Therapy Dogs Provide Reward for ASD Behavioral Improvements

Innovative new research discovers a novel reward of having the opportunity to interact with therapy dogs, can improve behavior among children with an autism spectrum disorder (ASD).

ASD may result in deficits in social communication and interaction, repetitive or restricted behavior, sensory issues, and cognitive delays, say researchers. These traits prevent children on the spectrum from performing or completing tasks in the same timeliness or fashion as other children.

Often, in order to get children with ASD to complete tasks, a reward-based system is implemented, where the child is given a toy or some other form of reward. But the offer of a reward doesn’t always guarantee completion of the task.

In a new study, Texas Tech University researchers investigate if providing access to therapy dogs as the reward — allowing students who complete certain academic tasks to spend time with the pooch — will help motivate them to complete those tasks.

“It is a reward-based program,” said Alexandra Protopopova, a behavioral analyst and assistant professor in companion animal science in the Department of Animal & Food Sciences.

“There is a second component to it, however, in that dogs, just by being dogs, may alleviate stress. Potentially, the dogs create a more pleasant environment and offer emotional support during academic sessions.”

Investigators believe the dogs create a more pleasant environment and offer emotional support during academic sessions.

“So, by mediating that stress level, the dogs may improve learning and potentially improve other outcomes as well as being a reward for the child ruing work.”

Protopopova is an expert in behavior issues with dogs across a wide array of subjects, from interaction with children with ASD to analyzing what behaviors are more attractive for potential adopters and ways to bring those behaviors out to improve adoption rates.

But she said the methods and philosophies of how behavior works in animals is, at the core, the same as it is in children, and it is that connection that made this current research both attractive and interesting.

“With an iPad or toy as a reward, a child might become bored over time,” Protopopova said. “With a dog you might see the exact opposite situation over time where the child grows attached to the dog and the quality of the reward grows as well.”

The innovative approach was spurned by Protopopova and a colleague in the College of Education, Professor Jeanne Donaldson, who wanted to connect the college and the Burkhart Center for Autism Education and Research with the Department of Animal & Food Sciences.

The most natural way to make that connection, she said was to incorporate therapy dogs with the research being done involving applied behavior analysis in children with disabilities.

“Social behavior and social interaction has been an often neglected component of these kinds of programs,” Protopopova said, “and that is something researchers have attempted to improve, that social behavior and communication.

There is some evidence that dogs or animals in general occasionally could bring out that social connection. That part of the research is definitely attractive to us.”

Measuring the effectiveness of using therapy dogs as a reward for academic performance in children with ASD was performed in two areas.

The first was done biologically; stress responses were detected through the collection of saliva. Breanna Harris, a research assistant professor in the Department of Biological Sciences, used salivary cortisol, a stress hormone, to determine a student’s stress level in regard to anticipating interaction with the dog.

The second aspect of measuring effectiveness was done by observing the rate of work in the children and how motivated the children were to engage in academic tasks. Each child was given an individual task based on his or her education level, so those tasks involved the same things they were learning in school at the time or what parents had indicated the child needed extra help with.

A control condition was created where there were not rewards and children received praise only for engaging in academic tasks. A second control group saw children work toward receiving inanimate leisure items such as iPads or toys, which Protopopova said have been proven through prior research to be effective motivational tactics.

Two other control conditions involved the therapy dogs. One condition involved the dogs being used as a reward for work performed and would be present only after that work was completed. The second condition was what Protopopova termed more of the typical animal assisted intervention where the dog was continuously present in the room.

Notably, the conditions where there was no reward at all and where the dog was constantly around proved to be the most ineffective methods of motivation, researchers found.

The two conditions where there were rewards provided upon completion of the work were the most effective; being rewarded with spending time with the therapy dog proved the most effective for some children.

“In fact, for most of the children, this was very useful as a reward because the dog motivated them quite a bit to do the work,” Protopopova said. “We did find, surprisingly to me, that one participant did in fact work where we hypothesized he wouldn’t during a session where the dog was present but not as a reward.”

In many cases, time and experience made a difference.

For example, single-use incidences of using the therapy dog show one thing, but the researchers wanted to determine whether prolonged exposure to the availability of a therapy dog as a reward for performing work continues those results.

For that reason, in this first study, children stayed in the program for anywhere from four to nine months to see if using the same dog repeatedly fosters the child’s attachment to the dog.

Prior to the child beginning the program, he or she is given a behavioral preference assessment where the child is asked to choose his or her favorite thing in the room, whether it’s a toy, an electronic device, a dog, etc.

They also were given the choice of performing the academic test instead. At the end of the program, the child is tested again with the same assessment to see if their preferences had changed.

“We wanted to see how all these preferences for inanimate objects or activities changed,” Protopopova said. “Right now we are still collecting the final pieces of data because we’re still finishing up with a couple of participants. We don’t yet have the clear answers there, but it’s not as straightforward as we imagined, either. For some of the children, we did not see the attachment we hypothesized, or at least any evidence of it in our data so far. But it’s too early to tell.”

Protopopova said one of the advantages of this study is its single-subject design where each child’s program or sessions are designed specifically for that child’s needs. That will allow, if the program is used outside of an educational setting, for other children to enter the program with a focus on their unique behaviors and what is best to encourage them to learn difficult academic or self-care tasks in a non-stressful learning environment.

She said one family in the original group took the data gathered about their child and obtained a dog and will train it as a service dog because of the benefits the data showed for their child.

“This is definitely a strength,” Protopopova said. “Instead of a group design and us concluding that the average child would benefit from some procedure, which is not really that meaningful to individual families, we can give each family specific answers whether their child would or would not benefit from a dog.”

One major question to come out of the preliminary research, she said, is whether using a shelter dog to encourage behavior can be used to determine the severity of the disability. Does it work on children who are higher- or lower-functioning?

Protopopova and other researchers are beginning another one to answer new questions that rose from the original, smaller study.

The larger study will involve at least 30 children, and they are actively recruiting children to enter the study. Those children must be between the ages of two and 14 with autism spectrum disorder and/or other developmental disabilities.

The hope is the larger study will allow the research to be used in schools and centers on a regular basis.

“There we can answer more generalized questions,” Protopopova said. “How useful is this and who is it most useful for? Can we tell which children are going to benefit and which ones will not? So when we get those answers we are going to be a bit closer to really giving that program out to schools to say, ‘we have strong evidence that it will be useful for this person or not for this person.”

Source: Texas Tech University

Childhood PTSD May Alter Structure of Brain Networks

A new neuroimaging study shows a link between childhood post-traumatic stress disorder (PTSD) and a disruption in the structure of brain networks. The findings, published in the the journal Radiology, could one dayhelp lead to the development of new treatments for PTSD.

Children are particularly vulnerable to the effects of PTSD. Research has shown that childhood trauma is tied to a variety of neurochemical and hormonal effects that can lead to lasting changes in brain structure and function.

Brain studies with magnetic resonance imaging (MRI) may be used to identify vulnerable patients, allowing interventions to begin sooner, potentially preventing any negative brain changes.

For the study, researchers from China used MRI to compare the brain structures of 24 children with PTSD to a control group of 23 trauma-exposed children without PTSD. The children had experienced the 2008 Sichuan earthquake, a massive disaster in south central China that killed almost 70,000 people and injured more than 370,000.

Diffusion tensor imaging (DTI), an MRI technique that reveals the integrity of the brain’s white matter, was used to evaluate the brain’s connectome — the map of the neural connections in the brain.

