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Friday, August 31, 2012

Daily or Severe Tantrums May Point to Mental Health Issues

From NIMH Science Update - National Institute of Mental Health

August 29, 2012

Most young children lose their temper sometimes, but daily tantrums or tantrums with severe behaviors, such as aggressive or destructive tantrums, are unusual and could signal a larger problem, according to an NIMH-funded study published online August 3, 2012, in a special issue of the Journal of Child Psychology and Psychiatry.

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NOTE: You can read/download the entire study HERE.
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Background

Distinguishing “normal” misbehaviors of early childhood from clinically worrisome problems can be challenging for pediatricians, parents, and others who work with young children.

To address this issue, Lauren Wakschlag, Ph.D. of Northwestern University, Margaret Briggs-Gowan, Ph.D. of University of Connecticut Health Center and their colleagues examined temper loss among preschoolers as a spectrum of behaviors ranging from mild or normal to “problem indicators” that may be signs of a greater, underlying mental health issue.


For this study, the researchers developed the Multidimensional Assessment of Preschool Disruptive Behavior (MAP-DB) questionnaire. Rather than merely asking whether a child had tantrums or not, the MAP-DB assesses the frequency, quality, and severity of behaviors related to temper tantrums and the extent of a child’s anger management skills over the past month. Parents of almost 1,500 preschoolers, ages 3-5, took part in the study.

Results of the Study

The researchers found that more than 80 percent of preschoolers had one or more tantrums in the past month. However, less than 10 percent had tantrums every day. Also, normal temper loss behaviors showed similar patterns and could be reliably distinguished from problem indicators.

For example, over a one month period, tantrums typically occurred:
  • when preschoolers were frustrated, angry, or upset (61 percent);
  • during daily routines, such as bedtime, mealtime, or getting dressed (58 percent);
  • with their parents (56 percent).
In contrast, it was less typical for preschoolers to have a tantrum:
  • with an adult who was not their parent, such as a babysitter or teacher (36 percent);
  • during which they broke or destroyed things (28 percent);
  • “out of the blue,” or for which parents could not discern a reason (26 percent);
  • that lasted an unusually long time (26 percent);
  • during which they hit, bit, or kicked someone else (24 percent).
Significance

The findings provide early evidence that studying behaviors as a spectrum may provide new insights into how mental disorders develop and better target early diagnosis, prevention, and treatment.

“Our goal was to provide a standard method that would take the guesswork out of ‘when to worry’ about young children’s behavior..."

“Our goal was to provide a standard method that would take the guesswork out of ‘when to worry’ about young children’s behavior and to provide a more developmentally sensitive way of characterizing the emergence of mental health problems, moving away from traditional approaches emphasizing extreme clinical distinctions to a dimensional approach that charts a progression from normal to abnormal,” said Wakschlag.

What’s Next

Further research is needed to confirm and evaluate the effectiveness of the MAP-DB questionnaire in identifying the point at which very young children would benefit from more specialized mental health screening and treatment. Changes in behavior as the child ages and whether problematic behaviors in early childhood lead to greater mental health issues later in life are also important areas for future study.

Reference

Wakschlag et al. "Defining the developmental parameters of temper loss in early childhood: Implications for developmental psychopathology." Journal of Child Psychology and Psychiatry.

Thursday, August 30, 2012

Yoga: Natural Remedy for Children with ADHD

From YogaTrends.org and Waking Times

By Colette Barry
July 26, 2012

Is your child affected by attention-deficit hyperactivity disorder (ADHD)? Do they often show lack of attention to important matters, difficulty concentrating, restlessness, hyperactivity, and low self- esteem? Well, if your answer is in the affirmative, get your child enrolled for a yoga program and help change their lives forever.

Regular practice of yoga can help your child manage ADHD, since different yoga poses promote a better mind-body connection, which is often missing in the affected children.

Yoga for ADHD Children

According to the U.S. Centers for Disease Control and Prevention, an increasing number of children are being diagnosed with attention deficit hyperactivity disorder (ADHD), with over 9% of the kids between 5 and 17 years affected with the syndrome.

An increasing number of people are now turning to yoga for a better mind-body connection to improve attention, focus, balance, relaxation, and mood.

Researchers reveal that 80% of children with ADHD display diminished academic performance. Any child with ADHD can benefit from yoga and experience reduced stress levels, better concentration and attention, and improved self awareness, which establish a better balance between the body and the mind. With a stronger mind-body connection, a child performs better in any field, and can concentrate on studies and other productive activities.

As an alternative (or adjunct) to medication, yoga can help ADHD children experience improved behavior and gain better self-control.

Some children with attention problems display aggressive behavior, poor social skills, and non-adherence to rules. If your child displays any such symptoms, yoga asanas can help them balance production of neurotransmitters in the brain, which creates a feeling of calm, resulting in better mood, more contentment and relaxation.
  • By increasing lung capacity, yoga helps increase the supply of oxygen to all parts of the body. As a result, more oxygen is supplied to the brain, improving motor balance and thereby helping your child with ADHD control hyperactivity and impulsivity and improve concentration.
  • Yoga changes the internal state of mind and consciousness while balancing the endocrine system and nervous system, thus helping tone the internal organs and rejuvenating the mind.
  • Yoga works on the alignment of skeletal and muscular systems, thus enabling better energy and blood circulation, which strengthens the brain cells and adds balance in the body.

Children affected with attention disorders, including ADHD, or Down syndrome and even autism, show remarkable results if they regularly practice yoga poses, which help release the pent-up energy that otherwise tends to make them disruptive.

Help your child overcome ADHD by attending a regular yoga class and watch them rediscover life!

Wednesday, August 29, 2012

Middle-Class Children: Squeaky Wheels in Training

From EurekAlert.org

By Jessica McCrory Calarco
August 19, 2012

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NOTE: It's important to teach children to advocate effectively for themselves. You can listen to Jessica McCrory discussing her research in a podcast entitled "'I Need Help!' Social Class and Children's Help-Seeking in Elementary School" HERE.

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A study by Indiana University Sociologist Jessica McCrory Calarco found that working-class and middle-class parents often take very deliberate, but different, approaches to helping their children with their school experiences.

Working-class parents, she found, coached their children on how to avoid problems, often through finding a solution on their own and by being polite and deferential to authority figures.

Middle-class parents, on the other hand, were more likely to encourage their kids to ask questions or ask for help.

These self-advocacy skills taught by middle-class parents not only can help the children in school -- because these parents know that in educational settings teachers often expect and reward such behavior -- but they could help later in life in other institutional settings.

"Youth who do not learn to advocate for themselves might have more difficulty interacting with social service providers, financial service providers, legal authorities and other bureaucratic institutions."

