Children with Autism: New Study questions traditional 'top down' research

The paper describes that rather than a single entity, autism is multiple disorders. Credit: CampASCCA

Information from the families of 1200 children with autism will be collected from next month to begin the largest autism data study in Australia which includes a team of WA researchers.

Telethon Institute of Child Health Research's Andrew Whitehouse says the project involves several prominent research groups across the nation under the umbrella of the Autism Co-operative Research Centre for Living with Autism Spectrum Disorders which received $31 million over eight years from the Federal Government earlier this year.

Professor Whitehouse says the centre will further extensive work by Telethon including its recent "proof of principle" research which advocates a new approach to autism investigation and whose findings have been documented in the Frontiers of Human Science Journal.

Prof Whitehouse says rather than using the traditional "top-down" approach to investigate the causes of autism, it takes the other end of the "causal pathway," starting with the factors that may produce the disorder.

The paper describes that it is now widely accepted that rather than a single entity, autism is multiple disorders. The variability in the nature and severity of behaviours is thought to exceed that of any other.

"What researchers tend to do is look at behaviours, classify people based on that and then look for genetic or biochemical markers that might be associated with those behaviours," Prof Whitehouse says.

"What we're suggesting is going at it the other way; look at genetic or environmental factors that are known to be associated with autism and look at whether they are then associated with behaviours."

He says after 70 years, researchers are frustrated by not being able to find a clear causal pathway but the only way research can proceed is through large collaborations.

"One lab group alone is not going to be able to solve the riddle of autism—that's just not going to happen," he says.

"We need large numbers of participants who can do both the "top-down" and "bottom-up" approach and that's what we're proposing."

The recently published "bottom-up" study selected participants from the WA Autism Biological Registry to analyse two areas previously linked to ASD diagnoses; low birth weight and maternal use of selective serotonin reuptake inhibitors (SRIs) during pregnancy.

These are found in medications used to treat anxiety and major depression.

Prof Whitehouse says the study provides a blueprint for a "bottom-up" approach, which creates smaller homogenous sub-groups with the autism spectrum, compared with a costly top down approach which requires larges sample sizes.

More Information: 'A “bottom-up” approach to aetiological research in autism spectrum disorders' Lisa M. Unwin1, Murray T. Maybery, John A. Wray and Andrew J. O. Whitehouse.

Stepparents are not always evil: Parents' need a strategy to love their children

Contrary to common belief, parents do not generally treat their stepchildren less favourably than their own. Until now, many researchers believed in the so-called "Cinderella effect."

It states that it is biologically inevitable that parents care less for stepchildren because they do not spread their genes.

Kai Willführ

Researchers at the Max Planck Institute for Demographic Research (MPIDR) in Rostock, Germany, have discovered an important exception.

If there is a reasonable chance of increasing wealth in the parents' environment then no difference is made between one's own children and stepchildren.

Thus, parental care depends on more than just the biological relationship.

Alain Gagnon

This is the result of a study published by MPIDR researcher Kai Willführ together with Alain Gagnon from the University of Montreal, Canada, in the scientific journal "Biodemography and Social Biology."

"We are now able to prove that the Cinderella effect is not an inevitable reflex of stepparents," says Kai Willführ.

The scientists investigated if and how strongly parents neglected their stepchildren by looking at the mortality of children in historic patchwork families from the 17th to 19th century.

They compared the Krummhörn region of East Frisia (Germany), which was a densely populated area with little space for economic development, and the growing Canadian settlements in Québec.

For both areas they calculated how the children's chances of survival changed when a stepmother moved in.

The conclusions showed that only in Krummhörn, which offered fewer opportunities for economic growth, the stepmother had a negative influence.

In Krummhörn children from a father's first marriage died more often before the age of 15 if a stepmother moved in.

This effect was not seen in Québec. The "Cinderella effect," therefore, does not inevitably seem to occur. The stepmothers must have treated their children in East Frisia and Canada completely differently.

When do stepchildren die young?
The extent of this effect is striking: if a Krummhörn girl lost her mother early, the likelihood of her dying before the age of 15 more than doubled compared to a girl whose mother did not die.