The human connectome includes a series of nodes, or brain regions, linked by connections known as edges. Nodes with a relatively high number of edges are referred to as hubs.

“Generally speaking, the structural connectome and the functional connectome are based on different types of raw images, which may be used to investigate the brain’s abnormalities through different views,” said study lead author Qiyong Gong, M.D., Ph.D., from West China Hospital of Sichuan University in Chengdu, China.

The findings revealed significant structural differences between the PTSD and non-PTSD groups. The brains of children with PTSD showed changes suggestive of reduced network efficiency due to damage or disconnection between linked regions.

The study also showed a concerning trend in the structural connectome of PTSD patients. Typically, the brain operates partly as a small-world network in which most nodes can be reached from every other node by only a few steps. A small-world network contributes to the high-efficiency transfer of information between networks.

However, in the brains of PTSD patients, the structural connectome was leaning more toward regularization, a phenomenon in which the neural network moves from a small-world to a more regular network. A regular network is more localized, so it takes many more steps to reach distant nodes.

“In a previous functional and current structural connectome study of the same patient group, we found a shift toward regularization in the brain networks of the PTSD patients relative to controls,” said Gong. “Thus, we speculate that this regularization process may be a general pattern of pediatric PTSD.”

Differences were also discovered in the salience network, a group of brain regions that select which stimuli are deserving of attention. The finding could point to a potential target for future treatment plans in pediatric PTSD.

“These abnormalities suggest that PTSD can be better understood by examining the dysfunction of large-scale spatially distributed neural networks,” said Gong.

The researchers hope to conduct follow-up imaging on at least some of the patients in the study to further study brain changes tied to PTSD.

Source: Radiological Society of North America

Kids with Autism May Be Over-Diagnosed with ADHD

A popular screening tool for attention-deficit hyperactivity disorder (ADHD) may be less accurate when a child has an autism spectrum disorder (ASD), according to a new study published in the Journal of Autism and Developmental Disorders.

This may result in children with ASD mistakenly being diagnosed with ADHD if their symptoms aren’t carefully traced to differentiate between social deficits or attention issues.

The researchers, including one of the psychologists who developed the ADHD screening tool — the ADHD Rating Scale Fourth Edition (ADHD-RS-IV) — say that the scale needs to be refined to better identify the correct disorder and that it should also be supplemented with careful clinical interviews.

“One of our best current screening measures for ADHD may be over-diagnosing ADHD in children with autism,” said study leader Benjamin E. Yerys, Ph.D., a researcher in the Center for Autism Research at Children’s Hospital of Philadelphia (CHOP).

“This is important because medications that work for ADHD may be less effective for a child on the autism spectrum.”

Scale scores are also used in recommending school-based services.

The study was conducted by researchers at CHOP, the Perelman School of Medicine at the University of Pennsylvania and Baylor University.

One complicating factor is comorbidity, as approximately 30 percent or more of children with ASD also have ADHD. The scale asks parents and teachers to provide numerical ratings regarding 18 items about a child’s behavior: nine items on inattention and nine on hyperactivity and impulsivity.

Study co-author Thomas J. Power, Ph.D., director of CHOP’s Center for Management of ADHD, developed ADHD-RS-IV in the 1990s (An updated version, the fifth edition, was published earlier this year, but not used in the current study).

“I’m excited to be involved in this study, and in efforts to refine our screening tools,” said Power, “especially since few researchers have previously investigated using this scale in children with ASD. Our research raises questions not only about this rating tool, but all such measures that rely on parent and teacher ratings to assess ADHD in children with ASD.”

For the study, the researchers analyzed ratings of 386 children, aged seven to 17, who had ASD without intellectual disability. To determine whether the tool was effective for children on the autism spectrum, the researchers used a method called factor analysis. They discovered that some questions on the ADHD rating scale were high for children with ASD instead of being high just for the subset of children who had significant ADHD symptoms.

“One underlying problem,” said Yerys, “may be in how we ask these questions.” For example, he explained, parents and teachers are asked “Does the child respond when spoken to directly?”

However, a simple yes or no to this question doesn’t distinguish between actual inattention (a symptom of ADHD) and a child’s lack of understanding about how to behave in a social situation (often found in ASD).

Similarly, other questions on the scale ask how well a child stays focused on one task during playtime. ADHD may cause a child to be easily distracted from an activity, but another child may instead stop playing because of ASD-related difficulties with social play.

“Until we’re able to develop and validate a new rating scale that takes symptoms of autism into account, parents who are concerned should seek out clinicians who are conducting evaluations for ADHD and are also taking into account the possibility of autism,” added Yerys.

Source: Children’s Hospital of Philadelphia

Impulsivity May Mean Meth Use at Earlier Age

A new study has discovered that methamphetamine users who described themselves as impulsive were more likely to start taking the drug at an earlier age.

Both attentional and motor impulsivity were linked to early meth use, even when accounting for total years of use, according to researchers at Oregon State University. On average, people who use methamphetamine start at about age 22.

According to researchers, about one percent of 12th graders report having used meth at least once, and more than six percent of people 26 and older have used meth in their lifetime.

“It’s really unclear if impulsivity is a contributor or a consequence of early methamphetamine use — I think it’s both,” said Dr. Anita Cservenka, an assistant professor in the School of Psychological Science at Oregon State University.

“Impulsivity is highly related to the number of years of using methamphetamine, specifically in men. Our findings suggest that impulsivity likely both contributes to using this substance and increases as a result of using it.”

For the study, funded by the National Institute on Drug Abuse, the researchers looked at 157 meth users’ scores on the Barratt Impulsiveness Scale, a widely used self-reporting measure of impulsive personality traits.

Participants in the study were between 18 and 50 years old, reported using meth in the last 30 days, and reported not using any other substances other than alcohol, tobacco or marijuana. According to the researchers, the participants were free of major mental or physical health problems and were not seeking treatment for their meth use.

The Barratt Impulsiveness Scale is broken into multiple types of impulsivity, some of which include attentional and motor impulsivity. Attentional impulsiveness has been defined as an inability to focus attention or concentrate. Motor impulsiveness refers to a tendency to act on whims.

“One possibility is that meth users are self-medicating,” Cservenka said. “If they have difficulty paying attention, they may try to use meth to perhaps improve their attentional ability, as amphetamines are clinically prescribed for this purpose.”

Illicitly manufactured and distributed, methamphetamine is a toxic, strong, highly addictive central nervous system stimulant. Using it can cause disturbed sleep patterns, hyperactivity, nausea, delusions, aggressiveness, irritability, confusion, anxiety, and hallucinations.

“Methamphetamine use is such a big burden on the individual and also at the societal level,” Cservenka said. “We pay a lot for users’ health care because meth use impairs both psychosocial function and physical health.

“These results suggest that if we find individuals during adolescence who show elevated symptoms of impulsivity or a lack of inhibitory control, they may be individuals we want to target for early intervention.”

Cservenka said longitudinal studies — tracking subjects over time — are needed to better determine if impulsivity is a trigger for early meth use.

“Because this was a cross-sectional study, we can’t say that impulsivity led to meth use,” she said. “We can only suggest that perhaps impulsivity might be a trait that individuals should pay attention to in at-risk youth, especially when it comes to late adolescence or young adulthood, when most meth use is initiated.

“We can only see the complete picture if we track adolescents at an early age and then follow them into young adulthood to understand what risk factors contribute to starting using a substance like meth,” she continued. “Impulsivity may be one of them, but there are likely a number of other risk factors.”

The study was published in the journal Addictive Behaviors.

