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Thousands of Toddlers Are Medicated for A.D.H.D., Report Finds, Raising Worries

By ALAN SCHWARZ ATLANTA — More than 10,000 American toddlers 2 or 3 years old are being medicated for attention deficit hyperactivity disorder outside established pediatric guidelines, according to data presented on Friday by an official at the Centers for Disease Control and Prevention. The report, which found that toddlers covered by Medicaid are particularly prone to be put on medication such as Ritalin and Adderall, is among the first efforts to gauge the diagnosis of A.D.H.D. in children below age 4. Doctors at the Georgia Mental Health Forum at the Carter Center in Atlanta, where the data was presented, as well as several outside experts strongly criticized the use of medication in so many children that young. The American Academy of Pediatrics standard practice guidelines for A.D.H.D. do not even address the diagnosis in children 3 and younger — let alone the use of such stimulant medications, because their safety and effectiveness have barely been explored in that age group. “It’s absolutely shocking, and it shouldn’t be happening,” said Anita Zervigon-Hakes, a children’s mental health consultant to the Carter Center. “People are just feeling around in the dark. We obviously don’t have our act together for little children.” Dr. Lawrence H. Diller, a behavioral pediatrician in Walnut Creek, Calif., said in a telephone interview: “People prescribing to 2-year-olds are just winging it. It is outside the standard of care, and they should be subject to malpractice if something goes wrong with a kid.” Friday’s report was the latest to raise concerns about A.D.H.D. diagnoses and medications for American children beyond what many experts consider medically justified. Last year, a nationwide C.D.C. survey found that 11 percent of children ages 4 to 17 have received a diagnosis of the disorder, and that about one in five boys will get one during childhood. A vast majority are put on medications such as methylphenidate (commonly known as Ritalin) or amphetamines like Adderall, which often calm a child’s hyperactivity and impulsivity but also carry risks for growth suppression, insomnia and hallucinations. Only Adderall is approved by the Food and Drug Administration for children below age 6. However, because off-label use of methylphenidate in preschool children had produced some encouraging results, the most recent American Academy of Pediatrics guidelines authorized it in 4- and 5-year-olds — but only after formal training for parents and teachers to improve the child’s environment were unsuccessful. © 2014 The New York Times Company

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 4: Development of the Brain
Link ID: 19627 - Posted: 05.17.2014

Exercising the Mind to Treat Attention Deficits

By DANIEL GOLEMAN Which will it be — the berries or the chocolate dessert? Homework or the Xbox? Finish that memo, or roam Facebook? Such quotidian decisions test a mental ability called cognitive control, the capacity to maintain focus on an important choice while ignoring other impulses. Poor planning, wandering attention and trouble inhibiting impulses all signify lapses in cognitive control. Now a growing stream of research suggests that strengthening this mental muscle, usually with exercises in so-called mindfulness, may help children and adults cope with attention deficit hyperactivity disorder and its adult equivalent, attention deficit disorder. The studies come amid growing disenchantment with the first-line treatment for these conditions: drugs. In 2007, researchers at the University of California, Los Angeles, published a study finding that the incidence of A.D.H.D. among teenagers in Finland, along with difficulties in cognitive functioning and related emotional disorders like depression, were virtually identical to rates among teenagers in the United States. The real difference? Most adolescents with A.D.H.D. in the United States were taking medication; most in Finland were not. “It raises questions about using medication as a first line of treatment,” said Susan Smalley, a behavior geneticist at U.C.L.A. and the lead author. In a large study published last year in The Journal of the American Academy of Child & Adolescent Psychiatry, researchers reported that while most young people with A.D.H.D. benefit from medications in the first year, these effects generally wane by the third year, if not sooner. “There are no long-term, lasting benefits from taking A.D.H.D. medications,” said James M. Swanson, a psychologist at the University of California, Irvine, and an author of the study. “But mindfulness seems to be training the same areas of the brain that have reduced activity in A.D.H.D.” © 2014 The New York Times Company

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 17: Learning and Memory
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 13: Memory and Learning
Link ID: 19608 - Posted: 05.13.2014

