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138-449: Anthony Godby Johnson is the subject and supposed author of the 1993 memoir A Rock and a Hard Place: One Boy's Triumphant Story . Subsequent investigations suggest that Johnson may have been the literary creation of Vicki Johnson, who purported to be Johnson's adoptive mother. The book initially appeared as an autobiography, describing Johnson's survival of an abusive childhood at the hands of his parents and their friends, his adoption by

276-476: A 20% change in the slope of the ALSFRS-R as being clinically meaningful, which is the most common threshold used to determine whether a new treatment is working in clinical trials. Difficulties with chewing and swallowing make eating very difficult ( dysphagia ) and increase the risk of choking or of aspirating food into the lungs. In later stages of the disorder, aspiration pneumonia can develop, and maintaining

414-503: A May 2019 study, published in the Cambridge University Press. Maltreated children may be at risk to become maltreating adults. Physical and emotional abuse have comparable effects on a child's emotional state and have been linked to childhood depression, low self-compassion, and negative automatic thoughts. Some research suggests that high stress levels from child abuse may cause structural and functional changes within

552-409: A baton. Tardieu made home visits and observed the effect on the children; he noticed that the sadness and fear on their faces disappeared when they were placed under protection. He commented, "When we consider the tender age of these poor defenceless beings, subjected daily and almost hourly to savage atrocities, unimaginable tortures and harsh privation, their lives one long martyrdom – and when we face

690-492: A bulbar onset have a worse prognosis than limb-onset ALS; a population-based study found that bulbar-onset ALS patients had a median survival of 2.0 years and a 10-year survival rate of 3%, while limb-onset ALS patients had a median survival of 2.6 years and a 10-year survival rate of 13%. Those with respiratory-onset ALS had a shorter median survival of 1.4 years and 0% survival at 10 years. While astrophysicist Stephen Hawking lived for 55 more years following his diagnosis, his

828-565: A child", and acts of omission (neglect), meaning "the failure to provide for a child's basic physical, emotional, or educational needs or to protect a child from harm or potential harm". The United States federal Child Abuse Prevention and Treatment Act defines child abuse and neglect as, at minimum, "any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation" or "an act or failure to act which presents an imminent risk of serious harm". As of 2006 ,

966-422: A close relationship with their parent, exhibit aggressive behavior or act nasty towards other children and animals. Older children may use foul language or act in a markedly different way to other children at the same age, struggle to control strong emotions, seem isolated from their parents, lack social skills or have few, if any, friends. Children can also experience reactive attachment disorder (RAD). RAD

1104-467: A common disease spectrum (ALS–FTD) because of genetic, clinical, and pathological similarities. Genetically, repeat expansions in the C9orf72 gene account for about 40% of genetic ALS and 25% of genetic FTD. Cognitive and behavioral issues are associated with poorer prognosis as they may reduce adherence to medical advice, and deficits in empathy and social cognition which may increase caregiver burden. It

1242-426: A crucial structure in the brain's reward circuits is compromised by childhood abuse and neglect, and predicts Depressive Symptoms later in life. In the case of 23 of the 27 illnesses listed in the questionnaire of a French INSEE survey, some statistically significant correlations were found between repeated illness and family traumas encountered by the child before the age of 18 years. According to Georges Menahem ,

1380-458: A curious bimodal distribution, idiopathic in infants and traumatic in adults, while unexplained ossifying periostitis of the long bones was similar to that occurring after breech extractions. In 1946, John Caffey, the American founder of paediatric radiology, drew attention to the association of long bone fractures and chronic subdural haematoma, and, in 1955, it was noticed that infants removed from

1518-430: A definitive diagnosis of PLS cannot be made until several years have passed. PLS has a better prognosis than classical ALS, as it progresses slower, results in less functional decline, does not affect the ability to breathe, and causes less severe weight loss than classical ALS. Progressive muscular atrophy (PMA) is another subtype that accounts for about 5% of the overall ALS category and affects lower motor neurons in

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1656-444: A disease, ALS itself can be classified in a few different ways: by which part of the motor neurons are affected; by the parts of the body first affected; whether it is genetic; and the age at which it started. Each individual diagnosed with the condition will sit at a unique place at the intersection of these complex and overlapping subtypes, which presents a challenge to diagnosis, understanding, and prognosis. ALS can be classified by

1794-509: A film , in which the main character begins correspondence with an HIV-positive boy who is not what he seems. The book parallels Maupin's experience with Johnson. The story was also adapted for a 2002 episode of Law & Order: Criminal Intent entitled " Faith ", with the child's sex being changed to female and the illness to amyotrophic lateral sclerosis . On January 12, 2007, the ABC newsmagazine program 20/20 revealed new evidence that Anthony

1932-461: A fraction of children suffering physical abuse. Cigarette burns or scald injuries may also prompt evaluation for child physical abuse. The long-term impact of child abuse and neglect on physical health and development can be: The Adverse Childhood Experiences Study is a long-running investigation into the relationship between childhood adversity, including various forms of abuse and neglect, and health problems in later life. The initial phase of

2070-403: A genetic cause, often linked to a family history of the disease , and these are known as familial ALS (hereditary). About half of these genetic cases are due to disease-causing variants in one of four specific genes . The diagnosis is based on a person's signs and symptoms , with testing conducted to rule out other potential causes. There is no known cure for ALS. The goal of treatment

2208-424: A healthy weight can become a significant problem that may require the insertion of a feeding tube. As the diaphragm and intercostal muscles of the rib cage that support breathing weaken, measures of lung function such as vital capacity and inspiratory pressure diminish. In respiratory-onset ALS, this may occur before significant limb weakness is apparent. Individuals affected by the disorder may ultimately lose

2346-431: A lack of parental warmth. The WHO defines physical abuse as: Intentional use of physical force against the child that results in – or has a high likelihood of resulting in – harm for the child's health, survival, development, or dignity. This includes hitting, beating, kicking, shaking, biting, strangling, scalding, burning, poisoning, and suffocating. Much physical violence against children in

2484-539: A large sum of the children who were abused are now currently addicted to alcohol. This case study outlines how addiction is a significant effect of childhood abuse. Children who have a history of neglect or physical abuse are at risk of developing psychiatric problems, or a disorganized attachment style. In addition, children who experience child abuse or neglect are 59% more likely to be arrested as juveniles, 28% more likely to be arrested as adults, and 30% more likely to commit violent crime. Disorganized attachment

2622-558: A more difficult time forming and maintaining relationships, such as romantic or friendship, later in life due to the lack of attachment they had in their earlier stages of life. Child abuse can result in immediate adverse physical effects but it is also strongly associated with developmental problems and with many chronic physical and psychological effects, including subsequent ill-health, including higher rates of chronic conditions, high-risk health behaviors and shortened lifespan. Child abuse has also been linked to suicide , according to

