It is Not Only Cars That Deserve Good Maintenance: Brain Care 101

By: Alvaro Fernandez

Last week, the US Car Care Coun­cil released a list of tips on how to take care of your car and “save big money at the pump in 2008.”

You may not have paid much atten­tion to this announce­ment. Yes, it’s impor­tant to save gas these days; but, it’s not big news that good main­te­nance habits will improve the per­for­mance of a car, and extend its life.

If we can all agree on the impor­tance of main­tain­ing our cars that get us around town, what about main­tain­ing our brains sit­ting behind the wheel?

A spate of recent news cov­er­age on brain fit­ness and “brain train­ing” has missed an impor­tant con­stituency: younger peo­ple. Recent advance­ments in brain sci­ence have as tremen­dous impli­ca­tions for teenagers and adults of all ages as they do for seniors.

In a recent con­ver­sa­tion with neu­ro­sci­en­tist Yaakov Stern of Colum­bia Uni­ver­sity , he related how sur­prised he was when, years ago, a reporter from Sev­en­teen mag­a­zine requested an inter­view. The reporter told Dr. Stern that he wanted to write an arti­cle to moti­vate kids to stay in school and not to drop out, in order to start build­ing their Cog­ni­tive Reserve early and age more gracefully.

What is the Cog­ni­tive Reserve?

Emerg­ing research since the 90s from the past decade shows that indi­vid­u­als who lead men­tally stim­u­lat­ing lives, through their edu­ca­tion, their jobs, and also their hob­bies, build a “Cog­ni­tive Reserve” in their brains. Only a few weeks ago another study rein­forced the value of intel­lec­tu­aly demand­ing jobs.

Stim­u­lat­ing the brain can lit­er­ally gen­er­ate new neu­rons and strengthen their con­nec­tions which results in bet­ter brain per­for­mance and in hav­ing a lower risk of devel­op­ing Alzheimer’s symp­toms. Stud­ies sug­gest that peo­ple who exer­cise their men­tal mus­cles through­out their lives have a 35–40% less risk of man­i­fest­ing Alzheimer’s.

As astound­ing as these insights may be, most Amer­i­cans still devote more time to chang­ing the oil, tak­ing a car to a mechanic, or wash­ing it, than think­ing about how to main­tain, if not improve, their brain performance.

Fur­ther, bet­ter brain scan­ning tech­niques like fMRI (glos­sary ) are allow­ing sci­en­tists to inves­ti­gate healthy live brains for the first time in his­tory. Two of the most impor­tant find­ings from this research are that our brains are plas­tic (mean­ing they not only cre­ate new neu­rons but also can change their struc­ture) through­out a life­time and that frontal lobes are the most plas­tic area. Frontal lobes, the part of our brains right behind the fore­head, con­trols “exec­u­tive func­tions” — which deter­mine our abil­ity to pay atten­tion, plan for the future and direct behav­ior toward achiev­ing goals. They are crit­i­cal for adapt­ing to new sit­u­a­tions. We exer­cise them best by learn­ing and mas­ter­ing new skills.

This part of the brain is del­i­cate: our frontal lobes wait until our mid to late 20s to fully mature. They are also the first part of our brain to start to decline, usu­ally by mid­dle age.

In my view, not enough young and middle-aged peo­ple are ben­e­fit­ing from this emerg­ing research, since it has been per­ceived as some­thing “for seniors.” Granted, there are still many unknowns in the world of brain fit­ness and cog­ni­tive train­ing, we need more research, bet­ter assess­ments and tools. But, this does not mean we can­not start car­ing for our brains today.

Recent stud­ies have shown a tremen­dous vari­abil­ity in how well peo­ple age and how, to a large extent, our actions influ­ence our rate of brain improve­ment and/or decline. The ear­lier we begin the bet­ter. And it is never too late.