Idea of New Attention Disorder Spurs Research, and Debate

By ALAN SCHWARZ With more than six million American children having received a diagnosis of attention deficit hyperactivity disorder, concern has been rising that the condition is being significantly misdiagnosed and overtreated with prescription medications. Yet now some powerful figures in mental health are claiming to have identified a new disorder that could vastly expand the ranks of young people treated for attention problems. Called sluggish cognitive tempo, the condition is said to be characterized by lethargy, daydreaming and slow mental processing. By some researchers’ estimates, it is present in perhaps two million children. Experts pushing for more research into sluggish cognitive tempo say it is gaining momentum toward recognition as a legitimate disorder — and, as such, a candidate for pharmacological treatment. Some of the condition’s researchers have helped Eli Lilly investigate how its flagship A.D.H.D. drug might treat it. The Journal of Abnormal Child Psychology devoted 136 pages of its January issue to papers describing the illness, with the lead paper claiming that the question of its existence “seems to be laid to rest as of this issue.” The psychologist Russell Barkley of the Medical University of South Carolina, for 30 years one of A.D.H.D.’s most influential and visible proponents, has claimed in research papers and lectures that sluggish cognitive tempo “has become the new attention disorder.” In an interview, Keith McBurnett, a professor of psychiatry at the University of California, San Francisco, and co-author of several papers on sluggish cognitive tempo, said: “When you start talking about things like daydreaming, mind-wandering, those types of behaviors, someone who has a son or daughter who does this excessively says, ‘I know about this from my own experience.’ They know what you’re talking about.” © 2014 The New York Times Company

Related chapters from BN: Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 14: Attention and Higher Cognition
Link ID: 19479 - Posted: 04.12.2014

ADHD treatment may be tied to obesity, study suggests

Linda Carroll TODAY contributor The stimulants used to treat ADHD might be making kids fat, a new study suggests. A study of more than 160,000 youngsters found that kids with Attention Deficit and Hyperactivity Disorder who received stimulants were at increased risk of becoming obese as they hit their teens. In contrast, kids with ADHD who took non-stimulant medications or got no therapy were very comparable, in terms of weight gain, to kids who didn’t have the disorder. “Our data suggest that stimulant use during childhood might have lifelong effects,” said Dr. Brian Schwartz, the study’s lead author and a professor of environmental health sciences, epidemiology, and medicine at the Johns Hopkins Bloomberg School of Public Health and senior investigator at the Geisinger Center for Health Research. “They might reset all sorts of physical properties and appetite parameters.” The new research may have uncovered a growing public health issue, Schwartz said. “Our data would seem to offer a lot of cause for concern with respect to prescribing stimulants,” he explained. Schwartz and his colleagues started the study because they were perplexed by the apparent paradox of hyperactive kids being prone to obesity. They scrutinized 12 years-worth of medical information from 163,820 Pennsylvania children, 13,427 of whom received an ADHD diagnosis.

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 19368 - Posted: 03.17.2014

Expand Pre-K, Not A.D.H.D.

By STEPHEN P. HINSHAW and RICHARD M. SCHEFFLER BERKELEY, Calif. — THE writing is on the chalkboard. Over the next few years, America can count on a major expansion of early childhood education. We embrace this trend, but as health policy researchers, we want to raise a major caveat: Unless we’re careful, today’s preschool bandwagon could lead straight to an epidemic of 4- and 5-year-olds wrongfully being told that they have attention deficit hyperactivity disorder. Introducing millions of 3- to 5-year-olds to classrooms and preacademic demands means that many more distracted kids will undoubtedly catch the attention of their teachers. Sure, many children this age are already in preschool, but making the movement universal and embedding transitional-K programs in public schools is bound to increase the pressure. We’re all for high standards, but danger lurks. The American Academy of Pediatrics now endorses the idea that the diagnosis of A.D.H.D. can and should begin at age 4, before problems accumulate. In fact, Adderall and other stimulants are approved for treatment of attentional issues in children as young as 3. Early intervention for children with A.D.H.D. could provide great relief. Children who go untreated have major difficulties in school and with their peers, and they have higher-than-normal rates of accidents and physical injuries. The problem is that millions of American children have been labeled with A.D.H.D. when they don’t truly have it. Our research has revealed a worrisome parallel between our nation’s increasing push for academic achievement and increased school accountability — and skyrocketing A.D.H.D. diagnoses, particularly for the nation’s poorest children. © 2014 The New York Times Company