"Youth who do not learn to advocate for themselves might have more difficulty interacting with social service providers, financial service providers, legal authorities and other bureaucratic institutions," said Calarco, assistant professor in the Department of Sociology in Indiana University's College of Arts and Sciences.

Calarco discussed her research August 19th during the American Sociological Association's meeting in Denver.

Her study focuses on the interaction between parents, children and teachers during the students' fourth- and fifth-grade years at a public elementary school. Her school observations took place at least twice a week, and then she interviewed the students and parents the summer following their fifth-grade year.

Conducted while Calarco was a doctoral student at the University of Pennsylvania, the study is among the first to provide evidence that parents from different social classes teach their children different lessons about interacting with institutions. It also shows that parents help to perpetuate inequalities not only through what they do for their children, such as equipping them with different resources or opportunities, but also through what they teach children to do for themselves.

"... parents help to perpetuate inequalities not only through what they do for their children, such as equipping them with different resources or opportunities, but also through what they teach children to do for themselves."

Calarco characterized both working-class and middle-class parents as "relentless" when it came to teaching their children important lessons. This sometimes even involved role-playing, when the middle-class parents wanted their children to solve their problem on their own -- but couldn't quite leave it to chance. She also found the students very receptive.

"Even very shy middle-class children learned to feel comfortable approaching teachers with questions, and recognized the benefits of doing so," she said. "Working-class children instead worried about making teachers mad or angry if they asked for help at the wrong time or in the wrong way, and also felt that others would judge them as incompetent or not smart if they asked for help.

These differences, in turn, seem to stem not from differences in how teachers responded to students -- when working-class students did ask questions, teachers welcomed and readily addressed these requests -- but from differences in the skills, strategies and orientations that children learn from their parents at home."

Calarco discussed her paper, "Training Squeaky Wheels: Social Class and Parents' Development of Children's Self-Advocacy Skills," on Sunday, August 19, during the Culture and Inequality section. The study was funded in part by the University of Pennsylvania, the Institute of Education Sciences, and the Otto and Gertrude K. Pollack Foundation.

She can be reached at JCalarco@indiana.edu. For additional information or assistance, please contact Tracy James at 812-855-0084 or traljame@iu.edu.

Tuesday, August 28, 2012

Big Chem, Big Harm?

From The New York Times Sunday Review - Opinion Pages

By Nicholas D. Kristof
August 25, 2012

New research is demonstrating that some common chemicals all around us may be even more harmful than previously thought. It seems that they may damage us in ways that are transmitted generation after generation, imperiling not only us but also our descendants.

Yet following the script of Big Tobacco a generation ago, Big Chem has, so far, blocked any serious regulation of these endocrine disruptors, so called because they play havoc with hormones in the body’s endocrine system.

One of the most common and alarming is bisphenol-A, better known as BPA. The failure to regulate it means that it is unavoidable. BPA is found in everything from plastics to canned food to A.T.M. receipts. More than 90 percent of Americans have it in their urine.

Even before the latest research showing multigeneration effects, studies had linked BPA to breast cancer and diabetes, as well as to hyperactivity, aggression and depression in children.

Maybe it seems surprising to read a newspaper column about chemical safety because this isn’t an issue in the presidential campaign or even firmly on the national agenda. It’s not the kind of thing that we in the news media cover much.

Yet the evidence is growing that these are significant threats of a kind that Washington continually fails to protect Americans from. The challenge is that they involve complex science and considerable uncertainty, and the chemical companies — like the tobacco companies before them — create financial incentives to encourage politicians to sit on the fence. So nothing happens.

Yet although industry has, so far, been able to block broad national curbs on BPA, new findings on transgenerational effects may finally put a dent in Big Chem’s lobbying efforts.

One good sign: In late July, a Senate committee, for the first, time passed the Safe Chemicals Act, landmark legislation sponsored by Senator Frank Lautenberg, a New Jersey Democrat, that would begin to regulate the safety of chemicals.

Evidence of transgenerational effects of endocrine disruptors has been growing for a half-dozen years, but it mostly involved higher doses than humans would typically encounter.

Now Endocrinology, a peer-reviewed journal, has published a study measuring the impact of low doses of BPA. The study is devastating for the chemical industry.

Pregnant mice were exposed to BPA at dosages analogous to those humans typically receive. The offspring were less sociable than control mice (using metrics often used to assess an aspect of autism in humans), and various effects were also evident for the next three generations of mice.

The BPA seemed to interfere with the way the animals processed hormones like oxytocin and vasopressin, which affect trust and warm feelings. And while mice are not humans, research on mouse behavior is a standard way to evaluate new drugs or to measure the impact of chemicals.

“It’s scary,” said Jennifer T. Wolstenholme, a postdoctoral fellow at the University of Virginia and the lead author of the report. She said that the researchers found behaviors in BPA-exposed mice and their descendants that may parallel autism spectrum disorder or attention deficit disorder in humans.

Emilie Rissman, a co-author who is professor of biochemistry and molecular genetics at University of Virginia Medical School, noted that BPA doesn’t cause mutations in DNA. Rather, the impact is “epigenetic” — one of the hot concepts in biology these days — meaning that changes are transmitted not in DNA but by affecting the way genes are turned on and off.

In effect, this is a bit like evolution through transmission of acquired characteristics — the theory of Jean-Baptiste Lamarck, the 19th-century scientist whom high school science classes make fun of as a foil to Charles Darwin. In epigenetics, Lamarck lives.

“These results at low doses add profoundly to concerns about endocrine disruptors,” said John Peterson Myers, chief scientist at Environmental Health Sciences. “It’s going to be harder than just eliminating exposure to one generation.”

The National Institutes of Health is concerned enough that it expects to make transgenerational impacts of endocrine disruptors a priority for research funding, according to a spokeswoman, Robin Mackar.

Like a lot of Americans, I used to be skeptical of risks from chemicals like endocrine disruptors that are all around us. What could be safer than canned food? I figured that opposition came from tree-hugging Luddites prone to conspiracy theories.

Yet, a few years ago, I began to read the peer-reviewed journal articles, and it became obvious that the opposition to endocrine disruptors is led by toxicologists, endocrinologists, urologists and pediatricians. These are serious scientists, yet they don’t often have the ear of politicians or journalists.

I’m hoping these new studies can help vault the issue onto the national stage. Threats to us need to be addressed, even if they come not from Iranian nuclear weapons, but from things as banal as canned soup and A.T.M. receipts.

