BC Speech Language Communication Blog

Scientists Find Age-Related Changes in How Autism Affects the Brain

In the study, titled “Developmental Meta-Analysis of the Functional Neural Correlates of Autism Spectrum Disorders,” Daniel Dickstein, M.D., FAAP, director of the Pediatric Mood, Imaging and Neurodevelopment Program at Bradley Hospital, found that autism-related changes in brain activity continue into adulthood.

“Our study was innovative because we used a new technique to directly compare the brain activity in children with autism versus adults with autism,” said Dickstein. “We found that brain activity changes associated with autism do not just happen in childhood, and then stop. Instead, our study suggests that they continue to develop, as we found brain activity differences in children with autism compared to adults with autism. This is the first study to show that.”

This new technique, a meta-analysis, which is a study that compiles pre-existing studies, provided researchers with a powerful way to look at potential differences between children and adults with autism.

Dickstein conducted the research through Bradley Hospital’s PediMIND Program. Started in 2007, this program seeks to identify biological and behavioral markers — scans and tests — that will ultimately improve how children and adolescents are diagnosed and treated for psychiatric conditions. Using special computer games and brain scans, including magnetic resonance imaging (MRI), Dickstein hopes to one day make the diagnosis and treatment of autism and other disorders more specific and more effective.
Among autism’s most disabling symptoms is a disruption in social skills, so it is noteworthy that this study found significantly less brain activity in autistic children than autistic adults during social tasks, such as looking at faces. This was true in brain regions including the right hippocampus and superior temporal gyrus — two brain regions associated with memory and other functions.

Dickstein noted, “Brain changes in the hippocampus in children with autism have been found in studies using other types of brain scan, suggesting that this might be an important target for brain-based treatments, including both therapy and medication that might improve how this brain area works.”

Rowland Barrett, Ph.D., chief psychologist at Bradley Hospital and chief-of-service for The Center for Autism and Developmental Disabilities was also part of the team leading the study.

“Autism spectrum disorders, including autistic disorder, Asperger’s disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS), are among the most common and impairing psychiatric conditions affecting children and adolescents today,” said Barrett. “If we can identify the shift in the parts of the brain that autism affects as we age, then we can better target treatments for patients with ASD.”

The above story is reprinted from materials provided by Lifespan, via EurekAlert!, a service of AAAS.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal Reference:
Daniel P. Dickstein, Matthew F. Pescosolido, Brooke L. Reidy, Thania Galvan, Kerri L. Kim, Karen E. Seymour, Angela R. Laird, Adriana Di Martino, Rowland P. Barrett. Developmental Meta-Analysis of the Functional Neural Correlates of Autism Spectrum Disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 2013; 52 (3): 279 DOI: 10.1016/j.jaac.2012.12.012

Why Girls May Be Protected Against Autism

Author: Maia Szalavitz

Boys outnumber girls when it comes to autism diagnoses, and researchers may have uncovered one reason why.

Boys are four times more likely to be diagnosed with autism than girls, but whether that trend is rooted in biological differences between the genders or the fact that girls might simply hide their symptoms better, hasn’t been clear.

The gender-based difference could be due to factors that increase the risk among boys, or, alternatively, factors that protect girls. Researchers led by Elise Robinson of Harvard Medical School decided to investigate the latter, and determine whether there might be something about being female that protected girls from the the developmental disorder. The team analyzed data from two large samples of twins, one from Sweden and the other from the U.K. They theorized that if something were protecting girls from autism spectrum disorders (ASDs), then families of girls who actually did develop them should have a greater than average risk, and that risk would overwhelm whatever protection they received from their gender. In other words, girls would have a higher threshold for developing ASDs — they would have to be faced with a heavier burden of whatever genetic or environmental risk factors cause ASD in order to actually develop it.

Such family-based risk can be measured by studying levels autistic symptoms in unaffected siblings: in families at high risk of developmental and psychiatric disorders, even unaffected members tend to have mild symptoms, but not enough to qualify for a diagnosis.

“If greater familial [risk] is required to produce autistic impairments in girls, the family members of affected females should on average carry greater risk than the family members of affected males,” the authors write. Because identical twins share the same genetics, they studied fraternal twins only, comparing sets in which only one had an autism spectrum disorder. Nearly 4,000 British twins and just over 6,000 Swedish twins were included in the research, which was published in the Proceedings of the National Academy of Sciences.

