Racial and Ethnic disparities in ADHD diagnosis

Black children and children in homes where a language other than English is spoken are less likely to receive an attention-deficit/hyperactivity disorder (ADHD) diagnosis by school entry, despite being otherwise similar to white children on many measured background characteristics, according to a study by a team of researchers.

Their findings indicate that disparities in ADHD diagnosis begin to occur early in children's school careers.

Paul Morgan

"We were interested in evaluating whether the disparities observed across elementary and middle school in our earlier study were evident as early as the fall of kindergarten, accounting for many factors measured prior to the children entering school," said Paul Morgan, associate professor of special education, Penn State.

"Whether these disparities extend to Hispanic children has also been unclear. We find that their initially observed disparities are related to non-English language use in the home."

Analyses of kindergarten teacher-reported classroom behaviour indicated that neither black nor Hispanic children displayed less frequent ADHD-related behaviours than white children, suggesting that a lower incidence of ADHD symptomology did not explain minority children's comparatively lower rates of diagnosis.

"One explanation for our findings is that black parents may be relatively more reluctant to obtain a mental health diagnosis for their children, while language barriers may explain Hispanic children's lower likelihood of diagnosis," Morgan said.

"It may also be the case that pediatricians and other professionals are not soliciting developmental concerns as often from minority families."

A lack of treatment for ADHD may result in some minority children experiencing more learning and behavioral problems as they start school, so that they quickly begin falling behind their peers.

"One practical application is that these groups of children may have unmet treatment needs," Morgan said.

"Pediatricians, psychiatrists and school-based practitioners should be sensitive to the possibility that cultural and linguistic barriers are resulting in systematic under-diagnosis for some groups of children."

"Ensuring minority children are appropriately diagnosed and treated for ADHD may require overcoming these barriers."

Providing minority parents with information on recognizing potential ADHD symptoms in their children, as well as encouraging help-seeking behaviours when meeting with professionals, may also help prevent or reduce racial/ethnic diagnosis disparities.

"I hope that our findings inform efforts to help all children with ADHD," Morgan said. "If untreated, ADHD can very quickly begin to interfere with children's opportunities for school success."

More information: "Racial/ethnic disparities in ADHD diagnosis by kindergarten entry." Morgan PL, Hillemeier MM, Farkas G, Maczuga S. J Child Psychol Psychiatry. 2014 Jan 24. DOI: 10.1111/jcpp.12204. [Epub ahead of print]

Reading before a nap benefits learning for toddlers

Reading before a nap benefits learning for toddlers.

A connection between sleep and learning has already been identified as beneficial for adults and older children.

Now University of Sussex psychologists Dr Jessica Horst and PhD candidate Sophie Williams have shown that three-year-olds who take a nap after having stories read to them will also perform better later in word-learning tasks.

Their study, published in Frontiers in Developmental Psychology today, involved 48 British children, half of whom took afternoon naps, and half of whom didn't.

They were read either the same story, or three different stories, but were exposed to the same number of unfamiliar words.

When tested two and a half hours later, 24 hours later and a week later, those children who had been read the same story before their nap performed significantly better than those who hadn't had a sleep.

Significantly, those children who had been read three different stories before their sleep performed 33 per cent better than those who had stayed awake after hearing those stories.

On subsequent tests, the researchers found the wakeful ones never caught up with their peers in word recall.

Jessica Horst

Previous studies by Dr Horst have shown that being read the same story rather than different stories was more beneficial to learning new words.

But the new study shows that sleep can have an additional significant advantage, especially when the children are exposed to different stories.

Dr Horst says: "Overall, all of the children in the study did very well—reading is always good, at any age and any time.

But, children who were learning something particularly difficult (new words from several stories) especially benefited from hearing the stories right before sleeping.

In fact, these children ended up learning the words as well as the children who had heard the same stories again and again, which we knew would be easier."

Dr Horst points that many studies have shown young children are now sleeping less than ever before and consistently less than recommended guidelines.

Chronically short sleep is significantly related to poorer vocabulary scores, childhood obesity and externalising behaviours, such as tantrums.

"Many preschool children take an afternoon nap, yet classroom naps are increasingly being curtailed and replaced due to curriculum demands," she adds.

