Study: Alternative Medicine Use High Among Children With Chronic Conditions

This study discusses how the use of alterative medicine is very high (71%) among children with chronic health conditions. This may pose an issue if the alternative medications and therapies are not discussed with a doctor.

Children who regularly see specialists for chronic medical conditions are also using complementary medicine at a high rate, demonstrates recently published research from the University of Alberta and the University of Ottawa.

About 71 per cent of pediatric patients attending various specialty clinics at the Stollery Children's Hospital in Edmonton used alternative medicine, while the rate of use at the Children's Hospital of Eastern Ontario in Ottawa was 42 per cent. Nearly 20 per cent of the families who took part in the study said they never told their physician or pharmacist about concurrently using prescription and alternative medicine.

Sunita Vohra, a researcher with the Faculty of Medicine & Dentistry at the U of A, was the lead investigator on the study, which was recently published in the peer-reviewed journal Pediatrics. Her co-investigator was W. James King from the University of Ottawa.

"The children in this study are often given prescription medicines," says Vohra, a pediatrician who works in the Department of Pediatrics and the School of Public Health at the U of A.

"And many of these children used complementary therapies at the same time or instead of taking prescription medicine. We asked families if they would like to talk about the use of alternative medicine, more than 80 per cent of them said, 'yes, please.'

"Right now, these families are getting information about alternative medicine from friends, family and the Internet, but a key place they should be getting this information from is their doctor or another member of their health-care team, who would know about possible drug interactions with prescription medicines." Vohra said the study "identified a gap in communications" in dealing with pediatric patients and their families.

"It's important to get these conversations going with every patient, especially when you consider it's not widely recognized how common it is for children with chronic illnesses to use alternative medicine," says the Alberta Innovates-Health Solutions scholar.

"We need to make sure these families are comfortable telling their specialists they are taking other therapies," she said. Right now, Vohra and her colleagues at the U of A have developed curricula for undergraduate medical students about the use of alternative medicine by pediatric patients, which is considered innovative and novel. Ensuring medical students receive information about alternative medicine is key because it arms them with more knowledge about potential interactions with prescription medicine, says Vohra.

"Considering parents are saying they want this information, we have an obligation to ensure future physicians have the education and resources they need for these conversations," Vohra says.

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Study finds treatment very effective for children with high functioning autism

A clinical trial found that children with high-functioning autism can have the symptoms effectively alleviated by intensive treatment.

In a second randomized clinical trial, researchers at the Institute for Autism Research at Canisius College have found a comprehensive summer treatment (summer Max) to be highly effective for children with high-functioning autism spectrum disorders (HFASDs). Children with the disorders endure lifelong impairments involving social and social-communicative functioning and restricted and repetitive interests and behaviors. Despite their significant needs, few comprehensive programs have been developed and validated for children with HFASDs.

Results of this randomized clinical trial found the comprehensive summer treatment to be effective in improving the social performance and clinical symptoms of children with HFASDs. According to Marcus L. Thomeer, PhD and Christopher Lopata, PsyD, the study's lead authors, the findings, which appeared in the journal, Psychology in the Schools (December 2012), supports and extends the findings of a previous randomized trial that initially demonstrated the efficacy of the manualized treatment.

Following the 5-week program, children in the treatment group demonstrated significantly higher scores on child measures of non-literal language skills and knowledge of appropriate social behaviors, as well as significantly higher parent-ratings for targeted and broader social skills and significantly lower ratings of autism symptoms compared to children in the control group. Secondary staff ratings corroborated the significant gains reported by parents. A follow-up assessment 2-3 months post-treatment for the treatment group indicated that the significant gains in social functioning were maintained, and a positive trend suggested that the reduction in autism symptoms continued.

According to Thomeer, "the increase in child understanding along with the increase in parent ratings of social and social-communication skills suggests that the children in treatment acquired new skills and social-cognitive understanding and translated those into effective social performance outside the treatment setting. This is an important finding as generalization of skills and behaviors beyond the treatment setting are a major obstacle for children with HFASDs." The significant decrease in autism symptoms following treatment is also noteworthy as few treatments have been able to reduce these long-term impediments to daily functioning.

One improvement over the previous trial was the addition of follow-up measures in the current study. "The follow-up measures allowed us to determine that the positive treatment effects on social performance continued to be present 2-3 months after the treatment ended," said Lopata. "Although not as robust as the social gains, the children in the treatment group also continued to show reduced autism symptoms." Results of these two randomized clinical trials provide strong evidence of the effectiveness of this unique comprehensive summer treatment for children with HFASDs. Thomeer noted that "this is the first comprehensive treatment specifically for children with HFASDs to be found effective in two randomized trials."

