Good Fats Needed: Your Child’s Brain and Health

Could government guidelines for a diet low in healthy fats be making our children sick? The numbers and new research suggest this may just be the case. From 2003 to 2011, for instance, ADD/ADHD rates increased by 43%, and continue to rise. The number of kids on antidepressants jumped 50% from 2005 to 2012, with over 7 million children now taking psychoactive drugs.

In 2015, 6 million children in the U.S. were diagnosed with ADD/ADHD and treated with Ritalin, Adderall, and related drugs. While this means that only two out of three kids with diagnosed ADHD are treated, some experts feel that not enough children are being medicated. This is backwards reasoning that fails to look at the cause of ADHD. Over 2.1 million kids in the U.S., meanwhile, are taking anti-depressants, according to 2017 statistics.

There is no sign that trends in these ailments are reversing, but the good news is that there are practical steps you can take to prevent or alleviate these disorders. Adding vitamins and healthier food to your child’s diet will provide essential nutrients that are missing in the Standard American Diet.

SAD daily food plan
Standard American Diet (SAD) daily food plan

New research is discovering nutritional solutions to mental health issues, pointing to vitamin supplementation and better diet as the most effective solution for mental health issues. Studies show that certain fats make excellent antidepressants. Even severe depression and schizophrenia have been successfully treated with vitamins and diet.

The good news is that you can keep kids happy and healthy by changing their diet. Your children can benefit from proven research which is not yet widely known or accepted. The bad news is that you have to be willing to buck traditional nutritional and medical advice.

There are many plusses to treating mental health issues with diet instead of drugs. Let’s compare diet to Ritalin, the most common psychoactive drug given to kids:

Dietary Approach to ADHD:Ritalin:
No side effects.Long list of side effects including nervousness, tics, insomnia, weight loss, psychosis, etc.

 

Lower cost.The cheapest discounted Ritalin will cost about $400 per year for 30-40 mg per day. Full price and higher dosage could easily triple that amount to $1,200.
Long-lasting improvement: Mental health benefits from dietary supplements can last for at least one year after stopping supplements.Ritalin works only for as long as it is taken.

 

 

Before we discuss diet, let’s take a look at how started down this path of declining mental and physical health.

Replacing Fat with Sugar

In the 1970s, the nutrition advice of the U.S. government underwent a radical change in an effort to stem rising heart attack rates in men. Wanting a quick solution, politicians seized on the results of the earliest studies, ignoring researchers who cautioned them to wait until all the data was in. Worse yet, the new nutrition guidelines targeted adult men, ignoring children’s differing needs. The assumption that the new guidelines were safe for all has since been proven incorrect. The diet, moreover, did not prevent male heart attacks.

The new policy recommended eating a carbohydrate-loaded diet and restricting fats, especially saturated fats. People stopped eating animal fats, and ate more sugar, a simple carbohydrate. Manufacturers “improved” tasteless, boring, fat-free snack foods by adding sugar. The resulting products were sold as health food, while butter and fatty meats were said to be dangerous. Sugary foods were even marketed as low-fat and heart-healthy, despite being mostly devoid of nutrients.

Snackwell Devil's Food cookies were low in fats, high in sugar
The Snackwell Effect: high-carb, low-fat cookies touted as a health food

The new food items were a win for food companies because they were cheap to produce and had shelf lives stretching far into the future. Some breakfast cereals were over 50% sugar, while claiming to be good for children. Now that we have adult-onset diabetes in kids under ten, we’re beginning to see that sugar was never just a source of empty “fat-free” calories.

Inexpensive high-fructose corn syrup (HCFS) was first marketed in the late 1960s, and plugged as healthier than sugar, because fructose doesn’t raise blood sugar. But HFCS is 45% glucose, 55% fructose, while table sugar is 50% glucose, 50% fructose. There’s no great difference between the two. And while fructose doesn’t raise blood sugar, it does go straight to the liver, just like alcohol. Children who drink large quantities of sugary soda, use lots of sugar-laden ketchup, and eat sweet treats, may just end up developing non-alcoholic fatty liver disease (NAFLD).

Hidden Sugar

Today the CDC recommends limiting sugars, but other than recommending that kids under two avoid added sugar, fails to specify how much sugar is too much.  We’re used to a sweet edge on food, so manufacturers add sugar to commercial foods to make them taste better. As parents and consumers, we do however, have the right to check packaged foods for hidden sugar and to choose sugarless items.

Avoiding sugar except for rare treats makes sense. According to pediatric researchers, NAFLD is now common among children, affecting 3-12% of children, in general, and occurring in 70-80% of obese children. After 2020, NAFLD will become the most common reason for liver transplants. For kids, and especially teens, obesity creates its own world of mental anguish, as obese kids often face rejection and bullying.

Sugar may create behavior issues, too. Many parents note that children are more manageable on a low-sugar diet. Kids seem to have better focus and concentration without sugar. Sugar may be harming our children’s mental health. Mental health statistics suggest that lowering dietary fats and replacing them with sugar has only made things worse.

The Wrong Fats

Until 1990, McDonald’s used beef fat to make its crispy fries taste hearty. But a consumer advocate group believing the early, flawed research results, waged war on saturated fats. McDonald’s switched to a “heart-healthy” fat for its fries.

The food industry already had an inexpensive answer to the fat conundrum. Crisco and margarine had been around since the early 1900s. These hydrogenated trans fats made from vegetable sources replaced “unhealthful” animal fats. Trans fats were vegan and miraculous for food texture—until 2001, when we found out just how bad they are. Heart inflammation and brain issues such as memory loss are just two side effects of these solid fats.

The food industry switched to liquid vegetable oils. But when repeatedly heated to high temperatures these oils produce dangerous, cancer-causing acrylamides. Eating foods deep fried in these seed oils during pregnancy deters fetal brain development. That means that families eating lots of deep-fried foods are at risk for brain issues.

Because we traded bad fats for worse fats.

Most commercial vegetable oils, for instance canola oil, are unstable seed oils, and are best avoided. Such oils are high in unhealthy Omega 6 fats and low or without beneficial Omega 3 fats. As a rule, if an oil can’t be produced outside of a factory, it is inflammatory. Inflammation is responsible for many harmful disease processes throughout the body.

complicated canola oil production versus simple olive oil extraction puts olive oil in the family of good fats
Canola oil is extracted with multiple chemical processes; olives are simply pressed to release their oil.

Better Fats, Better Brains

If canola oil is bad for your child’s general health and brain health, what fats are good? For non-meat, non-dairy options, coconut oil, cold-pressed extra virgin olive oil, or avocado oil are all good choices. Coconut oil contains medium-chain triglycerides (MCTs) which are great for brain health and mental clarity. Avocadoes are a food source containing healthy fats.

We need healthy fats because the nervous system needs fat for proper function and because the human brain is 60% fat. Brain growth and development reach their full potential when we eat a traditional pre-industrial diet of home-cooked foods. In spite of what we now know, current CDC recommendations still advise a low-fat diet for children.

Cleveland dentist, Weston A. Price, demonstrated a number of the benefits of animal fats in the 1930s. Adding good grass-fed butter to the diet resolved nutrition and health issues in malnourished inner-city children, including tooth decay. These days, the CDC-recommended low-fat diet has left even affluent children malnourished.

Important: Fat-Soluble Vitamins D, A, and K

Parents once gave kids butter and cod liver oil rich in Vitamins D, A, and K, to keep them healthy. We ate fatty foods and foods fried in animal fats. The high-carb, low-fat trends of today’s Standard American Diet have left us literally SAD and reeling from depression. By putting nutritional fats back into the diet we can turn that frown upside down.

Vitamin D

Most people including children are, today, deficient in Vitamin D, a major cause of depression. The two sources of Vitamin D are sunshine and food. When kids play mostly indoors, they lose out on sun exposure. This means kids make less Vitamin D in their skin. Instead, they get their Vitamin D from milk with added Vitamin D2, which is inferior to the D3 we make in response to sunlight or consume from animal sources.

Animal sources are the most bio-available form of D. Bio-availability means that a nutrient source is eaten in the same form that our body uses directly. Non-bio-availability means that a chemical conversion is required, and this usually means a shortfall in that nutrient.

Why do we need Vitamin D3? Vitamin D3 acts as a hormone in the body. It helps us fight viral infections; absorb calcium for growth and maintenance; and regulate blood pressure. The mental wellness effects of D3 were well-known to traditional peoples who prized fatty fish.

Dr. Jay Wortman, a Canadian M.D. and researcher, interviewed an older First Nations man about his traditional diet, which includes oil from the oolichan fish. High in D3 and other fat-soluble nutrients, oolichan oil was described by his grandfather as “your sun in the winter”. In the far north, the mood-boosting effects of the oil are important in the long, dark winter. Another key component of that northern diet is salmon, also a fatty fish. Traditional peoples did not avoid fats; they prized them as health-giving components of a proper diet.

Native American smelting process for oolichan or eulachon fish, a source of healthy fats
Oolichan or eulachon fish were a prized source of healthy fats for the indigenous population. Here they are rendered to extract the fat.

