Sunday, July 19, 2015

Request from FEMA for a Child with Cerebral Palsy - Wheelchair and Hospital Bed

Please contact me or Linda Landers.  JR

Good Morning,

I am hoping I can take you up on your offer of assistance for children impacted by the flooding.  We have a 15 year old girl with cerebral palsy who has lost her wheelchair and bed.  

We are trying to find replacement equipment for her but have not been able to find anything at this point.  She uses a manual chair  with supports and a head rest. 

 The mother has indicated they do not have insurance. We are working with her to ensure she knows about social security and other government programs. 

 Even with that, it will take time to get a replacement and I am concerned about the risk to her health if she has to wait that long.  

Any suggestions you have would be greatly appreciated. 

"The information I have so far is the child is 15 years old.  She has a manual chair with head support.  She is a quadriplegic and only able to move her hands a little.  The mother is looking for the model number.  

We can check with volunteer agencies to see if they can do the delivery.  

She is in Edinburg (near McAllen).  

No info on the bed yet but apparently a hospital bed."

Thank your help.


Linda Landers, MPA
FEMA Region 6
Serving Arkansas, Louisiana, New Mexico, Oklahoma and Texas
800 N. Loop 288
Denton, TX 76205

If you require an accommodation due to a disability to access this information, contact Linda Landers at or at 940-230-6765

Saturday, July 18, 2015

Talking to Children about disaster - Floods in Texas Oklahoma!

Friends, As many of you know, my family was affected by the memorial Day Houston floods. Thank God, we are OK. But our kids have responded in different ways. It took time for us to catch up and recognize some of these repossess since we are caught up in the mechanics of recover (what when how etc). 

Here is a nice resource.  - JR

Talking to Children About Disasters

Children can cope more effectively with a disaster when they feel they understand what is happening and what they can do to help protect themselves, family, and friends. Provide basic information to help them understand, without providing unnecessary details that may only alarm them.
For very young children, provide concrete explanations of what happened and how it will affect them (eg, a tree branch fell on electrical wires and that is why the lights don't work). Let children know there are many people who are working to help them and their community to recover after a disaster (such as repair crews for the electric company, or firefighters, police, paramedics, or other emergency personnel). Share with them all of the steps that are being taken to keep them safe; children will often worry that a disaster will occur again.

Older children will likely want, and benefit from, additional information about the disaster and recovery efforts. No matter what age, start by asking children what they already know and what questions they have and use that as a guide for the conversation. Limit media coverage of the disaster—if children are going to watch media coverage, consider taping it (to allow adults to preview) and watch along with them to answer questions and help them process the information. While children may seek and benefit from basic information about what happened so that they can understand what is happening in their world, they (and adults) don't benefit from graphic details or exposure to disturbing images or sounds.  In the aftermath of a crisis is a good time to disconnect from all media and sit down together and talk as a family.

Be sure to ask children what questions or concerns they have. Often they have fears based on limited information or because they misunderstood what they were told. Reassure children when able to do so, but if their fears are realistic, don't give false reassurance. Instead, help them learn how to cope with these feelings.

 - See more at:

Talking to Children about Disasters

Children can cope more effectively with a disaster when they feel they understand what is happening and what they can do to help protect themselves, family, and friends. Provide basic information to help them understand, without providing unnecessary details that may only alarm them.
  • Very Young Children: Provide concrete explanations of what happened and how it will affect them (e.g., a tree branch fell on electrical wires and that is why the lights do not work). Let children know there are many people who are working to help them and their community to recover after a disaster (such as repair crews for the electric company, or firefighters, police, paramedics, or other emergency personnel). Share with them all of the steps that are being taken to keep them safe; children will often worry that a disaster will occur again.
  • Older Children: They will likely want, and benefit from, additional information about the disaster and recovery efforts. No matter what age, start by asking children what they already know and what questions they have and use that as a guide for the conversation. Limit media coverage of the disaster—if children are going to watch media coverage, consider taping it (to allow adults to preview) and watch along with them to answer questions and help them process the information. While children may seek and benefit from basic information about what happened so that they can understand what is happening in their world, they (and adults) do not benefit from graphic det​ails or exposure to disturbing images or sounds. In the aftermath of a crisis is a good time to disconnect from all media and sit down together and talk as a family.
Be sure to ask children what questions or concerns they have. Often they have fears based on limited information or because they misunderstood what they were told. Reassure children when able to do so, but if their fears are realistic, do not give false reassurance. Instead, help them learn how to cope with these feelings. See the following articles for more information:

Dog Shaming: Sleeping Problems and Snoring Dogs!

