The Mysteries of ADD and High IQ

The five truths about attention deficit disorder.
Published on August 16, 2011 by Thomas E. Brown, Ph.D. in The Mysteries of ADD

We recently published a study of 117 high IQ children and adolescents with ADD. (Note: In this article, the term ADD is used to refer to both ADD and ADHD). All of these very bright students were struggling in school and often also in social relationships because of their ADD-related problems. Results from that study uncovered a pattern of vulnerabilities in executive functions, the management system of the brain, that caused these bright students to have chronic difficulty in focusing on their work, in getting their work done adequately, in keeping in mind what they had just heard or read, and in organizing and completing assignments. Some have been mystified as to how very bright students could suffer from ADD. They assume that being smart protects a person from the difficulties associated with ADD. This study shows that it doesn'

Here are 5 questions that our research team repeatedly encountered from high IQ kids and their parents and teachers:

1. Doesn't a person have to be hyper or have behavior problems to have ADD?

No! Most of the children and teenagers in this study of ADD were not hyperactive and had few, if any, significant behavior problems. For decades, this syndrome now known as ADD or ADHD was seen as a behavior disorder, a set of problems seen just in little kids who couldn't sit still, wouldn't shut up and who frustrated parents and teachers with chronic misbehavior. Research over the past 20 years has dramatically changed understanding of ADD by showing that many who fully meet diagnostic criteria for ADD have never had significant behavior problems. The core of ADD as it is now understood is a developmental delay in executive functions, a cluster of cognitive abilities that regulate other functions of the mind.

2. How can someone be really smart and yet have ADD?

All of the 117 kids in this study fully met diagnostic criteria for ADD and all had IQ scores of 120 or more, placing them in the top 9 percent of their age group on basic intelligence. Some were strongest in verbal comprehension, some were strongest in visual-spatial reasoning, and some were equally strong in both.

ADD has nothing to do with how smart a person is. Some individuals with ADD are super-smart on IQ tests, many score in the average range, and some are much lower.

Students in this study, compared to others of the same age, were impaired not by lack of smarts, but by chronic inability to deploy their smarts in effective work and in getting along with other people. One of the measures used in our study was a rating scale that inquires about impairments in various clusters that describe executive functions (EF). Everyone has problems with these various functions sometimes; people with ADD have much more difficulty with these functions than do most others of the same age.

 


Data from this study show that individuals can have very high IQ and still suffer significant impairments in each of these executive functions that are essential for working effectively and for getting along with other people.

3. How can someone be an honor student in elementary school and then struggle and fail repeatedly in high school or college?

Most of the students in this study got high grades in elementary school. Many were in special programs for talented and gifted students. Their school difficulties tended to begin when they made the move from elementary school, where they were with one teacher and the same group of classmates most of the day. Entry into middle school or junior high often brought increasing difficulties in keeping track of assignments and in completing homework. We explain that these students struggled when required to operate more independently without that one teacher who can help to keep tasks and expectations organized for all subjects throughout the day. As homework requirements escalated and parents were less able to monitor what was going on in all the various classes, many of these very bright students began to flounder.

Some of the older students in the study had managed to function well even with the demands of middle school and high school. Many of them had parents who were successful in maintaining supportive scaffolding around their sons and daughters, helping them to prioritize, plan, monitor and complete multiple assignments. Often the ADD impairments of these strongly supported high IQ students did not show up until they went away to college or university. There, lost without the strong daily support of their parents, many of these very bright students were unable to cope with their schoolwork, had plummeting grades and were required to take a semester off or transfer to another, less challenging college. Just being very smart is not enough to be successful in college, university or employment; one also needs to be able to manage oneself, to work productively and to get along reasonably well with peers, professors, supervisors, and employers.

4. How can someone focus very well on playing a sport, video games, drawing, or making music and not be able to focus enough on almost anything else?

The most mystifying aspect of ADD is that everyone who has this disorder is able to focus very well on a few specific types of tasks, even though they have great difficulty in focusing effectively on almost everything else. All of the students in this study reported that they had no difficulty in exercising executive functions very well for a few specific activities. For some it was participating in a sport or making art or music. For others, focus came easily for repairing car engines, cooking, using the computer, or designing websites. When asked to explain why they could focus on those few specific activities, but not on other tasks they recognized as important, the students typically responded by saying: "If it's something that really interests me, I can focus. If it's not really interesting to me, I just can't focus, even when I know it's important and I really need to do it."

