ADHD Nation

By: Bernstein, Linda, Current Health 2, 0163156X, Feb2006, Vol. 32, Issue 6
Can't find your focus? You aren't alone.
Dan's parents and teachers became concerned about his behavior when he was in grade school. His mind wandered during class--and his body did too; Dan would get up and walk around, even out of the room. "Until middle school, I couldn't understand why anyone was fussing. I just thought of myself as normal," says Dan, 14, from Fairfield, Conn. One day he realized, "Hey, other kids don't have so much [of a] problem paying attention."
The ABCs of ADHD
Dan was showing the classic symptoms of attention-deficit/hyperactivity disorder (ADHD), according to Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Schneider Children's Hospital in New Hyde Park, N.Y. Adesman explained that ADHD is "a biological disorder characterized by significant difficulty with attention span." This isn't just doctorspeak. People with this condition really do have a hard time staying focused. To complicate matters, ADHD often teams up kith impulse control problems and learning disorders. The Centers for Disease Control and Prevention estimates that 8 percent of 4- to 17-year-olds (4.4 million) are diagnosed with ADHD, and 56 percent of those are taking medication for the condition.
No one knows exactly what causes ADHD, though there may be "a genetic component," says Dr. Stephanie Hamarman, chief of psychiatry at the Stanley S. Lamm Institute in Brooklyn, N.Y., who has been working with children with ADHD for many years. In other words, people are probably born with ADHD, and scientists think it may run in families.
However, other biological and environmental factors may be involved, Adesman explains. "The part of the brain that controls how we pay attention is delicate and susceptible to injury," he adds.
Though other genetic conditions, such as asthma, epilepsy, and diabetes, can be determined through blood tests, X-rays, or other exams, no medical test yet diagnoses ADHD. "That doesn't mean that doctors won't ever be able to use a brain scan to detect ADHD," Hamarman says. "We are discovering more about the brain and about ADHD every day."
Diagnosing the Invisible
Most doctors diagnose ADHD by observing behavior, Dr. David W. Goodman, an ADHD specialist at the John's Hopkins University School of Medicine in Baltimore, explains. People with ADHD have difficulty concentrating and may not be able to get organized enough to begin a task, let alone finish it. The person also may interrupt people, forget things (such as homework), and have trouble keeping track of time.
But not all people who have trouble paying attention have ADHD. Perhaps they're not getting enough sleep; perhaps there are problems in the home, and they're preoccupied. Maybe they have a hearing or a vision problem, Goodman suggests. Doctors look at the severity of the symptoms.
Unfortunately, many people with ADHD are not diagnosed and treated--which can involve medication (including stimulants and antidepressants), behavior modification or alternative treatments--because their conduct isn't really unusual. "This is especially true with girls; for some reason we don't understand, girls are less frequently hyperactive," Hamarman says.
The brighter a person is, the later he or she is likely to be diagnosed, because a very smart person can compensate for the disorder. "The child isn't paying attention, but she's still getting B's. That's pretty good, so no one worries," Goodman elaborates.
The Teen Factor
An early diagnosis, coupled with a treatment routine, is important for several reasons, says Adesman. First, the sooner a person is treated, the more he Or she will benefit from treatment. Second, teens with untreated ADHD are much more likely than others to smoke cigarettes and abuse drugs. And although teens take many risks, "those with untreated ADHD take even more risks," Goodman adds. "A big problem is that someone with undiagnosed ADHD may prompt other kids to do something really dangerous," he warns.
High school students with untreated ADHD are also three times as likely as other teens to get into car accidents and lose their licenses. They are more likely to drop out of school too. Experts agree that teens with untreated ADHD are more likely to have poor self-esteem and social problems.
The earlier ADHD treatment begins, especially medication, the more likely the person is to stick with it in high school. "High school is an especially sensitive time. The less-structured environment can be very stressful, and medication helps kids deal better with stress and other teenage issues," Adesman says.
Still, newly diagnosed teens benefit from treatment almost immediately. Gabriel from New York City was diagnosed with ADHD late--his freshman year of high school. Not having a diagnosis earlier led to serious consequences; Gabriel flunked all his courses that year. "I felt that no matter what, I couldn't do the work, and the more I fell behind, the worse it got," Gabriel, now 15, remembers. When Gabriel was diagnosed with ADHD, he began taking medication. "Now I'm more hopeful," he says. He went to summer school to make up his courses and started adopting strategies that would make it easier for him to concentrate in school. Gabriel's experience shows that even if a person's ADHD isn't identified until high school or adulthood, he or she can still immediately benefit from treatment and can function as well as others.
Managing ADHD
One of Gabriel's strategies involves watching how good students function. "I see what they do, and I copy it," he says. In class, Gabriel turns his chair so that he's facing the board and can't be distracted by others--a practice experts recommend. They also suggest the following:
• Keep one set of books at home to always be prepared to do homework.
• Ask family for help in getting organized. A parent can remind a teen of a project's due date and help him or her work on it every day instead of at the last minute.
• Do only a little work at a time, taking a break, and then getting back to work. "If I try to do homework all at once, I'm more likely to get distracted," Dan says.
• Take advantage of coaching. Many schools have resource rooms where smaller classes make it easier for students to pay attention.
Doing Well With ADHD
Here's the good news: Young people who receive treatment for ADHD are just as likely to do well in school and in life as anyone else. "A patient of mine just graduated [from] college at the top of her class," Adesman says.
Still, there are things kids with ADHD wish others knew. "You don't have to talk slowly," says Gabriel. "I understand English."
Dan adds, "Teachers need to be patient, but at the same time, they need to know that if I want to be treated like everyone else, I know I have to live up to expectations."
New treatments make life easier for people with ADHD. But one of the biggest breakthroughs has been the change in attitude over the past two decades, says Adesman. For instance, studies show that teens are less likely to stigmatize ADHD than are grown-ups.
So if your class includes students with ADHD, treat them as you would want to be treated. Teens with ADHD need people to be patient and helpful. In other ways, they're just like everyone else.
ADHD Didn't Stop Me!
Type "famous people" and "ADHD" into an Internet search engine, and you'll find Web page after Web page claiming that Mozart, Einstein, and other well-known dead people had ADHD. However, there's no need to search history books to find successful people who had the disorder. The following celebrities have talked about having ADHD:
Ellen DeGeneres, comedian and actor Scott Eyre, relief pitcher for the San Francisco Giants David Neeleman, founder and CEO of JetBlue Airways Philip Manuel, jazz musician

