Thursday, January 23, 2014

Secrets of the ADHD Brain

Most people are neurologically equipped to determine what's important and get motivated to do it, even when it doesn't interest them. Then there are the rest of us, who have attention deficit.
by William Dodson, M.D.

ADHDers know that they are bright and clever, but they are never sure whether their abilities will show up when they need them.
ADHD is a confusing, contradictory, inconsistent, and frustrating condition. It is overwhelming to people who live with it every day. The diagnostic criteria that have been used for the last 40 years leave many people wondering whether they have the condition or not. Diagnosticians have long lists of symptoms to sort through and check off. The Diagnostic and Statistical Manual of Mental Disorders has 18 criteria, and other symptom lists cite as many as 100 traits.
Practitioners, including myself, have been trying to establish a simpler, clearer way to understand the impairments of ADHD. We have been looking for the "bright and shining line" that defines the condition, explains the source of impairments, and gives direction as to what to do about it.
My work for the last decade suggests that we have been missing something important about the fundamental nature of ADHD. I went back to the experts on the condition — the hundreds of people and their families I worked with who were diagnosed with it — to confirm my hypothesis. My goal was to look for the feature that everyone with ADHD has, and that neurotypical people don't have.
I found it. It is the ADHD nervous system, a unique and special creation that regulates attention and emotions in different ways than the nervous system in those without the condition.
The ADHD Zone

Almost every one of my patients and their families want to drop the term Attention Deficit Hyperactivity Disorder, because it describes the opposite of what they experience every moment of their lives. It is hard to call something a disorder when it imparts many positives. ADHD is not a damaged or defective nervous system. It is a nervous system that works well using its own set of rules. Despite ADHD's association with learning disabilities, most people with an ADHD nervous system have significantly higher-than-average IQs. They also use that higher IQ in different ways than neurotypical people. By the time most people with the condition reach high school, they are able to tackle problems that stump everyone else, and can jump to solutions that no one else saw.
The vast majority of adults with an ADHD nervous system are not overtly hyperactive. They are hyperactive internally.

Those with the condition don't have a shortage of attention. They pay too much attention to everything. Most people with unmedicated ADHD have four or five things going on in their minds at once. The hallmark of the ADHD nervous system is not attention deficit, but inconsistent attention.
Everyone with ADHD knows that they can "get in the zone" at least four or five times a day. When they are in the zone, they have no impairments, and the executive function deficits they may have had before entering the zone disappear. ADHDers know that they are bright and clever, but they are never sure whether their abilities will show up when they need them. The fact that symptoms and impairments come and go throughout the day is the defining trait of ADHD. It makes the condition mystifying and frustrating.

People with ADHD primarily get in the zone by being interested in, or intrigued by, what they are doing. I call it an interest-based nervous system. Judgmental friends and family see this as being unreliable or self-serving. When friends say, "You can do the things you like," they are describing the essence of the ADHD nervous system.

ADHD individuals also get in the zone when they are challenged or thrown into a competitive environment. Sometimes a new or novel task attracts their attention. Novelty is short-lived, though, and everything gets old after a while.
Most people with an ADHD nervous system can engage in tasks and access their abilities when the task is urgent — a do-or-die deadline, for instance. This is why procrastination is an almost universal impairment in people with ADHD. They want to get their work done, but they can't get started until the task becomes interesting, challenging, or urgent.

How the Rest of the World Functions

The 90 percent of non-ADHD people in the world are referred to as "neurotypical." It is not that they are "normal" or better. Their neurology is accepted and endorsed by the world. For people with a neurotypical nervous system, being interested in the task, or challenged, or finding the task novel or urgent is helpful, but it is not a prerequisite for doing it.

Neurotypical people use three different factors to decide what to do, how to get started on it, and to stick with it until it is completed:
1. the concept of importance (they think they should get it done).
2. the concept of secondary importance--they are motivated by the fact that their parents, teacher, boss, or someone they respect thinks the task is important to tackle and to complete.
3. the concept of rewards for doing a task and consequences/punishments for not doing it.
A person with an ADHD nervous system has never been able to use the idea of importance or rewards to start and do a task. They know what's important, they like rewards, and they don't like punishment. But for them, the things that motivate the rest of the world are merely nags.

The inability to use importance and rewards to get motivated has a lifelong impact on ADHDers' lives:
How can those diagnosed with the condition choose between multiple options if they can't use the concepts of importance and financial rewards to motivate them?
How can they make major decisions if the concepts of importance and rewards are neither helpful in making a decision nor a motivation to do what they choose? This understanding explains why none of the cognitive and behavioral therapies used to manage ADHD symptoms have a lasting benefit. Researchers view ADHD as stemming from a defective or deficit-based nervous system. I see ADHD stemming from a nervous system that works perfectly well by its own set of rules. Unfortunately, it does not work by any of the rules or techniques taught and encouraged in a neurotypical world.

That's why:
ADDers do not fit in the standard school system, which is built on repeating what someone else thinks is important and relevant.
ADDers do not flourish in the standard job that pays people to work on what someone else (namely, the boss) thinks is important.
ADDers are disorganized, because just about every organizational system out there is built on two things — prioritization and time management — that ADDers do not do well.
ADDers have a hard time choosing between alternatives, because everything has the same lack of importance. To them, all of the alternatives look the same.

People with an ADHD nervous system know that, if they get engaged with a task, they can do it. Far from being damaged goods, people with an ADHD nervous system are bright and clever. The main problem is that they were given a neurotypical owner's manual at birth. It works for everyone else, not for them.  
Don't Turn ADHDers into Neurotypicals
The implications of this new understanding are vast. The first thing to do is for coaches, doctors, and professionals to stop trying to turn ADHD people into neurotypical people. The goal should be to intervene as early as possible, before the ADHD individual has been frustrated and demoralized by struggling in a neurotypical world, where the deck is stacked against him. A therapeutic approach that has a chance of working, when nothing else has, should have two pieces:

Level the neurologic playing field with medication, so that the ADHD individual has the attention span, impulse control, and ability to be calm on the inside. For most people, this requires two different medications. Stimulants improve an ADHDer's day-to-day performance, helping him get things done. They are not effective at calming the internal hyperarousal that many with ADHD have. For those symptoms, the majority of people will benefit by adding one of the alpha agonist medications (clonidine/Kapvay or guanfacine/Intuniv) to the stimulant.

Medication, though, is not enough. A person can take the right medication at the right dose, but nothing will change if he still approaches tasks with neurotypical strategies.
The second piece of ADHD symptom management is to have an individual create his own ADHD owner's manual. The generic owner's manuals that have been written have been disappointing for people with the condition. Like everyone else, those with ADHD grow and mature over time. What interests and challenges someone at seven years old will not interest and challenge him at 27.

Write Your Own Rules
The ADHD owner's manual has to be based on current successes. How do you get in the zone now? Under what circumstances do you succeed and thrive in your current life? Rather than focus on where you fall short, you need to identify how you get into the zone and function at remarkable levels.