One of our patients explained this: "ADD is like having erectile dysfunction of the mind. If the task is something that really interests you, you're up for it and can perform. If it's not something that turns you on, you can't get it up and you're not able to perform." The capacity to focus and mobilize executive functions for a task depends primarily on release of dopamine in specific areas of the brain and that release of dopamine is not under voluntary control.

5. Does anyone ever get over having ADD as they get older?

Back when ADD was seen as simple hyperactivity, it was believed that anyone with ADD would outgrow those problems by the time they were about 14 years old, if not before. That view made sense because for several decades ADD was seen as just hyperactive behavior, not as a problem with attention and EF. Often, though not always, hyperactive symptoms of ADD do go away as one gets older. But longer term studies have shown that for about 70-80 percent of those with ADD, their attentional symptoms tend to persist into adulthood, even if hyperactive problems have remitted. We published an earlier study of 157 high IQ adults with ADD. The design of that research was almost identical to this recent study of kids with ADD and the results were very similar. For many, the EF impairments of ADD persist into adulthood.

Despite the persistence of ADD, many of those affected experience less impairment from ADD symptoms as they get older. Three reasons may contribute to such improvement: for many with ADD, junior high, high school and the first few years of university are the most difficult. This is because these are the years when one is required to cope with the widest range of academic tasks with the least opportunity to escape from the ones you're not that good in. When one gets further along in education or employment it is often possible to specialize in work that is more interesting and which one can do reasonably well, without carrying so much of a burden of more challenging tasks. Second, imaging studies have shown that the course of brain development in adolescents with ADD is very similar to that of their age mates, except in a few specific regions of brain that are essential for executive functions. Individuals with ADD tend to catch up in development of these delayed regions of brain crucial for EF about 3 to 5 years behind their peers. This may account for some students who do poorly in high school and early college, then return to more advanced education a few years later and are very successful.

A third factor that helps many with ADD to improve their impaired executive functioning is treatment with appropriate medication. For about 80 percent of those with ADD, executive function can be improved significantly with a carefully managed regimen of medication approved for treatment of ADD. Medications cannot cure ADD, but, just as eyeglasses can improve vision when worn, for most individuals, regardless of IQ level, medication treatment for ADD can significantly improve executive functioning when it is appropriately used.

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How To Make a Visit to the Dentist Less Scary for Autistics, Aspergians, Sensitives and Any Anxious Person Advice for sensitive patients, dentists, and medical office designers

Published on August 25, 2011 by Rudy Simone in Aspergirls

Sensory issues are part and parcel of the autistic and aspergian experience, but we're not the only sensitives in the world ("The Princess and the Pea" was written in 1835, folks!) Today I had to go to the dentist for an exam and cleaning and was inspired to write this blog. I've been meaning to do it for ages; since a visit to a dentist in upstate NY three years ago. I asked him to hand me a toy that he had for kids so I could squeeze it to help me deal with my anxiety. I thanked him and explained, kind of apologetically, that I had Aspergers and he replied, "Don't worry, I'm used to dealing with all sorts of crazy folks." Lesson Number One, my fellow Aspergians: Never apologize for having AS. Be polite, yes, but apologetic, Never!

This article is aimed at the patients-but it is also aimed at the professionals who run/own these practices.

To the auties, aspies, sensitives and anxious folks: you will be poked, prodded, blinded by the light, scraped, suctioned and maybe even subjected to some of the worst music ever heard by human ears. Take heart, there are things you can do to ease the pain to the point of being almost painless.

    Don't forget your squidgy toys...if you don't bring them, the dentist might not have them, and if you are over the age of twelve you might be embarrassed to ask if they have any of these things in their cupboard.

    The lead bib that that they throw over you during x-ray time is similar to the weighted vests and shoulder bibs they make specifically for autistics. Ask to keep yours on after the x-ray is over and before the worst part begins--the cleaning. The heavy bib very comforting, like Temple Grandin's squeeze machine. You could even ask for it at the beginning, during the examination itself, when the dentist uses that little tiny metal claw that looks like it belongs on the arm of a Tinkerbell-sized Captain Hook.

    Ask if you can wear sunglasses. It'll keep you from having to completely close your eyes which might cause you to fall asleep and make dentist angry (we wouldn't want that). They'll also keep you from having to look dentist in the eye. For the first several dental visits of my life, I made eye contact with my dentist the whole time, causing him I'm sure, to think that I was either a nutter or a giant flirt. The office might have blinds or busy wallpaper patterns or bothersome lights, so the sunglasses will help you with that as well.

    You probably cannot wear an Ipod since you need to hear the dentist's directions (turn your head, open wide, etc.) but perhaps, you could ask if they mind if you wear either noise canceling headphones or perhaps just keep one earbud in your ear so you can have control of the tunes.