A diet deficient in D3 can mean poor mental and physical health. Correcting D3 deficiency may help fight autism. D3 acts to combat depression. Diagnosing and correcting a deficiency in Vitamin D3 levels should be the first line of treatment for depression. If your child suffers from depression, you will need to tackle the problem with sunshine and outdoor exercise, fatty fish, or D3 drops. You can check recommended sun exposure times for season and location here.

Vitamin A

Vitamin A is another important vitamin that fights infections, and long-term deficiency causes night blindness. A lack of Vitamin A leaves one prone to infectious diseases like pneumonia and measles. Enough Vitamin A means the ability to fight off serious infections. For school kids, that’s a big edge, especially in flu season.

Some think that a low-fat carrot muffin made with vegetable oil has enough beta carotene to provide Vitamin A. But the beta-carotene in carrots and yellow vegetables doesn’t readily convert to enough usable Vitamin A. That does not mean you shouldn’t eat yellow vegetables. It means you need to add a meat source, for instance liver, once a week, to get enough bio-available Vitamin A in your diet.

Start serving liver when children are young, and you won’t have to introduce it later. The secret is not to overcook liver, and to serve it with a smile. If kids won’t eat liver, try flavored cod liver oil for a balanced dose of A, D3 and other essential nutrients.

While Vitamin A is essential, you can get too much, so:

  • Always check dosage information for your child’s age and body weight.
  • Keep your pediatrician in the loop whenever you use supplements.
  • Remember it is always best to get nutrients from food.

Vitamin K2

Vitamin K2 is another key nutrient we are coming to appreciate for its many health benefits. Vitamin K2 has many important and distinct functions.

K2 Functions:

  • Supports brain function
  • Supports growth and development
  • Keeps skin healthy
  • Reduced inflammation
  • Prevents heart disease
  • Maintains bone strength
  • Prevents cancer

Eating foods with Vitamins K2, D3, and A will keep your child in good mental and physical health. We’re still learning about the best K2 food sources.

K2 Food Sources:

  • Fermented foods like natto and sauerkraut
  • Meats, including beef, chicken, and cured meats such as salami
  • Chicken liver
  • Butter and fatty cheeses
  • Egg yolks

Health and dietary trends show that the outmoded low-fat, high-carbohydrate diet recommendations aren’t working. Replacing fats with sugar, damages the health. Yet we stick with poor government advice. Mental health issues, childhood obesity, and diabetes are epidemic. Yet these urgent issues have not made a dent in the anti-fat CDC guidelines. Happily, parents have the power to make food choices for their children.

Real Food and Fats for Better Mental and Overall Health

Simple diet choices can have major impact. Serve kids real foods like eggs scrambled in grass-fed butter instead of breakfast cereal. Use full-fat cheese and olives on a lunch salad, and nourishing meats and fish for dinner. You don’t have to labor for hours, just plan ahead when shopping. Fish and hamburgers each take 20 minutes, tops. Frozen veggies like cauliflower, broccoli and spinach can be cooked with butter and full-fat cream or coconut cream. Blend veggies and cream with an immersion blender and a few seasonings for a hearty, filling soup. Add eggs instead and bake a casserole that can also be packed as tomorrow’s lunch along with a handful of nuts.

Cooking real food doesn’t have to be hard, and kids will find the fats so satisfying and filling that they won’t be looking for overpriced between-meal snacks.

This writer strongly believes that the evidence is sufficient and urgent enough for parents to make bold dietary decisions for their families. Our children’s mental and physical health are at stake. Our national institutions show little interest in revoking long-held and long-discredited nutritional advice. But there’s no time to wait. It’s up to us to protect our children.

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Kate Spade and Anthony Bourdain: Mental Illness, Suicide, and Stigma

The suicide of two celebrities in a single week. Two people who had it all, Kate Spade and Anthony Bourdain. No one spoke of their pain beforehand. None of us knew.

What does this mean for us as parents?

It means that after all this time, there remains a stigma associated with mental health that prevents people from talking about their health concerns. Which begs the question: if there had been no stigma regarding mental health issues, would these two celebrities and countless others now be dead by their own hands? If they hadn’t been afraid to reach out for help, or perhaps ashamed to do so, might they have received the help they needed to stop them from ending it all?

The stigma that makes it so difficult to speak of these things makes it even more imperative to speak about mental health year round and not just in May, a month arbitrarily chosen as National Mental Health Awareness Month. We must put a spotlight on the impact of dialogue. Especially when it comes to kids and teens.

Girl feels isolated, a risk factor for suicide

Mental health problems are not limited by age, and are in fact common among children and adolescents. Most children understand the meaning of the word “suicide” by the third grade, which should shock and dismay us as parents. As for teens, according to the Centers For Disease Control (CDC), suicide is the leading cause of death in young people aged 15-19, with the leading cause of teen suicide being mental illness.

So where do we go from here? How do we remove the stigma? Facilitating dialogue is the obvious first step. And beginning the discussion of mental health at a young age will naturally translate into a better-educated adulthood. One where a Kate Spade or an Anthony Bourdain could speak of their issues publicly and receive the help and support they need. To make positive change, in other words, we must start having tough conversations about mental health with our kids.

Understanding Diagnosis

Underscoring the fact that mental health should be an ongoing discussion, the National Alliance on Mental Illness  has found that, “more than 90% of children who die by suicide have a mental health condition.” Understanding mental health and its role in our overall health is essential. The more knowledge you obtain, the easier it is to understand the importance of diagnosis and treatment.

Take depression, for instance. Thirteen percent of 12 to 17-year-olds experience some type of depression. As parents we need to know that depression is diagnosed when five of the following symptoms are present:

  • Feeling sad, or irritable and angry, nearly all the time
  • No interest in day-to-day activities
  • Loss or increase of appetite, noticeable weight loss or gain
  • Can’t sleep or sleeps too much
  • Nervous and jazzed up or listless
  • Tired all the time, has no energy
  • Feeling worthless or guilty without cause
  • Can’t concentrate or make decisions
  • Thinks about or talks about death and dying and suicide; May have a suicide plan

Boy feels hopeless, a risk factor for suicide

If your child has been diagnosed with a mental health disorder, you may not know where to begin, or what questions to ask. You might take to Google and research your child’s mental health problem. But it’s difficult to know which resources are trustworthy. One good place to begin is Jumo Health. Among its many free health materials are several mental health resources geared to the layman.

There are Jumo discussion guides, for most of the common mental health issues affecting youth, for instance Attention Deficit Hyperactivity Disorder (ADHD), anxiety, and depression. Each guide contains a set of questions that are illness-specific to help guide conversation between patient (or parent of a patient) and doctor. The doctor is a key resource in any mental health quest, the address for questions and a place to receive answers, too.

In addition to education, it’s important to establish the utter normalcy of a struggle with mental illness, to create an authentic voice for those who suffer. Jumo offers podcasts that follow the stories of real teens living with illness, including a series specific to mental health and suicide prevention. A teen can listen to the story of Gianna, for instance, a teenager who suffers from depression and anxiety.

Sympathetic mental health professional listens to teenage boy

In her podcast, Gianna shares her experiences with mental illness and a suicide attempt in order to connect other teens to her journey in a relatable manner. Hearing a real person like Gianna talk about a diagnosis of mental illness can allow other sufferers to feel a sense of camaraderie. Listening to Gianna speak, teens can come to feel that they are not alone.

Knowing the Risk Factors

Mental illness, for example depression, is the leading cause of teen suicide. But while depression and other mental health conditions are risk factors for suicide, a diagnosis of mental illness is only one signpost. Other behaviors and risk factors for suicide that should alert parents of teens to the possibility of suicide include:

  • Chronic physical illness
  • Family history of suicide
  • Substance abuse
  • Feeling hopeless
  • Lack of impulse control
  • Acts out, is aggressive
  • Loss of income/financial problems
  • Social issues
  • Loss of or lack of social network, isolation
  • Loss of a relationship
  • Easy access to suicide means and methods
  • Knows someone who committed suicide
  • Past suicide attempt(s)
  • Mental health issues including depression, anxiety, and schizophrenia

Crying teenage girl on sofa hugs pillow as she speaks to older mental health professional about suicide

To be clear, having risk factors for suicide does not mean that your child will try to commit suicide. However, teens showing signs of these risk factors means there is a higher risk for attempting suicide than for those teens who do not have these behaviors and risk factors. To limit a teen’s risk for suicide parents should:

  • Offer easy access to treatment for physical and mental health disorders and for substance abuse
  • Limit access to methods and items that could be used to commit suicide
  • Provide unconditional support from a variety of sources, for instance, family, friends, and community
  • Work to build good relationships with and provide easy access to physical and mental health care professionals and personnel
  • Practice social skills at home, for instance problem-solving and nonviolent conflict-resolution
  • Hold and express strong household or personal religious and/or cultural beliefs that discourage suicide

Know whom to call if you need help. If you or someone you know is suffering from the threat of suicide, The National Suicide Prevention Lifeline provides instant contact with a mental health care professional. Anyone who is depressed, thinking about committing suicide, or simply needs to talk can use this service. The lifeline provides free, confidential support to those in distress 24 hours a day, 7 days a week. If you are in need, you can reach the lifeline at 1-800-273-TALK (8255). There may be other local prevention and crisis resources for you and your loved ones.