I usually suggest that my patients carry around a notepad or a tape recorder for a month to write down or explain how they get in the zone.

Is it because they are intrigued? If so, what, specifically, in the task or situation intrigues them? Is it because they feel competitive? If so, what in the "opponent" or situation brings up the competitive juices?

At the end of the month, most people have compiled 50 or 60 different techniques that they know work for them. When called on to perform and become engaged, they now understand how their nervous system works and which techniques are helpful.

I have seen these strategies work for many ADDers, because they stepped back and figured out the triggers they need to pull. This approach does not try to change people with an ADHD nervous system into neurotypical people (as if that were possible), but gives lifelong help because it builds on their strengths.

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Common Warning Signs of Dysgraphia in Children in Grades 9-12

Has your teenager always struggled with written expression? Is his or her written work messy, disorganized, and incomplete? If the answer is "yes", review the following list of common warning signs of dysgraphia in high school students. Dysgraphia is a learning disability (LD) that affects writing, which requires a complex set of motor and information-processing skills.

Most people struggle with learning at times, but learning disabilities are different – they may affect performance differently throughout a person’s school years and beyond, but what they share in common is that they persist over time. Dysgraphia is no different. If your child has displayed any of the signs below for at least the past six months, it may be time to seek help from the school or other professionals. Be sure to think back about writing-related challenges your child may have had in preschool and elementary school and share that information (and even work samples if available) when you reach out for help.

Also, be aware that some of the signs listed below also apply to other types of learning disabilities and/or to Attention Deficit/Hyperactivity Disorder (AD/HD), which often co-exist. You may want to review out more comprehensive Interactive Learning Disabilities Checklist to clarify your concerns.

For at least the past six months, my child has had trouble:
    * Gripping a pencil comfortably when writing or drawing.
    * Writing neatly, evenly, and legibly.
    * Writing on a line or within margins.
    * Copying letters and numbers neatly and accurately.
    * Spelling even familiar words correctly.
    * Using correct syntax structure and grammar.
    * Expressing written ideas in an organized way.
    * Preparing outlines and organizing written work.
    * Turning ideas spoken aloud into a written format.
    * Thinking of words to write and then remembering to write them down.
    * Focusing on the meaning of what he writes; (because of the physical demands during writing)
    * Maintaining energy and easy posture when writing/drawing.

    * Aligning numbers correctly when doing math problems.

    * Feeling motivated and confident about writing.
    * Taking pride in written work.
    * Responding appropriately to teasing or criticism by peers and adults who don't understand "messy, incomplete, and disorganized" writing.

Don't hesitate to seek help if your teenager displays several of these warning signs. Print out this article, check off the items that apply to your child, and take the list to the educators or other professionals who you seek advice from about your child. The good news is that with proper identification and support, your teenager will be better able to succeed in school, the workplace, and in life.

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Math Help for Children with ADHD or Learning Disabilities

A dozen ways to improve math comprehension and testing for children with ADHD or learning disabilities.

4 Steps to Solving a Math Problem

  1.  Read the problem through carefully. Make sure you understand exactly what the question is.
  2.  Devise a plan to solve the problem. Choose which formulas you'll use, and decide the order in which to use them.
  3.  Focus on each step of the problem individually. Take your time with each step.
  4.  Always review your math. Ask yourself, "Does the answer seem reasonable? Does it make sense?" If not, repeat these steps.
Like it or hate it, we all need to study math.
Even if you don't find it the most thrilling subject, you'll certainly discover it's one of the most useful. You calculate the miles you run in the park, budget paychecks from your summer job, and before you know it, you'll be balancing your own checkbook. So having a sound knowledge of math really pays off.
But when you're a teenager with attention deficit disorder (ADD ADHD) or a learning disability, math poses many challenges. More than other subjects, math requires sustained attention and good test-taking ability. It's a cumulative subject, so you need to understand today's material in order to keep up with tomorrow's. The more advanced the math, the more sequential steps you'll need to solve problems.
If you're someone whose mind wanders, you can easily fall behind in math, even if you maintain good grades in other subjects. So whether you're working on equations in summer school, or getting ready for math class to resume in September, these useful tips can help you succeed in this essential subject.

Location, location

Identify any distractions that may be limiting your ability to stay focused. This may mean requesting a seat up front near the chalkboard, or away from a window or - sorry - your friends.

Speak up

For any school subject, perhaps even more so for mathematics, asking questions will help you pay attention. If you think you missed something, ask the teacher to repeat it. Chances are, someone else missed it too. Do you find you work better at a particular time of day? Ask your guidance counselor if you can schedule math for that particular time.

Solve problems

Math requires active - not passive - studying. In other words, you have to do math problems, not just think about how to do them. The more you practice problems, the better your math skills will become. Working on math consistently throughout the year, even in summer when school isn't in session and homework hasn't been assigned, will make formulas and techniques easier to master.

Keep things interesting

As a teen with ADHD, boredom may be your number-one enemy. If the doldrums set in, you'll have even more trouble concentrating than you usually do. So, instead of sitting at your desk for two hours being bored by your math homework, form a study group and make math fun. (Start a study group this summer, and all of you will have a head start on September's lessons.) Others can help you focus by making math interactive.
As a rule, the more challenging the material, the more time you'll have to spend on it. Suggest that your group meet once or twice a week. The end of the course will be more difficult, so meet with your study group more frequently as lessons get more involved. Also, think of ways to use the math concepts you are studying in class outside of class. For example, add up numbers relating to your budget, instead of just adding random ones, to make learning math skills more interesting.

The big test

Unlike English or history, where you may be graded on papers, math grades largely depend on tests. And while you probably won't be taking any until fall, it's never too early to start addressing test-taking anxiety. The condition is very common in students with ADHD - especially when the test is in math. Here are ways to lessen it:

Stay on top of your homework. 

Studying over an extended period instead of cramming the night before is a must. This helps transfer information from your short-term memory to your long-term memory, which will be easier to draw upon during the actual test - even if you're nervous. Ask your teacher for assistance in preparing far in advance. If you're on the border between a C and a B, and your teacher knows you put effort into studying, it could tip the scale in your favor

Be your own advocate. 

Find out what accommodations are available at school, and ask for them. Maybe you'd like permission to use a calculator. If you feel anxious about finishing on time, ask for extra time. If you're easily distracted, ask to take the test in a quiet room away from the rest of the class.

Get a good night's sleep. 

And not just the night before the test. According to research done by Trent University in Peterborough, Ontario, it's important to get sufficient sleep on a routine basis. Staying out late on weekends can affect how much information you retain during the week. If you're studying complex logic problems, for example, you can lose up to 30% of what you learn if you don't get enough sleep.

Eat and drink sensibly before a test. 

