A recent large study reported in the journal "Pediatrics" found that the use of Tylenol for 30 or more days before and during pregnancy was associated with a two-fold increased risk of ADHD in offspring. Reported in the journal Pediatrics, the study examined the results of over 112,000 births. Questionnaires were used to assess medication use during pregnancy. Mothers filled out two questionnaires, one during and one after birth; fathers completed surveys on medication use 6 months before pregnancy. This interesting study adds to the mounting scientific literature highlighting possible connections between chemically active substances and the etiology of ADHD.
The Food and Drug Administration has issued new requirements in food labeling, which are scheduled to go into effect in July of 2018. They include larger, bolder type for serving size and calorie content, updated and more realistic serving size claims, updated daily values for nutrients, inclusion of the amount of “added sugars,” and requirements for indicating amounts of Vitamin D, calcium, iron, and potassium. These improvements will move parents closer to being able to identify foods suitable for children with special nutritional needs and are a welcome contribution from the FDA.
The IQ (intelligence quotient) is a popular but often misunderstood mathematical representation of overall thinking ability. The notion of “mental age” became popularized through use of the Stanford-Binet (pronounced bih-NAY) Intelligence Test. Though not intended to be so biased, it came to represent approximation of the overall verbal skills, knowledge and thinking ability of a typical U.S middle class child of a certain age. A mental age of 7 essentially meant the verbal, knowledge and thinking skills of a typical middle-class U.S. seven-year-old. Computing the ratio of a child’s mental age divided by his or her real (“chronological”) age rendered a quotient that was called an intelligence quotient.
In part because of its slant and biases, the Stanford-Binet has all but disappeared from the field of clinical practice and has been largely supplanted by less biased instruments, including the popular series of Wechsler IQ tests. It was my privilege to write some of the items for revisions of the Wechsler Intelligence Scale for Children and the Wechsler Adult Intelligence Scale. While the Wechsler series doesn’t use the mental age concept, a “mean test age” can be computed from them and represents almost the same concept, though not as heavily dependent on verbal skills and a rich educational experience.
IQ, in its most basic form, is mental age divided by chronological age, both ages expressed in years and fractions of years. For example, a child who just had her seventh birthday (7 years 0 months) might provide answers and give performance equivalent to that expected from an average child who just had her sixth birthday (6 years 0 months). The IQ would be derived from the ratio of 6 divided by 7. Because the answer is.86, the IQ would be 86. In other words, her mental age is about 86% of her chronological age.
During hot summer days, there is increased concern about sunscreens and their effect of children with ADHD and related conditions. Avoid use of tanning beds. Don’t depend on sunscreen alone for protection against sunburn; the best protection is a hat and clothing. Get lots of vitamin D3 protection. Zinc oxide and titanium dioxide are desirable components of sunscreen, while retinyl palmitate and oxybenzone are not.
New research suggests that combining sign language with intensive speech therapy could be useful for children with apraxia of speech. Researchers from Penn State College of Medicine report in Pediatrics the case of a child who was diagnosed with apraxia of speech at 18 months and was taught sign language as a way to communicate while his verbal speech developed. The child underwent intensive speech therapy using two therapeutic programs: one to develop his mouth muscle control and one to develop sounds. In addition, his mother followed a home program to help improve the child's tongue movement. Following treatment, the child was able to hold conversations with his parents. They reported understanding 90 percent of what he said, while the speech therapist understood at least 80 percent. As his own speech developed, the child discontinued use of sign language on his own.
Autism, like ADHD, is characterized by massive problems with sleep. A 2009 study published in Sleep Medicine Reviews noted parents report sleep problems for children with Autism Spectrum Disorder at a rate of 50% to 80%, much higher than the rate for non-ASD control subjects and children with non-ASD developmental disabilities.
In a recent study titled ‘Sleep Problems and Autism’, UK-based advocacy group Research Autism noted that the following sleep issues are common among children and adults with ASD.