2760-490: A new family, and his subsequent contraction of HIV/AIDS . A second, lesser-known book was published under Johnson's name in 1994, entitled Love Letters to Hawaii from Aboard the A-Train . When several magazines and journalists, including Newsweek and Keith Olbermann , attempted to investigate the claims of the book and profile Anthony, they contacted the woman who claimed to be his adoptive mother, Vicki Johnson. Suspicion

2898-463: A number of ALS genes that encode for RNA-binding proteins. The first to be discovered was TDP-43 protein, a nuclear protein that aggregates in the cytoplasm of motor neurons in almost all cases of ALS; however, mutations in TARDBP , the gene that codes for TDP-43, are a rare cause of ALS. FUS codes for FUS, another RNA-binding protein with a similar function to TDP-43, which can cause ALS when mutated. It

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3036-510: A physician suspects the person may have a myopathy rather than ALS, a muscle biopsy may be performed. A number of infectious diseases can sometimes cause ALS-like symptoms, including human immunodeficiency virus ( HIV ), human T-lymphotropic virus (HTLV), Lyme disease , and syphilis . Neurological disorders such as multiple sclerosis, post-polio syndrome , multifocal motor neuropathy , CIDP , spinal muscular atrophy , and spinal and bulbar muscular atrophy can also mimic certain aspects of

3174-473: A police officer with his supposed biological father's name, and the New York State Department of Corrections and Community Supervision lists no inmate by that name having ever been incarcerated, let alone killed in prison. Were these things true, verification could easily be obtained by internet searches or Freedom of Information Act requests. Lastly, no court records exist which list a couple with

3312-464: A predominantly upper motor neuron phenotype. Emotional lability is a symptom in which patients cry, smile, yawn, or laugh, either in the absence of emotional stimuli, or when they are feeling the opposite emotion to that being expressed; it is experienced by about half of ALS patients and is more common in those with bulbar-onset ALS. While relatively benign relative to other symptoms, it can cause increased stigma and social isolation as people around

3450-463: A rapid worsening of symptoms. Sudden death or acute respiratory distress are uncommon. Access to palliative care is recommended from an early stage to explore options, ensure psychosocial support for the patient and caregivers, and to discuss advance healthcare directives . As with cancer staging , ALS has staging systems numbered between 1 and 4 that are used for research purposes in clinical trials. Two very similar staging systems emerged around

3588-611: A relationship of responsibility, trust or power." The WHO also says, "Violence against children includes all forms of violence against people under 18 years old, whether perpetrated by parents or other caregivers, peers, romantic partners, or strangers." In the United States, the Centers for Disease Control and Prevention (CDC) uses the term child maltreatment to refer to both acts of commission (abuse), which include "words or overt actions that cause harm, potential harm, or threat of harm to

3726-406: A series of 32 such cases, of which 18 were fatal, the children dying from starvation and/or recurrent physical abuse; it included the case of Adeline Defert, who was returned by her grandparents at the age of 8, and for 9 years tortured by her parents – whipped every day, hung up by her thumbs and beaten with a nailed plank, burnt with hot coals and her wounds bathed in nitric acid, and deflorated with

3864-521: A similar time, the King's staging system and Milano-Torino (MiToS) functional staging. 2B: Involvement of the second region 4B: Need for non-invasive ventilation 4B: 30.3 months Providing individual patients with a precise prognosis is not currently possible, though research is underway to provide statistical models on the basis of prognostic factors including age at onset, progression rate, site of onset, and presence of frontotemporal dementia . Those with

4002-436: A single region for at least a year; they progress more slowly than classical ALS and are associated with longer survival. These regional variants of ALS can only be considered as a diagnosis should the initial symptoms fail to spread to other spinal cord regions for an extended period of time (at least 12 months). Flail arm syndrome is characterized by lower motor neuron damage affecting the arm muscles, typically starting with

4140-573: A small percentage of people have a much slower progression, on average people with ALS lose about 1 ALSFRS-R point per month. Brief periods of stabilization ("plateaus") and even small reversals in ALSFRS-R score are not uncommon, due to the fact the tool is subjective, can be affected by medication, and different forms of compensation for changes in function. However, it is rare (<1%) for these improvements to be large (i.e. greater than 4 ALSFRS-R points) or sustained (i.e. greater than 12 months). A survey-based study among clinicians showed that they rated

4278-477: A smaller family, older generations dying earlier of causes other than ALS, genetic non-paternity , and uncertainty over whether certain neuropsychiatric conditions (e.g. frontotemporal dementia , other forms of dementia , suicide, psychosis, schizophrenia ) should be considered significant when determining a family history. There have been calls in the research community to routinely counsel and test all diagnosed ALS patients for familial ALS, particularly as there

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4416-432: A tendency for victims to blame themselves ( self-blame ) for the abuse, learned helplessness , and overly passive behavior in order to avoid such a situation again. Child neglect is the failure of a parent or other person with responsibility for the child, to provide needed food, clothing, shelter, medical care, or supervision to the degree that the child's health, safety or well-being may be threatened with harm. Neglect

4554-497: A way of coping, physically abused children may rely on primitive defense mechanisms such as projection , introjection , splitting , and denial . They may also have impaired impulse control and a negative self-concept, which can lead to self-destructive behavior. Victims of childhood abuse also have different types of physical health problems later in life. Some reportedly have some type of chronic head, abdominal, pelvic, or muscular pain with no identifiable reason. Even though

4692-647: Is a relationship between child physical and sexual abuse and suicide. For legal and cultural reasons as well as fears by children of being taken away from their parents most childhood abuse goes unreported and unsubstantiated. It has been discovered that childhood abuse can lead to the addiction of drugs and alcohol in adolescence and adult life. Studies show that any type of abuse experienced in childhood can cause neurological changes making an individual more prone to addictive tendencies. A significant study examined 900 court cases of children who had experienced sexual and physical abuse along with neglect. The study found that

4830-408: Is a symptom experienced by most people with ALS caused by reduced mobility. Symptoms of lower motor neuron degeneration include muscle weakness and atrophy, muscle cramps, and fleeting twitches of muscles that can be seen under the skin ( fasciculations ). Although the initial site of symptoms and subsequent rate of disability progression vary from person to person, the initially affected body region

4968-560: Is a time consuming and lengthy legal process. The state of New York has no record of a boy by that name or fitting that description having ever been adopted by anyone with his supposed adoptive mother's name. Even in a time before computers, it would have been impossible to adopt a child without creating a paper trail. Also, in his book Anthony stated that his biological father was an ex-police officer in New York, and that he had been tried, convicted, and killed in prison. However, no record exists of

5106-432: Is also a lack of attention from the people surrounding a child, and the non-provision of the relevant and adequate necessities for the child's survival, which would be a lack of attention, love, and nurturing. Some observable signs of child neglect include: the child is frequently absent from school, begs or steals food or money, lacks needed medical and dental care, is consistently dirty, or lacks appropriate clothing for