ADHD The Trouble With Boys

The Trouble With Boys , By: Tyre, Peg, Murr, Andrew, Juarez, Vanessa, Underwood, Anne, Springen, Karen, Wingert, Pat, Newsweek, 00289604, 1/30/2006, Vol. 147, Issue 5
They're kinetic, maddening and failing at school. Now educators are trying new ways to help them succeed.
Spend a few minutes on the phone with Danny Frankhuizen and you come away thinking, "What a nice boy." He's thoughtful, articulate, bright. He has a good relationship with his mom, goes to church every Sunday, loves the rock band Phish and spends hours each day practicing his guitar. But once he's inside his large public Salt Lake City high school, everything seems to go wrong. He's 16, but he can't stay organized. He finishes his homework and then can't find it in his backpack. He loses focus in class, and his teachers, with 40 kids to wrangle, aren't much help. "If I miss a concept, they tell me, 'Figure it out yourself'," says Danny. Last year Danny's grades dropped from B's to D's and F's. The sophomore, who once dreamed of Stanford, is pulling his grades up but worries that "I won't even get accepted at community college."
His mother, Susie Malcom, a math teacher who is divorced, says it's been wrenching to watch Danny stumble. "I tell myself he's going to make something good out of himself," she says. "But it's hard to see doors close and opportunities fall away."
What's wrong with Danny? By almost every benchmark, boys across the nation and in every demographic group are falling behind. In elementary school, boys are two times more likely than girls to be diagnosed with learning disabilities and twice as likely to be placed in special-education classes. High-school boys are losing ground to girls on standardized writing tests. The number of boys who said they didn't like school rose 71 percent between 1980 and 2001, according to a University of Michigan study. Nowhere is the shift more evident than on college campuses. Thirty years ago men represented 58 percent of the undergraduate student body. Now they're a minority at 44 percent. This widening achievement gap, says Margaret Spellings, U.S. secretary of Education, "has profound implications for the economy, society, families and democracy."
With millions of parents wringing their hands, educators are searching for new tools to help tackle the problem of boys. Books including Michael Thompson's best seller "Raising Cain" (recently made into a PBS documentary) and Harvard psychologist William Pollack's definitive work "Real Boys" have become must-reads in the teachers' lounge. The Gurian Institute, founded in 1997 by family therapist Michael Gurian to help the people on the front lines help boys, has enrolled 15,000 teachers in its seminars. Even the Gates Foundation, which in the last five years has given away nearly a billion dollars to innovative high schools, is making boys a big priority. "Helping underperforming boys," says Jim Shelton, the foundation's education director, "has become part of our core mission."
The problem won't be solved overnight. In the last two decades, the education system has become obsessed with a quantifiable and narrowly defined kind of academic success, these experts say, and that myopic view is harming boys. Boys are biologically, developmentally and psychologically different from girls--and teachers need to learn how to bring out the best in every one. "Very well-meaning people," says Dr. Bruce Perry, a Houston neurologist who advocates for troubled kids, "have created a biologically disrespectful model of education."
Thirty years ago it was girls, not boys, who were lagging. The 1972 federal law Title IX forced schools to provide equal opportunities for girls in the classroom and on the playing field. Over the next two decades, billions of dollars were funneled into finding new ways to help girls achieve. In 1992, the American Association of University Women issued a report claiming that the work of Title IX was not done--girls still fell behind in math and science; by the mid-1990s, girls had reduced the gap in math and more girls than boys were taking high-school-level biology and chemistry.
Some scholars, notably Christina Hoff Sommers, a fellow at the American Enterprise Institute, charge that misguided feminism is what's been hurting boys. In the 1990s, she says, girls were making strong, steady progress toward parity in schools, but feminist educators portrayed them as disadvantaged and lavished them with sup-port and attention. Boys, meanwhile, whose rates of achievement had begun to falter, were ignored and their problems allowed to fester (page 53).