Here is what you need to know: you can be the difference. The solution to improving the discussion on mental health is through awareness, education and support. You can break the stigma by beginning conversations about mental health. And that’s important, because those who are struggling should not feel ashamed or be afraid to speak out about mental health. To the contrary, asking for help and receiving treatment is something to be encouraged, a matter of pride.

Our teens see the deaths of Kate Spade and Anthony Bourdain and they wonder: is suicide an option for me? We must let them know that the only option is to say, “I’m suffering. Help me, please.”

And then we must follow through with kindness and compassion. We must let them know we stand behind them no matter what and no matter how long it takes to get better. Because love is love: it knows no boundaries or shame.

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ADHD Symptoms: ADHD or Sleep Deprivation?

ADHD symptoms can sometimes be a sign of simple sleep deprivation. That’s the upshot of the discussion at a recent conference in Paris. Psychiatric researchers presented a roundup of the data that suggests that sleep and attention deficit hyperactivity disorder (ADHD) are linked. Some of the experts, however, remain unconvinced that such a connection exists. Instead, they say the ADHD symptoms we see in sleep-deprived children only mimic the symptoms of ADHD. What we’re really seeing, say these dissenting experts, may be a sleep disorder.

That’s important, because the upward increase in the number of children diagnosed with ADHD is striking. We need to know if it’s possible we’re not seeing ADHD after all, but something altogether different. If it’s not ADHD and we treat the symptoms with drugs, we may not be addressing the root cause, and may even be making things worse. Especially since some medications for ADHD, for instance, Ritalin, can make it difficult for children to sleep.

“If adults don’t get enough sleep, they’ll appear sleepy,” says Dr. Syed Naqvi, a pediatric sleep expert at UT Southwestern’s Peter O’Donnell Jr. Brain Institute and Children’s Health. “Children don’t do that. They show ADHD-like behavior instead—hyperactive or inattentive.”

Dr. Naqvi says he sees lots of children in his practice who have been diagnosed with ADHD whose behavior doesn’t respond to medication. What they really need is sleep. Once the issue of quality and duration of sleep is treated, the symptoms improve.

ADHD Symptoms from Ritalin

Naqvi has seen the occasional case where ADHD medication was the actual source of the sleep problem. In other words: these kids with ADHD symptoms didn’t actually have ADHD. They were exhibiting the symptoms of ADHD because they needed better and more sleep. And the drugs they were given for their ADHD symptoms exacerbated their sleep issues and caused them to be even more symptomatic. They needed sleep, not Ritalin.

Dr. Preston Wiles, an ADHD expert with the O’Donnell Brain Institute, agrees that the rise in the number of children taking medications for ADHD symptoms is “concerning.” Wiles says the increase in pediatric prescriptions for ADHD medications is due, in large measure, to the fact that there are so few clinicians who are qualified to render an accurate diagnosis of ADHD. Many of the “experts” prescribing these medications have little understanding of child behavior.

“Pills can be a poor substitute for taking the time to truly understand what is going on with behavior,” Dr. Wiles says.

Little Girl wearily rubbing her eyes
ADHD symptoms or just plum tuckered out?

Kars4Kids spoke with Dr. Naqvi to find out more about why children aren’t getting enough quality sleep and what parents can do to help:

Kars4Kids: What is the impact of technology, for instance, kids texting friends at night and the exposure to bright screens, on our children’s quality and quantity of sleep?

Dr. Syed Naqvi: Using technology in the bed with blue light-emitting screens or socializing at that time results in increased arousal and stimulation of the brain that should actually be winding down time in preparation for sleep. Such technology use frequently results in an artificial delay in sleep, causing inadequate sleep which in turn, impacts on daytime alertness.

Kars4Kids: What can parents do to improve a child’s quantity and quality of sleep?

Dr. Syed Naqvi: Parents should make sure there is a consistent routine for bedtime for the whole family with dimmer lights and a quiet environment, and allowing for age-appropriate sleep time and duration. Control the use of technology an hour before bedtime, and limit caffeine or sugary drinks intake from late in the afternoon. Younger children should go to sleep earlier, teenagers a little later.

Kars4Kids: Is it safe and/or effective to give children melatonin to help improve quantity and quality of sleep?

Dr. Syed Naqvi: Normal children do not need any sleep aid. Melatonin in small amounts may be used in select cases and is generally safe. Discuss the issue with a sleep specialist for a persistent sleep difficulty or any other need for using melatonin.

Mother showing tired boy with ADHD symptoms that it's time to go to bed
Is he exhibiting ADHD symptoms? He may just need more sleep.

Dr. Naqvi also offers a few tips to help parents figure out whether sleep disturbances may be affecting their children’s behavior:

  • Watch for signs of breathing problems, for instance snoring or short intervals where breathing is halted. If you see possible signs of breathing problems, have your child evaluated by a sleep expert.
  • Measure the duration of nighttime sleep the child is getting and monitor any daytime sleepiness.
  • Monitor your children’s school performance and seek help if things don’t improve after starting on ADHD medications.

How Does the Brain Learn?

How does the brain learn and truly absorb the information it receives? The brain learns through a process of Sequencing: putting information into the right order; Abstraction: making sense of that information; and Organization: using the information to form thoughts. When the brain completes these three steps of processing information, this is called Integration.

The term “integration” is a way of saying the brain has learned something. This may be input from the classroom, or input from life. A child can learn how to add and subtract in the classroom. The child can also learn through life experience that touching a hot stove can burn the skin and cause pain. No matter the source of the information, once it is input and integrated, the brain understands the information it has been fed.

How does the brain, this remarkable organ, take in the information it receives, make sense of it, and use it to create and do incredible things? And what happens when something goes wrong along the way? Is there a way to assist the brain in understanding and absorbing information?

Answering these questions begins with knowing how the brain learns, or the steps we take in processing information. The three steps of the brain’s unique learning formula (sequencing, abstraction, and organization), also provide clues where there are learning difficulties. These clues can ensure we offer children with learning problems the right kind of help.

How Does the Brain Learn: Sequencing

What kind of problems might be spotted as the child learns information? A child might, for example, have a problem with sequencing. If the child has a consistent weakness in this area, a learning difficulty or disability might be suspected. A child may have trouble learning to count, for instance. This might suggest the child has trouble sequencing numbers: putting them in order.

Confirmation that the difficulty has to do with sequencing might come when the child then has trouble learning the correct order of the letters of the alphabet, or the months of the year. When one looks at all the difficulties the child has, and sees they are about placing information into the correct order, two things become clear:

  • The child’s brain has a problem with processing information
  • The specific neurological (brain) problem is sequencing: putting information in order.

How Does the Brain Learn: Abstraction

Once the brain has the information sorted into the right sequence, it’s time to understand the meaning of the information (abstraction). Most children with learning difficulties have no serious problem with this part of learning. Abstraction is about things like understanding symbols (for example, a stop sign), or the meaning of a word (sit, eat, sleep). These are basic brain tasks. A child with a serious problem in the area of abstraction wouldn’t have a learning disability or difficulty, but an intellectual disability.

How Does the Brain Work: the brain does abstract thinking in the chemistry lab

There can, however, be minor problems with abstraction. A person who doesn’t “get” jokes, and doesn’t seem to have a sense of humor, may have a problem with abstraction. A person who doesn’t understand puns or idioms may be having problems with abstraction. Call this person a “pig” and he won’t understand that the word “pig” is not just an animal, but an insult. These types of abstraction issues are exceptions to the rule.

How Does the Brain Learn: Organization

When we think of organization difficulties, it’s easy to imagine a child with a messy room. The child can never find anything. Nothing has a specific place. The child loses things, forgets to bring important items to school, mislays homework, text books, notebooks. These issues may extend to time management. The child is always late and can never turn in assignments on time.

Each of these scenarios: messy room; losing things; forgetfulness; time management issues, have to do with different pathways in the brain. Learning creates new brain pathways. When we call on these brain pathways, electrical impulses light up and activate those parts of the brain.

In some children, the wiring gets crossed or tangled. In other children, the brain pathways may be damaged. Since the circuit in the brain is interrupted, the information never gets to where it is sent, at least not in the form it was intended. Sometimes only part of the information is sent. This leads to incomplete or flawed information processing.

tangled wires

When such processing problems repeat on a regular basis and interfere with the child’s learning, it is time to think whether the child might have a learning difficulty or disability. This is where an evaluation is both necessary and helpful. A thorough evaluation can help pinpoint subtle issues in brain functioning. This can tell parents and educators where the failure is occurring within the three-step procedure of information processing.

That doesn’t mean an exact diagnosis is easy to obtain. A child who calls a fork, a “korf,” may have a problem, but it is difficult to say what the problem might be. It could be the child has a problem with sequencing, verbal output, or auditory processing. The mispronunciation may be about integrating any or all of the these processing areas into one solid whole. For this reason, the child must be assessed in all of these areas.

How Does the Brain Learn: Basic Skills

Whether the problem is sequencing, abstraction, organization, or something else, If a child’s brain has a problem processing information, the child may find it difficult to learn even basic skills such as reading, writing, and arithmetic. When neurological (brain) processing interferes with reading, for instance, the child will be said to have dyslexia. When a processing problem interferes with learning to write, we call it dysgraphia. A problem with processing numbers is called dyscalculia. These are just three examples of learning difficulties that are labeled according to the specific skill sets affected by neurological processing problems.