Source: Oregon State University

Liver Disorders Increase Risk of Depression and Anxiety in Young Adults

Emerging research finds that many __teens and young adults with chronic liver conditions suffer from depression and anxiety. The mental health disorders can have considerable impacts on their emotional and physical health, say investigators.

The findings, which appear in Liver Transplantation, indicate that greater attention should be directed to the mental health of these young patients.

Adolescence is a challenging time for young people in general, but even more so for those with medical conditions. Young people with chronic illness have higher rates of mental health problems than the general population, which can affect how well they take care of themselves.

In the new study, a team led by Marianne Samyn, M.D., FRCPCH and Anna Hames, of King’s College Hospital investigated the prevalence of anxiety and depression in young people with chronic liver diseases.

The researchers also sought to identify the factors that might cause distress in these young patients and how anxiety and depression might affect their beliefs about their illness and treatment.

For the study, 187 patients aged 16 to 25 years who were attending an outpatient liver transition clinic in London completed an electronically-administered questionnaire. The clinic is a multidisciplinary service dedicated to young patients with a range of liver conditions that aims to provide developmentally appropriate care and a smooth transition between pediatric and adult services.

Patients were divided in three groups: those who had undergone liver transplantation, those with autoimmune liver disease, and those with other chronic liver conditions.

Based on the questionnaire, 17.7 percent of the patients in the study screened positive for anxiety or depression, which is significantly higher than the four percent to six percent prevalence in the general adolescent population. There were no significant differences between disease groups.

Patients most frequently attributed their distress to fatigue, sleep difficulties, financial concerns, problems at work/school, worry, and low self-esteem.

Depression and anxiety seemed to influence how patients felt their illness affected them emotionally, how concerned they were about their illness, how many symptoms they experienced, and how much impact they felt the illness had on their lives.

Depression and anxiety did not have a significant relationship with patients’ perceived understanding of their illness or their beliefs as to how much treatment can help.

“Health care professionals should be aware of the high prevalence of mental health problems in young people with liver conditions and routinely inquire about young people’s psychosocial circumstances as both can impact on their illness and outcome,” said Dr. Samyn.

“Interestingly, the most common concerns young people with liver conditions report — such as lethargy, problems with sleeping and money, and work- or school-related issues — are very similar to their peers and can be addressed by a multidisciplinary team looking after them.”

Source: Wiley/EurekAlert

Addressing Gender-Specific Issues Can Improve Co-Parenting

Although most agree that co-parenting after a divorce provides the best environment for kids, successful co-parenting is often challenged by a variety of gender-specific issues.

More than half of America’s courts require some type of education for divorcing parents to help them establish workable co-parenting plans. Nevertheless, successful co-parenting remains difficult.

A new study from the University of Missouri examines co-parenting challenges from a gender standpoint with a goal of improving the ability of divorced parents to work together in supporting their children’s development.

Dr. Lawrence Ganong, co-chair of the Human Development and Family Science Department, and Dr. Marilyn Coleman, professor emerita in the same department, partnered with doctoral candidate Luke Russell to analyze data collected from “Focus on Kids,” a program developed by University of Missouri faculty.

“We know that cooperative co-parenting is the best bet for children of divorce,” Russell said. “However, co-parenting plans often can be derailed by parental conflict and concerns. Our question as researchers was how concerns differed between mothers and fathers, so we could use that information to improve co-parental education programs.”

Russell and his colleagues found that fathers’ parenting behaviors were most affected by financial and legal concerns, especially regarding child support payments perceived as unjust or excessive.

They found that mothers’ co-parenting, on the other hand, were more influenced by concerns about the mental instability and parental fitness of their ex-spouses.

Although both parents also reported logistical concerns — for example, the fear that distance and demanding work schedules would prohibit them from visiting their child — these concerns had no impact on the reported behaviors of either parent.

“Divorce education programs devote significant energy to addressing logistical barriers, such as distance and schedules — yet, we found these concerns had no impact on behavior or parenting styles,” Russell said.

“However, other perceived barriers, financial for fathers and parental fitness for mothers, did have the potential to impact behaviors, which can make it more difficult to implement workable co-parenting plans.”

Russell suggests that family professionals could help couples overcome economic and legal concerns through increased career-training or teaching mothers to better communicate financial needs. Fathers may be more willing to accept paying child support when they understand how payments benefit their children, and when they themselves are more financially secure.

To counteract mothers’ concerns about parental fitness, Russell suggests that family professionals focus on helping fathers develop the skills they need to be effective parents when they are alone with their children, and to take steps to actively demonstrate this capability to their ex-spouse.

To reduce children’s exposure to conflict, however, in some situations it may be necessary to suggest reducing contact between ex-spouses.

The study appears in the journal Family Relations.

Source: University of Missouri

Teens Often Ignore Online Risks

New research finds that adolescents are more likely than adults to take online risks, regardless of the gamble involved.

Investigators from the University of Plymouth explored the psychological mechanisms underpinning why teenagers are more likely to take risks online when compared to young adults.

Dr. Claire White from the School of Psychology and her team gave adolescents (aged 13-17) and young adults (aged 18-24) the same online quiz gambling scenario. For both groups, the exam was framed in two different ways — one highlighting what could be won, and one highlighting what could be lost.

After dealing with both scenarios, the overall results showed adolescents demonstrated the riskier behavior.

These results were partially linked to sensation seeking, but more fully explained by Fuzzy Trace Theory — the notion that people process information in both a verbatim (quantitative) and gist (qualitative) fashion.

However, the older a person gets, and the more memories and experiences they have, the more inclined they are to consider risk intuitively, drawing on simple gist representations.

Researchers also discovered that, independent of sensation-seeking, adolescents were not swayed by how the question was framed. Conversely, young adults were — choosing not to make the gamble when the potential losses were highlighted.

Calculating the risks involved, compared to making intuitive decisions, led to higher rates of risk-taking by adolescents.

Investigators said results highlighted the importance of conveying information online in a clear and objective way to teenagers. The research also suggests that risk-averse beliefs and values should be communicated in a manner that are easy to remember and retrieve, and effectively tailored to different age groups.

White said, “Our findings provide important and novel insights into ways in which online safety training and risk communication is understood by people of different ages, and so how experts and campaigners can tailor their information to keep everyone safe online.

“Drawing on Fuzzy Trace Theory enabled us to explain why younger people were more likely to take risks, over and above the influence of sensation seeking.

“But whereas it may have been assumed that hinting at a risk’s severity might deter anyone from taking a risk online, our results show that this is irrelevant when it comes to adolescents due to their lesser ability to draw upon the gist of risky situations.

“We hope that the study goes some way to understanding more about young people’s behavior online, and so can help keep them safe in future.”

The full study is published in Decision, an American Psychological Association journal.

Source: University of Plymouth

For Kids, More Time on Digital Devices = Less Homework Completed

New research finds that the more time children spend using digital devices, the less likely they are to finish their homework, complete other tasks, or display interest in learning new things. Moreover, the more digital media time, the more difficult it is for kids to remain calm when challenged.

Although the finding is not a surprise to most parents, the research provides detail on the direct relationship between time on digital media — be it watching TV, using computers, playing video games, using tablets and smartphones, or using other digital media devices for purposes other than school work — and homework completion.

Researchers determined children who spent two to four hours a day using digital devices outside of schoolwork had 23 percent lower odds of always or usually finishing their homework, compared to children who spent less than two hours consuming digital media.

The abstract was presented at the American Academy of Pediatrics (AAP) 2016 National Conference & Exhibition in San Francisco.

