Tuesday, April 28, 2015

Poor sleep affects you over a lifetime

New research indicates that poor sleep not only affects you the next day, but over a lifetime.

A poor night's sleep can affect performance at work the next day, but over time, could disrupted sleep affect brain function in a permanent way? New evidence suggests it could.
A new study found that patients with issues like sleep apnea or heavy snoring developed problems with cognition around 10 years earlier than those without sleep-breathing troubles.
"Abnormal breathing patterns during sleep such as heavy snoring and sleep apnea are common in the elderly, affecting about 52 percent of men and 26 percent of women," explained the study's lead author, Ricardo S. Osorio, M.D., of the NYU School of Medicine in New York, in a press release.
In sleep apnea, breathing starts and stops repeatedly over the course of the night. Osorio and team wanted to see whether sleep apnea and other abnormal breathing patterns (called sleep-disordered breathing) were tied to cognitive issues.
To do so, these researchers looked at data from the Alzheimer’s Disease Neuroimaging Initiative, which involved over 2,000 adults between the ages of 55 and 90. Some patients had no cognitive problems, while some developed Alzheimer's disease or mild cognitive impairment (MCI). In MCI, cognitive issues have developed beyond what is expected in normal aging but not far enough to be considered dementia.
Osorio and team found that patients who had sleep-disordered breathing started showing signs of cognitive problems an average of 10 years earlier than those who did not have issues with abnormal breathing patterns during sleep.
When looking only at patients with cognitive issues, those with sleep-disordered breathing started showing signs of MCI at an average age of 77. The same was true for those without the breathing troubles at an average age of 90.
In this group of patients, Alzheimer's disease was also seen earlier -- at an average age of 83 among those with sleep-disordered breathing, compared to an average age of 88 among those without breathing issues.
Osorio and team also looked at the effects of treating abnormal breathing patterns with continuous positive airway pressure (CPAP). CPAP delivers air pressure through a mask during sleep, helping to keep the airways open.
Treatment with CPAP seemed to reduce the risk of developing cognitive issues earlier, Osorio and colleagues found. Patients who used CPAP developed MCI at an average age of 82, compared to an average age of 72 among those who did not receive treatment for their sleep-disordered breathing.
"These findings were made in an observational study and as such, do not indicate a cause-and-effect relationship,” Osorio noted. “However, we are now focusing our research on CPAP treatment and memory and thinking decline over decades, as well as looking specifically at markers of brain cell death and deterioration.”
This study was published online April 15 in the journal Neurology.
Several study authors received industry support within the past two years and held patents involving procedures related to the study. A number of groups funded this research, such as the Foundation for Research in Sleep Disorders and the Alzheimer’s Disease Neuroimaging Initiative.
Read more here

Study: Children with ADHD may have to squirm to learn

New research indicates that children with ADHD may have to squirm to learn.

For decades, frustrated parents and teachers have barked at fidgety children with ADHD to "Sit still and concentrate!"
But new research conducted at UCF shows that if you want ADHD kids to learn, you have to let them squirm. The foot-tapping, leg-swinging and chair-scooting movements of children with attention-deficit/hyperactivity disorder are actually vital to how they remember information and work out complex cognitive tasks, according to a study published in an early online release of the Journal of Abnormal Child Psychology.
The findings show the longtime prevailing methods for helping children with ADHD may be misguided.
"The typical interventions target reducing hyperactivity. It's exactly the opposite of what we should be doing for a majority of children with ADHD," said one of the study's authors, Mark Rapport, head of the Children's Learning Clinic at the University of Central Florida. "The message isn't 'Let them run around the room,' but you need to be able to facilitate their movement so they can maintain the level of alertness necessary for cognitive activities."
The research has major implications for how parents and teachers should deal with ADHD kids, particularly with the increasing weight given to students' performance on standardized testing. The study suggests that a majority of students with ADHD could perform better on classroom work, tests and homework if they're sitting on activity balls or exercise bikes, for instance.
The study at the UCF clinic included 52 boys ages 8 to 12. Twenty-nine of the children had been diagnosed with ADHD and the other 23 had no clinical disorders and showed normal development.
Each child was asked to perform a series of standardized tasks designed to gauge "working memory," the system for temporarily storing and managing information required to carry out complex cognitive tasks such as learning, reasoning and comprehension.
Children were shown a series of jumbled numbers and a letter that flashed onto a computer screen, then asked to put the numbers in order, followed by the letter. A high-speed camera recorded the kids, and observers recorded their every movement and gauged their attention to the task.
Rapport's previous research had already shown that the excessive movement that's a trademark of hyperactive children -- previously thought to be ever-present -- is actually apparent only when they need to use the brain's executive brain functions, especially their working memory.
The new study goes an important step further, proving the movement serves a purpose.
"What we've found is that when they're moving the most, the majority of them perform better," Rapport said. "They have to move to maintain alertness."
By contrast, the children in the study without ADHD also moved more during the cognitive tests, but it had the opposite effect: They performed worse.
Read more here