What can we do to main­tain our brain, espe­cially the frontal lobes? Focus on four pil­lars of brain health: phys­i­cal exer­cise , a bal­anced diet , stress man­age­ment , and brain exer­cise . Stress man­age­ment is impor­tant since stress has been shown to actu­ally kill neu­rons and reduce the rate of cre­ation of new ones. Brain exer­cises range from low-tech (i.e. med­i­ta­tion , mas­ter­ing new com­plex skills, life­long learn­ing and engage­ment ) to high-tech (i.e. using the grow­ing num­ber of brain fit­ness soft­ware pro­grams ).

I know, this is start­ing to sound like those lists we all know are good for us but we actu­ally don’t do. Let me make it eas­ier by propos­ing a new New Year Res­o­lu­tion for 2008: every time you wash your car or have it washed in 2008, ask your­self, “What have I done lately to main­tain my brain?”

Article retrieved: http://www.sharpbrains.com/blog/2008/01/11/it-is-not-only-cars-that-deserve-good-maintenance-brain-care-101/

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Brain Plasticity: How learning changes your brain

By: Dr. Pascale Michelon

You may have heard that the brain is plas­tic. As you know the brain is not made of plas­tic! Neu­ro­plas­tic­ity or brain plas­tic­ity refers to the brain’s abil­ity to CHANGE through­out life. The brain has the amaz­ing abil­ity to reor­ga­nize itself by form­ing new con­nec­tions between brain cells (neurons).

In addi­tion to genetic fac­tors, the envi­ron­ment in which a per­son lives, as well as the actions of that per­son, play a role in plasticity.

Neu­ro­plas­tic­ity occurs in the brain:

1– At the begin­ning of life: when the imma­ture brain orga­nizes itself.

2– In case of brain injury: to com­pen­sate for lost func­tions or max­i­mize remain­ing functions.

3– Through adult­hood: when­ever some­thing new is learned and memorized
Plas­tic­ity and brain injury

A sur­pris­ing con­se­quence of neu­ro­plas­tic­ity is that the brain activ­ity asso­ci­ated with a given func­tion can move to a dif­fer­ent loca­tion as a con­se­quence of nor­mal expe­ri­ence, brain dam­age or recovery.

In his book “The Brain That Changes Itself: Sto­ries of Per­sonal Tri­umph from the Fron­tiers of Brain Sci­ence , Nor­man Doidge describes numer­ous exam­ples of func­tional shifts.

In one of them, a sur­geon in his 50s suf­fers a stroke. His left arm is par­a­lyzed. Dur­ing his reha­bil­i­ta­tion, his good arm and hand are immo­bi­lized, and he is set to clean­ing tables. The task is at first impos­si­ble. Then slowly the bad arm remem­bers how too move. He learns to write again, to play ten­nis again: the func­tions of the brain areas killed in the stroke have trans­ferred them­selves to healthy regions!

The brain com­pen­sates for dam­age by reor­ga­niz­ing and form­ing new con­nec­tions between intact neu­rons. In order to recon­nect, the neu­rons need to be stim­u­lated through activity.

Plas­tic­ity, learn­ing and memory

For a long time, it was believed that as we aged, the con­nec­tions in the brain became fixed. Research has shown that in fact the brain never stops chang­ing through learn­ing. Plas­tic­ity IS the capac­ity of the brain to change with learn­ing. Changes asso­ci­ated with learn­ing occur mostly at the level of the con­nec­tions between neu­rons. New con­nec­tions can form and the inter­nal struc­ture of the exist­ing synapses can change.

Did you know that when you become an expert in a spe­cific domain, the areas in your brain that deal with this type of skill will grow?

For instance, Lon­don taxi dri­vers have a larger hip­pocam­pus (in the pos­te­rior region) than Lon­don bus dri­vers (Maguire, Wool­lett, & Spiers, 2006). Why is that? It is because this region of the hip­pocam­pus is spe­cial­ized in acquir­ing and using com­plex spa­tial infor­ma­tion in order to nav­i­gate effi­ciently. Taxi dri­vers have to nav­i­gate around Lon­don whereas bus dri­vers fol­low a lim­ited set of routes.