Send us true pet confessions about their sleep problems! JR

Friday, July 10, 2015

Sleep disorders are more common in racial/ethic minorities

According to a recent study, sleep disturbances occur more frequently in middle-aged and older adults who are racial or ethnic minorities.

A new study suggests that sleep disturbances and undiagnosed sleep apnea are common among middle-aged and older adults in the U.S., and these sleep problems occur more frequently among racial/ethnic minorities.
Results show that 34 percent of participants had moderate or severe sleep-disordered breathing measured by polysomnography, and 31 percent had short sleep duration with less than 6 hours per night measured by actigraphy. Validated questionnaires also showed that 23 percent reported having insomnia, and 14 percent reported excessive daytime sleepiness. Only 9 percent of participants reported being told by a doctor that they had sleep apnea.
After adjustment for sex, age, and study site, blacks were most likely to have short sleep duration of less than six hours, and they were more likely than whites to have sleep apnea syndrome, poor sleep quality, and daytime sleepiness. Hispanics and Chinese were more likely than whites to have sleep-disordered breathing and short sleep duration, but Chinese were least likely to report having insomnia.
"Our findings underscore the very high prevalence of undiagnosed sleep disturbances in middle-aged and older adults, and identify racial/ethnic disparities that include differences in short sleep duration, sleep apnea and daytime sleepiness," said lead author Dr. Xiaoli Chen, research fellow in the Department of Epidemiology at Harvard T.H. Chan School of Public Health in Boston.
Study results are published in the June issue of the journalSleep.
The study population was recruited from six U.S. communities and comprised 2,230 racially/ethnically diverse men and women who were between the ages of 54 and 93 years. Data gathered by polysomnography, actigraphy and validated questionnaires were obtained between 2010 and 2013.
According to Dr. Chen and her colleagues, this is the first study that has comprehensively evaluated objective measures of sleep apnea, short sleep, and poor sleep, as well as subjective measures of habitual snoring, insomnia, and daytime sleepiness in a multi-ethnic U.S. population that includes Chinese Americans. Results suggest that sleep disturbances may contribute to health disparities among U.S. adults.
"As sleep apnea has been implicated as a risk factor for cardiovascular disease, stroke, diabetes, and mortality, our findings highlight the need to consider undiagnosed sleep apnea in middle-aged and older adults, with potential value in developing strategies to screen and improve recognition in groups such as in Chinese and Hispanic populations," said senior author Dr. Susan Redline, professor of medicine at Harvard Medical School and Division of Sleep Medicine at Brigham and Women's Hospital and Beth Israel Deaconess Medical Center in Boston. The study was supported by grants from the National Institutes of Health (NIH) and an award from the National Center for Advancing Translational Sciences (NCATS).
Read more here

Study: People with autism may be more susceptible to genetic sleep issues

A study indicates that people with autism might be more susceptible to carrying genetic mutations that changes their circadian clock.

People with autism are twice as likely to carry alterations in genes that regulate the circadian clock, or the body’s sleep-wake cycle, as those without the disorder. The findings, published 6 May in Brain and Development, may help to explain why most children with autism have troubled sleep1.
Insufficient sleep is known to exacerbate the core symptoms of autism, such as social deficits and repetitive behaviors. The new findings suggest that the relationship between sleep and autism may have genetic roots.
“Sleep disturbance seems to be a main feature of autism,” says lead researcher Takanori Yamagata, professor of pediatric developmental medicine at Jichi Medical University in Shimotsuke, Japan. “My hypothesis is that some circadian genes may be related to some of the genetics of autism.”
To investigate this potential link, Yamagata and his team sequenced 18 genes known to govern the body’s day-night rhythms in 28 children and adults with autism, half of whom have sleep disorders, as well as 23 controls.
They identified a total of 68 mutations in 15 of these genes. About half of the mutations are ‘silent,’ which means they have no effect on the proteins the genes encode. But the other half are ‘missense’ mutations that disrupt the corresponding protein sequence. Nine of the mutations had never been reported before, Yamagata says.
People in the autism group have about twice as many mutations in circadian genes as do members of the control group, regardless of whether they have a sleep disorder.
Within the autism group, the researchers found seven missense mutations among individuals who have sleep disorders and the same number in those who sleep normally. By contrast, just one person in the control group carries a missense mutation in a circadian rhythm gene.
“We detected many mutations only in patients with autism, but almost nothing in the control group,” Yamagata says. “So I think these genes relate to some pathophysiology of autism.”
The researchers then used three types of computer algorithms to predict the impact of the missense mutations on the gene’s function. They found that 25 of the 33 missense mutations are likely to be benign, but 8 appear to be damaging.
One of the analyses found more damaging mutations in the individuals with autism who have sleep disorders than in those who sleep normally.
But the algorithms did not agree on which mutations are likely to be harmful. “Some of these virtual programs may reflect real damage, but they are not perfect,” Yamagata says.
The researchers are investigating whether these eight mutations in circadian genes interfere with brain development in mice. They’re starting with a mutation in a gene called TIMELESS that they found in a 9-year-old boy with autism who sleeps all day and stays awake all night. The boy’s mother, who also struggles with sleep but does not have autism, has the same mutation.
The results of these mouse studies may help elucidate the genetic relationship between sleep and autism.
“It is not yet clear exactly what the basis of this interaction is,” says Mustafa Sahin, associate professor of neurology at Harvard Medical School, who was not involved in the study. “It will be very interesting to further investigate the effects of these sequence variations.”
Read more here