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About Nicholas D. Kristof

Nicholas Donabet Kristof is a journalist, author, op-ed columnist, and a winner of two Pulitzer Prizes. He has written an op-ed column for The New York Times since November, 2001, and The Washington Post says that he "rewrote opinion journalism" with his emphasis on human rights abuses and social injustices, such as human trafficking and the Darfur conflict. Archbishop Desmond Tutu of South Africa has described Kristof as an "honorary African" for shining a spotlight on neglected conflicts.
 
He invites you to comment on this column on his blog, On the Ground. Please also join him on Facebook and Google+, watch his YouTube videos and follow him on Twitter.

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NOTE: Since early in 2010, we have reported periodically on the health risks associated with BPA. You can read more about them HERE (video), HERE, HERE and HERE.

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Monday, August 27, 2012

Preventing Meltdowns: Outsmarting the Explosive Behavior of Individuals with Autism Spectrum Disorders

From SpecialEducationAdvisor.com

By Judy Endow, M.S.W.
August 22, 2012

Meltdown behavior is quite common for those with Autism Spectrum Disorders. And, indeed, the most frequently asked question by parents and educators is: “What do I do when my child has meltdowns?”

When a meltdown occurs, the best reaction is to ensure the safety of all concerned. Know that explosive behavior is not planned, but instead, is most often caused by subtle and perplexing triggers. When the behavior happens, everyone in its path feels pain, especially the child.

Stages of Explosive Behavior

So, what exactly is explosive behavior? In my book Outsmarting Explosive Behavior: A Visual System of Support and Intervention for Individuals with Autism Spectrum (Endow, 2009), explosive behavior is defined as having four distinct stages, followed by a clearly defined recovery period. In addition, the physiological fight/flight mechanism is triggered immediately prior to the explosion.

In this model, the four stages of explosive behavior are the same for all experiencing explosive behavior and are depicted by four train cars called Starting Out, Picking Up Steam, Point of No Return, and Explosion. The idea is to try to prevent the train cars from hooking up, because when they do, we have a runaway train that ends in explosion.

Working backwards, the Explosion is the stage where the meltdown behavior is evident. Immediately prior to this is the Point of No Return, which is exactly what it implies — there is no going back from the meltdown because this stage is where the fight/flight response is triggered. The pupils dilate, and breathing and heart rates increase.

Physiologically, our bodies respond as if our very lives are at stake, and we automatically behave accordingly: We fight for our lives. It is entirely impossible to reason with anyone in this survival mode. As soon as you see the child’s identified Point of No Return behavior, you can know the Explosion is coming, and need to do your best to quickly create and maintain a safe environment.

The place to impact explosive behavior is ahead of when it occurs. In the Starting Out phase, whispers of behaviors are evident. The Picking Up Steam phase is just that—the whispers become louder. Though you can learn to successfully intervene at these stages, the most effective way to manage explosive behavior is proactively, before the whispers even start.

Strategies to Prevent Meltdowns Before They Start

An individual mix of three major supports and interventions is usually most effective in preventing the first stage of meltdown behavior from starting. These three major supports include:
  • proactive use of a sensory diet to maintain optimal sensory regulation;
  • visual supports;
  • managing emotions that are too big (Endow, 2011).
People with ASD usually do not have sensory systems that automatically regulate; instead, they must discover how to keep themselves regulated. This is most often accomplished by employing a sensory diet. A sensory diet for a person with autism is like insulin for a person with diabetes.

It is easy to understand that a person with diabetes has a pancreas that is unable to regulate insulin effectively. We can measure blood sugar and know the exact state of affairs, and then, figure out how much insulin the person needs.

Sensory Diet: Unfortunately, medical science does not allow us to take a blood sample to measure sensory dysregulation. However, we can figure out and employ a sensory diet to prevent dysregulation, and just like insulin prevents serious consequences for a diabetic, a sensory diet prevents serious troubles for an individual with ASD.

As an adult with autism, I spend time every day on sensory integration activities in order to be able to function well in my everyday life. A sensory diet employed proactively goes a long way in preventing the Starting Out stage of explosive behavior from ever occurring (Brack, 2004).

Visual Supports: Another crucial area of support to put in place proactively is that of visual supports. As an autistic, I can tell you the saying “A picture is worth a thousand words” is the monumental truth. Although each person with ASD has a unique experience, processing written and spoken words is not considered by most of us to be our “first language.” For me, the meaning I get from spoken words can drop out entirely when I am under stress, my sensory system is dysregulated or my emotions are too big.

Visual supports can be anything that shows rather than tells. Visual schedules are very commonly used successfully with many individuals with ASD. Having a clear way to show beginnings and endings to the activities depicted on the visual schedule can support smooth transitions, thus keeping a meltdown at bay.

For maximum effectiveness, visual supports need to be in place proactively rather than waiting until behavior unravels to pull them out.

Managing Felt Emotions: A third area in which many with ASD need proactive support is in managing felt emotions. Most often, felt feelings are way too big for the situation. An example in my life is when I discover the grocery store is out of a specific item; I get a visceral reaction very similar to the horror I felt when first hearing about the 9/11 tragedy. I know cognitively the two events have no comparison and, yet, my visceral reaction is present and I need to consciously bring my too big feelings down to something more workable in the immediate situation.

Managing felt emotions does not come automatically, but can be learned over time with systematic instruction and visual supports such as The Incredible 5-Point Scale (Buron & Curtis, 2004).

The good news is that explosive behavior can be positively impacted. With proactive supports, explosive behavior can be outsmarted so individuals with ASD can move on to living purposeful and self-fulfilling lives.

About Judy Endow, M.S.W.

Judy Endow, M.S.W., maintains a private practice in Madison, Wisconsin, providing consultation for families, school districts and other agencies. Besides having autism herself, she is the parent of three grown sons, one of whom is on the autism spectrum. Judy does workshops and presentations on a variety of autism-related issues, is part of the Wisconsin DPI Statewide Autism Training Team and a board member of both the Autism Society of America, Wisconsin Chapter and the Autism National Committee.

In addition, Judy is a member of the Autistic Global Initiative (AGI), a program of the Autism Research Institute. For more information about AGI, please visit www.autisticglobalinitiative.com.

Her first book, Making Lemonade, Hints for Autism’s Helpers (CBR Press, 2006), shows how Judy has used the lemons of her autism to “make lemonade” in her own life. Paper Words, Discovering and Living with My Autism (AAPC Publishing, 2009) was 2010 International Book Award Finalist in Autobiographies/Memoirs.

Judy has also received the 2010 Autism Society Media Excellence Award for her DVD The Power of Words: How we talk about people with autism spectrum disorders matters! (AAPC Publishing, 2009). In addition, she has authored the annual Hidden Curriculum Calendar for Older Adolescents and Adults (AAPC Publishing 2009, 2010).