The study found that if a girl scored in the top 10% on autistic traits, the odds of her twin scoring in a similarly high range were 37% greater than those for a boy. That meant the girls came from families with significantly greater risk levels. Because the study looked at autistic traits in a sample from the general population, rather than from those who sought treatment, the results do not simply reflect the fact that girls are less likely to be diagnosed, even if they have the condition.

“It is a really interesting and generally well-done study,” says Marjorie Solomon, associate professor of clinical psychiatry at the University of California Davis MIND Institute, who was not associated with the research. She adds, “The differences in gender ratio in ASD have been a source of great curiosity, given their many implications.”

The study was only designed to test the theory that families of girls with ASDs might have higher than risk of the disorders, and was not structured to test for exactly what it is that seems to protect girls. But that knowledge could lead to potentially better treatment options for both genders. Based on earlier research, experts see genes, rather than social or environmental factors, as the most likely explanation for lower risk among girls.

What might some of those genetic factors be? It’s possible that they may involve the social bonding hormones, oxytocin and vasopressin. “The basic thought is that girls have less vasopressin and higher natural oxytocin,” says Solomon, “And oxytocin is a social hormone, so that would be protective.” The lower levels of vasopressin might also be helpful: while this hormone is thought to be involved in social connections—particularly for boys, who tend to have higher levels — in animals it is also linked to aggressive defense of territory and mates.

Or it may involve other metabolic systems that aren’t as obviously connected to social development. Either way, the findings raise interesting questions about how developmental disorders like ASDs are seeded, and open up intriguing new possibilities for treating them. “An understanding of the biology underlying female advantage could greatly aid progress in understanding,” autism and “in identifying prevention factors for ASDs,” the researchers write.

About the Author: Maia Szalavitz is a neuroscience journalist for TIME.com and co-author of Born for Love: Why Empathy Is Essential — and Endangered.

Szalavitz’s latest book is Born for Love: Why Empathy Is Essential — and Endangered. It is co-written with Dr. Bruce Perry, a leading expert in the neuroscience of child trauma and recovery.

Read more: http://healthland.time.com/2013/02/22/why-girls-may-be-protected-against-autism/#ixzz2M19twjDS

Can Breakfast Make Kids Smarter?

Feb. 5, 2013 — New research from the University of Pennsylvania School of Nursing has found that children who regularly have breakfast on a near-daily basis had significantly higher full scale, verbal, and performance IQ test scores.

In one of the first studies to examine IQ and breakfast consumption, researchers examined data from 1,269 children six years old in China, where breakfast is highly valued, and concluded that children who did not eat breakfast regularly had 5.58 points lower verbal, 2.50 points lower performance, and 4.6 points lower total IQ scores than children who often or always ate breakfast after adjusting for seven sociodemographic confounders.

“Childhood is a critical period in which dietary and lifestyle patterns are initiated, and these habits can have important immediate and long-term implications,” said lead author Jianghong-Liu, PhD, RN, FAAN, associate professor at Penn Nursing. “Breakfast habits appear to be no exception, and irregular breakfast eating has already been associated with a number of unhealthy behaviors, such as smoking, frequent alcohol use, and infrequent exercise.”

At age 6, a child’s cognitive ability as both the verbal and performance levels is rapidly developing. Both the nutritional and social aspects of breakfast play a role. After a whole night of fasting, breakfast serves as a means to supply “fuel” to the brain. Meanwhile, social interaction at breakfast time with parents may promote brain development. Mealtime discussions may facilitate cognitive development by offering children the opportunity to expand their vocabulary, practice synthesizing and comprehending stories, and acquire general knowledge, noted the authors.

The researchers suggest that schools play a role in stressing the importance of eating breakfast by delaying start times and/or providing breakfast to allow students to profit from the cognitive benefits of eating before a morning curriculum.

“Because adequate nutrition in early childhood has been linked to increased IQ through childhood, which is related to decreased childhood behavioral disorders, better career satisfaction, and socioeconomic success in adults, breakfast consumption could ultimately benefit long-term physical and mental health outcomes as well a quality of life,” said Dr. Liu. “These findings may reflect nutritional as well as social benefits of breakfast consumption on children and hold important public health implications regarding regular breakfast consumption in early young children.

This study was based on data collected from the China Jintan Child Cohort Study, led by Dr. Liu, an on-going prospective longitudinal study with the main aim of assessing the early health risk factors for the development of child neurobehavioral outcomes. The study was funded by the National Institute of Environmental Health Sciences.

