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Autism and Asperger Syndrome

Expert in Mind

Autism and Asperger Syndrome are both part of a range of related developmental disorders known as Autistic Spectrum Disorders (ASDs). They begin in childhood and last through adult hood. It is a spectrum condition, which means that while all people with autism share difficulties, their condition will affect them in different ways. The symptoms are grouped into three categories. ASD's are characterised by significant problems with language, social interaction, social imagination, and behaviour. Many people with an autistic disorder also have learning difficulties/below average intelligence. Another category of diagnoses known as pervasive developmental disorder not otherwise specified (PD-NOS) is given to those individuals who display symptoms that fall between an autistic disorder and Asperger's syndrome. They share some, but not all of the traits of an Autistic Disorder or Asperger's Syndrome.

Individuals with Asperger's Syndrome tend to present with milder symptoms that affect social interaction and behaviour but language development is usually not affected. They do often have problems in areas of language such as understanding humour or figures of speech.

Individuals on the autistic spectrum are not able to maintain eye to eye contact, as they find this painful and intimidating. They can misinterpret social situations and this can often leave them feeling socially isolated and at times resorting to social media sites to engage in social interchange. Failure to understand the behaviors and intentions of others can lead to individuals with an ASD to get involved or be influenced into participating in illegal activities, which in their mind is likely to be considered normal behavior (because they have not understood the intention of the person or persons involved).

Autistic individuals typically have processing delays, and as a result, need extra time to respond to questions or instructions. They take things very literally, and may not fully understand instructions unless they are concise and clear.

While the person with an ASD may have, in the literal sense, committed a criminal offence, they usually do not understand the question of intent. For example, they can be very literal in the way they obey instructions instead of thinking about the impact their actions can have on another person/s.

People with an ASD often do not understand the implications of their behavior due to their difficulties with social imagination and they may require support to understand the consequences or implications of his/her actions and decisions.

It is very possible that an individual with an ASD may not comprehend 'intent', 'responsibility' and 'conspiracy' because they tend to be concrete and 'rule oriented' in their interpretation of their outer world. For example, the individual may accept the meaning of the word 'intent' but not understand how this might apply to their current situation.

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Personal Injury

Expert in Mind

The Personal Injury market is now controlled by the insurance industry. And, there is more to follow...

The combination of the Jackson Reforms and the Ministry of Justice reforms in personal injury were fully implemented in July of this year, largely in respect of new cases but some of the effects are affecting accidents before 2013. Cases where the damages awarded do not exceed £25,000 (and this can include some significant injuries) have seen the legal fees recoverable slashed dramatically particularly for cases where liability is admitted. These fees bear little resemblance to reality. It is necessary to obtain medical evidence to prove losses and when an insurer will not accept the true value of a claim, it costs money to pursue it. As the burden of proof remains on the claimant, unless an insurer agrees a fair and reasonable amount for the claim early on, it is unlikely that solicitors will be able to help in these cases as they will not recover their costs. The paying and receiving of referral fees for personal injury work has been banned. This is something that we applaud as in PMI we do not pay referral fees for any work that we receive. We have been fortunate that our clients find us through recommendation because of the reputation we have in this field.

Liability and legal expense insurers have taken over existing law firms and created law firms, announcing in many cases that they will become alternative business structures. In effect, these enable referrals of work to continue but now it is paid by way of profit sharing within an organisation rather than a fee, which would be illegal. Because a large part of the market is controlled effectively by insurers now, proponents will say that resulting efficiencies will ultimately benefit all consumers. We doubt that, because the primary objective for liability insurance companies is to reduce the amount they pay out on claims, to avoid claims where they can and to look at issues with the policy to see if they can, in some way, declare it void. Their motive is to maximise the return to their shareholders not to compensate the injured.

It has been the insurers' aim for some time to control the claimants' side of the insurance industry as of course it is in their best interests to reduce their outlay. We doubt that there will be any reduction in the overall cost of insurance premiums and sadly this will all be at the expense of those consumers who have legitimate claims. 2% of our population per year are injured. It is becoming increasingly difficult for clients to be able to enforce their legal rights to receive full compensation for their injuries. We hope that there is still a place for us in the market completely independent, unencumbered and still making a difference to the lives of our seriously injured clients. We are delighted to be recognised in the Chambers UK - A Client's Guide to the UK Legal Profession 2014 as "leaders in the field" in personal injury receiving the highest accreditation of Band 1.

