Parenting: Feeding Issues in childhood

Helping children learn to eat well can sometimes be a challenge. 

Some children happily eat whatever is put in front of them while others seem to eat like birds and exist more on air than food.

A new study by a researcher at the University of Colorado School of Medicine shows that parents influence how much children eat more than they may think.

In this collaborative study between the CU School of Medicine, Baylor College of Medicine and University of Alabama Birmingham, researchers observed normal, everyday mealtimes in the homes of 145 parents and their preschoolers recruited from a Head Start program in the Houston area.

They investigated the relationships between how much parents served themselves at mealtime, the amounts of foods they served to their children and how much children ate at dinner time.

The results revealed that parents served children very similar amounts to those they gave themselves and that the amounts children were served strongly predicted the amounts they ate.

For some children, this resulted in the consumption of adult-sized portions.

"The good news," said Susan Johnson, PhD, professor of pediatrics at the CU School of Medicine and a lead investigator for the study, "is that parents influence their children much more than they may feel they do."

"The challenge remains as to how to encourage children to consume a healthy diet and to eat amounts that help them grow appropriately."

"Clearly, family habits and behaviours are both incredibly important in this regard."

Johnson suggests paying attention to the portions offered to children and for parents to ensure that they offer child-sized portions of healthy foods.

Prompting children to eat according to their feelings of hunger and fullness, rather than parents deciding how much is enough, also is an important step towards promoting healthy eating and growth.

This study will be published in the April 2014 issue of The American Journal of Clinical Nutrition.

More Information: 'Portion sizes for children are predicted by parental characteristics and the amounts parents serve themselves' Susan L Johnson, et al., Am J Clin Nutr April 2014 ajcn.078311 - doi: 10.3945/​ajcn.113.078311

Thirty percent of adults with ADHD report childhood physical abuse

Thirty percent of adults with Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder (ADD/ADHD) report they were physically abused before they turned 18.

This compares to seven per cent of those without ADD/ADHD who were physically abused before 18. The results were in a study published in this week's online Journal of Aggression, Maltreatment, and Trauma.

"This strong association between abuse and ADD/ADHD was not explained by differences in demographic characteristics or other early adversities experienced by those who had been abused," says lead author Esme Fuller-Thomson, Professor and Sandra Rotman Chair at University of Toronto's Factor-Inwentash Faculty of Social Work.

"Even after adjusting for different factors, those who reported being physically abused before age 18 had seven times the odds of ADD/ADHD."

Investigators examined a representative sample of 13,054 adults aged 18 and over in the 2005 Canadian Community Health Survey including 1,020 respondents who reported childhood physical abuse and 64 respondents who reported that they had been diagnosed by a health professional with either ADHD or ADD.

"Our data do not allow us to know the direction of the association. It is possible that the behaviors of children with ADD/ADHD increase parental stress and the likelihood of abuse," says co-author Rukshan Mehta, a graduate of the University of Toronto's Master of Social Work program.

"Alternatively, some new literature suggests early childhood abuse may result in and/or exacerbate the risk of ADD/ADHD."

According to co-author Angela Valeo from Ryerson University, "This study underlines the importance of ADD/ADHD as a marker of abuse.

With 30 per cent of adults with ADD/ADHD reporting childhood abuse, it is important that health professionals working with children with these disorders screen them for physical abuse."

More information: "Establishing a Link Between Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder and Childhood Physical Abuse." Esme Fuller-Thomsona*, Rukshan Mehtaa & Angela Valeob. Journal of Aggression, Maltreatment & Trauma. Volume 23, Issue 2, 2014 pages 188-198. DOI: 10.1080/10926771.2014.873510

Parenting Skills: Positive Reframing

Positive reframing can shore up children’s confidence as well. Credit: iStock

Leo Kanner, author of the first textbook on child psychiatry, used to tell anecdotes about two mothers he knew.

One complained that her sons would spread the Sunday comics on the living room floor to read them.

The other, whose sons had done the same thing as children, said it was one of her fondest memories.

He used to argue that the second mother was the better parent, because she had a more positive attitude.

But what was behind that positive attitude?

Perhaps the mother was thinking about how her children were honing their reading skills. Or, how they were sharing both comics and floor space without fighting.

In other words, she was most likely engaging in what we now call positive reframing, the practice of either focusing on the positive aspects of a bothersome situation or just looking at it differently.

Positive reframing helps us see our children, and our children see themselves in a more favourable light.

If this approach is applied to how we view children, the technique can prevent us from overreacting.

Adolescents
When an adolescent does all those adolescent things, such as leaving her room a mess and spending too much time texting, we can take refuge in the knowledge that by challenging authority and connecting with friends, she is working through an important developmental stage.

Positive reframing can help us understand children from different cultures, too.

For example, Native American students often resist participating in competitive learning games such as spelling bees, causing some teachers to see them as disengaged.

However, when the students' resistance is understood as an expression of a cultural bias toward cooperation over competition, the teacher can see strength in it.

Overcoming Aversions
Applied to helping kids interpret their own behaviour, positive reframing can foster growth. It can help overcome aversions, as it did for one young boy who hated bath time.

Knowing he enjoyed war play, his mother got him to see the bath as a place to enact sea battles, bringing in toy ships and using bubble bath to simulate foamy waves.

The mother of a reluctant eater presented broccoli as "dino trees"—which her "brontosaurus" son would then devour.

Fighting Sleep
A couple with a daughter who resisted going to sleep because her room was dark and scary held a dance party in the dark, after which she associated being in the dark with having a good time.