    Lastly, do not be afraid to ask for numbing cream for the cleaning, even for the exam. The basic stuff won't cost extra and really does help if you have a low pain threshold or are afraid of possible pain and are on hyper-alert. The cream will wear off by the time the exam is over.



Okay, the rest is for you dentists. You think you have created the coolest, most state-of-the-art office for your patients, but you are probably not thoroughly understanding the needs of your autistic, sensitive, or high anxiety patients.

Visually: high contrast wallpaper, e.g. black and white, might contain some groovy pattern to you, but might be so disorienting to an aspie that they get dizzy and even throw up, especially if they've had any sort of laughing gas or muscle relaxer. Even slatted blinds can drive us nuts. I got up out of my chair today at the dentist, ostensibly to look at the view (which was gorgeous) but also to raise the blinds--the lowered, slatted position created a dark and light, almost flickering pattern which can be painful to the autistic brain. And God forbid, Dr. Dentist, if you must use fluorescents, make sure they are the full-spectrum kind which contain the same colors as natural light and NOT flickering.

Doctor, do let the patient keep the bib and offer it at the beginning. It's a virtual hug that makes us feel more secure.

Tactile things, such as a squidgy toy, furry pillow (since grown ups won't want to be seen cuddling Tigger) are also good stress relievers.

Ask the patient if they would prefer to wear goggles in the beginning, not just when the polishing starts and the pink stuff starts to fly. I have been hit in the eye by my own tartar during the manual cleaning and believe me, I found it pretty gross. Get and offer tinted goggles. We don't like extended eye contact (if any) so if we keep our eyes closed, don't be offended.

And please, don't ask us questions while we are sitting there like horses at auction having our teeth and jaws examined. We respect and need what you do, but there's nothing more embarrassing than trying to answer questions while drooling and slurring.

Think about having a choice of music. While you have to be happy too, asking us if we prefer jazz, pop or classical give us some control even though you've chosen the Cds or stations.

Aspies talk to each other, in their communities and online and if you are known for having a sensory-friendly environment, you will have an edge over your competitors. And perhaps there will be more Aspies with shiny white teeth walking around, smiling a little more.

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Can a Lack of Sleep Set Back Your Child's Cognitive Abilities?

Overstimulated, overscheduled kids are getting at least an hour’s less sleep than they need, a deficiency that, new research reveals, has the power to set their cognitive abilities back years.

Snooze or Lose
By Po Bronson Published Oct 7, 2007

Morgan is a 10-year-old fifth-grader in Roxbury, New Jersey. She’s fair-skinned, petite, with freckles across her nose and wavy, light-brown hair. Her father is a police sergeant on duty until 3 a.m. Her mother, Heather, works part time, devoting herself to shuffling Morgan and her brother to their many activities. Morgan plays soccer, but her first love is competitive swimming, with year-round workouts that have broadened her shoulders. She’s also a violinist in the school orchestra, with practices and lessons each week. Every night, Morgan sits down to homework before watching Flip This House or another show with her mother. Morgan has always appeared to be an enthusiastic, well-balanced child.


But once Morgan spent a year in the classroom of a demanding teacher, she could no longer unwind at night. Despite a reasonable bedtime of 9:30 p.m., she would lay awake in frustration until 11:30, sometimes midnight, clutching her leopard-fur pillow. On her fairy-dust purple bedroom walls were taped index cards, each with a vocabulary word Morgan was having trouble with. Unable to sleep, she turned back to her studies, determined not to let her grades suffer. Instead, she saw herself fall apart emotionally. During the day, she was noticeably crabby and prone to crying easily. Occasionally, Morgan nearly fell asleep in class.

Concerned about her daughter’s well-being, Heather asked the family’s pediatrician about Morgan’s sleep. “He kind of blew me off and didn’t seem interested in it,” she recalls. “He said, ‘So she gets tired once in a while. She’ll outgrow it.’”

The pediatrician’s opinion is typical. According to surveys by the National Sleep Foundation, 90 percent of American parents think their child is getting enough sleep. The kids themselves say otherwise. In those same surveys, 60 percent of high schoolers report extreme daytime sleepiness. In another study, a quarter admit their grades have dropped because of it. Over 25 percent fall asleep in class at least once a week.

The raw numbers more than back them up. Half of all adolescents get less than seven hours of sleep on weeknights. By the time they are seniors in high school, according to studies by the University of Kentucky, they average only slightly more than 6.5 hours of sleep a night. Only 5 percent of high-school seniors average eight hours. Sure, we remember being tired when we went to school. But not like today’s kids.