Learning difficulties are not limited to basic skills. Sometimes processing problems interfere with a child’s higher level skills. Higher level skills include managing time, organization, and abstract thinking. Here too, a learning difficulty is recognized according to the specific processing issue.

How Does the Brain Learn: Four Areas of Processing

A child’s processing problem may have to do with taking in information (input); or it may be about making sense of information (integration). For another child, the difficulty may be storing information and retrieving it for later use (memory). In some cases, a child may have no trouble taking in information, making sense of it, and remembering it, but can’t use this information to form words, write, draw, or gesture (output). It is in one or more of these four basic areas that children diagnosed with learning difficulties will be found to have a processing problem.

Input Output sockets

When the brain receives information, this is called input. Sometimes input is visual, or information we understand with our eyes. Sometimes input is auditory, or information we understand with our ears.

How Does the Brain Learn: Visual Input

A difficulty with visual input doesn’t mean, for instance someone who has a vision problem, such as near or far-sightedness. A visual input problem has to do with the way the brain understands what is seen. If the brain sees letters in reverse, for example, this might be a visual input processing problem.

Let’s say a child has trouble with the mechanics of catching a ball. In order to catch the ball, the eyes have to focus on the ball. This is called figure-ground. At the same time, the brain must be able to pinpoint the position of the ball and its path (depth perception). This helps the body understand where and when to move. Finally, the body must obey the brain’s commands, to stretch out the hands and actually catch the ball as it arrives. If the child misjudges the speed of the ball, or how far it must travel, or if the brain doesn’t issue the right commands to the arms and hands, the child may very well fail to catch the ball.

These are just two examples of visual processing problems. In one example, the visual processing problem leads to letter reversals. In the other example, visual processing problems quite literally lead to dropping the ball. There are many other ways we might see the effects of visual processing problems.

How Does the Brain Learn: Auditory Input

Just as a visual processing problem isn’t about being near or far-sighted, a difficulty with auditory input doesn’t mean that someone is, for example, hearing challenged. An auditory processing problem has to do with the way the brain understands what is heard. A child who has an auditory processing problem, may, for instance, be unable to understand how the words too, two, and to are not the same word. This can lead to confusion when the child hears these words in spoken sentences.

In another example of an auditory input processing problem, the child might need more time to understand what is heard. Because of this, the child misses some of what you say because the speed of your speech is too quick for his understanding. This is called an “auditory lag.”

Children can have both visual and auditory processing problems. This might make it difficult for a child to make sense of what is happening when the child receives visual and auditory information at the same time. An example of this could be the student who sees writing on a blackboard while listening to an explanation of those words.

How Does the Brain Learn:  Integration

Once input is complete, through visual and/or auditory means, it’s time for the three-step integration process. The brain must put all the information into the right order (sequencing). The brain must be able to understand how to use the information (abstraction). Last of all, the brain must take each piece of information and add it to the whole to make a complete thought. This type of organization of information is the final step in integration. It is what makes integration complete.

How Does the Brain Learn:  Memory

At this point, learning is still not complete. Will the brain hold onto the memory for tomorrow’s French test (short-term memory or working memory), or will the child remember that French phrase ten years later (long-term memory) when she visits France as an exchange student? Like abstraction, it is unlikely that your child would have a serious long-term memory disability. Such a problem would not be a learning difficulty, but rather an intellectual disability.

A short-term memory disability, on the other hand, is a real phenomenon. You see it with the child who spends hours memorizing the names of countries on a map for geography class and then forgets everything during the test the next morning. By the same token, the teacher may be very patient in the classroom, explaining how to divide fractions. But when the child pulls out her math homework that night, she cannot remember how to do the work.

How Does the Brain Learn:  Output

The final step in learning is actual using the information. This is called output. Output may be verbal, by way of spoken words or language, or motor, which is by way of muscle activity. Motor output includes drawing, writing, and pointing, for example. A child with issues in these areas might have a language disability or a motor disability.

There are two types of language we use to communicate: spontaneous language and demand language. Spontaneous language is where you begin a conversation. You’ve chosen the topic, and had time to think about what you’re going to say. Most children have no problem here.

In demand language, however, someone might ask you a question. You haven’t chosen the subject, thought about your response, or organized your thoughts. You’ve got this split-second to answer the question. For the child with a language disability, this is a tongue-tying situation. The child may ask you to repeat the question, or simply answer, “What?” or “I don’t know.” Some children will respond but the response won’t make any sense—won’t seem to relate to the question.

Child draws outline with colored pen

In motor disabilities, the child may have a problem using the large muscle groups. This is known as a gross motor disability. For other children, it’s hard to perform tasks that requires using many muscles to work together at once. This is called a fine motor disability.

A child with gross motor disabilities may always be tripping over her own feet. She might fall a lot, spill her milk, bump into things, and drop things often. The child will find it hard to learn how to swim or ride a bike.

A child with a fine motor disability may have trouble writing or speaking. The child who has trouble speaking because of a fine motor disability may find it difficult to coordinate all the parts of the mouth, tongue, throat, and face used in speech. Writing, on the other hand, requires coordinating the use of many muscles in the hand at the same time. Children with handwriting problems may write slowly, or have messy handwriting. The child may even find that the writing hand, when writing, develops a cramp.

This should be considered a very broad overview of a complicated subject. For more information, follow the links for deeper reading. If you suspect your child has an information processing problem or learning disability, it’s important to have the child evaluated.

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Manage ADHD by Developing Skills

You can’t manage ADHD with drugs alone. Anyone who has ever parented one of the 6 million children in the United States age 4-17 diagnosed with the condition knows that. But with school now back in session, frustrated parents and their children may be asking what more can be done to manage ADHD and its symptoms. Because taking drugs isn’t enough, and may not even be the right way to go.

ADHD is complicated. It makes learning difficult. That’s why children with ADHD need a great deal of support from their parents, teachers, and school counselors. A school counselor, in particular, can play a special role in helping students with ADHD by serving as an intermediary between parents and teachers.

With so many children experiencing ADHD, it becomes crucial to offer them some sort of support system that goes beyond purchasing a prescription and hoping for the best. Here, school counselors can fulfill an important function, by serving as the pipeline for communication between parents and teachers. School counselors can also be an important resource for all those who work with children with ADHD, both in and out of the classroom. While most children are diagnosed with the combined form of ADHD, the presentation of symptoms can change over time. The school counselor can offer strategies to cope with changing behaviors as these changes arise.

In order to manage ADHD, however, it is important to gain an understanding of the skills a student with ADHD must develop. The aim of any therapies for ADHD must have, as their ultimate goal, improved impulse control, time management, and the ability to focus or concentrate on tasks. If students fail to develop these critical skills, they will remain in perpetual frustration, become worn out from trying so hard, develop poor self-esteem, and suffer from acute embarrassment, as well.

One practical way to help students with ADHD develop these skills is to provide them with a dependable structure. A student who struggles with forgetfulness, for instance, should be made to do homework at the same time every day. Over time, the student internalizes that homework is always done at 4 PM, so that when 4 PM rolls around, the student knows just what to do and never forgets. A student who tends to forgetfulness can also be instructed to store his schoolbooks in one designated space. Since the item is always placed in the same spot, there will never be a time when the child cannot find the item. These are meaningful methods for developing time management and organizational skills to really address and manage ADHD.

But let’s say there is to be a school field trip at 4 PM on a certain date. That can throw the student with ADHD for a loop, since 4 PM is homework time. The student should be prepared well in advance of any such changes in schedule or routine. Talking about how and when the child will get dressed, do homework, and eat on that day is going to be a necessary conversation that may have to be reviewed several times over several days or weeks. Students with ADHD need lots of help and much spatience in learning to organize their time.

As for developing a student’s powers of concentration and focus, ADHD expert Dr. Edward Hallowell believes Dr. Edward Hallowell, ADHD expertthat staying focused for shorter periods of time is the right way to go. “Kids with ADHD must learn to manage large projects. Break down large topics or tasks into small, manageable bits. For example, a book report might be subdivided into eight steps, or a science project outlined in a dozen doable steps. This helps the child with ADHD not feel overwhelmed.”

Strategies to Manage ADHD

These coping tips and tricks help students manage ADHD symptoms by teaching them strategies that have been proven to work, based on evidence. Such strategies are called evidence-based interventions (EBIs). An example of an EBI would be helping the parents of the student with ADHD to develop and put into place a system of organization to assist the student in carrying out more homework assignments and chores and getting them done on time. Parents might use calendars, charts, notebook or computer, and class syllabi to make it work.

Anil Chacko, a professor for Counseling@NYU’s online master’s in school counseling program from NYU Steinhardt, describes some strategies that school counselors can use when working with students who have ADHD. “School counselors should utilize methods that support students’ time management, planning, and organization,” Chacko says, citing the work of Joshua Langberg at Virginia Commonwealth University (VCU) and Howard Abikoff at New York University’s (NYU) School of Medicine, leading scholars in the field of ADHD in children and adolescents. “I would also encourage school counselors to work directly with parents to create a school-home note system to support cross-setting changes.”

Dr. Langberg developed and published the successful Homework, Organization, and Planning Skills (HOPS) intervention. HOPS is about teaching kids to use physical organization tools, for instance book bags, binders, and lockers, and homework management tools such as writing down assignments and recording them accurately, entering test dates on a calendar, and in general, planning things out.