The above story is reprinted from materials provided by University of Pennsylvania School of Nursing.

The University of Pennsylvania School of Nursing is one of the premier research institutions in nursing, producing new knowledge in geriatrics, pediatrics, oncology, quality-of-life choices, and other areas. Researchers here consistently receive more research funding from the National Institutes of Health than any other private nursing school, and many Master’s programs are ranked first in the country.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Using Whole Body Listening to Increase Executive Functioning Skills

Written by: Elizabeth Sautter, MA, CCC-SLP & Sarah Ward, MS, CCC-SLP

How many times have we, as parents and teachers, said to our children, “Pay attention!” or asked “Why aren’t you listening to me?” in a not-so-nice tone of voice. We give our children many directives, “Clean up the bathroom!”, “Get your backpack!”, “Put your homework in your bag!”, “It’s bedtime! Go get ready!” or “Don’t forget your …”. We assume our children know what we mean by those words and what to do. When they don’t respond, it can be incredibly frustrating.

When we say “Pay attention!” or “Put your homework in your bag!” we are not simply asking the child to do the explicit task but rather we are expecting them to use situational awareness to observe what is happening around them, ‘create a mental image’ of what the situation should look like in the future and finally compare the two images to understand the ‘why’ of the required action of the moment.

So when we said, “Pay attention!” we really meant:

[Situational Awareness]‘Please observe that right now all your friends in the cub scout troop are attending to our guest speaker’s lesson on how to tie knots and you need to listen to his words, watch his demonstration and respect your friends who are listening’ so that

[Memory for the Future] ‘when you go back to the work tables you will know how to tie the knots on your own and can use this skill for the upcoming pack trip’.

“Put your homework in your bag!” really meant:

[Situational Awareness] ‘Please notice that the assignment that you just spent the last 35 minutes working on and printed out, is still on the printer tray and the required notecards you made for the research are still on the table.’ so that

[Memory for the Future] ‘when you get into class tomorrow and Mrs. Smith asks for the notecards and the rough draft of your research paper you have it and do not lose points for not turning it in on time.’

In school, when children struggle to pay attention, they are thought of as “lazy”, “non-compliant” or having a “behavioral problem.” We expect children to learn how to focus, listen, and follow directions intuitively, using their “built in” social and self regulation skills. However, not all children acquire these skills automatically and it is our job to teach them.

When we think of a student who has difficulties with executive function we think of that child being disorganized. Executive functioning has become a real buzz word in schools and it’s important to know what is really causing that disorganization. Self regulation (self control) is the foundation of executive functioning and essential for listening and task execution. World renowned expert on attention deficit disorder, Dr. Russell Barkley, defines self regulation as an aspect of executive function skills involving three key components: 1) any action that allows the student to stop and direct themselves so as to 2) result in a change in their behavior in order to 3) change the likelihood of a future consequence or attainment of a goal.

So when we ask a student to listen and follow directions for task execution we are really asking them to momentarily stop (inhibit) their own actions and thoughts to consider the what, where and when of the desired future as well as why it is important. We are asking them to stop, listen, ‘read’ the situation and see/feel the future. This can be very difficult for children to learn and adults to teach.

In 1990, Susanne Poulette Truesdale created the concept of whole body listening which she describes in her article, “Whole-¬Body Listening: Developing Active Auditory Skills” (Language, Speech, and Hearing in Schools, Volume 21, 183-¬?184, July 1990). A forward thinker, she astutely recognized that while we provide practice in listening, “do we teach students how to listen?” She noted that it entails more than hearing with our ears, “we also listen with our brain, eyes, mouth, hands, feet and even your seat!” Nita Everly, author of Can You Listen with Your Eyes, tailored the whole body listening concept to the preschool population and added the “heart” to the list of body parts that are needed to increase empathy and perspective taking.

Inspired by Truesdale and Everly, Elizabeth Sautter and Kristen Wilson created the character Whole Body Listening Larry and two children’s books (Whole Body Listening Larry at Home and Whole Body Listening Larry at School, 2011). Larry inspires preschool and early elementary school students to use their:

• eyes to look at the person talking

• ears to hear what is being said

• mouth by remaining quiet

• hands by keeping them by their side or in lap

• feet by placing them on the floor and keeping them still

• body by facing the speaker or sitting in chair

• brain to think about what the speaker is saying

• heart to care about what the speaker talks about

Larry also teaches children to increase their perspective taking skills by thinking about why these skills are important and how their behavior changes the thoughts and feelings of others.