Plas­tic­ity can also be observed in the brains of bilin­guals (Mechelli et al., 2004). It looks like learn­ing a sec­ond lan­guage is pos­si­ble through func­tional changes in the brain: the left infe­rior pari­etal cor­tex is larger in bilin­gual brains than in mono­lin­gual brains.

Plas­tic changes also occur in musi­cians brains com­pared to non-musicians. Gaser and Schlaug (2003) com­pared pro­fes­sional musi­cians (who prac­tice at least 1hour per day) to ama­teur musi­cians and non-musicians. They found that gray mat­ter (cor­tex) vol­ume was high­est in pro­fes­sional musi­cians, inter­me­di­ate in ama­teur musi­cians, and low­est in non-musicians in sev­eral brain areas involved in play­ing music: motor regions, ante­rior supe­rior pari­etal areas and infe­rior tem­po­ral areas.

Finally, Dra­gan­ski and col­leagues (2006) recently showed that exten­sive learn­ing of abstract infor­ma­tion can also trig­ger some plas­tic changes in the brain. They imaged the brains of Ger­man med­ical stu­dents 3 months before their med­ical exam and right after the exam and com­pared them to brains of stu­dents who were not study­ing for exam at this time. Med­ical stu­dents’ brains showed learning-induced changes in regions of the pari­etal cor­tex as well as in the pos­te­rior hip­pocam­pus. These regions of the brains are known to be involved in mem­ory retrieval and learning.

To go fur­ther: Q and A about Brain plas­tic­ity

Q: Can hor­mones change my brain?

A: It seems that the brain reacts toits hor­monal milieu with struc­tural mod­i­fi­ca­tions. Read more: Can the pill change women’s brains .

Q: Can new neu­rons grow in my brain?

A: Yes in some areas and through­out your life­time. Learn how and read about what hap­pens to these new neu­rons here: New neu­rons: good news, bad news .

Q: Where can I find more information?

A: Read the answers to 15 com­mon ques­tions about neu­ro­plas­tic­ity and brain fitness

Q: Can you rec­om­mend a good book to learn more about all this and how to apply it?

A: Sure! We pub­lished The Sharp­Brains Guide to Brain Fit­ness: 18 Inter­views with Sci­en­tists, Prac­ti­cal Advice, and Prod­uct Reviews, to Main­tain Your Brain Sharp (April 2009; 182 pages) to pro­vide a com­pre­hen­sive and acces­si­ble entry into the research AND how to apply it. And we’re happy to report that AARP named it a Best Book on the subject!

—————-

Finally, you will find more related infor­ma­tion on how to improve con­cen­tra­tion and mem­ory by check­ing out these resources:

- Neu­ro­science Inter­view Series : inter­views with over 15 brain sci­en­tists and experts.

- Col­lec­tion of brain teasers and games : atten­tion, mem­ory, problem-solving, visual, and more.

Article retrieved from: http://www.sharpbrains.com/blog/2008/02/26/brain-plasticity-how-learning-changes-your-brain/

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Working Memory and the Classroom

Why it is important to assess Working Memory in an educational setting
Published on June 11, 2012 by Tracy P. Alloway, Ph.D. in Keep It in Mind

As a psychologist, I have spent over a decade investigating how Working Memory is crucial to learning. Throughout this journey, I have the privilege of working closely with educators and parents and I am grateful to those who have contacted me and taken me beyond the world of theory and data to see the classroom from their perspective. Here are excerpts from some recent emails:

I have an 8-year-old son who has been struggling with school since he was 5. I've taken him to several psychologists, psychiatrists, and even pediatric neurologists and I have not gotten a clear diagnosis other than ADHD. What I noticed is that my son has an issue with his working memory. All of the research I did points to this being his major problem.

Samantha is 12 and has been assessed as having difficulties with her working memory. The school has identified this [and] I am keen to see if I can find ways to help my daughter.

Now more than ever, it is crucial to accurately assess Working Memory. The incidence of learning disorders is increasing and there is growing awareness of how Working Memory deficits feature in a number of learning difficulties. Working memory has also been described as a ‘controller’, a cognitive resource that can keep a goal in mind, bring in cognitive resources from different parts of the brain, and also manage incoming information.