If the father remarried and the stepmother joined the family, mortality doubled again. Thus, the arrival of a stepmother affected the girls in East Frisia as much as the death of their own mother.

In Québec, however, the risk of dying young barely changed when the new mother moved in.

"The stepmothers in Québec seemed to understand that the offspring from their husband's first marriage were not competition for their own children with their new husband," says MPIDR researcher Kai Willführ.

In fact, the Canadian half siblings were considered to be allies of the biological children. On the contrary, according to the "Cinderella effect", stepparents would always consider foreign children to be competitors to their own children and thus neglect them.

Love for children is strategy
But that only happened in Krummhörn, where siblings competed for basic needs. "We assume that stepmothers neglected, exploited or even abused the children from their husband's first marriage," says socio-biologist Willführ.

The fact that this only happened in East Frisia shows that the context in which patchwork families are living - whether there is room for economic development or not - strongly influences how parents allocate their affection to their own children and stepchildren.

Although the scientists used historic data, their results have fundamentally challenged the veracity of the "Cinderella effect.

"It is therefore also true today, that stepparents are not always evil," says researcher Kai Willführ. For their study, Willführ and Gagnon traced thousands of children up to age 15 in East Frisia and Québec.

By individually reconstructing whether and when a parent died, a stepmother or stepfather moved in, and whether half-siblings were born during this period, they were able to calculate the influence of all those events on the survival rate of boys and girls.

Dates of births, christenings, weddings and funerals were taken from old church registers. For the Krummhörn region in East Frisia the researchers looked at the birth cohorts from 1720 to 1859, and for Québec at those from 1670 to 1750.

More information: Kai Willführ, Alain Gagnon, Are step-parents always evil? Parental death, remarriage, and child survival in demographically saturated Krummhörn (1720-1859) and expanding Québec (1670-1750) Biodemography and Social Biology, DOI: 10.1080/19485565.2013.833803

10 Things Your Dog Can Teach Your Child and You - Cesar Milan

A balanced pup or dog can teach a child so much more than how to properly care for an animal and be confident in their lives.

But first you, the Parent, have to create and maintain the balance in the dog and in the child.

You can be loving and friendly but you are NOT a 'friend' of the dog or the child and you should behave accordingly.

They will find and develop their own friendships separate from you and it is important that they do so.

You have a primary responsibility to be the Parent to the child and the Packleader to the dog, focus on those tasks, take them seriously and all will benefit.

Studies have found that a pet encourages a child's physical, social, emotional, and cognitive development.

Children who have pets are more likely to have higher self-esteem, develop better social skills, and even have more friends but do not discount your role in this relationship. It is pivotal.

Here are just a few of the lessons that Cesar Milan, the Dog Whisperer, suggests your dog can impart to your child.

Love and Loyalty
There are few (if any!) species on earth that boast the devotion that comes naturally to a dog. Coming home to that happy face and wagging tail every day without fail can help your child develop confidence and self-esteem.

Exercise
Dogs provide a wealth of opportunities for your child to get active — joining for the walk, romping around the backyard, or playing a game of fetch.

They also serve as an example of why exercise is so important. Dogs need regular physical activity to stay emotionally and mentally balanced — that's true for humans, too.

The Importance of Family
Dogs are naturally pack animals, and research shows that they bring out that instinct in humans, too. Families spend more time interacting after getting a pet.

Use your dog as an opportunity to connect as a parent. Get the whole pack out for walks, playtime, and involve them in the care and grooming.

A dog is not just another toy to be picked up and put away when your child claims they are bored. A dog is a commitment for the child, as the child is to you as a parent! There is a vital life lesson right there.

Reading
If you can't help your child practice reading because you have to cook dinner? No problem! Your dog can take over for awhile.

Research shows that he may actually do a better job than you anyway, particularly if your child is struggling. Why? Children are more relaxed, likely because a dog is a nonjudgmental audience.

Recent research claims that children with reading and learning difficulties such as Dyslexia, benefit greatly when they practice in front of their dog.

Patience and Compassion
A dog isn't capable of all the things that humans are, and as your dog ages, she will require special care and attention.