Positive reframing can shore up children's confidence as well.

On the last play of an important ball game, the right fielder on a children's team I coached, dropped a line-drive fly ball (???), which allowed our opponents to score the winning run.

When the boy came to me distraught, I shared what the pitcher had told me, that his last pitch was too easy to hit, resulting in a hard-to-catch line drive.

I also reminded the boy that before the game, I had denied him time in the outfield to practice 'shagging fly balls.'(???)

He went from thinking he had blown the game to understanding that several factors had contributed to our team's loss.

Finally
Even some of the toughest behaviour problems often respond to positive reframing. For instance, when a first-grader made a beeline for the coloured pencils by walking on chairs and desktops, his teacher said, "That's a great idea to use coloured pencils for your journal and you got them all by yourself."

She went on to suggest that in the future, he keep his feet on the floor, which he agreed to do.

Another teacher, faced with a student, James, who suddenly jumped up from a class meeting and started to dance, turned to his classmates and said matter-of-factly, "James likes to dance." James responded by sitting down and rejoining the meeting.

The developmental psychologist Jerome Bruner praises the unflappable Head Start teacher who, while reading "Little Red Riding Hood" to her young students, was stopped short at the famous lines "All the better to eat you!" line.

At this point, one little boy leapt to his feet, furious, and began cursing the wolf, swearing like a sailor. The teacher simply reflected to herself on how much meaning the boy was finding in the story and then asked him how he would have written it differently. The question got him thinking and quieted him down.

We might try to emulate that teacher's self-possession and know-how the next time a kid's shenanigans drive us to salty language ourselves.

Remember, looking on the bright side is for anyone who wants to help children develop while preserving their own sanity.

Childhood Autism: Evidence-based Interventions helps parents make better choices

More children than ever are being diagnosed with autism, which means more parents than ever face a dizzying array of often expensive treatment options. 

Giving parents and professionals authoritative information is the purpose of a new review spearheaded by the Frank Porter Graham Child Development Institute at the University of North Carolina at Chapel Hill.

Without a thorough review of autism interventions, Allison Smith of Pawtucket, R.I., might never have asked to try video-modeling to help her twin sons, age 4, develop the key motor skill of blowing a feather, a steppingstone to speech.

Allison Smith

"Knowledge is power," said Smith, who found video-modeling on a list of proven interventions from the US National Professional Development Center (NPDC) on Autism Spectrum Disorders, a multi-university center to promote the use of evidence-based practices.

UNC is one of three NPDC operating sites.

"Knowing what works has given us the upper hand in acquiring appropriate therapy and tools."

Autism incurs an average lifetime price tag of $3.2 million per person, according to a 2007 research study in the Archives of Pediatric and Adolescent Medicine but the Autism Society estimates that early diagnosis and effective interventions can reduce that lifetime cost by two-thirds.

Samuel L. Odom

"Parents often pay for interventions that have no evidence behind them," said FPG director Samuel L. Odom, who co-headed the new review.

"This report will allow them to make the best choices."

In this five-year update for the NPDC, UNC scientists screened 29,000 articles about autism spectrum disorders to find the ones proven to work best.

Compared to the 24 proven interventions in the 2008 report, the new report lists 27.

Applying even more stringent criteria this time, the FPG team dropped "structured work systems" and added five practices: "exercise," "structured play groups," "scripting," "modeling" and "cognitive behaviour intervention."

After considering more studies, scientists also renamed and broadened one category, "technology-aided instruction."

Kristine Ganley

"Expanding the list offers more tools to educators and service providers. This improves outcomes for children with ASD," said Kristine Ganley, a training and technical assistance provider at George Mason University.

NPDC's report on evidence-based practices provides important guidance for professionals and families.

Before NPDC's list, parents and professionals often searched for practices online, with unreliable results.

Connie Wong

"Some interventions may seem cutting-edge, but we don't yet know if they have any drawbacks or trade-offs," said FPG investigator Connie Wong, the new report's lead author and co-head of the review of research.

"Our report only includes what's tried and true."

More information: Report: autismpdc.fpg.unc.edu (PDF)

Childhood Obesity: In-home intervention improves risk reduction routines

This is one of the pieces sent to parents as part of the "Healthy Habits, Happy Homes" program.

Credit: Healthy Habits, Happy Homes Study Group, Harvard Pilgrim Healthcare Institute

In the battle to reduce childhood overweight and obesity, several in-home factors have been identified as reducing those risks – participation of children in regular family dinners, getting enough sleep and less time watching television or other "screen time."

A new study appearing in JAMA Pediatrics describes how a home-based program that helped at-risk families improve household routines was able to slow weight gain in a group of young children.

"While childhood obesity rates may have stabilized in some population subgroups, overall rates remain stubbornly high, and racial/ethnic and socioeconomic disparities persist.

Elsie Taveras

For these reasons, seeking solutions that will particularly influence high-risk families is important." says Elsie Taveras, MD, MPH, chief of General Pediatrics at Massachusetts General Hospital for Children who led the study.

"Our findings demonstrate that relatively simple, no-cost changes in routines within the home can help children maintain or achieve a healthful weight."

The study was conducted at four community health centers in Boston, Cambridge, and Somerville, Mass., all of which serve predominantly low-income, minority populations.

The research team enrolled 121 families – each with a child aged 2 to 5 who slept in a room with a television – that were randomly divided into two groups.

At the beginning and end of the 6-month study period, each family received an in-home visit during which research assistants administered surveys about household routines, measured the child's height and weight, and observed other aspects of the home environment.