Each of the learning needs listed in the Figure have very different areas of difficulty. For example, students with dyslexia are characterized by their trouble reading, those with dyscalculia find an assortment of math problems tricky, students with dyspraxia have motor impairments, those with ADHD display troublesome behavior, and students with Autistic Spectrum Disorder have limited social skills. Given their distinctive profile, what do these groups have in common? All of them have a weakness in working memory. That is not to say that poor working memory causes the core deficit in their respective disorder. However, it coexists as a separate problem and ultimately leads to learning difficulties. For example, a deficit in working memory does not cause motor problems, however in my own published research I found that working memory weaknesses in a student with dyspraxia leads to learning difficulties, regardless of their IQ.

Research to date indicates that teachers’ awareness of working memory deficits in the classroom can still be quite low. In a recent study, the majority of teachers interviewed only picked up early warning signs of working memory failure in their students 25 percent of the time, often thinking that the students were unmotivated or daydreaming instead.

So how can an educator accurately diagnosis a potential Working Memory problem in a student? Stemming from my research findings, I have published the Automated Working Memory Assessment, a computer-based assessment of working memory that has automatised test administration and presents results in a form that is easy to interpret by non-experts. The AWMA provides measures each of verbal and visuo-spatial short-term memory and working memory and currently, it is the only standardised assessment of working memory available for teachers to use. Not only does the AWMA eliminate the need for prior training in test administration, it also provides a practical and convenient way for educators to screen students for significant working memory problems. It is standardised for use from childhood (five years) to adulthood (80 years) in a revised version (due end-2012).

Once the specific strengths and weaknesses of a student’s working memory profile are known, specific and targeted accommodations can be made to support learning. The aim in supporting students with learning difficulties is not just to help them survive in the classroom, but to thrive as well. Strategies can provide scaffolding and support that will unlock their working memory potential to boost learning.

Recently, there has been an explosion of research investigating the potential benefits of training Working Memory. In a recent study of students with learning difficulties, a computerized working memory training programme (www.JungleMemory.com) was found to significantly improve verbal and visual-spatial working memory, IQ scores, as well as language scores as measured by standardized assessments.

When working with schools, I have seen how supporting their Working Memory can make a significant difference to their learning and ultimately their academic success. The interested reader is welcome to look at the resources listed below for further information on Working Memory and learning.

Article retrieved from: http://www.psychologytoday.com/blog/keep-it-in-mind/201206/working-memory-and-the-classroom

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Working Memory in Any Language: Is It the Same?

Published on February 13, 2012 by Tracy P. Alloway, Ph.D.

Working memory is critical for many activities at school, from complex subjects such as reading comprehension, mental arithmetic, and word problems to simple tasks like copying from the board and navigating the halls. We have a limited space for processing information, and the size of various individuals' working memory capacity can vary greatly. For example, a 7-year-old who has working-memory problems may have a working memory capacity the same size as an average 4-year-old. This student will likely find it difficult to keep up with what the teacher says, will struggle to remember instructions, and will mix up words. In contrast, another 7-year-old may have working-memory skills the same size as an average 10-year-old. This student will be the first to finish individual work, will respond quickly to questions during group time, and may even be bored by school.

In everyday classroom activities, students with poor working memory often struggle in activities that place heavy demands on working memory. Thus, it is especially important for educators to be able to directly and accurately assess Working Memory. In my own research, I have published the Automated Working Memory Assessment (AWMA; published by Pearson Assessment, UK), a standardized assessment of verbal and visuo-spatial Working Memory. Not only does the AWMA eliminate the need for prior training in test administration, it also provides a practical and convenient way for educators to screen students for significant working memory problems. Currently, it is the only standardized assessment of working memory available for educators to use, and to date has been translated into 15 languages. Details on the reliability and validity of the AWMA, including research on it use with different learning needs populations, like dyslexia, ADHD, and Autistic Spectrum Disorder, can be found here:

A key question is whether the AWMA provides an accurate assessment of Working Memory in other languages. This is a question that colleagues of mine in Argentina were particularly interested in. The first step was to translate all 12 tests of the AWMA into Spanish. My colleagues who conducted the translation took into account various aspects of phonology, orthography, syntax, semantics, and communicational context (such as, word frequency). They also compared the translation, especially of the verbal tests, to a written work of different literary genres, such as popular science, editorial essays, and news articles from diverse Spanish-speaking countries, not only Spain or a particular Hispano- American country.