Boys have always been boys, but the expectations for how they're supposed to act and learn in school have changed. In the last 10 years, thanks in part to activist parents concerned about their children's success, school performance has been measured in two simple ways: how many students are enrolled in accelerated courses and whether test scores stay high. Standardized assessments have become commonplace for kids as young as 6. Curricula have become more rigid. Instead of allowing teachers to instruct kids in the manner and pace that suit each class, some states now tell teachers what, when and how to teach. At the same time, student-teacher ratios have risen, physical education and sports programs have been cut and recess is a distant memory. These new pressures are undermining the strengths and underscoring the limitations of what psychologists call the "boy brain"-- the kinetic, disorganized, maddening and sometimes brilliant behaviors that scientists now believe are not learned but hard-wired.
When Cris Messler of Mountainside, N.J., brought her 3-year-old son Sam to a pediatrician to get him checked for ADHD, she was acknowledging the desperation parents can feel. He's a high-energy kid, and Messler found herself hoping for a positive diagnosis. "If I could get a diagnosis from the doctor, I could get him on medicine," she says. The doctor said Sam is a normal boy. School has been tough, though. Sam's reading teacher said he was hopeless. His first-grade teacher complains he's antsy, and Sam, now 7, has been referring to himself as "stupid." Messler's glad her son doesn't need medication, but what, she wonders, can she do now to help her boy in school? For many boys, the trouble starts as young as 5, when they bring to kindergarten a set of physical and mental abilities very different from girls'. As almost any parent knows, most 5-year-old girls are more fluent than boys and can sight-read more words. Boys tend to have better hand-eye coordination, but their fine motor skills are less developed, making it a struggle for some to control a pencil or a paintbrush. Boys are more impulsive than girls; even if they can sit still, many prefer not to--at least not for long.
Thirty years ago feminists argued that classic "boy" behaviors were a result of socialization, but these days scientists believe they are an expression of male brain chemistry. Sometime in the first trimester, a boy fetus begins producing male sex hormones that bathe his brain in testosterone for the rest of his gestation. "That exposure wires the male brain differently," says Arthur Arnold, professor of physiological science at UCLA. How? Scientists aren't exactly sure. New studies show that prenatal exposure to male sex hormones directly affects the way children play. Girls whose mothers have high levels of testosterone during pregnancy are more likely to prefer playing with trucks to playing with dolls. There are also clues that hormones influence the way we learn all through life. In a Dutch study published in 1994, doctors found that when males were given female hormones, their spatial skills dropped but their verbal skills improved.
In elementary-school classrooms--where teachers increasingly put an emphasis on language and a premium on sitting quietly and speaking in turn--the mismatch between boys and school can become painfully obvious. "Girl behavior becomes the gold standard," says "Raising Cain" coauthor Thompson. "Boys are treated like defective girls."
Two years ago Kelley King, principal of Douglass Elementary School in Boulder, Colo., looked at the gap between boys and girls and decided to take action. Boys were lagging 10 points behind girls in reading and 14 points in writing. Many more boys --than girls were being labeled as learning disabled, too. So King asked her teachers to buy copies of Gurian's book "The Minds of Boys," on boy-friendly classrooms, and in the fall of 2004 she launched a bold experiment. Whenever possible, teachers replaced lecture time with fast-moving lessons that all kids could enjoy. Three weeks ago, instead of discussing the book "The View From Saturday," teacher Pam Unrau divided her third graders into small groups, and one student in each group pretended to be a character from the book. Classes are noisier, Unrau says, but the boys are closing the gap. Last spring, Douglass girls scored an average of 106 on state writing tests, while boys got a respectable 101.
Primatologists have long observed that juvenile male chimps battle each other not just for food and females, but to establish and maintain their place in the hierarchy of the tribe. Primates face off against each other rather than appear weak. That same evolutionary imperative, psychologists say, can make it hard for boys to thrive in middle school--and difficult for boys who are failing to accept the help they need. The transition to middle school is rarely easy, but like the juvenile primates they are, middle-school boys will do almost anything to avoid admitting that they're overwhelmed. "Boys measure everything they do or say by a single yardstick: does this make me look weak?" says Thompson. "And if it does, he isn't going to do it." That's part of the reason that videogames have such a powerful hold on boys: the action is constant, they can calibrate just how hard the challenges will be and, when they lose, the defeat is private.