It has been documented in a handful of major studies that children, from elementary school through high school, get about an hour less sleep each night than they did 30 years ago. While parents obsess over babies’ sleep, this concern falls off the priority list after preschool. Even kindergartners get 30 minutes less a night than they used to.

There are many causes for this lost hour of sleep. Overscheduling of activities, burdensome homework, lax bedtimes, televisions and cell phones in the bedroom all contribute. So does guilt; home from work after dark, parents want time with their children and are reluctant to play the hard-ass who orders them to bed. All these reasons converge on one simple twist of convenient ignorance: Until now, we could overlook the lost hour because we never really knew its true cost to children.

Using newly developed technological and statistical tools, sleep scientists have recently been able to isolate and measure the impact of this single lost hour. Because children’s brains are a work-in-progress until the age of 21, and because much of that work is done while a child is asleep, this lost hour appears to have an exponential impact on children that it simply doesn’t have on adults.

The surprise is how much sleep affects academic performance and emotional stability, as well as phenomena that we assumed to be entirely unrelated, such as the international obesity epidemic and the rise of Attention Deficit Hyperactivity Disorder. A few scientists theorize that sleep problems during formative years can cause permanent changes in a child’s brain structure: damage that one can’t sleep off like a hangover. It’s even possible that many of the hallmark characteristics of being a tweener and teen—moodiness, depression, and even binge eating—are actually symptoms of chronic sleep deprivation.

Dr. Avi Sadeh of Tel Aviv University is one of the authorities in the field. A couple of years ago, Sadeh sent 77 fourth-graders and sixth-graders home with randomly drawn instructions to either go to bed earlier or stay up later for three nights. Each child was given an actigraph (a wristwatchlike device that’s equivalent to a seismograph for sleep activity), which enabled Sadeh’s team to learn that the first group managed to get 30 minutes more sleep per night. The latter got 31 minutes less sleep.

After the third night’s sleep, a researcher went to the school in the morning to test the children’s neurobiological functioning. The test they used is highly predictive of both achievement-test scores and how teachers will rate a child’s ability to maintain attention in class.

Sadeh knew that his experiment was a big risk. “The last situation I wanted to be in was reporting to my grantors, ‘Well, I deprived the subjects of only an hour, and there was no measurable effect at all, sorry—but can I have some more money for my other experiments?’” he says.

Sadeh needn’t have worried. The effect was indeed measurable—and sizable. The performance gap caused by an hour’s difference in sleep was bigger than the normal gap between a fourth-grader and a sixth-grader. Which is another way of saying that a slightly sleepy sixth-grader will perform in class like a mere fourth-grader. “A loss of one hour of sleep is equivalent to [the loss of] two years of cognitive maturation and development,” Sadeh explains.

Sadeh’s findings are consistent with other researchers’ work, all of which points to the large academic consequences of small sleep differences. Dr. Monique LeBourgeois of Brown University studies how sleep affects pre-kindergartners. Virtually all young children are allowed to stay up late on Fridays and Saturdays. Yet she’s discovered that the sleep-shift factor alone is correlated with performance on a standardized school-readiness test. Every hour of weekend shift costs students seven points on the test. Dr. Paul Suratt of the University of Virginia studied the impact of sleep problems on vocabulary-test scores of elementary-school students. He also found a seven-point reduction in scores. Seven points, Suratt notes, is significant: “Sleep disorders can impair children’s I.Q.’s as much as lead exposure.”

Every study done shows a similar connection between sleep and school grades—from a study of second- and third-graders in Chappaqua to a study of eighth-graders in Chicago. The correlations really spike in high school, because that’s when there’s a steep drop-off in kids’ sleep. Dr. Kyla Wahlstrom of the University of Minnesota surveyed more than 7,000 high schoolers in Minnesota about their sleep habits and grades. Teens who received A’s averaged about fifteen more minutes sleep than the B students, who in turn averaged eleven more minutes than the C’s, and the C’s had ten more minutes than the D’s. Wahlstrom’s data was an almost perfect replication of results from an earlier study of more than 3,000 Rhode Island high schoolers by Brown’s Mary Carskadon. Certainly, these are averages, but the consistency of the two studies stands out. Every fifteen minutes counts.

With the benefit of functional MRI scans, researchers are now starting to understand exactly how sleep loss impairs a child’s brain. Tired children can’t remember what they just learned, for instance, because neurons lose their plasticity, becoming incapable of forming the synaptic connections necessary to encode a memory.