Sleep and breast cancer diagnosis

Having poor sleep before diagnosis is linked to poorer diagnoses for women with breast cancer.

Breast cancer patients who had poor sleep and frequent snoring before their cancer diagnosis appear to have lower survival rates, a new study finds.
The study, which was not designed to prove cause-and-effect, included more than 18,000 cancer patients whose progress was tracked in the Women's Health Initiative study.
All of the women provided information about a number of aspects of their sleep prior to their cancer diagnosis, including the amount of sleep they got, whether or not they snored, and any history of insomnia.
Researchers led by Amanda Phipps, an assistant professor of epidemiology at the University of Washington in Seattle, found that women who slept 6 hours or less per night and were frequent snorers had more than twice the odds of a poor prognosis compared to women with neither of those factors.
A similar finding was seen for women with lung cancer, although the effect was not as large as was seen in women with breast cancer, the study authors said.
The study was published online in the journal Sleep and was also presented June 10 at the annual meeting of the Associated Professional Sleep Societies in Seattle.
"Our results suggest that sleep duration is important for breast cancer survival, particularly in women who snore," Phipps said in a journal news release.
Two breast cancer experts were cautious in interpreting the study results, however.
"At first glance it seems as though recommending more sleep could be of benefit [to breast cancer patients]," said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City. "However, one must remember that perhaps the factors that allow women to have more restful sleep -- such as healthier lifestyle or lower amounts of stress -- are the real reasons women who sleep well have better breast cancer outcomes."
Dr. Charles Shapiro co-directs the Dubin Breast Center at the Mount Sinai Hospital, also in New York City. "Sleep patterns often get disrupted, and insomnia is prevalent, in women who are diagnosed and treated for breast cancer and other cancers," he said.
"Precisely why insomnia is prevalent in cancer populations is unknown, but there are many potential causes including depression, anxiety, fatigue and [other issues] such as hot flashes," Shapiro added.
But he agreed with Bernik that "important factors like depression and obesity, known to be associated with increased breast cancer mortality, were not assessed [in the study]," and they could be the link between sleeplessness and breast cancer outcomes.
"Insomnia is a common but under-recognized and undertreated problem among breast cancer survivors," Shapiro said, "but whether it actually causes increased cancer deaths is unknown and we need a lot more information before we make that link."
Read more here
A new drug may be able to preemptively treat migraine headaches before they happen.

Patients may now have a solution to their migraines even before the attack happens, as experts found a new class of drugs shows great potential for migraine management. These medicines are the first of its kind that specifically target prevention of migraine. Research findings show that these drugs can greatly help alleviate the symptoms of the patients.
The drug belongs to a new class called Calcitonin Gene-Related Peptide (CGRP) monoclonal antibodies. CGRP is a neurotransmitter or chemical that transmits signals within the brain and throughout the body. So far, the compounds are exhibiting favorable effects in the management of chronic migraine and frequent but intermittent migraine.
"We've known for a long time that CGRP was involved in the mechanism of migraines, so during migraine attacks you can measure elevation of CGRP in the blood of the person having the migraine," said Dr. Richard Lipton, director of the Montefiore Headache Center at the Albert Einstein College of Medicine in New York. "If you treat it, CGRP blood levels fall."
Various pharmaceutical companies have been testing the effects of substances that target the CGRP; these companies include Amgen, Alder Pharmaceuticals, Teva Pharmaceuticals and Eli Lilly and Company.
Teva conducted its studies and submitted it to the American Headache Society meeting. In the phase IIb trials, where patients with migraine were tested, patients experienced a notable drop in the hours of headache experienced one week after the trial was started. Half of the said patients reported that the frequency of headache was reduced by 50 percent or more.
Lilly also presented how efficient their product is. They conducted their phase II trials by testing their product against a placebo, which were both administered every month. Amgen also presented their phase II data that reveal how their product was able to reduce the days of migraine attacks by 50 percent in half of their study participants in a span of 12 weeks. Alder Pharmaceutical also demonstrated their phase II trial results, but specific details were not presented at the meeting.
"The potential of these new compounds is enormous and gives us real hope that effective specific treatments for migraine may be on the near horizon," said Peter J. Goadsby, MD, PhD, Chief of the UCSF Headache Center and chair of the American Headache Society's annual Scientific Meeting. "The development of CGRP antibodies offers the simple, yet elegant and long awaited option for migraine patients to finally be treated with migraine preventives; it's a truly landmark development."
In America, more than 36 million people have migraine, which is far more than the incidence of patients with diabetes and asthma combines. Chronic migraine, which is characterized by 15 migraine days monthly, is experienced by approximately four million Americans.
Read more here