Dr. Abikoff researches interventions and training in children with ADHD, for instance Organizational Skills Training (OST). OST targets specific organizational skills goals. Here is a description of the OST program from program’s creators:

OST is a 20-session, twice-weekly, clinic-based program, which focused on building organizational skills in four areas:

  • Tracking Assignments: Teaching students a system for consistently recording assignments and due dates in a specially designed planner.
  • Managing Materials: Providing students with methods for storing and organizing their papers and materials through the use of an accordion binder system, materials checklists included in their planner, systems for organizing their desks, and by developing prominently visible checklists for backpacks and other tools for material transfer, as well as other related strategies.
  • Time Management: Helping students become more aware of their use of time and how to plan ahead to structure their time effectively through the use of an afternoon scheduling component in their planners; helping students improve their time estimation skills and their awareness of how much time they need to complete tasks; teaching students to work efficiently by minimizing distractions in their work spaces.
  • Task Planning: Showing students how to break larger projects and goals into steps and create schedules for task completion through the use of task-planning pages in their planners.

OST students are taught that each OTMP (organization, time management, and planning) problem area is the result of a brain “glitch.” Each glitch is depicted as a naughty character who likes to watch children make mistakes due to organizational problems. This concept helps motivate the students and makes the program “lighthearted and fun.” The concept of glitches is also meant to make the issues encountered by students with ADHD less personal. Kids come to understand that it’s not they who fail, but the symptoms of ADHD getting in the way of their academic and social success.

Each organizational skill is taught using the same basic method:

1) The new skill is discussed, defined, and explained. A rationale is given for the importance of the skill. The child hears about the settings in which the skill might be used.

2) The skill is demonstrated

3) The skill is practiced by the child under the guidance of an instructor and feedback is given. The skill is practiced many times. The student is taught to identify situations in which the skill should be used.

Studies as recent as this one from 2016, have found that early behavioral therapy (HOPS, OST, and the like), begun before any other interventions, such as medication, had “four fewer rules violations an hour at school than the medication-first group.” That’s not to say that behavioral therapy takes the place of medication. Medication has proven benefits for children with ADHD. What we should take away from the research is that 1) We shouldn’t begin with medication and 2) Teaching children to develop their OTMP skills even before they reach school age, can really make a difference. In terms of cost, by the way, behavior-first therapy is estimated to cost an annual $700 less per year when compared to medication-first treatment.

Strategies for Teachers

Besides using EBIs like OST and HOPS in their work with children, school counselors can also train teachers to support children who are coping with ADHD in the classroom. A school counselor might, for instance, suggest the teacher give out points or tokens for good behavior. Here are some other practical tips from the National Resource Center (NRC) on ADHD:

For the easily distracted student (predominantly inattentive)

  • Seat the student close to the teacher’s desk and away from distractions such as windows or school corridors
  • Split long assignments into smaller segments
  • Offer more breaks during class time

For the students that fidgets and squirms (predominantly hyperactive/impulsive)

  • Seat the student where the fidgeting and squirming will be least likely to disturb classmates, for instance along the side of the classroom
  • Offer opportunities throughout the day that allow the fidgety student to move, for instance, handing out work sheets.

More Tips to Manage ADHD

Scott Ertl, M.Ed., was an elementary school counselor for 18 years before he became the CEO of BouncyBands, a device to help fidgety students cope in the classroom. Here are Ertl’s top 5 tips for helping students with ADHD succeed in the classroom:

1) The child or teacher, depending on the child’s maturity, should clean out the child’s desk every Friday afternoon so the week starts off as organized and prepared as possible.

2) Allow movement. Let the child earn the ability to deliver a book to the media center, a note to the front office, or a message to a teacher when their work is completed correctly. Bouncy Bands, yoga balls, and standing desks in class are also great ways to allow movement throughout the day. Kids need appropriate ways to release their extra energy without distracting others.

3) Set them up for success. Give them advance notice that you are going to call on them to answer a question in class so they are ready. This works much better than catching them off task as a way to shame them into paying attention.

4) Have specific goals on their desk to accomplish, like: Check over my work when completed, Make sure all of my homework is written down before leaving class, and Raise my hand to ask for help when unsure of what to do in class.

5) Communicate. Give specific feedback during the day when these goals are being accomplished to recognize their improvements. Use them as model in class to encourage other students to improve those behaviors as well.

Teachers who must manage ADHD in the classroom may also want to try using sentences that suggest an order of action, for instance, “First read all the questions, then answer them,” or, “First put your crayons away, then take out your geography book.” In addition, enlisting a student’s help can increase self-worth and help refocus the child’s energy. Teachers and parents should always watch for good behavior and give praise whenever and wherever it happens!

How Can Parents Manage ADHD?

Here are some things parents can do at home to help their children who struggle with ADHD:

  • Use a system to acknowledge and reward good behavior, for instance, a chart with stickers
  • Stick to a home routine with as little deviation as possible (e.g. homework, dinner, bedtime, and etc., are at the same time each day)
  • Create written to-do lists for chores so that the child can cross things off the list as they are done
  • Practice at home, OTMP strategies learned at therapy sessions

Professor Chacko encourages parents to educate themselves. If you have a child with ADHD, seek out information on behavior parent training programs in your area. Some consider these programs to be the most important and most effective means to manage ADHD behaviors both in and out of the classroom. Parents, along with teachers and school counselors, should also be aware that ADHD often coexists (see: Comorbidity and ADHD: It’s Not Just About ADHD) with learning disabilities and difficulties. “The challenges these children face may be more than just ‘ADHD,’” says Chacko.

What do you do at home to help support your child with ADHD?

Fidget Spinners: Help or Hindrance

Fidget spinners have been wildly popular since they burst on the scene in December 2016. Touted as a way to alleviate anxiety and the symptoms of attention deficit hyperactivity disorder (ADHD) and autism, spinners have also created not a little controversy. Teachers have had to ban them from the classroom, since the toys tend to distract, well, anyone who isn’t using one. And that would include the teachers.

Imagine a classroom filled with kids turning these things around in their hands all day long, and you begin to get a picture of what today’s classroom looks like. Unless the teacher should intervene to ban the toys. How do you teach students to conjugate French verbs or draw an isosceles triangle while 30 of them are spinning their fidget spinners?

In case you live in a cave, and have no idea what a fidget spinner might be, these handheld devices are like small propellers attached to ball-bearings. The user rotates the toy between the fingers to make it spin. The vibrations of the ever-cycling fidget spinner provide a sensory experience. The sensations help relieve sensory overload, enabling the user to regain focus, for instance in the classroom.

Fidget spinner marketing may describe the toys as aids for those with learning disabilities like ADHD, or as a device that can free up the mind to reach its fullest potential. Scientists and experts remain unimpressed. Marriage and family therapist Lisa Bahar is concerned with children developing a dependency on spinners. “The goal is to have a mindful and participatory experience in life situations. If a student is focusing on the fidget spinner the pupil is not engaged in the moment with the full sensory experience.

“Fidget Spinners are good for a beginning, but ideally children would be encouraged not to depend on them for the long process and to taper off with mindfulness practice and being present and participating. This takes practice,” says Bahar.

Dr. Fran Walfish, Beverly Hills family and relationship psychotherapist, author, The Self-Aware Parent, disagrees. “Fidget spinners are intended to help children with ADHD and Sensory Integration Disorder focus their attention. Squeezing a golf ball-sized Nerf ball or spinning a spinner helps distract the jittery, impulsive child from acting out of turn in the classroom.

“For example, if the impulsive child quickly calls out answers to the teacher’s questions before giving his classmates a chance to raise their hands, he can try spinning a fidget spinner to serve as a helpful reminder to ‘Stop, spin, raise your hand, and wait for the teacher to call your name.'”

There are, on the other hand, other toys that provide sensory stimulation without causing so much disruption. Fidget cubes, for instance are quiet and don’t draw the eye like a spinner. These dice-shaped objects fit in the palm of the hand and have various interactive doodads on the sides, for example dials and push buttons. Users simply press, click, or dial, to release pent up nervous energy. The cubes have a modest following among executives, who like to fiddle with the cubes during dull conference call meetings or while stuck in traffic jams.

Teachers might prefer their students use fidget cubes. But the fidget spinner is the runaway bestseller. It’s a fad, a trend, and the irony is that what is supposed to help kids focus, is distracting the heck out of everyone else. Especially those who must confront a classroom full of fidget spinning students each day. Dr. Wendy Hirsch Weiner, a principal and social studies teacher at a small school with an outsized population of students with ADHD finds fidget spinners make learning impossible. “Several of our students came to school with the spinners last semester and we as teachers all found that the students became very focused on the spinners and were not able to concentrate on anything else. The spinners would drop from their hands and the students would spend time finding them on the floor. Several of the kids had light-up spinners, which became even more of a stimulant and increased the hyperactivity of our already distracted students. Our school will be banning spinners this coming fall.”

Dr. John Mayer, a leading expert on kids and families and the author of Family Fit: Find Your Balance In Life, says it even stronger. “Horrible, horrible, horrible!

“First, even if they have some therapeutic benefit, a diversion device like this, takes the person away from developing ‘compensation techniques’ that are necessary for the long-term control of their condition and better functioning.