Acetaminophen use in pregnancy linked to kids’ slightly higher risk of ADHD

by Nathan Seppa Women who take acetaminophen during pregnancy are more likely to have a child with attention-deficit/hyperactivity disorder than are women who don’t, according to an analysis of nearly 41,000 pairs of mothers and children in a Danish birth registry. Researchers found that more than half of the women, who gave birth between 1996 and 2002, had used the pain reliever during pregnancy. Calls to the women when the children were 7 years old revealed that children whose moms used any acetaminophen during pregnancy were 37 percent more apt to be diagnosed with ADHD or a related disorder than children whose moms didn’t use the drug. If the women used it in all three trimesters, the apparent risk for offspring was 61 percent higher than for children whose mothers didn’t use the drug. Out of nearly 41,000 children, fewer than 1,000 were diagnosed with ADHD and related disorders. The data establish an association and not cause and effect. But the researchers note that acetaminophen, also sold as Tylenol or Panadol, can cross the placental barrier and may affect hormones in a fetus. Citations Z. Liew et al. Acetaminophen use during pregnancy, behavioral problems, and hyperkinetic disorders. JAMA Pediatrics. Online February 24, 2014. doi:10.1001/jamapediatrics.2013.4914. © Society for Science & the Public 2000 - 2013.

Doctors Train to Spot Signs of A.D.H.D. in Children

By ALAN SCHWARZ Jerry, 9 years old, dissolved into his Game Boy while his father described his attentional difficulties to the family pediatrician. The child began flitting around the room distractedly, ignoring the doctor’s questions and squirming in his chair — but then he leapt up and yelled: “Freeze! What do you think is the problem here?” Nine-year-old Jerry was in fact being played by Dr. Peter Jensen, one of the nation’s most prominent child psychiatrists. On this Sunday in January in New York, Dr. Jensen was on a cross-country tour, teaching pediatricians and other medical providers how to properly evaluate children’s mental health issues — especially attention deficit hyperactivity disorder, which some doctors diagnose despite having little professional training. One in seven children in the United States — and almost 20 percent of all boys — receives a diagnosis of A.D.H.D. by the time they turn 18, according to the Centers for Disease Control and Prevention. It narrowly trails asthma as the most common long-term medical condition in children. Increasing concern about the handling of the disorder has raised questions about the training doctors receive before diagnosing the condition and prescribing stimulants like Adderall or Concerta, sometimes with little understanding of the risks. The medications can cause sleep problems, loss of appetite and, in rare cases, delusions. Because the disorder became a widespread national health concern only in the past few decades, many current pediatricians received little formal instruction on it, sometimes only several hours, during their seven years of medical school and residency. But the national scarcity of child psychiatrists has placed much of the burden for evaluating children’s behavioral problems on general pediatricians and family doctors, a reality that Dr. Jensen and others are trying to address through classes that emphasize role-playing exercises and spirited debate. © 2014 The New York Times Company

Kids With ADHD Can Train Their Brains

Kids with ADHD may be able to learn better focus through a computer game that trains the brain to pay attention, a new study suggests. The game was part of a neurofeedback system that used bicycle helmets wired to measure brain waves and gave immediate feedback when kids were paying attention, researchers reported Monday in Pediatrics. Giving kids feedback on what their brains are doing is "like turning on a light switch," said Dr. Naomi Steiner, the study's lead author and a developmental and behavioral pediatrician at the Floating Hospital for Children at Tufts Medical Center. "Kids said 'Oh, this is what people mean when they tell me to pay attention.'" To test the system, Steiner and her colleagues randomly assigned 104 Boston area elementary school children to one of three groups: no treatment, 40 half-hour sessions of neurofeedback or 40 sessions of cognitive therapy. The kids getting neurofeedback wore standard bicycle helmets fitted with brain wave sensors while they performed a variety of exercises on the computer. In one exercise, kids were told to focus on a cartoon dolphin. When people pay attention, theta wave activity goes down while beta waves increase, Steiner explained. If the kids' brains showed they were paying attention, the dolphin would dive to the bottom of the sea. Parents' reports on ADHD symptoms six months later showed a lasting improvement in kids who had done neurofeedback.