A total of 35 children, ages 7-12 years participated, with 17 randomly assigned to receive the treatment and 18 to a wait-list control condition. Children in the treatment were in groups of six children and three clinical staff. The treatment was conducted five days per week over five weeks and targeted clinical and associated features of autism spectrum disorders including social skills, non-literal language skills, emotion recognition skills, and interest expansion.

Treatment was provided during five, 70-minute treatment cycles each day using direct instruction, modeling, role-playing, and performance feedback. Each treatment cycle consisted of 20-minutes of skills instruction followed by a 50-minute therapeutic activity designed to practice and reinforce target skills. A point system was used to reinforce positive social behaviors and reduce autism symptoms and negative behaviors across the treatment day. Weekly parent education was also provided.

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Increased Vulnerability for Repeat Traumatic Brain Injury

This article discusses the poor outcomes associated with repeat traumatic brain injury in children and young adults.

Repeat traumatic brain injury affects a subgroup of the 3.5 million people who suffer head trauma each year. Even a mild repeat TBI that occurs when the brain is still recovering from an initial injury can result in poorer outcomes, especially in children and young adults. A metabolic marker that could serve as the basis for new mild TBI vulnerability guidelines is described in an article in Journal of Neurotrauma, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers.

In an Editorial, "The Window of Risk in Repeated Head Injury," accompanying this article, John T. Povlishock, PhD, Editor-in-Chief ofJournal of Neurotrauma and Professor, VCU Neuroscience Center, Medical College of Virginia, Richmond, states that recent studies of TBI in animal models have shown that while repeat injury can exacerbate structural, functional, metabolic, and behavioral responses, "these responses only occur when the injury is repeated within a specific time frame post-injury."

"Specifically, this window of risk is greatest when the interval between injuries is short, hours to days, while any risk for increased damage is obviated when the intervals between injuries are elongated over days to weeks," says Dr. Povlishock. It is not yet clear if these time periods of increased risk are age- or gender-specific or depend on the intensity of the initial injury.

A consistent finding following TBI in both humans and animal models is a decrease in glucose uptake by the brain. Mayumi Prins, Daya Alexander, Christopher Giza, and David Hovda, The UCLA Brain Injury Research Center, Los Angeles, CA, simulated single and repeat (after 1 or 5 days) mild TBI in rats and measured cerebral glucose metabolism. They tested the hypothesis that the rats' brains would be more vulnerable to the damaging effects of repeat TBI at 1 day post-injury, when glucose metabolism was still decreased, than at 5 days, when it had returned to normal levels.

In the article, "Repeat Mild Traumatic Brain Injury: Mechanisms of Cerebral Vulnerability," the authors propose that the duration of metabolic slowdown in the brain could serve as a valuable biomarker for how long a child might be at increased risk of repeat TBI.

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Study: Bullying Causes Significant Emotional and Physical Consequences for Children With Autism

This study discusses the short term physical and emotional stresses of bullying on children with autism.

Nearly 70 percent of children with autism spectrum disorders (ASD) experience emotional trauma as a result of being bullied, according to findings published today in the Journal of Developmental & Behavioral Pediatrics, while a significant portion were concerned for their own safety at school. The study also found that children with ASD who presented with pre-existing psychiatric diagnoses were at increased risk for involvement in bullying, with children diagnosed with ASD and attention deficit hyperactivity disorder (ADHD) or depression at highest risk of being victimized over a one month period.

This study was led by researchers from the Interactive Autism Network, a project of the Kennedy Krieger Institute that is the nation's first online autism registry with participants from 47 states, making it the largest collection of autism data in the world.

"Recent research indicates that children receiving special education services are at risk of being victimized at higher rates than regular education students," says Dr. Paul Law, senior study author and director of the Interactive Autism Network at Kennedy Krieger. "Our findings show that not only are these children being bullied more, but they are also experiencing significant short-term, and likely long-term, effects of being bullied."

Participants in the study included parents of 1,221 children with ASD recruited through an online questionnaire. Researchers utilized the Bullying and School Experiences of Children with ASD Survey, a 63-item questionnaire, to collect key data from parents regarding their child's school environment, involvement in bullying, and the child's educational and psychological functioning. Additionally, researchers used the Parent Observation of Child Adaptation (POCA) to reflect parents' ratings of their child's behaviors and level of psychological distress after a bullying incident. The study's findings on the characteristics and psychiatric comorbidities most associated with bullying are below.