For the study, pediatricians from Brown University School of Public Health in Rhode Island analyzed children’s use of digital media to better understand how it relates to childhood “flourishing,” or overall positive well-being. This characteristic was measured by behaviors and characteristics including diligence, initiative, task completion, and interpersonal relationships.

Investigators used data from the 2011/2012 National Survey of Children’s Health to analyze the media use and homework habits of more than 64,000 children ages six to 17 years, as reported by their parent or guardian.

When examining children’s use of digital media, researchers found 31 percent were exposed to less than two hours of digital media per day.

Another 36 percent used digital media for two to four hours per day; 17 percent were exposed to four to six hours; and 17 percent were exposed to six or more hours of digital media per day.

For every additional two hours of combined digital media use per day, there was a statistically significant decrease in the odds of always or usually completing homework.

Children who spent four to six hours on digital media had 49 percent lower odds of always or usually finishing their homework than those with less than two hours per day. Those with six or more hours of media use had 63 percent lower odds of always or usually finishing their homework compared to children who spent less than two hours per day using media.

The authors found a similar relationship between digital media exposure and four other measures of childhood flourishing, including always or usually caring about doing well in school, completing tasks that are started, showing interest in learning new things, and staying calm when faced with challenges.

The trends all remained significant regardless of the child’s age group, sex, or family income level.

Prior studies have shown a wide variety of negative health and behavioral consequences of digital media exposure. This study adds to what is already known by showing that digital media exposure is associated with decreased measures of overall child well-being.

“It is important for parents and caregivers to understand that when their children are exposed to multiple and different forms of digital media each day, the combined total digital media exposure is associated with decreases in a variety of childhood well-being,” said study author Stephanie Ruest, M.D., F.A.A.P.

“Parents should consider these combined effects when setting limits on digital media devices.”

Source: American Academy of Pediatrics

Childhood Trauma Affects Development, Physical Health

While it’s well-known that adverse childhood experiences carry over into adult life, a new study focuses on the effects of these experiences during the childhood years.

For the study, presented at the American Academy of Pediatrics 2016 National Conference & Exhibition, researchers conducted a systematic literature review to identify some of the clinical signs that can be used to recognize children at risk after experiencing trauma. They examined 39 cohort studies to determine the effect adverse childhood experiences has on health and biological outcomes in children.

The researchers found that household dysfunction affects children’s weight early in childhood, and abuse and neglect affect children’s weight later in childhood.

Children exposed to early adversity also have increased risk for asthma, infection, somatic complaints, and sleep disruption, according to the study’s findings.

Maternal mental health issues are associated with elevated cortisol levels, and maltreatment is associated with a lower cortisol profile, researchers add.

“The majority of research on early adversity has looked at long-term adult outcomes,” said Debby Oh, Ph.D., a research associate at the Center for Youth Wellness in San Francisco, California. “While this research has helped identify the problem, we must also deepen our understanding of what is happening in the brains and bodies of our children as they experience adversity.”

Oh said that with appropriate intervention, children are able to recover from some of these negative health effects, making early detection a powerful tool to protect the health and well-being of children before long-term adult outcomes occur.

Source: The American Academy of Pediatrics

Many Young Athletes Return to Play After Concussion Despite Risk

Long-standing concussion guidelines discourage young athletes from returning to the game if they display any signs of concussion after an injury. A new study, however, shows that athletes between the ages of seven and 18 often return to play on the same day.

Researcher Shane M. Miller, M.D., FAAP, a pediatric sports medicine specialist at Texas Scottish Rite Hospital for Children in Plano, Texas, noticed that a significant number of his patients had reported returning to play after experiencing a concussion before being cleared by a medical professional.

This practice is contrary to medical guidelines, state laws and educational efforts.

Miller and Meagan Sabatino, senior clinical research coordinator at the same hospital, analyzed records for 185 patients, ages seven to 18, treated for concussion at a Texas pediatric sports clinic during a 10-month period in 2014. Nearly half (47 percent) of the young athletes sustained a concussion while playing football; the next most common sport among concussion patients was soccer (16 percent).

Of these patients, 71 (38 percent) had returned to play on the same day as their initial injury. Athletes who immediately returned to play after their injury reported less severe symptoms of dizziness and balance problems immediately after being hurt.

However, by the time they were seen in the clinic, they were statistically more likely to report the presence and increased severity of nausea, dizziness, balance problems, sensitivity to light and noise, feeling “slowed down,” pressure in the head, confusion and trouble with both concentrating and falling asleep.

“Our findings suggest that we still have work to do to change behaviors to protect short- and long-term brain health of youth athletes,” said Sabatino.

While the majority of the patients in the study were male (72 percent), the researchers said there were no statistical differences found in gender, age, presence of concussion symptoms on day of injury, sport, mechanism of injury or impact location between those who returned to play on the same day and those who did not. The researchers said this is the largest study to date looking at return to play patterns in young athletes with concussions.

Miller emphasized the continual need for better concussion education. “We need to emphasize the message, when in doubt, sit them out — and keep them out — until full recovery,” he said.

The research abstract was presented at the American Academy of Pediatrics (AAP) 2016 National Conference & Exhibition in San Francisco.

Source: American Academy of Pediatrics

Kids of Bipolar or Schizophrenic Parents More Likely to Face Early Mental Health Issues

New research shows that children born to one or both parents with schizophrenia or bipolar disorder are more likely to suffer mental health problems by the age of seven.

Presented at the International Early Psychosis Association (IEPA) meeting in Milan, Italy, in October 2016, the Danish High Risk and Resilience Study — VIA 7 — included 522 children who were seven at the start of the study.

Of the children, 202 were born to at least one person diagnosed with schizophrenia (located using Danish registries), while 120 of them were born to least one parent diagnosed with bipolar disorder. The remaining 200 children were born to parents without any of these diagnoses.

The results show children born to parents with schizophrenia or bipolar disorder score higher than the other children using a tool called the child behavior checklist (CBCL). This is a widely used questionnaire with more than 100 questions given to parents and teachers that describes behavioral problems or signs of possible illness, the researchers said, explaining a higher score represents more problems.

Mean scores for children in the schizophrenia group were 27.2, the bipolar group 23.5, and control group 17.1.

There were also marked differences between the three groups concerning psychopathology, neurocognition, motor functioning and their home environment, according to the study’s findings.

Children born to parents with schizophrenia, and to a minor extent also bipolar disorder, were found to have increased risk for problems such as anxiety, attention-deficit hyperactivity disorder (ADHD) and stress/adjustment disorder, and were also more likely to display neurocognitive problems or delays. They also were more likely to grow up in families with a lower social status and a higher risk of adverse life events, according to the researchers.

“Results from this first assessment in the VIA 7 study indicate that many children and families have unmet needs and problems,” said Dr. Anne Thorup, an assistant professor in the Institute of Clinical Medicine, Faculty Health and Medical Science at the  University of Copenhagen in Denmark.

She noted the researchers plan to follow the children until age 11, conducting a new assessment before puberty.

“We do not know if the impaired children will catch up in neurocognitive areas or if their mental problems will be in remission, but since social aspects and environmental factors contribute significantly to child development — and they were quite marked already at age seven years — we are expecting similar or even worse results could be seen at age 11 years,” she said.

“At the same time, we are developing an early, integrated, specialized and family based intervention, called VIA family, to prevent or slow development of severe mental illness in individuals born to parents with schizophrenia or bipolar disorder.”

Source: International Early Psychosis Association 

Common for ADHD Symptoms to Persist into Adulthood

New research discovers compelling evidence that symptoms associated with attention deficit hyperactivity disorder often persist into adulthood.