Monday, April 27, 2015

App offers non-medication treatment for ADD/ADHD

An app created in Israel offers a medication-free alternative treatment for children with ADD and ADHD.

Aziz Kaddan, one of the co-founders of Myndlift, didn’t flinch when asked in front of an audience at the recent BrainTech conference in Tel Aviv how he plans to go up against the better-funded American companies with his alternative non-drug treatment for attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD).
Myndlift uses neurofeedback, also known as electroencephalographic (EEG) biofeedback, to train the brain to focus. It’s a computer-based technique developed and tested by NASA to improve attention, focus, and learning. Kaddan, the 22-year-old phenom taking Israel’s brain-tech world by storm, knows the path to changing hyperactivity treatment is a tough one, but he’s positive his app-based, wearable neurofeedback solution, coupled with specially tailored mobile games that only work through concentration, can increase attention levels with just 10 minutes of play time a day.
“I know that I have a product that has a value to a lot of people,” he said, from his co-working space for high-tech entrepreneurship and innovation at Tel Aviv’s public library. Myndlift’s idea is to get sufferers of ADD and ADHD off medications like Ritalin, which suppresses appetite and has other negative side effects, and help them focus their minds using a mobile app, neurofeedback, and a brain-sensing wearable technology.
“Myndlift brings personalized neurofeedback training to mobile, making it easier for people with hyperactivity, professionals in demanding careers, students, athletes and anyone concerned about brain fitness to improve concentration abilities effectively without prescription drugs, inconvenience to visit specialized clinics and huge bills, thus saving thousands of dollars and tens of commuting hours,” according to the company’s elevator pitch.
Read more here

Sunday, April 26, 2015

Houston Reisbord BBYO Supports Houston TIRR Hotwheels

May 17 from 12pm-5pm we will host our Third Annual Wheelchair Basketball Tournament to support the chapter and the Houston Hotwheels. The event will bring together able-bodied and disabled teens for a fun day of competition. 

So lets all reach out to our family and friends and raise fund and make teams!  

Reisbord Supports Houston TIRR Hotwheels

TIRR Memorial Hermann Hotwheels was founded in 1997, first competing in the 1997-98 basketball season with only five players. As the seasons have continued we have had over 75 wheelchair athletes participate on the Hotwheels basketball team.
Five players from the 2007 TIRR Memorial Hermann Hotwheels team were awarded scholarships to colleges with collegiate wheelchair teams and are continuing to play the sport they love on a college level. One member from the 2009 Hotwheels team continued his basketball career with a scholarship to University of Texas in Arlington and another was selected to the residency program at the US Olympic Training Center in Denver, CO for swimming. A senior on the 2010-2011 team was offered a full athletic scholarship to the University of Texas in Arlington. In 2011-2012, a senior was offered a spot with the University of Illinois fighting Illini Ladies wheelchair basketball team.