"Given the growing body of evidence that sleep consolidation has a significant effect on children's learning, such policies may be doing our children a huge disservice."

"In fact, findings like those from the current study indicate we should be encouraging young children to nap and should take advantage of the period right before they nap for instruction in key academic areas such as word learning and arithmetic."

More information: "Goodnight Book: Sleep Consolidation Improves Word Learning via Storybooks." Sophie E. Williams and Jessica S. Horst. Front. Psychol. DOI: 10.3389/fpsyg.2014.00184

Dyslexia, Reading difficulties and vision

Although Dyslexia is recognised as a cognitive disorder it is prudent to have children's eyes tested to rule out vision problems.

Children do not know if they are perceiving the world differently from others. In fact few of us do, even into middle age.

To help a child who may be have difficulty reading, it is good practice to rule out any physical or eye issues.

Many optometrists believe that all reading difficulties and Dyslexia is caused by vision problems.

This is certainly not the case, and many parents are paying out for expensive bogus treatments and special glasses, which are ineffective.

Have your child's eyesight thoroughly checked to rule out any physical defect and, if their reading difficulties remain, then look at ways to help them overcome  their difficulties around Dyslexia.

I hope you will be able to find some help from the articles in this blog.

You will certainly be able to find good information on the latest scientific research and discoveries around Dyslexia and other cognitive disorders.

Unfortunately, you will not find any 'quick fixes' or any 'cures' for Dyslexia. The first step is acceptance and then you need to support your child in developing a strategy to learn and to live with Dyslexia.

Dyslexia: Our Education System is failing students - Cartoon

Dyslexia: Being different and a success!

Chances are that when you think of the most successful and wealthy entrepreneurs, you don’t think of a group of weird people. 

Instead, you probably think of well-respected and brilliant people who exhibit all the admirable qualities of well-rounded, well-adjusted leaders. 

Ironically, research shows just the opposite; entrepreneurs, especially those in technology, are indeed quite odd. In fact, the data show that being odd is the norm.

A recent survey of entrepreneurs conducted by Julie Login of Cass Business School found that 35 percent of those surveyed suffered from dyslexia, compared with 10 percent of the population as a whole. 

One reason for this trend posits that those with dyslexia, a learning disability affecting one’s reading and comprehension, tend to delegate tasks to manage their disability. 

Some of the most notable dyslexics of our time are founders Steve Jobs of Apple, John Chambers of Cisco, and Richard Branson of the Virgin Group.

In another study, attention-deficit disorder (ADD) is common among entrepreneurs. 

A recent article in The Economist mentioned that “people with ADD are six times more likely than average to end up running their own businesses.” 

Sufferers of ADD are known to be disorganized procrastinators who are unable to focus, all normally bad characteristics. 

But some entrepreneurs who have the disorder, like Paul Orfalea, founder of Kinko’s, interpret these characteristics as an advantage because people with ADD can be creative in ways that “normal” people would not.

Furthermore, many entrepreneurs display symptoms of Asperger’s syndrome, which, according to the Mayo Clinic, is a “developmental disorder that affects a person’s ability to socialize and communicate effectively with others.” 

Some refer to it as a mild form of autism. Asperger’s is perhaps the most prevalent among software developers like me who would prefer to send an e-mail or instant message to someone sitting next to them in the office rather than to talk to them face to face. 

We often appear robotic and detached. Mark Zuckerberg, the cofounder of Facebook, is a good example of an entrepreneur who exhibits these traits. 

In Silicon Valley, several entrepreneurs display the symptoms of Asperger’s syndrome. In fact, it’s cool to act this way. 

Most people would just call it being a geek. In the Valley, the social butterflies are considered offbeat.

In addition to these disabilities, disorders, and syndromes, entrepreneurs have habits that are just plain bizarre. 

Steve Jobs had perhaps the strangest habits, including use of acid and LSD. In fact, he attributed his creativity to his taking LSD. 

Other CEOs have been said to perform karaoke in drag, to have an obsession with guessing measurements, to ideate underwater, and to wear the same clothing every day.

In a strange turn of events, these so-called oddities that are common among prominent entrepreneurs are attracting investors. 

To use a term in computer science, pattern matching has become quite popular. 