In the study, investigators found that sixty percent of children with ADHD demonstrated persistence of symptoms into their mid-20’s, and 41 percent had both symptoms and impairment as young adults.

Experts have often disagreed on the rate of ADHD persistence into adulthood. The variation in opinion is believed to stem from how information is collected and analyzed.

The current study represents a 16-year follow-up of the ‘Multimodal Treatment Study of Children with ADHD (the “MTA”)’. Saliently, researchers utilized a new study methodology to improve accuracy of findings.

Investigators believe the new method — which combines parent and self-reports plus a symptom threshold that is adjusted for adulthood — provides a better assessment of retained symptoms.

“There has been a lot of recent controversy over whether children with ADHD continue to experience symptoms into adulthood,” said Dr. Margaret Sibley, lead author of the Journal of Child Psychology and Psychiatry study.

“This study found that the way you diagnose ADHD can lead to different conclusions about whether or not an adult still has the disorder that started in childhood.

First, if you ask the adult about their continued symptoms, they will often be unaware of them; however, family members or others who know them well often confirm that they still observe significant symptoms in the adult.”

Dr. Sibley added that if the classic childhood definition of ADHD is used when diagnosing adults, many cases will be missed because symptom presentation changes in adulthood.

“By asking a family member about the adult’s symptoms and using adult-based definitions of the disorder, you typically find that around half of children with moderate to severe ADHD still show significant signs of the disorder in adulthood.”

Source: Wiley/EurekAlert

Pet Ownership Offers Emotional Life Skills to Children

A new paper discusses how the death of a pet helps children begin to understand the realities of life within their home environment.

Given the relatively short lifespans of many pets, it’s not unusual for children to witness the death of pets. But “how children understand death in these moments, and the ideas, feelings, and responses they have when their pets die are largely ignored topics,” said Joshua J. Russell, Ph.D.

In his research Russell, an assistant professor of animal behavior, ecology and conservation (ABEC) at Canisius College in Buffalo, N.Y., has discovered that pets are more than just animals to children.

“They often see themselves as the center of their pets’ affections,” says Russell, who conducted one-on-one interviews with children between the ages of six and 13. “They describe their pets as siblings or best friends with whom they have strong connections.”

For example, Neville, a 13-year-old boy was shaken by the sudden death of his cat, even though it occurred two years earlier. “I asked Neville how he felt when he learned his cat was struck by a car and he replied, ‘My life was over.’”

Unfortunately, the joy of owning a pet often goes hand-in-hand with the heartbreak of losing one. Children, in particular, “have a distinct sense of existential fairness around whether or not an animal lived until an appropriate age,” Russell explains.

A short lifespan “is normal for hamsters and fish,” according to the children interviewed, “but unexpected for dogs, cats, and rabbits.” Similarly, different kinds of deaths mean different things to children.

“Children whose pets lived the extent of their potential lifetimes — or beyond — expressed acceptance upon their deaths,” Russell says.

The children also suggested that euthanasia “was the moral thing to do when a pet is suffering.” Conversely, children whose pets died unexpectedly “described it as emotionally and morally unfair, and had a much more difficult time reconciling the loss.”

In all instances, family and friends helped the children cope with the loss of their beloved pets through discussions and family rituals. Although, Russell discovered ambivalence about whether a new pet would lessen their grief.

“There were those who felt it would be wrong to move on to a new pet because they had to honor their relationships with the deceased one.”

Several children, however, “explicitly linked getting a new pet with feeling better,” Russell said. “They explained it as an opportunity to start over and suggested that replacing a companion animal is more about beginning a new relationship than erasing memories of an old one.”

Neville summarized it best, Russell concludes, when he said, “Sometimes death is tragic, like when a cat is run over by a car. But ultimately, death is part of life and life does go on.”

Source: Canisius College/Newswise

Folate Extract May Help Autistic Kids Communicate

A preliminary study suggests that prescribed doses of folinic acid, a reduced form of Vitamin B known as folate, could help improve the language and communication skills of children with autism spectrum disorder (ASD).

The study also identifies specific biomarkers that can predict treatment response in children with autism and verbal communication problems.

The findings stem from a placebo-controlled trial in which children were randomized to receive either high-dose folinic acid or a placebo.

Up to two percent of American children are said to experience symptoms that place them on the autism spectrum. Many of these children have difficulty communicating and interacting with others, especially within a social setting.

Researchers do not yet fully understand all the reasons behind the development of ASD and, importantly, there are currently no approved treatments that address the core symptoms of this disorder.

“The only currently approved medications for autism are both antipsychotic medications that address non-core symptoms and can lead to unwanted side effects,” said John Slattery, clinical research program manager at Arkansas Children’s Research Institute  and a co-author of the study.

Scientific research has linked this disorder to abnormalities in the metabolism of folate as well as genes that are involved in folate metabolism. Certain studies have also shown that the offspring of women who took folate supplements before conception and during pregnancy had a lower risk of having a child with ASD.

About 10 years ago a condition known as cerebral folate deficiency (CFD) was described in which the concentration of folate is below normal in the central nervous system but not in the blood. Many children with CFD had ASD symptoms and responded well to treatment with high-dose folinic acid.

Lead author Dr. Richard Frye of and his team had previously shown that folate receptor autoantibodies were found with a high prevalence in children with ASD.

In the current study, researchers found that participants with folate receptor autoantibodies had a more favorable response to the folinic acid treatment. This leads the way to a test that might be useful for clinicians to determine if high-dose folinic acid might be a treatment for a particular child with ASD.

Related research on laboratory rat models have confirmed the deleterious effects of folate receptor antibodies on brain development and function.

“Improvement in verbal communication was significantly greater in participants receiving folinic acid as compared with those receiving the placebo,” Frye said. He added that the findings should be considered preliminary until the treatment has been assessed further in larger long-term studies.

The study appears in the journal Molecular Psychiatry.

Source: Springer

Foster Children at Risk for Physical, Mental Health Issues

A new study finds that children who have been in the U.S. foster care system are at a significantly higher risk of mental and physical health problems than children who haven’t been in foster care.

University of California, Irvine researchers discovered foster children have a higher incidence of a variety of conditions including learning disabilities, developmental delays, and depression as well as behavioral issues, asthma, and obesity.

”No previous research has considered how the mental and physical well-being of children who have spent time in foster care compares to that of children in the general population,” said study co-author Kristin Turney, University of California, Irvine associate professor of sociology.

“This work makes an important contribution to the research community by showing for the first time that foster care children are in considerably worse health than other children. Our findings also present serious implications for pediatricians by suggesting that foster care placement is a risk factor for health problems in childhood.”

The study has been published online ahead of print in Pediatrics, and is the first large-scale study to offer health comparisons based on a nationally representative sample of U.S. children.

Turney and co-author Christopher Wildeman, associate professor of policy analysis & management at Cornell University, analyzed data from the 2011-2012 National Survey of Children’s Health. Of the more than 900,000 kids included in the survey, 1.3 percent were identified as having been in foster care.

They were compared to children who hadn’t spent time in foster care, those who had been adopted from foster care, and those living in a variety of family arrangements, including single-mother and economically disadvantaged households. Using logistic regression models, researchers found that kids who’d been in foster care were:

• Seven times as likely to experience depression;
• Six times as likely to exhibit behavioral problems;
• Five times as likely to feel anxiety;
• Three times as likely to have attention deficit disorder, hearing impairments, and vision issues;
• Twice as likely to suffer from learning disabilities, developmental delays, asthma, obesity, and speech problems.