Medication: The smart-pill oversell

Katherine Sharpe Ben Harkless could not sit still. At home, the athletic ten-year-old preferred doing three activities at once: playing with his iPad, say, while watching television and rolling on an exercise ball. Sometimes he kicked the walls; other times, he literally bounced off them. School was another story, however. Ben sat in class most days with his head down on his desk, “a defeated heap”, remembers his mother, Suzanne Harkless, a social worker in Berkeley, California. His grades were poor, and his teacher was at a loss for what to do. Harkless took Ben to a therapist who diagnosed him with attention deficit hyperactivity disorder (ADHD). He was prescribed methylphenidate, a stimulant used to improve focus in people with the condition. Harkless was reluctant to medicate her child, so she gave him a dose on a morning when she could visit the school to observe. “He didn't whip through his work, but he finished his work,” she says. “And then he went on and helped his classmate next to him. My jaw dropped.” ADHD diagnoses are rising rapidly around the world and especially in the United States, where 11% of children aged between 4 and 17 years old have been diagnosed with the disorder. Between half and two-thirds of those are put on medication, a decision often influenced by a child's difficulties at school. And there are numerous reports of adolescents and young adults without ADHD using the drugs as study aids. © 2014 Nature Publishing Group,

ADHD: About 1 in 20 adults may have a disorder usually associated with grade school

By Suzanne Allard Levingston, Chris Ecarius had so much difficulty filling out his Social Security application online that the 62-year-old went to a doctor to find out why his brain didn’t seem to work properly. Over the years, he’d seen other doctors about similar struggles. He’d been told that he was depressed, but he didn’t feel depressed. This time, Ecarius got a different diagnosis: attention deficit hyperactivity disorder, a conclusion that seemed more appropriate for a child in grade school than an adult in retirement. When Ecarius, who lives in Houghton Lake, Mich., was young, he had trouble paying attention. He’d dropped out of school and left several jobs, had several traffic accidents and had never quite gotten on track. “I could have been a doctor,” he said. “I could have been a pharmacist, I could have been anything I wanted to be,” had someone diagnosed his ADHD when he was a child. With the help of his wife, Ecarius was able to settle into a skilled trade job with General Motors, a position he held until age 58, when, he says, he became overwhelmed by the computers at work. Ecarius is not alone. While ADHD — a condition marked by inattention, hyperactivity and impulsivity — is one of the most common brain disorders in children, it also occurs in approximately one in 20 adults, according to a 2006 study. A 2012 study based on interviews with almost 1,500 people by researchers in the Netherlands found that 2.8 percent of adults older than 60 have ADHD, with 4.2 percent of people in that age group reporting several ADHD symptoms and some impairment. But just being forgetful or scatterbrained doesn’t mean you have ADHD. Of course, many people, especially those older than 60, have these problems, but they could be a sign of something else — or nothing at all. © 1996-2013 The Washington Post

Related chapters from BN: Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 14: Attention and Higher Cognition
Link ID: 19042 - Posted: 12.17.2013

The Selling of Attention Deficit Disorder

By ALAN SCHWARZ After more than 50 years leading the fight to legitimize attention deficit hyperactivity disorder, Keith Conners could be celebrating. Severely hyperactive and impulsive children, once shunned as bad seeds, are now recognized as having a real neurological problem. Doctors and parents have largely accepted drugs like Adderall and Concerta to temper the traits of classic A.D.H.D., helping youngsters succeed in school and beyond. But Dr. Conners did not feel triumphant this fall as he addressed a group of fellow A.D.H.D. specialists in Washington. He noted that recent data from the Centers for Disease Control and Prevention show that the diagnosis had been made in 15 percent of high school-age children, and that the number of children on medication for the disorder had soared to 3.5 million from 600,000 in 1990. He questioned the rising rates of diagnosis and called them “a national disaster of dangerous proportions.” “The numbers make it look like an epidemic. Well, it’s not. It’s preposterous,” Dr. Conners, a psychologist and professor emeritus at Duke University, said in a subsequent interview. “This is a concoction to justify the giving out of medication at unprecedented and unjustifiable levels.” The rise of A.D.H.D. diagnoses and prescriptions for stimulants over the years coincided with a remarkably successful two-decade campaign by pharmaceutical companies to publicize the syndrome and promote the pills to doctors, educators and parents. With the children’s market booming, the industry is now employing similar marketing techniques as it focuses on adult A.D.H.D., which could become even more profitable. Few dispute that classic A.D.H.D., historically estimated to affect 5 percent of children, is a legitimate disability that impedes success at school, work and personal life. Medication often assuages the severe impulsiveness and inability to concentrate, allowing a person’s underlying drive and intelligence to emerge. © 2013 The New York Times Company