A different mechanism causes children to be inattentive in class. Sleep loss debilitates our body’s ability to extract glucose from the bloodstream. Without this stream of basic energy, one part of the brain suffers more than the rest: the prefrontal cortex, which is responsible for what’s called “executive function.” Among these executive functions are the orchestration of thoughts to fulfill a goal, the prediction of outcomes, and perceiving consequences of actions. So tired people have difficulty with impulse control, and their abstract goals like studying take a back seat to more entertaining diversions. A tired brain perseverates—it gets stuck on a wrong answer and can’t come up with a more creative solution, repeatedly returning to the same answer it already knows is erroneous.

Convinced by the mountain of studies, a handful of school districts around the nation are starting school later in the morning. The best known of these is in Edina, Minnesota, an affluent suburb of Minneapolis, where the high school start time was changed from 7:25 a.m. to 8:30. The results were startling. In the year preceding the time change, math and verbal SAT scores for the top 10 percent of Edina’s students averaged 1288. A year later, the top 10 percent averaged 1500, an increase that couldn’t be attributed to any other variable. “Truly flabbergasting,” said Brian O’Reilly, the College Board’s executive director for SAT Program Relations, on hearing the results.

Another trailblazing school district is Lexington, Kentucky’s, which also moved its start time an hour later. After the time change, teenage car accidents in Lexington were down 16 percent. The rest of the state showed a 9 percent rise.

Although the evidence is telling, few districts have followed this lead. Conversely, 85 percent of America’s public high schools start before 8:15 a.m. Thirty-five percent start at or before 7:30 a.m. In New York City, each school principal sets his own school schedule, and a randomized sample of 50 of the city’s 500 public high schools revealed that 30 percent begin by or before 7:30. At Midwood, class starts at seven on the dot; Van Buren lets you slide in at 7:05.

Obstacles to later start times are numerous. Having high schools start earlier often allows buses to first deliver the older students, then do a second run with the younger children. This could mean doubling the size of the bus fleet. Teachers prefer driving to school before other commuters clog the roads. Coaches worry their student athletes will miss games because they’re still in class at kickoff time.

Dr. Mark Mahowald, a University of Minnesota professor who runs a sleep clinic, has been at the center of many school start-time debates, and he dismisses those claims. “Of all the arguments I’ve heard over school start-times, not one person has argued that children learn more at 7:15 a.m. than at 8:30.”

Parents and educators might remain skeptical about the importance of the lost hour, but the sleep-research community considers the evidence irrefutable. Their convictions hardened as scientists began to understand sleep’s vital role in synthesizing and storing memories.

Dr. Matthew Walker of UC Berkeley explains that during sleep, the brain shifts what it learned that day to more efficient storage regions of the brain. Each stage of sleep plays a unique role in capturing memories. For example, studying a foreign language requires learning vocabulary, auditory memory of new sounds, and motor skills to correctly enunciate new words. The vocabulary is synthesized by the hippocampus early in the night during “slow-wave sleep,” a deep slumber without dreams. The motor skills of enunciation are processed during Stage 2 non-rem sleep, and the auditory memories are encoded across all stages. Memories that are emotionally laden get processed during R.E.M. sleep. The more you learned during the day, the more you need to sleep that night.

To consolidate these memories, certain genes appear to up-regulate during sleep; they literally turn on, or get activated. One of these genes is essential for synaptic plasticity, the strengthening of neural connections. The brain does synthesize some memories during the day, but they’re enhanced and concretized during the night: New inferences and associations are drawn, leading to insights the next day.

Perhaps most fascinating, the emotional context of a memory affects where it gets processed. Negative stimuli get processed by the amygdala; positive or neutral memories get processed by the hippocampus. Sleep deprivation hits the hippocampus harder than the amygdala. The result is that sleep-deprived people fail to recall pleasant memories yet recall gloomy memories just fine.

In one experiment by Walker, sleep-deprived college students tried to memorize a list of words. They could remember 81 percent of the words with a negative connotation, like cancer. But they could remember only 41 percent of the words with a positive or neutral connotation, like sunshine or basket.

“We have an incendiary situation today,” Walker remarks, “where the intensity of learning that kids are going through is so much greater, yet the amount of sleep they get to process that learning is so much less. If these linear trends continue, the rubber band will soon snap.”

While the neurocognitive sleep discoveries are impressive, there’s equally groundbreaking research on how sleep affects metabolism.

Five years ago, already aware of an association between sleep apnea and diabetes, Dr. Eve Van Cauter at the University of Chicago discovered a “neuroendocrine cascade” that links sleep to obesity.