Throughout the study period, the control group received monthly packages with educational information on early childhood development.

Families in the intervention group participated in a program called "Healthy Habits, Happy Homes," designed to encourage families to have regular meals together, ensure adequate sleep for children, limit the time children spend watching television and remove television from rooms where children sleep.

The intervention also encouraged parenting practices such as role modeling and limit setting. Parents were not told that these changes were designed to limit weight gain in their child.

Interventions were delivered in four home visits that addressed project goals and checked in on progress, monthly coaching phone calls, and frequent text messages to encourage healthy practices.

Mailings included newsletters for the parents and, for the children, toys focused on the program goals – such as stickers, coloring books, a copy of Good Night Moon for bedtime reading, and toys for active play.

At the end of the study period, children in the intervention group were sleeping about 45 minutes longer than children in the control group.

Time spent watching television on weekends dropped about an hour per day in the intervention group, leading to a significant difference from the control group, which increased weekend TV viewing.

Both groups had a small reduction in weekday TV viewing, with a greater decrease in the intervention group.

Neither group had any significant change in the frequency of family meals together – which may reflect the fact that participating families already shared an average of six meals per week together – and there was little change in the presence of television sets in the rooms where children slept, possibly because 80 percent of parents reported that their child slept in the parents' bedrooms.

At the end of the study period, the body mass index of children in the intervention group dropped an average of 0.18, while it rose 0.21 in the control group.

Taveras explains that increasing height, weight, and body mass index would be expected among children in this age group, as they are developing and growing.

"The Healthy Habits, Happy Homes intervention was able to slow weight gain relative to height increase in these children, which is important because – as our earlier research has shown – rapid weight gain in these early years can lead to higher rates of obesity later in life."

Jess Haines

Jess Haines, PhD, MHSc, RD, University of Guelph, Ontario, lead author of the study, adds, "Our findings suggest that, by encouraging parents to establish household routines that increase children's sleep and decrease TV viewing, health professionals can help prevent children from becoming overweight or obese.

Almost 90 percent of participating parents reported they were satisfied with the program, and 98 percent said they would recommend it to family and friends.

A longer-term study, currently being planned by our research group,will tell us how long the changes we observed here can be maintained.

We also need to investigate how large an interventional 'dose' is required to change these behaviours – for example, could they be accomplished with a single visit or just with phone calls?"

Taveras, an associate professor of Pediatrics and Population Medicine at Harvard Medical School, adds, "For now, interventions such as ours can be one way of keeping young children off an obesity trajectory that would be hard to alter by the time they enter middle school."

FASD impacts brain development throughout childhood and adolescence

Highlighted areas are some of the white matter tracts the research group studied. Credit: U of A

Medical researchers at the University of Alberta recently published findings showing that brain development is delayed throughout childhood and adolescence for people born with Fetal Alcohol Spectrum Disorder (FASD).

Christian Beaulieu and Carmen Rasmussen, the two primary investigators in the research study, recently published the results of their work in the peer-reviewed journal, The Journal of Neuroscience.

Carmen Rasmussen

Their team scanned 17 people with FASD, and 27 people without the disorder, who were between 5 and 15 years old.

Each participant underwent two to three scans, with each scan taking place two to four years apart.

This is the first research study involving multiple scans of the same FASD study participants.

Researchers used an advanced MRI method that examines white matter in the brain. White matter forms connections between various regions of the brain and usually develops significantly during childhood and adolescence.

Those who took part in the study were imaged multiple times, to see what kinds of changes occurred in brain development as the participants aged.

Those without the disorder had marked increases in brain volume and white matter – growth that was lacking in those with FASD.

However, the advanced MRI method revealed greater changes in the brain wiring of white matter in the FASD group, which the authors suggest may reflect compensation for delays in development earlier in childhood.

Sarah Treit

"These findings may suggest that significant brain changes happened earlier in the study participants who didn't have FASD," says the study's first author, Sarah Treit, who is a student in the Centre for Neuroscience at the U of A.

"This study suggests alcohol-induced injury with FASD isn't static – those with FASD have altered brain development, they aren't developing at the same rate as those without the disorder. And our research showed those with FASD consistently scored lower on all cognitive measures in the study."

Treit said the research team also made other important observations. Children with FASD who demonstrated the greatest changes in white matter development also made the greatest gains in reading ability – "so the connection seems relevant."

Christian Beaulieu

And those with the most severe FASD showed the greatest changes in white matter brain wiring. Scans also confirmed those with FASD have less overall brain volume – this issue neither rectified itself nor worsened throughout the course of the study.

The team is continuing their research in this area, in hopes of finding a biomarker for FASD, and to examine how the brain changes from adolescence into adulthood in those with the disorder.

The advanced MRI imaging the team used can pinpoint brain damage present in those with FASD, and could one day guide medical interventions for those with the disorder, which affects one in every 100 Canadians.

Asthma and Allergies: Five things you need to hear from you child

The allergist's office might not be a child's favorite place to visit, but it is a place where they should be able to say how their asthma makes them feel.

While children might rely on parents to tell their doctor about how they are feeling, according to a study released today, children should do most of the talking.

The study, published in the July issue of Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI), found that children with asthma report having a better quality of life in regards to activity limitation, than their parents think they have.

"Our research shows that physicians should ask parents and children about the effects asthma is having on the child's daily life," said lead study author Margaret Burks, MD.

"Parents can often think symptoms are better or worse than what the child is really experiencing, especially if they are not with their children all day."