When Brian Johns hit seventh grade, he never admitted how vulnerable it made him feel. "I got behind and never caught up," says Brian, now 17 and a senior at Grand River Academy, an Ohio boarding school. When his parents tried to help, he rebuffed them. When his mother, Anita, tried to help him organize his assignment book, he grew evasive about when his homework was due. Anita didn't know where to turn. Brian's school had a program for gifted kids, and support for ones with special needs. But what, Anita asked his teachers, do they do about kids like her son who are in the middle and struggling? Those kids, one of Brian's teachers told Anita, "are the ones who fall through the cracks."
It's easy for middle-school boys to feel outgunned. Girls reach sexual maturity two years ahead of boys, but other, less visible differences put boys at a disadvantage, too. The prefrontal cortex is a knobby region of the brain directly behind the forehead that scientists believe helps humans organize complex thoughts, control their impulses and understand the consequences of their own behavior. In the last five years, Dr. Jay Giedd, an expert in brain development at the National Institutes of Health, has used brain scans to show that in girls, it reaches its maximum thickness by the age of 11 and, for the next decade or more, continues to mature. In boys, this process is delayed by 18 months.
Middle-school boys may use their brains less efficiently, too. Using a type of MRI that traces activity in the brain, Deborah Yurgelun-Todd, director of the cognitive neuroimaging laboratory at McLean Hospital in Belmont, Mass., tested the activity patterns in the prefrontal cortex of children between the ages of 11 and 18. When shown pictures of fearful faces, adolescent girls registered activity on the right side of the prefrontal cortex, similar to an adult. Adolescent boys used both sides--a less mature pattern of brain activity. Teenage girls can process information faster, too. In a study about to be published in the journal Intelligence, researchers at Vanderbilt University administered timed tests--picking similar objects and matching groups of numbers--to 8,000 boys and girls between the ages of 5 and 18. In kindergarten, boys and girls processed information at about the same speeds. In early adolescence, girls finished faster and got more right. By 18, boys and girls were processing with the same speed and accuracy.
Scientists caution that brain research doesn't tell the whole story: temperament, family background and environment play big roles, too. Some boys are every bit as organized and assertive as the highest-achieving girls. All kids can be scarred by violence, alcohol or drugs in the family. But if your brain hasn't reached maturity yet, says Yurgelun-Todd, "it's not going to be able to do its job optimally."
Across the nation, educators are reviving an old idea: separate the girls from the boys--and at Roncalli Middle School, in Pueblo, Colo., administrators say, it's helping kids of both genders. This past fall, with the blessing of parents, school guidance counselor Mike Horton assigned a random group of 50 sixth graders to single-sex classes in core subjects. These days, when sixth-grade science teacher Pat Farrell assigns an earth-science lab on measuring crystals, the girls collect their materials--a Bunsen burner, a beaker of phenyl salicylate and a spoon. Then they read the directions and follow the sequence from beginning to end. The first things boys do is ask, "Can we eat this?" They're less organized, Farrell notes, but sometimes, "they're willing to go beyond what the lab asks them to do." With this in mind, he hands out written instructions to both classes but now goes over them step by step for the boys. Although it's too soon to declare victory, there are some positive signs: the shyest boys are participating more. This fall, the all-girl class did best in math, English and science, followed by the all-boy class and then coed classes.
One of the most reliable predictors of whether a boy will succeed or fail in high school rests on a single question: does he have a man in his life to look up to? Too often, the answer is no. High rates of divorce and single motherhood have created a generation of fatherless boys. In every kind of neighborhood, rich or poor, an increasing number of boys--now a startling 40 percent--are being raised without their biological dads.
Psychologists say that grandfathers and uncles can help, but emphasize that an adolescent boy without a father figure is like an explorer without a map. And that is especially true for poor boys and boys who are struggling in school. Older males, says Gurian, model self-restraint and solid work habits for younger ones. And whether they're breathing down their necks about grades or admonishing them to show up for school on time, "an older man reminds a boy in a million different ways that school is crucial to their mission in life."