Avoid food and beverages that will lead to a "sugar crash" or make you feel drowsy. Protein snacks and plain old water are excellent test-taking fuels. Consumption of foods rich in choline - which stimulates the brain neurotransmitter acetylcholine and is found in fish, eggs, meat, and rice - may help improve memory.

Address both the mental and physical components of test-anxiety. 

Stress-management tools, like exercise, yoga, and meditation, can help. Start making these rituals part of your routine this summer. During the test, take deep breaths, concentrate on which muscles feel tense. Experiment with visualization. Picture a serene scene, like a waterfall or a beautiful forest. If you practice these techniques before the exam, by the day of the test, you should have no trouble relaxing. And always arrive early for an exam, or you'll send your relaxation skills down the drain.

Get up.

 If you're like most people with ADHD, you find sitting for a long time difficult. When you can, take a bathroom break. Break your pencil and go sharpen it. Stretch in your seat

Be positive. 

The second aspect of test anxiety is mental, and you can start addressing this now. If you tend to make negative comments about your abilities, change them to positive ones. Focus your thoughts on the test - not on your performance. Above all, remember that a test grade is not a reflection of who you are, nor does it predict future success.

Reward yourself after the exam. 

It doesn't matter how well you think you did. It's the effort that counts, and preparing is hard work, so celebrate.

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Raising Your ADD Child: 12 Parenting Strategies

Most parents are good parents. But if your son or daughter has attention deficit disorder (ADD ADHD), "good" may not be enough. To ensure that your child is happy and well-adjusted now and in the future—and to create a tranquil home environment—you've got to be a great parent.
Fortunately, it's easier than you might imagine to go from good to great. All it takes is a few small adjustments in your parenting skills and the way you interact with your child. Here's what works, and why:

1. Accept the fact that your child—like all children—is imperfect.

It's not easy to accept that there's something not quite "normal" about your child. But a child who senses his parents' resentment—and their pessimism about his prospects—is unlikely to develop the self-esteem and can-do spirit he'll need in order to become a happy, well-adjusted adult.
"For a child to feel accepted and supported, he needs to feel that his parents have confidence in his abilities," says Ken Brown-Gratchev, Ph.D., a special education instructor at Kaiser Permanente in Portland, Oregon. "Once parents learn to look at the gifts of ADD—things like exceptional energy, creativity, and interpersonal skills—they can see the shine inside their child."
Carol Barnier, of New Fairfield, Connecticut, certainly sees the "shine" in her ADD child. "My child is destined for something wonderful, something that would be impossible for those calmer, regular-energy level children," she says. "I can think of several occupations where boundless energy would be an incredible asset. I'm even jealous of his tireless enthusiasm for life and wonder what more I could accomplish if I were so blessed."
Do your best to love your child unconditionally. Treat him as if he were already the person you would like him to be. That will help him become that person.

2. Don't believe all the "bad news" about your child.

It's no fun to hear school employees describe your child as "slow" or unmotivated. But don't let negative remarks deter you from doing everything in your power to advocate for his educational needs. After all, kids with ADD can succeed if they get the help they need.
"While it's true that your child's mind works differently, he certainly has the ability to learn and succeed just like any other kid," says George DuPaul, Ph.D., professor of school psychology at Lehigh University in Bethlehem, Pennsylvania. "Look at it this way—if your child was diabetic or had asthma, would you, for one single minute, hesitate to advocate for his benefit?" Just as a diabetic needs insulin and an asthmatic child needs help breathing, the ADDer needs his learning environment regulated.
Sue Greco of Warwick, Rhode Island, is adamant about being her 11-year-old's strongest advocate. "My son has a great brain," she says. "He's a leader, with great ideas, but he's been labeled 'unable to succeed' at the local public school. Because I know he's capable of more, I've enrolled him in a Catholic school, hoping the higher academic expectations and greater structure will challenge him in a positive way."

3. Don't overestimate the importance of medication.

There's no doubt that, for many children with ADD, the right medication makes a huge difference in behavior. But by no means is medication the only thing that makes a difference, and talking about it as if it were will leave the child feeling that good behavior has little to do with her own efforts. When you catch your child doing something you've repeatedly asked her not to do, fight the urge to ask, "Did you forget to take your medication this morning?" And don't ever threaten to increase her dosage because she did something inappropriate.
"Statements like these give your child the impression that her behavior is controlled solely by external factors," says Dr. Brown-Gratchev. "It's a parent's responsibility to send the clear message that, while medication will improve the skills she already possesses, it won't magically fix all of her troubles."
As Sara Bykowski, a mother of two sons with ADD living in Angola, Indiana, puts it, "I tell my kids that their medicine is like glasses. Glasses improve eyesight that the person already has. My kids know that their self-control, no matter how limited, is the main factor in their behavior management."

4. Make sure you know the difference between discipline and punishment.

How often have you complained to friends or family members (or even a therapist), "I've yelled, lectured, threatened, given time-outs, taken away toys, canceled outings, bribed, begged, and even spanked—and nothing works!" Do you see the problem with this approach? Any child exposed to such a variety of "sticks" would be confused. And one of the most effective approaches to discipline—the "carrot" of positive feedback—isn't even mentioned.
"Many parents use the terms 'discipline' and 'punishment' interchangeably," says Sal Severe, Ph.D., the author of How to Behave So Your Preschooler Will Too! "In fact, they're vastly different." Discipline, he says, is preferable because it teaches the child how to behave. It includes an explanation of the inappropriate behavior and redirection to acceptable behavior—along with positive reinforcement each time the child makes a good behavior choice. Punishment, on the other hand, uses fear and shame to force the child to behave.
Punishment certainly has its place. However, it should never involve physical or verbal abuse, and it should be used only as a last resort. For example, if your child continues to yank the cat's tail despite being repeatedly told not to—he should be punished.
Often, the best way to discipline an ADD child is via a simple program of behavior modification: Define age-appropriate, attainable goals and then systematically reward each small achievement until the behavior becomes routine. By rewarding positive behavior (rather than punishing negative behavior), you help your child feel successful—and further increase his motivation to do the right thing.

5. Never punish a child for behavior that he is unable to control.

Imagine telling your 10-year-old to make his bed. Now imagine finding him, minutes later, lying on his unmade bed playing cards. What should you do? Give him a sharp word and put him in time-out?
According to Dr. Severe, that's probably not the best approach. In many cases, he says, a child with ADD fails to comply not because he is defiant, but simply because he becomes distracted from the task at hand (in this case, making the bed). Distractibility is a common symptom of ADD—something that he may be unable to control. And when you repeatedly punish a child for behavior he can't control, you set him up to fail. Eventually, his desire to please you evaporates. He thinks, "Why bother?" The parent-child relationship suffers as a result.
The best approach in situations like this might be simply to remind your child to do what you want him to do. Punishment makes sense if it's abundantly clear that your child is being defiant—for example, if he refuses to make the bed. But give him the benefit of the doubt.