For instance, if you are looking for the next Facebook and you have to choose between funding two CEOs of equally great tech companies, one who is jovial and the other who is introverted, you’ll probably go with the introvert. 

This may seem a bit ridiculous, but it happens more and more often.

So when it comes to being a successful entrepreneur, it pays to be odd, and besides, when you become wealthy and successful, people tend to forget how odd you might really be. 

Regardless, everyone wants to be your friend.

Self-esteem: Research reveals the cultural origins

What gives you self-worth? University of Sussex research shows our self-esteem is based on the prevailing values of our culture.

Whatever our personal values, we largely base our self-worth on living up to the prevailing values of our culture, new University of Sussex-led research reveals.

Vivian Vignoles

Sussex social psychologists Dr Vivian Vignoles and Dr Maja Becker collaborated with a global team of researchers to address a long-standing debate about what influences our self-esteem.

Their findings are published online this month (12th February, 2014) in the Personality and Social Psychology Bulletin.

More than 5,000 adolescents and young people in 19 countries spanning Western and Eastern Europe, the Middle East, South America, Africa and Asia took part in the research.

Participants were found to base their self-worth on living up to the prevailing values of others in their cultural contexts, but—surprisingly—their own personal values appeared to have little or no influence on self-esteem.

Dr Vignoles explains: "We can all think of different things that make us see ourselves positively, whether it is succeeding at work or school, our relationships with friends and family, behaving morally towards others, or having the right possessions—as well as other aspects of ourselves that we may feel less good about. But what gives these things their importance?

"An intuitive answer would be that every individual bases their self-esteem on living up to the values that they personally see as most important—and this has been the dominant view in psychology for over 100 years. But firm evidence for this idea has been surprisingly elusive.

"Our new findings paint a very different picture, suggesting that it is the value priorities of others in the surrounding context, not the individual's own value priorities, that predict which aspects of ourselves will give us the greatest sense of self-worth."

Funded by the Economic and Social Research Council (UK), the research was conducted by the Culture and Identity Research Network, directed by Dr Vignoles.

Research participants were initially asked to list ten aspects of themselves in answer to the question "Who are you?".

Their answers were very wide ranging, including descriptions of their personality characteristics, important relationships, social roles and group memberships.

Participants were subsequently asked: "How much does each of these things make you see yourself positively?"

The researchers used further data from the questionnaires to predict which aspects of themselves each participant would see as providing the greatest sense of self-esteem.

The results showed that participants derived the most self-esteem from aspects of their identities that best fulfilled the values of their surrounding culture.

For example, participants in cultural contexts where people most emphasized values such as self-direction and having a stimulating life (e.g., the UK, Western Europe, and some parts of South America) were more likely to derive self-esteem from controlling their own lives, whereas those in cultures where there was relatively more emphasis on values such as conformity, tradition, and security (e.g., parts of the Middle East, Africa, and Asia) were relatively more likely to derive self-esteem from doing their duty.

Dr Vignoles comments: "Popular psychology and self-help books often seem to imply that people can build self-esteem on their own. These findings should remind us that no-one is an island. Building self-esteem is mostly a collaborative enterprise."

"Our research suggests that the self-esteem system is an important way in which individuals internalise the values of their culture on an implicit level, even if they do not profess to believe in these values when they are asked explicitly."

"These subtle processes may encourage people to act in ways that are desirable in their society, and thus help to maintain social solidarity."

More information: "Cultural bases for Self-Evaluation: Seeing Oneself Positively in Different Cultural Contexts", lead authors Dr Maja Becker and Dr Vivian Vignoles, is published in Personality and Social Psychology Bulletin. dx.doi.org/10.1177/0146167214522836

Dyslexia: Action video games help people with Dyslexia learn to read

In addition to their trouble with reading, people with dyslexia also have greater difficulty than typical readers do when it comes to managing competing sensory cues, according to a study reported February 13 in Current Biology.

The findings suggest that action video games might improve literacy skills in those with dyslexia, which represent five to ten percent of the population.

"Imagine you are having a conversation with someone when suddenly you hear your name uttered behind you," says Vanessa Harrar of the University of Oxford.

