Children with ADHD and traffic accidents

Children with ADHD may be more likely to get into traffic accidents due to impulsivity.

Children with attention-deficit hyperactivity disorder (ADHD) may be more likely to have accidents when crossing busy intersections on their bicycles because they're impulsive and have trouble paying attention, a new study suggests.

Researchers said it was known that these children were at increased risk, but the reasons were unclear.

"Crossing roads on a bicycle requires decision and action. What we found is children with ADHD have deficits in both areas," study corresponding author Molly Nikolas said in a University of Iowa news release. Nikolas is an assistant professor in the department of psychological and brain sciences.

Bicycle crashes are a leading cause of severe injuries in children. Each year, nearly 400,000 kids are treated in U.S. emergency departments for bicycle-related injuries, according to the study.

Using a lab-based stationary bicycle, researchers studied how 27 children with ADHD and 36 children without the disorder crossed busy intersections, shown by computer simulation. The children were between the ages of 10 and 14. None of those with ADHD was on medication at the time.

Overall, children crossed when there were similar-sized gaps between cars. But those with ADHD were less precise in timing when to enter the intersection and had less time to spare, according to the study in the December issue of Journal of Child Psychology and Psychiatry.

Moreover, after being exposed to heavy traffic with shorter gaps between cars, youngsters with ADHD had difficulty readjusting when traffic eased and gaps between cars widened. Rather than waiting for the wider gaps, the children with ADHD continued to choose shorter gaps, increasing their risk of an accident.

"The timing issues were more related to symptoms of inattention while the decisions about which gaps to cross were related to hyperactivity and impulsivity -- all core symptoms of ADHD," Nikolas said.

The best way to help children with ADHD cross busy intersections may be to teach them to look for longer gaps between cars, no matter how heavy the traffic, she said.

"Even if their timing remains off, if they have a big enough gap, they will be OK," Nikolas said. "If we can have some intervention or prevention strategies that focus on the decision-making, that may help compensate for the timing deficit."

Almost 6 million American children between the ages of 3 and 17 have ADHD, according to the U.S. Centers for Disease Control and Prevention.

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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."

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Attention issues may be helped by music therapy

Children with ADD, ADHD, and attention issues might be able to be helped by music therapy.

Focus can be a real struggle for people with learning disabilities like ADHD and ADD, but music is being found to be a powerful tool to train minds.

Middle school student Thomas Beckman has the developmental disability Down syndrome and uses music to help him focus.

He takes adapted music lessons at Rhythm & Rehab in Durham, where he gets to play his favorite instrument -- the drums -- as a form of neurologic music therapy.

"Music therapy is using music to accomplish non-musical goals," said Paula Scicluna, the founder and executive director of Rhythm & Rehab. "So, using music to improve speech skills, language, sensory motor skills, cognitive skills, social emotional skills."

At the beginning of his lesson, Thomas banged the drums loudly, looked around at his surroundings and was not focused. He was very distracted.

Encouraging him to keep in time, Scicluna patted the drums saying, "Together, together, together. Can you do it together?"

Thomas ignored instruction.

However, as the session progressed -- in a matter of minutes -- something clicked and his focus increased.

He and Scicluna then moved to the keyboard, and as they attempted to play a duet, he was more in tune to the rhythm and "making music." He intently glanced up at his song sheet and glanced down making sure he hit each key precisely.

"I don't expect him to leave here playing Chopin," said Donna Beckmann, Thomas' mother.

She said the benefits of playing music, such as hand-eye coordination, helps him in his everyday life.

"Whether he's writing something, whether he's helping in the kitchen and cutting up vegetables, it's all connected, she said.

Scicluna pointed out that the quality of Thomas' playing is not what matters, but rather he "continued to play and that he stayed with the activity until I told him to stop."

She said music helps organize the brain, and repetition is key.

"Once you add that rhythm and you add that structure, it helps actually organize the firing of the neurons. Focus, attention [and] impulse control -- all those behaviors that you see children with ADHD and ADD struggle with," Scicluna said. "That's how music therapy is helpful to those children."

So, while some may view Thomas' drumming as noise, he hears music.

"He gets a lot of feedback from heavy movements. So for him to be banging on the drums, that does something for him," his mother said. "The type of focus that this trains him in is to focus when he needs to. The therapy gives him tools to reach his goals."