Wednesday, April 22, 2015

Attention Texas Parents of Children with Disabilities - Make Your Voice Heard - inventory of postsecondary educational programs and services for persons with intellectual and developmental disabilities

Attention Texas Parents of Children with Disabilities - Make Your Voice Heard on a bill in the state house. Inventory of postsecondary educational programs and services for persons with intellectual and developmental disabilities  - JR

DEVELOPMENTAL DISABILITIES. (a) The board shall maintain an
inventory of all postsecondary educational programs and services
provided for persons with intellectual and developmental
disabilities by institutions of higher education.
       (b)  The board shall:
             (1)  post the inventory on the board's Internet website
in an easily identifiable and accessible location;
             (2)  submit the inventory to the Texas Education Agency
for inclusion in the transition and employment guide under Section
29.0112; and 
             (3)  update the inventory at least once every two
       (c)  At times prescribed by the board, each institution of
higher education shall report to the board all programs and
services described by Subsection (a) provided by that institution.


Spectrum: Partisan Bill (Democrat 1-0)
Status: Introduced on February 23 2015 - 25% progression
Action: 2015-04-22 - Scheduled for public hearing on . . .
Pending: House Higher Education Committee
Hearing: April 22, 2015 @ 08:00 AM in E2.014
Text: Latest bill text (Introduced) [HTML]


Relating to requiring the Texas Higher Education Coordinating Board to maintain an inventory of postsecondary educational programs and services for persons with intellectual and developmental disabilities.

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Relating to requiring the Texas Higher Education Coordinating Board to maintain an inventory of postsecondary educational programs and services for persons with intellectual and developmental disabilities.



2015-04-22HouseScheduled for public hearing on . . .
2015-03-12HouseReferred to Higher Education
2015-03-12HouseRead first time


Texas State Sources

Sunday, April 19, 2015

Houston Area Ataxia Support Group Meeting for Adults, Children and Families

http://content.delivra.com/etapcontent/NationalAtaxiaFoundation/atalogo.jpgThis is a grass roots group that shares experience and information. 1/1 pediatric neurologists in my house can say from experience that you / your child are highly likely to benefit from the shared knowledge....
and, there are no side effects. - JR


Sunday, April 26, 2015
2:00 PM to 4:00 PM
New Location:   The Women’s Hospital of Texas
Classroom 107, 7800 Fannin St
Houston, TX 77054 

Plenty of Parking
Valet Parking is available (optional)
Meeting Agenda:
Safety Moment and Facility Orientation
Meet & Greet
Update from Bonnie Sills on the National Conference held in Denver
Dr Partha Sarkar, Researcher at UTMB Galveston

Family, friends, and caregivers are welcome! An RSVP is appreciated.

To RSVP, more information, or to be added to the mailing list for this group please contact
Bonnie Sills at (713) 944-5183 texasnanow@aol.com or David Brunnert at (713) 578-0607 david.brunnert@sbcglobal.net.

We are stronger together!

Home test can diagnose sleep apnea in children

Of course this is interesting, but consider the importance of sleep studies in kids is not just to find evidence of sleep apnea. We need to identify those who have severe apnea to know who is at medical risk of complications from surgery.  

This is why the AAP recommends a sleep study BEFORE tonsillectomy.

Note that the agreement was higher in the lab for the same device. So..can you trust the results at home?

I dont like "probably" as an answer.

So, if its positive, a child needs a psg ...and..if its negative, the child needs a psg. 

Bottom line: kids are different than adults....JR

A respiratory polygraphy test that can be administered at home accurately diagnoses children with sleep apnea.

The use of home respiratory polygraphy to diagnose children with sleep apnea was reliable and comparable to the results of polysomnography and an in-laboratory respiratory polygraphy, according to study results.