One of our clients said that we are "exceptionally personable and have always had the client at the heart of their drive and their thoughts". We were described as "incredibly compassionate" and "maintaining our professionalism very well".

Our Frances Pierce, head of the PMI Team, was also named a leading individual in the field of personal injury and clinical negligence work.

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Why is Post Traumatic Stress Disorder Often Missed in Children and Adolescents?
Expert in Mind

Post-Traumatic Stress Disorder (PTSD) involves exposure to a traumatic event, and the development numerous subsequent symptoms which fall into the categories of re-experiencing, avoidance, and hyperarousal. The re-experiencing presents as intense psychological distress on reminders of the trauma, physical symptoms such as sweating, raised heart rate, or tummy aches, repetitive play, bad dreams and/or nightmares, and flashbacks. Bad dreams are often not reported, especially as they are often not remembered, and the child may just appear grumpy and underslept. The flashbacks can often impair concentration, and may simply present as being in trouble for reduced academic performance.

The next group of symptoms are avoidance symptoms. In my clinical experience, these are extremely common after a trauma, and lead to avoidance of all thoughts, discussions, people and places creating reminders of the bad memory. Entire families, for example, who have been through an accident, or traumatic loss, will never mention the incident, in case anyone becomes upset. The longer it goes on, the more chronic the PTSD can become.

Hyperarousal typically leads to poor sleep, anger outbursts, and poor concentration. The young person may seem permanently 'jumpy', or 'on edge'. Children may just be seen as 'naughty', or behaviourally disturbed.

Sometimes, children with PTSD end up with secondary depression, because they are so tired, socially withdrawn, and with deteriorating schoolwork due to poor concentration.

So how can PTSD be accurately assessed? The Child Revised Impact of Events Scale (Children and War Foundation) is an easy short symptom checklist which gives an indication of the level of PTSD symptomatology. This was developed from the original Impact of Events Scale for Adults devised by Horowitz in 1979. A more detailed structured Interview typically used for research into childhood PTSD is the Children's PTSD Inventory developed by Philip Saigh (2004). This gives an accurate picture as to the presence or absence of a diagnosis of PTSD (DSM IV Criteria), and also clarifies whether the PTSD is acute, chronic or of delayed onset.

Unfortunately, as PTSD is so often missed, once it is recognised, it is often chronic. However, the good news is that it is never too late to attempt treatment, even years after the original traumatic event.

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The Introduction

Zofia Expert in Mind

I am delighted to announce the launch of Expert in Mind Ltd. The company, formerly known as Sececetra Ltd, has recently undergone a total facelift and in addition to providing high quality medico-legal reports is now offering a wider range of services.

We are able to offer Consultants experienced in providing psychiatric and psychological assessments within Occupational Health and/or Employment Tribunals. With stress in the workplace becoming increasingly recognisable and a far less 'taboo' subject, we have found that insurance companies, human resource departments and legal representatives are regularly requesting professional intervention to assess and assist employees either on an ongoing basis while at work, or with a 'managed' return to work.

In addition, following popular demand for recommendations of professionals who are able to provide treatment to those affected by the trauma of personal injury or clinical negligence experiences, we are delighted to be able to offer a treatment service. Our highly experienced psychologists and psychiatrists are able to provide recommended treatment plans either on an individual basis or in conjunction with each other. We are also able to assist with treatment for children and adolescents affected by trauma, including cyber bullying which seems to be an ever increasing issue.

Our aim, as it always has been, is to provide an efficient and flexible service to our clients to try to save the busy professional as much time as possible. We work closely with our consultants and each one is assigned an individual assistant, which gives one 'port of call' if you wish to discuss a case or have a query requiring a quick response.

We are incredibly proud of our reputation and the strong working relationships we have built with both our clients and consultants, some of whom I have been working with for over ten years. Please do take a moment to have a look at our new website and the services we are able to offer. We do our utmost to try to accommodate any request, and indeed any timescale, so please give us a call if you would like to discuss your requirements or would like us to provide you with recommendations.

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