6. Stop blaming other people for your child's difficulties.

Are you the kind of parent who finds fault with everyone except your child? Do you say things like "That driver has no control over the kids on the bus," or "If only the teacher were better at behavior management, my daughter wouldn't have so much trouble in school?"
Other people can contribute to your child's problems. But trying to pin the blame exclusively on others encourages your child to take the easy way out. Why should she take personal responsibility for her actions if she can blame someone else (or if she repeatedly hears you blame someone else)?

7. Be careful to separate the deed from the doer.

"Sticks and stones may break my bones, but words can never hurt me"? Don't believe it. Kids who repeatedly hear bad things about themselves eventually come to believe these things.
No matter how frustrating your child's behavior, never call him "lazy," "hyper," "spacey," or anything else that might be hurtful. And stop yourself if you start to say something like "You're such a slob—why can't you keep your room clean?" or "What's wrong with you? If I've told you once, I've told you a thousand times... ."
Carol Brady, Ph.D., a child psychologist in Houston, explains it this way: "Parents must make ADD the enemy—not the child. When you personalize a child's ADD-associated problems, her self-esteem plummets. But when you team up with your child to problem-solve various negative behaviors, you create a climate where your child feels loved and supported despite her shortcomings."
Next time your child's room is a disaster, tell her, "We have a problem, and I need your help to solve it." Tell her it's hard for you to tuck her in at night because you're afraid you might trip over the toys on her bedroom floor - or that leaving food in her room attracts bugs. Ask for her input. The more involved your child is in the solution, the better the outcome.

8. Don't be too quick to say "no."

All children need to be told "no" at certain times—to keep them from doing something dangerous or inappropriate. But many parents say "no" reflexively, without considering whether it might be OK to say "yes." And a child who hears "no" too many times is apt to rebel—especially if he is impulsive to begin with.
Why are parents so quick to say "no"? Often, it's out of fear ("No, you cannot walk to school by yourself."), worry ("No, you can't sleep over at Jake's house until I meet his parents."), a desire to control ("No, you can't have a snack before supper."), or a competing need ("Not tonight, kiddo, I'm too tired."). Smart parents know when to say "no," and when it makes more sense to take a deep breath and answer in the affirmative.
In many cases, a small change in the way you use the words "yes" and "no" with your child can mean the difference between a pleasant interaction and a nasty confrontation.
Let's say your child wants to go outside to play but you want him to sit down and do his homework. "Instead of automatically saying no," suggests Dr. DuPaul, "ask him to help you brainstorm a workable solution." That way, he feels that he has at least some measure of control over the situation and that you are trying to accommodate his wishes. He will feel less frustrated and be more cooperative.

9. Pay more attention to your child's positive behavior.

In their quest to quash behavior problems, many parents overlook all the positive ways in which their child behaves. The resulting negativity can cast a pall over the household that affects every aspect of life.
"Retrain yourself to look at the positives," says Dr. Severe. "Catch your child being good or doing something well, and praise her. When you point out and praise desirable behaviors, you teach her what you want—not what you don't want."
Bear in mind that some of the problem behaviors you ascribe to ADD may be common to all children of that age. It's helpful to read up on the stages of childhood development - especially if your ADD child happens to be your first-born.
Make happiness and laughter the cornerstones of family life. Spend fun time with your children. Go with them on bike rides. Play with them at the park. Visit museums together. Take them to the movies. Sure, life with ADD can be challenging. But the rewards are great for parents who really connect with their children.

 10. Learn to anticipate potentially explosive situations.

Imagine that your daughter has been invited to a party. That's good news, especially for a child who isn't very popular with her peers. Now imagine that the party is hosted by a girl with whom your daughter recently quarreled. Do you simply cross your fingers and hope for the best?
"Absolutely not," warns Dr. DuPaul. "Parents spend a lot of time in reactive mode instead of thinking ahead and planning ahead." A simple plan, he says, is all it takes to keep a positive experience from turning negative for all concerned.
"In our house, we have 'the plan,'" says Sara Bykowski. "Before we go into a store or to a friend's home, we talk about the behavior that is expected and possible pitfalls. We also have a routine for any problems that arise. I might say, 'Can I talk to you for a minute?' and then take him away from the group. We discuss what's happening and try to come up with a solution. Sometimes we still have to leave early, but that happens much less often now."
Whatever you do, be consistent. "All kids benefit from consistency," says Dr. DuPaul, "but ADD kids, in particular, need consistency. It's not a luxury for them." A last-minute change in schedule or an interruption of a familiar routine can wreak havoc with a child who already feels like she spends most of her time off-balance and "catching up." Better to have set routines and plans and do all you can to stick to them.
"Set your home up in a way that encourages organization and responsibility, then run it like an army barracks," suggests ADDer Shirley McCurdy, an organizational expert and the author of The Floor Is Not an Option. "Think easy and accessible - clear storage bins for clothes, zippered pouches for homework, and a large, color-coded family calendar."
Make sure you and your spouse are in agreement on matters of organization and discipline. "Parents who aren't on the same page in their general approach to motivation and discipline with their ADD child can cause problems," says Stephen Grcevich, M.D., a child psychiatrist in Chagrin Falls, Ohio. "Behavioral interventions for kids with ADD are unlikely to be successful unless applied consistently."
When parents present a united front, their children know exactly what to expect. Ultimately, the more predictable and consistent your child's environment becomes, the happier the whole family will be.

11. Be a good role model.

Parents are a child's most influential role model, so think carefully about your behavior. If you're unable to control yourself, how can you expect your child to exercise self-control?
"Yelling sets a poor example of how your child should handle his emotions," says Dr. Brady. "Parents tend to think that, the louder they get, the bigger the impact on the child—but it doesn't work. The only thing the child hears is the anger. The situation quickly spirals out of control."
It's perfectly normal to feel angry at your child from time to time. It's not OK to continually shout at her. You wouldn't dream of screaming and swearing at friends or coworkers, so you know you can control your anger if you must.
Next time your child does something that causes your blood to boil, leave the room, take a few deep breaths, or do something else to calm yourself. When you demonstrate self-calming techniques in this way, you teach your child the importance of managing her emotions.
If you do lose your temper, do not hesitate to apologize to your child.

12. Seek help from others

.Some things in life simply cannot be done well alone, and raising an ADD child is one of them. "If you take the Clint Eastwood approach, you'll wind up exhausted mentally, emotionally, and physically," says Dr. Brown-Gratchev. "Build a NASA-worthy support system. That way, when your own 'system' overloads or fails, as it inevitably will from time to time, there's someone to put you back together again."
Ask your pediatrician for the name of a psychologist or other mental-health professional who specializes in ADD. Or contact CHADD - chances are, there's a chapter in your community.
Sue Kordish, of Tyngsboro, Massachusetts, knows the value of a reliable support system. "For years, my husband and I worried that no sitter would understand our son's special needs," she says. "We tried hiring a teenager, but it didn't work out, and the experience left us even more wary. With no family members living nearby, the situation was hard. We just didn't go out. Then we found a sitter who works with special-needs kids. We were finally able to relax and enjoy some seriously overdue couple time."