Understanding those differences can help your child learn to be patient and compassionate with those who suffer from disabilities, the elderly, and younger children.

Communication
Reading your dog's body language can help your child pick up on non-verbal communication between humans, too.

You can encourage this by taking the time to teach your child about common cues. It's beneficial for his safety around other dogs, too.

Socialisation
One study asked children what advice they had for kids who had trouble making friends. Their answer? Get a pet!

Dogs encourage your child to put their communication skills to use. Since dogs serve as an easy icebreaker and a shared interest, it makes meeting new friends easier.

Trust
If your child has trouble opening up to you, he may still feel comfortable talking to his dog, providing a safe outlet for private thoughts and secrets. The trust he builds with his dog can help him eventually learn to open up to others, too.

Responsibility
The more your child is involved in the care of your animal, the more she'll learn about responsibility. Let your child take the lead on providing for your dog's basic needs (with your supervision, of course).

Silliness
Sure, dogs help teach responsibility, but more importantly, they also serve as a reminder to let loose, have some fun, and live in the moment!

There are few things more fun (and mood-boosting) than acting nutty and carefree with your pup.

Clearly these lessons are valuable for parents, too.

It's all too easy in this busy day-and-age to lose sight of what's really important. Take a moment to thank your pup for imparting these important life lessons to your pack — and for bringing you all back to the here and now.

Children with Autism: Risk of Vitamin deficiencies from food refusal

The life-threatening health problems that a 9-year-old boy with autism faced recently shed light on an issue that is rarely discussed.

Many children with autism or other developmental disorders tend to eat an extremely narrow range of foods, and this may put them at risk for serious health problems, said Dr. Melody Duvall, lead author of the case report, which was published online Nov. 4 in the journal Pediatrics.

What is it about autism that often makes children resistant to eating a normal and varied diet? One expert had some theories.

"We know many children with autism spectrum disorder have sensory issues, are overly sensitive to certain textures, sounds and perhaps tastes," said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at the Steven & Alexandra Cohen Children's Medical Center in New Hyde Park, N.Y.

"And many children with an autism spectrum disorder will have an insistence on sameness, are comfortable with routines and have difficulty with transitions."

Those traits often make children insist on eating only a very limited combination of foods, Adesman explained.

"This case report highlights how atypical and narrow the diets are with some children with autism or other severe developmental problems, and that the potential for serious health consequences can follow," said Adesman.

In the case of the 9-year-old boy, the situation was extremely challenging to figure out, explained Duvall, his physician at Boston Children's Hospital.

He came to the emergency department twice, complaining of hip pain so severe he refused to walk.

Physicians looked for neurological or orthopedic reasons for the limp, but found no underlying cause. Physical therapy only worsened his discomfort. He had the usual blood tests, and they were normal.

The physicians then thought he might have Lyme disease, but it was ruled out, Duvall said. He then started developing serious lung and heart problems, had a rapid heart rate, dry cough and difficulty breathing. Eventually, he became so ill he was taken to the intensive care unit, she added.

A chest x-ray showed his right lung and the lower parts of his left lung were filling up with fluid. Tests showed the right side of his heart was functioning poorly.

Physicians thought he might have pneumonia, or even cancer, but those possibilities were eliminated by further tests.

The physicians had no idea what was happening. "The definitive diagnosis of what was underlying his pulmonary hypertension [lung problems] was hard," recalled Duvall. "But then his mother told us he had bleeding gums when his teeth were brushed."

That simple clue led to the boy's diagnosis: severe nutritional deficiency. The bleeding gums were a classic sign of scurvy, a disease caused by not getting enough vitamin C.

The doctors ordered a blood test to check his vitamin and mineral levels. They discovered he had a completely undetectable level of vitamin C and inadequate amounts of vitamin B1, B6, B12 and D.

It was then that the physicians asked about the boy's diet. His mother told them that he would only eat chicken nuggets, crackers, cookies and water. He refused milk, juice, vegetables and fruits, and would not take any form of vitamin.

To treat him, the physicians put him on "an intravenous concoction of vitamins to replete his total body deficiency," explained Duvall.