"Your attention shifts from the person you are talking to—the visual—to the sound behind you. This is an example of a cross-sensory shift of attention."

"We found that shifting attention from visual to auditory stimuli is particularly difficult for people who have dyslexia compared to good readers."

In fact, researchers already knew that people with dyslexia had some challenges with auditory processing in addition to their visual impairments.

New evidence had also begun to link multisensory integration and dyslexia to the same parts of the brain.

That evidence, together with Harrar's own personal challenges with reading and writing, prompted her and her colleagues to conduct one of the first investigations of how people with dyslexia process multisensory stimuli.

Participants in the study were asked to push a button as quickly as possible when they heard a sound, saw a dim flash, or experienced both together.

The speed with which they pressed the buttons was recorded and analyzed.

While everyone was fastest when the same type of stimuli repeated itself, the data showed that people with dyslexia were particularly slow at pressing the button when a sound-only trial followed a visual-only trial.

In other words, they showed "sluggish attention shifting," particularly when asked to shift their attention from a flash of light to a sound.

While the researchers say further study is needed, they suggest based on the findings that dyslexia training programs should take this asymmetry into account.

"We think that people with dyslexia might learn associations between letters and their sounds faster if they first hear the sound and then see the corresponding letter or word," Harrar says.

Of course, traditional approaches to reading, in which letters are first seen and then heard, do just the opposite.

Harrar's team goes on to propose a unique, nonverbal approach to improve reading and writing with action video games.

"We propose that training people with dyslexia to shift attention quickly from visual to auditory stimuli and back—such as with a video game, where attention is constantly shifting focus—might also improve literacy.

Action video games have been shown to improve multitasking skills and might also be beneficial in improving the speed with which people with dyslexia shift attention from one task, or sense, to another."

More information: Current Biology, Harrar et al.: "Multisensory integration and attention in developmental dyslexia." dx.doi.org/10.1016/j.cub.2014.01.029

More Reading, more talking, and longer sentences help babies' brains

The sooner parents start explaining the world to their baby, the better.

That does not mean flash cards for tots, or merely pointing out objects: "Here's an orange. That's a bowl."

New research shows that both how much and how well parents talk with babies and toddlers helps tune the youngsters' brains in ways that build crucial language and vocabulary skills—a key to fighting the infamous word gap that puts poor children at a disadvantage at an even younger age than once thought.

The idea is to connect words and meaning, so the brain becomes primed to learn through context: "Let's put the orange in this bowl with the banana and the apple and the grapes."

Anne Fernald

"You're building intelligence through language," is how Stanford University psychology professor Anne Fernald explains it.

And forget dumbed-down baby talk: Longer, more complex sentences are better.

Erika Hoff

"The advice I give mothers is to have conversations with your babies," said Erika Hoff, a psychology professor at Florida Atlantic University.

"Children can hear lots of talk that goes over their head in terms of the meaning, and they still benefit from it."

The research, presented Thursday and Friday at a meeting of the American Association for the Advancement of Science, comes amid a growing push for universal preschool, to help disadvantaged youngsters catch up.

But it also begs the question of whether children from low-income, less educated families need earlier intervention, such as preschool that starts at age 3 instead of 4, or higher quality day care or even some sort of "let's talk" campaign aimed at new parents to stress talking, singing and reading with tots even before they can respond.

That can be difficult for parents working multiple jobs, or who may not read well or who simply don't know why it's important.

Scientists have long known that before they start kindergarten, children from middle-class or affluent families have heard millions more words than youngsters from low-income families, leaving the poorer children with smaller vocabularies and less ready to succeed academically.

Fernald said by some measures, 5-year-olds from low-income families can lag two years behind their peers in tests of language development, an achievement gap that's difficult to overcome.

Kimberly Noble

Brain scans support the link, said Dr. Kimberly Noble of Columbia University Medical Center.

Early experiences shape the connections that children's brains form, and kids from higher socioeconomic backgrounds devote more "neural real estate" to brain regions involved in language development, she found.

How early does the word gap appear? 
Around age 18 months, Stanford's Fernald discovered when she compared how children mentally process the language they hear.

Lower-income kids in her study achieved at age 2 the level of proficiency that more affluent kids had reached six months earlier.