5244-889: Is associated with a number of developmental problems, including dissociative symptoms, as well as anxiety, depressive, and acting out symptoms. A study by Dante Cicchetti found that 80% of abused and maltreated infants exhibited symptoms of disorganized attachment . When some of these children become parents, especially if they have PTSD, dissociative symptoms, and other sequelae of child abuse, they may encounter difficulty when faced with their infant and young children's needs and normative distress, which may in turn lead to adverse consequences for their child's social-emotional development. Additionally, children may find it difficult to feel empathy towards themselves or others, which may cause them to feel alone and unable to make friends. Despite these potential difficulties, psychosocial intervention can be effective, at least in some cases, in changing

5382-724: Is defined as markedly disturbed and developmentally inappropriate social relatedness, that usually begins before the age of 5 years. RAD can present as a persistent failure to start or respond in a developmentally appropriate fashion to most social situations. The long-term impact of emotional abuse has not been studied widely, but recent studies have begun to document its long-term consequences. Emotional abuse has been linked to increased depression, anxiety, and difficulties in interpersonal relationships (Spertus, Wong, Halligan, & Seremetis, 2003). Victims of child abuse and neglect are more likely to commit crimes as juveniles and adults. Domestic violence also takes its toll on children; although

5520-572: Is more likely to be genetic in origin than adult-onset ALS; the most common genes associated with juvenile ALS are FUS , ALS2 , and SETX . Although most people with juvenile ALS live longer than those with adult-onset ALS, some of them have specific mutations in FUS and SOD1 that are associated with a poor prognosis. Late onset (after age 65) is generally associated with a more rapid functional decline and shorter survival. The disorder causes muscle weakness, atrophy , and muscle spasms throughout

5658-657: Is not known what causes sporadic ALS, hence it is described as an idiopathic disease . Though its exact cause is unknown, genetic and environmental factors are thought to be of roughly equal importance. The genetic factors are better understood than the environmental factors; no specific environmental factor has been definitively shown to cause ALS. A multi-step liability threshold model for ALS proposes that cellular damage accumulates over time due to genetic factors present at birth and exposure to environmental risks throughout life. ALS can strike at any age, but its likelihood increases with age. Most people who develop ALS are between

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5796-631: Is now a licensed gene therapy ( tofersen ) specifically targeted to carriers of SOD-1 ALS. A shortage of genetic counselors and limited clinical capacity to see such at-risk individuals makes this challenging in practice, as does the unequal access to genetic testing around the world. More than 40 genes have been associated with ALS, of which four account for nearly half of familial cases, and around 5% of sporadic cases: C9orf72 (40% of familial cases, 7% sporadic), SOD1 (12% of familial cases, 1–2% sporadic), FUS (4% of familial cases, 1% sporadic), and TARDBP (4% of familial cases, 1% sporadic), with

5934-412: Is often feasible, albeit slow, and needs may change over time. Despite these challenges, many people in an advanced state of disease report satisfactory wellbeing and quality of life. Although respiratory support using non-invasive ventilation can ease problems with breathing and prolong survival, it does not affect the progression rate of ALS. Most people with ALS die between two and four years after

6072-532: Is often marked by walking with a " dropped foot " that drags gently on the ground. If the arms are affected first, they may experience difficulty with tasks requiring manual dexterity, such as buttoning a shirt, writing, or turning a key in a lock. In bulbar-onset ALS, the first symptoms are difficulty speaking or swallowing. Speech may become slurred, nasal in character, or quieter. There may be difficulty with swallowing and loss of tongue mobility. A smaller proportion of people experience "respiratory-onset" ALS, where

6210-495: Is respiratory-onset, in which the initial symptoms are difficulty breathing ( dyspnea ) upon exertion, at rest, or while lying flat ( orthopnea ). Primary lateral sclerosis (PLS) is a subtype of the overall ALS category which accounts for about 5% of all cases and only affects the upper motor neurons in the arms, legs, and bulbar region. However, more than 75% of people with apparent PLS go on to later develop lower motor neuron signs within four years of symptom onset, meaning that

6348-447: Is the main transporter that removes glutamate from the synapse; this leads to increased synaptic glutamate levels and excitotoxicity. Riluzole , a drug that modestly prolongs survival in ALS, inhibits glutamate release from pre-synaptic neurons; however, it is unclear if this mechanism is responsible for its therapeutic effect. No single test can provide a definite diagnosis of ALS. Instead,

6486-424: Is thought that misfolded mutant SOD1 can cause misfolding and aggregation of wild-type SOD1 in neighboring neurons in a prion-like manner. Other protein degradation genes that can cause ALS when mutated include VCP , OPTN , TBK1 , and SQSTM1 . Three genes implicated in ALS that are important for maintaining the cytoskeleton and for axonal transport include DCTN1 , PFN1 , and TUBA4A . There are

6624-403: Is thought that mutations in TARDBP and FUS increase the binding affinity of the low-complexity domain, causing their respective proteins to aggregate in the cytoplasm. Once these mutant RNA-binding proteins are misfolded and aggregated, they may be able to misfold normal proteins both within and between cells in a prion-like manner. This also leads to decreased levels of RNA-binding protein in

6762-429: Is thought to account for 10–15% of cases overall and can include monogenic , oligogenic , and polygenic modes of inheritance. There is considerable variation among clinicians on how to approach genetic testing in ALS, and only about half discuss the possibility of genetic inheritance with their patients, particularly if there is no discernible family history of the disease. In the past, genetic counseling and testing

6900-498: Is to slow the disease progression, and improve symptoms. FDA approved treatments that slow the progression of ALS include riluzole and edaravone . Non-invasive ventilation may result in both improved quality, and length of life. Mechanical ventilation can prolong survival but does not stop disease progression. A feeding tube may help maintain weight and nutrition. Death is usually caused by respiratory failure. The disease can affect people of any age, but usually starts around

7038-431: Is usually the most affected over time, and symptoms usually spread to a neighbouring body region. For example, symptoms starting in one arm usually spread next to either the opposite arm or to the leg on the same side. Bulbar-onset patients most typically get their next symptoms in their arms rather than legs, arm-onset patients typically spreads to the legs before the bulbar region, and leg-onset patients typically spread to

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7176-475: The ALS Functional Rating Scale - Revised (ALSFRS-R), a 12-item instrument survey administered as a clinical interview or self-reported questionnaire that produces a score between 48 (normal function) and 0 (severe disability). The ALSFRS-R is the most frequently used outcome measure in clinical trials and is used by doctors to track disease progression. Though the degree of variability is high and

7314-596: The Centers for Disease Control and Prevention (CDC) and Behavioral Risk Factor Surveillance System corroborate these high rates. There is a high correlation between the number of different adverse childhood experiences (A.C.E.s) and risk for poor health outcomes in adults including cancer, heart attack, mental illness, reduced longevity, and drug and alcohol abuse. An anonymous self-reporting survey of Washington State students finds 6–7% of 8th, 10th and 12th grade students actually attempt suicide. Rates of depression are twice as high. Other risk behaviors are even higher. There