“This is typically a difficult-to-reach population, so having access to descriptive statistics on their living arrangements, physical well-being and behavior provided an excellent opportunity to help identify the health challenges they face,” Turney said.

“This study expands our understanding of the mental and physical health of these highly vulnerable children, but we must take a closer look if we are to understand how foster care really affects child well-being.”

Source: University of California, Irvine/EurekAlert

Poverty, Fear of Loss in Childhood Can Lead to Poor Health as Adult

Low socioeconomic status and fear of abandonment early in life can lead to poor health in adulthood regardless of adult socioeconomic status, according to a new study from Rice University in Houston.

The study, published in The Annals of Behavioral Medicine, examined the self-reported measures of childhood socioeconomic status; attachment orientations, such as fear of abandonment or difficulty in forming relationships; stress; and adult health of 213 participants from 2005 to 2011.

The study found that people who were in the lowest 25 percent of the sample for socioeconomic status as children had 65 percent worse self-reported health as adults.

The researchers added that this poor health later in life occurred regardless of adult socioeconomic status.

“Low socioeconomic status places burdens on parents where they are less available to their kids at times,” said Dr. Chris Fagundes, an assistant professor of psychology at Rice and the study’s co-author. “This can lead to the development of ‘attachment orientations,’ which include fear of abandonment or difficulty in forming close relationships, that can compromise adult health.”

Fagundes and his co-author, Dr. Kyle Murdock, a postdoctoral research fellow in psychology, also found that a person’s biological capacity to regulate their emotions — including stress — had a correlation to overall health.

“If individuals are better at managing negative feelings and levels of stress, they are more likely to be healthy as adults,” Murdock said. “However, if they are not so good at managing emotions, they are more likely to be less healthy.”

Fagundes and Murdock said they hope the study will encourage further exploration of why low socioeconomic status during childhood is associated with an increased risk of experiencing health disparities in adulthood.

“Ultimately, early childhood is a critical time for adult health, regardless of whether you move up the socioeconomic ladder as an adult,” they concluded.

Source: Rice University 

Sleep-Deprived Preschoolers May Eat More

A new study shows that preschoolers who are sleep-deprived for just one day tend to consume a greater number of calories on both that day and the following day.

The findings, published in the Journal of Sleep Research, shed light on how sleep loss can increase weight gain and why preschoolers who do not get enough sleep are more likely to be obese as a child and later in life.

The study involved three- and four-year-old children — all regular afternoon nappers — who were deprived of roughly three hours of sleep on one day. This involved getting no afternoon nap and being kept awake for about two hours past their normal bedtimes. The children were then awakened at their regularly scheduled times the next morning.

During the day of lost sleep, the young children consumed about 20 percent more calories than usual, 25 percent more sugar, and 26 percent more carbohydrates, said lead study author Dr. Monique LeBourgeois of the University of Colorado, Boulder.

The following day, the kids were allowed to sleep as much as they needed. On this “recovery day,” they returned to normal baseline levels of sugar and carbohydrate consumption, but still consumed 14 percent more calories and 23 percent more fat than normal.

“With this study design, children missed a daytime nap and stayed up late, which mimics one way that children lose sleep in the real world,” said LeBourgeois, assistant professor in the Department of Integrative Physiology.

“We found that sleep loss increased the dietary intake of preschoolers on both the day of and the day after restricted sleep.”

According to the National Sleep Foundation, about 30 percent of preschoolers do not get enough sleep.

Even with an increase in obesity prevention efforts in the past decade, childhood obesity remains an epidemic. In 2014, 23 percent of American children under the age of five years were overweight or obese, said LeBourgeois.

Childhood obesity increases the risk for future chronic illnesses like diabetes and is linked to low self-esteem and depression. Overweight youth are about four times more likely to be obese as adults.

“We think one of the beauties of this study is that parents were given no instructions regarding the kind or amount of food or beverages to provide their children,” said LeBourgeois. Parents fed their children just like they would on any normal day.

The researchers also studied each child across all study conditions, such as when their sleep was optimized, restricted, and recovered, which helped reveal how kids differ individually in their eating preferences and sleep habits.

Each preschooler wore a small activity sensor on their wrist to measure time in bed, sleep duration, and sleep quality. Parents kept track of all food and beverages consumed by the children, including portion sizes, brand names, and quantities, using household measures like grams, teaspoons, and cups.

For homemade dishes, parents recorded ingredients, quantities, and cooking methods.

“To our knowledge, this is the first published study to experimentally measure the effects of sleep loss on food consumption in preschool children,” said Elsa Mullins, the study first author and a University of Colorado, Boulder researcher who worked with LeBourgeois as an undergraduate.

“Our results are consistent with those from other studies of adults and adolescents, showing increased caloric intake on days that subjects were sleep deprived,” she said.

Source: University of Colorado at Boulder

New Study Finds 15 Percent of 6th Graders Commit Cyber Abuse

According to a new study, 15 percent of sixth-grade students report they have perpetrated at least one form of abuse toward a dating partner through technology.

For the study, researchers from the University of Texas Health Science Center at Houston (UTHealth) School of Public Health analyzed survey results from 424 sixth graders in southeast Texas.

The students, who had a boyfriend or a girlfriend, has just been enrolled in Me & You: Building Healthy Relationships, a classroom- and computer-based curriculum to teach young people the importance of having healthy relationships and how to make good decisions in their relationships with peers, friends, family, and future dating partners.

The survey was taken before the students received the curriculum, the researchers noted.

The most common forms of cyber dating abuse were using a dating partner’s social networking account without permission and making a dating partner afraid of not responding to their partner’s calls or messages, the study discovered.

The students who were more likely to perpetrate cyber dating abuse had participated in bullying before, according to the researchers. The students also believed it was more normal for a boy to perpetrate violence against a girl, researchers found.

“We still don’t know if cyber dating abuse is really a distinct form of dating violence or if it’s just dating violence being perpetrated through a new avenue. The literature has shown that there’s a lot of overlap,” said Melissa Peskin, Ph.D., lead author of the study and associate professor in the Department of Health Promotion and Behavioral Sciences at University of Texas, Health School of Public Health.

“In this study, we did find that many of the factors associated with cyber dating abuse are also factors associated with traditional forms of dating violence.”

Peskin stressed that interventions are needed to educate students about the dangers of dating violence.

“We need interventions that focus on reducing dating violence, but that also include lessons on how to have healthy relationships in the online environment,” said Peskin.

In future research, Peskin said she hopes to evaluate how participating in the Me & You program affects rates and perceptions about cyber dating abuse among students.

The study was published in the Journal of Youth and Adolescence.

Source: The University of Texas Health Science Center at Houston
 
Photo: Lead researcher Melissa Peskin, Ph.D. Credit: UTHealth.

Parenting Challenges in IT Connected Work/Family Environment

Advances in digital communication and mobile technology has created an environment in which people are never really “away” from work. A new study investigates new parenting conflicts created by the omnipresent work connection and provides suggestions on how parents can maintain balance.

University of Michigan researchers explain that in today’s world it is common for a parent to come home just as a new email “dings” on his or her phone. At the same time, a toddler may be calling out for a snack, a sibling conflict may be brewing, and big sister would really like to show off what she accomplished in preschool while the parents were at work.

Meanwhile, the phone keeps buzzing — more emails, social media notifications, a breaking news alert, an “urgent” text.