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 3: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19039 - Posted: 12.16.2013

Premature baby steroids 'may raise risk of ADHD'

By James Gallagher Health and science reporter, BBC News Steroids given to help premature babies develop may also be slightly increasing the risk of mental health disorders, say researchers. The drugs are often given to pregnant mothers at risk of a premature birth to help the baby's lungs prepare for life outside the womb. The study, in the journal PLoS One, showed there was a higher risk of attention disorders at age eight. The charity Bliss said it reinforced the need for regular health checks. Being born too soon can lead to long-term health problems and the earlier the birth the greater the problems. One immediate issue is the baby's lungs being unprepared to breathe air. Steroids can help accelerate lung development. However, the study by researchers at Imperial College London and the University of Oulu in Finland showed the drugs may also be affecting the developing brain. They compared what happened to 37 premature children whose mother was injected with steroids with 185 premature children, of the same weight and gestational age, who were not exposed to the extra dose of steroid. When the children were followed to the age of eight, there was a higher incidence of attention deficit hyperactivity disorder. No difference could be detected at age 16, but this may have been due to the small size of the study. BBC © 2013

Common Insecticides May Be Linked to Kids' Behavior Problems

By Lindsey Konkel and Environmental Health News Insecticides commonly used in households may be associated with behavior problems in children, according to a new study by researchers in Quebec. The study is one of the first to investigate potential human health effects of pyrethroids, which are used in more than 3,500 commercial products, including flea bombs and roach sprays. The findings raise some questions about the safety of the compounds, which have replaced other insecticides with known risks to children’s brain development. Exposure to pyrethroids, which kill insects by interfering with their nervous systems, is widespread because they are used inside homes and schools, in municipal mosquito control and on farms. In the study, the urine of 779 Canadian children between the ages of 6 and 11 was tested, and their parents answered questions about each child’s behavior. Ninety-seven percent of the children had traces of pyrethroid breakdown products in their urine, and 91 percent had traces of organophosphates, another class of pesticides. A 10-fold increase in urinary levels of one pyrethroid breakdown product, cis-DCCA, was associated with a doubling in the odds of a child scoring high for parent-reported behavioral problems, such as inattention and hyperactivity. Another breakdown product, trans-DCCA, was also associated with more behavior problems, although the association was not statistically significant, meaning the finding could be due to chance. The breakdown product, trans- and cis-DCCA, is specific to certain pyrethroids – namely permethrin, cypermethrin and cyfluthrin. © 2013 Scientific American

Despite years of ADHD research, diagnosis remains tricky and treatment, more so

By Amanda Mascarelli, When my son was in preschool, I did what many parents of excessively energetic and impulsive preschoolers have surely done: I worried whether his behavior might be a sign of attention-deficit hyperactivity disorder (ADHD). Then I sought input from two pediatricians and a family therapist. The experts thought that his behavior was developmentally normal but said it was still too early to tell for sure. They offered some tips on managing his behavior and creating more structure at home. One pediatrician worked with my son on self-calming techniques such as breathing deeply and pushing on pressure points in his hands. He also suggested an herbal supplement, Valerian Super Calm, for him to take with meals and advised us on dietary adjustments such as increasing my son’s intake of fatty acids. Studies have shown that a combination of omega-3 (found in foods such as walnuts, flaxseed and salmon) and omega-6 fatty acids (from food oils such as canola and flax) can reduce hyperactivity and other ADHD symptoms in some children. In the couple of years since trying these techniques, my son has outgrown most of those worrisome behaviors. I had just about written off the possibility of ADHD until a few weeks ago, when his kindergarten teacher mentioned that she was going to keep an eye on him for possible attention issues. Hearing that left me worried and heavy-hearted. Why is it still so hard to diagnose ADHD? And why is there so much emotional baggage associated with treating it? There are no firm numbers for the number of children with ADHD in the United States. The Centers for Disease Control and Prevention estimates that 9 percent of U.S. children ages 5 to 17 had received diagnoses of ADHD as of 2009. © 1996-2013 The Washington Post