Sleep can be improved by some exercises but not others

A study claims that certain traditional exercises (e.g., walking, aerobics, yoga, etc.) can help you get better sleep at night while others (such as child care and household chores) may hurt your sleep.

Certain types of physical activity help you sleep better, while others might leave you tossing and turning, a new study finds.
Researchers looked at data from a survey of more than 429,000 American adults. They found that activities such as walking, bicycling, running, weight lifting, aerobics/calisthenics, gardening, yoga/Pilates and golfing were all linked to better odds of a good night's slumber.
But, people who got physical activity from household chores and child care had a greater risk of poor sleep, according to the study.
Results of the study were presented this week at the annual meeting of the Associated Professional Sleep Societies, in Seattle. Findings presented at meetings are generally viewed as preliminary until they've been published in a peer-reviewed journal.
The results of this study were surprising, according to study leader Michael Grandner, a psychiatry instructor at the Center for Sleep and Circadian Neurobiology at the University of Pennsylvania in Philadelphia.
"Not only does this study show that those who get exercise simply by walking are more likely to have better sleep habits, but these effects are even stronger for more purposeful activities, such as running and yoga, and even gardening and golf," Grandner said in a university news release.
"It was also interesting that people who receive most of their activity from housework and child care were more likely to experience insufficient sleep -- we know that home and work demands are some of the main reasons people lose sleep," Grandner added.
"These results are consistent with the growing scientific literature on the role of sleep in human performance. Lab studies show that lack of sleep is associated with poor physical and mental performance, and this study shows us that this is consistent with real-world data as well," he explained.
But since the study design only allowed the researchers to find associations between activity and sleep, instead of proof of a cause-and-effect relationship, more studies are needed, according to Grandner.
Read more here

How sleep can affect your heart

This article describes the negative effects of getting a poor night's sleep, especially on your heart.

You might think that those nights when you don’t get a wink of sleep can’t do you any harm apart from the frustration you feel knowing that you have to work the next day and you might be asleep at the wheel.

However, sleep disorders have been associated with many conditions that you might develop later on in life. There are studies proving that insomnia or very few hours of sleep per night are linked to memory loss or to strokes as you become older.
Thus, it was proved that people who have the tendency to sleep less than seven hours every day are more likely to suffer a stroke.
A new research now shows that fewer hours of sleep every night might also be a cause for heart attacks later on in life.
The study conducted by researchers at World Health Organization revealed that sleeping disorders are as bad for your heart as smoking or leading a sedentary life.
“Sleep is not a trivial issue. Sleeping disorders were associated with greatly increased incidences of both heart attack and stroke. Poor sleep should be considered a modifiable risk factor for cardiovascular disease along with smoking, lack of exercise and poor diet,” said Professor Valery Gafarov.
He also added that a normal person should sleep between 7 and 8 hours every night and, if they don’t manage to do that, they should seek specialized help from a sleep doctor.
The study, which began in 1994, involved 657 men whose ages varied from 25 to 64 years old, from Russia. They had never suffered any heart attack or stroke and they did not have diabetes, which is a disease that can lead to these conditions.
Their sleep quality was rated according to the Jenkins Sleep Scale and it was regarded as either very bad, bad or poor for those who had a sleeping disorder.
They were monitored for heart attacks and strokes over the next 14 years and it was revealed that 63 percent of those who suffered a heart attack also suffered from a sleeping disorder.
Therefore, it was shown that people who had sleeping problems were more than 2 times more likely to have a heart attack and 1.5 to 4 times more at risk of having a stroke that those who had a  normal sleep every night.
These findings are extremely worrying, given the fact that the mortality rate associated with heart attacks is extremely high. It was estimated that it represents half of the causes of death all over the world, making it the leading cause in many countries, including the U.S.
This is why preventive measures are extremely important. We need to sleep well, exercise regularly, avoid smoking and drinking alcohol, eat healthy food and maintain a normal body weight.
Read more here

Study: Children can experience disturbed sleep after traumatic brain injury

A study indicates that children's sleep can be disturbed following a traumatic brain injury.