- Difficulty with sleep onset, or falling asleep
- Difficulty with sleep maintenance, or staying asleep throughout the night
- Early morning waking
- Short-duration sleeping
- Sleep fragmentation, characterized by erratic sleep patterns throughout the night
- Hyperarousal, or heightened anxiety around bedtime
Excessive daytime sleepiness
As with ADHD, one of the causes appears to be disrupted release of melatonin, the hormone affecting drowsiness in the evening. My recommendations to reduce sleep problems in children with ADHD (and thus with autism spectrum disorder as well) appear in my book Helping Your ADD Child. An excellent book on this topic is Sleep And Your Special Needs Child. Both are available on our online bookstore.
Gluten is a tough protein. Stomach enzymes can’t chop it up the way they do other proteins, so long fragments of gluten can enter the small intestine. The immune system of persons with celiac disease then mistakes the gluten for an invading protein and reacts the way it would with a true invader. The result includes intestinal damage, abdominal pain, diarrhea and related symptoms. Researchers are currently looking for an enzyme that will break down the small amounts of gluten that those with celiac disease invariably experience despite their best efforts to reduce gluten intake. Don’t trust current products with attractive names like Gluten Cutter, Gluten Rid, and Gluten Digest, as they have not been shown scientifically to help. Whereas the right enzyme theoretically could help, it has yet to be discovered. The best strategy currently is to make consistent efforts to reduce gluten intake.
Here are some of the Easter Bunny’s secrets for making chemical-free colorings:
Pink – Cook chopped beets in a small amount of water or use the juice from canned beets. Concentrate the color by dehydrating it or microwave into a syrup. Freeze extra syrup in a small container.
Yellow – Add turmeric (from the supermarket spice section) to white frosting. Refrigerate to deepen the color. Consider adding a small amount of lemon extract to disguise the taste.
Green – Cook chopped spinach to the bright green stage. Store in freezer.
Purple – Boil chopped red cabbage in some water. Concentrate it as directed for “pink”. Keep the syrup in a freezer.
Blue – A steely, grey-blue may be made by adding baking soda to cabbage juice.
Brown – Add cocoa to frosting.
A landmark study published in the online journal Lancet Psychiatry last month has provided the largest definitive uncovering of long-suspected brain structural anomalies in persons who have ADHD. I, along with some others at the forefront of ADHD, have long maintained that there are genuine neurological and biological bases for ADHD. This study goes a long way to finalize this issue, which has remained controversial for decades.
Dutch neuroscientists analyzed MRI scans of the brains of more than 3,200 people (ages 4 through 63 with a median of 14) about half of whom were diagnosed as having ADHD. The brain scans revealed that five brain regions were smaller in people with ADHD: the amygdala, an almond-shaped structure involved in processing emotions like fear and pleasure; the hippocampus, which plays a role in learning, memory and emotion; and three brain areas within the striatum (caudate nucleus, putamen and nucleus accumbens) that help process the brain’s reward system. Brain volume differences did not correlate with stimulant use, suggesting that such discrepancies were not a result of medication.
Prevent sensory overload while shopping. Children with autism are especially prone to experience being overwhelmed sights, sounds, touch sensations and smells when out in public. If you are the parent, be alert to the specific triggers that cause this problem. Consider keeping a journal about possible triggers, noting the circumstance and the severity and duration of the overload reaction in your child.
To help you focus on the most likely ones, hunt for your child’s distinct mannerism that indicate overload. Teach your child to use a codeword to indicate discomfort. Steer clear of noisy areas with bright or chaotic lighting while shopping. Time shopping trips to occur during periods of least patronage of the stores you are going to. Bring earplugs or earphones and a comfortable visor or sunglasses for the child. Take your child’s hand when necessary for calming, always avoiding surprise touch.
Fragile X syndrome, named for the unstable condition of the X chromosome, affects boys much more often than girls. Girls suffer less obvious symptoms, often having a normal range of intelligence, and only about 1/3 of the girls with Fragile X syndrome have recognized learning problems. All children with Fragile X syndrome have numerous symptoms that overlap (and are often misdiagnosed and representing exclusively) ADHD symptoms. Poor concentration skills, difficulties with interpersonal relationships, anxiety in social situations and in unfamiliar situations are common symptoms. Occasionally prominent jaw and ears along with a long narrow face can occur. All children with this condition merit professional interventions, primarily targeting the ADHD symptoms.