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

Researchers ferret out function of autism gene

The structure of the protein NHE9 is one piece of the puzzle of what causes autism. 

Credit: Kalyan Kondapalli and Rajini Rao

Researchers say it's clear that some cases of autism are hereditary, but have struggled to draw direct links between the condition and particular genes.

Now a team at the Johns Hopkins University School of Medicine, Tel Aviv University and Technion-Israel Institute of Technology has devised a process for connecting a suspect gene to its function in autism.

In a report in the Sept. 25 issue of Nature Communications, the scientists say mutations in one such autism-linked gene, dubbed NHE9, which is involved in transporting substances in and out of structures within the cell, causes communication problems among brain cells that likely contribute to autism.

"Autism is considered one of the most inheritable neurological disorders, but it is also the most complex," says Rajini Rao, Ph.D., a professor of physiology in the Institute for Basic Biomedical Sciences at the Johns Hopkins University School of Medicine.

"There are hundreds of candidate genes to sort through, and a single genetic variant may have different effects even within the same family. This makes it difficult to separate the chaff from the grain, to distinguish harmless variations from disease-causing mutations. We were able to use a new process to screen variants in one candidate gene that has been linked to autism, and figure out how they might contribute to the disorder."

An estimated one in 88 children in the United States is affected by autism spectrum disorders, a group of neurological development conditions marked by varying degrees of social, communication and behavioral problems.

Scientists for years have looked for the biological roots of the problem using tools such as genome-wide association studies and gene-linkage analysis, which crunch genetic and health data from thousands of people in an effort to pinpoint disease-causing genetic variants.

But while such techniques have turned up a number of gene mutations that may be linked to autism, none of them appear in more than 1 percent of people with the condition. With numbers that low, researchers need a way to screen variants in order to make a definitive link, Rao says.

For the new study, Rao and her collaborators focused on NHE9, which other researchers had flagged as a suspect in attention-deficit hyperactivity disorder, addiction and epilepsy as well as autism spectrum disorders.

The gene was already known to be involved in transporting hydrogen, sodium and potassium ions in and out of cellular compartments called endosomes, and the team wondered how this function might be related to neurological conditions.

Rao's collaborators at Tel Aviv University and Technion-Israel Institute of Technology constructed a computer model of the NHE9 protein based on previous research on a distant relative in bacteria.

They then used the model to predict how autism-linked variants in the NHE9 gene would affect the protein's shape and function.

Some of them were predicted to cause dramatic changes, while other changes appeared to be more subtle.

Rao's team next tested how these variant forms of NHE9 would affect a relatively simple organism often used in genetic studies: yeast.

"Using yeast to screen the function of variants was a quick, easy and inexpensive way of figuring out which were worth further study, and which we could ignore because they didn't have any effect," Rao says.

To do that, the team engineered the yeast form of NHE9 to have the variants seen in autistic people.

For those mutations that did have a detectable effect on the yeast, the team moved on to a third and more challenging step, in mouse brains.

They homed in on astrocytes, a type of brain cell that clears the signaling molecule glutamate out of the way after it has performed its job of delivering a message across a synapse between two nerve cells.

Using lab-grown mouse astrocytes with variant forms of NHE9, the researchers found a change in the pH (acidity) inside cellular compartments called endosomes, which in turn altered the ability of cells to take up glutamate.

Because endosomes are the vehicles that deliver cargo essential for communication between brain cells, changing their pH alters traffic to and from the cell surface, which could affect learning and memory, Rao says.

"Elevated glutamate levels are known to trigger seizures, perhaps explaining why autistic patients with mutations in NHE9 and related genes also have seizures," she notes.

Rao and her team hope that pinpointing the importance of this trafficking mechanism in autism spectrum disorders may lead to the development of new drugs for autism that alter endosomal pH.

As the use of genomic data becomes increasingly commonplace in the future, the step-wise strategy devised by her team can be used to screen gene variants and identify at-risk patients, she says.

More information: www.nature.com/ncomms/2013/130925/ncomms3510/full/ncomms3510.html

Autistic Children: Sleep education helps families

Parent sleep education is beneficial in improving sleep and aspects of daytime behavior and family functioning in children with autism spectrum disorders (ASD), according to a Vanderbilt study published in the Journal of Autism and Developmental Disorders.