Characteristics of Children with ASD Involved in Bullying

• Over a one month period, 38 percent of children with ASD were bullied, with 28 percent frequently bullied.
• Immediate consequences of being bullied included emotional trauma (69 percent) and physical injuries (8 percent).
• Nearly 14 percent of children who were bullied reported being scared for their own safety.
• Eighteen percent of children were reported to have been triggered into fighting back, with 40 percent having an emotional meltdown or outburst that resulted in disciplinary action from school staff.
• Nine percent of children with ASD acted as bullies, with five percent identified as frequent perpetrators of bullying.

Psychiatric Comorbidity and Bullying Behaviors

• Children with ASD who also presented with ADHD and depression were more likely to be bullied.
• Children with ASD who also presented with conduct disorder or oppositional defiant disorder were more likely to be bullies.
• Children with ASD who also presented with ADHD, conduct disorder or oppositional defiant disorder were most likely to be bully-victims, characterized as being both victims of bullying and behaving as bullies.

According to Dr. Law, it is well documented that short-term consequences of bullying include poor mental and physical health outcomes. The long-term consequences can also have a serious effect on the well-being of an individual with ASD. In many cases, the effects of bullying can extend into adulthood with an increased risk for later psychiatric illness.

"Our results provide insights that will help teachers and school staff identify children with autism who may be at the greatest risk for bullying involvement, either as victims or perpetrators," says Dr. Law. "Outside of school, parents should be encouraged to talk to their child about bullying, particularly if they are concerned their child may be a victim. Parents should also set up appointments to talk to the staff or teachers at their child's school to learn more about how they can work to prevent bullying and help children involved in bullying cope with the consequences."

Future research is needed to clinically validate the correlation between a child's psychiatric diagnosis and bullying behavior. Longitudinal study designs will also help to provide insight into the sequence of events related to bullying behaviors and psychological and physical issues. Researchers hope that with greater information on the bullying behaviors and the consequences of bullying on children with ASD, parents, school staff, teachers and health care providers can better protect this particularly vulnerable population.

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Study: Concussions Affect Children's Brains After Symptoms Subside

Study shows that concussions continue to affect children after the symptoms go away. Seeking specialty care from a pediatric brain specialist is sensible. JR

Brain changes in children who have sustained a mild traumatic brain injury, or concussion, persist for months following injury -- even after the symptoms of the injury are gone, according to a study published in the December 12 issue of The Journal of Neuroscience. The findings highlight the potential benefit of using advanced imaging techniques to monitor recovery in children following concussions.

Despite growing concerns over the risk of concussions in youth, the majority of research examining their effects on the brain has involved adults. These studies suggest that, among other things, concussions alter the brain's white matter -- the long fibers that carry information from one area of the brain to another. Some recent data suggest the developing brains of children may be more vulnerable to the effects of mild traumatic brain injury.

In the current study, Andrew Mayer, PhD, and colleagues at the Mind Research Network and the University of New Mexico in Albuquerque, New Mexico, specifically studied older children (ages 10-17) with mild traumatic brain injury. They found that structural changes in the children's white matter seen about two weeks after the injury remained evident more than three months later despite the disappearance of symptoms related to the injury.

"These findings may have important implications about when it is truly safe for a child to resume physical activities that may produce a second concussion, potentially further injuring an already vulnerable brain," Mayer said.

The researchers conducted cognitive testing and used an advanced imaging technique known as diffusion tensor imaging (DTI) to examine the brains of 15 children who had recently (within 21 days of injury) experienced a concussion and 15 unaffected children. In the brain, DTI specifically images white matter. During a follow-up visit approximately four months post-injury, scientists repeated cognitive testing and imaging.

Initial testing revealed that children with the mild brain injury had subtle cognitive deficits and changes in white matter compared with healthy counterparts. While the children did not report symptoms of the injury during the follow-up visit months later, DTI revealed that the structural changes to the brain remained.

"The magnitude of the white matter changes in children with mild traumatic brain injury was larger than what has been previously been reported for adult patients with mild traumatic brain injury," Mayer said. "This suggests that developmental differences in the brain or the muscular-skeletal system may render pediatric patients more susceptible to injury," he added.

Based on the imaging data collected during the study, the researchers were able to accurately distinguish the brains of patients who had mild traumatic brain injury from those who were healthy 90 percent of the time. Such findings suggest DTI, which does not require the use of ionizing radiation, could one day be used to diagnose the injury and to better characterize the recovery process in the brain.