7452-501: The International Society for Prevention of Child Abuse and Neglect (ISPCAN) identify multiple factors at the level of the individual, their relationships, their local community, and their society at large, that combine to influence the occurrence of child maltreatment. At the individual level, studies have shown that age, mental health, and substance use, and a personal history of abuse may serve as risk factors of child abuse. At

7590-426: The intercostal muscles that support breathing are affected first. Over time, people experience increasing difficulty moving, swallowing ( dysphagia ), and speaking or forming words ( dysarthria ). Symptoms of upper motor neuron involvement include tight and stiff muscles ( spasticity ) and exaggerated reflexes ( hyperreflexia ), including an overactive gag reflex. While the disease does not cause pain directly, pain

7728-431: The language barrier , and other nations remained ignorant of the cause of many traumatic lesions in infants and toddlers; almost one hundred years would pass before humankind began to systematically confront Tardieu's "appalling problem". In the 20th century, evidence began to accumulate from pathology and paediatric radiology, particularly in relation to chronic subdural haematoma and limb fractures: subdural haematoma had

7866-468: The lower motor neurons in the spinal cord. Primary lateral sclerosis (PLS) involves degeneration of only the upper motor neurons, and progressive muscular atrophy (PMA) involves only the lower motor neurons. There is debate over whether PLS and PMA are separate diseases or simply variants of ALS. Classical ALS accounts for about 70% of all cases of ALS and can be subdivided into where symptoms first appear as these are usually focussed to one region of

8004-432: The neuromuscular junction , such as myasthenia gravis (MG) and Lambert–Eaton myasthenic syndrome , may also mimic ALS, although this rarely presents diagnostic difficulty over time. Benign fasciculation syndrome and cramp fasciculation syndrome may also, occasionally, mimic some of the early symptoms of ALS. Nonetheless, the absence of other neurological features that develop inexorably with ALS means that, over time,

8142-545: The pathogenesis of ALS. It is still not fully understood why neurons die in ALS, but this neurodegeneration is thought to involve many different cellular and molecular processes. The genes known to be involved in ALS can be grouped into three general categories based on their normal function: protein degradation, the cytoskeleton , and RNA processing. Mutant SOD1 protein forms intracellular aggregations that inhibit protein degradation. Cytoplasmic aggregations of wild-type (normal) SOD1 protein are common in sporadic ALS. It

8280-463: The French sociologist who found out these correlations by studying health inequalities, these relationships show that inequalities in illness and suffering are not only social. Health inequality also has its origins in the family, where it is associated with the degrees of lasting affective problems (lack of affection, parental discord, the prolonged absence of a parent, or a serious illness affecting either

8418-400: The U.S. in 2013, of the 294,000 reported child abuse cases only 81,124 received any sort of counseling or therapy. Treatment is greatly important for abused children. On the other hand, there are some children who are raised in child abuse, but who manage to do unexpectedly well later in life regarding the preconditions. Such children have been termed dandelion children , as inspired from

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8556-491: The United States, about 15% to 25% of women and 5% to 15% of men were sexually abused when they were children. Most sexual abuse offenders are acquainted with their victims; approximately 30% are relatives of the child, most often brothers, sisters, fathers, mothers, uncles or cousins; around 60% are other acquaintances such as friends of the family, babysitters, or neighbours; strangers are the offenders in approximately 10% of child sexual abuse cases. In over one-third of cases,

8694-444: The United States, affecting nearly 3 million children annually. Research has suggested that the consequences of child psychological abuse may be equally as harmful as those of sexual or physical abuse. Victims of emotional abuse may react by distancing themselves from the abuser, internalizing the abusive words, or fighting back by insulting the abuser. Emotional abuse can result in abnormal or disrupted attachment development ,

8832-416: The United States, is a rare, terminal neurodegenerative disorder that results in the progressive loss of both upper and lower motor neurons that normally control voluntary muscle contraction. ALS is the most common form of the motor neuron diseases . ALS often presents in its early stages with gradual muscle stiffness , twitches , weakness , and wasting . Motor neuron loss typically continues until

8970-521: The World Health Organization distinguishes four types of child maltreatment: physical abuse ; sexual abuse ; emotional (or psychological) abuse ; and neglect . Among professionals and the general public, there is disagreement as to what behaviors constitute physical abuse of a child. Physical abuse often does not occur in isolation but as part of a constellation of behaviors including authoritarian control, anxiety-provoking behavior, and

9108-665: The abilities to eat, speak, move, and, lastly, breathe are all lost. While only 15% of people with ALS also fully develop frontotemporal dementia , an estimated 50% face at least some minor difficulties with thinking and behavior . Depending on which of the aforementioned symptoms develops first, ALS is classified as limb-onset (begins with weakness in the arms or legs) or bulbar-onset (begins with difficulty in speaking or swallowing ). Most cases of ALS (about 90–95%) have no known cause , and are known as sporadic ALS . However, both genetic and environmental factors are believed to be involved. The remaining 5–10% of cases have

9246-418: The ability to initiate and control all voluntary movement, known as locked-in syndrome . Bladder and bowel function are usually spared, meaning urinary and fecal incontinence are uncommon, although trouble getting to a toilet can lead to difficulties. The extraocular muscles responsible for eye movement are usually spared, meaning the use of eye tracking technology to support augmentative communication

9384-420: The above personality traits might underlie lifestyle choices which are in turn risk factors for ALS. Upon examination at autopsy, features of the disease that can be seen with the naked eye include skeletal muscle atrophy , motor cortex atrophy, sclerosis of the corticospinal and corticobulbar tracts , thinning of the hypoglossal nerves (which control the tongue), and thinning of the anterior roots of

9522-466: The age of 60. The average survival from onset to death is two to four years, though this can vary, and about 10% of those affected survive longer than ten years. Descriptions of the disease date back to at least 1824 by Charles Bell . In 1869, the connection between the symptoms and the underlying neurological problems was first described by French neurologist Jean-Martin Charcot , who in 1874 began using

9660-425: The age of onset. While the peak age of onset is 58 to 63 for sporadic ALS and 47 to 52 for genetic ALS, about 10% of all cases of ALS begin before age 45 ("young-onset" ALS), and about 1% of all cases begin before age 25 ("juvenile" ALS). People who develop young-onset ALS are more likely to be male, less likely to have bulbar onset of symptoms, and more likely to have a slower progression of the disease. Juvenile ALS

9798-512: The ages of 40 and 70, with an average age of 55 at the time of diagnosis. ALS is 20% more common in men than women, but this difference in sex distribution is no longer present in patients with onset after age 70. While they appear identical clinically and pathologically, ALS can be classified as being either familial or sporadic, depending on whether there is a known family history of the disease and/or whether an ALS-associated genetic mutation has been identified via genetic testing. Familial ALS

