Bend State Park, or a drive through animal park.
Tip #2: Set yourself up to talk side-by-side instead of face-to-face.
Use truth serum. Ok, well maybe not exactly that. I have noticed that kids will talk to me while sitting in a hot tub, running, and engaging in any physical activity. There is actually brain science behind this. As an individual exercises, the brain releases feel good chemicals. Although the hot tub idea seems to work instantaneously, often exercise requires multiple attempts before the child will talk freely. My theory is the child realizes they have a captive audience and in that predictable scenario the adult is safe to talk to. In other words, you are not distracted. Routine evening walks with a dog, running at the park, and bike rides are easy and repeatable activities to try.
Tip #3: Prime the brain through exercise and soothing activities before you talk.
A final thought is about simple approachability. I am also that parent who is tired at the end of the day and uses the same go-to conversation starters about how the day went and homework questions. The truth is kids are more likely to talk when a parent is approachable and interesting. Are you acting like you are person they want to be around? Are you doing things like smiling, acting playful, and asking novel questions about their world? What makes you laugh? Can you reveal that side of yourself more often?
Tip #4: Show up with a positive attitude and fun-loving approachability.
Communication is something we all work on. With a few new tactics, you might speed up the process to success. Summer is a perfect time to try a new approach.
I am fortunate enough to have a brilliant collection of friends whom I call “The Tribe.” They are a mish-mosh of all different types of folks with different ways of living and being, and I absolutely adore them because each and every one of them is magnificent in their own way.In my Tribe, we all have dealings with children. Be it our own, our nieces, our nephews, our neighbor’s kids …it matters not. My Tribe takes care of – and tends to – all of the children in our lives; and let me tell you…there is a lot of anxiety when it comes time to send the wee ones off to school. Every single member of the Tribe has some sort of nervous anticipation around this topic.
We all have had difficult moments with this rite of passage.
I want you to take a moment and breathe that in…it happens to us all.
There is not a parent/friend/relative/guardian on the planet, not a soul who loves and cares for children who has not experienced the stress and anxiety regardingthe relinquishment of control over a child.
Now, there are going to be people out there who tell you that it’s a piece of cake…that both they and their child are just smiling and perfect every day. Everyone is cleaned, dressed, lunches packed, homework finished, love is in the air and everything is stunning, beautiful, and practically perfect in every way.
They lie.
Liar-Liar, pretty perfect Mary Poppins pants on fire.
I’ll get back to the flaming Poppins pants in a moment.
Just among my small Tribe there is an impressive assortment of physical and psychological symptoms that go hand-in-hand with school (as well as for the working parent – surrendering a chunk of your child’s care over to another so you can work is just as difficult!). The children in our group range from infants to pre-teens. Some of the parents stay home to care for their children, some work and have to rely on daycare to look after their youngest. Symptoms of anxiety expressed by my circle of peoplethis most recent summer-to-school transition range from:
· Eating too much
· Drinking too much
· Falling back into other unhealthy habits
· Stomach problems (nausea/diarrhea)
· Weight gain
· Skin problems
· Headaches, toothaches, leg cramps
· Restless sleep/too much sleep/not sleeping enough
· Ripping out flooring/tile/wallpaper/chunks of lawn/bushes/trees
· And the worry…worry…WORRY!!
And that’s just the adults! As for the children in our group, there has been an array of tummy complaints, headaches, poor sleep, acting out, junk food cravings, extra whining and crying and an overall upping of the standard kiddo manipulation scale into overdrive.
And guess what? Every last bit of that is perfectly normal. Around this time of the year, if you start to Google “school a…,” or “child a…,” it will fill in the blanks and offer you up thousands of topics concerning anxiety. Even here at the Tarnow centerwe have already addressed this in blogs here and here and here. Everyone just loses their marbles a little bit when it comes to school, daycare, and letting go. I wouldn’t be writing yet another blog on the topic if it wasn’t a real thing.
It’s okay. Really, it is. You are never, ever alone in feeling this way, and neither are your children. Stress, anxiety and fear happen.
Back to the earlier topic of the flaming Poppins pants – I am all for searching out for support and information on the internet, I really am. However, beware the unhelpful sort who poo-poos your anxiety as a weakness, or accuses you of poor parenting. Be wary too of the Mary Poppins of Motherdom/Fatherdom for who all runs smoothly and whose world is a living Pinterest board of free-range, color-coordinated, sushi’d bento boxes and hand-stitched Hungarian Mayto culottes.
Rubbish.
One should especially be on thelookout for the most awful of the internet unhelpfuls…The Trolls. If you find yourself already feeling fractured, some of these people can shatter you. Beware. Our own Dr. Walker Peacock has addressed these types in a piece he has written for the center called “Lord of the Trolls” and you can find it here.
Having said all of that, there are times when it really is too much to bear and the symptoms of the stress are taking a toll. Be it you, your partner, your children, or your entire family. When the weight of it all becomes a burden in daily functioning, that’s when we at the Tarnow Center are here to help.
The following is a list of symptoms that can be exhibited by you or your child. Before you read, please remember that most of these are perfectly normal, human responses to stressors. However, when they begin to impede your way of life – then it is time to ask for help.
To reiterate, it is not necessarily the symptom itself that is problematic (albeit as annoying as it is), it’s the intensity and longevity of the symptoms that should trigger your attention that there might be a problem that needs to be tended to.
Specifically, separation anxiety is a very common problem for preschool children, especially during the first few weeks of school. A preschool child is at the age wherethey are learning to negotiate their independence, which is a concept that is both exciting and scary at the same time. When a young child begins to grasp that they are their own person with wants and needs that are separate from yours, there is also the terrifying realization that you may not always be by their side. Going to preschool or daycare can make this last point painfully clear, which might result in your child becoming anxious about you getting out of sight at all…anywhere!
Some tips for cutting down on separation anxiety are:
After all of these tips, bullets, suggestions and stories, the fact of the matter is sometimes we need to ask for help. Within my Tribe there are those who are on medication for anxiety and depression, some are in therapy, and even a few of the children have become so worried and anxious they too are in therapy. It happens. Their support needs ebb and flow, as life does. Some times are easier, others not so much. Tide of troubles in, tide of troubles out.
If the tide comes in and you find yourself crushed under the swirling weight of it all, we are here to help. The Tarnow Center offers several treatment modalities and options and many caring professionals on our team who can tend to the needs of any member of your family who might need us. Please call us any time at (713) 621-9515.
Personally, I have recently come on board to tend to the needs of your youngest family members. Along with our other staff members, we will treat your entire family as the living organism it is, and together your child and I will explore their troubles through verbal and non-verbal therapies to help tease out the knots that may be impeding their development and/or functioning. And although I might not be Mary Poppins, I won’t float away should the wind change direction.
However, I might just know where to find tap dancing penguins...