“Second, by allowing spinners in the classroom and other settings such as activities, clubs, church, what effect do these have on the remainder of the kids??

“Third, in that same respect, these spinners have disastrous effects on classroom discipline and order.”

Asked what parents should do to help their children with special needs, Mayer says, “Work with them to overcome their lack of focus in ways that are socially appropriate and build life-long skills, such as taking more time to read the material; have them make notes in the margins of books; help them to memorize material; and work with them using flash-cards and learning drills rather than toys and gimmicks.”

The fidget spinner may be the bane of every teacher’s existence, but the toys have accomplished something positive. There’s more awareness of attention deficit. There’s more awareness of the need of some children (and adults) for extra sensory stimulation as a result of the fidget spinner’s popularity.

There are some parents of children with disabilities who praise the fidget spinner to the skies. Children and adults with autism engage in repetitive behaviors to relieve sensory overload. This is called “stimming.”

Chewing on chewelry, or handling items like Koosh balls or even something as simple as a rubber ice cube tray, can help those with autism self-treat and calm their sensory overload. The fidget spinner is just the latest iteration of an old-school group of toys for this purpose. But children with autism who are mainstreamed may depend on such sensory toys to relieve the stress that builds up during the school day. It may, in fact, not be possible for the child with autism to be mainstreamed without that crutch. For such a child, stimming with a fidget spinner tends to level the playing field and make the child with autism feel less different, less stand-out, and more cool; more like her neurotypical classmates.

That’s why banning the fidget spinner can seem almost cruel. Some educators and therapists see the fidget spinners as tools rather than toys. These experts believe that fidget spinners can enhance classroom performance if accepted as part of classroom culture. In this sense, fidget spinners would be considered part and parcel of a student’s learning strategy.

Most teachers believe, however, that the spinner is thought of as a toy, used like a toy, and an annoying toy at that.

Research suggests that children with ADHD who are allowed to move around the classroom may do better at tasks that involve the working memory. This is the type of memory that is used to process new information. Another study found that children with ADHD do better in their schoolwork after exercising. “Ensuring that children, with or without special needs, have opportunities to move, stretch, and release energy throughout the school day is critical to managing anxiety, boosting focus, and helping children manage their impulses. Building in extra recess time, ensuring that kids are encouraged to move and play during breaks and recess (as opposed to habitually losing time as a punishment), and implementing curriculum that teaches stress management skills such as meditation and mindfulness are excellent ways to help students cope with restlessness and improve focus,” says Stephanie O’Leary, Psy.D., a clinical child neuropsychologist, expert in child behavior, and author of Parenting in the Real World.

Fidget Spinners Too New For Research

While no studies have specifically targeted fidget spinners—they’re too new—at least one study suggests that fidget spinners can improve the academic performance in children with ADHD. The aforementioned study found that children with ADHD who receive sensory intervention therapy sessions were better able to focus and learn without distraction in a noisy classroom environment. The therapy sessions for the students in this study included brushing the skin both lightly and deeply, swinging on swings, and working with an exercise ball.

The research does suggest that both movement and sensory stimulation improve academic performance in children with ADHD. These same studies would also appear to suggest, however, that a child who uses a fidget spinner outside of the classroom for a long enough time may also receive the full benefit from fiddling with a spinner. If your child’s teacher bans spinners from the classroom, this may be the way to go: have your child use his spinner outside the classroom at every opportunity and then see if his classroom performance improves.

Using a spinner in the hours outside of school would also solve the problem of creating a distraction for neurotypical students and teachers. Not to mention that fidget spinners are arguably dangerous. Some fidget spinners have been found to contain unacceptable levels of lead and/or mercury. Some children have choked on the small parts of broken spinners. One child had to have a piece of a spinner removed from his finger under general anesthesia. And the spinners aren’t sturdy. They break all too easily, increasing the danger to children from choking on small parts.

Experts suggest that parents read and follow age labels on fidget spinners and only purchase them at reputable toy shops. The better shops only stock toys that have undergone U.S. testing. Fidget spinners that light up should have a locked in battery. After purchase, look over the toy at least daily, keeping an eye out for broken parts that can serve as choking hazards. If the spinner breaks, replace it with a new one, following the same guidelines.

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This is How Much Sleep Kids Need to Be Healthy

How much sleep do kids need to be at their best? It’s a question parents struggle with when their children beg to sleep just a little longer on school days. Letting them sleep in means letting them be tardy for school. But letting them sleep in means healthier, happier kids, more able to take in their lessons.

On weekends and in summer, on the other hand, how long kids sleep is far less of a problem. School’s not in session, so kids can sleep ’til the cows come home, and it won’t make a lick of a difference. For this reason, summer comes to many parents as a big relief. Kids can stay up late and wake up late and there’s no need to fuss or freak out.

Of course, parents often think to themselves during the school year, if kids would only go to bed on time, they’d wake up on time. Except science tells us it’s not like that at all. The American Medical Association (AMA) has found that puberty comes with a natural shift in circadian rhythm that cause kids go to sleep later and wake up later. Which is why the AMA has recommended school start times begin no earlier than 8:30 a.m.

In addition to actively pushing middle and high schools across the U.S. to have later start times, the AMA is encouraging doctors to educate parents and teachers about the importance of sleep for good mental and physical health. By now, scientists know exactly how much sleep kids need to be healthy. They also know the impact on kids of not getting enough sleep. “Sleep deprivation is a growing public health issue affecting our nation’s adolescents, putting them at risk for mental, physical and emotional distress and disorders,” said AMA Board Member William E. Kobler, M.D.

“Scientific evidence strongly suggests that allowing adolescents more time for sleep at the appropriate hours results in improvements in health, academic performance, behavior, and general well-being. We believe delaying school start times will help ensure middle and high school students get enough sleep, and that it will improve the overall mental and physical health of our nation’s young people,” says Kobler.

How Much Sleep Should Teens Get?

How much sleep kids need is an issue that is now front and center, since just 32% of American teens are getting, on average, the bare minimum of 8 hours of sleep on school nights. Meanwhile, the American Academy of Sleep Medicine (AASM) just issued consensus guidelines on how much sleep kids need, according to age. AASM says “teenagers 13 to 18 years of age should sleep eight to 10 hours per 24 hours on a regular basis to promote optimal health.”

It’s Official!

The American Academy of Sleep Medicine (AASM) has released, for the first time, official consensus recommendations for the amount of sleep needed to promote best health in children and teenagers and to avoid the health risks of insufficient sleep:
 
 
• Infants four to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health.
• Children one to two years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health.
• Children three to five years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health.
• Children six to 12 years of age should sleep nine to 12 hours per 24 hours on a regular basis to promote optimal health.
• Teenagers 13 to 18 years of age should sleep eight to 10 hours per 24 hours on a regular basis to promote optimal health.

“Sleep is essential for a healthy life, and it is important to promote healthy sleep habits in early childhood,” said Dr. Shalini Paruthi, Pediatric Consensus Panel moderator and fellow of the American Academy of Sleep Medicine. “It is especially important as children reach adolescence to continue to ensure that teens are able to get sufficient sleep.”

So you’ve got fewer than half of all American teenagers getting the minimum amount of sleep they need to be healthy and do well in school. And we know that teens need to go to bed later and wake up later according to their natural biological sleep cycles. At the same time, some 10% of all U.S. high schools have start times of 7:30 a.m. or even earlier.

Why the early start times, if kids need more sleep, and later sleep and wake times? Schools are trying to cram in extra classes for things like sports and extracurricular activities. There just aren’t enough hours in the school day to get them all in.

Meantime, research shows that not getting enough sleep affects health, academic performance, and behavior. Lack of sleep results in poor memory and mood disorders. Teens who sleep fewer than 6 hours of sleep per night, are more likely to exhibit symptoms of anxiety and depression.

As for health, sleep deprivation can bring on high blood pressure, metabolic conditions like diabetes, and a weakened immune system. Researchers have also found a connection between body mass index (BMI) and sleep. It seems those who don’t get enough sleep are more likely to be underweight, overweight, or even obese.

Schools may struggle (as parents have struggled all these years) with finding enough hours in the school day to serve students all they want to give them, now that the AMA is pushing for later start times. But in the end, it looks like something’s got to give, and that something has got to be the schools. “While implementing a delayed school start time can be an emotional and potentially stressful issue for school districts, families, and members of the community, the health benefits for adolescents far outweigh any potential negative consequences,” said Dr. Kobler.

Ten Top Misconceptions About ADHD

Misconceptions about ADHD abound, despite the fact that at least 1 in 20 U.S. children are affected. These misconceptions about ADHD make it more difficult to identify and treat the condition, with the result that some children and adults go undiagnosed and untreated. Here are the top ten misconceptions about ADHD—some of them are bound to surprise you, while others will have you nodding your head:

#1 Misconception: ADHD is something someone made up to excuse bad behavior and poor grades

Reality Check: ADHD is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a genuine disorder that is “characterized by a pattern of behavior, present in multiple settings (e.g., school and home), that can result in performance issues in social, education, or work settings.”

The DSM-5 specifies that children must have at least six symptoms of inattention and/or hyperactivity and impulsivity to be diagnosed with ADHD, while teens and adults must have five such symptoms.