9936-466: The alleged death of Vicki Johnson, Anthony has seemingly vanished and has not been in contact with any of his previous supporters, lending credence to the assertion that he never existed. Since Vicki has supposedly died, the truth or fiction of Anthony and his story cannot be verified, leaving the story without resolution. Though the majority of people now believe that he never existed, there are still some people that believe that Anthony is/was real, and with

10074-482: The arms rather than the bulbar region. Over time, regardless of where symptoms began, most people eventually lose the ability to walk or use their hands and arms independently. Less consistently, they may lose the ability to speak and to swallow food. It is the eventual development of weakness of the respiratory muscles, with the loss of ability to cough and to breathe without support, that is ultimately life-shortening in ALS. The rate of progression can be measured using

10212-497: The arms, legs, and bulbar region. While PMA is associated with longer survival on average than classical ALS, it is still progressive over time, eventually leading to respiratory failure and death. As with PLS developing into classical ALS, PMA can also develop into classical ALS over time if the lower motor neuron involvement progresses to include upper motor neurons, in which case the diagnosis might be changed to classic ALS. Isolated variants of ALS have symptoms that are limited to

10350-466: The article's publication, injuries to children—even repeated bone fractures—were not commonly recognized as the results of intentional trauma. Instead, physicians often looked for undiagnosed bone diseases or accepted parents' accounts of accidental mishaps such as falls or assaults by neighborhood bullies. The study of child abuse emerged as an academic discipline in the early 1970s in the United States. Elisabeth Young-Bruehl maintained that despite

10488-465: The body at initial presentation before later spread. Limb-onset ALS (also known as spinal-onset) and bulbar-onset ALS. Limb-onset ALS begins with weakness in the hands, arms, feet, and/or legs and accounts for about two-thirds of all classical ALS cases. Bulbar-onset ALS begins with weakness in the muscles of speech, chewing, and swallowing and accounts for about 25% of classical ALS cases. A rarer type of classical ALS affecting around 3% of patients

10626-419: The body due to the degeneration of the upper motor and lower motor neurons. Sensory nerves and the autonomic nervous system are generally unaffected, meaning the majority of people with ALS maintain hearing , sight , touch , smell , and taste . The start of ALS may be so subtle that the symptoms are overlooked. The earliest symptoms of ALS are muscle weakness or muscle atrophy, typically on one side of

10764-499: The body. Other presenting symptoms include trouble swallowing or breathing, cramping, or stiffness of affected muscles; muscle weakness affecting an arm or a leg; or slurred and nasal speech. The parts of the body affected by early symptoms of ALS depend on which motor neurons in the body are damaged first. In limb-onset ALS, the first symptoms are in the arms or the legs. If the legs are affected first, people may experience awkwardness, tripping, or stumbling when walking or running; this

10902-401: The brain to muscle, causes different types of symptoms. Damage to the upper motor neuron typically causes spasticity including stiffness and increased tendon reflexes , and/or clonus , while damage to the lower motor neuron typically causes weakness , muscle atrophy , and fasciculations . Classical, or classic ALS, involves degeneration to both the upper motor neurons in the brain and

11040-628: The brain, and therefore cause emotional and social disruptions. Abused children can grow up experiencing insecurities, low self-esteem , and lack of development. Many abused children experience ongoing difficulties with trust, social withdrawal, trouble in school, and forming relationships. Babies and other young children can be affected differently by abuse than their older counterparts. Babies and pre-school children who are being emotionally abused or neglected may be overly affectionate towards strangers or people they have not known for very long. They can lack confidence or become anxious, appear to not have

11178-563: The care of aggressive, immature and emotionally ill parents developed no new lesions. As a result, professional inquiry into the topic began again in the 1960s. The July 1962 publication of the paper "The Battered Child-Syndrome" authored principally by pediatrician C. Henry Kempe and published in The Journal of the American Medical Association represents the moment that child maltreatment entered mainstream awareness. Before

11316-483: The chances of experienced behavioral and emotional problems (depression, irritability, anxiety, academic problems, and problems in language development). The immediate physical effects of abuse or neglect can be relatively minor (bruises or cuts) or severe (broken bones, hemorrhage, death). Certain injuries, such as rib fractures or femoral fractures in infants that are not yet walking, may increase suspicion of child physical abuse, although such injuries are only seen in

11454-475: The child is not the one being abused, the child witnessing the domestic violence is greatly influenced as well. Research studies conducted such as the "Longitudinal Study on the Effects of Child Abuse and Children's Exposure to Domestic Violence", show that 36.8% of children engage in felony assault compared to the 47.5% of abused/assaulted children. Research has shown that children exposed to domestic violence increases

11592-600: The child, among other problems. Children who are the victims are also at an increased risk of sexually transmitted infections due to their immature immune systems and a high potential for mucosal tears during forced sexual contact. Sexual victimization at a young age has been correlated with several risk factors for contracting HIV including decreased knowledge of sexual topics, increased prevalence of HIV, engagement in risky sexual practices, condom avoidance, lower knowledge of safe sex practices, frequent changing of sexual partners, and more years of sexual activity. As of 2016 , in

11730-463: The condition, but as of 2023 are not in general medical use. Because symptoms of ALS can be similar to those of a wide variety of other, more treatable diseases or disorders, appropriate tests must be conducted to exclude the possibility of other conditions. One of these tests is electromyography (EMG), a special recording technique that detects electrical activity in muscles. Certain EMG findings can support

11868-447: The cytoplasm of motor neurons. In about 97% of people with ALS, the main component of the inclusion bodies is TDP-43 protein; however, in those with SOD1 or FUS mutations, the main component of the inclusion bodies is SOD1 protein or FUS protein, respectively. Prion -like propagation of misfolded proteins from cell to cell may explain why ALS starts in one area and spreads to others. The glymphatic system may also be involved in

12006-455: The death of Vicki Johnson, their claims cannot be completely disproven. Child abuse Different jurisdictions have different requirements for mandatory reporting and have developed different definitions of what constitutes child abuse, and therefore have different criteria to remove children from their families or to prosecute a criminal charge . As late as the 19th century, cruelty to children, perpetrated by employers and teachers,

12144-469: The deliberate infliction of serious injuries, or actions that place the child at obvious risk of serious injury or death, to be illegal. Bruises, scratches, burns, broken bones, lacerations—as well as repeated "mishaps", and rough treatment that could cause physical injuries—can be physical abuse. Multiple injuries or fractures at different stages of healing can raise suspicion of abuse. The psychologist Alice Miller , noted for her books on child abuse, took

12282-424: The diagnosis of ALS is primarily made based on a physician's clinical assessment after ruling out other diseases. Physicians often obtain the person's full medical history and conduct neurologic examinations at regular intervals to assess whether signs and symptoms such as muscle weakness, muscle atrophy , hyperreflexia , Babinski's sign , and spasticity are worsening. A number of biomarkers are being studied for