Seventy-nine pediatric asthma patients and their parents were enrolled in the study. While researchers noted useful information comes from caregivers' responses, it's important for the allergist to ask both the parents and children about symptoms, activity limitations and adherence to medications to better understand and treat the child's condition.

"Asthma is a serious condition that results in more than 10.5 million missed schools days for children annually," said James Sublett, MD, chair of the ACAAI public relations committee.

"It is important for children to tell their allergist about their symptoms so the best treatment can be provided and over-treating doesn't occur."

To help parents and their children understand the five most important topics they should discuss with their allergist, ACAAI has put together the following list.

1. Asthma prevents me from playing sports and taking part in other activities—If your child cannot play sports or participate in gym class and recess activities, it's important they tell their allergist. This can be an indication their asthma isn't properly controlled. If they can participate in activities, it is also important they tell their allergist, to show their condition is being well managed.
2. When I am outside or at home my asthma symptoms become worse—An estimated 60 to 80 percent of children with asthma also have an allergy. If nearly inescapable allergens, such as pollen, mold, dust and pet dander are triggering your child's asthma symptoms, an allergist may include immunotherapy (allergy shots) as part of a treatment plan.
3. I often feel sad or different from other kids because I have asthma—Nearly half of children with asthma report feeling depressed or left out of activities due to their condition. Anyone with asthma should be able to feel good and be active. No one should accept less.
4. There have been times I have missed school because of my condition—Asthma is the most common chronic illness in childhood and is a leading caused in missed school days. Research shows children under the care of a board-certified allergist see a 77 percent reduction in lost time from school.
5. My asthma disappeared—It is important your child carry and use their inhaler as prescribed, even if symptoms aren't bothersome. While asthma symptoms are controllable with the proper treatment, there isn't a cure for asthma and it likely won't disappear. An asthma attack can strike at any time.

Effective asthma control begins with the right diagnosis early in the disease by a board-certified allergist. Delays can lead to permanent lung damage. To learn more about asthma and to locate an allergist in your area, visit http://www.AllergyAndAsthmaRelief.org.

Divorce early in childhood affects parental relationships in adulthood

Divorce has a bigger impact on child-parent relationships if it occurs in the first few years of the child's life, according to new research.

Those who experience parental divorce early in their childhood tend to have more insecure relationships with their parents as adults than those who experience divorce later, researchers say.

R. Chris Fraley

"By studying variation in parental divorce, we are hoping to learn more about how early experiences predict the quality of people's close relationships later in life," says R. Chris Fraley of the University of Illinois at Urbana-Champaign.

Psychologists are especially interested in childhood experiences, as their impact can extend into adulthood, but studying such early experiences is challenging, as people's memories of particular events vary widely.

Parental divorce is a good event to study, he says, as people can accurately report if and when their parents divorced, even if they do not have perfect recollection of the details.

In two studies published today in Personality and Social Psychology Bulletin, Fraley and graduate student Marie Heffernan examined the timing and effects of divorce on both parental and romantic relationships, as well as differences in how divorce affects relationships with mothers versus fathers.

In the first study, they analyzed data from 7,735 people who participated in a survey about personality and close relationships through yourpersonality.net.

More than one-third of the survey participants' parents divorced and the average age of divorce was about 9 years old.

The researchers found that individuals from divorced families were less likely to view their current relationships with their parents as secure.

And people who experienced parental divorce between birth and 3 to 5 years of age were more insecure in their current relationships with their parents compared to those whose parents divorced later in childhood.

"A person who has a secure relationship with a parent is more likely than someone who is insecure to feel that they can trust the parent," Fraley says.

"Such a person is more comfortable depending on the parent and is confident that the parent will be psychologically available when needed."

Although there was a tendency for people to experience more anxiety about romantic relationships if they were from divorced families, the link between parental divorce and insecurity in romantic relationships was relatively weak.

This finding was important, the researchers say, as it shows that divorce does not have a blanket effect on all close relationships in adulthood but rather is selective – affecting some relationships more than others.

They also found that parental divorce tends to predict greater insecurity in people's relationships with their fathers than with their mothers.

Conclusion
While it is premature to speculate on the implications of this work for decision-making regarding child custody, the work is valuable as it suggests that "something as basic as the amount of time that one spends with a parent or one's living arrangements" can shape the quality of child-parent relationships, write Fraley and Heffernan.

"People's relationships with their parents and romantic partners play important roles in their lives," Fraley says.

"This research brings us one step closer to understanding why it is that some people have relatively secure relationships with close others whereas others have more difficulty opening up to and depending on important people in their lives."

Read the full article here

More information: doi: 10.1177/0146167213491503

Explosive Rise in Teenage obesity and obesity-related admissions in England

Doctors in the NHS in England and Wales have seen a four-fold increase in the number of children and teenagers admitted to hospital for conditions linked to obesity.

The explosive rise in admissions from 872 to 3,806 occurred in the space of a decade between 2000 and 2009.

Over the whole 10-year period, a total of 20,885 young people were treated in hospital for obesity-related conditions.

Nearly three-quarters of cases involved problems complicated by being overweight, such as asthma, breathing difficulties during sleep, and pregnancy complications.

Teenage girls accounted for the biggest rise in obesity-related hospital admissions. In 2009, obesity is believed to have contributed to complications in 198 pregnant girls.

The number of bariatric surgery procedures conducted to help children and young people lose weight also saw a sharp rise, from one per year in 2000 to 31 in 2009.

Three-quarters of the patients were teenage girls. Bariatric surgery is a drastic obesity remedy that involves shrinking the stomach with a gastric band, removing part of the stomach, or re-routing the small intestine to a small stomach pouch.