To reduce frustration when asking students to listen and execute a direction, it is helpful to provide strategies such as whole body listening and creating a future image of what the end goal should look like.

Listening skills are foundational executive and self-regulation skills for children to posses in order to be successful in both academics and social situations. If students are able to attend and listen, they are more available to absorb academic and social content and be successful in managing tasks and social situations. Whole body listening is a concept to support this fundamental skill, as well as a powerful means to increase their executive function skills.

Note from Authors: To learn more about developing independent executive function skills, mark your calendars and attend Sarah Ward’s upcoming conference in the Bay Area on March 2nd and March 3rd. For more information and to register, click here.

Also, help us document Larry’s travels and support his mission of teaching children how to listen with their whole body. We are tracking Who’s Listening to Larry Now? by posting testimonials, stories, or activities to share on his Facebook page: http://www.facebook.com/WholeBodyListeningLarry . Once we hear from you, we will pin your location on our Who’s Listening to Larry Now? map located at his home at Communication Works in Oakland, CA. Join the fun, we look forward to hearing from you!

Elizabeth Sautter is the co-director/owner of Communication Works. She is a licensed and certified speech-language pathologist who has? been working with clients and their families since 1996. She is experienced in the areas of autism, developmental disabilities, social cognitive deficits, and challenging behaviors. Elizabeth has worked with individuals ranging from preschoolers to adults in private practice, schools, and hospitals.

Sarah Ward is the Co-Director of Cognitive Connections and has over 15 years of experience in diagnostic evaluations, treatment and case management of children, adolescents and adults with a wide range of developmental and acquired brain based learning difficulties and behavioral problems.

For more information, visit www.cwtherapy.com and www.cognitiveconnectionstherapy.com

Children’s Complex Thinking Skills Begin Before Going to School

This story is reprinted from materials provided by University of Chicago.

Jan. 23, 2013 — New research at the University of Chicago and the University of North Carolina at Chapel Hill shows that children begin to show signs of higher-level thinking skills as young as age 4 ½. Researchers have previously attributed higher-order thinking development to knowledge acquisition and better schooling, but the new longitudinal study shows that other skills, not always connected with knowledge, play a role in the ability of children to reason analytically.

The findings, reported in January in the journal Psychological Science, show for the first time that children’s executive function has a role in the development of complicated analytical thinking. Executive function includes such complex skills as planning, monitoring, task switching, and controlling attention. High, early executive function skills at school entry are related to higher than average reasoning skills in adolescence.

Growing research suggests that executive function may be trainable through pathways, including preschool curriculum, exercise and impulse control training. Parents and teachers may be able to help encourage development of executive function by having youngsters help plan activities, learn to stop, think, and then take action, or engage in pretend play, said lead author of the study, Lindsey Richland, assistant professor in comparative human development at the University of Chicago.

Although important to a child’s education, “little is known about the cognitive mechanisms underlying children’s development of the capacity to engage in complex forms of reasoning,” Richland said.

The new research is reported in the paper “Early Executive Function Predicts Reasoning Development” and follows the development of complex reasoning in children from before the time they go to school until they are 15. Richland’s co-author is Margaret Burchinal, senior scientist at the Frank Porter Graham Child Development Institute at the University of North Carolina at Chapel Hill.

The two studied the acquisition of analogical thinking, one form of complex reasoning. “The ability to see relationships and similarities between disparate phenomena is fundamental to analytical and inductive reasoning, and is closely related to measurements of general fluid intelligence,” said Richland. Developing complex reasoning ability is particularly fundamental to the innovation and adaptive thinking skills necessary for a modern workforce, she pointed out.

Richland and Burchinal studied a database of 1,364 children who were part of the Early Child Care and Youth Development study from birth through age 15. The group was fairly evenly divided between boys and girls and included families from a diverse cross-section of ethnic and income backgrounds.

The current study examined tests children took when they were 4 ½, when they were in first grade, third grade, and when they were 15. Because the study was longitudinal, the same children were tested at each interval. Among the tests they took were ones to measure analytical reasoning, executive function, vocabulary knowledge, short-term memory and sustained attention.

Children were tested at 4 ½ on their ability to monitor and control their automatic responses to stimuli. In first grade they worked on a test that judged their ability to move objects in a “Tower of Hanoi” game, in which they had to move disks between pegs in a specific order.

