Study: Texting negatively affects teen's sleep and academic performance

A study shows that teenagers who text at night hurts their sleep and academic performance.

Can't stop texting? If you're a teenager, it may be to blame for falling grades and increased yawning in school, according to a new Rutgers study.

The study, published in the Journal of Child Neurology, is the first of its kind to link nighttime instant messaging habits of American teenagers to sleep health and school performance.

"We need to be aware that teenagers are using electronic devices excessively and have a unique physiology," says study author Xue Ming, professor of neuroscience and neurology at Rutgers New Jersey Medical School. "They tend to go to sleep late and get up late. When we go against that natural rhythm, students become less efficient."

The American Academy of Pediatrics reports that media use among children of all ages is increasing exponentially; studies have found that children ages 8 to 18 use electronic devices approximately seven-and-a-half hours daily.

Ming's research is part of a small but growing body of evidence on the negative effects of electronics on sleep and school performance. But few studies, Ming says, have focused specifically on instant messaging.

"During the last few years I have noticed an increased use of smartphones by my patients with sleep problems," Ming says. "I wanted to isolate how messaging alone - especially after the lights are out - contributes to sleep-related problems and academic performance."

To conduct her study, Ming distributed surveys to three New Jersey high schools - a suburban and an urban public school and a private school - and evaluated the 1,537 responses contrasting grades, sexes, messaging duration and whether the texting occurred before or after lights out.

She found that students who turned off their devices or who messaged for less than 30 minutes after lights out performed significantly better in school than those who messaged for more than 30 minutes after lights out.

Students who texted longer in the dark also slept fewer hours and were sleepier during the day than those who stopped messaging when they went to bed. Texting before lights out did not affect academic performance, the study found.

Although females reported more messaging overall and more daytime sleepiness, they had better academic performance than males. "I attribute this to the fact that the girls texted primarily before turning off the light," Ming says.

The effects of "blue light" emitted from smartphones and tablets are intensified when viewed in a dark room, Ming says. This short wavelength light can have a strong impact on daytime sleepiness symptoms since it can delay melatonin release, making it more difficult to fall asleep - even when seen through closed eyelids.

"When we turn the lights off, it should be to make a gradual transition from wakefulness to sleep," Ming says. "If a person keeps getting text messages with alerts and light emission, that also can disrupt his circadian rhythm. Rapid Eye Movement sleep is the period during sleep most important to learning, memory consolidation and social adjustment in adolescents. When falling asleep is delayed but rising time is not, REM sleep will be cut short, which can affect learning and memory."

Ming notes some benefits to early-evening media use, such as facilitating collaboration for school projects, providing resources for tutoring, increasing school readiness and possibly offering emotional support systems.

She suggests that educators recognize the sleep needs of teenagers and incorporate sleep education in their curriculum. "Sleep is not a luxury; it's a biological necessity. Adolescents are not receiving the optimal amount of sleep; they should be getting 8-and-a-half hours a night," says Ming. "Sleep deprivation is a strong argument in favor of later start times for high schools - like 9 a.m."

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Academic outcomes for epileptic children post-surgery

A study of epileptic children indicates that those who had brain surgery struggled in their class post-surgery.

A new study by a University of Toronto Mississauga researcher has taken the first-ever look at the academic outcomes of children with epilepsy who have had brain surgery, and found that they have a higher chance of struggling in class following their surgery.

Psychology professor Mary Lou Smith was co-leader of a team of researchers who studied the arithmetic, spelling, reading and reading comprehension abilities of children after having resective epilepsy surgery, a procedure that involves removing a part of the brain in order to halt seizures. The patients completed standardized tests both before their surgery and about 14 months afterwards, and all received lower scores on the second test in the first three academic areas. The results, Smith says, challenge a commonly-held but false assumption that stopping seizures can free up brain power for better academic performance.

"The surgery stops the seizures, but it's not like we put a new brain in there. These children still have a preexisting brain abnormality," says Smith, a UTM psychology professor, and a senior associate scientist in the Neurosciences and Mental Health Program in the Research Institute of the Hospital for Sick Children. The study published in the June 2015 edition of the journal Epilepsy & Behavior.