Vanderbilt joined with the University of Colorado Denver and the University of Toronto to carry out a study of 80 children with ASD, ages 2-10 years, primarily focused on teaching parents the basics of sleep education.

Beth Malow

"We found that one hour of one-on-one sleep education or four hours of group sleep education delivered to parents, combined with two brief follow-up phone calls, improved sleep as well as anxiety, attention, repetitive behaviour and quality of life in children with ASD who had difficulty falling asleep," said study author Beth Malow, M.D., professor of Neurology and Pediatrics, and the Burry Professor of Cognitive Childhood Development.

"The parents also benefited; they reported a higher level of parenting competence after completing the education sessions. The one-on-one and group sessions showed similar levels of success. In contrast, an earlier study that simply gave parents a pamphlet without guidance on how to use it did not provide the same level of improvement in child sleep."

Before entering the study, all children were examined for medical conditions that could cause sleep problems, such as gastrointestinal disorders or seizures.

In the instructional sessions, parents learned about daytime and evening habits that promote sleep, including the importance of increasing exercise, limiting caffeine during the day and minimizing use of video games and computers close to bedtime.

Sleep educators helped parents put together a visual schedule for their children to help them establish a bedtime routine and discussed ways to help children get back to sleep if they woke up at night.

Malow, also a Vanderbilt Kennedy Center investigator, said future studies are needed to determine the best approaches for providing sleep education to families, including those related to telemedicine and Internet-based technologies.

Malow and her colleagues within the Autism Speaks Autism Treatment Network are also developing partnerships with local pediatric practices to provide training on sleep education.

Content from the sessions is available to download for free on the Autism Speaks website. A toolkit, "Strategies to Improve Sleep in Children with Autism Spectrum Disorders," and three Quick Tips sheets are currently posted here.

"We are grateful to Autism Speaks for all of their support with our research and our toolkit materials. With their support, we have been able to help many children with ASD and their families get the rest they need to be at their best during the day," Malow said.

"We are also appreciative to all of the families who participated in this research."

TBI: Massive Increase in Emergency room visits for kids with concussions

Researchers report a skyrocketing increase in the number of visits to the emergency department for kids with sports-related traumatic brain injuries (TBI), such as concussions.

The study, conducted by emergency physicians at Cincinnati Children's Hospital Medical Center, shows that emergency visits for sports-related TBI increased 92 percent between 2002 and 2011.

The number of children and teens admitted to the hospital with the same diagnosis also increased. That increase was proportionate to the increase in emergency department visits – about 10 percent.

Patients admitted during the later years of the time period had less severe injuries and stayed in the hospital shorter amounts of time.

"More people are seeking care for TBI in the emergency department, and proportionately more are being admitted for observation," says Holly Hanson, MD, an emergency medicine fellow at Cincinnati Children's and lead author of the study.

"Here in Cincinnati, we anticipate more children will be seeing their primary care physician or going to the Cincinnati Children's TBI clinic, due to the passage of recent Ohio legislation mandating medical clearance to return to play."

The study of emergency department trends in sports-related TBI is published online in the journal Pediatrics.

The researchers studied more than 3,800 children and teens who came to Cincinnati Children's with a sports-related TBI between 2002 and 2011. Of these patients, 372 were admitted.

Injury severity, however, decreased from 7.8 to 4.8, based on an established medical score to measure trauma severity. Length of stay changed little but trended downward.

Skiing, sledding, inline skating and skateboarding had the highest admission rates for patients who visited the emergency department.

Their research did not concentrate on why more children and teens with less severe injuries were admitted to the hospital during this time period.

They speculate that emergency physicians may be ordering fewer CT scans and observing patients in the hospital, or perhaps that athletes are getting bigger and stronger, causing more head injuries needing longer periods of observation.

The Centers for Diseases Control and Prevention has called TBI an "invisible epidemic" because these injuries are often profound but not readily apparent to the public.

TBI is responsible for approximately 630,000 emergency visits, more than 67,000 hospitalizations, and 6,100 deaths in children and teens each year.