Conclusion: ADHD is all too real, affects daily life for millions of sufferers, and since it tends to run in families, may even have a genetic component.

#2 Misconception: A quiet child who sits nicely in class, cannot possibly have ADHD

Reality Check: Not all children with ADHD have symptoms of hyperactivity. ADHD has three subtypes:

  • Combined Presentation with symptoms of both inattention and hyperactivity/impulsivity
  • Predominantly Inattentive Presentation with mostly symptoms of inattention
  • Predominantly Hyperactive-Impulsive Presentation with mostly symptoms of hyperactivity/impulsivity

The second type of ADHD, Predominantly Inattentive Presentation, used to be known as “ADD” because this type of ADHD presents without hyperactivity or impulsivity. Children and adults with this type of ADHD tend to look as though they are daydreaming. They seem to be off in their own little worlds. Those with this type of ADHD often go undiagnosed because the symptoms are less obvious. By the way, people with ADHD can have one subtype of ADHD and go on to develop a different subtype.

Conclusion: You don’t have to be bouncing off the walls to have an all-too-real case of ADHD.

#3 Misconception: Kids with ADHD just need some firm parenting

Reality Check: ADHD has nothing to do with poor or lax parenting. It’s not about putting your foot down and making that child behave. While children with ADHD can be wild and out of control, this is the result of a brain-based medical condition. It’s not helpful to criticize parents who are struggling to raise kids with ADHD and will only make things worse by generating hurt feelings.

Conclusion: Parenting doesn’t cause ADHD, a medical condition that is looking more and more like a genetic disorder every day.

#4 Misconception: Girls don’t get ADHD

Reality check: More boys are diagnosed with ADHD. That’s because they are more likely to present with the more obvious symptoms of hyperactivity and impulsivity. Girls tend to get the second subtype of ADHD, Predominantly Inattentive Presentation, which is the type without hyperactivity/impulsivity. A teacher may not realize that a quiet girl who tends to daydream in class a lot, is actually showing signs of ADHD. That’s why experts believe that a lot of girls with ADHD are falling under the radar. They simply escape notice and go untreated for the condition, which is a shame.

Conclusion: Statistics show more boys have ADHD than girls, because girls with ADHD get the quieter type of ADHD and are going undetected, undiagnosed, and untreated.

#5 Misconception: ADHD is way over diagnosed

Reality Check: As awareness of ADHD grows, more people than ever before are being diagnosed with ADHD. It sometimes looks as though just about everyone has it. Because of this new awareness there is also a kneejerk tendency to diagnose and medicate children for ADHD without careful examination, when they act out in class. At the same time, research shows that ADHD is also under diagnosed among girls and minorities.

Conclusion: ADHD is both over and under diagnosed.

#6 Misconception: Kids can outgrow ADHD

Reality Check: ADHD doesn’t go away. Someone with ADHD is stuck with it for life. The symptoms may change over time and one can get better at coping with the symptoms of ADHD, but that’s not the same thing as outgrowing the condition. The symptoms continue into adulthood.

Conclusion: Kids with ADHD grow up to be adults with ADHD.

#7 Misconception:  Medication is the only thing you need to treat ADHD

Reality Check: Medications such as Adderall and Ritalin are the first line of treatment for ADHD. But there are other things one can do to help cope with the symptoms of ADHD. Behavioral therapy, for instance, can be very helpful in curbing impulsivity, and writing up and sticking to a schedule can be helpful for maintaining order in a child or adult’s everyday life. Using a system like Google Calendar is a great help here, as reminders can be scheduled, to prevent the person with ADHD from forgetting important tasks.

Conclusion: Medication is a big help for treating the symptoms of ADHD, but there are other helpful therapies and steps to take, as well.

#8 Misconception: Ritalin and other meds don’t help adults with ADHD

Reality Check: Ritalin and other stimulants used to treat ADHD are most useful in younger children. The medications help children to sit attentively and/or without fidgeting in class. After a few years of taking the medication, the children have effectively been trained to manage their symptoms and can often take  a smaller dose of medication or stop taking the medication altogether. But every case of ADHD is different and some children will continue to need medication. Sometimes, adults are not diagnosed as children, and the medication may be a tremendous help to them in managing their symptoms of ADHD.

Conclusion: Every case of ADHD is different. For some adults with ADHD, medication is very helpful for symptom management.

#9 Misconception: If you have trouble concentrating, you for sure have ADHD

Reality Check: At one time or another, everyone has trouble focusing. Not getting enough sleep, or being stressed out can affect your ability to concentrate. Vitamin deficiencies, depression, and even not getting enough exercise can make it difficult to concentrate, too. Most of the reasons behind an inability to pay attention are easy to fix and have nothing to do with ADHD.

Conclusion: ADHD should not be the only or even the first thing you think of, when you see yourself or your child having trouble concentrating.

#10 Misconception: ADHD isn’t so bad

Reality Check: People with ADHD struggle for a lifetime with managing even simple chores like paying the bills on time (which can affect credit ratings), or not leaving the sugar out of the recipe when baking a cake, for instance. The challenges of ADHD are also rough on relationships.  Finally, ADHD makes it hard to manage lifestyle issues, which leads to higher rates of obesity, which in turn may lead to higher levels of blood cholesterol, and a risk for heart disease, stroke, and diabetes.

Conclusion: Living with ADHD is hard. Minimizing the struggle and the suffering of those with ADHD is demeaning and uncaring.

Melatonin for Kids: Is it Safe

Melatonin for Kids: Is it Safe?Melatonin is a hormone that helps us know when to sleep and when to be awake. At night, our brains make and release more melatonin and this makes us sleepy. When the sun comes up, the brain slows its production and release of melatonin, so we feel wide awake.

It is light and darkness that tell the brain when to make and release melatonin. The brain produces and releases more melatonin at night in response to darkness, and less of it in the morning, when the sun is high in the sky. As long as there is sunlight or another source of light, such as a computer screen, we feel wakeful. When we stop looking at our computer screens and the sun sets for the day, we begin to get sleepy as our levels of melatonin gradually rise. This is how melatonin teaches us to be sleepy at night and awake during the day. This is called the sleep-wake cycle.

Some children have difficulties in falling asleep. Their parents, looking for a way to help them get the sleep they need, may  think about giving children melatonin pills. After all, melatonin can be found in every drugstore, in some health food stores, and in many supermarkets. You don’t need a prescription to buy melatonin.

Melatonin is thought of as a natural supplement. Since the body produces melatonin, we may see this hormone as both natural and safe. We also know that melatonin plays a role in helping us sleep and that without this hormone, we would toss and turn.

While some parents praise melatonin to the skies as a safe and natural sleep aid, other parents may express concern. Is it really safe to give children melatonin to help them sleep? Isn’t melatonin, used as a sleep aid, just a kind of sleeping pill?

Some parents find melatonin effective in helping their children sleep and continue to use it long term. They feel it is safe to do so, since melatonin is a natural substance created by the body. They see the supplements as giving natural melatonin production a boost.

Melatonin: Sleep Vitamin?

Parents may not even consult their physicians before giving their children melatonin. They reason that it would not be so easy to buy melatonin, if it was a true drug. These parents see melatonin as a sort of vitamin for sleep.

Children given melatonin may have sleep problems that are behavioral. That means that parents may not be strict enough in making kids go to sleep at a certain hour every night. It may be that the children are spending time at the computer, too close to bedtime, so that their brains don’t have time to make and release melatonin before bed. It seems obvious that instead of popping melatonin pills, it would be better to stop looking at a computer screen an hour or so before bed. That way, the body can work as it should.

Other children may have conditions that make it difficult for them to fall asleep at night. ADHD, for instance, can make it difficult for children to wind down and fall asleep at night. It’s even more difficult for kids to fall asleep at night if they are taking medication for ADHD, such as Ritalin, during the day. Autism is also a condition which can make it difficult for children to fall asleep at night. When children have true conditions that make it difficult to fall asleep and stay asleep throughout the night, here is a true reason to look into taking melatonin supplements.

But here too, parents can run into difficulties. Melatonin is not a sleeping pill. It needs to be taken at least an hour before bed. And melatonin is a hormone. Parents should consider whether they want their children taking a hormone supplement on a regular basis, long-term.

Sleep experts at the University of Adelaide, in Australia, are warning parents that melatonin, given to children as sleep aids, may cause serious side effects that show up later. No one knows for certain what melatonin, used for a long time during childhood, will do to the body. There have been no long-term studies.

The author of the Australian study, Professor David Kennaway says that the United States is the only place where melatonin is not regulated. Kennaway talks about lab studies showing all sorts of changes to body systems as a result of taking melatonin. He mentions changes to cardiovascular, immune, and metabolic systems and also says that melatonin affects reproduction in animals.

“Melatonin is also a registered veterinary drug which is used for changing the seasonal patterns of sheep and goats, so they are more productive for industry. If doctors told parents that information before prescribing the drug to their children, I’m sure most would think twice about giving it to their child,” Professor Kennaway says.

“The word ‘safe’ is used very freely and loosely with this drug, but there have been no rigorous, long-term safety studies of the use of melatonin to treat sleep disorders in children and adolescents,” says Professor Kennaway. “There is also the potential for melatonin to interact with other drugs commonly prescribed for children, but it’s difficult to know without clinical trials assessing its safety.”