In addition, Judy has authored Outsmarting Explosive Behavior, A Visual System of Support and Intervention for Individuals with Autism Spectrum Disorders (AAPC Publishing, 2009) and Practical Solutions for Stabilizing Students With Classic Autism to Be Ready to Learn: Getting to Go (AAPC Publishing, 2011).

Judy’s newest book, Learning the Hidden Curriculum: The Odyssey of One Autistic Adult, is now available (AAPC Publishing, 2012). She continues to bring a great depth of understanding and compassion to all the work she does.

References

Brack, J.C. (2004). Learn to Move, Move to Learn! Sensorimotor Early Childhood Activity Themes. Shawnee Mission, KS: Autism Asperger Publishing Company.

Buron, K.D., & Curtis, M. (2004). The Incredible 5-Point Scale. Shawnee Mission, KS: Autism Asperger Publishing Company.

Endow, J. (2009). Outsmarting Explosive Behavior: A Visual System of Support and Intervention for Individuals with Autism Spectrum Disorders. Shawnee Mission, KS: Autism Asperger Publishing Company.

Endow, J. (2011). Practical Strategies for Stabilizing Students With Classic Autism to Be Ready to Learn: Getting to Go. Shawnee Mission, KS: Autism Asperger Publishing Company.

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First printed on Education.com with permission of the Autism Society.

Sunday, August 26, 2012

Executive Functions: Critical Skills that Schools Don’t Teach

By Thinking Outside the Classroom: An Introduction to the Mindset and Toolkit for Parents of K-12 Students

Is homework a nightly struggle? Does your child have trouble organizing materials, managing time or producing work? Is your child’s academic performance meeting his/her potential? Do you want to learn about your role in your child’s executive function development?

In this talk, Senior Coach and Supervisor Jackie Stachel will explain executive functions, their development and how challenges with them impact students’ academic outcomes. A hierarchy of executive functions will be examined as a pathway to productivity.

What sets the stage for overcoming executive function difficulties? How do we foster growth and change?

These concerns will be discussed, as will some specific tools that can facilitate change in students with executive function challenges. Finally, the parents’ role in the process of executive function growth is considered, with an eye toward the goal of students developing autonomy and ownership of their academic performance.

When:   7:00 - 9:00pm, Wednesday, September 19th

Where: Northshore Unitarian Universalist Church, 
                  323 Locust Street (Route 35), Danvers, MA 
                  (look for sign; building is set back from street)

Admission is FREE if you register in advance!

To register, visit www.ThinkingOutsideTheClassroom.com or email: info@ThinkingOutsideTheClassroom.com

An Immune Disorder at the Root of Autism

From The New York Times Sunday Review - Opinion Pages

By Moises Velasquez-Manoff
August 25, 2012

In recent years, scientists have made extraordinary advances in understanding the causes of autism, now estimated to afflict 1 in 88 children. But remarkably little of this understanding has percolated into popular awareness, which often remains fixated on vaccines.

" At least a subset of autism — perhaps one-third, and very likely more — looks like a type of inflammatory disease."

So here’s the short of it: At least a subset of autism — perhaps one-third, and very likely more — looks like a type of inflammatory disease. And it begins in the womb.

It starts with what scientists call immune dysregulation. Ideally, your immune system should operate like an enlightened action hero, meting out inflammation precisely, accurately and with deadly force when necessary, but then quickly returning to a Zen-like calm. Doing so requires an optimal balance of pro- and anti-inflammatory muscle.

In autistic individuals, the immune system fails at this balancing act. Inflammatory signals dominate. Anti-inflammatory ones are inadequate. A state of chronic activation prevails. And the more skewed toward inflammation, the more acute the autistic symptoms.

Nowhere are the consequences of this dysregulation more evident than in the autistic brain. Spidery cells that help maintain neurons — called astroglia and microglia — are enlarged from chronic activation. Pro-inflammatory signaling molecules abound. Genes involved in inflammation are switched on.

These findings are important for many reasons, but perhaps the most noteworthy is that they provide evidence of an abnormal, continuing biological process. That means that there is finally a therapeutic target for a disorder defined by behavioral criteria like social impairments, difficulty communicating and repetitive behaviors.

But how to address it, and where to begin? That question has led scientists to the womb. A population-wide study from Denmark spanning two decades of births indicates that infection during pregnancy increases the risk of autism in the child. Hospitalization for a viral infection, like the flu, during the first trimester of pregnancy triples the odds. Bacterial infection, including of the urinary tract, during the second trimester increases chances by 40 percent.

The lesson here isn’t necessarily that viruses and bacteria directly damage the fetus. Rather, the mother’s attempt to repel invaders — her inflammatory response — seems at fault. Research by Paul Patterson, an expert in neuroimmunity at Caltech, demonstrates this important principle. Inflaming pregnant mice artificially — without a living infective agent — prompts behavioral problems in the young. In this model, autism results from collateral damage. It’s an unintended consequence of self-defense during pregnancy.

"In this model, autism results from collateral damage. It’s an unintended consequence of self-defense during pregnancy." 

Yet to blame infections for the autism epidemic is folly. First, in the broadest sense, the epidemiology doesn’t jibe. Leo Kanner first described infantile autism in 1943. Diagnoses have increased tenfold, although a careful assessment suggests that the true increase in incidences is less than half that. But in that same period, viral and bacterial infections have generally declined. By many measures, we’re more infection-free than ever before in human history.

Better clues to the causes of the autism phenomenon come from parallel “epidemics.” The prevalence of inflammatory diseases in general has increased significantly in the past 60 years. As a group, they include asthma, now estimated to affect 1 in 10 children — at least double the prevalence of 1980 — and autoimmune disorders, which afflict 1 in 20.

Both are linked to autism, especially in the mother. One large Danish study, which included nearly 700,000 births over a decade, found that a mother’s rheumatoid arthritis, a degenerative disease of the joints, elevated a child’s risk of autism by 80 percent. Her celiac disease, an inflammatory disease prompted by proteins in wheat and other grains, increased it 350 percent. Genetic studies tell a similar tale. Gene variants associated with autoimmune disease — genes of the immune system — also increase the risk of autism, especially when they occur in the mother.

In some cases, scientists even see a misguided immune response in action. Mothers of autistic children often have unique antibodies that bind to fetal brain proteins. A few years back, scientists at the MIND Institute, a research center for neurodevelopmental disorders at the University of California, Davis, injected these antibodies into pregnant macaques. (Control animals got antibodies from mothers of typical children.) Animals whose mothers received “autistic” antibodies displayed repetitive behavior. They had trouble socializing with others in the troop. In this model, autism results from an attack on the developing fetus.