Beckmann said the structure grounds him, and his instructors have high expectations.

"They know the potential. They know what these individuals are able to do, and they don't settle for less," she said. "That's why you see the phenomenal things my son can do."

Thomas was so focused, he continued to play the keyboard.

"To see him so focused and visually tracking and using the right fingers on the right keys," Scicluna said. "For those of us that don't have to really think about all of those skills independently, you think of all those skills that have to come together in order for that to happen, it's incredible."

Beckmann said, "It's working on so many different pieces of what he needs. I see a more whole child because of music therapy. It's music, it's fun."

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Language and attention gene variations in those with ADHD

A study shows that in those with ADHD, gene variations are seen specifically in language and attention.

Are deficits in attention limited to those with attention-deficit/hyperactivity disorder (ADHD) or is there a spectrum of attention function in the general population? The answer to this question has implications for psychiatric diagnoses and perhaps for society, broadly.

A new study published in the current issue of Biological Psychiatry, by researchers at Cardiff University School of Medicine and the University of Bristol, suggests that there is a spectrum of attention, hyperactivity/impulsiveness and language function in society, with varying degrees of these impairments associated with clusters of genes linked with the risk for ADHD.

Viewing these functions as dimensions or spectrums contrasts with a traditional view of ADHD as a disease category.

To answer this question, researchers led by senior author Dr. Anita Thapar used genetic data from patients with ADHD as well as data from the Avon Longitudinal Study of Parents and Children (ALSPAC). The ALSPAC is based in England and is a large, ongoing study of parents and children followed since birth in the early '90s.

They created polygenic risk scores -- a 'composite' score of genetic effects that forms an index of genetic risk -- of ADHD for 8,229 ALSPAC participants.

They found that polygenic risk for ADHD was positively associated with higher levels of traits of hyperactivity/impulsiveness and attention at ages 7 and 10 in the general population. It was also negatively associated with pragmatic language abilities, e.g., the ability to appropriately use language in social settings.

"Our research finds that a set of genetic risks identified from UK patients with a clinical diagnosis of childhood ADHD also predicted higher levels of developmental difficulties in children from a UK population cohort, the ALSPAC," said Thapar.

First author Joanna Martin added, "Our results provide support at a genetic level for the suggestion that ADHD diagnosis represents the extreme of a spectrum of difficulties. The results are also important as they suggest that the same sets of genetic risks contribute to different aspects of child development which are characteristic features of neurodevelopmental disorders such as ADHD and autism spectrum disorder."

"It may be the case that at some point polygenic risk scores may, in conjunction with other clinical information, help to identify children who will struggle in school and other demanding contexts due to attention difficulties," said Dr. John Krystal, Editor of Biological Psychiatry. "The objective of this type of early identification would be to provide children who are at risk for difficulties with support so that problems at school may be prevented."

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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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Baby's interactions can predict autism development

This article explains how a baby's interactions with others can predict their eventual development of autism.

Some babies are at risk for autism because they have an older sibling that has the disorder. To find new ways to detect Autism Spectrum Disorder (ASD) earlier in life, researchers are exploring the subtleties of babies' interactions with others and how they relate to the possibility and severity of future symptoms.

A new study helps us to understand the connection between early joint attention before one year and later ASD symptoms. Joint attention is an early form of communication that develops toward the end of the first year. It's the act of making eye contact with another person to share an experience.

Previous studies have shown that low levels of initiating joint attention are linked to later autism symptoms in high-risk siblings. The current study reveals that joint attention without a positive affective component (a smile) in the first year is particularly important to this relationship.

"The ability to coordinate attention with another person without a smile, without an emotional component, seems to be particularly important for high-risk siblings in the development of ASD symptoms," says Devon Gangi, Ph.D. student in the UM College of Arts and Sciences and first author of the study. "The detection of markers associated with autism early in life, before a child can be diagnosed with autism, is important to help identify children at the greatest need for early interventions."

The findings show that early joint attention initiation without smiling -- matter-of-fact looking at an examiner to communicate interest in a toy -- was negatively associated with ASD symptoms. According to the study, the less joint attention without smiling at 8 months in a high-risk sibling, the more likely they were to have elevated ASD symptoms by 30 months. Impairments in joint attention are a core deficit in ASD. Now we know that less early initiating joint attention without smiling is a particularly important skill for high-risk siblings.