Christopher Giza, MD, an expert on developmental brain injury from the Mattel Children's Hospital and the Brain Injury Research Center at the University of California, Los Angeles, who was not involved in the study, noted that while the number of patients in the study was small, the findings mark "an important step forward in our understanding of the effects of mild traumatic brain injury on the developing brain."

"Further work is needed to determine whether the changes in white matter present at four months represent a prolonged recovery process or permanent change in the brain," Giza added. "Determining the duration of the structural changes, and whether these changes have clinical implications, remain critical areas for future studies," he said.

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Study Shows Children's Seizures Not Always Damaging

A study claims that seizures in children caused by fevers do not cause long-term damage.

Not all prolonged seizures permanently hurt children with epilepsy, according to preliminary findings from a long-term follow-up study.

The study included 74 children with epilepsy who underwent an evaluation of brain health and mental skills within 10 years of initial enrollment.

The tests showed that those who had experienced prolonged febrile seizures (convulsions triggered by a fever) were normal, the American and British researchers said.

The study authors said they were surprised to discover that only one child had mesial temporal sclerosis, a type of brain damage that is most common in temporal lobe epilepsy. This suggests that the connection between febrile seizures and this condition is weaker than previously believed.

The study was scheduled for presentation Monday at the annual meeting of the American Epilepsy Society in San Diego.

"We have good reason to be confident that children with childhood status epilepticus can have good long-term outcomes, based on these preliminary results," Dr. Richard Chin, one of the researchers, said in a society news release.

The study team includes researchers from University College London's Institute of Child Health, Young Epilepsy in Lingfield, U.K., Edinburgh University, Dartmouth Medical School, Hanover, N.H., and Great Ormond Street Hospital for Children, London.

The data and conclusions of research presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

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6 tips to help parents of children with ADHD

This article contains six tips of a coaching approach for parents of children with ADHD.

Raising kids with ADD/ADHD can be stressful, to say the least. You try everything the “experts” tell you, but sometimes it still feels like you’re running on a treadmill. A coach-approach to parenting can take the pressure off.

Parents who learn to “coach” their kids with ADD/ADHD get out of survival mode and help their kids become more independent and successful.

There are six key strategic areas for parents to focus on when managing ADD/ADHD and literally hundreds of coaching skills to help parents help their kids. Here’s a specific tip for each strategy that will get you off that treadmill and help you rediscover the joy of parenting:

1. Educate yourself and your child about ADHD: This is a critical first step. Learn whatever you can and help your child identify the ways ADHD causes challenges at home and at school. Use this to empower your child to understand that he/she is not stupid and there is a reason for his/her challenges. If you’re not sure if something is caused by the ADD/ADHD or not, it probably has something to do with it!

2. Activate the brain: Since ADD/ADHD is based in the brain, it’s a logical step for improvement. Whether your child is taking medication or not, try exercise and/or protein before school — or before homework time — to improve focus and get better results.

3. Manage the behavior: People with ADD/ADHD often avoid structure, even though it’s what they need the most. Perhaps the most important structure is to help your child figure out his/her motivators. Identify good reasons that make sense to your child, not you, and you’ll see improved results.

4. Parent positively: Kids with ADD/ADHD make mistakes … a lot. They are constantly dropping, losing, breaking or forgetting things, and we correct them from sun up to sun down, without even realizing it. They need you to “catch ‘em being good." Let them know when they are successful, even if you think they “should” be doing it. For them, small victories mean a lot.

5. Establish appropriate expectations: On average, kids with ADD/ADHD are at least three years behind their peers in behavioral development. Keep that in mind when you set expectations for chores and following directions, especially in the evenings when they are tired. Yes, that may mean letting things slide. It helps to think of them as very mature 10-year-olds, instead of immature teenagers.

6. Take care of yourself: This may seem out of place, but it’s so important! Kids with ADD/ADHD need to learn to take care of themselves for future success more than their typical peers. When parents model self-care, their kids begin to learn to eat well, exercise, etc. On the other hand, when parents do not take care of themselves, they send a message to their kids that it’s not important. 

How you approach your child’s ADD/ADHD makes a big difference. Two final pieces of advice can have more of an impact than anything else: Believe in your kids and laugh a lot.

Kids with ADD/ADHD tend to be bright, creative, innovative and interesting. They respond well to positive encouragement and humor. When parents use coaching skills to manage the challenges and humor to downplay the mistakes, the results are positive for the entire family.

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Study: Research Lacking on Drugs for Older Children With Autism

A new study claims that there is a lack of research in the effect of medication and drugs for older children who have autism.

More and more children are growing up with autism, and although many treatments and interventions are now available, clinical studies on the use of medications in teens and young adults are lacking, according to new research.