In the past, boys had many opportunities to learn from older men. They might have been paired with a tutor, apprenticed to a master or put to work in the family store. High schools offered boys a rich array of roles in which to exercise leadership skills--class officer, yearbook editor or a place on the debate team. These days, with the exception of sports, more girls than boys are involved in those activities.
In neighborhoods where fathers are most scarce, the high-school dropout rates are shocking: more than half of African-American boys who start high school don't finish. David Banks, principal of the Eagle Academy for Young Men, one of four all-boy public high schools in the New York City system, wants each of his 180 students not only to graduate from high school but to enroll in college. And he's leaving nothing to chance. Almost every Eagle Academy boy has a male mentor--a lawyer, a police officer or an entrepreneur from the school's South Bronx neighborhood. The impact of the mentoring program, says Banks, has been "beyond profound." Tenth grader Rafael Mendez is unequivocal: his mentor "is the best thing that ever happened to me." Before Rafael came to Eagle Academy, he dreamed about playing pro baseball, but his mentor, Bronx Assistant District Attorney Rafael Curbelo, has shown him another way to succeed: Mendez is thinking about attending college in order to study forensic science.
Colleges would welcome more applications from young men like Rafael Mendez. At many state universities the gender balance is already tilting 60-40 toward women. Primary and secondary schools are going to have to make some major changes, says Ange Peterson, president-elect of the American Association of Collegiate Registrars and Admissions Officers, to restore the gender balance. "There's a whole group of men we're losing in education completely," says Peterson.
For Nikolas Arnold, 15, a sophomore at a public high school in Santa Monica, Calif., college is a distant dream. Nikolas is smart: he's got an encyclopedic knowledge of weaponry and war. When he was in first grade, his principal told his mother he was too immature and needed ADHD drugs. His mother balked. "Too immature?" says Diane Arnold, a widow. "He was six and a half!" He's always been an advanced reader, but his grades are erratic. Last semester, when his English teacher assigned two girls' favorites--"Memoirs of a Geisha" and "The Secret Life of Bees" Nikolas got a D. But lately, he has a math teacher he likes and is getting excited about numbers. He's reserved in class sometimes. But now that he's more engaged, his grades are improving slightly and his mother, who's pushing college, is hopeful he will begin to hit his stride. Girls get A's and B's on their report cards, she tells him, but that doesn't mean boys can't do it, too.
Elementary School
Boys start off with lower literacy skills than girls, and are less often encouraged to read, which only widens the gap.
Girls ages 3 to 5 are 5% more likely than boys to be read to at home at least three times a week.
Girls are 10% more likely than boys to recognize words by sight by the sprint of first grade.
Boys ages 5 to 12 are 60% more likely than girls to have repeated at least one grade.
Girls' reading scores improve 6% more than boys' between kindergarten and third grade.
First-to fifth-grade boys are 47% more likely than girls to have disabilities such as emotional disturbances, learning problems or speech impediments.
Fourth-grade girls score #% higher on standardized reading tests than boys.
Fourth-grade girls score 12% higher on writing tests than boys.
GRAPH: AVERAGE SCORES: FOURTH-GRADE STUDENTS
Middle School
Coming of age in a culture that discourages bookishness, boys are more likely to fall victim to drugs and violence.
Eighth-grade girls scores an average of 11 points higher than eighth-grade boys on standardized reading tests.
Eighth-grade girls score 21 points higher than boys on standardized writing tests.
Between 1993 and 2003, the number of ninth-grade boys who skipped school at least once a month because they didn't feel safe increased 22%.
Boys between the ages of 5 and 14 are 200% more likely to commit suicide than girls.
Ninth-grade boys are 78% more likely than girls to get injured in a fight at least once a year.
Between the ages of 5 and 14, boys are 36% more likely to die than their female counterparts.
High School and Beyond
Many boys continue to fall behind girls in reading and writing proficiency, and fewer are going to college.
Boys are 33% more likely than girls to drop out of high school.
Twelfth-grade girls score 16 points higher than boys on standardized reading tests.
High-school boys are 30% more likely to use cocaine than high-school girls.
Twelfth-grade girls score 24 points higher than boys on standardized writing tests.
High-school girls are 36% more likely to take Advanced Placement or honors biology than high-school boys.
22% more high-school girls are planning to go to college than boys.
The percentage of male undergraduates dropped 24% from 1970 to 2000.
AVERAGE TEST SCORES*