Researchers from England's Imperial College London analysed NHS statistics for children and teenagers aged five to 19 who had a written record of obesity. Their findings are reported in the online journal Public Library of Science ONE.

Sonia Saxena

Study leader Dr Sonia Saxena, from the school of public health at Imperial College, said:

"The burden of obesity is usually thought to have its serious consequences in adulthood, but we now see it manifesting earlier, in childhood." 

"It's clear that rising obesity levels are causing more medical problems in children, but the rise we observed probably also reflects increasing awareness among clinicians, who have become better at recognising obesity."

Surveys suggest that around 30% of English children aged two to 15 are overweight and up to a fifth are obese.

Children who are obese are more likely to suffer health problems such as Type-2 diabetes, asthma, and sleep apnea - a condition that causes interrupted breathing during sleep - researchers said.

In their paper, the scientists wrote:

"Our findings support emerging evidence that the childhood obesity epidemic may lead to substantial problems of obesity-related disease much sooner in children and young people's lives than previously expected." 

"With levels of admissions for obesity-related diagnoses rising, there is likely to be increasing demand on health services and also greater use of more radical interventions, such as pharmacological or surgical treatment, as part of efforts to address the increasing trend of obesity that threatens the lives of many children and young people in England and globally."

Tam Fry

England's National Obesity Forum member Tam Fry, who chairs the Child Growth Foundation charity, said:

"I'm not surprised by this leap, and I won't be surprised if in five years we're talking about another significant rise." 

"When it comes to obesity we have taken our eyes off children to such an extent that they are now completely unmonitored and left to get on with it." 

"The medical profession is not really paying too much attention to them. A lot of these young people are completely unaware that piling on the pounds will not only make them fat but give rise to these other conditions."

He said the "real tragedy" was obese schoolgirls becoming pregnant. "Girls are not only getting fat, but getting pregnant," said Mr Fry.

"The result is not only distressing for the girls but threatening for their children." Pregnancy complications linked to obesity included gestational diabetes, high blood pressure, the dangerous condition pre-eclampsia, and neural tube defects.

Obese girls gave birth to overweight babies, who started life "on the back foot" and were predisposed to obesity, Mr Fry said.

He added:

"We've got a substantial number of our children going into their secondary school life ill-equipped to know what the consequences of fatness and obesity are." 

"If we're going to see the end of this problem we need to be addressing it from the word go to ensure we do all we can to stop children becoming fat in the first place." 

"We need a thorough reappraisal of the way we allow the food industry to get away with stuffing unhealthy levels of fat and sugar into their food." 

"We need to ban fizzy drinks and sugar-laden drinks entirely. We need to take really radical steps."

.

More TV time equals higher consumption of sweetened beverages among children

Stina Olafsdottir

More time in front of the TV set and higher exposure to TV adverts may lead to increased consumption of sweetened beverages among children.

This is the conclusion of a new study from the University of Gothenburg, Sweden.

The parents of more than 1,700 two- to four-year-olds in Sweden responded to questions about their children's TV and screen habits and consumption of sweetened drinks.

About one parent in seven indicated that they tried to reduce their children's exposure to TV adverts; the same parents stated that their children were less prone to drink soft drinks and other sweetened beverages.

Children of parents who were less strict about TV adverts were twice as likely to consume sweetened beverages every week.

The study was conducted in 2007–2010 as part of the EU research project IDEFICS – Identification and Prevention of Dietary and Lifestyle -Induced Health Effects in Children and Infants.

It reveals a very clear link between children's TV habits and their consumption of sweetened drinks. 'The children who watched more TV were more likely to drink these beverages.

In fact, each additional hour in front of the TV increased the likelihood of regular consumption by 50 per cent.

A similar link was found for total screen time,' says Stina Olafsdottir, PhD student at the Department of Food and Nutrition, and Sport Science and one of the researchers behind the study.

The study also found that children with higher exposure to food adverts on TV were more likely to consume sweetened beverages on a regular basis in a follow-up study conducted two years after the initial study.

However, exposure to TV adverts could not explain the link between TV habit and beverage consumption entirely.

It is therefore likely that the TV programmes watched also matter or that children simply enjoy drinking these types of beverages while watching TV.

The article Young children's screen habits are associated with consumption of sweetened beverages independently of parental norms is published in the International Journal of Public Health.

More information: Olafsdottir, S. et al. Young children's screen habits are associated with consumption of sweetened beverages independently of parental norms, International Journal of Public Health. link.springer.com/… 8-013-0473-2

NCLD: 10 Helpful Dyslexia Resources

NCLD offer a number of dyslexia resources at LD.org, but where else can you seek reliable assistance and information about dyslexia?

The following resources will help you learn more about dyslexia and find local help.

You can also use NCLD’s Resource Locator to find programs in your local area. Click on the image to be directed to the NCLD Website.

Raising Readers Poster: Brains Under Construction

Raising Readers

Reactive Attachment Disorder (RAD) in childhood

Dr Minnis

Dr Minnis is a Senior Lecturer in Child and Adolescent Psychiatry. Her main research interest is in Reactive Attachment Disorder in childhood and her research has involved developing new assessment tools and increasing understanding of the aetiology of this serious disorder of social functioning.

She has also developed computerised assessment tools for aspects of child and adolescent mental health.

Background
Reactive attachment disorder (RAD) is described in clinical literature as a severe and relatively uncommon disorder that can affect children.

There is potentially a higher level of incidence in homes where the family is long-term unemployed and there is a history of social care provision but RAD can also occur in, what is believed to be, the best of family situations.