Children who sustain traumatic brain injury (TBI) are more likely to experience greater daytime sleepiness, sleep disturbances, and poorer overall sleep quality, and to have impaired emotional, physical, and social functioning, when compared with children without TBI, a small study suggests.
"For clinicians treating children with TBI, it's worth asking children or their parents about their sleep," principal investigator Kimberly Allen, PhD, RN, from the Center for Narcolepsy, Sleep and Health Research, Department of Women Children and Family Health Science, University of Illinois-Chicago, noted in an interview withMedscape Medical News.
She presented the study at SLEEP 2015: the Annual Meeting of the Associated Professional Sleep Societies.
Research Gaps
Pediatric TBI is common. Each year in the United States over 500,000 children are admitted to the hospital with a TBI. The short- and long-term consequences can include motor and sensory impairments; cognitive, emotional, and psychosocial impairments; and sleep problems, although sleep is less well studied, Dr Allen said.
She and her colleagues assessed the sleep of 15 children with TBI (3 with mild TBI, 5 with moderate TBI, 6 with severe TBI, and 1 with unknown TBI severity) compared with that of 15 healthy children, matched on age, race, and maternal education level. The children were about 11 years of age on average. Those with TBI were an average of 594 days post-injury (range, 26 to 1076 days).
As hypothesized, compared with healthy children, children with TBI demonstrated statistically significant increases in daytime sleepiness on the modified Epworth Sleepiness Scale (P = .03), poorer sleep quality on the Child Sleep Wake Scale (P = .001), and poorer functional status on the Pediatric Quality of Life Inventory (P < .001). Overall, the effect sizes were "high and clinically relevant," the researchers note in their poster.
"Sleep is something physicians need to ask about in children with TBI," Dr Allen said.
She noted that "in most studies of pediatric TBI and sleep, sleep has been a secondary aim, not a primary aim," and they haven't used standardized sleep measures.
"This study," Dr Allen said, "provides a first glance at what children with TBI look like in terms of sleep compared to their peers that are healthy, typically developing children. We need more research in this area."
It should be noted, she added, that most children with TBI were hospitalized for more than 1 week and required rehabilitation, which may play a role in why they experienced daytime sleepiness, poorer sleep quality, and poorer functional status.
"Important" Study
Reached by email for comment, Suresh Kotagal, MD, consultant in neurology, pediatrics and sleep medicine, Mayo Clinic, Rochester, Minnesota, said, "The results are important as they address an important gap in pediatric sleep medicine, i.e., hypersomnia, that develops after head injury."
Dr Kotagal, who wasn't involved in the study, said there are likely "multiple factors underlying excessive daytime sleepiness after head injury. To start with, one has to consider variables prior to trauma that can impact sleep such as hyperactivity and anxiety. The head injury itself could also lead to central neurotransmitter imbalance or hypocretin deficiency that predispose to drowsiness. Medications utilized in head injured children such as antiepileptic drugs and antispasticity agents like baclofen can also contribute to drowsiness."
"Pediatric physical medicine and rehabilitation programs need to pay more attention to post-traumatic hypersomnia as an important treatable symptom that influences cognitive function and the overall quality of life," Dr Kotagal told Medscape Medical News.
Shalini Paruthi, MD, fellow of the American Academy of Sleep Medicine and director of the Pediatric Sleep and Research Center at SSM Cardinal Glennon Children's Medical Center, St. Louis, Missouri, toldMedscape Medical News that sleep in children with TBI "hasn't been studied enough, so it's great to have this pilot data. Being able to recognize that sleep problems might be part of the TBI effects is very important."
"As part of comprehensive care for our kids who have traumatic brain injuries, we should also be thinking about their sleep. Better sleep may have an impact on healing. We don't know that yet, but it's possible," added Dr Paruthi, who wasn't involved in the study.
Read more here

Wednesday, July 01, 2015

FDA Approved Nasal Spray to

The FDA recently approved a nasal spray to treat migraines in children. Please see the entire press release for more information.