Sleep loss increases the hormone ghrelin, which signals hunger, and decreases its metabolic opposite, leptin, which suppresses appetite. Sleep loss also elevates the stress hormone cortisol. Cortisol is lipogenic, meaning it stimulates your body to make fat. Human growth hormone is also disrupted. Normally secreted as a big pulse at the beginning of sleep, growth hormone is essential for the breakdown of fat.

It’s drilled into us that we need to be more active to lose weight. So it spins the mind to hear that a key to staying thin is to spend more time doing the most sedentary inactivity humanly possible. Yet this is exactly what some scientists seem to be finding. In light of Van Cauter’s discoveries, sleep scientists have performed a flurry of analyses on children. All the studies point in the same direction: On average, children who sleep less are fatter than children who sleep more. This isn’t just in the U.S.; scholars around the world are considering it, as they watch sleep data fall and obesity rates rise in their own countries.

Three foreign studies showed strikingly similar results. One analyzed Japanese elementary students, one Canadian kindergarten boys, and one young boys in Australia. They all showed that kids who get less than eight hours of sleep have about a 300 percent higher rate of obesity than those who get a full ten hours of sleep. Within that two-hour window, it was a “dose-response” relationship, according to the Japanese scholars.

In Houston public schools, according to a University of Texas at Houston study, adolescents’ odds of obesity went up 80 percent for each hour of lost sleep.

Sleep’s role in obesity is a comparatively new theory, and one difficult to prove in a controlled experiment. But the traditional approach to solving childhood obesity is an abject failure. The federal government spends over a billion dollars a year on nutrition-education programs in our schools. A recent analysis by McMaster University in Hamilton, Ontario, found that of 57 such programs, 53 had no effect whatsoever, and the four remaining programs’ results were meager at best.

For a long time, there’s been one culprit to blame for these failed efforts: television. Rather than running around the neighborhood like when we were young, today’s kids sit in front of the boob tube an average of 3.3 hours a day. The connection to obesity seemed so obvious that few people thought it needed to be supported scientifically.

Last year, Dr. Elizabeth Vandewater at the University of Texas at Austin got fed up with hearing scholars blame it all on television. “It’s treated as gospel without any evidence,” she says. “It’s just bad science.” Vandewater analyzed the best large data set available, the Panel Study of Income Dynamics, which has extensively surveyed 8,000 families since 1968. She found that obese kids watch no more television than kids who aren’t obese. All the thin kids watch massive amounts of television, too. There was no statistical correlation between obesity and media use, period. “It’s just not the smoking gun we assumed it to be.”

Vandewater examined the children’s time diaries, and she realized why the earlier research had got it wrong. “Children trade functionally equivalent things. If the television’s off, they don’t go play soccer,” she says. “They do some other sedentary behavior.”

In fact, while obesity has spiked exponentially since the seventies, kids watch only seven minutes more TV a day. Although they do average a half-hour of video games and Internet surfing on top of television viewing, the leap in obesity began in 1980, well before home video games and the invention of the Web browser. This doesn’t mean it’s healthy to watch television. But it does mean that something other than television is making kids heavier.

“We’ve just done diet and exercise studies for a hundred years and they don’t work well, and it’s time to look for different causes,” says Dr. Richard Atkinson, co-editor-in-chief of the International Journal of Obesity.

Despite how persuasive all this science is, somehow it still seems like a huge leap of faith to consider giving back an hour of our children’s lives to slumber. Statistical correlations are fine evidence for scientists, but as parents, we want more—we want control.

Dr. Judith Owens runs a sleep clinic in Providence, Rhode Island, affiliated with Brown. Recently, a father came in with his 15-year-old daughter, who was complaining of severe headaches. Interviewing the patient, Owens quickly learned that her daily routine was a brutal grind; after violin lessons, bassoon lessons, dance classes, and the homework from honors classes, she was able to get only five hours of sleep a night before waking every morning at 4:30 to hustle off to the gym. The father wanted to know if a lack of sleep could be causing her headaches. Owens told him that was probably the case. She recommended his daughter cut back on her schedule.

The word probably made this father hesitant. He would let her cut back, but only if Owens could prove, in advance, that sacrificing an activity would stop the headaches. Sure, he knew that sleep was important, but was it more important than honors French? Was it more important than getting into a great college?

Owens tried her standard argument. “Would you let your daughter ride in a car without a seat belt? You have to think of sleep the same way.” But in the father’s mind, he saw the transaction the other way around: Cutting back was putting his daughter at risk. What if the headaches didn’t stop and she gave up one of her great passions, like dance, for no reason?