Brain surgery is performed on patients who don't respond to drugs, and whose source of seizures can be pinpointed in the brain. Smith says that of the approximately 25 per cent of people for whom drugs don't work, about 30 per cent meet the criteria to have epilepsy surgery. Working with three other researchers from SickKids and UTM -- including two UTM graduates -- Smith examined the academic achievement levels of 136 children ages 5 to 18, most of whom live in Ontario, and who had underwent pediatric epilepsy surgery between 1995 and 2013. All had completed academic testing as part of their pre-surgical and post-surgical neurological evaluations.

In the pre-surgery tests, most of the children displayed low or underachievement in at least one of the academic domains. This is because children with epilepsy are at higher risk of having cognitive problems in areas such as language, problem solving, learning and memory. The children's post-surgery test results, meanwhile, revealed drops in marks when it came to reading, spelling and numeral operations. Most students decreased about two to six points, but some declined by 10 points or more. This means that while brain surgery can help improve patients' quality of lives by stopping seizures, it doesn't necessarily stall or reverse the tendency toward lower-than-average academic performance.

"What I think is happening now is as they're getting older, they're not progressing at the same rate their peers are progressing, and so as a result of that, over time, you see these lower scores, because the difference between their performance and what's expected given their increasing age is widening," Smith says.

Smith cannot say whether the findings are due to the surgery, the epilepsy, or the children's development, but she is now conducting more research to figure out why. Meanwhile, she says, this new study may be useful to families weighing the pros and cons of surgery for their child with epilepsy.

"This is a tremendously challenging decision for parents, and they want to know the risks and benefits," Smith says. "I think this information is very important for health care providers if they're counseling patients, and for pursuing evidence-based practice."

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Children's academic performance and sleep

This article explains how academic performance in children is affected by their sleep.

Making sure school-aged kids get to sleep at a regular hour is often a struggle for parents. But a study by researchers at McGill University and the Douglas Mental Health University Institute in Montreal suggests it's well worth the effort: the researchers found that a good night's sleep is linked to better performance in math and languages -- subjects that are powerful predictors of later learning and academic success.

In findings published recently in the journal Sleep Medicine, the researchers reported that "sleep efficiency" is associated with higher academic performance in those key subjects. Sleep efficiency is a gauge of sleep quality that compares the amount of actual sleep time with the total time spent in bed.

While other studies have pointed to links between sleep and general academic performance, the Montreal scientists examined the impact of sleep quality on report-card grades in specific subjects. The upshot: with greater sleep efficiency, the children did better in math and languages -- but grades in science and art weren't affected.

"We believe that executive functions (the mental skills involved in planning, paying attention, and multitasking, for example) underlie the impact of sleep on academic performance, and these skills are more critical in math and languages than in other subjects," says Reut Gruber, a clinical child psychologist who led the study. Low academic achievement in children is a common and serious problem that affects 10-20 % of the population. "Short or poor sleep is a significant risk factor for poor academic performance that is frequently ignored," says Gruber, who is a researcher at the Douglas Institute and professor in McGill's Department of Psychiatry.

Gruber's research team, in collaboration with the Riverside School Board in Saint-Hubert, Quebec, studied 75 healthy children between 7 and 11 years of age. The children's nighttime sleep was monitored by actigraphy, which uses a wristwatch-like device to evaluate sleep by measuring movements. "We averaged the data over five nights to build the children's habitual sleep patterns and correlated the data with their report-card grades," Gruber says.

The takeaway for parents

The findings underscore the importance of identifying sleep issues that may otherwise go unnoticed, Gruber says. That doesn't mean parents need to rush out and have their kids tested at sleep clinics -- but it does point to a need for pediatricians to incorporate questions about sleep into routine checkups, she adds.

"I think many kids might have some sleep issues that nobody is aware of," she says. "And if the pediatrician doesn't ask about it, we don't know that it's there. Regular screening for possible sleep issues is particularly important for students who exhibit difficulties in math, languages or reading."

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ADHD affects school performance as early as 2nd grade

A study claims that ADHD can negatively affect a child's performance in school as early as the 2nd grade.

Attention-deficit/hyperactivity disorder can harm a child's academic performance and social skills as early as the second grade, a new Australian study contends.