"The majority of (older) individuals with autism spectrum disorders appear to be taking medications that we have very little evidence for," said the study's lead author, Dr. Jeremy Veenstra-VanderWeele, medical director of the Treatment and Research Institute for Autism Spectrum Disorders at the Vanderbilt Brain Institute in Nashville, Tenn.

"In the absence of sufficient evidence, parents and people with autism should find a clinician who tells you what's known and unknown about the potential benefits and risks of any medication," he said. "It should be a shared decision-making process."

Results of the study were published online on Sept. 24 in the journal Pediatrics.

Autism spectrum disorders are neurodevelopmental disorders that impair social development and communication. Autism spectrum disorders also may cause repetitive movements and even self-abusive behavior, such as head banging, according to the U.S. National Institute of Neurological Disorders and Stroke (NINDS).

It is estimated that about one in 88 American children has been identified with an autism spectrum disorder

As children with autism age, some do experience significant improvements, according to NINDS, but many do not. There is no cure for autism, although there are many treatments available, including education and behavioral interventions and medications.

Medications usually are used to treat some of the symptoms associated with autism, rather than the core symptoms of the condition, according to background information in the new study. For example, the medication risperidone (brand name Risperdal) may be used to treat behavioral symptoms associated with autism, such as aggression, outbursts and irritability, said Dr. Melissa Nishawala, medical director of the Autism Spectrum Disorders Clinical and Research Program at the NYU Child Study Center in New York City.

"Medications like risperidone and aripiprazole don't address the cause of autism, but they help calm down [people with autism]," Veenstra-VanderWeele said.

For the new study, the researchers reviewed medical literature from 1980 through 2011 to find clinical trials on drugs for people with autism between the ages of 13 and 30 years old. They found eight studies with at least 20 participants. Two investigators independently assessed the quality of the studies.

The researchers said they found four studies of fair quality while the other four were poor. The studies included reviews of antipsychotic medications, such as risperidone and haloperidol (Haldol); serotonin reuptake inhibitors, such as fluvoxamine (Luvox) and clomipramine (Anafranil); and opioid receptor agonists, such as naltrexone (Depade).

The researchers felt that, overall, there wasn't enough data on medications in the teen and young adult autism population. Risperidone wasn't well studied in teens and young adults, but there was evidence for its use if the entire pediatric population was considered, the study said.

Although behavioral and educational interventions weren't included in the new study, Veenstra-VanderWeele said he suspects there's a lack of evidence for these types of treatments in older children and young adults too.

"We really don't know if intensive behavior interventions continue to benefit individuals as they get older," he said.

NYU's Nishawala said: "The most important thing for parents to take away is that we know there are a few medications that have been studied that can help. Certain symptoms like irritability, agitation and aggression can be controlled with medications, but there's lesser evidence that repetitive behaviors can be treated."

Nishawala added that although she and others who treat older children and young adults with autism would love to have more evidence-based research on the medications they use, it can be difficult to get parents and older children to participate in clinical trials when medications are already available to them for what's known as "off-label" use. That's when doctors prescribe medications for a condition for which the drug has yet to receive U.S. Food and Drug Administration approval.

In addition, she said, it's difficult to get funding for trials, particularly when a drug already has been approved.

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Obstructive sleep apnea, seizures, and childhood apraxia of speech. Pediatric Neurology - Volume 38, Issue 6 (June 2008) (MEDLINE® is the source for the citation and abstract of this record)  - About This Journal  DOI: 10.1016/j.pediatrneurol.2008.03.002

Abstract:

Associations between obstructive sleep apnea and motor speech disorders in adults have been suggested, though little has been written about possible effects of sleep apnea on speech acquisition in children with motor speech disorders. This report details the medical and speech history of a nonverbal child with seizures and severe apraxia of speech. For 6 years, he made no functional gains in speech production, despite intensive speech therapy. After tonsillectomy for obstructive sleep apnea at age 6 years, he experienced a reduction in seizures and rapid growth in speech production. The findings support a relationship between obstructive sleep apnea and childhood apraxia of speech. The rather late diagnosis and treatment of obstructive sleep apnea, especially in light of what was such a life-altering outcome (gaining functional speech), has significant implications. Most speech sounds develop during ages 2-5 years, which is also the peak time of occurrence of adenotonsillar hypertrophy and childhood obstructive sleep apnea. Hence it is important to establish definitive diagnoses, and to consider early and more aggressive treatments for obstructive sleep apnea, in children with motor speech disorders.