12420-484: The diagnosis of ALS. Another common test measures nerve conduction velocity (NCV). Specific abnormalities in the NCV results may suggest, for example, that the person has a form of peripheral neuropathy (damage to peripheral nerves) or myopathy (muscle disease) rather than ALS. While a magnetic resonance imaging (MRI) is often normal in people with early-stage ALS, it can reveal evidence of other problems that may be causing

12558-424: The diagnosis. Around 50% of people with ALS die within 30 months of their symptoms beginning, about 20% live between five and ten years, and about 10% survive for 10 years or longer. The most common cause of death among people with ALS is respiratory failure , often accelerated by pneumonia . Most ALS patients die at home after a period of worsening difficulty breathing, a decline in their nutritional status, or

12696-426: The disease and should be considered. ALS must be differentiated from the "ALS mimic syndromes", which are unrelated disorders that may have a similar presentation and clinical features to ALS or its variants. Because the prognosis of ALS and closely related subtypes of motor neuron disease are generally poor, neurologists may carry out investigations to evaluate and exclude other diagnostic possibilities. Disorders of

12834-408: The diversity of acts that qualify as child abuse, are also factors. The World Health Organization (WHO) defines child abuse and child maltreatment as "all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child's health, survival, development or dignity in the context of

12972-417: The doctor's attention for a problem unrelated to abuse or after experiencing an acute injury, but when examined, they show signs of long-term abuse. In most cases, the caretakers try to justify the visible injuries by blaming them on minor accidents. When asked, parents may attribute the injuries to a child's behaviour or habits, such as being fussy or clumsy. Despite the abuse, the child may show attachment to

13110-462: The excitatory neurotransmitter glutamate , is a mechanism thought to be common to all forms of ALS. Motor neurons are more sensitive to excitotoxicity than other types of neurons because they have a lower calcium-buffering capacity and a type of glutamate receptor (the AMPA receptor ) that is more permeable to calcium. In ALS, there are decreased levels of excitatory amino acid transporter 2 ( EAAT2 ), which

13248-413: The fact that their tormentors are the very mothers who gave them life, we are confronted with one of the most appalling problems that can disturb the soul of a moralist, or the conscience of justice". His observations were echoed by Boileau de Castélnau (who introduced the term misopédie – hatred of children), and confirmed by Aubry and several theses . These early French observations failed to cross

13386-449: The first to describe the battered-child syndrome in 1962. The battered-child syndrome is a term used to describe a collection of injuries that young children sustain as a result of repeated physical abuse or neglect. These symptoms may include: fractures of bones , multiple soft tissue injuries, subdural hematoma (bleeding in the brain), malnutrition , and poor skin hygiene. Children suffering from battered-child syndrome may come to

13524-759: The foster and adoptive populations manifest different emotional and behavioral reactions to regain lost or secure relationships and are frequently reported to have disorganized attachments and a need to control their environment. Such children are not likely to view caregivers as being a source of safety, and instead typically show an increase in aggressive and hyperactive behaviors which may disrupt healthy or secure attachment with their adopted parents. These children seem to have learned to adapt to an abusive and inconsistent caregiver by becoming cautiously self-reliant, and are often described as glib, manipulative and disingenuous in their interactions with others as they move through childhood. Children who are victims of neglect can have

13662-465: The growing numbers of child advocates and interest in protecting children which took place, the grouping of children into "the abused" and the "non-abused" created an artificial distinction that narrowed the concept of children's rights to simply protection from maltreatment, and blocked investigation of how children are discriminated against in society generally. Another effect of the way child abuse and neglect have been studied, according to Young-Bruehl,

13800-439: The hand or with an implement – whip, stick, belt, shoe, wooden spoon, etc. But it can also involve, for example, kicking, shaking or throwing children, scratching, pinching, biting, pulling hair or boxing ears, forcing children to stay in uncomfortable positions, burning, scalding, or forced ingestion (for example, washing children's mouths out with soap or forcing them to swallow hot spices). Most nations with child abuse laws deem

13938-567: The home is inflicted with the object of punishing. Overlapping definitions of physical abuse and physical punishment of children highlight a subtle or non-existent distinction between abuse and punishment, but most physical abuse is physical punishment "in intent, form, and effect". As of 2006, for instance, Paulo Sergio Pinheiro wrote in the UN Secretary-General's Study on Violence Against Children: Corporal punishment involves hitting ('smacking', 'slapping', 'spanking') children, with

14076-519: The level of society, factors contributing to child maltreatment include cultural norms that encourage harsh physical punishment of children, economic inequality , and the lack of social safety nets . WHO and ISPCAN state that understanding the complex interplay of various risk factors is vital for dealing with the problem of child maltreatment. Amyotrophic lateral sclerosis Amyotrophic lateral sclerosis ( ALS ), also known as motor neurone disease ( MND ) or Lou Gehrig's disease ( LGD ) in

14214-878: The likelihood of a very rare condition by a small amount. For instance an individual's lifetime risk of developing ALS might go from "1 in 400" without an exposure to between "1 in 300" and "1 in 200" if they were exposed to heavy metals. A range of other exposures have weaker evidence supporting them and include participation in professional sports , having a lower body mass index , lower educational attainment , manual occupations, military service, exposure to Beta-N-methylamino-L-alanin (BMAA), and viral infections. Although some personality traits, such as openness , agreeableness and conscientiousness appear remarkably common among patients with ALS, it remains open whether personality can increase susceptibility to ALS directly. Instead, genetic factors giving rise to personality might simultaneously predispose people to developing ALS, or

14352-913: The literature. Child maltreatment can also be an umbrella term covering all forms of child abuse and child neglect . Defining child maltreatment depends on prevailing cultural values as they relate to children, child development , and parenting . Definitions of child maltreatment can vary across the sectors of society which deal with the issue, such as child protection agencies, legal and medical communities, public health officials, researchers, practitioners, and child advocates . Since members of these various fields tend to use their own definitions, communication across disciplines can be limited, hampering efforts to identify, assess, track, treat, and prevent child maltreatment. In general, abuse refers to (usually deliberate) acts of commission while neglect refers to acts of omission. Child maltreatment includes both acts of commission and acts of omission on

14490-805: The majority of childhood abuse victims know or believe that their abuse is, or can be, the cause of different health problems in their adult life, for the great majority their abuse was not directly associated with those problems, indicating that they were most likely diagnosed with other possible causes for their health problems, instead of their childhood abuse. One long-term study found that up to 80% of abused people had at least one psychiatric disorder at age 21, with problems including depression, anxiety, eating disorders, and suicide attempts. One Canadian hospital found that between 36% and 76% of women mental health outpatients had been sexually abused, as had 58% of female patients with schizophrenia and 23% of male patients with schizophrenia. A recent study has discovered that