Kennaway should know. He’s been researching melatonin for 40 years. His concerns, however, are going unnoticed and ignored. “Considering the small advances melatonin provides to the timing of sleep, and considering what we know about how melatonin works in the body, it is not worth the risk to child and adolescent safety,” says Kennaway, but his words are mostly falling on deaf ears.

Canadian physicians, such as Dr. Shelly Weiss, are also cautious about the use of melatonin for sleep problems in children. “Melatonin is not a magic pill. It’s a hormone,” says Weiss.

Still, for children with chronic sleep onset insomnia, which is the failure to fall asleep within 30 minutes after laying down, melatonin can be a godsend. Chronic insomnia is no joke. Lack of sleep can lead to depression, learning difficulties, and poor school performance. If melatonin can help such children, for whom sleep never comes easy, then it is important to consider melatonin as an available option.

How many children suffer from chronic insomnia? Experts believe that some 15%-25% of all children and adolescents find it hard to sleep on a regular basis. Melatonin does work for most of them and with few side effects. But again, there are no long-term studies to prove that melatonin is safe for children.

One National Institutes of Health (NIH) study followed children with ADHD taking melatonin regularly for almost 4 years and  found no terrible long term side effects or issues. Not nearly long enough to be called a long-term study. And even the NIH recommends against melatonin pills for children because they might be unsafe, and because as a hormone, melatonin could affect a child’s development.

The bottom line is that melatonin should not be thought of as some sort of vitamin pill that makes the body work better. If your child is having sleep problems, you shouldn’t be turning to melatonin first. And certainly not without consulting your child’s doctor.

Helpful Sleep Tips

If your child has trouble falling asleep at night, here are some helpful steps to try:

Put Sleep First
If your child is busy with lots of after school activities, this may be the reason he is not getting enough sleep. And sleep isn’t something he can make up in his spare time. Children need a consistent amount of sleep every night. Does your child go to extracurricular classes and then come home to do his homework until quite late? If so, he may end up going to sleep too late to get enough rest. The solution? Cut out those after school activities. Sleep has to come first.

Stick to the Plan

Children should have a regular bedtime and stick to it every night. This helps regulate your child’s sleep-wake cycle: his body clock. Give your child an hour to wind down and do the things that help make him ready for sleep: bath, book, soft lights, and finally, lights out.

No Screens in the Bedroom

Anything that has a bright screen, such as an iPad or tablet, a cell phone, or a television, should be thought of as light sources that keep your child’s brain from making and releasing melatonin.  A no screens in the bedroom rule is a good one.

No Screens Before Bed

Your child’s brain will make and release melatonin to help him get sleepy, as long as he’s not looking at a screen. So put a limit on using electronics. Make a no screens from at least an hour before bedtime rule. Give your child’s body a chance to make its own melatonin. That is how things are supposed to work.

Get a Checkup

If these measures don’t help your child fall asleep at night, talk to the doctor. Your child may benefit from seeing a sleep specialist. The specialist may use cognitive behavioral therapy to help your child sleep. And he may end up suggesting melatonin. If so, the expert will tell you how to use it, and will monitor your child’s progress.
Have you used melatonin to help your child sleep? Does it work?  Do you have any concerns about your child using melatonin?

Immunization Debate: Do You Say Yes to Vaccines?

Immunization Awareness Month: Do You Say Yes to Vaccines?
(credit: ChameleonsEye / Shutterstock.com)

Immunization Awareness Month is upon us which means we wake up the sleeping beast: the debate for and against vaccination. There’s a lot of hot feeling on either side of the debate which is only natural. These are our children we’re talking about and their lives are in our hands. As parents, it’s our duty to protect them.

But just try and read through all the medical mumbo jumbo on the web. Most parents are not doctors. We just want to understand what it is we need to know about immunization to make the right decision, for or against.

And then of course there’s the problem of whose “facts” to believe. How can you, as a parent without medical training, know which facts about immunization are true? Is the decision to vaccinate your child going to come down to a crapshoot, or perhaps, a leap of faith (to one side or the other)?

Let’s take a look at the facts, and the pros and cons of immunization, dumbed down:

Fact: Immunization Recommended/Not A Law

The Centers for Disease Control (CDC) says children up to age six should be getting 28 doses of 10 vaccines. But that’s only a recommendation. There is no federal law that says children must be vaccinated. In other words, the medical establishment says you should vaccinate your child, but you won’t go to jail if you don’t.

Fact: Immunization A Must For Public School Kids With Few Exceptions

All 50 states require some vaccinations for children going to public school. Almost every state offers exemptions on the grounds of medical or religious issues while some state allow exemptions for philosophical reasons. In other words, if your religion forbids vaccination or your child has a medical problem which means he can’t be vaccinated, you can get out of vaccinating your child. If you are against immunization for other reasons, you may be able to get out of vaccinating your child, depending on where you live. You can check what laws apply in your state HERE.

Pro: Immunization Is Safe/Reactions Rare

Bad reactions to vaccines are very rare. Experts don’t have an exact statistic, but agree that the odds are very small of having a severe allergic reaction (anaphylaxis) to a vaccine. Some say the number is one severe allergic reaction per every several hundred thousand vaccinations, while other experts say the chance of a bad reaction is one in one million vaccinations.

Con: Immunization Is Risky/Dangerous

Some kids do actually die as a result of getting vaccinated. While reactions to vaccines are rare, they do happen to an unfortunate few. Bad reactions to vaccines include seizures, paralysis, and even death.

Pro: Immunization Prevents Illness, Saves Lives

Those in favor of immunization say that vaccination is the greatest medical advancement of our time. Thanks to vaccination, smallpox, polio, diphtheria, rubella (German measles), and whooping cough have been wiped out, at least for now. These are diseases that have killed children in the past. Pro-immunization medical experts estimate that vaccines have saved millions of children’s lives.

Con: Immunization Unnecessary/Risk Not Worth Taking

Those against immunization say that a child’s immune system can fight against most diseases without any help from vaccines. They say that putting the substances of a vaccine into a child’s body can not only cause serious side effects but may be the trigger for a lot of the health problems and learning disabilities we see in children today, such as autism, diabetes, and ADHD.

Pro: Link Between Immunization And Autism Not Proven

Andrew Wakefield had a study published in 1998 in the Lancet, an important medical journal. The study showed a link between the Measles Mumps Rubella (MMR) vaccine and autism. As a result of the study, many parents stopped vaccinating their children. They feared their children would develop autism as the result of immunization.

Wakefield’s study was small. There were only 12 children studied. Eight of them supposedly developed symptoms of what Wakefield called “regressive autism” within days of receiving the shot. The problem was that no one could replicate Wakefield’s results, though they tried again and again.

The results of a study are accepted only after others repeat the study and gets the same results. That just didn’t happen with Wakefield’s study. By 2004, people were getting suspicious and a reporter began investigating. Finally, Wakefield was called before a review board and in 2010, was exposed as a complete fraud. The Lancet withdrew the paper saying their experts been deceived, and Wakefield lost his medical license.

Even though Wakefield was proven a fraud, parents continue to claim their children developed autism as a result of immunization. Other parents may not have heard that Wakefield was a phony. They continue to believe that the MMR vaccine causes autism. You will see plenty of web pages that continue to insist there is a link between autism and the MMR shot.

The Wakefield study is believed to be the reason for the Disneyland measles outbreak in California. Parents stopped vaccinating their kids after Wakefield’s study was published. They were scared  their children would develop autism.

While most parents in American vaccinated their children (at least until the Wakefield report), parents in poorer countries may not have had good medical care for their children. Children in those countries may be vulnerable to diseases like the measles, because they were not immunized. If a child with measles should come to visit Disneyland in America, and spends time with children who were not vaccinated, those children can get and spread the measles.

Some parents who stopped vaccinating their children because of the Wakefield report thought their children were safe from the measles, because vaccination had for the most part wiped out the disease in America. They thought: “Why vaccinate our children when there is no measles in America? Why risk autism or worse, when the disease has been mostly wiped out?”

The problem is, so many parents had this thought, that many American children ended up getting the measles as a result of contact with a tourist at Disneyland. The Disneyland outbreak brought more hot debate about immunization, both for and against. The media scrambled to cover it all.

One media story did a lot to explain how immunization works. The father of six year-old boy, Rhett Krawitt, asked school officials not to let kids come to school who were not vaccinated because of their families’ religious or personal beliefs. Rhett is getting over leukemia and it would be dangerous for him to get the measles vaccine. His system is too weak and the vaccine could make him actually get the measles. Because he is so weak, measles could be especially dangerous to him and might even kill him.

Since Rhett cannot be immunized, his parents feel it is dangerous for him to be around healthy children who have not been vaccinated. They fear that with the all the measles outbreaks, Rhett could be exposed to the measles from these children. It seems unfair to them that their child has to stay home from school because of parents who refuse to vaccinate their healthy children.

There are many other issues around the immunization debate. For instance, some people say that vaccines are unethical because some of the ingredients of the vaccines are animal byproducts, while other ingredients may cause cancer. Part of the debate on immunization has to do with government: should the government force people to get vaccinated or would that take away peoples’ basic freedoms.

A good website for reading more about the pros and cons of vaccination is the webpage on vaccination at ProCon.org.