Citation:

Obstructive sleep apnea, seizures, and childhood apraxia of speech.
Caspari SS - Pediatr Neurol - 01-JUN-2008; 38(6): 422-5
MEDLINE® is the source for the citation and abstract of this record 

NLM Citation ID:
18486825 (PubMed ID)

abstract here

High-Tech Gadgets Can Help Diagnose and Study Autism

New technology claims that it can help diagnose autism in children, and also help study autism.

Researchers in Georgia Tech's Center for Behavior Imaging have developed two new technological tools that automatically measure relevant behaviors of children, and promise to have significant impact on the understanding of behavioral disorders such as autism.

One of the tools -- a system that uses special gaze-tracking glasses and facial-analysis software to identify when a child makes eye contact with the glasses-wearer -- was created by combining two existing technologies to develop a novel capability of automatic detection of eye contact. The other is a wearable system that uses accelerometers to monitor and categorize problem behaviors in children with behavioral disorders.

Both technologies already are being deployed in the Center for Behavior Imaging's (CBI) ongoing work to apply computational methods to screening, measurement and understanding of autism and other behavioral disorders.

Children at risk for autism often display distinct behavioral markers from a very young age. One such marker is a reluctance to make frequent or prolonged eye contact with other people. Discovering an automated way to detect this and other telltale behavioral markers would be a significant step toward scaling autism screening up to much larger populations than are currently reached. This is one goal of the five-year, $10 million "Expeditions" project, funded in fall 2010 by the National Science Foundation under principal investigator and CBI Director Jim Rehg, also a professor in Georgia Tech's School of Interactive Computing.

The eye-contact tracking system begins with a commercially available pair of glasses that can record the focal point of their wearer's gaze. Researchers took video of a child captured by a front-facing camera on the glasses, worn by an adult who was interacting with the child. The video was then processed using facial recognition software available from a second manufacturer. Combine the glasses' hard-wired ability to detect wearer gaze with the facial-recognition software's ability to detect the child's gaze direction, and the result is a system able to detect eye contact in a test interaction with a 22-month-old with 80 percent accuracy. The study was conducted in Georgia Tech's Child Study Lab (CSL), a child-friendly experimental facility richly equipped with cameras, microphones and other sensors.

"Eye gaze has been a tricky thing to measure in laboratory settings, and typically it's very labor-intensive, involving hours and hours of looking at frames of video to pinpoint moments of eye contact," Rehg said. "The exciting thing about our method is that it can produce these measures automatically and could be used in the future to measure eye contact outside the laboratory setting. We call these results preliminary because they were obtained from a single subject, but all humans' eyes work pretty much the same way, so we're confident the successful results will be replicated with future subjects."

The other new system, developed in collaboration with the Marcus Autism Center in Atlanta and Dr. Thomas Ploetz of Newcastle University in the United Kingdom, is a package of sensors, worn via straps on the wrists and ankles, that uses accelerometers to detect movement by the wearer. Algorithms developed by the team analyze the sensor data to automatically detect episodes of problem behavior and classify them as aggressive, self-injurious or disruptive (e.g., throwing objects).

Researchers first developed the algorithms by putting the sensors on four Marcus clinic staff members who together performed some 1,200 different behavior instances, and the system detected "problem" behaviors with 95 percent accuracy and classified all behaviors with 80 percent accuracy. They then used the sensors with a child diagnosed along the autism spectrum, and the system detected the child's problem-behavior episodes with 81 percent accuracy and classified them with 70 percent accuracy.

"These results are very promising in leading the way toward more accurate and reliable measurement of problem behavior, which is important in determining whether treatments targeting these behaviors are working," said CSL Director Agata Rozga, a research scientist in the School of Interactive Computing and co-investigator on the Expeditions award. "Our ultimate goal with this wearable sensing system is to be able to gather data on the child's behavior beyond the clinic, in settings where the child spends most of their time, such as their home or school. In this way, parents, teachers and others who care for the child can be potentially alerted to times and situations when problem behaviors occur so that they can address them immediately."

"What these tools show is that computational methods and technologies have great promise and potential impact on the lives of many children and their parents and caregivers," said Gregory Abowd, Regents' Professor in the School of Interactive Computing and a prominent researcher in technology and autism. "These technologies we are developing, and others developed and explored elsewhere, aim to bring more effective early-childhood screening to millions of children nationwide, as well as enhance care for those children already diagnosed on the autism spectrum."

Both technologies were presented in early September at the 14th ACM International Conference on Ubiquitous Computing (Ubicomp 2012). Among the other devices under study at CSL are a camera/software system that can track children's facial expressions and customized speech analysis software to detect vocalization patterns.