Children between 6 and 8 years old who were tested and scored high for ADHD symptoms were more likely to get lower grades in elementary school and have trouble fitting in with other kids, compared with children without ADHD, the study authors reported.

Kids with ADHD also were more likely to have other mental health or developmental disorders, including anxiety, depression and autism, according to the study.

"Already at this stage, which is relatively young, it's very clear the children have important functional problems in every domain we registered," said study lead author Dr. Daryl Efron, a developmental-behavioral pediatrician with the Royal Children's Hospital Melbourne. "On every measure, we found the kids with ADHD were performing far poorer than the control children."

The researchers also said they discovered that about 80 percent of the young children with ADHD symptoms had not been diagnosed with the disorder, a finding called "striking" by Dr. David Fassler, a clinical professor of psychiatry at the University of Vermont College of Medicine.

"For this reason, I would fully agree with the authors' conclusion that the results of the study underscore the need for earlier recognition and treatment of ADHD in young children," Fassler said.

The study, published online Sept. 29 in the journal Pediatrics, is one of the first reports from the Children's Attention Project, a long-term examination of ADHD funded by the Australian government.

The researchers tested nearly 400 children between 6 and 8 years of age at 43 Melbourne schools, identifying 179 with ADHD and another 212 without ADHD who will serve as a "control group." These children will be observed throughout their academic careers.

By the second grade, the children with ADHD were already struggling. They were more likely to score below-average in reading and mathematics, and more likely to have problems connecting socially with their peers, the researchers said.

For example, 33 percent of kids with ADHD were reading below average and 46 percent had math skills below average. For non-ADHD kids, only about 6 percent were reading below average and nearly 15 percent had below-average math skills, the researchers found.

And the ADHD children were more likely to have other mental health or developmental problems -- such as anxiety, obsessive-compulsive disorder, depression, mania and autism, said Efron, who's also a senior lecturer at the University of Melbourne.

"Some people think it's only when kids get older you can pick up these comorbidities [overlapping health issues]. But we've shown you can pick them up at this early stage if you are looking for them," he said.

What's more, these problems seem to accumulate in some kids with ADHD, with 30 percent having two such impairments and 24 percent having three. By comparison, about 6 percent of non-ADHD kids had two such impairments, and about 1 percent had three, according to the study.

The investigators found that boys and girls with ADHD were equally impaired by the disorder.

"There hasn't been that much research into girls with ADHD, so we don't know that much," Efron said. "When we do see girls, in my experience, they are as impaired as the boys. But it is a novel research finding."

In another study published in the same issue of Pediatrics, researchers presented disappointing results for a drug that some had hoped would ease the insomnia experienced by many children with ADHD.

The drug, eszopiclone, failed to help children aged 6 to 17 with their ADHD-related insomnia. Both low and high doses of the drug proved ineffective, the researchers found.

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Children with ADHD perform worse than peers in second grade

A study shows that children with ADHD perform below their peers as early as second grade.

Children with attention-deficit/hyperactivity disorder (ADHD) perform well below their peers who do not have ADHD on multiple functional domains as early as grade 2, a new community-based study shows.

Daryl Efron, MD, Murdoch Children's Research Institute, Melbourne, Australia, and colleagues found that children with ADHD between 6 and 8 years of age were 11.0 times more likely to meet criteria for externalizing disorders than non-ADHD control children (P < .001).

They were also almost 3 times more likely than control individuals to meet criteria for internalizing disorders (P = .02).

On both reading and math computation, "striking" differences in academic performance were again observed between children who had ADHD and control children, equating to nearly a full standard deviation for both literacy and numeracy, the researchers report.

Children with ADHD were also more likely than control children to have problems with their peers according to both parent and teacher reports.

Yet prior to study enrollment, only 17% of children in the ADHD group had been diagnosed with ADHD, and only 13% were taking a medication for it.

"In their second year of school, children who had ADHD performed worse than controls across all functional domains, yet only a minority had been formally diagnosed with ADHD," investigators write.

"Findings highlight the need for earlier diagnosis and intervention."

The study was published online September 29 in Pediatrics.

High Comorbidity Burden

Participants were recruited from 43 elementary schools in metropolitan Melbourne, Australia.