His heart and lung problems were soon resolved, as was his limp, which had been caused by bone disease associated with his poor diet.

Once home, his mother finally found a way to get him to accept taking a vitamin, Duvall said. She crushed the pill and mixed it into a "peanut butter fluff" sandwich, which involves putting marshmallow cream and peanut butter on bread.

That combination successfully disguised the taste of the vitamin. He also started getting regular vitamin injections from his pediatrician.

Duvall emphasized that the risk of severe health problems from nutritional deficiencies goes beyond children with autism or behavioral problems.

Those also at risk include people with anorexia and other restrictive eating disorders; the elderly; those with severe mental illness, such as schizophrenia; alcoholics; immigrants and refugees; and patients with chronic diseases, such as HIV/AIDS.

The researchers noted that while they did not prove definitively that the nutritional deficiency caused the boy's problems, his health issues were resolved soon after he was given vitamins.

Physicians, especially pediatricians, often overlook the topic of nutrition, Duvall said.

"Pediatricians are supposed to talk about immunization, diet and weight maintenance, blood pressure, bullying, parent violence, all in a 10-minute visit," she said. "They have to pick and choose what they talk about."

Duvall said physicians should routinely screen for vitamin and mineral deficiency with a simple blood test.

The bottom line for young and old on less-than-ideal diets? Take a multivitamin, Duvall said.

More information: Learn more about healthy diets from the U.S. Centers for Disease Control and Prevention.

Sibling Bullying: Are Parents in denial about sibling aggression?

Siblings routinely pick on one another, but when does bickering become bullying - and what can parents do about it?

Sibling relationships can be difficult, and never more so than in childhood. But society often regards the scrapping and squabbling, the play fighting and not-so-playful fighting as a normal part of growing up.

"The public brushes off aggression between siblings as just rivalry," says Corinna Tucker of the Carsye Institute, University of New Hampshire.

Tucker is the lead author of a new study on the issue for the journal Pediatrics. Almost a third of the 3,600 children questioned said they had been the victim of some sort of sibling aggression in the past 12 months.

This included a range of acts from theft and psychological abuse to physical assault, either mild or severe. In comparison, research suggests that up to a quarter of children are victims of schoolyard aggression every year.

Corinna Tucker uses the term "sibling aggression" in her study, but psychologists are increasingly reaching for a familiar label for the bad stuff that goes on between brothers and sisters - bullying.

This is defined by experts as intentional acts of aggression, repeated over a period of time, where an individual or group is in a position of power over someone.

So sibling relationships would seem the perfect breeding ground for bullying, since children live together for a long period of time and there is usually an intellectual and physical power imbalance.

Although there might not be an outright malevolence, there is often reason for jealousy.

"A sibling relationship is emotionally intense - it's one of those relationships where you can love them and you can hate them at the same time," says Tucker.

"And siblings are natural competitors for family resources and parents' attention."

Laura - who grew up in a house she shared with four siblings and a foster brother - did not consider it bullying at the time, but now thinks the term captures what went on in their house in Ohio.

"My older brother - I would say he beat up on all of us," she says, her voice breaking. Although he never hurt them badly, he liked to wrestle his sisters, pinning them to the floor.

"He was bigger and stronger than us - he could put us in very powerless situations. It was really scary."

For her brother, she believes, the activity gave him a momentary sense of control at a chaotic time for the family. Her mother, who had depression, had left home.

The children were all particularly mean to the youngest sister Tracy who had been the focus of their mother's attention. In the afternoons, after school and before their father came home from work, they would tease Tracy until she phoned her mother to try to get them to stop.

"I remember us saying to her: 'Mum can't do anything about it - she isn't coming here,'" recalls Laura. "And my dad - I think he was so overwhelmed that he only ended up dealing with the most serious things."

Her father later told Laura that he had sent her foster brother back to the orphanage because he was being bullied so much by Laura's middle sisters, a pair of twins.

Research led by Dieter Wolke at the University of Warwick on large samples of British and Israeli schoolchildren has found that half the children who suffered from sibling bullying also suffered bullying at school - and that this group was particularly at risk of unhappiness or developing behavioural problems.