RAD is characterised by markedly disturbed and developmentally inappropriate ways of relating socially in most contexts.

It can take the form of a persistent failure to initiate or respond to most social interactions in

• a developmentally appropriate way, known as the "inhibited form," (RAD) or
• an indiscriminate sociability, such as excessive familiarity with relative strangers known as the "disinhibited form" (DAD). 

The term is used in both the World Health Organization's International Statistical Classification of Diseases and Related Health Problems (ICD-10) and in the DSM-IV-TR, the revised fourth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM).

ICD-10 Definition
In ICD-10, the inhibited form is called RAD, and the disinhibited form is called "disinhibited attachment disorder", or "DAD".

DSM Definition
In the DSM, both forms are called RAD; for ease of reference, this article will follow that convention and refer to both forms as reactive attachment disorder.

RAD arises from a failure to form normal attachments to primary caregivers in early childhood. Such a failure could result from severe early experiences of neglect, abuse, abrupt separation from caregivers between the ages of six months and three years, frequent change of caregivers, or a lack of caregiver responsiveness to a child's communicative efforts. Not all, or even a majority of such experiences, result in the disorder.

The criteria for a diagnosis of a Reactive Attachment Disorder are very different from the criteria used in assessment or categorisation of attachment styles such as insecure or disorganised attachment, e.g. Pervasive Development Disorder (PDD).

PDD: Pervasive Development Disorder
It is differentiated and has a separate classification from Pervasive Developmental Disorder (PDD) or developmental delay and from possibly comorbid conditions such as mental retardation, all of which can affect attachment behaviour.

Dr Minnis appeared on BBC Radio 4's Women's hour program to discuss RAD with the presenter and families that had suffered from the experience of having a teenager with RAD.

Childhood Bullying Has Long term Effects: Mood Disorders

Bullying by peers changes the structure surrounding a gene involved in regulating mood, making victims more vulnerable to mental health problems as they age.

This is the reported finding of a recent study by a researcher at the Centre for Studies on Human Stress (CSHS) at the Hôpital Louis-H. Lafontaine and professor at the Université de Montréal suggests that .

The study published in the journal Psychological Medicine seeks to better understand the mechanisms that explain how difficult experiences disrupt our response to stressful situations.

"Many people think that our genes are immutable; however this study suggests that environment, even the social environment, can affect their functioning. This is particularly the case for victimization experiences in childhood, which change not only our stress response but also the functioning of genes involved in mood regulation," says Isabelle Ouellet-Morin, lead author of the study.

A previous study by Ouellet-Morin, conducted at the Institute of Psychiatry in London (UK), showed that bullied children secrete less cortisol -- the stress hormone -- but had more problems with social interaction and aggressive behaviour.

The present study indicates that the reduction of cortisol, which occurs around the age of 12, is preceded two years earlier by a change in the structure surrounding a gene (SERT) that regulates or transports serotonin, and is a neurotransmitter involved in mood regulation and depression.

To achieve these results, 28 pairs of identical twins with a mean age of 10 years were analyzed separately according to their experiences of bullying by peers: one twin had been bullied at school while the other had not.

"Since they were identical twins living in the same conditions, changes in the chemical structure surrounding the gene cannot be explained by genetics or family environment. Our results suggest that victimization experiences are the source of these changes," says Ouellet-Morin.

According to the author, it would now be worthwhile to evaluate the possibility of reversing these psychological effects, in particular, through interventions at school and support for victims.

Supporting orphaned children in Africa: Stop AIDS Now

I was fortunate enough this week to stumble across a most remarkable event whilst walking through the streets of Amsterdam.

Amsterdam is many things to many people but to me it is a constant source of surprise and amazement, mainly because of it's window on the raw humanity of our world and also to the shear creativeness of our species.

I was walking towards Amsterdam's Nieuwmarkt, the open market space that spreads out in front of one of the ancient gates known as De Waag, which was once the Gestapo HQ for the German Occupying forces during WWII,

On most weekends this square, or 'plein,' can be occupied by street traders, rowdy tourists and the odd street performer but on this occasion it was occupied by strings of large cardboard dolls house.

Each one had been printed as a large cardboard 'cutout', in the manner of a children's toy and had been folded and constructed into the form of a doll's house. Individually they stood 5' tall.

This in itself was a creative and amazing piece of art but in addition to this the organisors, Stop AIDS Now (Holland), had arranged this assemblage of, possibly 100+ dolls' houses, into the form of a crossed ribbon. Almost filling the entire square with them.

The positioning of each doll's house was precisely placed as was the location of the event because not more than a stones-throw away is Amsterdam's Red light district.

To advertise the event the organisers had arranged for some Dutch celebrities to act as ambassadors, Angela Groothuizen en Nicolette Kluijver, to pose for photographs and to be interviewed by Dutch TV channels. An excellent event, well publicised.

I took the liberty, for you my readers, to climb the official photographer's platform to capture a few photographs, to better record the event and to experience the layout in it's entirety.

The organiser's representatives were too busy speaking to the TV crews and celebrities to be able to discuss the event with me, at this point. So, I continued on my way and returned later when things were quieter.

I was told that Stop AIDS Now had devised this campaign to highlight the plight of children in Africa who had become orphaned by AIDS, and that these children were now struggling to raise their siblings, unaided, acting as a substitute parent.

They very kindly gave me a small version of the cardboard cutout doll's house, which acts as a collection box. This is shown below.

These small cardboard versions are available from Stop Aids Now's Dutch website but feel free to print out the picture below and construct it from cardboard. Any money you collect will be put to good use.