The Conners 3 ADHD Index was distributed to parents of all second grade children in participating schools. Teachers completed the same measure.

Children were defined as screening negative for ADHD if their score on the ADHD Index was less than the 75th percentile (boys) or less than the 80th percentile (girls) by both parent and teacher reports and there was no parent-reported diagnosis of ADHD.

Each positive screen was randomly matched on sex and school to a negative screen.

ADHD Index cases were confirmed, and the presence of mental health comorbidities was assessed using the National Institute of Mental Health's Diagnostic Interview Schedule for Children, Version IV, conducted face-to-face with parents.

Children were classified as having an internalizing disorder if they met criteria for separation anxiety disorder; social phobia; generalized anxiety disorder; posttraumatic stress disorder; obsessive-compulsive disorder; hypomania; or manic episode.

Children were classified as having an externalizing disorder if they met criteria for oppositional defiant disorder or conduct disorder.

Academic achievement was assessed using the word reading and math computation subtests of the Wide Range Achievement Test 4, and social functioning was assessed by using the 5-item parent- and teacher-reported peer problems scale of the Strengths and Difficulties Questionnaire.

A total of 179 children with ADHD and 212 children without were compared across the various functional domains. Among those with ADHD, 93 had the combined ADHD subtype; 64, the inattentive subtype; and 22, the hyperactive subtype.

The most prevalent comorbid mental health disorder in children with ADHD was oppositional defiant disorder, affecting 54.2% of the group.

Children with ADHD were also significantly more likely than control children to have multiple impairments (P < .001).

The authors note that only 11% of children with ADHD had no functional impairments, compared with 57% of non-ADHD control children.

Children with ADHD "had a high burden of mental health comorbidities, were performing markedly worse academically, and had poorer peer relations," the investigators write.

"Our findings suggest that comorbidities are identifiable by early primary school age if symptoms are inquired about systematically."

"This is important," they add, "as children who have ADHD and comorbidities respond optimally to a combination of medication and behavioral interventions."

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Binge drinking, marijuana use, and poor academic performance predicted by sleeping problems

A study shows that binge drinking, marijuana use, and poor academic performance are predicted by problems sleeping.

While the temptations to stay up late are many, a small new study suggests a very good reason for college students to hit the hay. Those who are poor sleepers are more likely to get worse grades and to withdraw from a course, according to a new study. In fact, the effects of poor sleep were about as strong as binge drinking and marijuana use on a student's academic performance.

The researchers analyzed data from over 43,000 students included in the spring 2009 American College Health Association's National College Health Assessment (NCHA). After controlling for potentially confounding factors that might predict how a college student fares academically, like clinical depression, feelings of isolation or chronic health problems, the researchers found that getting poor sleep was a strong predictor of problems at school.

While few students are likely to have a clinical sleep disorder, Roxanne Prichard, Ph.D., associate professor of psychology at the University of St. Thomas in St. Paul, Minnesota tells The Huffington Post, about 60 percent say they have some kind of problem sleeping. But for all the effort colleges put into anti-drinking and de-stressing campaigns, little time or money is spent to promote better sleep -- and doing so could help both students and the colleges themselves, she says.

"Sleep really isn't systematically approached in a way that could have major economic benefits to both the students and the universities in terms of increased retention," she says. Indeed, reducing the number of courses a student withdraws from by just one ups his or her probability of graduating by 14 percent, she says -- and it goes without saying that student retention is good for a university's bottom line.

Prichard hopes more schools decide to include a screening for sleep problems among students, which could ultimately limit costs of care of university health centers, she says. "I don't think sleep problems are showing up on the questionnaire intake forms for health services, and that could be explaining a lot of the other problems that you see showing up," she says. "Recurrent illness could be sleep problems."

Prichard and co-investigator Monica Hartmann, Ph.D., professor of economics at the University of St. Thomas, found that poor sleep was even more detrimental among freshmen, according to the study. "I think that's partially because freshmen have the worst sleep of any age group," she says. Not only are they hungry for independence from their parents, but they also are more likely to be "delayed phase" -- essentially, they are more biologically inclined to be night owls because of their age, she says. Focusing especially on first-year students is a smart idea for universities, she says, because freshmen-year success (or lack thereof) is a strong predictor of whether or not a student drops out his or her sophomore year.