"If you only have sibling bullying or school bullying you are about 2.7 times more likely to have behaviour problems, but if you have both then it's 14 times more likely," says Wolke. "And the point about this is that you don't have any escape. It's 24/7."

Little is known about the long-term effects of sibling bullying but Jan Parker, a family psychotherapist and a co-author of Raising Happy Brothers and Sisters, is certain that they can be "serious and lifelong".

"We're very familiar with discussions on the impact of [school] bullying," she says. "I don't think it takes a great imaginative leap to understand the impact of it happening within your own home. You feel that you are not only let down by the person bullying you, but also by the adults in your life that are letting it go unchecked."

While sibling fights are normal, parents need to be aware of a pattern developing over time, she says. Parents are advised to talk to the children about what's happening. If they are worried, they could speak to a health professional.

They should also consider what might be causing the problems. "There is one known predictor - it's when siblings perceive there to be a wide disparity between how they are treated and how their brother and sister are treated," she says.

Robin Kowalski spoke to Health Check on the BBC World Service - listen again to the programme on iPlayer or get the Health Check podcast.

Psychotropic drugs commonly prescribed to children with ASD

Psychotropic medications, singly and in combination, are commonly prescribed for children with autism spectrum disorders (ASD), according to research published online Oct. 21 in Pediatrics.

Donna Spencer, Ph.D., of OptumInsight in Eden Prairie, Minn., and colleagues reviewed claims data from 2001 to 2009 for 33,565 children with ASD to assess rates and predictors of psychotropic use.

The researchers found that 64 percent of children with ASD had filled a prescription for at least one psychotropic medication.

Polypharmacy was evident, with concurrent medication fills across at least two drug classes in 35 percent and across at least three classes in 15 percent.

Factors associated with greater risk of psychotropic use and multiclass polypharmacy included older age; psychiatrist visit; and evidence of comorbid conditions such as seizures, attention-deficit disorders, anxiety, bipolar disorder, or depression.

"Despite minimal evidence of the effectiveness or appropriateness of multidrug treatment of ASD, psychotropic medications are commonly used, singly and in combination, for ASD and its co-occurring conditions," the authors write.

More information: Psychotropic Medication Use and Polypharmacy in Children With Autism

ADHD: Do sunny climates reduce the symptoms of ADHD?

Attention-deficit/hyperactivity disorder, or ADHD, is the most common childhood psychiatric disorder.

ADHD is more and more believed to have a genetic element but other risk factors have also been identified, including premature birth, low birth weight, a mother's use of alcohol or tobacco during pregnancy, and environmental exposures to toxins like lead.

ADHD is characterized by an inability to focus, poor attention, hyperactivity, and impulsive behavior, and the normal process of brain maturation is delayed in children with ADHD.

Many individuals with ADHD also report sleep-related difficulties and disorders. In fact, sleep disorder treatments and chronobiological interventions intended to restore normal circadian rhythms, including light exposure therapy, claim to improve ADHD symptoms.

Estimates suggest that the average worldwide prevalence of ADHD ranges from about 5 to 7%, but it also varies greatly by country and region.

A simple visual comparison of data maps released by the U.S. Centers for Disease Control and Prevention and the U.S. Department of Energy that display ADHD prevalence rates by state and solar intensities (sunlight) across the country, respectively, reveals an interesting pattern indicative of an association.

So does this mean that there could be an identifiable relationship between ADHD prevalence rates and the sunlight intensity levels of particular regions?

The accumulation of these points led Dr. Martijn Arns and his colleagues to systematically and scientifically investigate this question.

They collected and analyzed multiple data-sets from the United States and 9 other countries.

Reporting their findings in the current issue of Biological Psychiatry, they did find a relationship between solar intensity and ADHD prevalence.

Even after controlling for factors that are known to be associated with ADHD, both U.S. and non-U.S. regions with high sunlight intensity have a lower prevalence of ADHD, suggesting that high sunlight intensity may exert a 'protective' effect for ADHD.

To further validate their work, they also looked at this same relationship with autism and major depressive disorder diagnoses.

They found that the findings were specific to ADHD, with no associations observed between the other two disorders.