WRITING
Girls Boys

1998 159 140
2002 160 136

READING
Girls Boys

1980 289 282
2004 292 278

*TWELFTH-GRADE SCORES

ADHD and Exercise in the Child, Teen and Adult

ADHD and Exercise in the Child, Teen and Adult

Exercise has a profound affect on ADHD and the child, teen or adult. In addition to promoting health, a regular exercise program can modifying behavior in the ADHD child and may even promote brain growth.

Aerobic exercise increases levels of the neurotransmitters dopamine, serotonin and norepinephrine. These neurotransmitters provide emotional stability, the ability to focus, mental alertness and calmness. Conversely, a deficiency in neurotransmitters can cause depression, mood swings, irritability, anxiety, attention problems, stress and sleep problems.

Exercise also releases endorphins, the opiate-classified messengers of our emotional system that elevate mood, increase pleasure and minimize pain.

The degree of chemical change is dependent on the intensity, duration and frequency of the aerobic activity.

Current fitness and exercise research makes a correlation between an active lifestyle and positive changes in brain chemistry, brain growth and development. Studies also show that exercise has a positive affect on curbing negative behaviors common in the ADHD child.

A 2001 State University of New York, Buffalo study showed the positive benefits of exercise on ADHD children. The study group - ADHD children between the ages of 5 and 12 - participated in 40 minutes of intense exercise five days per week.