Next they recruited 6, 8, and 11 year olds from different demographic backgrounds in Buenos Aires and gave them the Spanish version of the AWMA. My colleagues found very similar patterns in performance between the Spanish-speaking children and the English-speaking children that I tested. Importantly, their results demonstrate that a normal distribution of scores and good relationship between the test scores.

This Spanish translation offers the first step in creating testing materials that are culturally appropriate and offers psychologists and clinicians an opportunity to reliably test Working Memory. The AWMA (and the various translations) is available from Pearson Assessment, UK.

Reference: Injoque-Ricle, I., Calero, A.D., Alloway, T.P., & Burin, D.I. (2011). Assessing Working Memory in Spanish-Speaking Children: Automated Working Memory Assessment Battery Adaptation. Learning and Individual Differences, 21, 78-84.



Article retrieved from: http://www.psychologytoday.com/blog/keep-it-in-mind/201202/working-memory-in-any-language-is-it-the-same

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How Exercise Could Lead to a Better Brain

By GRETCHEN REYNOLDS
Published: April 18, 2012

The value of mental-training games may be speculative, as Dan Hurley writes in his article on the quest to make ourselves smarter, but there is another, easy-to-achieve, scientifically proven way to make yourself smarter. Go for a walk or a swim. For more than a decade, neuroscientists and physiologists have been gathering evidence of the beneficial relationship between exercise and brainpower. But the newest findings make it clear that this isn’t just a relationship; it is the relationship. Using sophisticated technologies to examine the workings of individual neurons — and the makeup of brain matter itself — scientists in just the past few months have discovered that exercise appears to build a brain that resists physical shrinkage and enhance cognitive flexibility. Exercise, the latest neuroscience suggests, does more to bolster thinking than thinking does.

The most persuasive evidence comes from several new studies of lab animals living in busy, exciting cages. It has long been known that so-called “enriched” environments — homes filled with toys and engaging, novel tasks — lead to improvements in the brainpower of lab animals. In most instances, such environmental enrichment also includes a running wheel, because mice and rats generally enjoy running. Until recently, there was little research done to tease out the particular effects of running versus those of playing with new toys or engaging the mind in other ways that don’t increase the heart rate.

So, last year a team of researchers led by Justin S. Rhodes, a psychology professor at the Beckman Institute for Advanced Science and Technology at the University of Illinois, gathered four groups of mice and set them into four distinct living arrangements. One group lived in a world of sensual and gustatory plenty, dining on nuts, fruits and cheeses, their food occasionally dusted with cinnamon, all of it washed down with variously flavored waters. Their “beds” were colorful plastic igloos occupying one corner of the cage. Neon-hued balls, plastic tunnels, nibble-able blocks, mirrors and seesaws filled other parts of the cage. Group 2 had access to all of these pleasures, plus they had small disc-shaped running wheels in their cages. A third group’s cages held no embellishments, and they received standard, dull kibble. And the fourth group’s homes contained the running wheels but no other toys or treats.

All the animals completed a series of cognitive tests at the start of the study and were injected with a substance that allows scientists to track changes in their brain structures. Then they ran, played or, if their environment was unenriched, lolled about in their cages for several months.

Afterward, Rhodes’s team put the mice through the same cognitive tests and examined brain tissues. It turned out that the toys and tastes, no matter how stimulating, had not improved the animals’ brains.