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Ten Disability Awareness Lessons Learned From Dr. Martin Luther King, Jr.

My children and I just finished reading a new book titled, “My Daddy, Dr. Martin Luther King, Jr.” by Martin Luther King III.  It’s a warm, intimate biography that explains a turning point in American history from the perspective of a child.  At the heart of the book are the lessons that Dr. King modeled for us in his lifetime regarding nonviolence, personal excellence, interdependence and justice.

As I plan for my children’s future, I find myself returning to those lessons for guidance.  Human rights are for everyone, and we still have a long way to go on our journey.  Here are 10 quotes from Dr. King that are relevant to human rights and disability awareness.

1. “Injustice anywhere is a threat to justice everywhere.”

2. “It is not possible to be in favor of justice for some people and not be in favor of justice for all people.”

Every time we choose to stand up for someone being treated unjustly, we are in fact standing up for everyone.  When I advocate for the best services for my son, I am also advocating for future students.

3. “Since being in India, I am more convinced than ever before that the method of nonviolent resistance is the most potent weapon available to oppressed people in their struggle for justice and human dignity.”

Dr. King traveled to India to learn more about nonviolent resistance in April 1959.  This quote comes from a radio speech delivered on his last day in India.  It’s a good reminder that being visible and gentle in our words and actions will have a more lasting impact than hurtful behavior.

4. “People fail to get along because they fear each other; they fear each other because they don’t know each other; they don’t know each other because they have not communicated with each other.”

There’s plenty of fear surrounding disabilities and disability awareness, but organizations like the Friendship Circle prove that personal relationships can break down walls of misunderstanding.

5. “If you can’t fly then run, if you can’t run then walk, if you can’t walk then crawl, but whatever you do you have to keep moving forward.”

One of my maternal fears is that my son will regress, because I’ve seen him lose and re-learn basic skills many times.  Every step forward is a source of pride and a cause for celebration!

6. “If I cannot do great things, I can do small things in a great way.”

I love this quote and the next one because they describe perfectly my son’s attitude about life. Greatness is all around us, if we are willing to open our eyes and cherish it.

7. “Everybody can be great…because anybody can serve. You don’t have to have a college degree to serve. You don’t have to make your subject and verb agree to serve. You only need a heart full of grace. A soul generated by love.”

8. “True compassion is more than flinging a coin to a beggar; it comes to see that an edifice which produces beggars needs restructuring. ”

This quote comes from the “Where Do We Go From Here?” speech of August 1967.  Superficial concern allows prejudice and injustice to continue, but authentic compassion changes lives for the better.  I have seen this effect in my son’s developmental progress and in the barriers to inclusion that he has overcome.

9. “Without love, there is no reason to know anyone, for love will in the end connect us to our neighbors, our children and our hearts.”

Interdependence is the goal of social skills classes, group speech therapy and group projects. Love is the basis for valuing each person’s contribution.

10. “It really boils down to this: that all life is interrelated. We are all caught in an inescapable network of mutuality, tied into a single garment of destiny. Whatever affects one destiny, affects all indirectly.”

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Hand-Eye Coordination Improves Cognitive and Social Skills

Researchers link hand-eye coordination to learning, cognition, and sociability.
Published on November 15, 2013
by Christopher Bergland in The Athlete's Way

Cognitive scientists at Indiana University have discovered a strong correlation between hand-eye coordination, learning abilities, and social communication skills. The study titled “Joint Attention Without Gaze Following: Human Infants and Their Parents Coordinate Visual Attention to Objects Through Eye-Hand Coordination," was published on November 13, 2013 in the online journal PLOS ONE.

The new research provides compelling evidence for a practical way that social partners—in this case, 1-year-olds and their parents—can coordinate their joint attention and focus, which is a key component of parent-child communication and early language learning.

Previous research involving visual attention between parents and toddlers has focused more on the ability of each person to follow the gaze of the other person’s eyes. In recent years, many studies have found a link between eye contact, gaze and autism spectrum disorder (ASD).

The Indiana researchers realized that hand-eye coordination is much more common throughout the day, and that when the parent and toddler both focus their hands and eyes on an object they interact as equals, rather than one or the other taking the lead.

"Currently, interventions consist of training children to look at the other's face and gaze," said Chen Yu, associate professor in the Department of Psychological and Brain Sciences at Indiana University, Bloomington. "Now we know that typically developing children achieve joint attention with caregivers less through gaze following and more often through following the other's hands."

The researchers understand that, "The daily lives of toddlers are filled with social contexts in which objects are handled, such as mealtime, toy play and getting dressed. In those contexts, it appears we need to look more at another's hands to follow the other's lead, not just gaze."

The findings open up exciting questions about language learning and the teaching of language. They could also have major implications for the treatment of children with early social-communication impairment, such as autism, where joint caregiver-child attention with respect to objects and events is a key issue. The researchers believe these findings solve some of the problems and inadequacies of the classic unified “gaze-following” theory.

The researchers found that gaze-following theory tends to be imprecise in the real and chaotic world outside the sterility of a laboratory. It can be hard to tell precisely what someone is looking at when there are several objects together. It is easier and more precise to follow someone's hands. In other situations, it may be more useful to follow the other's gaze, according to the researchers. "Each of these pathways can be useful," Yu said. "A multi-pathway solution creates more options and gives us more robust solutions."

Researchers used innovative head-mounted eye-tracking technology that records the views of those wearing it, like Google Glass, which has never been used before with young children. While recording moment-to-moment data of what both parent and child visually attend to as they play together in the lab, the researchers also applied advanced data-mining techniques to discover fine-grained eye, head and hand movement patterns from a rich dataset they obtained from multimodal digital data.

"This really offers a new way to understand and teach joint attention skills," said co-author Linda Smith, Distinguished Professor in the Department of Psychological and Brain Sciences at Indiana University. Smith has done pioneering research and theoretical work in the development of human cognition, particularly as it relates to children ages 1 to 3 acquiring their first language. "We know that although young children can follow eye gaze, it is not precise, cueing attention only generally to the left or right. Hand actions are spatially precise, so hand-following might actually teach more precise gaze-following."

The Cerebellum Coordinates Eye and Hand Tracking Movements

I have written extensively in The Athlete’s Way about the possible role the cerebellum plays in cognitive function and well-being throughout a lifespan. This research from Indiana University offers more proof of the connection between the cerebellum and cerebral functions linked to learning and social behavior.
The mysterious and powerful cerebellum (Latin: Little Brain) is only 10% of brain volume but holds over 50% of your brain’s neurons. My father, who was a neurosurgeon and neuroscientist always said, “whatever the cerebellum is doing, it’s doing a lot of it.”