‘This study shows that [home respiratory polygraphy (HRP)] provides a reasonably valid alternative to [in-laboratory polysomnography (PSG)] for the diagnosis of [obstructive sleep apnea-hypopnea syndrome (OSAS)] in children clinically referred with a high index of clinical suspicion for the presence of OSAS,” María Luz Alonso-Álvarez, MD, of the Hospital Universitario de Burgos in Spain, and colleagues wrote. “This frequent and highly prevalent pediatric condition is associated with adverse consequences and excessive and costly use of health care services.”
The researchers conducted a prospective, blinded study on 50 randomly selected children (mean age, 5.3 years) being evaluated for clinical suspicion of OSAS. Participants were given an HRP and within 2 weeks a simultaneousPSG and in-laboratory respiratory polygraphy (LRP).
Sixty-six percent of the children were diagnosed with OSAS based on a PSG-defined obstructive respiratory disturbance index (ORDI) of at least three events per hour during sleep.
Using the interclass correlation coefficient, ORDI agreement between PSG and LRP (ORDI = 96.5; 95% CI, 92.3-98.2) as well as HRP (ORDI = 86.7; 95% CI, 76.5-92.5) was greater than 80% in all cases but higher for LRP than HRP.
The researchers emphasized the importance and validity of using HRP in the diagnoses of children suspected of having OSAS, namely reduced cost and the comfort of home testing.
“We should stress, however, that when inconclusive HRP findings occur, a conventional PSG should be performed, and we further recommend incremental research efforts, particularly for the mild diagnosis of OSA using HRP in children,” the researchers wrote.
Read more here

Saturday, April 18, 2015

Therapy of encephalopathy with status epilepticus during sleep (ESES/CSWS syndrome): an update.

Epileptic Disord. 2012 Mar;14(1):1-11. doi: 10.1684/epd.2012.0482.

Therapy of encephalopathy with status epilepticus during sleep (ESES/CSWS syndrome): an update.


Electrical status epilepticus in sleep (ESES)/continuous spikes and waves during slow sleep (CSWS) is an age-related, self-limiting disorder characterised by epilepsy with different seizure types, global or selective neuropsychological regression, motor impairment, and a typical EEG pattern of continuous epileptiform activity for more than 85% of non-rapid eye movement (NREM) sleep. Although the first description of ESES/CSWS dates back to 1971, an agreement about the optimal treatment for this condition is still lacking. ESES/CSWS is rare (incidence is 0.2-0.5% of all childhood epilepsies) and no controlled clinical trials have been conducted to establish the efficacy of different antiepileptic drugs; only uncontrolled studies and case reports are reported in the literature. Treatment options for ESES/CSWS include some antiepileptic drugs (valproic acid, ethosuximide, levetiracetam, and benzodiazepines), steroids, immunoglobulins, the ketogenic diet, and surgery (multiple subpial transections). In this study, the comparative value of each of these treatments is reviewed and a personal therapeutic approach is proposed.

When do you treat Benign epilepsy with centrotemporal spikes or Rolandic epilepsy?

Epilepsy Behav. 2015 Feb 9;44C:117-120. doi: 10.1016/j.yebeh.2015.01.004. [Epub ahead of print]

Benign childhood epilepsy with Centro-Temporal spikes (BCECTSs), electrical status epilepticus in sleep (ESES), and academic decline - How aggressive should we be?


Since many of the children with BCECTSs display electrical status epilepticus during sleep and many present with different comorbidities, mainly ADHD and behavioral disturbances, clinicians are often confronted with the dilemma of how aggressive they should be with their efforts of normalizing the EEG. We conducted a retrospective study by screening medical records of all consecutive patients with BCECTSs, spike-wave index (SWI) >30%, and ADHD/ADD that were evaluated in our pediatric epilepsy service and were followed up for at least two years. Patients with neurocognitive deterioration detected by formal testing were excluded. A total of 17 patients with mean age of 6.9years at BCECTS diagnosis were identified. The patients' mean SWI was 60% and that dense electrical activity lasted 1.5years on average (range: 1-4.5years). Six children were formally diagnosed with learning disabilities in addition to ADD/ADHD. All of them were treated with an average of three antiepileptic medications, mainly for the purpose of normalizing the EEG, but none of them was treated with steroids or high-dose diazepam. The mean duration of follow-up was 5.5years. A cognitive or behavioral deterioration was not detected in any of them. Our data suggest that when treating a child with BCECTSs, high SWI, and school difficulties, the most critical parameter that determines the necessity of using second-line antiepileptic agents such as steroids or high-dose diazepam is a formal psychological evaluation that proves cognitive (I.Q.) decline. Otherwise, these agents may be avoided.