Extra gene makes mice manic

Amanda Mascarelli Duplication of a single gene — and too much of the corresponding protein in brain cells — causes mice to have seizures and display manic-like behaviour, a study has found. But a widely used drug reversed the symptoms, suggesting that it could also help some people with hyperactivity who do not respond to common treatments. Smooth functioning at the synapses, the junctions between brain cells, is crucial to functions that control everything from social etiquette to everyday decision-making. It is increasingly thought that some neuropsychiatric disorders are caused by function of the synapses going awry1, and indeed researchers have found that neuropsychiatric conditions such as schizophrenia and autism can sometimes be traced to missing, mutated or duplicated copies of SHANK32, a gene that encodes one of the 'architectural' proteins that help to ensure that messages are relayed properly between cells. Some people with attention deficit hyperactivity disorder (ADHD), Asperger's syndrome or schizophrenia have an extra copy of a wider region of DNA that contains SHANK33. To explore the role of SHANK3, Huda Zoghbi, a neurogeneticist at Baylor College of Medicine in Houston, Texas, and her colleagues created mice with duplicate copies of the gene. “The mouse was remarkably hyperactive, running around like mad,” says Zoghbi. But the animals did not respond to stimulant medications typically used to treat ADHD. Instead, their hyperactivity grew much worse. “That’s when we knew this was not typical ADHD,” says Zoghbi. The study is published today in Nature4. © 2013 Nature Publishing Group

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 14: Attention and Higher Cognition
Link ID: 18829 - Posted: 10.24.2013

The Not-So-Hidden Cause Behind the A.D.H.D. Epidemic

By MAGGIE KOERTH-BAKER Between the fall of 2011 and the spring of 2012, people across the United States suddenly found themselves unable to get their hands on A.D.H.D. medication. Low-dose generics were particularly in short supply. There were several factors contributing to the shortage, but the main cause was that supply was suddenly being outpaced by demand. The number of diagnoses of Attention Deficit Hyperactivity Disorder has ballooned over the past few decades. Before the early 1990s, fewer than 5 percent of school-age kids were thought to have A.D.H.D. Earlier this year, data from the Centers for Disease Control and Prevention showed that 11 percent of children ages 4 to 17 had at some point received the diagnosis — and that doesn’t even include first-time diagnoses in adults. (Full disclosure: I’m one of them.) That amounts to millions of extra people receiving regular doses of stimulant drugs to keep neurological symptoms in check. For a lot of us, the diagnosis and subsequent treatments — both behavioral and pharmaceutical — have proved helpful. But still: Where did we all come from? Were that many Americans always pathologically hyperactive and unable to focus, and only now are getting the treatment they need? Probably not. Of the 6.4 million kids who have been given diagnoses of A.D.H.D., a large percentage are unlikely to have any kind of physiological difference that would make them more distractible than the average non-A.D.H.D. kid. It’s also doubtful that biological or environmental changes are making physiological differences more prevalent. Instead, the rapid increase in people with A.D.H.D. probably has more to do with sociological factors — changes in the way we school our children, in the way we interact with doctors and in what we expect from our kids. © 2013 The New York Times Company

Forget the meds and special schools: The best cure for my son’s learning issues is time off

By Rebecca Lanning, Everywhere I went, people asked me about my son Will. They knew he’d graduated from high school, and they wanted to know what he was doing. Smiling politely, I told them that Will had been accepted to his first-choice college. But, I always added — in case someone saw him around town — that he had deferred enrollment. He was taking a gap year, I’d say. “So what’s your son doing with his windfall of free time? Traveling abroad? Doing research?” My cheeks burned as I played along, offering sound bites. A start-up venture. A film project. Independent study. Anything to avoid the truth: that my handsome, broad-shouldered son was, probably, at that very moment, home in bed with the shutters drawn, covers pulled over his head. Officially, Will was taking a gap year. But after 13 years of school, what he needed, what he’d earned, was a nap year. Will has long suffered from learning difficulties. It took years to pinpoint a diagnosis — and even when we did, figuring out how to manage it wasn’t easy. He needed a break. So did I. Will’s problems began to surface when he was in kindergarten. “He’s not where the other children are,” his teacher whispered to me one morning. I knew what she meant. Clumsy and slow to read, Will rested his head on his desk a lot. His written work, smudgy from excessive erasing, looked like bits of crumpled trash. School was torture for Will. He couldn’t take notes, failed to turn in homework, forgot when tests were coming up. Yet on standardized tests, his verbal scores consistently exceeded the 99th percentile. I wondered why he struggled, when clearly he was bright. © 1996-2013 The Washington Post