Not all smiles are the same. Children who were at risk for autism (both those who did and did not later develop symptoms of autism) had lower levels of anticipatory smiles than children who were not at risk for ASD. That is, when an infant first looks at an object, smiles, and then turns that smile towards a social partner, as if the smile anticipates the gaze. On the other hand, a reactive smile occurs when an infant first gazes at a partner, then smiles. Children at risk for ASD did not show differences from low-risk siblings in reactive smiling.

"High-risk siblings seem to have particular difficulty in sharing their preexisting positive affect with another person, which is what happens during an anticipatory smile," says Daniel Messinger, professor of psychology in the UM College of Arts and Sciences and principal investigator of the study. "This difficulty may be indicative of a broader deficit autism trait among most high-risk siblings."

The study is titled "Joint attention initiation with and without positive affect: Risk group differences and associations with ASD symptoms." It was recently published in the Journal of Autism and Developmental Disorders. Lisa V. Ibañez, who received her Ph.D. working with Dr. Messinger at UM, is co-author of the study.

The researchers primarily predicted the children's symptom level. Symptoms vary in at-risk siblings, some of whom have an ASD outcome and some of whom do not. They did not look at whether the younger sibling eventually received an ASD diagnosis. In the future, the researchers would like to examine whether these early behaviors also predict who will have autism.

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Snoring in Children

This article discusses what is important to know about snoring in children.

Snoring in children is a common event, with estimates placing it at about 12 to 15 percent. Most of these children are healthy, show no symptoms and have primary snoring. Snoring happens during sleep due to a blockage of air when breathing as it passes through the back of the mouth. The loudness is affected by how much air passes through and how fast the throat tissue is vibrating. Snoring can be due to an upper respiratory infection, allergies, or it can be a sign of obstructive sleep apnea (OSA).

Infants and toddlers spend over half of their lives sleeping and, by adolescence, greater than on third of our lives are spent sleeping. Quality sleep is essential for proper development and daily functioning. Proper sleep helps with learning, consolidating memories, physical growth, recharging the body and helping our bodies fight infections.

Approximately 2 to 3 percent of children have OSA, which occurs when the posterior air collapses and blocks the throat. Frequent pauses in breathing, lasting from several seconds to a minute, often lead to the brain briefly waking up and causing us to breathe. This leads to gasping or snorting, waking us up and re-breathing. This can occur all through out the night.

Interrupted sleep can lead to behavioral issues, problems with social function, poor school performance and poor growth. These children are also more likely to be hyperactive and have trouble paying attention in school, mimicking signs of attention-deficit hyperactivity disorder (ADHD).

Studies also show that children with OSA are at risk of developing heart and lung problems which can lead to serious consequences later in life if it goes undetected. Untreated OSA, in the short term, often leads to daytime sleepiness, morning headaches, irritability, bed wetting and mouth breathing. The risk of apnea is higher in overweight children.

Other signs might include large tonsils and/or adenoids with frequent mouth breathing, restless sleep or sleep in abnormal positions, sleep in elevated position or with neck extended, excessive sweating during sleep, nasal speech, poor weight gain or being overweight, and high blood pressure. Even primary snoring (i.e. snoring without breathing pauses, frequent arousals, or drips in oxygen levels), which was once thought to be normal, still can lead to problems in school performance or behavior issues.

If you suspect your child may have symptoms of OSA don’t assume his or her snoring will go away on its own. Talk to your child’s doctor. The American Academy of Pediatrics has recognized this as a serious problem and has published recent guidelines for screening of obstructive sleep apnea, which will help doctors recognize, diagnose, and treat children with OSA.

Testing can be done if your child is suspected of having OSA, including an overnight sleep study. You may also videotape your child’s sleep to bring to the doctor for review. Night-time pulse oximetry to measure oxygen levels is also a useful tool. Your doctor may refer your child to a sleep specialist as well, as sometimes these tests are normal even when your child may still have OSA.

Once your child has been found to have obstructive sleep apnea syndrome, referral to doctors who specialize in treating OSA include pediatric otolaryngologists (ENT), pulmonologists and neurologists. Treatment options usually include removing enlarged tonsils and adenoids (T&A). Often removing the tonsils and adenoids stops the snoring and helps with improved appetite and growth in young children. It also improves academic performance and behavior in school-aged children as they get more uninterrupted, quality sleep. Other options include treating allergies or helping children lose weight. A night-time treatment called continuous positive airway pressure (CPAP) therapy is another option for children who can’t have surgery or have persistent OSA even after a T&A has been performed.