In another study from March 2013, a research team honed in on the gene Tsc2 in Purkinje cells of the cerebellum and found that loss of Tsc2 in Purkinje cells lead to autistic-like behavioral deficits. These studies provide compelling evidence that Purkinje cell loss in the cerebellum and/or dysfunction may be an important link between ASD as well as a "general anatomic phenomenon that contributes to the ASD phenotype," according to researchers.

A 2001 study published in the journal Nature Neuroscience confirmed that the cerebellum coordinates eye and hand tracking movements. The researchers used functional magnetic resonance imaging (fMRI) during visually guided tracking tasks that required varying degrees of hand-eye coordination.

The researchers found that the cerebellum was more active during independent rather than coordinated eye and hand tracking. However, in three further tasks, they also found increases in cerebellar blood oxygenation as hand-eye coordination increased.

This proves that the cerebellum has a direct relationship to tracking performance, with high activity seen during both coordinated and independent conditions of hand and eye tracking. This data provides the most direct  evidence that the cerebellum not only supports motor coordination but plays a significant role in learning to coordinate eye and hand movement.

Could the Vestibulo-Ocular Reflex be Linked to Autism?

The cerebellum also controls the vestibulo-ocular reflex (VOR) which is a reflex eye movement that stabilizes images during head movement by producing an eye movement in the direction opposite to head movement, which keeps the image in the center of your visual field. VOR is used for tracking a target and for helping to coordinate hand-eye movement. For example, when the head moves to the right, the eyes move to the left, and vice versa. Since slight head movement is present all the time, the VOR is very important for stabilizing vision.

The vestibulo-ocular reflex needs to work very quickly to maintain clear vision and focus. Head movements must be compensated for almost immediately—otherwise, your vision would look like a video taken with a shaky hand or in motion. VOR is used to play most sports and is key for hitting a tennis ball, hockey puck, baseball, catching a football... and for striking any moving target.
My father—who was a nationally ranked tennis player in his youth—always said, "Of this I am absolutely positive, becoming a neurosurgeon was the direct consequence of my eye for the ball." When people say 'keep-your-eye-on-the-ball,' they are literally describing the importance of a finely tuned vestibulo-ocular reflex.

To achieve clear vision, signals from the inner ear are sent as directly as possible to the eye muscles: the connection involves only three neurons, and is correspondingly called the three neuron arc. Using these direct connections, eye movements lag the head movements by less than 10 milliseconds. A well functioning vestibulo-ocular reflex is one of the fastest reflexes in the human body.

My fascination with the cerebellum and VOR is something my father passed on to me. I've yet to find research that connects the VOR to brain connectivity, autism, or learning disabilities. To my knowledge, the role of VOR in autism spectrum disorder and other learning disabilities is still an educated guess.

Brain Connectivity Between Hemispheres is Key to Learning

Another study from August 2013 found that atypical visual orientation in 7-month-olds could be a sign of risk for autism. The study titled “White Matter Microstructure and Atypical Visual Orienting in 7-Month-Olds at Risk for Autism” was published in American Journal of Psychiatry. White matter in the corpus callosum connects the left and right hemispheres of your cerebrum.

The researchers from Philadelphia found that children who are later diagnosed with autism have subtle but measurable differences in attention as early as 7 months of age. Researchers found that infants who went on to be diagnosed with autism are slower to shift their gaze from one object to another (by approximately 50 milliseconds), compared to peers who did not receive the diagnosis.

The scientists identified specific brain circuits in the corpus callosum were responsible for causing the slower response. The findings point to a problem they called "sticky attention," which is a phenomenon observed in preschool and older children with autism, but not yet well studied before in babies at risk for autism.

They were slower than both high-risk-negative and low-risk infants to orient or shift their gaze to objects that appeared outside their direct gaze. Results also implicate a specific neural circuit (the splenium of the corpus callosum), which may develop differently in those at risk for ASD compared to typically developing infants, who show more rapid orienting to visual stimuli.

"This is a very exciting study, because the impairments in shifting gaze and attention that we found in 7-month-olds may be a fundamental problem in autism," said Robert T. Schultz, Ph.D. Director of the Center for Autism Research and a co-author on the study. "These results are another piece of the puzzle in pinpointing the earliest signs of autism. Understanding how autism begins and unfolds in the first years of life will pave the way for more effective interventions and better long-term outcomes for individuals with autism and their families."

Other research on the benefits of playing an instrument before age 7 and the importance of hand gesticulation early in life imply that the neural scaffolding that connects brain hemispheres needs to be laid down early for the neural connections to have an infrastructure to build upon.

Conclusion: Scaffolding for Brain Connectivity is Built in Toddlers via Hand-Eye Coordination

Research is mounting that creating strong connectivity between both hemispheres of the cerebrum and both hemispheres of the cerebellum holds the key for optimizing brain function throughout a lifespan.

This new research on the role of hand-eye coordination in the early development of toddlers is another clue for practical ways that we can give toddlers and children the best odds for learning, creating social connectivity and lay the neural groundwork for maximizing their potential.

Just like a baby chick who has a patch put over one eye throughout early development would not have the scaffolding to build the neural connections needed for vision in that eye ...  it makes sense that daily activities in early life are important for laying down an initial neural scaffolding between brain hemispheres that serves as an infrastructure to fortify well-connected brain hemispheres in childhood and beyond.

As I put the pieces of this puzzle together, my hypothesis (and advice) is that parents, teachers and caregivers should strive to include daily activities that strenghten brain connectivity between all four brain hemispheres—starting from the first day of a person’s life. These initial neural connections will play a crucial role in optimizing a child's human potential for a lifespan.

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Separation Anxiety in Children: Easing Separation Anxiety Disorder

It's natural for your young child to feel anxious when you say goodbye. Although it can be difficult, separation anxiety is a normal stage of development. With understanding and these coping strategies, separation anxiety can be relieved—and should fade as your child gets older. However, if anxieties intensify or are persistent enough to get in the way of school or other activities, your child may have separation anxiety disorder. This condition may require professional treatment—but there is also a lot that you as a parent can do to help.

Separation anxiety in children: what’s normal and what’s not
In early childhood, crying, tantrums, or clinginess are healthy reactions to separation. Separation anxiety can begin before a child’s first birthday, and may pop up again or last until a child is four years old, but both the intensity level and timing of separation anxiety vary tremendously from child to child. A little worry over leaving mom or dad is normal, even when your child is older. You can ease your child’s separation anxiety by staying patient and consistent, and by gently but firmly setting limits.

Some kids, however, experience separation anxiety that doesn’t go away, even with a parent’s best efforts. These children experience a continuation or reoccurrence of intense separation anxiety during their elementary school years or beyond. If separation anxiety is excessive enough to interfere with normal activities like school and friendships, and lasts for months rather than days, it may be a sign of a larger problem: separation anxiety disorder.

Easing normal separation anxiety in children
For children with normal separation anxiety, there are steps you can take to make the process of separation anxiety easier.