Dr. John Krystal

"The reported association is intriguing, but it raises many questions that have no answers," commented Dr. John Krystal, Editor of Biological Psychiatry.

"Do sunny climates reduce the severity or prevalence of ADHD and if so, how? Do people, who are prone to develop ADHD, tend to move away from sunny climates and if so, why?"

As with all scientific research, further work is necessary, including a prospective replication of these findings.

It is also important to realize that this data reflects only an association - not a causation - between ADHD and solar intensity levels so worried parents should not start planning cross-country moves.

However, these findings do have significant implications, explains Dr. Arns.

"From the public health perspective, manufacturers of tablets, smartphones and PCs could investigate the possibility of time-modulated color-adjustment of screens, to prevent unwanted exposure to blue light in the evening."

"These results could also point the way to prevention of a sub-group of ADHD, by increasing the exposure to natural light during the day in countries and states with low solar intensity.

For example, skylight systems in classrooms and scheduling playtime in line with the biological clock could be explored further."

More information: The article is "Geographic Variation in the Prevalence of Attention-Deficit/Hyperactivity Disorder: The Sunny Perspective" by Martijn Arns, Kristiaan B. van der Heijden, L. Eugene Arnold, and J. Leon Kenemans (DOI: 10.1016/j.biopsych.2013.02.010). The article appears in Biological Psychiatry, Volume 74, Issue 8 (October 15, 2013)

Moving on to solids: Raising an adventurous eater

Dinner that evening (anchovy crostini, burrata drizzled with olive oil, and prosciutto-topped Neapolitan pizza) was already stimulating and shaping our child's tastes.

So was the vegetable burrito, drenched in hot sauce, she had eaten for lunch.

Julie Mennella

"Learning about food occurs long before the first taste of food," says Julie Mennella, a biopsychologist at the Monell Chemical Senses Centre in Philadelphia, where she studies how we learn and accept flavours.

"The flavours of the mother's diet get into the amniotic fluid." The same thing happens when the mother breastfeeds, she says.

We had already decided that Indira would be breastfed, and because her diet is nearly as varied as my own, she'd expose our child to a panoply of cuisines.

Born in January, Zephyr was a healthy little boy with a full head of hair and a ravenous hunger.

The next few months were a happy blur, and it wasn't long before we were talking about adding solid foods to his diet.

Though I have rudimentary cooking skills, I'm no culinary maestro. Before Zephyr was born, Indira did most of the cooking, but now the opposite was true. Because I work from home, I had more time to spend in the kitchen.

Still, I needed help crafting the purées that could be the bridge to more complex solids. After consulting our paediatrician, I contacted Tucker Yoder, the executive chef of the Clifton Inn in Charlottesville, Virginia, and a father of three. He agreed to come and teach me a few tricks.

Yoder and his wife have a few simple rules for feeding their children. "We try to give them what we're having," he says, "and we'll try giving them anything."

The children enjoy a wide variety of food, including kale-fortified breakfast smoothies and omelettes filled with freshly foraged mushrooms.

His next rule sounds identical to one that my mother enforced. "If it's on your plate, you've got to try it," he says.

"For me, it's if you don't eat it, you go to bed hungry." The couple shop seasonally and locally, and draw on their own garden for tomatoes, greens, herbs and root vegetables.

Placing Zephyr in his high chair that evening, I mentally crossed my fingers as I dipped his spoon into the pineapple-mango mixture and fed him solids for the first time. He looked confused for a moment.

Then his eyes lit up, he worked his jaw, and he swallowed. He pulled the spoon toward his mouth for seconds.

In his haste, Zephyr managed to smear most of the mixture on his hands, chin and bib, but another smidgeon made it into his mouth.

Trying the strawberry-beetroot purée the next evening, I experienced similarly success. Two days later, however, when I picked Zephyr up from nursery, they told me: "He didn't like the sweet potatoes. He spat them out."

I shouldn't have been surprised. Maybe we got too cocky putting crushed red pepper flakes in there, though it was just a few specks.

Indira has an insatiable appetite for spicy food, and I thought Zephyr might have inherited it but his palate wasn't ready.