Medical evaluations for sports-related TBI increased 62 percent between 2001 and 2009, according to previous studies.

More Information: Sports related head injuries
Read more about minor head injuries on children

Leadership and Energy: Newborn Babies and Dogs: Stage 2: The Sitter and the Food Thief

At this stage, your baby is sitting without support, so you’ve likely begun feeding purees and may even be ready to start solid foods.

Pretty soon your dog will discover just how rewarding having this new family member around can be.

All babies enjoy throwing their food to see what happens, but your baby gets an added benefit:

The entertainment of watching your dog beg, jump, and dive for tasty morsels. In fact, your baby may enjoy offering food directly to your dog, making it even harder to discourage this kind of thievery.

So what can you do to keep baby’s mealtime under control?
Know your dog. Is he the type to sneak a treat from the kitchen table? Does she get possessive over particularly delectable snacks?

Recognizing the issues you may confront before the first feeding can help prepare you for that first meal.

Claim the high chair. Set clear rules, boundaries, and limitations from day one. Bring it out before you’re even considering feeding your baby anything besides breast milk and formula, and let your dog know who owns it. Then take things up a notch by adding some food to the tray.

Get help. It can be hard to keep track of an unruly dog and an unruly baby at the same time.

Even if you don’t expect to have any issues with your dog, plan for the first meal to be at a time when there’s someone else at home, so one of you can focus on correcting the dog and one of you can focus on the baby’s needs.

Beware of dangerous human foods. Most of the food that you will be feeding your baby at this stage will be mild on the stomach.

In fact, some veterinarians even recommend feeding baby food to a dog with a troubled tummy. But that doesn’t mean that all food you feed to your baby is safe for your dog.

For example, avocado is a great treat for a baby — but potentially dangerous for your pup and any sudden shift in diet can wreak havoc on a dog’s tummy.

Keep a list of foods to beware of near the fridge as a reminder, and talk to your veterinarian about any concerns you have.

Put the dog away. If you have any fears about your baby being hurt by an overexcited or possessive pup, make dinner a time when the dog goes away for a while but be aware that this issue won’t go away over time.

Eventually, your baby will grow into a toddler who will want to walk and snack. Consider hiring a professional to work through the issue.

Leadership and energy: 5 Stages of Baby, Canine Friendship - Part 1

You spent the last nine months preparing your dog for this new family member, and the introduction and initial meeting went well but that’s just the beginning!

Your dog’s relationship with your baby will change over time. At each stage of your baby’s development, you’ll encounter new joys and new challenges.

The key is to be alert to changes and to monitor interactions between them so you can step in and correct problem behaviour — from either your dog or your baby!

Here are a few of the dynamics you may encounter as your baby grows — and how to get through them as a pack.

Stage 1: Newborn and the Baby Alarm
A newborn brings a whole range of new smells and sounds into your home, and perhaps the most worrying is crying.

Remember, your dog picks up on energy, and the energy that your baby is giving off while crying is anything but calm and assertive. Your dog may become distressed, too, whimpering, whining, and barking.

This may be endearing at times (“Aww, look — Spot is worried about you, too!”), but it can also be a problem.

A barking dog can get in the way when you’re trying to get a baby to sleep, and often those crying jags happen in the middle of the night, when your neighbors may not appreciate the commotion.

You can help accustom your canine (and human!) family members to the sounds of crying before the new arrival by playing the sound on your computer at loud volumes for extended periods of time.

If possible, keep your dog some place where the noises of the baby can’t reach him at night. (That way, at least someone is the house is getting a good night’s sleep!)

NB: If you have issues with your newborn baby sleeping go to www.dream-angus.com for solutions and counselling.

One of the most important things you can do during this stage is maintain a regular routine of walks with the whole pack — mom and baby out the door first and at the front of the pack.

This not only helps send a message about your baby’s role as a pack leader, but also helps drain your dog’s energy, leading to better behavior overall.

With all the changes of having a new baby, many new parents put dog walks on the back burner, resorting to just letting the dog out in the backyard or a quick stop to the corner.

Of course, you may have days where this is simply a necessity, but make that the exception to the rule. Consider dog walks a priority. It’s not just good for your dog; it’s good for you, too.