Technology to help you sleep

While we hear a lot about how technology keeps people up at night, some technology, like the ones described below, are made to help you sleep.
Nothing throws off your day like a lack of sleep the night before. It ruins your concentration, makes you impatient, cause memory lapses and worse. Over the long term, sleep deprivation can lead to depression, diabetes, hypertension and obesity.
It can also be deadly. According to AAA, people who only sleep 6 to 7 hours per night are twice as likely to be involved in a car accident as those who sleep 8 hours or more. Sleep less than 5 hours per night and you are four or five times more likely to be in a car accident.
That's a bigger problem when the Centers for Disease Control reports that 30 percent of adults say they sleep an average of 6 hours, and up to 70 million Americans will have a sleep disorder at some point. Fortunately, technology can actually help sleep.
There's been an explosion of gadgets that are designed to monitor your sleep and help you improve it. The market for these gadgets is headed for more than $125 million in 2017.
Sense, for example, is a little orb that sits in your room monitoring noise, light, temperature, humidity and air particles, and can wake you up at the ideal part of your sleep cycle. A tiny clip attached to your pillow tracks your movements. In the morning, it can tell you through an Apple app how much sleep you really got, and if something in your environment is disturbing your rest. It's currently available for pre-order on Kickstarter for $99 and will cost $129 when it ships in November.
Some similar monitors already available include Beddit ($149), which also tracks your heart rate and breathing, and SleepRate ($100), which has an app full of useful information plus a wearable heart rate sensor. Withings Aura ($300) is another upcoming gadget that not only monitors your sleep, but it cycles through light and sound programs to try and improve your sleep.
You probably already have a sleep-improving gadget sitting next to you at night. I'm talking, of course, about your smartphone.
A sleep-recording app coupled with your smartphone's sensors can give you a good idea of your sleep patterns. You usually just have to put your phone on the bed near your pillow and let it do the rest.
Important warning: Never put your phone under your pillow or cover it with a blanket. The phone could overheat and catch on fire.
Some popular sleep-tracking apps are Sleep Better (Android, Apple; Free), SleepBot (Android, Apple, Free) and Sleep Cycle Alarm (Android, Apple; $1). They all track your movements during sleep.
Sleep Better includes a journal to keep track of sleep-affecting factors like diet, exercise and even your dreams. So it's good for tracking down lifestyle choices that may be hurting your sleep.
SleepBot tracks your sleep like the others, but also includes sound recording so you can detect problems like sleep apnea, or find out what nighttime sounds cause you to move around.
Sleep Cycle Alarm is the one to get if you generally sleep OK, but seem to always wake up at a bad time. It uses your movements to predict the perfect time for you to wake up, and includes plenty of restful alarms.
Soon, you might not need a stand-alone sleep-tracking gadget. Everything you need will be built right into your mattress, and that future is now if you're willing to pay for it.
I'm sure you've seen commercials for Sleep Number mattresses. These mattresses let you continually adjust how hard or soft the mattress is to get the perfect sleeping experience. They can even have dual zones so you and your significant other can each tailor the bed to your preference.
Now, Sleep Number offers SleepIQ. The mattress includes sensors that track your breathing rate, heart rate and movements. You can then pull up your sleep statistics on the companion app to see how long you slept and how well. There's also a journal function to keep track of your diet, exercise and more that could be impacting your sleep. For those with a partner in bed, SleepIQ can track their sleep as well and even figure out how your sleep patterns affect each other.
Naturally, any new mattress is going to be a serious financial commitment, and SleepIQ is no exception, starting at $999.98 for a queen mattress. While it might be worth the cost in the long run, you might be hesitant in the short run.
If that's the case, take a look at Luna. It's a mattress cover that adds SleepIQ-style sensors and tracking to any mattress. So it keeps tabs on your sleep cycle, heart rate and breathing rate over time so you know if your sleep is improving or not. However it has some other impressive features. For example, it includes temperature adjustment so you have just the right level of comfort for sleep. There are two zones, naturally, so you and your partner won't need to argue about how warm is too warm.
Because Luna tracks your sleep cycle, it can work with your alarm clock to wake you at the ideal moment in your sleep cycle; no more groggy mornings. It can even learn your habits, so it knows when you typically go to bed and starts adjusting the temperature in advance. You can control it remotely using your smartphone. Luna is available for pre-order right now starting at $235 and should be shipping in late Summer 2015.
While technology is rushing to cure sleep problems, one growing cause of poor sleep is technology itself. It's easy to get sucked in to Facebook, playing a hot new game, or binge-watching a show on Netflix instead of going to bed on time. Then there's that text from a friend that makes your phone light up right as you're dropping off to dreamland.
I know forcing yourself to turn off the gadgets, or silence your phone, is tough but it is worth it. There are some ways you can help yourself out if you're struggling. Go poking in your network router settings and you'll see that you can schedule it to cut off Internet access at night. The parental controls for most video game consoles include blackout times as well. For Android gadgets, an app like Tasker lets you program times and places to cut off communications.
Of course, even using technology near bedtime is still a problem. The blue light from most screens tricks your brain into thinking it is daytime even when it isn't. That's why many sleep experts recommend shutting down your gadgets at least two hours before bedtime.
If that isn't possible, a program like F.lux for computers and Apple gadgets, and Lux for Android, tints your screen red at night. That reassures your brain it's night time, and that means you'll fall asleep easier.
Read more here