The research, published in an online supplement of the journal SLEEP, will be presented Tuesday, June 3, at SLEEP 2014, the 28th annual meeting of the Associated Professional Sleep Societies.

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Language problems more common in children with ADHD

A study found that children with ADHD are more likely to have language problems.

Children who have attention-deficit/hyperactivity disorder are nearly three times more likely to have language problems than kids without ADHD, according to new research.

And those language difficulties can have far-reaching academic consequences, the study found.

The study, published online April 21 in Pediatrics, looked at 6- to 8-year-olds with and without ADHD in Australia.

"We found that 40 percent of children in the ADHD group had language problems, compared to 17 percent of children in the 'control' group," said Emma Sciberras, a clinical psychologist and post-doctoral research fellow at the Murdoch Children's Research Institute in Victoria, Australia. "Rates of language problems were similar in boys and girls with ADHD," she added.

Children with ADHD commonly have trouble with school performance and social functioning. The impact that language problems might have on these factors hasn't been well-studied, the study authors noted.

"The differences in academic functioning between children with ADHD and language problems, compared to those with ADHD alone, were quite large and clinically meaningful," said Sciberras.

Language problems refer to spoken language -- both receptive and expressive language. Receptive language is the ability to listen and understand what's being said; expressive is the ability to speak and be understood.

In a separate study in the same issue of the journal, Sciberras and her colleagues looked at almost 400 children with ADHD, aged 5 to 13, and found almost two-thirds had one or more anxiety disorders.

When children with ADHD had two or more anxiety disorders -- this was true for one-third of the kids -- their quality of life, behavior and daily functioning suffered, the researchers said.

"It is very common for children with ADHD to experience additional difficulties," said Sciberras. "Both of these studies demonstrate that the additional difficulties that go along with ADHD, in this case anxiety and language problems, can make daily functioning even harder for children with ADHD."

The language study included 179 children diagnosed with ADHD and 212 without the attention disorder. Fewer than half of the children with ADHD were taking medications to help control their symptoms.

After adjusting for sociodemographic factors and other conditions, such as autism spectrum disorders, the researchers found that the risk of language problems was 2.8 times higher in children with ADHD.

When the researchers looked at how those language problems affected school work, they found lower math, reading and academic scores.

However, the researchers didn't find that language problems had an impact on social functioning.

"We were surprised that language problems were not associated with poorer social functioning for children with ADHD," Sciberras said. "It could be that children with ADHD are already experiencing poorer social functioning due to other factors including their ADHD symptoms or other associated difficulties."

However, Sciberras cautioned that language troubles might become more problematic as these kids get older because social relationships get more complex with age.

One outside expert said the study is a good reminder for parents and physicians.

"If a child has ADHD and they're struggling in school, even though their ADHD symptoms are well-controlled, in addition to getting tested for learning disabilities, they should also be looked at for language difficulties as well. And that's not something we always think of," said Dr. Bradley Berg, medical director of McLane Children's Pediatrics at Baylor Scott & White Healthcare in Round Rock, Texas.

Whether speech-language interventions will help the youngsters with ADHD isn't clear, however.

Berg also pointed out that this issue is a "chicken-and-egg" problem. "Do these kids have a language disorder that's causing them to not understand what's going on at school and that's making them restless and fidgety because they're bored. Or do they have ADHD and that's causing difficulty understanding the language. Or is there something going on in an area of the brain that creates both of these problems?" he said. "We don't know."

It's possible that the findings from this Australian study might not translate to a U.S. population. For one thing, medication trends might differ, Berg said.

For children with ADHD who also suffer anxiety, Sciberras said medications might help, and a type of psychotherapy called cognitive behavioral therapy could also be useful. The researchers are currently conducting a study to treat anxiety in children with ADHD.

"If parents are concerned that their child with ADHD has anxiety, language or any other additional difficulties that are not currently being managed, we encourage them to discuss their concerns with their child's treating clinician," she said.

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Sleep, academics, and behavior all improved by limited screen time

A study shows that limiting screen time improves sleep quality, academic performance, and behavior in children. JR

Parents may not always see it, but efforts to limit their children's screen time can make a difference. A new study, published inJAMA Pediatrics, found children get more sleep, do better in school, behave better and see other health benefits when parents limit content and the amount of time their children spend on the computer or in front of the TV.