Jenny Carenco

"They're not going to eat everything," Jenny Carenco, the author of Bébé Gourmet: 100 French-Inspired Baby Food Recipes for Raising an Adventurous Eater and the former owner of the French frozen baby food manufacturer Les Menus Bébé, reassured me. "My kids don't eat everything. My daughter hates courgettes."

Repetition is the key to winning children over to new tastes, says Carenco. "Just keep serving it and make it a positive experience," she says.

"The mistake is to stop serving it. If they don't like peas, it's not going to kill you to cook up and throw away a spoonful of peas after every meal. Serve them at every meal. And if they have one, it's a victory. Then they'll have two."

Heather Stouffer, the founder and chief executive of US company Mom Made Foods, agrees. "You've got to be patient, consistent and a good role model," she says.

The company launched in 2006, selling organically certified frozen puréed baby foods at a farmers market, though it has phased out those products. ("It was too niche a market," explains Stouffer.)

Now it produces frozen meals and snacks for children aged from two to 10 that are available in US grocery stores.

Stouffer is conscious of what she feeds her own children, eight-year-old Emory and three-year-old Audrey, and her pint-sized customers.

"I'm a huge believer in starting kids out from their very first bite through childhood with healthy, real foods," she says.

Like Yoder, she believes in feeding the children the same meal that she and her husband are eating, in a slightly modified form.

To see how that is accomplished, we met at my house to cook a tilapia fajita dinner with mango salsa and guacamole, then puréed some of the fruit and fish plus spinach for Zephyr.

Mashing some of the leftover avocado with a little water yielded him a small bowl of guacamole, too. Both were a hit, though his bib looked like a Jackson Pollock when he was finished.

As my wife and I laughed over his reaction while eating our own dinner, I thought back on something his paediatrician had said: "Make eating enjoyable, and do it as a family as much as you can."

This was just the beginning of Zephyr's appreciation for food, but so far, so good.

I was still smiling as I went to store the remainder of the peaches and cream. When I opened our refrigerator, the second shelf was filled with a rainbow of purées – not one of them beige.

Older Mothers favour one child, always

Similarities in personal values and beliefs between an adult child and an older mother is what keeps that child in favor over the long-term, and that preference can have practical applications for mother's long-term care, according to a Purdue University study.

Jill Suitor

"Favouritism matters because it affects adult sibling relationships and caregiving patterns and outcomes for mothers, and now we know that who a mother favours is not likely to change," said Jill Suitor, professor of sociology, who has been studying older parent relationships with adult children for nearly 30 years.

"Knowing that favoritism, particularly regarding caregiving, is relatively stable will be helpful for practitioners when designing arrangements that are going to work best for moms."

Approximately three-quarters of the mothers identified that the child who they favored as their preferred caregiver at the start of the study was the same child they favoured seven years later.

Megan Gilligan

"One of the biggest predictors of who remained the favourite was mother's perception of similarity between herself and her child," said Megan Gilligan, an assistant professor in human development and family studies at Iowa State University and a former Purdue graduate student who is a collaborator on the project.

"Mothers were likely to continue to prefer children who they perceived were similar to them in their beliefs and values, as well as to prefer children who had cared for them before."

Their research, co-authored with Karl Pillemer, professor of human development in the College of Human Ecology at Cornell University, is published in the Journal of Marriage and Family.

The findings are based on the Within-Family Differences Study in which data were collected seven years apart from the same 406 mothers, ages 65-75. The study is funded by the National Institute on Aging.

Karl Pillemer

Gender similarity also was a consistent factor to show long-term favoritism, which is not surprising because the mother-daughter connection has been shown in previous research to typically be the strongest, closest and most supportive parent-child relationship.

In addition to looking at the similarity of personal values, the researchers also looked at whether a child's financial independence, adult roles as a spouse or parent themselves, consistent employment, and lawful behaviour influenced which child remained the favorite.

What was surprising is that whether a child was married, divorced or achieved independence, mattered much less than sharing personal values, said Suitor, who is a member of the Center on Aging and the Life Course.