Remember to be suspicious that your child may have OSA if he or she regularly snores and has apnea, daytime sleepiness or school/behavior problems. If detected early, treatment of this problem may be reversible.

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Link between sleep apnea and ADHD

This article discusses the potential link between sleep apnea and ADHD in children.

Parents with toddlers displaying symptoms like decreased attention span, hyperactivity, irritability, sleep walking, snoring or breathing through the mouth must check with doctors if the child is suffering from sleep apnea.

Experts emphasize that even if two of these symptoms are seen, the child should be taken to a specialist and tested. If any form of sleep apnea is detected during the sleep study, then appropriate treatment should be sought, they said.

Even two-year-olds can be affected by sleep apnea, and if left untreated, it may hamper the child's growth.

"I have seen children affected almost in the same numbers as adults, and if left undetected and untreated for a long period, may affect the growth of the facial structure of a child," said Seemab Shaikh, ENT surgeon and sleep specialist. He is also the founder and national president of the Indian Association of Surgeons for Sleep Apnea. He sees at least three children with sleep apnea symptoms every day.

Sleep apnea is a condition in which the breathing pauses for a few seconds to minutes during sleep. Typically, normal breathing starts again, with a loud snort or a choking sound. If left untreated, sleep apnea may result in poor performance in academics and physical activities, and behavioral problems such as attention deficit which is sometimes diagnosed as attention deficit hyperactivity disorder (ADHD).

"Various parts of the body do not get proper supply of oxygen and over a longer period of time, this affects the cardiovascular system and the nervous system," said Shaikh.

Shripal Shrishrimal, who specializes in pulmonary medicine and is an American Board certified sleep specialist, said the common symptoms of sleep apnea in children would be - snoring, frequent nightmares, lethargy, hyperactivity, mouth breathing, drooling in sleep, irritability, lack of focus, constant headache, frequent awakening, gasping, sleep walking, bed wetting, daytime sleepiness, drop in academic performance and improper growth.

Just like adults, children too may suffer from any form of sleep apnea - obstructive, central and mixed. Obstructive sleep apnea (OSA), is the most common form and is caused by partial or complete blockage of the upper airway. Central sleep apnea occurs when the brain does not send proper signals to the muscles to control the breathing.

Shrishrimal said the most common causes of sleep apnea in children are swelling or enlargement of tonsils and adenoids, also kn as adenotonsillar hypertrophy. Children who are obese or overweight may also suffer from sleep apnea, and are in this case, asked to first lose weight and then treated through medicines.

"Though surgery is prescribed to remove polyps or correct adenotonsillar hypertrophy, in case symptoms persist, then the continuous positive airway pressure (CPAP) method is used, in which masks are to be worn over the face or nose," said KT Mohan, pulmonologist and sleep disorder breathing specialist.

Doctors say minimally invasive technologies are available to remove extra tissue and enable better breathing, such as radiofrequency ablation and coblation. Although, with early diagnosis, sometimes surgical intervention can be avoided, said Shaikh.

Shrishrimal added that if untreated, sleep apnea over a long term in children may cause cardiac complications, growth failure, learning problems and behavioral problems.

"Often, OSA is the underlying cause of various serious health problems and due to lack of awareness, goes undetected. People with no history of heart or high blood pressure suffer from life-threatening strokes," said Shaikh. "Cases of depression, poor memory, mood disorders and even marital problems happen because of sleep apnea," he added.

Don't ignore the snore

As many as four percent children are affected by sleep apnea

Symptoms

Decreased attention span, drop in academic performance, snoring, frequent nightmares, lethargy, hyperactivity, mouth breathing, drooling in sleep, irritability, lack of focus, constant headache, frequent awakening, gasping, sleep walking, bed wetting, daytime sleepiness

Treatment options

Surgery in case of enlarged tonsils, adenoids or polyps

Weight loss combined with medicine for overweight children

Positional therapy

CPAP therapy, where positive air pressure is forced through the throat by a mask worn over the nose or face

Tests for sleep apnea are a must for children who are obese, have family history of sleep apnea, have cerebral palsy, Down syndrome, or craniofacial anomalies

Sleep necessary for mental health and well-being

This article discusses how crucial good sleep is for a person's mental health and well-being, and the consequences of not having good quality sleep.