Children involved in this study showed a significant improvement in behavior over the six-week duration of the study. Behavior changes were generally noticeable two to four weeks after beginning the exercise program and children with oppositional behaviors made the greatest improvements with exercise.

This study makes good common sense; give hyperactive an outlet for their excess energy and they will have less to cause trouble with.

National statistics show that today’s children are increasingly less active than children 10 years ago. Not so coincidentally, psychosomatic disorders and ADHD prescriptions have skyrocketed over the same time frame.

If you have an ADHD child or teen or if you are an adult with ADHD, the kindest most healthy treatment plan is one that focuses on routine intense aerobic exercise, and one that includes a nutritious diet and an attentional supplement program to fill any gaps.

The child, teen or adult with ADHD needs to incorporate at least 30 minutes of activity to each day. At least 20 minutes of this exercise needs to be at a moderate to intense level. Below are a few aerobic exercises to incorporate into your and your child’s life:

_ Bicycling at 10 mph.
_ Brisk walking at 4 mph (15 minutes/mile).
_ Jogging.
_ Hiking.
_ Ice skating.
_ In-line skating or roller skating.
_ Jumping roping.
_ Raking leaves.
_ Shoveling snow.
_ Skateboarding.
_ Washing and waxing the car.
_ Weight training.
_ Circuit training.

It is important for an adult to make the exercise effort a family affair. An adult displaying a positive attitude and a shared interest in exercise supports and encourages the child or teen to follow suit. This may be the time to start addressing those extra pounds that have made way to the body over the years.

News Flash for People With ADHD

By: Shute, Nancy, McGrath, Anne, U.S. News & World Report, 00415537, 2/20/2006, Vol. 140, Issue 6

Alarmed by 25 sudden deaths in people taking certain drugs for attention deficit hyperactivity disorder, an FDA panel last week recommended a "black box" warning that the drugs might cause cardiovascular problems. The FDA also found 54 nonfatal problems, including heart attack and stroke in adults and children on Ritalin, Adderall, Concerta, and other stimulants. It's not clear whether the drugs were at fault; some people had high blood pressure and other underlying issues. People with heart problems and hypertension are already cautioned about stimulants. For others, for now, "I don't think the risk in any way justifies not using it, "says Larry Diller, a pediatrician and author of Running on Ritalin. Millions take the drugs safely each day, he notes.

Mixed messages on ADHD , USA Today, 07347456, FEB 15, 2006
Parents can face conflicting advice on drugs' safety
Section: Life, Pg. 13b
Parents who are concerned about the heart risks of stimulants to treat attention deficit/hyperactivity disorder may hear conflicting advice from doctors, depending on whom they consult.
Last week, an advisory panel to the Food and Drug Administration voted 8-7 to suggest adding the agency's strongest warning label to Ritalin, Adderall and similar medications. The panel based its decision on an FDA report that found 25 children and adults had died suddenly from 1999 to 2003 after taking ADHD drugs.
Steven Nissen, an advisory committee member, says many of the 4million people who use the drugs may not realize that they have serious side effects. "I want parents and doctors, before they prescribe amphetamines and amphetamine-like drugs to children, to think a little harder whether they need them," says Nissen, interim chairman of the Cleveland Clinic's department of cardiovascular medicine.
Nissen suggests patients ask their doctors questions such as: "Do I really need these drugs? Am I on the lowest possible dose? Are there safer alternatives?"
The FDA typically follows the advice of its advisory committees. But Thomas Laughren, director of the FDA's division of psychiatry products, says it would be unusual for the agency to issue a "black box" warning based on such thin evidence. He notes that the reported number of sudden deaths in patients taking stimulants is lower than the figure that experts would expect to see among people who aren't taking the drugs. A second FDA committee, which focuses on pediatrics, will consider the drugs' safety next month, Laughren says.
Edward Hallowell, a doctor and co-author of Driven to Distraction, notes that about one in 10 of his patients stop using stimulants for ADHD because of side effects, which can include loss of appetite, abnormal heartbeats, elevated blood pressure, tics and twitches. "These meds are far from perfect," Hallowell said in an e-mail. "But they are the best medication option we have and are very safe when used correctly."
Worried patients have been calling David Goodman for several days. Goodman, an assistant professor of psychiatry at the Johns Hopkins University School of Medicine, says he sees no reason for his patients to stop taking the drugs. Goodman notes that teenagers who do not treat their ADHD face risks because such children are more likely than others to use drugs, drop out of school or get into accidents.
Lawrence Diller, author of Running on Ritalin and Should I Medicate My Child?, notes that people often rush to use medications for problems that might be addressed by changing parenting strategies, exploring special education or improving classroom management. These non-medical options can help some children avoid prescription medications and allow others to reduce their doses.
Although stimulants might seem like an easy fix, Diller says, "just because it works doesn't make it an ethical substitute for giving kids the proper attention at home and school."
(c) USA TODAY, 2006
Warnings advised on ADHD drugs , USA Today, 07347456, FEB 10, 2006