But there are still other paths to the disorder. A mother’s diagnosis of asthma or allergies during the second trimester of pregnancy increases her child’s risk of autism.

So does metabolic syndrome, a disorder associated with insulin resistance, obesity and, crucially, low-grade inflammation. The theme here is maternal immune dysregulation. Earlier this year, scientists presented direct evidence of this prenatal imbalance. Amniotic fluid collected from Danish newborns who later developed autism looked mildly inflamed.

Debate swirls around the reality of the autism phenomenon, and rightly so. Diagnostic criteria have changed repeatedly, and awareness has increased. How much — if any — of the “autism epidemic” is real, how much artifact?

Yet, when you consider that, as a whole, diseases of immune dysregulation have increased in the past 60 years — and that these disorders are linked to autism — the question seems a little moot. The better question is: Why are we so prone to inflammatory disorders? What has happened to the modern immune system?

There’s a good evolutionary answer to that query, it turns out. Scientists have repeatedly observed that people living in environments that resemble our evolutionary past, full of microbes and parasites, don’t suffer from inflammatory diseases as frequently as we do.

Generally speaking, autism also follows this pattern. It seems to be less prevalent in the developing world. Usually, epidemiologists fault lack of diagnosis for the apparent absence. A dearth of expertise in the disorder, the argument goes, gives a false impression of scarcity. Yet at least one Western doctor who specializes in autism has explicitly noted that, in a Cambodian population rife with parasites and acute infections, autism was nearly nonexistent.

For autoimmune and allergic diseases linked to autism, meanwhile, the evidence is compelling. In environments that resemble the world of yore, the immune system is much less prone to diseases of dysregulation.

Generally, the scientists working on autism and inflammation aren’t aware of this — or if they are, they don’t let on. But Kevin Becker, a geneticist at the National Institutes of Health, has pointed out that asthma and autism follow similar epidemiological patterns. They’re both more common in urban areas than rural; firstborns seem to be at greater risk; they disproportionately afflict young boys.

In the context of allergic disease, the hygiene hypothesis — that we suffer from microbial deprivation — has long been invoked to explain these patterns. Dr. Becker argues that it should apply to autism as well. (Why the male bias? Male fetuses, it turns out, are more sensitive to Mom’s inflammation than females.)

More recently, William Parker at Duke University has chimed in. He’s not, by training, an autism expert. But his work focuses on the immune system and its role in biology and disease, so he’s particularly qualified to point out the following: the immune system we consider normal is actually an evolutionary aberration.

Some years back, he began comparing wild sewer rats with clean lab rats. They were, in his words, “completely different organisms.” Wild rats tightly controlled inflammation. Not so the lab rats. Why? The wild rodents were rife with parasites. Parasites are famous for limiting inflammation.

Humans also evolved with plenty of parasites. Dr. Parker and many others think that we’re biologically dependent on the immune suppression provided by these hangers-on and that their removal has left us prone to inflammation. “We were willing to put up with hay fever, even some autoimmune disease,” he told me recently. “But autism? That’s it! You’ve got to stop this insanity.”

What does stopping the insanity entail? Fix the maternal dysregulation, and you’ve most likely prevented autism. That’s the lesson from rodent experiments. In one, Swiss scientists created a lineage of mice with a genetically reinforced anti-inflammatory signal. Then the scientists inflamed the pregnant mice. The babies emerged fine — no behavioral problems. The take-away: Control inflammation during pregnancy, and it won’t interfere with fetal brain development.

For people, a drug that’s safe for use during pregnancy may help. A probiotic, many of which have anti-inflammatory properties, may also be of benefit. Not coincidentally, asthma researchers are arriving at similar conclusions; prevention of the lung disease will begin with the pregnant woman. Dr. Parker has more radical ideas: pre-emptive restoration of “domesticated” parasites in everybody — worms developed solely for the purpose of correcting the wayward, postmodern immune system.

Practically speaking, this seems beyond improbable. And yet, a trial is under way at the Montefiore Medical Center and the Albert Einstein College of Medicine testing a medicalized parasite called Trichuris Suis in autistic adults.

First used medically to treat inflammatory bowel disease, the whipworm, which is native to pigs, has anecdotally shown benefit in autistic children.

And really, if you spend enough time wading through the science, Dr. Parker’s idea — an ecosystem restoration project, essentially — not only fails to seem outrageous, but also seems inevitable.

Since time immemorial, a very specific community of organisms — microbes, parasites, some viruses — has aggregated to form the human superorganism. Mounds of evidence suggest that our immune system anticipates these inputs and that, when they go missing, the organism comes unhinged.

Future doctors will need to correct the postmodern tendency toward immune dysregulation. Evolution has provided us with a road map: the original accretion pattern of the superorganism. Preventive medicine will need, by strange necessity, to emulate the patterns from deep in our past.

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Moises Velasquez-Manoff covered science and the environment for The Christian Science Monitor, and his work has appeared in The New York Times Magazine, The Chicago Tribune, and the Minneapolis Star, among other publications. He graduated from the Columbia Graduate School of Journalism’s Master of Arts program, with a concentration in science writing.

Saturday, August 25, 2012

Annie Murphy Paul on Learning: Two New Posts by One of Our Favorites

From DeepakChopra.com

Six Ways To Get Motivated To Learn

By Guest Blogger Annie Murphy Paul
August 16, 2012

Maybe it's the August heat that's making us all droop, or maybe it's the looming start of school in September, but I've been fielding a lot of questions lately about motivation—how to get kids, or employees, or ourselves excited about learning. Fortunately, scientific research has provided us with a number of ways to get the learning juices flowing, none of which involve paying money for good grades.

1.) Fine-tune the challenge. We’re most motivated to learn when the task before us is matched to our level of skill: not so easy as to be boring, and not so hard as to be frustrating. Deliberately fashion the learning exercise so that you’re working at the very edge of your abilities, and keep upping the difficulty as you improve.

2.) Start with the question, not the answer. Memorizing information is boring. Discovering the solution to a puzzle is invigorating. Present material to be learned not as a fait accompli, but as a live question begging to be explored.

3.) Beat your personal best. Some learning tasks, like memorizing the multiplication table or a list of names or facts, are simply not interesting in themselves. Generate motivation by competing against yourself: run through the material once to establish a baseline, then keep track of how much you improve (in speed, in accuracy) each time.

4.) Connect abstract learning to concrete situations. Adopt the case-study method that has proven so effective for business, medical and law school students: apply abstract theories and concepts to a real-world scenario, using these formulations to analyze and make sense of situations involving real people and real stakes.