Douglas Gentile, lead author and an associate professor of psychology at Iowa State, says the effect is not immediate and that makes it difficult for parents to recognize. As a result, parents may think it is not worth the effort to monitor and limit their children's media use. But Gentile says they have more power than they realize.

"When parents are involved it has a powerful protective effect across a wide range of different areas that they probably never would have expected to see," Gentile said. "However, parents aren't likely to notice that putting limits on the children's media is having these effects seven months later."

Considering that children average more than 40 hours of screen time a week, not counting time spent on a computer at school, even small changes can make a difference, researchers said. They are not suggesting parents completely eliminate screen time, but find a healthy balance.

The study found there is a ripple effect associated with the benefits of limiting both screen time and media content. Gentile is not surprised to see a direct impact on sleep, academics and behavior. However, limited screen time also indirectly affects body mass index. The study found that children got more sleep if parents limited screen time, which also resulted in lower risk of obesity. Parents limiting exposure to violent media resulted in increased prosocial behavior and lowered aggressive behavior seven months later.

Researchers analyzed the media habits of more than 1,300 school children who were recruited to participate in an obesity prevention program. Students and parents were surveyed about everything from screen time limits, to violent media exposure, to bedtimes and behavior. Teachers reported grades and commented on student behavior and school nurses measured each student's height and weight.

Data were collected at the start of the program and seven months later at the end of the program. By looking at these factors collectively with a group of children over a school year, it was easier for researchers to identify patterns that are hard to recognize in individual children.

"As parents, we don't even see our children get taller and that's a really noticeable effect. With media, what we're often looking for is the absence of a problem, such as a child not gaining weight, making it even more difficult to notice," Gentile said.

"Even with changes that we do notice, we really don't recognize in the moment how all these things are related to each other across time," he added. "Yes, as screen time goes up, school performance goes down, but that doesn't happen overnight. If I watch a lot of TV today, I don't get an F in my class tomorrow."

Doctors can make a difference, too

The American Association of Pediatrics recommends no more than one to two hours of screen time a day for children two years and older. Reality far exceeds those recommendations, which might explain why doctors feel it is futile to talk with parents about guidelines for media use, Gentile said. The study provides further evidence of why pediatricians need to have that conversation.

"Hopefully, this study will give pediatricians a better sense of efficacy that it's worth taking the time to talk to parents," Gentile said. "Even if doctors only influence 10 percent of the parents, that's still millions of children having much better health outcomes as a result."

Researchers recommend doctors talk with parents about setting limits and actively monitoring media use. This can include talking with children about media content, explaining the purpose of various media and providing overall guidance.

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Challenges for college students with ADHD

This article looks into challenges that college students with ADHD face.

Many students with Attention Deficit Hyperactivity Disorder (ADHD) attend college. College students with ADHD face a number of challenges, including choosing a supportive school and community where they can:

• find and access medical services


• get help with organizing their schedule and life


• succeed academically

Most people with ADHD are diagnosed before college. However, some people may not recognize the signs and symptoms of ADHD until they are at college. Trying to balance school work and the freedom of living away from home for the first time may be challenging. It can be natural to feel unfocused, distracted, overwhelmed, or disorganized when attending college. However, if these issues have caused significant problems in the past and are getting in the way of current functioning, the student may have ADHD.

If a student is struggling, it may be helpful to seek consultation with a qualified mental health professional. The diagnosis of ADHD is made based on a comprehensive clinical assessment. This may include information from multiple sources, including rating scales, getting history from the student, family, or past teachers if possible. There is no single test (brain imaging, blood testing, or psychological testing) that can reliably diagnose ADHD. Research shows that medication is the most effective treatment for ADHD. Cognitive-behavioral therapy, social skills training, and academic support can also be helpful.

There are many ways to successfully manage ADHD before and during college.

Preparing for and Staying Organized While at College

• Consider the best college environment to meet your needs, such as class size, workload, academic calendar, and availability of support services. Resources to help you find the best college include: high school counselors, parents, friends who are in or have attended college, and national ADHD organizations or websites.