In third grade and at 15 year olds, they were tested on their ability to understand analogies, asked in third grade for instance to complete the question “dog is to puppy as cat is to__?” At 15 year olds, they were asked to complete written tests of analogies.

The study found a strong relationship between high scores among children who, as preschoolers, had strong vocabularies and were good at monitoring and controlling their responses to later ability on tests of understanding analogies.

“Overall, these results show that knowledge is necessary for using thinking skills, as shown by the importance of early vocabulary, but also inhibitory control and executive function skills are important contributors to children’s analytical reasoning development,” Richland said.

The National Academy of Education/Spencer Foundation, the Office of Naval Research and the National Science Foundation supported the research.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Five Tips for Building Resiliency in Students with Special Education Needs

Author: Crawford Dedman
Special Education Consultant

www.challengingminds.com

As we venture into the second half of the school year, I have been thinking a lot about the topic of resiliency in students. Resiliency can be defined as the ability to persist in the face of adversity or the ability to bounce back after facing a challenging situation. Helping students develop resiliency skills and attitudes has a positive effect on academic achievement, behavior, and long-term success in life. Often students with special education needs are labeled with such terms as “at-risk” or “high-risk” for academic failure or inappropriate behavior.

Here are some tips to help students with special education needs become resilient:

1. Model a positive attitude. Both parents and teachers need to model positive attitudes and emotions. Students need to hear their parents thinking out loud positively and being determined to persist until a goal is achieved. Using a positive approach to solving problems teaches students a sense of power and promise.

2. Avoid using negative labels, such as “high-risk” or “at-risk.” Switch the focus to high-risk environments or situations that present challenging conditions. Students with special education needs often are told what their deficits are. Instead they need to be reminded that they are capable of achieving great things if they are given the right support.

3. Provide them with examples of role models with exceptionalities that they can learn from. These students need to understand and believe that they can succeed. They need to hear stories and experiences from role models with similar challenges, in order to reinforce the message that they can also reach their goals.

4. View students not as problems to be fixed but as individuals with strengths, dreams, and opinions. Traditionally schools have been places where the focus has been on identification and remediation of their deficits. Schools do need to know where students are struggling and work towards improving their learning. However, need to leverage their strengths, interests and abilities for them to thrive and overcome adverse situations.

5. Students must be actively involved in the life of the school and in their own learning. Resiliency isn’t developed being passive. Students need to connect to the people, the content, and the overall learning environment in order to thrive. This can be a very difficult task for many exceptional students that have challenges with social and communication skills. Use the student’s Individual Education Plan (IEP) to identify goals and strategies to improve these areas and help the student better connect with peers at school with similar interests.

We cannot protect our children and students against all of life’s ups and downs. However, what we can give them is a feeling of competency and the skills to face challenging circumstances. The more we practice these approaches as parents and educators, the better able our children will be to withstand the challenges of life.

Study Says Background TV Adds Significantly to Children’s Exposure

Author: Julie Rasicot

Many families may be spending time relaxing around the TV over the holidays. A recent study suggests, however, that parents and caregivers should be mindful of turning off the set if no one’s actually watching to limit hours of unintended exposure for kids.

Researchers found that, on average, children in the United States ages 8 and under were actually exposed to nearly four hours per day of television that was left on as background noise. For kids on the younger side and African-American children, that exposure was more like five and a half hours a day on average; the total was six hours for kids from the poorest families, according to the study by researchers from the University of Amsterdam, in the Netherlands; the University of North Carolina; and the University of Iowa.

Two major factors associated with increased background TV exposure are leaving the television on while no one is viewing and the presence of TVs in kids’ bedrooms, the study says.

“When we saw the numbers, we were just shocked. The sheer amount of exposure is shocking,” researcher Jessica Taylor Piotrowski, an associate professor of communication research at the University of Amsterdam, told WebMD Health News.

The results were based on a telephone survey of more than 1,450 parents and caregivers of kids between the ages of 8 months and 8 years old who were asked to record their children’s exposure to background television in a 24-hour diary as well as report the number of televisions in their home, the number in bedrooms, and how often the television was on, according to a news release from the University of Amsterdam. The results were published in the journal Pediatrics in October.

The hours of unintended exposure are worrisome because experts have suggested that television watching by young children can impact their cognitive development and lead to problems paying attention and interacting with others. The American Academy of Pediatrics warned in October that parents should limit exposure to all screen time for young children, especially those ages 2 and under, because it provides no educational benefit and limits time that could be spent playing and interacting with others—activities that positively impact kids’ development.