  • Practice separation: Leave your child with a caregiver for brief periods and short distances at first.
  • Schedule separations after naps or feedings: Babies are more susceptible to separation anxiety when they’re tired or hungry.
  • Develop a “goodbye” ritual: Rituals are reassuring and can be as simple as a special wave through the window or a goodbye kiss.
  • Keep familiar surroundings when possible and make new surroundings familiar: Have the sitter come to your house. When your child is away from home, let him or her bring a familiar object.
  • Have a consistent primary caregiver: If you hire a caregiver, try to keep him or her on the job.
  • Leave without fanfare: Tell your child you are leaving and that you will return, then go—don’t stall.
  • Minimize scary television: Your child is less likely to be fearful if the shows you watch are not frightening.
  • Try not to give in: Reassure your child that he or she will be just fine—setting limits will help the adjustment to separation.

Symptoms of separation anxiety disorder in children
Separation anxiety disorder is NOT a normal stage of development, but a serious emotional problem characterized by extreme distress when a child is away from the primary caregiver. However, since normal separation anxiety and separation anxiety disorder share many of the same symptoms, it can be confusing to try to figure out if your child just needs time and understanding—or has a more serious problem.

The main differences between healthy separation anxiety and separation anxiety disorder are the intensity of your child’s fears, and whether these fears keep him or her from normal activities. Children with separation anxiety disorder may become agitated at just the thought of being away from mom or dad, and may complain of sickness to avoid playing with friends or attending school. When symptoms are extreme enough, these anxieties can add up to a disorder.

Common symptoms of separation anxiety disorder: worries and fears
Kids with separation anxiety disorder feel constantly worried or fearful about separation. Many kids are overwhelmed with one or more of the following:

  • Fear that something terrible will happen to a loved one: The most common fear a child with separation anxiety disorder experiences is the worry that harm will come to a loved one in the child's absence. For example, the child may constantly worry about a parent becoming sick or getting hurt.
  • Worry that an unpredicted event will lead to permanent separation: Kids with separation anxiety disorder may fear that once separated from a parent, something will happen to keep the separation. For example, they may worry about being kidnapped or getting lost.
  • Nightmares about separation: Children with separation anxiety problems often have scary dreams about their fears.

Common symptoms of separation anxiety disorder: refusals and sickness
Separation anxiety disorder can get in the way of kids’ normal activities. Children with this disorder often:

  • Refuse to go to school: A child with separation anxiety disorder may have an unreasonable fear of school, and will do almost anything to stay home.
  • Display reluctance to go to sleep: Separation anxiety disorder may make these children insomniacs, either because of the fear of being alone or due to nightmares about separation.
  • Complain of physical sickness like a headache or stomachache: At the time of separation, or before, children with separation disorder often complain they feel ill.
  • Cling to the caregiver: Children with separation anxiety problems may shadow you around the house or cling to your arm or leg if you attempt to step out.

Common causes of separation anxiety disorder in children
Separation anxiety disorder occurs because a child feels unsafe in some way. Take a look at anything that may have thrown your child’s world off balance, or made him or her feel threatened or could have upset your child’s normal routine. If you can pinpoint the root cause—or causes—you’ll be one step closer to helping your child through his or her struggles.

The following are common causes of separation anxiety disorder in children:

  • Change in environment: In children prone to separation anxiety, it is possible that changes in surroundings—like a new house, school, or day care situation—could trigger separation anxiety disorder.
  • Stress: Stressful situations like switching schools, or the loss of a loved one, including a pet, can trigger separation anxiety disorder.
  • Over-protective parent: In some cases, separation anxiety disorder may be the manifestation of the parent’s own anxiety—parents and children can feed one another’s anxieties.
Separation anxiety or trauma?
If it seems like your child’s separation anxiety disorder happened overnight, the cause might be something related to a traumatic experience rather than separation anxiety. Although these two conditions can share symptoms, they are treated differently. Help your child benefit from the most fitting treatment.

Helping children with separation anxiety disorder
You can help your child combat separation anxiety disorder by taking steps to make him or her feel safer. Providing a sympathetic environment at home can make your child feel more comfortable, and making changes at school may help reduce your child’s symptoms. Even if your efforts don’t completely solve the problem, your empathy can only make things better.

Tips for dealing with separation anxiety in children
The following tips can help you create a stable and supportive environment for your child.

  • Educate yourself about separation anxiety disorder: If you learn about how your child experiences this disorder, you can more easily sympathize with his or her struggles.
  • Listen to and respect your child’s feelings: For a child who might already feel isolated by his or her disorder, the experience of being listened to can have a powerful healing effect.
  • Talk about the issue: It’s healthier for children to talk about their feelings—they don’t benefit from “not thinking about it.” Be empathetic, but also remind the child—gently—that he or she survived the last separation.
  • Anticipate separation difficulty: Be ready for transition points that can cause anxiety for your child, such as going to school or meeting with friends to play. If your child separates from one parent more easily than the other, have that parent handle the drop off.
Tips for helping children with separation anxiety feel safe and secure
  • Provide a consistent pattern for the day: Don’t underestimate the importance of predictability for children with separation anxiety problems. If your family’s schedule is going to change, discuss it ahead of time with your child.
  • Set limits: Let your child know that although you understand his or her feelings, there are rules in your household that need to be followed.
  • Offer choices: If your child is given a choice or some element of control in an activity or interaction with an adult, he or she may feel more safe and comfortable.
Tips for encouraging healthy separation and independence in children
  • Keep calm during separation: If your child sees that you can stay cool, he or she is more likely to be calm, too.
  • Support the child's participation in activities: Encourage your child to participate in healthy social and physical activities.
  • Help a child who has been absent from school return as quickly as possible: Even if a shorter school day is necessary initially, children's symptoms are more likely to decrease when they discover that they can survive the separation.
  • Praise your child’s efforts: Use the smallest of accomplishments—going to bed without a fuss, a good report from school—as reason to give your child positive reinforcement.

Easing separation anxiety in children: Tips for school

Address the cause for avoidance of school.
Initiate a plan for your child to return to school immediately. This may include gradual reintroduction with partial days at first.

Accommodate late arrival.
If the school can be lenient about late arrival at first, it can give you and your child a little wiggle room to talk and separate at your child’s slower pace.

Identify a safe place.
Find a place at school where your child can go to reduce anxiety during stressful periods. Develop guidelines for appropriate use of the safe place.

Allow the child contact with home.
At times of stress at school, a brief phone call—a minute or two—with family may reduce separation anxiety.

Send notes for your child to read.
You can place a note for your child in his or her lunch box or locker. A quick “I love you!” on a napkin can reassure a child.

Provide assistance to the child during interactions with peers.
An adult's help, whether it is from a teacher or counselor, may be beneficial for both the child and his or her peers.

Reward a child's efforts.
Just like at home, every good effort—or small step in the right direction—deserves to be praised.
Combat separation anxiety in children by relieving your own stress
Kids with anxious or stressed parents may be more prone to separation anxiety. In order to help your child overcome separation anxiety disorder, you may need to take measures to become calmer and more centered yourself.