Long before children become overscheduled high schoolers gunning for college, parents start making trade-offs between their kids’ sleep and their other needs. This is especially true in the last hour of a child’s day, a time zone let’s call “the Slush Hour.” The Slush Hour is both a rush to sleep and a slush fund of potential time, sort of a petty-cash drawer from which we withdraw ten-minute increments. During the Slush Hour, children should be in bed, but there are so many competing priorities. As a result, sleep is treated much like the national debt—What’s another half-hour on the bill? We’re surviving; kids can, too.

Sleep is a biological imperative for every species on Earth. But humans alone try to resist its pull. Instead, we see sleep not as a physical need but a statement of character. It’s considered a sign of weakness to admit fatigue, and it’s a sign of strength to refuse to succumb to slumber. Sleep is for wusses.

But perhaps we are blind to the toll it is taking on us. The University of Pennsylvania’s David Dinges did an experiment shortening adults’ sleep to six hours a night. After two weeks, they reported they were doing okay. Yet on a battery of tests, they proved to be just as impaired as someone who has stayed awake for 24 hours straight.

Dinges did the experiment to demonstrate how sleep loss is cumulative, and how easily our judgment can be fooled by sleep deprivation. Nevertheless, it’s easy to read his research and think, “I would suffer, but not that bad. I would be the exception.” We’ve coped on too-little sleep for years and managed to get by. But when it comes to a child’s developing brain, is just getting by enough?


Article retrieved from: http://nymag.com/news/features/38951/index4.html
Image retrieved from retrieved from: http://files.myopera.com/meoc/albums/756598/6638_ Baby_ Sleep.jpg

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Catching learning disabilities at a young age is key to academic success

STATEN ISLAND, N.Y. — By the time her son, Luis, was 2 years old, Wendy Ramos realized he wasn’t hitting important speech milestones and enrolled him in speech therapy.

“Luis wasn’t talking, but he understood what I was saying and he was great at art and puzzles,” the Great Kills mom explained. “As he got older, he wasn’t recognizing letters or rhymes or nursery songs. He was frustrated, because he wasn’t progressing.”

DYSLEXIA DIAGNOSIS

Luis was diagnosed with dyslexia, a verbal learning disability (LD) that’s caused by a neurological impairment in an area of the brain that helps decode language.

According to Dr. Greg Liptak of the American Academy of Pediatrics (AAP), children with LDs oftentimes are very intelligent but struggle with a specific task.

Liptak, who’s on the board of the Council on Children with Disabilities, explained there are two types of LDs: verbal, in which reading and writing skills are affected, and non-verbal, in which the child has difficulties with coordination and/or reading body language.

While signs of LD often vary, some red flags the AAP states parents need to look out for include: delayed language, short attention spans and coordination issues.

Liptak also lists poor balance, poor movement and low muscle tone as warning signs.

TROUBLE WRITING

As children with LDs get older, they may have trouble writing clearly, conveying their thoughts in speech or writing, reading and sounding out words, understanding directions, staying organized and concentrating or remembering facts and information.

Liptak said denial from parents, especially those with successful careers, and misdiagnosing LD as laziness are two common problems.

He stresses that parents who suspect their kid has a problem to get him or her checked immediately. They also may inquire with the school district about psychoeducational testing.

Mrs. Ramos agreed the earlier parents get their child tested the better.

“Statistically, parents wait a year before getting their children help with their learning disabilities. This is a year of help they [the children] could have been receiving,” she said.

TREATMENT

If an LD is diagnosed, there are two types of treatment: remediation, which involves repeated practice and accommodating for the child’s specific needs, such as having him listen to tapes if he’s struggling with reading, or using a keyboard, if writing proves to be a problem. Phonics practice also can be useful.

Liptak also stressed that youngsters with LDs need to stay on top of school work throughout the summer.

“Children with LDs lose their skills when not in use, so it’s important to keep kids reading and writing and doing activities they enjoy, like going to museums,” he said.

Mrs. Ramos said it’s important parents concentrate on their child’s strengths.

“Too much emphasis is often placed on what learning disabled children cannot do, leaving them feeling defeated and overwhelmed,” she explained, adding, “Our dyslexic children are our artists, creators, engineers, builders, actors, entrepreneurs, our out-of-the box thinkers. Parents should encourage that.”