Researchers offered this advice to help limit kids’ screen exposure: Turn off the TV if no one is actively watching and keep TVs out of children’s bedroom

Tips for Improving Reading Fluency

The following tips are a summary from the National Reading Panel’s Report on reading fluency.

When your child reads out loud, does it sound choppy or broken up? Does your child have trouble understanding and remembering things he has read out loud? Your child may benefit from some tips on improving reading fluency.

What Is Reading Fluency?

According to the National Reading Panel, reading fluency is defined as follows:

“Fluency is the ability to read a text accurately and quickly. When fluent readers read silently, they recognize words automatically. They group words quickly to help them gain meaning from what they read. Fluent readers read aloud effortlessly and with expression. Their reading sounds natural, as if they are speaking. Readers who have not yet developed fluency read slowly, word by word. Their oral reading is choppy and plodding.”

How Can I Help Improve My Child’s Reading Fluency?

1. Model Fluent Reading: You can help improve your child’s reading fluency by showing them what it sounds like when you read fluently. Choose something to read that is fairly easy for your child (not too many words that they wouldn’t know) and read it out loud to your child. Read effortlessly and with expression. This will help your child hear what it sounds like to read fluently and will also show your child how reading fluently can provide meaning to the text. Point to each word as you read. However, make sure that you’re not putting in extra pauses because your finger needs extra time to catch up. Point to the words like this will help your child understand where natural pauses occur and which words should be emphasized.

2. Talk About Punctuation: Another way to improve your child’s reading fluency is to talk about how the punctuation changes the way you read sentences. Explain to your child that when you see a question mark, your voice should raise in pitch at the end of the sentence to indicate a question. Show your child some examples of this. Explain how your voice lowers in pitch and there is a pause when you see a period. Commas and colons indicate short pauses and exclamation marks tell you to get loud and sometimes more high pitch. You can point these out and demonstrate them before, during, and after you read something out loud to your child.

3. Have Your Child Read The Text Back To You: After you have read the text out loud to your child, have him read it back to you. Provide your child praise and help as they go along. Have your child continue to read the text repeatedly until he is quite fluent with it. This usually takes three or four readings. If it takes longer than that, your text is too hard and you should find something easier.

4. Read The Text With Your Child: Reading a text at the same time as your child (in unison) is another great way to practice reading fluency. You can start by reading the text to your child the first time. The next time you read it, encourage your child to join in and read with you whenever she feels comfortable. After three-five times reading this text, your child should be able to read the entire thing with you. If not, the text is too hard and you should try something easier.

5. Have Your Child Read Along with a Book On Tape: Buy some books on tape (or CD) or record yourself reading a book out loud for your child. The first time, have your child listen to the tape and point to the words as he hears them being read. The next time, encourage your child to read along. For this activity, it is best if there are no sound effects or music in the background.

ADHD Linked to Oxygen Deprivation Before Birth

Story Source: The below story is reprinted from materials provided by Kaiser Permanente, via EurekAlert!, a service of AAAS.

Dec. 10, 2012 — Children who had in-utero exposure to ischemic-hypoxic conditions, situations during which the brain is deprived of oxygen, were significantly more likely to develop attention deficit hyperactivity disorder later in life as compared to unexposed children, according to a Kaiser Permanente study published in the journal Pediatrics. The findings suggest that events in pregnancy may contribute to the occurrence of ADHD over and above well-known familial and genetic influences of the disorder.

-The population-based study examines the association between IHC and ADHD. Researchers examined the electronic health records of nearly 82,000 children ages 5 years old and found that prenatal exposure to IHC — especially birth asphyxia, neonatal respiratory distress syndrome, and preeclampsia — was associated with a 16 percent greater risk of developing ADHD. Specifically, exposure to birth asphyxia was associated with a 26 percent greater risk of developing ADHD, exposure to neonatal respiratory distress syndrome was associated with a 47 percent greater risk, and exposure to preeclampsia (high blood pressure during pregnancy) was associated with a 34 percent greater risk. The study also found that the increased risk of ADHD remained the same across all race and ethnicity groups.

“Previous studies have found that hypoxic injury during fetal development leads to significant structural and functional brain injuries in the offspring,” said study lead author Darios Getahun, MD, PhD, of the Kaiser Permanente Southern California Department of Research & Evaluation. “However, this study suggests that the adverse effect of hypoxia and ischemia on prenatal brain development may lead to functional problems, including ADHD.”