5.) Make it social. Put together a learning group, or find a learning partner, with whom you can share your moments of discovery and points of confusion. Divide the learning task into parts, and take turns being teacher and pupil. The simple act of explaining what you’re learning out loud will help you understand and remember it better.

6.) Go deep. Almost any subject is interesting once you get inside it. Assign yourself the task of becoming the world’s expert on one small aspect of the material you have to learn—then extend your new expertise outward by exploring how the piece you know so well connects to all the other pieces you need to know about.

Comments or questions? I'd love to hear from you. Email me at annie@anniemurphypaul.com. And, if you'd like to read even more about learning, visit my website, follow me on Twitter, and join the conversation on Facebook.

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About Annie Murphy Paul

Annie Murphy Paul is an author, journalist and speaker who helps people understand how we learn and how we can do it better. A contributing writer for Time, she writes a weekly column about learning for Time.com.



She contributes to The New York Times Magazine, The New York Times Book Review, Slate, and O - The Oprah Magazine, among many other publications. She is the author of The Cult of Personalitya cultural history and scientific critique of personality tests, and of Origins, a book about the science of prenatal influences. Her new book, out in 2013, is Brilliant: The New Science of Smart.

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Where’s the Joy in Learning?

By Annie Murphy Paul
August 17, 2012

A school is not a desert of emotions,” begins an article by Finnish educators Taina Rantala and Kaarina Määttä, published in the journal Early Child Development and Care. But you’d never know that by looking at the scientific literature.

“In the field of educational psychology, research on feelings is lacking,” the authors note, “and the little that does exist has focused more on negative rather than positive feelings.” Rantala, the principal of an elementary school in the city of Rovaniemi, and Määttä, a professor of psychology at the University of Lapland, set out to remedy this oversight by studying one emotion in particular: joy.

The researchers followed a single class through first and second grade, documenting the students’ emotions with photographs and videos. Through what they call “ethnographic observation,” Rantala and Määttä identified the circumstances that were most likely to produce joy in the classroom. No doubt many pupils would agree with this example of their findings: “The joy of learning does not include listening to prolonged speeches.”

“The joy of learning does not include listening to prolonged speeches.” 

Such teacher-centric lessons are much less likely to generate joy than are lessons focused on the student, the authors report. The latter kind of learning involves active, engaged effort on the part of the child; joy arrives when the child surmounts a series of difficulties to achieve a goal.

One of the authors’ videos shows seven-year-old Esko, tapping himself proudly on the chest and announcing, “Hey, I figured out how to do math!”

A desire to master the material leads to more joy than a desire to simply perform well, Rantala and Määttä add: joy often accompanies “the feeling of shining as an expert.”

Likewise, the joy of learning is more likely to make an appearance when teachers permit students to work at their own level and their own pace, avoiding making comparisons among students. The authors recommend that children be taught to evaluate and monitor their own learning so they can tell when they’re making progress.

Some pupils will take longer than others—as Rantala and Määttä write, “The joy of learning does not like to hurry.” Because joy is so often connected to finishing a task or solving a problem, they point out, allowing time for an activity to come to its natural conclusion is important.

Granting students a measure of freedom in how they learn also engenders joy. Such freedom doesn’t mean allowing children to do whatever they want, but giving them choices within limits set by a teacher. These choices need not be major ones, the authors note: “For us adults, it makes no difference whether we write on blue or red paper, but when a student can choose between these options, there will be a lot of joy in the air.”

Not surprisingly, play was a major source of joy in the classroom Rantala and Määttä observed (even when that play was not exactly what a teacher would wish: the researchers’ video camera caught one student fashioning a gun out of an environmental-studies handout). “Play is the child’s way of seeking pleasure,” the authors write, and it is a learning activity in itself; it shouldn’t be viewed as “a Trojan horse” in which to smuggle in academic lessons.

“Play is the child’s way of seeking pleasure, and it is a learning activity in itself; it shouldn’t be viewed as a 'Trojan Horse' in which to smuggle in academic lessons."

Lastly, sharing and collaborating with other students is a great source of joy. One of the authors’ videotapes shows a student reacting with pleasure when a classmate, Paavo, says, “You are so good at making those dolls!” The researchers conclude: “Joy experienced together, and shared, adds up to even more joy.”

Finland leads the world in its scores on international tests, and the country has become an educational model for many in the U.S. Rantala and Määttä’s paper is a welcome reminder that academic excellence can coexist with delight.


Friday, August 24, 2012

Jill O’Connell-Nordin, M.S.W. Joins NESCA as AASC Clinician

Ms. O’Connell-Nordin has joined NESCA as a clinician in the innovative AASC (Anxiety & Attention Skills Coaching) Program, where she will work with Angela Currie, Ph.D.

She brings to NESCA a wide range of clinical experience, having served most recently as a substitute school social worker. Ms. O’Connell-Nordin has provided one-on-one consultation and case management support to students in the Duxbury Partnership Program. She has also provided both short- and long-term care to high-risk adolescent females and their families, which included conducting Dialectical Behavior Therapy groups. She has work and volunteer experience as a victims’ advocate and counselor.

Jill O’Connell-Nordin received her M.S.W. from Boston College. Her email address is jnordin@nesca-newton.com.

About the AASC Program

NESCA's unique Anxiety and Attention Skills Coaching (AASC) Program is a time-limited, intensive intervention focused on developing self-regulation skills in children and adolescents with anxiety and/or attentional difficulties that are interfering with their ability to fully engage in their academic, social, recreational, or home environments.

It was developed on the belief that children and adolescents best learn new skills through well-focused interventions that allow for frequent repetition and rehearsal.

The program uses a short-term, intensive skills-based approach to teaching emotional awareness and self-regulation. It is designed for children and adolescents who, for a variety of reasons, cannot wait a year to make progress in traditional once-weekly interventions, or whose parents report “we tried individual therapy and it did not work.”

Individualized interventions encourage quick acquisition of skills through personalized psychoeducational plans and aids, as well as opportunities for generalization to outside environments.

For more information about AASC, please contact Dr. Angela Currie at 617-658-9825, or email acurrie@nesca-newton.com.

Two Dispatches from the Frontiers of Autism Research

From the Autism Speaks Blog

Donated Tissue Makes New Findings Possible

By Jill James, Ph.D., Director of the Autism Metabolic Genomics Laboratory at Arkansas Children’s Hospital Research Institute

Autism Speaks' Autism Tissue Program and its donors enable the study of brain inflammation, cell damage and antioxidants.

Postmortem brain tissue is one of the most precious donations a family can make. I am forever grateful to families who make this remarkable gift. In fact, the research that I do has been made possible by Autism Speaks Autism Tissue Program (ATP), which makes brain tissue available to qualified scientists studying autism.