“Only one thing had mattered,” Rhodes says, “and that’s whether they had a running wheel.” Animals that exercised, whether or not they had any other enrichments in their cages, had healthier brains and performed significantly better on cognitive tests than the other mice. Animals that didn’t run, no matter how enriched their world was otherwise, did not improve their brainpower in the complex, lasting ways that Rhodes’s team was studying. “They loved the toys,” Rhodes says, and the mice rarely ventured into the empty, quieter portions of their cages. But unless they also exercised, they did not become smarter.

Why would exercise build brainpower in ways that thinking might not? The brain, like all muscles and organs, is a tissue, and its function declines with underuse and age. Beginning in our late 20s, most of us will lose about 1 percent annually of the volume of the hippocampus, a key portion of the brain related to memory and certain types of learning.

Exercise though seems to slow or reverse the brain’s physical decay, much as it does with muscles. Although scientists thought until recently that humans were born with a certain number of brain cells and would never generate more, they now know better. In the 1990s, using a technique that marks newborn cells, researchers determined during autopsies that adult human brains contained quite a few new neurons. Fresh cells were especially prevalent in the hippocampus, indicating that neurogenesis — or the creation of new brain cells — was primarily occurring there. Even more heartening, scientists found that exercise jump-starts neurogenesis. Mice and rats that ran for a few weeks generally had about twice as many new neurons in their hippocampi as sedentary animals. Their brains, like other muscles, were bulking up.

But it was the ineffable effect that exercise had on the functioning of the newly formed neurons that was most startling. Brain cells can improve intellect only if they join the existing neural network, and many do not, instead rattling aimlessly around in the brain for a while before dying.

One way to pull neurons into the network, however, is to learn something. In a 2007 study, new brain cells in mice became looped into the animals’ neural networks if the mice learned to navigate a water maze, a task that is cognitively but not physically taxing. But these brain cells were very limited in what they could do. When the researchers studied brain activity afterward, they found that the newly wired cells fired only when the animals navigated the maze again, not when they practiced other cognitive tasks. The learning encoded in those cells did not transfer to other types of rodent thinking.

Exercise, on the other hand, seems to make neurons nimble. When researchers in a separate study had mice run, the animals’ brains readily wired many new neurons into the neural network. But those neurons didn’t fire later only during running. They also lighted up when the animals practiced cognitive skills, like exploring unfamiliar environments. In the mice, running, unlike learning, had created brain cells that could multitask.

Just how exercise remakes minds on a molecular level is not yet fully understood, but research suggests that exercise prompts increases in something called brain-derived neurotropic factor, or B.D.N.F., a substance that strengthens cells and axons, fortifies the connections among neurons and sparks neurogenesis. Scientists can’t directly study similar effects in human brains, but they have found that after workouts, most people display higher B.D.N.F. levels in their bloodstreams.

Few if any researchers think that more B.D.N.F. explains all of the brain changes associated with exercise. The full process almost certainly involves multiple complex biochemical and genetic cascades. A recent study of the brains of elderly mice, for instance, found 117 genes that were expressed differently in the brains of animals that began a program of running, compared with those that remained sedentary, and the scientists were looking at only a small portion of the many genes that might be expressed differently in the brain by exercise.

Whether any type of exercise will produce these desirable effects is another unanswered and intriguing issue. “It’s not clear if the activity has to be endurance exercise,” says the psychologist and neuroscientist Arthur F. Kramer, director of the Beckman Institute at the University of Illinois and a pre-eminent expert on exercise and the brain. A limited number of studies in the past several years have found cognitive benefits among older people who lifted weights for a year and did not otherwise exercise. But most studies to date, and all animal experiments, have involved running or other aerobic activities.

Whatever the activity, though, an emerging message from the most recent science is that exercise needn’t be exhausting to be effective for the brain. When a group of 120 older men and women were assigned to walking or stretching programs for a major 2011 study, the walkers wound up with larger hippocampi after a year. Meanwhile, the stretchers lost volume to normal atrophy. The walkers also displayed higher levels of B.D.N.F. in their bloodstreams than the stretching group and performed better on cognitive tests.