14628-474: The medications that slow the progress of the disease were not known at the time that Anthony's AIDS allegedly became severe. With so many similarities between the purported life of Anthony and proven hoaxes such as that of Kaycee Nicole and Kodee Kennings , the prevailing belief is that Anthony never existed. Further investigation by snopes.com has turned up still more evidence that Anthony never existed. No birth records are available for Anthony and adoption

14766-405: The mother or father) that individuals report having experienced in childhood. Many children who have been abused in any form develop some sort of psychological disorder. These disorders may include: anxiety, depression, eating disorders, OCD, co-dependency , or even a lack of human connections. There is also a slight tendency for children who have been abused to become child abusers themselves. In

14904-412: The names of Anthony's supposed biological mother and father, who were supposedly tried and convicted of the crimes Anthony alleged in his book. Paul Monette wrote a foreword for an edition of A Rock and a Hard Place , later defending the book's veracity. Armistead Maupin , who wrote a blurb for an edition of A Rock and a Hard Place , later wrote The Night Listener , a novel subsequently made into

15042-727: The nucleus, translation of the RNA into toxic dipeptide repeat proteins in the cytoplasm, and decreased levels of the normal C9orf72 protein. Mitochondrial bioenergetic dysfunction leading to dysfunctional motor neuron axonal homeostasis (reduced axonal length and fast axonal transport of mitochondrial cargo) has been shown to occur in C9orf72 -ALS using human induced pluripotent stem cell (iPSC) technologies coupled with CRISPR/Cas9 gene-editing, and human post-mortem spinal cord tissue examination. Excitotoxicity , or nerve cell death caused by high levels of intracellular calcium due to excessive stimulation by

15180-705: The nucleus, which may mean that their target RNA transcripts do not undergo normal processing. Other RNA metabolism genes associated with ALS include ANG , SETX , and MATR3 . C9orf72 is the most commonly mutated gene in ALS and causes motor neuron death through a number of mechanisms. The pathogenic mutation is a hexanucleotide repeat expansion (a series of six nucleotides repeated over and over); people with up to 30 repeats are considered normal, while people with hundreds or thousands of repeats can have familial ALS, frontotemporal dementia, or sometimes sporadic ALS. The three mechanisms of disease associated with these C9orf72 repeats are deposition of RNA transcripts in

15318-444: The outcome), indecent exposure of the genitals to a child, displaying pornography to a child, actual sexual contact with a child, physical contact with the child's genitals, viewing of the child's genitalia without physical contact, or using a child to produce child pornography . Selling the sexual services of children may be viewed and treated as child abuse rather than simple incarceration. Effects of child sexual abuse on

15456-406: The parent. Child sexual abuse (CSA) is a form of child abuse in which an adult or older adolescent abuses a child for sexual stimulation. Sexual abuse refers to the participation of a child in a sexual act aimed toward the physical gratification or the financial profit of the person committing the act. Forms of CSA include asking or pressuring a child to engage in sexual activities (regardless of

15594-484: The part of parents or caregivers that cause actual or threatened harm to a child. Some health professionals and authors consider neglect as part of the definition of abuse , while others do not; this is because the harm may have been unintentional, or because the caregivers did not understand the severity of the problem, which may have been the result of cultural beliefs about how to raise a child. Delayed effects of child abuse and neglect, especially emotional neglect, and

15732-456: The patient struggle to react appropriately to what can be frequent and inappropriate outbursts in public. In addition to mild changes in cognition that may only emerge during neuropsychological testing, around 10–15% of individuals have signs of frontotemporal dementia (FTD). Repeating phrases or gestures , apathy, and loss of inhibition are the most frequently reported behavioral features of ALS. ALS and FTD are now considered to be part of

15870-614: The perpetrator is also a minor. In 1999 the BBC reported on the RAHI Foundation 's survey of sexual abuse in India , in which 76% of respondents said they had been abused as children, 40% of those stating the perpetrator was a family member. There are multiple definitions of child psychological abuse: In 2014, the APA found that child psychological abuse is the most prevalent form of childhood abuse in

16008-425: The publishers) they utilize the methodology of social research to define child abuse, illuminate strategies for remedying and preventing child abuse, and examine how professionals and the community view child mistreatment . Definitions of what constitutes child abuse vary among professionals, between social and cultural groups, and across time. The terms abuse and maltreatment are often used interchangeably in

16146-908: The remaining genes mostly accounting for fewer than 1% of either familial or sporadic cases. ALS genes identified to date explain the cause of about 70% of familial ALS and about 15% of sporadic ALS. Overall, first-degree relatives of an individual with ALS have a ~1% risk of developing ALS themselves. The multi-step hypothesis suggests the disease is caused by some interaction between an individual's genetic risk factors and their cumulative lifetime of exposures to environmental factors, termed their exposome . The most consistent lifetime exposures associated with developing ALS (other than genetic mutations) include heavy metals (e.g. lead and mercury ), chemicals (e.g. pesticides and solvents ), electric shock , physical injury (including head injury ), and smoking (in men more than women). Overall these effects are small, with each exposure in isolation only increasing

16284-448: The spinal cord. The defining feature of ALS is the death of both upper motor neurons (located in the motor cortex of the brain) and lower motor neurons (located in the brainstem and spinal cord). In ALS with frontotemporal dementia, neurons throughout the frontal and temporal lobes of the brain die as well. The pathological hallmark of ALS is the presence of inclusion bodies (abnormal aggregations of protein) known as Bunina bodies in

16422-679: The story was fabricated. A Rock and a Hard Place claimed that Anthony's biological parents were arrested and tried for abusing him, and that his police officer father was killed in prison. An alleged conspiracy of rogue police officers trying to kill Anthony was Vicki Johnson's justification for zealously preserving Anthony's privacy. However, no case matching that description could be found at any social service agency. Many sources found it medically implausible that Anthony could be alive, given that he had supposedly been living with AIDS for over 19 years. Most long-term survivors are actually living with HIV but had not yet developed AIDS; furthermore,

16560-999: The study was conducted in San Diego, California from 1995 to 1997. The World Health Organization summarizes the study as: childhood maltreatment and household dysfunction contribute to the development – decades later – of the chronic diseases that are the most common causes of death and disability in the United States... A strong relationship was seen between the number of adverse experiences (including physical and sexual abuse in childhood) and self-reports of cigarette smoking, obesity, physical inactivity, alcoholism, drug abuse, depression, attempted suicide, sexual promiscuity and sexually transmitted diseases in later life. A long-term study of adults retrospectively reporting adverse childhood experiences including verbal, physical and sexual abuse, as well as other forms of childhood trauma found 25.9% of adults reported verbal abuse as children, 14.8% reported physical abuse, and 12.2% reported sexual abuse. Data from

16698-405: The symptoms, such as a spinal cord tumor, multiple sclerosis , a herniated disc in the neck, syringomyelia , or cervical spondylosis . Based on the person's symptoms and findings from the examination and from these tests, the physician may order tests on blood and urine samples to eliminate the possibility of other diseases, as well as routine laboratory tests. In some cases, for example, if