To help illustrate the importance of these donations, please see today’s news story on the findings we published in Translational Psychiatry. We also had the opportunity to present our results at the Autism Speaks National Conference for Families and Professionals, earlier this month.

In this study, we found lowered levels of the antioxidant glutathione in the postmortem brain tissues of persons who had autism. These results support our previous findings of oxidative stress and damage in plasma and immune cells from children with autism. Together, this suggests that damaging oxidation may be pervasive in autism.

Further, it may be that markers of oxidative stress outside the brain may allow us to gauge oxidative stress in the brain of living persons with autism.

Taken together, these results suggest that a genetic predisposition to insufficient antioxidant protection in the brain may contribute to autism risk. At the least, this may be true in the presence of certain stresses during brain development.

In recent years, research has made it increasingly clear that autism can result from a combination of genetic predisposition and environmental stress during critical periods of early brain development. Our research supports this line of thinking.

These findings represent a small step forward. But we see great potential to deepen our understanding of the underlying biology of autism in ways that may lead to new methods for preventing and treating it.

I can’t emphasize enough how much this scientific progress depends on the support of families such as yours – whether it’s research dollars raised at an Autism Speaks Walk or a post-mortem donation of precious brain tissue. We could not do what we do without your support. Thank you.

Learn more about participating in Autism Speaks Autism Tissue program here and a wide range of other autism studies here. Explore more of the studies Autism Speaks is funding through the grant search, and find more news and perspective on the Autism Speaks Science page.

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From Spoonful of Medicine - A Blog from NATURE Medicine

First US Stem Cell Trial for Autistic Children Launches Today

By Kathleen Raven
August 21, 2012

"Go slowly and think hard about your decision.”

Families with autistic children must navigate a condition where questions outnumber the answers, and therapies remain sparse and largely ineffective. A clinical trial being conducted by the Sutter Neuroscience Institute in Sacramento, California to address this situation began recruiting participants today for a highly experimental stem cell therapy for autism. The institute plans to find 30 autistic children between ages 2 and 7 with cord blood banked at the privately-run Cord Blood Registry, located about 100 miles west of the institute.

Already one other clinical trial, with 37 total participants between ages 3 and 12 years old, has been completed in China. The researchers affiliated with Beike Biotechnology in Shenzhen, the firm that sponsored the study, have not yet published any papers from that the trial, which used stem cells from donated cord blood. Mexican researchers are currently recruiting kids for yet another type of autism stem cell trial that will harvest cells from the participant’s fat tissue.

But for each of these officially registered trials, many more undocumented stem cell therapy treatments take place for clients who are willing to pay enough. “Our research is important because many people are going to foreign countries and spending a lot of money on therapy that may not be valid,” says Michael Chez, a pediatric neurologist and lead investigator of the study at Sutter.

A major difference between the Sutter trial and those in China is that his will use the child’s own stem cells, rather than those from a donor. Chez hypothesizes that one way autologous stem cell infusion might work is by reducing inflammation within the body’s immune system. This would answer previous research that suggests that autism may be an autoimmune disease. “One of our exploratory goals will be to look at inflammatory markers in cells,” he says.

The study’s primary goal, however, will be assessing changes in patients’ speaking and understanding of vocabulary. For each individual, researchers will create a baseline benchmark that establishes current skill levels. The group will be evenly divided, with one initially receiving an infusion of their own, unmodified cord blood stem cells and the other a placebo treatment of saline injection. Six months later, all of the children will be tested on their ability to comprehend and form words. The groups will then be switched. In the course of the 13-month-long study, both groups will receive only one stem cell therapy infusion.

Not all stem cell scientists who study neurodevelopmental diseases are ready to invest great hope that the autism stem cell trial will succeed. “I wish I could tell you I’m optimistic about the end results,” says James Carroll, a pediatric neurologist at the Georgia Health Sciences University in Augusta who began a clinical trial two years ago to better understand how stem cell therapy affects patients with cerebral palsy. “But so far we have not seen any kind of miraculous recovery in our cerebral palsy patients. I would be delighted if that changes.”

Members in the stem cell therapy patient community think Chez will have no shortage of volunteers for the trial. Jeremy Lowey, who lives in Sacramento and has struggled with a rare condition known as non-verbal learning disorder, arranged for his own stem cell therapy treatment in India last year, which he called life-changing. He receives numerous Facebook requests from parents of autistic children who are curious to know more. He always begins his conversations by saying, “Go slowly and think hard about your decision.”

Thursday, August 23, 2012

Father’s Age Is Linked to Risk of Autism and Schizophrenia

From The New York Times - Health

By Benedict Carey
August 22, 2012

Older men are more likely than young ones to father a child who develops autism or schizophrenia, because of random mutations that become more numerous with advancing paternal age, scientists reported on Wednesday, in the first study to quantify the effect as it builds each year.

The age of mothers had no bearing on the risk for these disorders, the study found.

Experts said that the finding was hardly reason to forgo fatherhood later in life, though it might have some influence on reproductive decisions. The overall risk to a man in his 40s or older is in the range of 2 percent, at most, and there are other contributing biological factors that are unknown.

But the study, published online in the journal Nature, provides support for the argument that the surging rate of autism diagnoses over recent decades is attributable in part to the increasing average age of fathers, which could account for as many as 20 to 30 percent of cases.

The findings counter the longstanding assumption that the age of the mother is the most important factor in determining the odds of a child having developmental problems.

The risk of chromosomal abnormalities, like Down Syndrome, increases for older mothers, but when it comes to some complex developmental and psychiatric problems, the lion’s share of the genetic risk originates in the sperm, not the egg, the study found.

Previous studies had strongly suggested as much, including an analysis published in April that found that this risk was higher at age 35 than 25 and crept up with age. The new report quantifies that risk for the first time, calculating how much it accumulates each year.

The research team found that the average child born to a 20-year-old father had 25 random mutations that could be traced to paternal genetic material. The number increased steadily by two mutations a year, reaching 65 mutations for offspring of 40-year-old men.

The average number of mutations coming from the mother’s side was 15, no matter her age, the study found.

“This study provides some of the first solid scientific evidence for a true increase in the condition” of autism, said Dr. Fred R. Volkmar, director of the Child Study Center at the Yale School of Medicine, who was not involved in the research. “It is extremely well done and the sample meticulously characterized.”

“This study provides some of the first solid scientific evidence for a true increase in the condition of autism. It is extremely well done and the sample meticulously characterized.”