In effect, the researchers concluded, the walkers had regained two years or more of hippocampal youth. Sixty-five-year-olds had achieved the brains of 63-year-olds simply by walking, which is encouraging news for anyone worried that what we’re all facing as we move into our later years is a life of slow (or not so slow) mental decline.


Gretchen Reynolds writes the Phys Ed column for The Times’s Well blog. Her book, ‘‘The First 20 Minutes,’’ about the science of exercise, will be published this month.

Editor: Ilena Silverman

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Article retrieved from: http://www.nytimes.com/2012/04/22/magazine/how-exercise-could-lead-to-a-better-brain.html?_r=4&pagewanted=all

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Behavioral Techniques for Children With ADHD

Learning behavior management techniques is considered to be an essential part of any successful ADHD treatment program for children. Most experts agree that combining medication treatments with extended behavior management is the most effective way to manage ADHD in children and adolescents.





There are three basic categories or levels of ADHD behavioral training for children:
1) Parent training in effective child behavior management methods.
2) Classroom behavior modification techniques and academic interventions.
3) Special educational placement.
Behavior management is most often used with younger children with ADHD, but it can be used in adolescents up to 18 years old and even adults. In children and adolescents, the two basic principles are:

• Modeling behavior by encouraging good behavior with healthy praise or rewards. This works best if the reward or praise immediately follows the positive behavior.
• Negatively reinforcing bad behavior by allowing appropriate consequences to occur naturally.

Behavior Management Strategies for Preschoolers (Age 5 and Younger)
To help younger kids with ADHD, try these behavior management techniques:

•  Provide a consistent routine to the days and structure to the environment. Let them know when the routine is changing or something unusual is going to happen, such as a visit from a relative, a trip to the store, or a vacation.
• Give your child clear boundaries and expectations. These instructions and guidelines are best given right before the activity or situation.
• Devise an appropriate reward system for good behavior or for completing a certain number of positive behaviors, such as a merit point or gold star program with a specific reward, such as a favorite activity. Avoid using food and especially candy for rewards.
• Engage your child in constructive and mind-building activities, such as reading, games, and puzzles by participating in the activities yourself.
• Some parents find that using a timer for activities is a good way to build and reinforce structure. For example, setting a reasonable time limit for a bath or playtime helps train the child to expect limitations, even on pleasurable activities. Giving a child a time limit for chore completion is also useful, especially if a reward is given for finishing on time.

Behavior Management Strategies for Children Ages 6-12
Behavior management strategies for older children with ADHD may include:

• As much as possible, give clear instructions and explanations for tasks throughout the day. If a task is complex or lengthy, break it down into steps that are more manageable, keeping in mind that as the child learns to manage their behavior, the steps and tasks can become more complex.
• Reward the child appropriately for good behavior and tasks completed. Set up a clear system of rewards (point system, gold stars) so that the child knows what to expect when they complete a task or refine their behavior.
• Bear in mind that as your child gets older they will be more sensitive to how they appear to others and may overreact or be unduly ashamed when they are disciplined in front of others. It is important to have a plan for appropriate discipline for misbehaving that does not require carrying out in front of others. Setting up a specific consequence for a certain behavior is probably the best method of providing consistency and fairness for your child.
• Communicate regularly with your child's teachers so that behavior patterns can be dealt with before they become a major problem and before the teachers get overly frustrated with the situation.
• Always set a good example for your child. Children with ADHD need role models for behavior more than other children, and the adults in their lives are very important.