As smartphones and tablets blur lines between work, home, and social lives, parents are grappling to balance it all, a new small study suggests. Moreover, parents’ use of mobile technology around young children may be causing internal tension, conflicts, and negative interactions with their kids.

It’s a challenge both parents and health care providers should tune in to.

“Parents are constantly feeling like they are in more than one place at once while parenting. They’re still ‘at work.’ They’re keeping up socially. All while trying to cook dinner and attend to their kids,” says lead author Jenny Radesky, M.D., a child behavior expert and pediatrician at University of Michigan who conducted the study with colleagues from Boston Medical Center.

“It’s much harder to toggle between mom or dad brain and other aspects of life because the boundaries have all blurred together. We wanted to understand how this was affecting parents emotionally. We found that parents are struggling to balance family time and the desire to be present at home with technology-based expectations like responding to work and other demands.”

The study, which appears in the Journal of Developmental & Behavioral Pediatrics, involved in-depth interviews with 35 caregivers, which included moms, dads, and grandmothers.

Participants consistently expressed an internal struggle between multitasking mobile technology use, work and children, information overload and emotional tensions around disrupting family routines, such as meal time. As one mom in a focus group described it, “the whole world is in your lap.”

Some parents also reported a trickle-down effect. That is, their emotional response to whatever they were reading on their mobile device — whether it was a work email or bad news — sometimes affected how they responded to their children.

Parents also described more attention-seeking behaviors from children when they were heavily attentive to their mobile devices, which prompted negative interactions such as snapping at kids.

At the same, caregivers said that mobile technology provided “an escape” from the boredom and stress of parenting and home life demands. One mom said that after long days with kids, plugging into the outside world was a reminder, “I have a life beyond this.”

Other boons included more ability to work from home (when digital connection to work could be kept in check); easier communication with estranged family members by allowing a more “filtered” view of their life; and serving as a tool to keep peace and quiet in the house.

“You don’t have to be available to your children 100 percent of the time — in fact, it’s healthy for them to be independent. It’s also important for parents to feel relevant at work and other parts of their lives,” Radesky says.

“However, we are seeing parents overloaded and exhausted from being pulled in so many different directions.”

Parents are estimated to use mobile devices such as tablets, smartphones, and wearables nearly three hours a day. But few studies have explored the role these technologies play in family interactions.

Radesky and colleagues wanted to explore the issue further after an observational study of caregivers eating with young children in fast food restaurants. In that study and subsequent videotaped research, her team found that parent mobile device use is associated with fewer verbal and nonverbal interactions with the children.

“Technology has transformed the way parents use digital media around their children,” Radesky says. “Compared to traditional distractions like books, mobile technology is described as much more commanding of attention that is unpredictable and requires a greater emotional investment.

“Kids require a lot of different types of thinking, so multitasking between them and technology can be emotionally and mentally draining. As clinicians, we have an opportunity to start conversations with parents and help them manage this conflict with ideas on how to unplug and set boundaries.”

With all this in mind, physicians can recommend some ideas for families struggling to stay unplugged. Some suggestions from Dr. Radesky:

• Set boundaries. Create a family plan that includes unplugged spaces or times of day. For example, you may abolish tech use at dinner time or bedtime. Or maybe it’s right when you get home and your kids are excited to see you. Maybe you plug in your device in a certain room and only use it there or agree not to use it in certain areas of the house (i.e. kids’ bedrooms).
• Track your mobile use. Consider creating a filter or block on your device to avoid the temptation of tech use at home. Apps like “Moment” and “Quality Time” may also help you track mobile use and see where you may be spending too much time. If 90 percent of your time is on Facebook or work email, for example, you can think of ways to cut down technology time for these purposes.
• Identify top device stressors. Think about which parts of your mobile device use are most stressful for you. If it’s reading the news or checking work email, for example, reserve these tasks for times when you know your kids are occupied. This way, you have your own time and space to process the information rather than interrupting time with kids who may react to your negative emotions with their own negative.

Source: University of Michigan

Moms, Dads Tend to Differ on Schooling Issues

A new study reveals clear gender differences of opinion among parents when it comes to our children’s schooling. Researchers found that moms are more likely than dads to favor both school diversity and neighborhood schools. They also found that moms are more likely to be concerned about challenges, dangers, and uncertainty related to school assignments.

“Our threshold question was whether there were gender differences among parents toward their children’s public school assignments, and we found clear differences,” said lead author Dr. Toby Parcel, a professor of sociology at North Carolina State University.

“This is the first time researchers have measured, in an empirical way, how school assignment concerns break down along gender lines,” Parcel says. “And it gives us a deeper, fundamental understanding of parental concerns about schooling.”

For the study, researchers looked at survey data from 547 parents of children in Wake County Public Schools in North Carolina. Survey participants were split about evenly between men and women.

And while this study focused on one North Carolina county, Parcel said the findings are broadly applicable to other parts of the United States.

“We found that mothers were more pro-diversity and more supportive of neighborhood schools than fathers, regardless of any other variables such as race, education, income, or political affiliation,” Parcel said.

“This highlights the policy challenges facing school administrators, who often have to find a balance between promoting school diversity and drawing a school population from its immediate neighborhood.”

The findings also show that moms tend to be more worried than dads about potential logistical challenges a school reassignment might pose, are more concerned that a reassignment may harm a child’s learning or friendships, and are more uncertain about the likelihood of a child being reassigned to a different school.

“We do know that school boards do take these concerns into account,” Parcel says. “For example, in Wake County, these concerns have slowed down the rate, and limited the number, of school reassignments.”

The study also highlighted another area of potential interest for future research: school choice.

“We think the work of making school choices — such as choosing among public, private, charter, magnet, and home-schooling options — is significant; it takes time, effort and emotional energy,” Parcel said.

“And it’s an understudied area. We’d like to see questions about this incorporated into national surveys that focus on the division of household labor.”

The paper is published in the journal Socius.

Source: North Carolina State University

Adverse Childhood Experiences May Up Risk of ADHD

A new study suggests that children who experience family and environmental stressors and traumatic experiences are more likely to be diagnosed with attention-deficit/hyperactivity disorder (ADHD).

Researchers at the Albert Einstein College of Medicine say adverse experiences such as poverty, mental illness, and exposure to violence are associated with childhood development of ADHD.

ADHD is the most common neurobehavioral disorder of childhood. There has been a significant increase in parent-reported ADHD prevalence over the last decade, and there has also been an associated rise in stimulant medication use.

Current ADHD clinical practice guidelines recommend evaluating for other conditions that have similar symptoms to ADHD, such as disruptive behaviors, impulsivity, and issues with memory, organization and problem-solving.

Despite the guidelines, few pediatricians routinely ask about psychosocial factors that could be affecting a child’s health during ADHD assessment.

Exposure to adverse childhood experiences (ACEs), commonly referred to as family or environmental stressors such as divorce and familial incarceration, is one way that behaviors similar to those exhibited by children with ADHD can be triggered.

Research has shown that this is because ACEs may increase a child’s risk for toxic levels of stress, which in turn may impair brain development, behavior, and overall physical and mental health.

“If clinicians aren’t routinely discussing exposure to traumatic experiences and identifying ACEs, particularly among children with behavioral concerns such as ADHD, there may be a heightened risk of missing an underlying trauma history or misattributing some of the symptoms of traumatic stress as solely those of ADHD,” said lead author Nicole M. Brown, M.D., M.P.H., M.H.S.

“We sought to examine the link between ADHD and ACEs in an effort to improve ADHD assessment and management.”

The study appears in the journal Academic Pediatrics.