The new investigation, led by the Icelandic firm DeCODE Genetics, analyzed genetic material taken from blood samples of 78 parent-child trios, focusing on families in which parents with no signs of a mental disorder gave birth to a child who developed autism or schizophrenia. This approach allows scientists to isolate brand-new mutations in the genes of the child that were not present in the parents.

Most people have many of these so-called de novo mutations, which occur spontaneously at or near conception, and most of them are harmless. But studies suggest that there are several such changes that can sharply increase the risk for autism and possibly schizophrenia — and the more a child has, the more likely he or she is by chance to have one of these rare, disabling ones.

Some difference between the paternal and maternal side is to be expected. Sperm cells divide every 15 days or so, whereas egg cells are relatively stable, and continual copying inevitably leads to errors, in DNA as in life.

Still, when the researchers removed the effect of paternal age, they found no difference in genetic risk between those who had a diagnosis of autism or schizophrenia and a control group of Icelanders who did not.

“It is absolutely stunning that the father’s age accounted for all this added risk, and it’s stunning that so little is contributed by the mother's age.”

“It is absolutely stunning that the father’s age accounted for all this added risk, given the possibility of environmental factors and the diversity of the population,” said Dr. Kari Stefansson, the chief executive of DeCODE and the study’s senior author. “And it’s stunning that the mother's age contirbutes so little."

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PODCAST
 
deCODE Genetic’s Kári Stefánsson explains to NATURE Reporter Ewen Callaway how a father’s age might affect a baby’s risk of disease, HERE.
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Dr. Stefansson’s co-authors included C. Augustine Kong of DeCODE, and researchers from the University of Iceland, Aarhus University in Denmark and Illumina Cambridge, Ltd.

Dr. Stefansson said it made sense that de novo mutations would play a significant role in brain disorders. At least 50 percent of active genes play a role in neural development, so that random glitches are more likely to affect the brain than other organs, which have less exposure.

In the end, these kinds of mutations may account for 20 to 30 percent of cases of autism, and perhaps schizophrenia, some experts said. The remainder is probably a result of inherited genetic predisposition and environmental factors that are the subjects of numerous studies.

Dr. Stefansson and other experts said that an increase in the average age of fathers had most likely led to more cases of autism. Unlike other theories proposed to explain the increase, like vaccinations, it is backed by evidence that scientists agree is solid.

This by itself hardly explains the overall increase in diagnoses, at least in the United States. The birthrate of fathers age 40 and older has increased by more than 30 percent since 1980, according to government figures, but the diagnosis rate has jumped tenfold, to 1 in 88 8-year-olds.

And it is not clear whether the rate of schizophrenia diagnosis has increased at all in that time.

Nonetheless, if these findings hold up and extend to other brain disorders, wrote Alexey S. Kondrashov of the University of Michigan, in an editorial accompanying the study, “then collecting the sperm of young adult men and cold-storing it for later use could be a wise individual decision.”

That very much depends on the individual. “You are going to have guys who look at this and say, ‘Oh no, you mean I have to have all my kids when I’m 20 and stupid?’ ” said Evan E. Eichler, a professor of genome sciences at the University of Washington in Seattle. “Well, of course not. You have to understand that the vast majority of these mutations have no consequences, and that there are tons of guys in their 50s who have healthy children.”

On Genetic Testing


Dr.Kari Stefansson, M.D., CEO of deCODE genetics talks about the nature of genetic tests, how they will affect the doctor-patient relationship and how they fit into the future of health care as a part of preventive approach well-care. deCODE genetics offers deCODEme, a comprehensive one million snip genomic scan and individual genetic tests for numerous diseases and conditions.

Wednesday, August 22, 2012

High School Daze: The Perils Of Sacrificing Sleep For Late-Night Studying

From NPR's Morning Edition

By Allison Aubrey - WBUR 90.9 FM
August 21, 2012

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NOTE: You can listen to this story HERE.

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High school students with heavy academic course loads often find the demands of homework colliding with the need for adequate sleep. And a new study published in the journal Child Development finds that when teens don't get the sleep they need on a given night, the next day all kinds of things can go poorly.

"We learned that when kids cram, particularly at the expense of sleep, the next day they're more likely to have academic problems even though they spent more time studying that night," explains researcher Andrew Fuligni of UCLA.

"These findings may come as a surprise to many researchers, educators, parents and teens who assume that more studying will surely lead to better grades," says Amy Wolfson, a professor of psychology at the College of the Holy Cross in Worcester, Massachusetts.


The study builds on a body of evidence that finds sleep and learning are inextricably linked.

"Lots of things happen during sleep," explains Helene Emsellem, director of The Center for Sleep and Wake Disorders in Chevy Chase, MD. "We don't just physically restore ourselves." We also process all the information we've gathered during the day. "We take the information and organize it and make all the connections," Emsellem explains.

Without adequate sleep, students don't learn as well.

Maybe this explains why rising 12th-grader Patrick Ottolini from suburban Washington, D.C., has realized it's not always the best strategy to stay up late and cram.

"If it's, like, a big test, it's not going to work at all," he says.

Instead of sacrificing sleep, he says, he has learned it's best to try to pace himself and find regular chunks of time each day to study. Classmate David LoBosco has another strategy that works for him: When it comes to prepping the night before a quiz, he finds it better to get some sleep and set the alarm.

"You know, wake up early in the morning and study."

The most helpful advice Emsellem gives families? "Have a lights-out time in the house," she says.

Emsellem has outlined strategies for success in her book Snooze or Lose - 10 "No-War" Ways to Improve Your Teen's Sleep Habits. This can be helpful for teens — and their parents.

Wolfson says one caution about the new study is that the data are self-reported rather than drawn from report cards or teacher reports. But she says it's important research that adds to our "need to remind school districts to think seriously about school start times, homework policies and the need to teach study skills and health to developing adolescents."

Here are some additional tips from Wolfson:

1.) Keep a regular sleep-wake schedule throughout the week. When your schedule varies by more than 60 to 90 minutes day to day (or school nights vs. weekend nights), this can have negative consequences for academics, mood and health.

2.) Try to get 8 1/2 to 9 1/2 hours of sleep a night: Best for middle and high school-age adolescents

3.) Keep a regular study schedule: Trying to study late at night interferes with a teen's ability to get a sufficient amount of sleep, and may create an irregular sleep-wake schedule as noted above.

4.) Minimize high-tech in one's sleep environment and particularly in the hour before trying to fall asleep (such as: text messaging, computer work/games, watching videos, etc.). These activities will also interfere with falling asleep and might wake you up at night if you keep your cellphone on during the night.

5.) Eliminate caffeine from your diet, particularly 3 to 5 hours before trying to fall asleep.