16836-419: The term amyotrophic lateral sclerosis . ALS is a motor neuron disease , which is a group of neurological disorders that selectively affect motor neurons , the cells that control voluntary muscles of the body. Other motor neuron diseases include primary lateral sclerosis (PLS), progressive muscular atrophy (PMA), progressive bulbar palsy , pseudobulbar palsy , and monomelic amyotrophy (MMA). As

16974-404: The types of motor neurons that are affected. To successfully control any voluntary muscle in the body, a signal must be sent from the motor cortex in the brain down the upper motor neuron as it travels down the spinal cord. There, it connects via a synapse to the lower motor neuron which connects to the muscle itself. Damage to either the upper or lower motor neuron, as it makes its way from

17112-509: The upper arms symmetrically and progressing downwards to the hands. Flail leg syndrome is characterized by lower motor neuron damage leading to asymmetrical weakness and wasting in the legs starting around the feet. Isolated bulbar palsy is characterized by upper or lower motor neuron damage in the bulbar region (in the absence of limb symptoms for at least 20 months), leading to gradual onset of difficulty with speech ( dysarthria ) and swallowing ( dysphagia ). ALS can also be classified based on

17250-559: The victim(s) include guilt and self-blame , flashbacks , nightmares , insomnia , fear of things associated with the abuse (including objects, smells, places, doctor's visits, etc.), self-esteem difficulties, sexual dysfunction , chronic pain , addiction , self-injury , suicidal ideation , somatic complaints, depression , PTSD, anxiety , other mental illnesses including borderline personality disorder and dissociative identity disorder , propensity to re-victimization in adulthood, bulimia nervosa , and physical injury to

17388-640: The view that humiliations, spankings, and beatings, slaps in the face, etc. are all forms of abuse, because they injure the integrity and dignity of a child, even if their consequences are not visible right away. Physical abuse as a child can lead to physical and mental difficulties in the future, including re-victimization, personality disorders, post-traumatic stress disorder (PTSD), dissociative disorders, depression, anxiety, suicidal ideation, eating disorders, substance use disorders, and aggression. Physical abuse in childhood has also been linked to homelessness in adulthood. C. Henry Kempe and his colleagues were

17526-416: The way that dandelions seem to prosper irrespective of soil, sun, drought, or rain. Such children (or currently grown-ups) are of high interest in finding factors that mitigate the effects of child abuse. Child abuse is a complex phenomenon with multiple causes. No single factor can be identified as to why some adults behave abusively or neglectfully toward children. The World Health Organization (WHO) and

17664-500: The ways maltreated parents think about their young children. Physically abused children may exhibit various types of psychopathology and behavioral deviancy. These include a general impairment of ego functioning, which can be associated with cognitive and intellectual problems. They may also struggle with forming healthy relationships and may fail to develop basic trust in others. Additionally, these children may experience traumatic reactions that can result in acute anxiety states . As

17802-718: The weather. The 2010 Child Maltreatment Report ( NCANDS ), a yearly United States federal government report based on data supplied by state Child Protective Services (CPS) Agencies in the U.S., found that neglect/neglectful behavior was the "most common form of child maltreatment". Neglectful acts can be divided into six sub-categories: Neglected children may experience delays in physical and psychosocial development, possibly resulting in psychopathology and impaired neuropsychological functions including executive function , attention , processing speed , language, memory and social skills . Researchers investigating maltreated children have repeatedly found that neglected children in

17940-558: Was Joanne Vicki Fraginals, had allegedly handed Anthony over to another caretaker in 1997 when she moved to Chicago and married Marc Zackheim , a child psychologist and owner of the Associates of Clinical Psychology . In 2004, Zackheim was indicted for abusing child patients at a treatment center for troubled children in Indiana ; his trial began in 2006 at the Marshall County courthouse. He

18078-429: Was Vicki Johnson's fictional creation. The photo of "Anthony" that Vicki had sent to Anthony's supporters was revealed to be a childhood photo of a healthy adult man who was shocked to find his childhood photo being represented to people as that of Anthony Godby Johnson; one childhood teacher of this man had been Vicki Johnson, who was said to have taken pictures of the children in her class. Vicki Johnson, whose real name

18216-422: Was acquitted of one felony count of practicing medicine without a license and three misdemeanor counts of battery for inappropriately touching boys. Three years later Zackheim was found in court again, confessing to accepting Medicaid for patients no longer in his clinic, accepting payments before services had been provided or for services never received, billing for therapeutic services when no licensed therapist

18354-506: Was an unusual case. Cognitive impairment or behavioral dysfunction is present in 30–50% of individuals with ALS, and can appear more frequently in later stages of the disease. Language dysfunction , executive dysfunction , and troubles with social cognition and verbal memory are the most commonly reported cognitive symptoms in ALS. Cognitive impairment is found more frequently in patients with C9orf72 gene repeat expansions, bulbar onset, bulbar symptoms, family history of ALS, and/or

18492-404: Was commonplace and widespread, and corporal punishment was customary in many countries, but in the first half of the 19th century, pathologists studying filicide (the parental killing of children) reported cases of death from paternal rage, recurrent physical maltreatment, starvation, and sexual abuse. In an 1860 paper, French forensic medical expert Auguste Ambroise Tardieu gathered together

18630-618: Was on site, billing for more expensive therapy services than provided, and fabricating diagnosis. In 2009 Marc Allen Zackheim was charged and sentenced to prison in federal court on felony charges for aiding and abetting health care fraud . Zackheim died of a heart attack in November 2009 before his sentence was served. ABC subsequently ran an update to the story, which included a 147-page response from Vicki Johnson's lawyer in response to ABC's questions. ABC also reported that Johnson and Zackheim have both died since their original 2007 story. Since

18768-497: Was only offered to those with obviously familial ALS. But it is increasingly recognized that cases of sporadic ALS may also be due to disease-causing de novo mutations in SOD1 , or C9orf72 , an incomplete family history, or incomplete penetrance , meaning that a patient's ancestors carried the gene but did not express the disease in their lifetimes. The lack of positive family history may be caused by lack of historical records, having

18906-400: Was raised when it was learned that no one other than Vicki Johnson had actually seen Anthony – not his agent, his editor, nor his publicist. Further concerns were raised when a voice analysis expert analyzed calls from "Anthony" and identified the voice to be that of Vicki Johnson. As a result of these irregularities, Olbermann hired an investigator, who suggested that there was no Anthony and

19044-521: Was to close off consideration of how children themselves perceive maltreatment and the importance they place on adults' attitudes toward them. Young-Bruehl wrote that when the belief in children's inherent inferiority to adults is present in society, all children suffer whether or not their treatment is labeled as "abuse". Two of the many academics who studied and published about child abuse and neglect, Jeanne M. Giovannoni and Rosina M. Bercerra, published Defining Child Abuse in 1979. In it (according to

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