• Learn about the medical services available at colleges before choosing where to go. Some college and university health centers do not prescribe ADHD medications. You may need to find a doctor in the surrounding community. Think about the transportation options and ease of access to that provider.


• Talk with your doctor about how to best manage your medications when at college. Do not make changes in your medication without consulting your doctor. Ask your current doctor and the doctor at college to coordinate care. It is also helpful to have a history of your medications and your response to those medications for your new doctor.


• If you have used tutors or support before college, think about continuing at college, at least for a little while.


• If you need specific support or accommodations, register at the college disability office. If you have a summary of treatment or any psychological tests that were done within the last 3 years, bring them to the visit.


• Practice using planners, calendars, or scheduling apps while still in high school. The demands on time management and organization increase greatly in college. Even if your parents helped you in the past, it is important to learn to do it yourself.

Managing Medications at College

• Many medications prescribed for ADHD have to be monitored regularly. While at college, you need to schedule and keep your own medical appointments. Changes to your medication should only be made after talking with your doctor.


• Learn how to use pharmacy services. Pay attention to prescription start dates and expiration dates. Many medications prescribed for ADHD are “controlled substances” so states may have additional rules on how these medicines can be provided, including limits on how often prescriptions can be refilled.


• Taking medication that is not prescribed for you, sometimes called “diversion” or “academic doping,” is illegal and unsafe. Your medications were prescribed by your doctor who knows you and your medical history. They should only be taken by you. There are serious cardiac, neurological, and psychological risks of misusing ADHD medications. There can also be serious risks to mixing medications with alcohol or other drugs.


• Keep medications safely stored or hidden to protect against theft. If medications are stolen, report it to campus or local police.

Adjusting to the academic, social, and organizational demands of college is difficult for most students. It can be especially difficult for students with ADHD. Arranging for support from medical and school professionals can help students with ADHD have a successful college experience, as well as a long career after graduation.

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Study: Teenagers who go to sleep late have lower grades

A study shows that teenagers with late bedtimes have lower grades than those who go to sleep earlier.

Teens with late bedtimes during the school year and schooldays that start early have lower academic performance and are at risk for later emotional distress. A new study in the Journal of Adolescent Health provides further evidence for a growing body of research that supports a movement to delay school start times for adolescents.

"Going to bed after 11:30 pm, particularly in younger adolescents, predicted worse cumulative grade point average (GPA) at high school graduation and more emotional distress in the college years and beyond," said the study's lead author Lauren D. Asarnow, MA, a doctoral student in the department of psychology at the University of California, Berkeley.

The study gathered data on sleep and the number of hours slept from 2,700 teens age 13 to 18 participating in the National Longitudinal Study of Adolescent Health in two cohorts, one in 1995, the second in 1996. In 2001-2002, as respondents aged, data on academic performance and self-reported emotional health were collected for longitudinal comparison. The overall goal of the study was to examine the relationship between the sleep/circadian patterns of high school adolescents in a nationally representative sample, their overall academic performance in high school and rates of emotional distress reported post graduation.

For both high school cohorts, 23 percent of participants reported going to bed at 11:15 pm or later. By the time these teens reached graduation and college age, late school year bedtimes in high school predicted both lower cumulative GPA at graduation and more emotional distress between age 18 and 26. The researchers noted previous research found that adolescents who prefer late activities and bedtimes (a pattern of behavior often referred to as an evening circadian preference) were tested in the morning; they performed worse on cognitive tasks.

Asarnow urged parents to help youngsters get to bed earlier and added that a teen's sleep behavior is highly modifiable with proper support. However, shifting a teen's bedtime from a late to an earlier hour can be hard, she added, in part because for 30 percent to 40 percent of teens, delayed bedtimes have a biological basis tied to the onset and progress of puberty. Furthermore, academic pressure, habits around technology use and the bedtimes of friends also influence a teen's choice to turn in or stay up late.

Timothy Monk, Ph.D., director of the Human Chronobiology Research Program at the University of Pittsburgh agreed that the need to rise very early for school can put students at risk for underperformance academically and for other problems tied to a lack of sleep. "An early school start time both limits the sleeping time of the student and asks him or her to learn at what is close to the nadir of their circadian cycle."

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