Article retrieved from: http://www.silive.com/relationships/index.ssf/2011/08/catching_learning_disabilities_at_a_young_age_is_key_to_academic_success.html?utm_source=Twitter&utm_campaign=LDOnLine.org

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New Brain Imaging Research Reveals Why Autistic Individuals Confuse Pronouns

ScienceDaily (Aug. 1, 2011) — Autism is a mysterious developmental disease because it often leaves complex abilities intact while impairing seemingly elementary ones. For example, it is well documented that autistic children often have difficulty correctly using pronouns, sometimes referring to themselves as "you" instead of "I."

A new brain imaging study published in the journal Brain by scientists at Carnegie Mellon University provides an explanation as to why autistic individuals' use of the wrong pronoun is more than simply a word choice problem. Marcel Just, Akiki Mizuno and their collaborators at CMU's Center for Cognitive Brain Imaging (CCBI) found that errors in choosing a self-referring pronoun reflect a disordered neural representation of the self, a function processed by at least two brain areas -- one frontal and one posterior.

"The psychology of self -- the thought of one's own identity -- is especially important in social interaction, a facet of behavior that is usually disrupted in autism," said Just, a leading cognitive neuroscientist and the D.O. Hebb Professor of Psychology at CMU who directs the CCBI. "Most children don't need to receive any instruction in which pronoun to use. It just comes naturally, unless a child has autism."

For the study, the research team used functional magnetic resonance imaging (fMRI) to compare the brain activation pattern and the synchronization of activation across brain areas in young adults with high-functioning autism with control participants during a language task that required rapid pronoun comprehension.

The results revealed a significantly diminished synchronization in autism between a frontal area (the right anterior insula) and a posterior area (precuneus) during pronoun use in the autism group. The participants with autism also were slower and less accurate in their behavioral processing of the pronouns. In particular, the synchronization was lower in autistic participants' brains between the right anterior insula and precuneus when answering a question that contained the pronoun "you," querying something about the participant's view.

"Shifting from one pronoun to another, depending on who the speaker is, constitutes a challenge not just for children with autism but also for adults with high-functioning autism, particularly when referring to one's self," Just said. "The functional collaboration of two brain areas may play a critical role for perspective shifting by supporting an attention shift between oneself and others.

"Pronoun reversals also characterize an atypical understanding of the social world in autism. The ability to flexibly shift viewpoints is vital to social communication, so the autistic impairment affects not just language but social communication," Just added.

Autism was documented for the first time in 1943, in a landmark article by Dr. Leo Kanner of Johns Hopkins University. In that first article, Kanner noted the puzzling misuse of pronouns by children with the disorder. "When he [the child] wanted his mother to pull his shoe off, he said: 'Pull off your shoe.'" Kanner added that, "Personal pronouns are repeated [by the child with autism] just as heard, with no change to suit the altered situation." Because his mother referred to him as "you," so did the child.

Just's previous brain imaging research in autism has shown that other facets of thinking that are disrupted in autism, such as social difficulties and language impairments, also may be attributed to a reduced communication bandwidth between the frontal and posterior parts of the brain. He refers to this as the "Theory of Frontal-Posterior Underconnectivity." In each of these types of thinking, the processing is done by a set of different brain regions that includes key frontal regions, and the lower frontal-posterior bandwidth limits how well the frontal regions can contribute to the brain's networked computations.

The brain's communication network is its white matter, the 45 percent of the brain that consists of myelinated (insulated) axons that carry information between brain regions. An emerging view is that the white matter is compromised in autism, specifically in the frontal-posterior tracts. In a groundbreaking study published in 2009, Just and his colleagues showed for the first time that compromised white matter in children with reading difficulties could be repaired with extensive behavioral therapy. Their imaging study showed that the brain locations that had been abnormal prior to the remedial training improved to normal levels after the training, and the reading performance in individual children improved by an amount that corresponded to the amount of white matter change. Ongoing research at the CCBI is assessing the white matter in detail, measuring its integrity and topology, trying to pinpoint the difference in the autistic brain's networks.

"This new understanding of what causes pronoun confusion in autism helps make sense of the larger problems of autism as well as the idiosyncrasies," Just said. "Moreover, it points to new types of therapies that may help rehab the white matter in autism."

In addition to Just and Mizuno, a psychology doctoral candidate and first author of the study, the research team included CMU's Yanni Liu, a postdoctoral associate, and Timothy A. Keller, a senior research psychologist; Duquesne University's Diane L. Williams, an assistant professor of speech-language pathology; and the University of Pittsburgh School of Medicine's Nancy J. Minshew, a professor of psychiatry and neurology.

This research was funded by the National Institute of Child Health and Human Development and the Autism Speaks Foundation.

Article retrieved from: http://www.sciencedaily.com/releases/2011/08/110801122956.htm

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