"These mothers are saying that if I can't make my own decisions involving my life than who can best make these decisions for me? Who thinks like I do?" Suitor said.

"Who has the same vision in life that I do, has a pretty good sense of what I would do? This is incredibly important with issues related to caregiving, and that is why understanding these family dynamics is so important."

While the importance similarity played in explaining why a mother's favorite child remained the same across the study, it was much harder to identify what drove changes when a child fell out of favour.

"One of the few predictors of changes was when children stopped engaging in deviant behaviours, such as substance abuse, during the seven years, and then their mothers were more likely to choose them as the children to whom they were most emotionally close," Gilligan said.

Suitor said, "This is an interesting change because if a child engaged in deviant behaviours seven years ago but then stopped they were even more likely to be chosen than were siblings who never engaged in deviant behaviours."

Suitor, Pillemer and Gilligan are planning to extend the Within-Family Differences Study to include interviewing the Baby Boomers about their own adult children.

More information: Continuity and Change in Mothers' Favoritism Toward Offspring in Adulthood, J. Jill Suitor, Megan Gilligan, Karl Pillemer, Journal of Marriage and Family, 2013.

Clinician observations of preschoolers' behavior help to predict ADHD at school age

Don't rely on one source of information about your preschoolers' inattention or hyperactivity. Rather, consider how your child behaves at home as well as information from his or her teacher and a clinician.

This advice comes from Sarah O'Neill, of The City College of New York, based on research she conducted at Queens College (CUNY), in an article published in Springer's Journal of Abnormal Child Psychology.

The study examines how well parent, teacher, and clinician ratings of preschoolers' behavior are able to predict severity and diagnosis of attention deficit hyperactivity disorder (ADHD) at age six.

Characterized by developmentally inappropriate levels of inattention, hyperactivity, and impulsivity, ADHD is one of the most frequently diagnosed childhood psychiatric disorders.

Although many studies focusing on school-aged children have shown that parents and teachers—rather than clinician observations alone—are more likely to assess ADHD accurately, scant evidence exists to support similar conclusions with preschoolers.

To fill this gap in the research, O'Neill and colleagues followed a group of 104 hyperactive and/or inattentive three- and four-year-olds for a period of two years. Both parents and teachers rated the preschoolers' behaviour.

In addition, clinicians, who were blind to parent and teacher reports, completed ratings of preschoolers' behavior during a psychological testing session.

By the time the children reached age six, more than half (53.8 percent) had been diagnosed with ADHD.

The likelihood of such a diagnosis increased when all three informants had rated the child as high on symptoms at age three or four.

Furthermore, after analyzing the reports separately, the research team found that parents' reports were critical, particularly when combined with either teacher or clinician reports.

Teacher reports alone were not as useful, and the research team ascribed the relative inability of educators' reports to predict a child's ADHD status over time to possible situational variables.

Preschoolers may initially have difficulty adjusting to the structured classroom setting, but this disruptive behavior is time-limited to the transition to school.

Teachers' perceptions of "difficult" behaviour may also be affected by factors such as classroom setting and size as well as their expectations of children's behaviour.

As a result of the study findings, O'Neill and her team emphasize the importance of using information from multiple informants who have seen the child in different settings.

Parent reports of preschoolers' behaviour appear to be crucial, but these alone are not sufficient. Augmenting the parent report with that of the teacher and/or clinician is necessary.

Also important are clinician observations of preschoolers during psychological testing, which are predictive of an ADHD diagnosis and its severity over time.

Being able to identify children at risk for poorer outcomes may help educators and clinicians to plan appropriate interventions.

"Consider a preschool child's behaviour in different contexts," O'Neill emphasized. "Although parents' reports of preschoolers' inattention, hyperactivity, or impulsivity are very important, ideally we would not rely solely on them. At least for young children, the clinician's behavioural observations appear to hold prognostic utility."

More information: O'Neill, S. et al. (2013). Reliable Ratings or Reading Tea Leaves: Can Parent, Teacher, and Clinician Behavioral Ratings of Preschoolers Predict ADHD at Age Six? Journal of Abnormal Child Psychology. DOI: 10.1007/s10802-013-9802-4