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Concussions can happen to all children, not just the athletes

This article discusses how concussions are possible in all children, not only the ones who are in football or other sports.

The gridiron is back in action. From little leagues to professional teams, football frenzy has begun, and with it, concerns about concussions. But it's not just jarring tackles that can lead to concussions in kids. According to Dr. Ryan Coates, pediatric neurologist at Loyola University Health System, there are many ways kids are exposed to concussion risks.

"We hear a lot about concussions when it comes to sports and we should be on the lookout for head injuries, but athletes aren't the only ones who are at-risk for brain trauma," said Coates.

Concussions are a result of a traumatic brain injury that causes a disruption of the brain function. Disruption of neurologic function can manifest itself with a multitude of symptoms, including headache, loss of consciousness, concentration and memory disturbances, dizziness, nausea/vomiting and confusion.

"What symptoms a person experiences depends on how the brain moves within the skull as a result of the injury," said Coates. "Everyone is different and how a person responds after brain trauma is variable. Symptoms can last for a few hours or several months." Coates said very young children are the most at risk for brain trauma because they have less protection.

"Young children are more dependent on caregivers to keep them safe and don't have as many ways of protecting themselves from falls and accidents as adults and older children," said Coats.

Falls are the leading cause of traumatic brain injury in the country, according to the Centers for Disease Control and Prevention. Also, nearly half of the traumatic brain injuries in children are from a fall.

"Parents need to watch their children carefully, especially around stairs and at the playground. Make sure your child isn't doing something that isn't age appropriate," said Coates. "Following safety guidelines for car seats is important for keeping kids safe as well."

Traumatic brain injuries and concussions shouldn't be taken lightly. Timely recognition and appropriate response are vital. Any child who has had a concussion should be seen by a physician within 24 hours and have a complete neurological exam.

"Even one concussion can have long-term effects, including learning difficulties and other issues that impact quality of life," said Coates.

Though all kids are susceptible to concussions, special attention does need to be given to kids participating in sports. According to Coates, it's imperative that coaches, supervisors and parents are all on the same page when it comes to brain injuries.

"Any child who has a head injury, even if it seems minor, should immediately be taken out of the event. Symptoms can happen immediately or even days after the injury, so don't take any chances. A child's brain function is more important than the next play," said Coates. "No one is immune to head injuries. Just because someone has had head trauma before and didn't have any apparent issues doesn't mean the next hit won't cause substantial injury and long-term effects."

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Anxiety in Children May Be Linked to Sleep Issues

This article shows a link between childhood anxiety and sleeping problems in children.

Does your child toss and turn at night? Does your child regularly wake up tired and unrefreshed? According to research, a small percentage of children who have sleep problems may be at risk of more serious emotional disorders, including anxiety and depression.

The study, authored by Flavia Giannotti, M.D., of Center of Pediatric Sleep Disorders at the University of Rome La Sapienza in Italy, was conducted on 122 children between 7 and 11 years of age, who had a major depressive disorder. All patients underwent a systematic psychiatric, cognitive and sleep evaluation and all children were medication-free. Depressed children, as well as those presenting both depression and an anxious disorder, entered the study, and their results were compared to those of 200 healthy peers.

According to the results, 82 percent of the depressed children reported problems sleeping, compared to five percent in the control group. In the group of children who suffered from both depression and anxiety, 42 percent showed a significantly higher frequency of sleep-onset insomnia, compared to 29 percent in the depression-only group. They also scored significantly higher on the “bedtime difficulties,” “sleep anxiety,” and “sleep duration” portions of the questionnaire.

Gianotti states, “Sleep problems are very common in typically developing children. Even though they are more frequent in toddlers and preschoolers, they affect also school-aged children. What was most interesting about this study was the finding that certain types of comorbid [e.g. anxiety and depression] conditions might be especially disruptive on sleep. Therefore, in childhood, considerable attention needs to be paid to the interrelation between sleep patterns and emotional disorders.”

Experts recommend that school-aged children get between 10-11 hours of sleep every night. If your child fails to get a sufficient amount of sleep of if your child is consistently tired or drowsy in the morning, he or she may have developmental or behavioral problems, like anxiety or depression.

“To ensure the most effective care, parents of sleep-disturbed children are advised to first consult with the child’s pediatrician, who may issue a referral to a sleep specialist for comprehensive testing and treatment,” Dr. Giannotti advised.

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Reasons Why Children Snore

This article discusses many reasons that could cause children to snore.