Having a good quality and restorative sleep is essential for one to be able to function well throughout the day. Failure to do so will lead to numerous impacts to health, both long- and short-term.

According to the Sleep Disorder Society Malaysia (SDSM) president Dr Muhammad Muhsin Ahmad Zahari, some of the short-term negative impacts include short attention span, memory recall and learning; while its long-term effects have long been associated with hypertension, ischaemic heart disease, stroke, obesity, diabetes, weakened immune system, and cancer.

Dr Muhammad Muhsin added that sleep disorder can also increase the risk of accidents.

"People who suffer from insomnia are seven times more likely to become involved in an accident which then resulted in death or serious injury," he said at the launch of the `World Sleep Day Celebration and Sleep 2014 Conference' at Cititel Hotel, here, today.

He revealed that sleep disorder actually constitute a global epidemic that threatens health and quality of life for up to 45% of the world's population, thus it is essential for everyone to have a better understanding of sleep conditions.

"Sleep is a basic human need and it is crucial not only to our health and well-being, it also plays an important role in the metabolic regulation in children," said Dr Muhammad adding that SDSM is working closely with the relevant authorities, associations and organisations in improving the quality of service of sleep medicine.

"With regards to the quality service in sleep medicine, facilities such as sleep laboratory are vital. As our population grows, there is definitely a need to increase the number of sleep laboratory in public hospitals to cater to the need of the people." he added.

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Study shows that infants with autism divert gaze while people are speaking

A study claims that six month olds who have autism do not look at a person's face when the person is speaking.

From birth, infants naturally show a preference for human contact and interaction, including faces and voices. These basic predispositions to social stimuli are altered in individuals diagnosed with autism spectrum disorders (ASD). A new study now reports that 6-month-old infants later diagnosed with autism divert their gaze from facial features when that face is speaking.

A new study published in Biological Psychiatry this week, from researchers at the Yale University School of Medicine, now reports that 6-month-old infants later diagnosed with autism divert their gaze from facial features when that face is speaking.

One of the best methods to examine autism in very young infants is the use of eye-tracking. This technology uses advanced video monitoring and special software that tracks and 'maps' exactly where the eyes were focused and for how long.

Dr. Frederick Shic and his colleagues used this method to examine how 6-month-old infants looked at videos of still, smiling, and speaking faces. The infants were later assessed at 3 years of age and divided into groups based on based on their diagnosis of ASD, other developmental delays, or typical development.

Infants who later developed ASD not only looked at all faces less than other infants, but also, when shown a face that was speaking, looked away from key facial features such as the eyes and mouth.

"These results suggest that the presence of speech disrupts typical attentional processing of faces in those infants later diagnosed with ASD," said Shic. "This is the first study to isolate an atypical response to speech as a specific characteristic in the first half year after birth that is associated with later emerging ASD."

These findings indicate that infants who later develop ASD have difficulty maintaining attention to relevant social information as early as 6 months of age, a phenomenon that could reduce the quality of their social and communicative exchanges with others and, consequently, the trajectory of their social development.

Autism typically can't be diagnosed until at least two years of age, but this and other studies confirm that abnormalities in behavior and attention can be detected as early as 6 months of age.

"It seems clear that brain changes related to autism appear much earlier than we traditionally diagnose this disorder," commented Dr. John Krystal, Editor of Biological Psychiatry. "This study elegantly illustrates that autism-related disturbances in social relatedness are present very early in life, shaping one's most fundamental social contacts."

These affected infants may be experiencing an altered social experience at a critical developmental point. The hope is that this and further research can help clarify how and when the developmental trajectory is altered in children who develop autism and, potentially, develop targeted interventions that could normalize their developmental processes.

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CDC claims 1 in 10 children has ADHD

A new poll by the CDC shows that 1 in every 10 children has ADHD. This is higher than the last poll done in 2007 showing ADHD cases are rising.

One in every 10 U.S. children has been diagnosed with attention-deficit/hyperactivity disorder (ADHD), but the steady rise in cases has started to slow, a new government survey shows.

The 2011 poll of more than 95,000 parents showed that about 11 percent -- or about 6.4 million -- of children aged 4 to 17 had been diagnosed with ADHD. That's up from a 2007 survey that found that 9.5 percent of youngsters in that age group had an ADHD diagnoses.