Impax Specialty Pharma, a division of Impax Laboratories, Inc. (NASDAQ: IPXL), announced today that the U.S. Food and Drug Administration (FDA) has approved ZOMIG Nasal Spray for use in pediatric patients 12 years of age and older for the acute treatment of migraine with or without aura.
ZOMIG Nasal Spray is the first nasal-delivered prescription medicine approved for the treatment of acute migraine attacks in pediatric patients. Nasal sprays may offer an alternative method of administration when patients experience migraine-associated nausea, have difficulty taking oral formulations, or do not have liquids available.
ZOMIG Nasal Spray's approval came after the FDA's review of safety and efficacy data from pivotal clinical trials demonstrating that ZOMIG Nasal Spray 5 mg is significantly more effective than placebo in providing no headache pain, relief of headache, and other associated symptoms of migraine when treating migraine in pediatric patients. In clinical trials, the medication also had a safety profile similar to that demonstrated in adults. For full safety and efficacy information, please see the prescribing information.
The American Migraine Prevalence and Prevention (AMPP) Study estimated the 1-year prevalence of migraine among US children ages 12 to 19 at 6.3%, with prevalence among boys at 5.0% and among girls 7.7%.2 "Until now, there have been few medications to treat pediatric patients with painful, debilitating attacks of migraine," said Dr. Alan M. Rapoport, Past President of the International Headache Society and Clinical Professor of Neurology at the David Geffen School of Medicine. "We are pleased that ZOMIG Nasal Spray has been approved by the FDA for use in patients ages 12 to 17."
"Treatment options have been limited for pediatric patients and we are pleased with FDA's decision and look forward to bringing migraine relief to pediatric patients by making ZOMIG Nasal Spray available to this 'school age' patient population," said Fred Wilkinson, President and Chief Executive Officer of Impax Laboratories. "This expanded indication exemplifies our strategy to broaden the reach of our current product portfolio to address unmet needs in underserved therapeutic areas, thereby adding value for patients and shareholders alike."
The recommended starting dose for ZOMIG Nasal Sprays in pediatric patients 12 years of age and older is 2.5 mg. As the individual response to ZOMIG Nasal Spray may vary, the dose should be adjusted on an individual basis. The maximum recommended single dose of ZOMIG is 5 mg. The maximum daily dose should not exceed 10 mg in any 24 hour period.
About ZOMIG Nasal Spray
ZOMIG Nasal Spray was first approved by the U.S. Food and Drug Administration (FDA) in September 2003for the acute treatment of migraine attacks, with or without aura, in adults. In clinical trials, ZOMIG Nasal Spray provided relief in as soon as 15 minutes for some patients and the maximum effect was reached within 2–4 hours for most adult patients. At 2 hours, 69% of patients taking the 5mg dose had headache response (taking the patient from moderate to severe pain to mild or no pain) and 36% were pain free.1
Read more here

Study: Fidgeting may help children with ADHD focus

A study claims that fidgeting may help children with ADHD focus on test taking.

Children with attention deficit hyperactivity disorder (ADHD) often fidget, but new research suggests intense fidgeting may actually help them focus on the task at hand.
If the research bears out, the traditional advice to encourage these children to sit still may be misguided, said lead researcher Julie Schweitzer, a professor of psychiatry and behavioral sciences at the MIND Institute of the University of California, Davis.
"Traditionally, it's recommended that kids stay still and not be disruptive," Schweitzer said.
But in her small study comparing 26 children with ADHD and 18 without the disorder, she found that when the children with ADHD were moving or fidgeting more intensely, they performed better on a test requiring attention.
Meanwhile, the movements of the children without ADHD did not affect test performance.
The study was published online June 11 in the journal Child Neuropsychology.
Why may fidgeting help the ADHD children?
"What I suspect is that kids with ADHD are moving to increase their attention by activating their arousal system," Schweitzer speculated. "Being aroused does increase attention."
The children all performed the same test, which required them to focus and to dismiss distractions. The children were asked to determine the direction of the middle arrow in a series of arrows. They needed to ignore the arrows surrounding the middle one.
The intensity of movement, but not its frequency, was linked with more correct answers in the children with ADHD. However, the research did not prove cause and effect, only a link or association.
The children in the study ranged in age from 10 to 17, and were 14 on average. Fifteen of the children with ADHD took stimulant medication, but stopped it for 24 hours before the testing.
Nearly 6 million children in the United States have a diagnosis of ADHD, according to the U.S. Centers for Disease Control and Prevention. Hyperactivity is a core symptom and one of the most observable hallmarks of the disorder, according to the researchers. The inability to sit still can cause challenges in school settings. Other symptoms include impulsivity and an inability to pay attention.
The theory of how fidgeting might help those with ADHD has been long talked about, said Brandon Korman, chief of neuropsychology at Nicklaus Children's Hospital in Miami. However, he believes the new research is one of the first studies to test the theory.
One limitation of the finding, however, was the small number of children who were involved, he said.
Korman also does not think the findings suggest fidgeting is always acceptable for these kids.
"It doesn't suggest we should let them fidget if it's disturbing the other kids," he said. He added that the researchers should look at the effect of physical activity before classwork, such as scheduling recess before academic tasks that require a lot of concentration.
Schweitzer said she would like to examine larger groups of children, to get a better idea of what is the best amount of movement for kids with ADHD.
"I'd love to tackle that in a future study, as it could guide parents and teachers," she said, "although I suspect it would be different on an individual basis, with some children needing to move more than others for the movement to improve their task performance."
Read more here