Behavior Management Strategies for Teenagers
Most parents know that teenagers (regardless of whether or not they have ADHD) are completely different animals. Here are some behavior management techniques just for teens:

• As your child matures, it is important to involve them in setting expectations, rewards, and consequences. Empowering them in this manner will improve their self-esteem and reinforce the concept that they are ultimately the masters of their own behavior and can create positive results with good behavior.
• Teenagers are often very sensitive of how they appear to others and may overreact or be unduly ashamed when they are disciplined in front of others. As adolescents they are experiencing hormonal changes and sexual development, and this brings up a whole host of new issues. Teenage years can be tough enough without ADHD, so be gentle and understanding. Communicate openly with them about the issues surrounding physical and sexual maturation.
• Continue to communicate regularly with your child's teachers so that behavior patterns can be dealt with before they become a major problem and before the teachers get overly frustrated with the situation.
• Continue to be consistent and fair in your own behavior. Having a predictable, reasonable parent is always an asset for children with ADHD.
• Continue to set a good example for your child. Teens with ADHD need role models for behavior more than other kids, and the adults in their lives are very important.
• If you find yourself becoming overwhelmed by the situation, speak to a professional. It is only natural that you have needs and questions in this process, so seek help when needed.

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CDC: U.S. kids with autism up 78% in past decade

By Miriam Falco, CNN
March 29, 2012

(CNN) -- The number of children with autism in the United States continues to rise, according to a new report released Thursday by the Centers for Disease Control and Prevention. The latest data estimate that 1 in 88 American children has some form of autism spectrum disorder. That's a 78% increase compared to a decade ago, according to the report.
Since 2000, the CDC has based its autism estimates on surveillance reports from its Autism and Developmental Disabilities Monitoring Network. Every two years, researchers count how many 8-year-olds have autism in about a dozen communities across the nation. (The number of sites ranges from six to 14 over the years, depending on the available funding in a given year.)
In 2000 and 2002, the autism estimate was about 1 in 150 children. Two years later 1 in 125 8-year-olds had autism. In 2006, the number was 1 in 110, and the newest data -- from 2008 -- suggests 1 in 88 children have autism.


Boys with autism continue to outnumber girls 5-to-1, according to the CDC report. It estimates that 1 in 54 boys in the United States have autism.
Mark Roithmayr, president of the advocacy group Autism Speaks, says more children are being diagnosed with autism because of "better diagnosis, broader diagnosis, better awareness, and roughly 50% of 'We don't know.'"
He said the numbers show there is an epidemic of autism in the United States.
Early recognition of signs of autism -- a neurodevelopment disorder that leads to impaired language, communication and social skills -- is vital because it can lead to early intervention, says Dr. Gary Goldstein, an autism specialist and president of the Kennedy Krieger Institute in Baltimore.
"There have been studies -- double-blinded studies -- to show that behavioral early intervention changes the outcome for children," Goldstein says.
Roy Sanders and Charlie Bailey sensed something was wrong with their son Frankie Sanders when he was 9 months old.
"Our pediatrician at the time who was a friend of ours tried to tell us that we were being too cautious, we were being too anxious," Sanders says.
Frankie's pediatrician thought his parents were seeing developmental delays that weren't really there. But Frankie wasn't talking, Sanders says. "He didn't have speech; he didn't have any communication skills at all. He didn't point. He would flap quite a bit. He would stare at fans; he would stare at lights; he would become frantic if he didn't have a Thomas the [Tank] Engine because he was obsessed with Thomas the [Tank] Engine."

His parents kept pushing, and Frankie, now a ninth-grade nose guard and defensive guard for the Decatur Bulldogs football team in Decatur, Georgia, was diagnosed with autism when he was 15 months old.


"Early detection is associated with better outcomes," says CDC Director Dr. Thomas Frieden. "The earlier kids are detected, the earlier they could get services, and the less impairment they'll have on their learning and in their lives on a long-term basis is our best understanding."
The CDC is working with the Academy of American Pediatrics to recommend that children get screened for autism at ages 18 months and 24 months, Frieden says.


However, according to the CDC report, most children were diagnosed between ages 4 and 5, when a child's brain is already more developed and harder to change.
"Doctors are getting better at diagnosing autism; communities are getting much better at [providing] services to children with autism, and CDC scientists are getting much better at tracking which kids in the communities we're studying have autism," Frieden says.
"How much of that increase is a result of better tracking and how much of it is a result of an actual increase, we still don't know. We know more about autism today than we have ever known," he says, "but there is still so much we don't know and wish that we knew."

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