Nearly one in every five high-school age boys, and about one in every 11 high school age girls, was reported by their parents as being diagnosed with having ADHD, the U.S. Centers for Disease Control and Prevention report found.

Numbers also varied widely between states, as well, with 15 percent of children in Arkansas and Kentucky reporting a history of ADHD treatment, compared to just 4 percent of those in Nevada.

The number of children placed on ADHD medications -- which include stimulants such as Ritalin or Concerta -- also rose by about 1 million between 2003-04 and 2011-12, the CDC said. That means that more than 3.5 million youngsters between the ages of 4 and 17 are now taking an ADHD drug.

The survey was published Nov. 22 in the Journal of the American Academy of Child and Adolescent Psychiatry.

According to the survey, half of children with ADHD are diagnosed with the disorder by the age of 6.

"This finding suggests that there are a large number of young children who could benefit from the early initiation of behavioral therapy, which is recommended as the first-line treatment for preschool children with ADHD," study author and CDC researcher Susanna Visser said in a journal news release.

Not every child with ADHD is getting proper treatment, the study found. According to the survey, 18 percent of kids with ADHD had not received either psychiatric counseling or drug therapy during 2011-2012.

"This finding raises concerns about whether these children and their families are receiving needed services," Dr. Michael Lu, senior administrator at the U.S. Health Resources and Service Administration (HRSA), said in the journal news release.

There was some good news from the survey, however. The CDC noted that ADHD diagnoses among American children were rising at a rate of about 6 percent a year in the mid-2000s, but that rate slowed to 4 percent a year from 2007 to 2011.

Visser told the Associated Press that this slower rate of diagnoses might reflect that doctors are closer to identifying most of the youngsters with the disorder.

ADHD makes it difficult for kids to pay attention and control impulsive behaviors. Treatments can include drugs, behavioral therapy or both.

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Digestive issues in children with ADHD

This article discusses how children with ADHD also commonly have digestive issues that go untreated in the child.

Children with attention-deficit/hyperactivity disorder (ADHD) are significantly more likely to suffer from chronic constipation and fecal incontinence than kids without the neurobehavioral condition, a new study says.

The study of more than 700,000 children found that constipation nearly tripled and fecal incontinence increased six-fold among kids with ADHD.

"We also found that children with ADHD tend to have more visits to see a doctor, suggesting that these children have more severe constipation and fecal incontinence than other children," said lead researcher Dr. Cade Nylund, an assistant professor of pediatrics at the Uniformed Services University of the Health Sciences.

Taking medication to treat ADHD did not seem to affect the number of office visits for these bowel problems, according to the study, which was published online Oct. 21 in the journal Pediatrics.

In the United States, more than 8 percent of children are diagnosed with ADHD. Kids with the condition display hyperactivity, as well as difficulty staying focused, paying attention and controlling their behavior.

These ADHD-related behavioral problems may lie behind the increased risk for bathroom woes, Nylund said.

"Kids with ADHD may not respond properly to physical cues to go to the bathroom," Nylund said. "They may have difficulty interrupting other or more desirable tasks they wish to engage in at that time."

Fecal incontinence is a more severe form of constipation, Nylund said. "What happens is, kids have constipation for several years and then they lose normal cues to go to the bathroom entirely. Then ... they just overflow and leak into their underwear."

Parents who notice that their child is suffering from constipation should see their pediatrician, Nylund said. In addition, parents can prevent constipation by increasing fiber in their child's diet, he said.

"Parents need to be aware that this risk exists and hopefully prevent constipation from occurring," Nylund said.

One expert said he sees this problem all the time among his patients -- both children and teenagers -- but it is often ignored and untreated.

"Their parents are noticing that they do have constipation, but they are not bringing it to the attention of a pediatrician or child psychiatrist, and it's going unnoticed and unaddressed," said Dr. Matthew Lorber, acting director of child and adolescent psychiatry at Lenox Hill Hospital in New York City.

Lorber said children with ADHD also might digest food more slowly or irregularly than children without ADHD. "Physiologically, that can lead to problems that cause constipation or fecal incontinence," he said.

Parents can help by setting consistent times for their child to go to the bathroom, such as before going to school or to bed, or before a long car trip, Lorber said.

He also said parents shouldn't "yell at their children for 'accidents.'"