With school days upon us, a good night's sleep should be on the top of each child's list of supplies. But for some children, getting the rest they need means more than an early bedtime. At Clarity Allergy Center in Chicago, allergy, asthma, and immunology expert, Dr. Brian Rotskoff, is helping parents recognize the signs of childhood obstructive sleep apnea by carefully monitoring childhood snoring and childhood nasal allergies.

Many children snore from time to time, particularly if they have a cold or asthma. But as Dr. Rotskoff, a highly specialized pediatric nasal congestion and sleep apnea expert explains, "if your child is a restless sleeper who chronically snores and mouth breaths and shows signs of daytime difficulties, obstructive sleep apnea could be the cause." He also points out that the symptoms ofsleep apnea in kids can be subtler than those of adult sleep apnea.

Beyond restless nights, Dr. Rotskoff encourages parents who suspect their child may have obstructive sleep apnea to watch for these warning signs that can begin as early as 2-6 years of age.

Nighttime Sleep Apnea Symptoms

• Persistent snoring and mouth breathing
• Gasping or labored breathing
• Frequent bedwetting beyond normal age range
• Night sweats
• Unusual sleeping positions

Daytime Sleep Apnea Symptoms

• Allergies, asthma, or frequent ear infections
• Poor school performance or trouble focusing on tasks
• Behavioral or social problems
• Bad mood or constant agitation
• Depression or anxiety

Childhood Nasal Allergies and Asthma

It's highly common for children with sleep apnea to have other breathing issues. "Some children are just persistent snorers and don't necessarily have sleep apnea," acknowledges Dr. Rotskoff, "but compounding issues, such as enlarged tonsils and adenoids, can elevate to sleep apnea."

Dr. Rotskoff is one of few allergy and asthma experts to give childhood sleep apnea the attention it deserves. Even if your child is getting 10-12 hours of sleep each night, sleep apnea can cause enough disruption to affect mood, school performance, and overall behavior. "Studies show that middle school and high school kids with moderate to severe sleep apnea achieve lower grades and have greater trouble focusing or paying attention in class," he says.

If you think your child suffers from sleep apnea, Dr. Rotskoff suggests a thorough exploration of all symptoms and physical factors that could contribute to breathing problems. Beyond monitoring your child's tonsil and adenoid size, Dr. Rotskoff will evaluate their soft palate and uvula, tongue, jaw positioning, and nasal passages and airways. He works closely with parents to determine the most conservative and effective treatment.

"Addressing your child's sleep issues early will not only improve academic and social performance, it will also position them for healthy adult sleep habits," concludes Dr. Rotskoff.

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Study Claims Excessive Daytime Sleepiness Linked With Attention Problems In Kids

If your child is having trouble focusing while doing schoolwork, you might need to take a look at his or her sleep habits, a new study suggests.

New research published in the journalSLEEP shows that excessive daytime sleepiness (or EDS) is linked with an increased risk of trouble paying attention at school, being hyperactive, difficulty learning and conduct problems.

"When children are referred for neurobehavioral problems, they should be assessed for potential risk factors for EDS," study researcher Susan Calhoun, Ph.D., of Penn State University, said in a statement. "Recognizing and treating EDS can offer new strategies to address some of the most common neurobehavioral challenges in young school-age children."

The study included 508 children who were part of the Penn State Child Cohort. The researchers conducted sleep testing on them and had the parents report whether their children had any excessive daytime sleepiness. Then, they divided the children up into two groups: One that had the excessive daytime sleepiness, and one that didn't.

The researchers found that excessive daytime sleepiness was linked with "neurobehavioral (learning, attention/hyperactivity, conduct) problems and poorer performance in processing speed and working memory," researchers wrote in the study.

Rather, researchers found that factors like depression or anxiety, inattention, obesity, asthma and trouble falling asleep were linked with excessive daytime sleepiness in the kids (even those who "got enough sleep" during the sleep testing, and didn't have sleep apnea).

Excessive daytime sleepiness can be caused by a number of factors, including not getting enough sleep at night, sleep apnea, medications, and other mental conditions or sleep disorders, according to a 2009 article in the journal American Family Physician.

Recently, a New York Times article also examined the link between sleep and attention problems at school. That article looked specifically at how some cases of attention deficit hyperactivity disorder (ADHD) might actually be a sign of sleep apnea, which leads to sleep deprivation and, then, problems with focusing and attention.

The New York Times reported on a recent Pediatrics journal article, showing that kids with sleep problems -- such as sleep apnea or snoring -- have a 40 to 100 percent increased risk of ADHD-like behavioral problems.

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