Link between mental illness and sleep aid use

A possible link exists between mental illness and using sleep aids.

In today's "always on," high-stress world, it has become commonplace to turn to over-the-counter sleep aids for a little help with drifting off into dreamland at night. However, that habit, if made a consistent one, could lead to potentially serious damage when it comes to ones mental health.
A new study zeroing in on anticholinergic drugs -- a category that includes common non-prescription sleeping aids and antihistamines like Benadryl -- found that the long-term use of such medications in higher doses can lead to an increased risk of developing dementia, including Alzheimer's disease, in the future. It's the first study of its kind to prove this dose-response effect, meaning that the higher, cumulative consumption of the drug, the higher the likelihood of a person developing dementia later in life. It's also the first to suggest that this dementia risk may persist -- and be irreversible -- even years after people have stopped taking these drugs. The study was published in JAMA Internal Medicine in late January.
Dr. Shelly Gray, a professor at the University of Washington's School of Pharmacy and lead author of this study, originally intended to disprove this association that had been researched previously and published last year with her more rigorous study design, she told The Huffington Post. Dr. Gray and her colleagues tracked approximately 3,5000 men and women aged 65 and older who exhibited no dementia symptoms at the beginning of the study. Each participant was part of the joint Group Health–University of Washington study funded by the National Institute on Aging, which made it more efficient for them to track exposure to anticholinergic drugs via each person's pharmacy computer records.
Anticholinergics, which block the neurotransmitter acetylcholine in the brain and body, are typically taken to address gastrointestinal problems, urinary issues, respiratory disorders and insomnia, with side effects ranging from drowsiness to constipation urine retention to dry mouth.
Using more rigorous methods, a follow-up period extending beyond seven years, a more thorough assessment of pharmacy records regarding the medication use (both prescription and over-the-counter options), Dr. Gray's team was better able toconfirm this link between anticholinergic medication use and mental illness.
The pharmacy data allowed Dr. Gray and her team to calculate the standard daily medication doses of each study participant as well as their cumulative exposure to anticholinergics over a 10-year period. Over the course of the study, almost 800 participants developed a degree of dementia. The pharmacy data also revealed themost common medications (and daily doses) used by the group of participants: antidepressants (10 mg per day of doxepin), first-generation antihistamines (4mg per day of chlorpheniramine) and antimuscarinics for bladder control (5 mg per day of oxybutynin). They estimated that the use of such amounts for more than three years could result in a greater risk of developing dementia.
According to Dr. Gray, substitutes are available for the first two medications in this list. A selective serotonin re-uptake inhibitor like citalopram or fluoxitene can aide depression symptoms, while a second-generation antihistamine like loratadine can address allergies without the harmful, anticholinergic exposure. However, it can be more difficult to find an effective alternative for for urinary incontinence.