Dr. William Muinos, associate director of pediatric gastroenterology at Miami Children's Hospital in Florida, agreed that children with ADHD often are distracted and forget to go to the bathroom.

"What we do is place them on lubrication therapy -- medication that will lubricate the bowel to help stimulate defecation," he said. "The other thing we do is simple behavior modification." This involves teaching the child to go to the bathroom at specific times, usually twice a day -- once before going to school and once in the evening, he said.

For the study, Nylund's team collected data on nearly 750,000 children, aged 4 to 12 years, who had a parent on active military duty. Among these children, nearly 33,000 were identified as having ADHD.

The researchers found that 4.1 percent of the children with ADHD suffered from constipation, compared with 1.5 percent of children without the condition.

In addition, 0.9 percent of the children with ADHD suffered from fecal incontinence, compared with 0.15 percent of children without ADHD.

Even when adjusted for factors such as age, gender and birth order, the researchers found the risk for fecal incontinence was more than six times greater among kids with ADHD and the risk for constipation was almost three times higher.

Although the research showed an association between ADHD and increased instances of constipation and incontinence, it did not prove a cause-and-effect relationship.

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Study: Symptoms of autism are not explained by impaired attention

A study claims that the characteristic symptoms of autism cannot be explained by impaired attention, although some people with autism will still have this characteristic.

Autism is marked by several core features -- impairments in social functioning, difficulty communicating, and a restriction of interests. Though researchers have attempted to pinpoint factors that might account for all three of these characteristics, the underlying causes are still unclear.

Now, a new study suggests that two key attentional abilities -- moving attention fluidly and orienting to social information -- can be checked off the list, as neither seems to account for the diversity of symptoms we find in people with autism.

"This is not to say that every aspect of attention is fine in all children with autism -- children with autism very often have attentional disorders as well," explain psychological scientists and lead researchers Jason Fischer and Kami Koldewyn of MIT. "However, our study suggests that attention impairments are not a key component of autism itself."

The study is published in Clinical Psychological Science, a journal of the Association for Psychological Science.

Attention has long been targeted as a possible causal mechanism in autism research: "Problems with attention early in life could have far-reaching consequences," say Fischer and Koldewyn. "For example, if young children with autism don't pay close attention to the behaviors of the people around them, they might never learn to read body language and other social cues."

But much of the previous research on attention, social learning, and autism had been mixed.

"Some of the most fundamental questions remain debated," Fischer and Koldewyn explain. "Our goal was to conduct careful, systematic, relatively large-scale studies of some of the mental processes most often implicated in autism to discover which of them are actually disrupted in autism and which are not."

To investigate this, Fischer, Koldewyn, and their team had children with high-functioning autism and children without autism complete an attention task while tracking their eye movements. Critically, the participants were matched on age and IQ before participating in the study to rule out the possible influence of global developmental delays that aren't specific to autism.

The task was intended to answer two questions: Are children with autism less able to reorient to a new stimulus (a plausible precursor of restricted interests)? And are children with autism slower to respond to social stimuli, such as faces?

Overall, children with and without autism showed clear signatures of shifting attention and orienting to social stimuli, but there was no difference in either ability between the two groups, challenging the hypothesis that impaired attention might be at the root of autism symptoms.

Fischer and Koldewyn underscore that these aren't simply null results -- they do contribute in a meaningful way to our understanding of autism.

"Understanding which mental capacities are intact in autism is not only encouraging, but also helps families and educators design effective interventions to work on those cognitive skills that are true areas of weakness in autism."

While finding those true cognitive impairments, and their antecedents, has proved difficult, it's not for lack of effort.

"We believe that the crux of autism lies in a difficulty interpreting the nuanced and complex information present in real life social situations," Fischer and Koldewyn conclude. "We plan to test children with autism in more natural scenarios than the typical laboratory environment in order to understand how social context interacts with attentional abilities in autism."

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Study: Smoking during pregnancy may cause conduct issues in children

New research shows that smoking while pregnant is a risk factor for conduct problems, such as ADD, in offspring.

Research led by University of Leicester examines relationship between maternal smoking during pregnancy and offspring conduct problems among children.

Smoking during pregnancy appears to be a prenatal risk factor associated with conduct problems in children, according to a study published byJAMA Psychiatry, a JAMA Network publication.