I hope, when you look at it, it will remind you of the children in this world who have been denied a full and enjoyable childhood by circumstances beyond their control and of the blight that AIDS has brought to all humanity.

Foetal Alcohol Exposure affects childhood development

Children exposed to alcohol during fetal development exhibit changes in brain structure and metabolism that are visible using various imaging techniques, according to a new study being presented today at the annual meeting of the Radiological Society of North America (RSNA).

Alcohol use by expectant mothers can lead to problems with the mental and physical development of their children—a condition known as fetal alcohol syndrome.

Research suggests an incidence of 0.2 to 1.5 per 1,000 live births, according to the Centers for Disease Control and Prevention.

Costs for care of individuals affected by fetal alcohol syndrome in the U.S. have been estimated at $4 billion annually.

Advancements in magnetic resonance imaging (MRI) are affording unprecedented insights into the effects of alcohol on the central nervous systems of children whose mothers drank alcohol during their pregnancy.

Recently, researchers in Poland used three different MRI techniques to better define these effects.

The study group included 200 children who were exposed to alcohol during their fetal stage and 30 children whose mothers did not drink while pregnant or during lactation.

Researchers used MRI to evaluate the size and shape of the corpus callosum, the bundle of nerve fibers that forms the major communication link between the right and left halves of the brain, in the two groups.

Prenatal alcohol exposure is the major cause of impaired development or complete absence of the corpus callosum.

The MRI results showed statistically significant thinning of the corpus callosum in the children exposed to alcohol compared with the other group.

“These changes are strongly associated with psychological problems in children,” said Andrzej Urbanik, M.D., chair of the Department of Radiology at Jagiellonian University in Krakow, Poland.

Dr. Urbanik and colleagues also used diffusion weighted imaging (DWI) to study six areas of the central nervous system in the children. DWI maps the diffusion process of water and can be a more sensitive means than traditional MRI for detecting tissue abnormalities.

Children in the alcohol group exhibited statistically significant increases in diffusion on DWI compared with the other children.

“The increase of diffusion indicates neurological disorders or damage to the brain tissue,” Dr. Urbanik said.

To noninvasively study metabolism in the brains of the children, the researchers used proton (hydrogen) magnetic resonance spectroscopy (HMRS), a common adjunct to structural MRI studies. HMRS results showed a complex collection of metabolic changes.

“In individual cases, we found a high degree of metabolic changes that were specific for particular locations within the brain,” Dr. Urbanik said.

Scientists uncover secrets of how intellect and behavior emerge during childhood

Scientists from the Florida campus of The Scripps Research Institute (TSRI) have shown that a single protein plays an oversized role in intellectual and behavioral development.

The scientists found that mutations in a single gene, which is known to cause intellectual disability and increase the risk of developing autism spectrum disorder, severely disrupts the organization of developing brain circuits during early childhood.

This study helps explain how genetic mutations can cause profound cognitive and behavioral problems.

The study was published in the Nov. 9, 2012, issue of the journal Cell.

The genetic mutations that cause developmental disorders, such as intellectual disability and autism spectrum disorder, commonly affect synapses, the junctions between two nerve cells that are part of the brain's complex electro-chemical signaling system.

A substantial percentage of children with severe intellectual and behavioral impairments are believed to harbor single mutations in critical neurodevelopmental genes.

Until this study, however, it was unclear precisely how pathogenic genetic mutations and synapse function were related to the failure to develop normal intellect.

"In this study, we did something no one else had done before," said Gavin Rumbaugh, a TSRI associate professor who led the new research.

"Using an animal model, we looked at a mutation known to cause intellectual disability and showed for the first time a causative link between abnormal synapse maturation during brain development and life-long cognitive disruptions commonly seen in adults with a neurodevelopmental disorder."

Losing Balance
The study focused on a critical synaptic protein known as SynGAP1. Mutations in the gene that encodes this protein cause disabilities in an estimated one million people worldwide, according to the paper.

"There are a few genes that can't be altered without affecting normal cognitive abilities," Rumbaugh said. "SynGAP1 is one of the most important genes in cognition -- so far, every time a mutation that disrupts the function of SynGAP1 has been found, that individual's brain simply could not develop correctly.

It regulates the development of synaptic function like no other gene I've seen."

Using animal models that were missing just one copy of SynGAP1, as seen in some patients with intellectual disability, the scientists found that certain synapses develop prematurely in the period shortly after birth.

This dramatically enhances what is known as "excitability" -- how often brain cells fire -- in the developing hippocampus, a part of the brain critical for memory.

The balance between excitability and inhibition is especially critical during early developmental periods, when neural connections that ultimately give rise to normal cognitive and behavioral functions are forming.

"You might think this accelerated development of brain circuits would make you smarter," Rumbaugh said. "But the increased excitability actually disorganizes brain development.

We think that early maturation of these excitatory synapses disrupts the timing of later developmental milestones.

It rains down chaos on this complex process, preventing normal intellectual and behavioral development."

Read the full article here 

The Autumn of your Life may mean Longevity

Autumn Colours

People born in autumn are more likely to live for 100 years compared to those born in summer, according to a report in the Journal of Aging Research.

Researchers from the University of Chicago have found that people, who are born in autumn, from September to November, are likely to live for 100 years compared to those who are born in March.

The discovery was made while analysing data from the Rootsweb ancestry website.

Researchers conducted a study on more than 1,500 centenarians born in the United States between 1880 and 1895. The data obtained from the study was compared with 10,855 shorter-lived siblings and 1,083 spouses.

