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Viagra for kids? Thats one medicine doctors are prescribing to more children. After the initial shock to parents, it poses problems for pharmacists since most medicines arent made for kids.
The Flack family flocks to LeBonheur Hospital for doctors and nurses to keep a watchful eye on baby Madelines heart.
When the four-year-old was born, her parents Tim and Bridgette were unaware their daughter had a heart condition. They didnt find out until she was ten-months-old.
We brought her to LeBonheur where she was diagnosed with four different congenital heart defects, said Tim.
Doctors repaired a hole in her heart and she began taking medicine to heal the rest. Her prescription? Viagra.
Viagra. Yeah that was interesting going to get the prescription filled saying thats for my daughter, its not for me, he said.
About five years ago, LeBonheur doctors started prescribing the blue pill for patients in intensive care with high blood pressure. The drug was originally designed for hypertension and cardiovascular disease. Its one example of an adult drug used to treat children.  .
The vast majority of drugs that are available in this country are only approved for adults, said pharmacist Dr. Michael Christensen.
Only about 30 percent of drugs have been properly tested for children which poses problems for pharmacists who try to make special made formulas for kids.
We would like to see, as parents, more of these drugs, if not specifically made for children, but studied so they can be used for children, said Tim.
Christensen, director of pediatric clinical research at LeBonheur, said congress implemented a successful program in the late 90s which gave incentives to pharmaceutical companies which conduct pediatric studies.
Over the last 10 years, more than 100 drugs have gone through this testing and we now have more information to properly prescribe and administer the drugs to children, he said.
Its encouraging news for parents like the Flacks who hope the creative cocktails are the perfect potion for their little ones.
Pharmaceutical companies can earn millions of dollars from the government for conducting studies in children. The move was first suggested by the FDA back in the 1970s.
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Forgiving someone that has wronged you can be extremely difficult. However there are rewards for those who learn to forgive
Many of us have been or may well be hurt at some point in our lives. In todays world nobody is perfect and it is very rare for someone to go through life not having felt the deep pain of being wronged. From something as hurtful as a marriage breakdown, to not getting an invite to the party of the year, these feelings are now part of our everyday lives.
Dealing with hurt
Everytime we are wronged we ask many different questions. What will I do know? How will this impact on my future? Forgiving can be very hard and it is sometimes better to think of what the consequences of not forgiving would be.
What happens when we dont forgive?
Often our desire not to forgive is based on a belief that to forgive is to some how let the person of the hook .How could we forgive a child abuser, Hitler or any other person that commits a hideous crime. Yet this is based on a lack of understanding of what forgiving really is. To forgive or not to forgive relates to an internal choice of what you choose to hold on to in your own thoughts and feelings.
The repercussions of never being able to forgive.
By being unforgiving you are holding on to the anger, resentment and a sense of betrayal. Being unforgiving youre saying to yourself I am not going to let this event go and I going to remain angry, bitter resentful and hurt. Being unforgiving does not change the past or hold back the person you dont forgive, rather it is a self inflicted poison that can only lead to a more miserable life.
A real event.
A very emotionally intelligent and big hearted client of mine told me what she did when she found out her husband of 30 years had run off with the successful younger woman next door. When you thought she would have rightfully punished him or made his life difficult she did the opposite. She told him although she was hurt and still angry that she loved him and she wished him happiness, she said this sincerely and honestly .She told me although what he had done brought her great sadness she recognized that he was still a good person. Who did she do this for? not him but herself, not in a selfish sense, but self-loving sense. She told me she didnt want to have a bitter heart, she didnt want to let him do that to her. In the process of forgiving him and letting go she freed herself from years of unnecessary misery.
What our actions mean for others.
When we forgive we are also taking into account that we too may have hurt someone perhaps unknowingly as well. Although your partner may have betrayed you, im sure if you look back through your life you will have also hurt somone or let them down in some way. Nobody is indeed perfect, everybody has their faults and so by forgiving others you are also getting the chance to forgive yourself. As usually what we condemn or judge about others will actually mirror how we judge ourselves.
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Although being forgiving may seem hard, you can be assured being unforgiving takes a lot more time, effort, energy and inevitably leaves us with nothing. So when you are faced with deep and painful hurt, look deep in your heart and make a choice to forgive, to let go, to embrace and welcome the liberating power of forgiveness in your heart, mind and soul.

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PROLAM-GM is an acronym for the various intervention and transfer strategies used in the management of stuttering. PROLAM, which stands for physiological adjustments, rate manipulation, operant controls, length and complexity of utterance, attitude changes, and monitoring, are the intervention strategies. GM, which stands for generalization and maintenance, are the transfer strategies.
Physiological Adjustments
Physiological adjustment strategies include tactics that manipulate bodily components known or thought to be involved in the production of stuttered speech. An example of this would be the attempt to use gentle contact between the articulators when talking.
The rationale behind this approach is that the physiological components necessary for the production of normal fluent speech are in some way used inappropriately when stuttering occurs. Therefore, the therapy tactics used will result in a of the disordered component, or in use of compensatory behaviors and strategies.
Rate of Speech Manipulations
Use of a reduced speech rate to modify stuttering operates in the belief that: (a) reduction of rate results in simplification of the physiological speech processes, thus allowing easier synchronization or; (b) reduction in the rate of speech prevents the stutterer from anticipating feared stimuli that result in the production of the stuttering response.
The rate of the stutterers speech may be reduced by: prolongation, combining prolongation with continuous phonation, and using an instructional rate control method.
Operant Controls
Use of operant controls in the management of stuttering believes that if stuttering is an operant behavior (behaviors whose frequency or probability of occurrence are influenced by the consequences they generate), then its frequency will increase if it is reinforced, and its frequency of occurrence will decrease if it is punished.
Two of the most frequently used operant procedures for treating stuttering are positive reinforcement of fluency and punishment of stuttering.
Length and Complexity of Utterance
Controlling the length and complexity of the stutterers utterance reduces stuttering and increases fluency. This technique is often used to increase fluent speech. Most of the approaches utilizing this technique combine manipulation of length and complexity of the clients language with operant controls (punishment of stuttering and reinforcement of fluency).
There are two components of stuttering namely: the feelings accompanying it and the speaking behaviors that are resulted from it. It is believed by some that to have a successful therapy, a balance of treating both factors should be done. Thats why attitude manipulation is done in some approaches while in other approaches it can be optional depending on the case of the client.
In the science of Speech Pathology, especially in the field of stuttering, there are a lot of meanings for the term . Some say its a process in which the PWS becomes aware of what he is doing at the time he is doing it. Some say it is a specific form of consciousness where the act of speaking is raised from an automatic level to a purposeful level. Basically, it has three key components: self-awareness, deliberate control and self-feedback.
The technical term for generalization is the occurrence of a relevant behavior under different nontraining conditions. The term generalization is usually interchanged with or .
Sometimes, when clients are able to achieve fluency, they think the fight is over. They forget to maintain their skills and in result they have a relapse with their stuttering. Maintenance refers to different after-treatment activities to help clients keep the skills they learned from therapy intact.
Some activities to help maintain skills are daily self-monitoring activities, regular clinic contacts, refresher programs and having self-help groups.

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