Conduct disorder represents an issue of significant social, clinical, and practice concern, with evidence highlighting increasing rates of child conduct problems internationally. Maternal smoking during pregnancy is known to be a risk factor for offspring psychological problems, including attention deficits and conduct problems, the authors write in the study background.

Professor Gordon Harold and Dr. Darya Gaysina, of the University of Leicester, with colleagues in the United States and New Zealand, examined the relationship between maternal smoking during pregnancy and offspring conduct problems among children raised by genetically related mothers and genetically unrelated mothers.

Three studies were used: The Christchurch Health and Development Study (a longitudinal cohort study that includes biological and adopted children), the Early Growth and Development Study (a longitudinal adoption-at-birth study), and the Cardiff IVF (In Vitro Fertilization) Study (an adoption-at-conception study among genetically related families and genetically unrelated families). Maternal smoking during pregnancy was measured as the average number of cigarettes per day smoked during pregnancy.

According to the study results,a significant association between maternal smoking during pregnancy and offspring conduct problems was observed among children raised by genetically related mothers and genetically unrelated mothers. Results from a meta-analysis affirmed this pattern of findings across pooled study samples.

"Our findings suggest an association between pregnancy smoking and child conduct problems that is unlikely to be fully explained by postnatal environmental factors (i.e., parenting practices) even when the postnatal passive genotype-environment correlation has been removed." The authors conclude, "The causal explanation for the association between smoking in pregnancy and offspring conduct problems is not known but may include genetic factors and other prenatal environmental hazards, including smoking itself."

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Back to school sleeping tips

This article gives tips for how to prepare your child to successfully go back to school, most importantly by making sure they are getting enough sleep.

Did you know the best preparation for back to school is a good night’s sleep? Lack of sleep can affect a child’s performance, attention, learning, behavior and biological functions, experts say. In fact, recent studies show that American students might be falling behind in school due to a lack of shut-eye.

With all the excitement and stress that accompanies the new school year, many children slip into a pattern all too familiar to tired parents. One more book, one more glass of water, one more TV show ... the child who continually resists going to bed experiences difficulty in falling asleep, resulting in what doctors identify as limit-setting sleep disorder.

Parents can help children through the transition by creating an enjoyable bedtime routine that’s fun and relaxing, says Dr. Laura Sergis, pediatrician for the Children’s Medical Group and advisory board member at Cloud b, creators of award-winning products designed to help children sleep. The all important routine can include family story time with favorite books, sing-alongs to favorite lullabies and cuddly companions that alleviate night time fears with soothing sounds and lights. Incorporating a trusted buddy like Cloud b’s newTwilight Carz in the bedtime routine helps children transition from playtime to bedtime with its fun push and play action by day and its soothing starlight projection by night.

Sleep expert Kim West, licensed certified social worker, also known as The Sleep Lady, recommends that all electronics be turned off an hour before bedtime. Homework and getting bags together should be done before the one-hour electronics off time – the one hour should be for relaxing activities including bathing, washing up, reading, talking about the day, etc. Read stories like the new Scholastic classic, “My Turtle and Me”, inspired by Cloud b’s Twilight Turtle, an adorable plush that projects a soothing view of the night sky to comfort children to a peaceful night’s sleep.

Parents can add another magical element to the routine with Cloud b’s new Twilight Turtle Tunes that plays personalized lullabies featuring favorite songs, soothing sounds and even the voices of loving parents or caregivers as it projects a starry sky above. Parents put it all together on the Twilight Turtle Tunes app that delivers the magic to the special edition toy via Bluetooth.

In planning the ideal bedtime, West suggests parents do “the math backwards.” For example, if your 2-year-old needs to be up at 7 a.m. to get dressed and out the door to daycare, then he should be asleep by 8 p.m. (This age needs, on average, 11 hours at night and two hours during the day.)

She notes that it also goes without saying that parents should eliminate caffeine from their children’s diets. If it can’t be done completely, then no caffeine after 3 p.m. Dinner should be at least two hours before bedtime so that your child gets a chance to digest.

Finally, exercise during the day does help a child sleep better, but try to avoid exercise an hour before bedtime. Definitely avoid rough-housing, which can really rile up a child just when you want him to be settling down.

As parents find the best routine and stick to it, they’ll discover that the whole family is functioning better. Bedtime may become the best time of the day – a calm, quiet moment before slumber to make great memories and strengthen the bond between parents and children.

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