Above average vision may be an early sign of autism

Research shows that above average vision as early as nine months old could be indicative of autism.

Exceptional visual perception might be an early hallmark of autism, which could help predict a child will be diagnosed with the developmental disability, a new British study suggests.
Infants who more quickly perceived a mismatched symbol on a screen when they were 9 months old were more likely to receive an autism diagnosis by age 2, the researchers found.
"Although atypical perception, such as better visual search and hypersensitivity to sounds, are common in autism, they were rarely considered as a core feature in early development," said study lead author Teodora Gliga of Birkbeck Babylab at the University of London. "Our finding is therefore striking since it strongly suggests atypical perception may be a driving force of later poor social interaction and communication symptoms."
Most autism research to date has focused on difficulties children have with social interactions, behavior and communication, such as poor eye contact, the authors noted in their study. Focusing on above-average perceptual skills is a new direction to research.
These findings might also help clinicians eventually make diagnoses earlier since most children cannot receive a full clinical assessment until they are 2 or 3 years old, said study co-author Rachael Bedford, a postdoctoral researcher in psychiatry, psychology and neuroscience at King's College London.
"It is difficult to know whether early impairments, such as communication difficulties, are specific to autism development, or might actually relate to a range of different developmental disorders," Bedford said. "Our finding that infants' superior perceptual abilities relate to autism might offer a more selective target for screening."
This is the first time an enhanced early ability relates to early autism symptoms, she added.
The findings were published June 11 in the journal Cell Press.
It's estimated that one in 68 U.S. children has an autism spectrum disorder. While there is no cure, early identification and services can improve a child's development, according to the U.S. Centers for Disease Control and Prevention.
For the experiment, the researchers presented 109 infants with a screen showing a circle of Xs along with either an O, S, V or + sign as part of the circle. Then they used eye-tracking technology to time how quickly the odd letter out drew the infants' attention at 9 months of age.
The infants also underwent standard assessments for autism symptoms at 9 months, 15 months and 2 years. Of the full group, 82 were at high risk for autism because an older sibling had been diagnosed with it. The other 27 children were at low risk.
By the time they turned 2 years old, 20 percent of the at-risk children had been diagnosed with autism, and another 30 percent showed several increased symptoms of autism, the researchers said.
When the researchers compared the children's speed at noticing the letter that did not match the Xs, they found that children who saw it the fastest at 9 months old had more autism symptoms at 15 months and 2 years old.
"People with autism have both difficulties and strengths compared to the rest of us," Gliga said. "We know some of the difficulties can be detected fairly early in life, but this study shows that unusual strengths can also be seen in infants."
This doesn't mean that every eagle-eyed infant will develop autism. While the study shows an association between a superior visual skill and later autism, it cannot show that children with exceptional visual perception will definitely develop autism, cautioned Dr. Glen Elliott, chief psychiatrist and medical director of Children's Health Council in Palo Alto, Calif.
"It is far too early to tell whether this methodology will lead to earlier diagnosis of children at risk for development of autism," said Elliott, who was not part of the research. "The sample size is too small and too narrow to permit generalizations about the utility of the technique, and much more information is needed for a diagnosis of autism spectrum disorder."
That additional information reduces the chance that someone with autism is missed or that someone without autism is incorrectly diagnosed with it. At the same time, he added, this method is simple and noninvasive, making it valuable if the findings hold up in future studies and in the real world.
"This discovery potentially allows us to design future therapies around these infants' strengths in order to enhance the later quality of life for individuals with the condition," Gliga said.
The study was funded by Britain's Medical Research Council.
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Study: Link between insomnia and stroke

A recent study indicates that those suffering from insomnia have a greater risk of stroke than those who do not have insomnia.