"Centenarians (cases) were compared to their "normal" shorter-lived siblings (controls) or spouses using a within-family analysis.

This approach allows investigators to study the within-family differences, not being confounded by the between-family variation.

Long-lived persons born in 1880-1895 were used as cases," said Leonid A Gavrilov, researcher at the University of Chicago, in a statement.

The study found that people who are born in September, October and November have a longer life span compared to their siblings born in March, April, May, June, July and August.

"These results demonstrate that persons born in September-November have significantly higher chances of exceptional longevity than persons born in March.

This survival advantage of persons born in the fall months is consistent across different lifespan cut-offs suggesting long-lasting influence of season of birth on longevity," said Natalia S Gavrilova, researcher at the University of Chicago, in a statement.

Researchers are not sure as how month of the birth affects mortality and health in later life but they have suggested some theories.

One is that the nutritional status of mother during pregnancy might have a long lasting effect on the child in later life, which in turn can increase the mortality risk.

Another theory is that children born between March and August are likely to be affected by several infections and disease, which in turn increase their mortality rate.

According to the researchers, the human enterovirus and it's cousin, poliovirus have epidemic peaks, only in the months of July and August.

The effect of environmental temperature during the time of birth may be another possible explanation for low proportion of centenarians among individuals born during the summer and spring months.

For example, Britons, who had experienced higher summer temperatures during their first year of life, had severe diarrhea and dehydration in infancy and they had higher blood pressure at older ages, according to the Journal of Aging Research.

Childhood Obstructive Sleep Apnea (OSA): Treatment reverses brain abnormalities

Treatment of obstructive sleep apnea (OSA) in children normalizes disturbances in the neuronal network responsible for attention and executive function, according to a new study.

“OSA is known to be associated with deficits in attention, cognition, and executive function,” said lead author Ann Halbower, MD, Associate Professor at the Children’s Hospital Sleep Center and University of Colorado Denver.

“Our study is the first to show that treatment of OSA in children can reverse neuronal brain injury, correlated with improvements in attention and verbal memory in these patients.”

The results will be presented at the ATS 2012 International Conference in San Francisco.

In the study, children (ages 8-11) with moderate-severe OSA were compared to healthy controls.

Brain imaging with magnetic resonance spectroscopy imaging was performed at baseline in 15 OSA patients and seven controls, along with neuro-psychological testing.

OSA treatment consisted of adenotonsillectomy followed by monitored continuous positive airway pressure (CPAP) or nasal treatments. Brain imaging and neuropsychological testing was performed again in 11 OSA patients and the seven controls six months after treatment.

Compared with controls at baseline, children with OSA exhibited significantly decreased N-acetyl aspartate to choline ratios (NAA/Cho) in the left hippocampus and left frontal cortex, along with significant decreases in the executive functions of verbal memory, and attention.

Following treatment, both left and right frontal cortex neuronal metabolites normalized, and hippocampal metabolites improved with a medium effect size (0.5).

More complete reversal of hippocampal abnormalities was seen in children with milder OSA when apnea-hypopnea index (AHI) improved (although this is very preliminary data).

Verbal memory and attention improved with medium to large effect sizes. Improvements in attention and verbal memory were correlated with normalization of NAA/Cho in the right and left frontal cortex (p=0.5).

“We have demonstrated for the first time that treatment of OSA in children normalizes brain metabolites in portions of the neuronal network responsible for attention and executive function,” concluded Dr. Halbower.

“We speculate that if OSA is treated earlier, there may be a more brisk improvement in the hippocampus, a relay station for executive function, learning, and memory.”

“Our results point to the importance of early diagnosis and treatment of OSA in children, as it could potentially have profound effects on their development.”

Scientists discover gene which causes FGD, rare disease in babies

A rare disease which often first presents in newborn babies has been traced to a novel genetic defect, scientists at Queen Mary, University of London have found.

 

The research, published online in Nature Genetics (27 May) discovered 20 distinct mutations in a specific gene found in patients with the rare adrenal disease, Familial Glucocorticoid Deficiency (FGD).

The potentially fatal disease means affected children are unable to produce a hormone called cortisol which is essential for the body to cope with stress.

Lead researcher Dr Lou Metherell*, endocrine geneticist at Queen Mary, University of London, said: "People who inherit this disease are unable to cope with physical stress.

For example, the normal response to infection or traumatic injury is to produce cortisol supporting the metabolic response to the event. Patients with FGD cannot do this and may die if untreated.

"We found 20 distinct defects in the antioxidant gene nicotinamide nucleotide transhydogenase (NNT) in patients from all over the world who suffer from FGD."

The researchers, which include Eirini Meimaridou and Professor Adrian Clark, also at Queen Mary in the William Harvey Research Institute, had previously found defects in four genes present in this disease.

The new research uncovered mutations in NNT, an antioxidant gene, which provides a new mechanism for this adrenal disease.

"Patients with this form of FGD exhibit oxidative stress (OS) in the adrenal, a process which is involved in other diseases such as neurodegenerative conditions, cancer, stroke, diabetes and cardiac dysfunction," Professor Clark said.

"If we can discover how the OS causes its effect then this might give us clues to the mechanism in other diseases like those listed above and it may then be possible to use appropriate drugs to reduce or prevent it."

More information: "Mutations in NNT encoding nicotinamide nucleotide transhydrogenase cause familial glucocorticoid deficiency" was published online in Nature Genetics on 27 May 2012.

Journal reference: Nature Genetics

Provided by Queen Mary, University of London