To understand why language processing is so important, consider this sentence: "The kitty's on the bench." If the youngster knows the word "kitty," and his brain recognizes it quickly enough, then he has can figure out what "bench" means by the context but if he's slow to recognize "kitty," then "bench" flies by before he has a chance to learn it.

Next, Fernald tucked recorders into T-shirts of low-income toddlers in Spanish-speaking households to determine what they heard all day—and found remarkable differences in what's called child-directed speech.

That's when children are spoken to directly, in contrast to television or conversations they overhear.

One child heard more than 12,000 words of child-directed speech in a day, while another heard a mere 670 words, she found.

The youngsters who received more child-directed speech processed language more efficiently and learned words more quickly, she reported.

But it's not just quantity of speech that matters—it's quality, Hoff cautioned. She studied bilingual families and found that whatever the language, children fare better when they learn it from a native speaker.

In other words, if mom and dad speak Spanish but aren't fluent in English, it's better for the child to have a solid grounding in Spanish at home and then learn English later in school.

Next, scientists are testing whether programs that teach parents better ways to talk to tots really do any good.

Fernald said preliminary results from one of the first, a program called Habla Conmigo that enrolls low-income, Spanish-speaking mothers in San Jose, California, are promising. She analysed the first 32 families of the 120 the program will enroll.

Mothers who underwent the eight-week training are talking more with their toddlers, using higher-quality language, than a control group of parents—and by their second birthday, the children have bigger vocabularies and process language faster, she said Thursday.

Foetal Alcohol Syndrome (FAS): Drinking alcohol during pregnancy could be ruled a crime in the UK

UK Lawyers plan to take a test case to the UK Court of Appeal over claims that children harmed in the womb by their mother's drinking should receive compensation as victims of crime

Harming an unborn child by consuming alcohol during pregnancy could be classified as a crime in the UK, if an unusual legal challenge succeeds.

An English council is planning to go to the UK Court of Appeal in an attempt to secure criminal injuries compensation for a six-year-old girl who was born with foetal alcohol spectrum disorder (FAS) as a result of her mother’s drinking while she was in the womb.

A UK tribunal ruled in 2011 that the unnamed child had sustained personal injury “directly attributable to a crime of violence” and so was eligible for a payout.

Her mother, who drank “grossly excessive quantities of alcohol” during her pregnancy, was never convicted of any offence.

But she was alleged to have maliciously administered poison so as to endanger life or inflict grievous bodily harm, a crime under section 23 of the UK Offences Against the Person Act 1861.

However, the UK Criminal Injuries Compensation Authority challenged the judgment, and it was overturned in December 2013 by the upper tribunal of the UK Administrative Appeals Chamber.

Judge Howard Levenson found that there had been “administration of a poison or other destructive or noxious thing, so as thereby to inflict grievous bodily harm”.

However, he concluded that the girl was “not a person” in legal terms at the time because she was still a foetus.

The judge added: “I conclude that the section 23 offence cannot be committed by a pregnant woman drinking alcohol during her pregnancy and thereby causing damage to her unborn child and that, in the present case, no evidence or argument has been offered in respect of the commission of any other offence.”

Now the council in north-west England which brought the original application for compensation on behalf of the girl, who is now in foster care, is preparing to take the case to the UK Court of Appeal.

Neil Sugarman, a managing partner at GLP Solicitors in Greater Manchester, who is handling the case, told the paper: "Sadly, we act for many, many children who have been damaged by excessive alcohol intake during pregnancy.

We were approached by a local authority with responsibility for a child very badly damaged as a consequence of foetal alcohol spectrum disorder (FAS).

“They considered making an application under the criminal injuries compensation scheme because they thought there was an argument that the child had been damaged by being victim of a crime. The crime being; the birth mother carrying on drinking knowing that it could damage the child.”

He added: "In all the cases we have, there is good evidence that warnings have been given either by social workers or treating consultants and nurses to say, 'you cannot go on doing this, you are going to damage your child'."

There is a history of similar cases being brought to the courts in the US but with limited success.

Listen to a spokeperson from the American Bar Association. This Podcast discusses what US legal representatives need to know about Fetal Alcohol Syndrome or Spectrum Disorder.

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.