Inner ear disorders 'linked to hyperactivity '

Inner-ear problems could be a cause of hyperactive behaviour, research suggests. A study on mice, published in Science, said such problems caused changes in the brain that led to hyperactivity. It could lead to the development of new targets for behaviour disorder treatments, the US team says. A UK expert said the study's findings were "intriguing" and should be investigated further. Behavioural problems such as ADHD are usually thought to originate in the brain. But scientists have observed that children and teenagers with inner-ear disorders - especially those that affect hearing and balance - often have behavioural problems. However, no causal link has been found. The researchers in this study suggest inner-ear disorders lead to problems in the brain which then also affect behaviour. The team from the Albert Einstein College of Medicine of Yeshiva University in New York noticed some mice in the lab were particularly active - constantly chasing their tails. They were found to be profoundly deaf and have disorders of the inner ear - of both the cochlea, which is responsible for hearing, and the vestibular system, which is responsible for balance. The researchers found a mutation in the Slc12a2 gene, also found in humans. Blocking the gene's activity in the inner ears of healthy mice caused them to become increasingly active. BBC © 2013

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 9: Hearing, Balance, Taste, and Smell
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 6: Hearing, Balance, Taste, and Smell
Link ID: 18613 - Posted: 09.07.2013

The "Right" Treatment for ADHD: Revealed

Posted by Dr. Sushrut Jangi The child's family and physician were making decisions about how to treat this disease. Many readers voted that starting an ADHD medication and behavioral therapy together might be a good way forward. Her doctor agrees with this approach. "A lot of judgement happens the day I talk about starting medicines for young children," Dr. Chan says. Most parents have already tried numerous other routes, such as behavioral therapy which is frequently recommended first. But behavioral therapy alone is hard to implement. "It's hard to access and there's not too many families who can actually carry it out," Chan says. "If you're a single parent working multiple jobs, its really hard to fit the time to take your child regularly. It's a huge time investment." J's parents tried the behavioral therapy route and they worked hard at it. But he wasn't improving. Dr. Chan is more than familiar with the culture of fear that surrounds ADHD medications, but she feels these fears are overinflated. Consequently, children who might benefit from being on medicine get delayed treatments, which can have harmful social effects. "Children in his class already know that he's different, so they react to him differently. Children with ADHD start getting negative feedback from their peers early on." Dr. Chan feels that this is one potential justification for starting medications early. "These medicines can help children get out of cycles of negative-feedback. And we're not condemning children to medicine for the rest of their lives. They can be started as a trial, and then stopped down the line." © 2013 NY Times Co.

Addictive gaming more common with autism and ADHD

Andrew M. Seaman, Reuters Children with an autism spectrum disorder spend about twice as much time playing video games as kids who don't have a developmental disability, according to a new study. Researchers also found that children with an autism spectrum disorder or attention deficit/hyperactivity disorder (ADHD) are at an increased risk of gaming addictions, compared to children without the disabilities. "What we found is that it looks like (addictive gaming) was largely driven by inattention," Christopher Engelhardt, one of the study's authors from the University of Missouri in Columbia, told Reuters Health. Previous studies have found that children with an autism spectrum disorder or ADHD spend more time playing video games and are at increased risk for gaming addictions than other children, write the researchers in the journal Pediatrics. No single study, however, has looked at the three groups to see whether shared features of autism and ADHD - such as inattention or hyperactivity - seem to drive video game use. For the new study, Engelhardt and his colleague surveyed the parents of 141 boys between the ages of 8 and 18 years old. Of those, 56 had an autism spectrum disorder, 44 had ADHD and 41 were developing normally. Overall, they found that kids with an autism spectrum disorder played - on average - 2.1 hours of video games per day. Children with ADHD spent about 1.7 hours per day playing video games and normally developing kids played about 1.2 hours per day.

Related chapters from BN: Chapter 17: Learning and Memory; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 13: Memory and Learning; Chapter 3: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 18442 - Posted: 08.01.2013

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