Dr. Gray hopes that this study will help inform older adults that many common medications have strong anticholinergic effects and come with a degree of risk when it comes to their mental health. However, for adults who are already taking drugs found to be problematic in this study, it's important to talk to your physician before terminating any medicinal regimen, as well as inform them of the over-the-counter drugs you take -- no matter how mainstream and benign they may seem.
Read more here

Study: Children with autism can learn social skills

A recent study indicated that children with autism can learn how to be social.

When Debra Kamps, senior scientist at the University of Kansas Life Span Institute, first began researching how to improve the social and communication skills of children with autism in natural settings like schools in the 1970s, it was hard to find children with autism spectrum disorders (ASD) who were in classrooms with their typically developing peers.
Today, Kamps and her colleagues from KU and the University of Washington can say with certainty that they know how teachers, speech therapists and others can teach social and communication skills to kids with ASD and their peers in the classroom, at lunch and even at recess after the results of the first large randomized study of a social communication intervention verified years of earlier research.
"We know how to do this, and our research has shown us that it is not hard to teach people how to do it," she said.
The four-year study, funded by the U.S. Department of Education, involved 95 students with ASD in Kansas and Washington. Of that group, 56 children participated in a two-year intervention from kindergarten through first grade in which each child was grouped with two to three typically developing classmates in a peer network, while the remaining 39 were the control group.
The social peer network focused on teaching social communication skills such as requesting, commenting and saying "niceties" such as please and thank you while playing with toys and board games.
To find out if the children were continuing to use social skills, the researchers followed up with probes outside of the intervention sessions at four points in time.
"We found that the children who participated in the social network not only made significant progress in social communication during the intervention but also made many more initiations to their peers in general," Kamps said. "Teachers also reported that children in the intervention were more social and had better classroom behavior."
Although peer networks are still not used routinely in schools, often due to lack of resources, Kamps hopes that the promising results from larger studies will change that, and she said that some teachers who participated in the study have adopted the Peer Networks intervention in their classrooms.
"Seeing the expression on the faces of the children when their peer buddies come to class -- that's what's kept me going all these years," she said.
Read more here

Oral devices to treat sleep apnea in children

This article discusses how oral devices can help treat sleep apnea in children.

Snoring and sleep apnea can affect anyone of any age.  For children, who frequently sleep alone, grinding of the teeth or reflux disease may be the first signs of the condition, and may first be noticed by a well-trained dentist.
Snoring and other signs of disturbed sleep, such as long pauses in breathing, tossing and turning in bed, chronic mouth breathing during sleep, and night sweats are possible signs of sleep apnea, according to www.sleepapnea.org.  The website states that studies suggest that as many as 25% of children diagnosed with attention-deficit hyperactivity disorder may actually have symptoms of obstructive sleep apnea, and that much of their learning difficulty and behavioral issues can be the result of chronic fragmented sleep.

Snoring occurs when the flow of air through the mouth and nose is physically obstructed.  Blocked nasal passages, poor muscle tone in the throat and tongue, bulky throat tissue (common in overweight patients), and a long soft palate or uvula can contribute to airflow obstruction.

Oral appliances for treatment of pediatric obstructive sleep apnea (OSA) can be helpful, especially in adolescents whose facial bone growth is largely incomplete.  One device, according to www.sleepapnea.com, which rapidly expands the transversal diameter of the hard palate over a six-month to one-year period, has been successfully used in patients as young as age six.

In the United States, oral devices to treat OSA can’t be sold over the counter. They must be prescribed by a physician and fitted by a dentist.  An oral breathing device used to treat pediatric OSA must be refitted periodically as the child grows.

Read more here