Brown and co-investigators at CHAM used a nationally representative sample of 76,227 children from the 2011-2012 National Survey of Children’s Health, to identify children four to 17 years old whose parents reported both the presence and severity of ADHD and their child’s exposure to nine adverse childhood experiences.

The ACE’s included socioeconomic hardship, divorce, death, domestic violence, neighborhood violence, substance abuse, incarceration, mental illness in the family, and discrimination.

The analysis found that children with parent-reported ADHD were more likely to have two or more ACEs exposures, compared to children without parent-reported ADHD.

Most significantly, children with socioeconomic hardship, parent/guardian divorce, familial mental illness, neighborhood violence, and familial incarceration were more likely to have an ADHD diagnosis.

Furthermore, those with socioeconomic hardship and familial mental illness were more likely to have moderate to severe ADHD, according to parental reports.

Children with parent-reported ADHD represented 8.8 percent of the 76,227 children, and were more likely to be male, aged 12 – 17 and non-Hispanic white.

“Our research shows there are significant associations between ACE exposures and having an ADHD diagnosis, and we encourage pediatric providers to more frequently evaluate for ACEs as part of ADHD assessments,” said Brown.

“Ultimately, this may lead to more trauma-informed approaches to care, particularly for children whose response to stimulant medications or targeted behavioral therapies are poor.”

Source: University Hospital for Albert Einstein College of Medicine, Montefiore Medical Center 

Boys from Loving Families May Have More Secure Marriages in Old Age

Boys who are raised in a warm family environment are more likely to feel secure in romantic relationships in their 80s, according to a new study published in the journal Psychological Science.

The findings show that boys who grow up in loving homes tend to be much better at managing stressful emotions when assessed at middle age, which may help explain why they have more secure marriages late in life.

“Our study shows that the influences of childhood experiences can be demonstrated even when people reach their 80s, predicting how happy and secure they are in their marriages as octogenarians,” said researcher Dr. Robert Waldinger of Harvard Medical School.

“We found that this link occurs in part because warmer childhoods promote better emotion management and interpersonal skills at midlife, and these skills predict more secure marriages in late life.”

The study, which tracked the same individuals for over six decades beginning in adolescence, provides evidence for the life-long effects of childhood experiences.

“With all the things that happen to human beings and influence them between adolescence and the ninth decade of life, it’s remarkable that the influence of childhood on late-life marriage can still be seen,” said Dr. Marc Schulz, study co-author and professor at Bryn Mawr College.

The researchers looked at data collected from 81 men who participated in a 78-year study of adult development, 51 of whom were part of a Harvard College cohort and 30 of whom were part of an inner-city Boston cohort. All of the men participated in regular interviews and questionnaires throughout the course of the study.

To gauge each participant’s family life, the researchers examined data collected when the participants were adolescents. This included reports about their home life, interviews with the participants’ parents, and developmental histories recorded by a social worker. The researchers used this data to create a composite measure of family environment.

When the subjects were 45 to 50 years old, they participated in interviews in which they talked about the challenges they faced in various aspects of their lives, including their relationships, their physical health, and their work. The researchers used the original interview notes to rate participants’ ability to manage their emotions in response to these challenges.

When participants reached their late 70s or early 80s, they completed a semistructured interview that focused on their attachment bond with their current partner. In these interviews, they were asked to discuss their marriage, including how comfortable they were depending on their partner and providing support to their partner.

The researchers used data from these interviews to develop an overall rating of participants’ security of attachment to their partner.

The new study adds to prior research showing that the quality of early family life can have “far-reaching effects on well-being, life achievement, and relationship functioning throughout the lifespan,” Waldinger said.

The findings emphasize the long term effects of childhood experience and the importance of prioritizing the wellbeing of children. The study also suggests that acquiring adaptive emotion management skills may help to lessen the impact of early childhood adversity, the researchers said.

Source: Association for Psychological Science

e-Book Features May Slow Preschool Learning

New research suggests reading e-books enhanced with sound, animation, and games not related to story content may reduce learning in young children.

University of California, Irvine researchers discovered the additional features were distracting to children between the ages of three and five.

“With the widespread adoption of tablets, youngsters’ use of e-books continues to increase,” said lead investigator Stephanie Reich, UCI associate professor of education.

“Preschoolers can learn equally well — and sometimes more — from appropriately designed e-books as from printed books, but enhanced e-books often contain features that are more distracting than educational, so careful selection is vital.”

Reich, along with Ph.D. student Joanna Chung-Yun Yau and professor of education and informatics Mark Warschauer, conducted a systematic review of comparative print/e-book studies with children five and younger.

Their results appear in the Journal of Developmental & Behavioral Pediatrics.

The team found that a child’s comprehension can be facilitated when e-book information is presented through visual and auditory modes related to the narration. For example, suspenseful music may play when the Big Bad Wolf approaches, or alphabet books may make the letter sound when one is tapped.

Surprisingly, researchers also discovered features that serve only a decorative function — such as the audio simulation of trees moving in the wind — can cause cognitive overload, impeding story comprehension.

Regardless of a book’s format — digital or print — youngsters learn more from in-person, shared reading experiences, as discussions of the story, text, and characters enhance language development and literacy.

However, the researchers noted that during e-book reading, the adult and child most often talked about the platform, while print book conversations were most frequently about the story.

“The pace of e-reading studies hasn’t kept up with the speed of e-book creation,” Reich said.

“More research on the effectiveness of digital books compared to traditional print books for children’s learning is needed so that parents and educators can be critical consumers of these technologies.”

Source: University of California, Irvine

Impulsivity, Sensation-Seeking Up Teens’ Risk of Substance Abuse

The teenage years are a time of change for both young people and parents as an adolescent experiences physical, mental, emotional, and social transformations.

Transition from a child to a young adult is accompanied by a teens’ desire to increase independence from parents as well as emerging concerns about body image. __teens are also more sensitive to peer influence and may face temptations to experiment with various substances.

For high-risk youth, especially those with a family history of substance use issues, the teenage years can be a pivotal time as unfortunately, this is the time when problem substance use typically begins.

Vulnerability likely stems from at least two changes that occur during adolescence: sensation-seeking and impulsivity.

Although there are rapid increases in sensation seeking during early- to mid-adolescence, gradual improvements in impulse control become evident only during later adolescence.

A new study, published in Alcoholism: Clinical and Experimental Research, examines how these processes develop in high-risk youths.

Researchers looked at 305 youths (153 girls, 152 boys) who were considered high-risk for behavioral problems due to having fathers with a history of alcohol- or other drug-use disorders.

Their trajectories of self-reported impulsivity and sensation seeking were compared with 81 youths (46 girls, 35 boys) with no family histories of substance-use disorders.

Researchers began assessments at ages 10-12, and continued the reviews for up to 42 months.

Also, a subset of 58 youths considered high risk who began using substances before age 15 were compared with 58 youths considered high risk who did not initiate substance use before age 15.

Investigators discovered high-risk youths had greater impulsivity, which may make them less able to regulate sensation-seeking drives that lead to problem alcohol and other drug use.

Additionally, high-risk youths who initiated early drug use also had greater increases in sensation seeking across adolescence than high-risk youths who were not drug users, which may contribute to more problem substance use.

In short, in youths with a family history of substance use disorders, the combination of greater impulsivity with adolescent sensation seeking may be an important underlying component of the risk associated with a family history of a substance use disorder.

In these individuals, early substance use, which further increases impulsivity, is an additional contributor to the risk of developing a substance-use disorder.

Source: Research Society on Alcoholism/ScienceDaily