Researchers also found that the association between IHC and ADHD was strongest in preterm births and that deliveries that were breech, transverse (shoulder-first) or had cord complications were found to be associated with a 13 percent increased risk of ADHD. These associations were found to be the case even after controlling for gestational age and other potential risk factors.

“Our findings could have important clinical implications. They could help physicians identify newborns at-risk that could benefit from surveillance and early diagnosis, when treatment is more effective,” said Getahun. “We suggest future research to focus on pre- and post-natal conditions and the associations with adverse outcomes, such as ADHD.”

During critical periods of fetal organ development, IHC may result in a lack of oxygen and nutrient transport from the mother’s blood to fetal circulation. The result may be compromised oxygen delivery to tissues and cerebrovascular complications. However, this study suggests that the adverse effect of hypoxia on prenatal brain development may lead to functional problems, including ADHD.

In 2005, the Centers for Disease Control and Prevention estimated the annual cost of ADHD-related illness in children under 18 years of age to be between $36 billion and $52.4 billion, making the condition a public health priority. In 2010, approximately 8.4 percent of children ages 3 to 17 had been diagnosed with ADHD. For about half the affected children, the disease persists into adulthood, according to CDC statistics. Symptoms of ADHD in children may include attention problems, acting without thinking, or an overly active temperament.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

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Journal Reference:
1.Darios Getahun, George G. Rhoads, Kitaw Demissie, Shou-En Lu, Virginia P. Quinn, Michael J. Fassett, Deborah A. Wing, and Steven J. Jacobsen. In Utero Exposure to Ischemic-Hypoxic Conditions and Attention-Deficit/Hyperactivity Disorder. Pediatrics, December 10, 2012 DOI: 10.1542/peds.2012-1298

Bedwetting and Special Needs Children

Author: Austin Sheeley

Bedwetting can be frustrating for both children and parents, whether or not they have special needs. But don’t worry–there are several things you can do to help your child overcome bedwetting.

1. Be Supportive!

Perhaps the most important thing is to simply be supportive. Children put great trust in their parents’ beliefs. If a parent is supportive and optimistic as their child tries to overcome bedwetting, the child will adopt that optimism.

2. Involve Your Child

Occasionally, children develop low self-esteem as a result of bedwetting. To prevent this, involve your child in the cleanup. Though it can be tempting to simply deal with it yourself and let your kid get back to sleep, involving children in the cleanup gives them a greater sense of control over the situation.

3. Don’t Limit Fluids

Many parents try limiting their child’s fluid intake before bed. But often enough this actually makes the situation worse. The higher concentration urine is more irritable to your child’s bladder than a larger amount of less concentrated urine. Plus, limiting fluids can lead to constipation which increases the odds of bedwetting. A better strategy is to have your kid “double void”—pee twice during the hour before bed.

If your child wets the bed, don’t limit his fluids–however, be sure to limit sugary and caffeinated drinks.

4. Do Limit Caffeinated or Sugary Drinks

Caffeine is known to increase urine production. Likewise, your child’s body will try to get rid of excess sugar by creating more urine. Limit any caffeinated or sugary drinks to earlier in the day, preferably before dinner.

5. Bedwetting Alarms

If you’re still experiencing issues over prolonged periods of time, some clinical trials have shown bedwetting alarms to be the one of the most effective and long-lasting bedwetting treatments (aside from medication). They work by conditioning the brain to respond to a full bladder. Most do this by ringing and/or vibrating when the child starts to wet. Recordable alarms allow parents to record verbal instructions instead, such as “It’s time to use the bathroom.” These may work well for children who might find traditional bedwetting alarms frightening.

6. Waterproof Bedding

If you opt for a bedwetting alarm, it’s not an instant solution. Most children take two to three months to achieve permanent dryness. In the meantime, you may want to get some waterproof bedding to protect the mattress and make cleanup easier.

7. Use Baking Soda

For a cheap and easy cleanup, try sprinkling baking soda on the wet area. It should absorb not only the urine, but also the smell. After you’ve let it sit for a few minutes, just vacuum it up.

What tips do you have for bedwetting? Share them below!

About the author: Austin Sheeley wrote one article for Enabled Kids. He is a writer for BedwettingStore.com, America’s largest distributor of enuresis related products. His goal is to help parents find the best treatment for bedwetting.