Insomniacs face a much higher risk of stroke than restful sleepers, according to a recent study.
The study, published in the peer-reviewed scientific journal Stroke, an American Heart Association (AHA) publication, sought to link cardiovascular health with sleep-related health.
Past research has shown that not getting enough sleep can lead to a significant number of health problems, including elevated stress levels, symptoms of Alzheimer's disease, and even widespread pain conditions such as fibromyalgia.
Now, researchers from Taiwan's Chia Nan University of Pharmacy and Science, and the Department of Medical Research at Chi-Mei Medical Center, have tied insomnia - a condition of chronic sleep deprivation - to an elevated risk of stroke.
To determine this, the researchers analyzed the medical records of more than 21,000 insomniacs in Taiwan, China. The medical data on these patients was observed for a four-year period, allowing the researchers to conclusively differentiate the intensity of each insomniacs' condition.
The participants were identified as having either chronic or persistent insomnia - disturbed sleep lasting for more than a month; relapse insomnia - return of insomnia symptoms after being free of the condition for more than 6 months; or remission insomnia - becoming non-insomniatic at any point during the study.
These groups were then compared to the medical histories of over 60,000 people who did not have insomnia.
Looking at hospital records, the researchers were able to determine that the patients with insomnia had a 54 percent increased risk of stroke than the non-insomniacs. Even more alarming, insomniacs who were diagnosed with the sleeping disorder when they were young-adults between 18 and 35 years old were a whopping eight times more likely to be hospitalized for stroke, compared to non-insomniacs.
Predictably, the risk of stroke was also found to be greatest in those who suffered from chronic or persistent insomnia or had diabetes.
According to the researchers, although they did not determine a cause-and-effect relationship with this study, past research has suggested that the stress disturbed sleep can have on your heart can cause inflammation, increased blood pressure, and even impaired glucose levels.
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Concussions occur during youth football practice

Many concussions happen during youth football practice, a recent study claims.

Most concussions among high school and college football players occur during practice, a new study finds.
Data on more than 20,000 young football players across the United States revealed that more than 57 percent of concussed high school and college players were injured at practice, not games.
Among youth football players, almost half of concussions were sustained during practice, according to the study published online May 4 in the journal JAMA Pediatrics.
Evaluating and modifying techniques used during practice may offer opportunities for prevention, experts say.
"While it is harder to change concussion incidence during games without major rule changes, a substantial number of concussions occur during practice across all levels," said lead researcher Thomas Dompier, president of Datalys Center for Sports Injury Research and Prevention Inc., in Indianapolis.
Policy makers and coaches could reduce the odds of serious head injury by limiting player-to-player, or full body, contact during practices, Dompier said.
Dr. John Kuluz, concussion director at Nicklaus Children's Hospital in Miami, said he isn't surprised so many concussions occur during football practice.
"There are a lot of concussions occurring in practices, but of course there are a lot more practices than games," he said. Kuluz pointed out that, according to the study, younger players had about three practices for each game; high school players had about four practices for each game; and college players had nearly 10 practices for a game.
Despite the greater number of practices, games are still more dangerous in terms of head trauma, Kuluz said.
Kuluz agreed that modifying physical contact -- the main cause of concussions -- would help reduce the odds of injury.
"You can't eliminate all player-to-player contact in practice," he said. "But there are alternatives -- like hitting dummies or using sleds -- rather than hitting each other," he said.
As awareness of long-term brain trauma increases, sports-related concussions are a growing public health concern, the researchers pointed out.
Schools are more aware than ever of the risk of concussions, Kuluz said. "All the schools I talk to are aware that there is a big risk of concussion when you play football," he said.
The study results are based on an analysis of data from three sources: the Youth Football Surveillance System; the National Athletic Treatment, Injury and Outcomes Network; and the National Collegiate Athletic Association Injury Surveillance Program.
The researchers found that during the 2012 and 2013 seasons 1,198 concussions occurred -- almost 12 percent of them among youth athletes, 66 percent among high school players, and 22 percent on the college field.
In all, concussions accounted for 9.6 percent of reported youth injuries, 4 percent of high school injuries and 8 percent of college injuries, the researchers found.
During practice, concussion rates were lower among college players than among high school players, the study found.
In 2012 and 2013, youth football players had the lowest concussion risk -- less than 4 percent both seasons. The one-season concussion risk was highest in high school at nearly 10 percent, and college players at 5.5 percent, the researchers said.
Among kids ages 5 to 7 there were no football-related concussions during that study period, researchers say.
Each year, approximately 3 million youth athletes, 1.1 million high school athletes and 100,000 college athletes play football, the researchers noted.
"Across all levels of football, policy makers, coaches, researchers and sports medicine officials should continue to seek ways to reduce concussion incidence," Dompier said.
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