The following strategies can help to keep your stress and anxiety levels in check:

  • Talk about your feelings: Expressing what you’re going through can be very cathartic, even if there’s nothing you can do to alter the stressful situation.
  • Exercise regularly: Physical activity plays a key role in reducing and preventing the effects of stress.
  • Eat right: A well-nourished body is better prepared to cope with stress, so be mindful of what you eat.
  • Practice relaxation: You can control your stress levels with relaxation techniques like yoga, deep breathing, or meditation.
  • Get enough sleep: Feeling tired will only increase your stress, causing you to think irrationally or foggily.
  • Keep your sense of humor: The act of laughing helps your body fight stress in a number of ways.

When to seek professional help for separation anxiety disorder in children
Your own patience and know-how can go a long way toward helping your child with separation anxiety disorder. But some kids with separation anxiety disorder may need professional intervention.

To decide if you need to seek help for your child, look for “red flags,” or extreme symptoms that go beyond milder warning signs. If your efforts to reduce these symptoms don’t work, it may be the time to find a mental health specialist. Remember, these may also be symptoms of a trauma that your child has experienced. If this is the case, it is important to see a child trauma specialist.

Red flags for anxiety separation disorder in children
If you see any of the following “red flags” and your interventions don’t seem to be enough, it may be necessary to get a professional to diagnose and help your child with separation anxiety disorder.

  • Age-inappropriate clinginess or tantrums
  • Constant complaints of physical sickness
  • Withdrawal from friends, family, or peers
  • Refusing to go to school for weeks
  • Preoccupation with intense fear or guilt
  • Excessive fear of leaving the house

Treatment for separation anxiety disorder in children
Child psychiatrists, child psychologists, or pediatric neurologists can diagnose and treat separation anxiety disorder. These trained clinicians integrate information from home, school, and at least one clinical visit in order to make a diagnosis. Keep in mind that children with separation anxiety disorder frequently have physical complaints that may need to be medically evaluated.

Specialists can address physical symptoms, identify anxious thoughts, help your child develop coping strategies, and foster problem solving. Professional treatment for separation anxiety disorder may include:

  • Talk therapy: Talk therapy provides a safe place for your child to express his or her feelings. Having someone to listen empathetically and guide your child toward understanding his or her anxiety can be powerful treatment.
  • Play therapy: The therapeutic use of play is a common and effective way to get kids talking about their feelings.
  • Counseling for the family: Family counseling can help your child counteract the thoughts that fuel his or her anxiety, while you as the parent can help your child learn coping skills.
  • School-based counseling: This can help a child with separation anxiety disorder explore the social, behavioral, and academic demands of school.
  • Medication: Medications may be used to treat severe cases of separation anxiety disorder. It should be used only in conjunction with other therapy.
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Bacteria and Your Brain: Gut flora affect brain function and might play important role in brain disorders

Published on December 12, 2013 by Kimberlee D’Ardenne, Ph.D. in Quilted Science

If you count cells, we are not even close to being a majority human.

In our bodies, bacteria far outnumber human cells, 10:1. The number of bacterial cells living inside the human body even exceeds the number of neurons in the brain (and that’s roughly 80 billion neurons).

Before you get disgusted at being a living Petri dish, realize that these bacteria are beneficial.  They have a symbiotic relationship with our bodies, one that is vital to physical and mental health.

Recent research on the bacteria in our intestines, which is also called gut flora or microbiota, really makes a strong case that we should suspend judgment that what goes on in our intestines is gross.  I am convinced that gut flora is actually awesome, and I’m going to talk about a few reasons why.

Gut flora plays an important role in digestion and health.  All gut flora is not created equal, and recently the FDA has approved fecal microbiota transplants to treat debilitating gastrointestinal conditions, such as hard-to-cure infections and autoimmune diseases like Crohn’s and colitis.  (Mercifully, scientists are working on a pill that aims to do the same thing as a fecal transplant.)

But—and this is the awesome part—gut flora also affects how our brain works.

Cross-disciplinary research spanning neuroscience and gastroenterology has started identifying the biological mechanisms behind the bidirectional connection between the gut and brain.

For example, scientists were able to make anxious mice non-anxious by transplanting gut flora from non-anxious mice into the intestines of anxious mice.  They were also able to do the reverse, making non-anxious mice anxious via fecal microbiota transplant, which is the same general procedure described above in humans.

And experiments in healthy humans show that just eating over-the-counter probiotic yogurt had widespread effects on the brain.

Published last week, a study in mice suggests a relationship between gut flora and some behaviors seen in autism spectrum disorder. This provocative study used an animal model of autism to examine how different populations of gut flora affected the animals.

The mice used in the study had gastrointestinal problems that are seen in certain subpopulations of autistic humans, and the mice also displayed analogs of behaviors seen in some autistic humans.

The researchers treated the mice with probiotics, which altered their gut flora in a controlled way.  The scientists then examined how probiotics changed both gastrointestinal malfunctions and behavior.

Probiotic treatment alleviated gastrointestinal issues, specifically leaky gut, present in the mice.  The authors point out that a recent study in humans identified that autistic children with leaky gut were missing the specific bacteria included in the mouse experimental probiotic.

But what is really interesting is that giving the mice probiotics improved the behaviors associated with autism in humans.  Changing the bacteria in the gut changed the brain and therefore behavior.

The authors summarize their results as “supporting emerging evidence for a gut-brain link in modulating neurodevelopmental disorders.”

Though this study used an animal model for autism, the finding of gut flora composition affecting behavior applies to other brain disorders as well.  “… the behavioral abnormalities characteristic to human ASD can be individually seen in other neurological diseases such as schizophrenia, obsessive compulsive disorder, Angelman syndrome, and Prader-Willi syndrome.”

So instead of thinking of the all bacteria you play host to as icky or gross, give your gut flora the respect it deserves.  Gut flora is pretty awesome.

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Tying his own shoes: When he's ready and how to teach him

By Jennifer Kelly Geddes

It'll take practice and patience (from you both!), but most 5- and 6-year-olds are ready to tackle the skill of lacing-up. Your child's dexterity and hand-eye coordination are better now, and his attention span is longer, which means he's able to focus more.

In addition to one less chore for you, there's another bonus when he learns to tie: The confidence he's building will come in handy as other milestones approach (think taking off the training wheels or attending a birthday party without you). If he becomes very frustrated, take a break and try again in a week or so.

Here's how to get started:

  • Consider getting laces in two different colors (it may be easier to teach him by saying "the blue one" rather than "the right" or "the left"). 
  • Have him cross the laces to create an "X." 
  • Slide one under the other and pull. 
  • Form loops or "bunny ears" with each lace. 
  • Cross the "ears" and tuck one under the other (tell him the bunny is crawling through a hole), then tighten.
  • Tie alongside him if you're both right- or left-handed; if you're not, sit opposite each other so your motions will match his.
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