Working with the ADHD Student

It is estimated that between three and five percent of children--or approximately two million children in the United States--have attention deficit hyperactivity disorder (ADHD). This means that in a classroom of 25 to 20 students, it is likely that at least one will have ADHD.

Those statistics come from the National Institute for Mental Health (NIMH), which also points out that while a child with ADHD faces a difficult task in achieving his or her full potential, the task is not insurmountable. Since ADHD often continues into adulthood, it is important to help children learn to deal with it early on, and that takes teamwork from parents, guidance counselors, teachers and school administration.

According to the NIMH, it is the school's obligation to evaluate children it suspects may have ADHD. The diagnosis is becoming more common, however, and children may come into the classroom having already received treatment such as behavior modification and medication--as well as an Individualized Educational Plan (IEP).

ASPERGER SYNDROME, PARENTAL LEADERSHIP, AND ADVOCACY

ASPERGER SYNDROME, PARENTAL LEADERSHIP, AND ADVOCACY by Sharon Link

This work explores advocacy strategies for parents to support their Asperger Syndrome child in a public school setting, particularly in a classroom environment. This work represents a maternal act of love for my own Asperger Syndrome child and is an exploration of my own journey to develop better advocacy strategies from a theoretically informed perspective. A detailed explanation of Asperger Syndrome demonstrates how individuals with this disorder require advocacy. My own personal illustration creates a connection between parental advocacy and the formation of personal leadership. Michael Powers, a noted expert in Autistic Disorders and Director of the Center for Children with Special Needs located in Tolland, Connecticut underscores my experience with a theoretical overview. Peter Senge’s work and three of his five disciplines explore how parents might construct a personal framework to interpret Powers’ work. Senge is nationally renowned and is the Director for the Center of Organizational Learning. His work helped me construct a “learningful” framework to better construct personal leadership and a parental advocacy model. Leadership formation strengthens parents’ credibility to advocate. Leadership strengthens voice. Voice strengthens advocacy.

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Candidacy Paper Sharon Link.pdf	98.63 KB

Asperger Syndrome and the Children who Don’t Quite Fit In

Asperger Syndrome and the Children who ‘Don’t Quite Fit In’
SUZY PORTWAY and BARBARA JOHNSON

Health Visitor, West Sussex NHS Primary Care Trust, The Surgery, Torton Hill Road, Arundel, West Sussex BN18 9HF, UK; bSt Bartholomew’s School of Nursing and Midwifery, City University, London, UK

This paper discusses some of the early findings of current Ph.D. work exploring the lives of young adults with Asperger Syndrome and their parents. The focus here is the experience of ‘growing up’ as perceived by people with Asperger Syndrome. The findings relating to the experience for parents and outcomes for families will be the subject of further papers. For the main study, twenty-five families were purposively sampled and informal interviews conducted with young adults with Asperger Syndrome and their parents. Participants with Asperger Syndrome were encouraged to talk about their own life story. Interviews were transcribed and constant comparative analysis used to identify, compare and code common themes across the data. The stories told are powerful accounts of children who from an early age ‘looked normal, talked normal’ but never seemed to ‘quite fit in’. They went through school and moved into adulthood feeling and being treated as ‘different’, with nobody seemingly understanding why. Many were excluded educationally, in that some were expelled from school while others were excluded by their peers within school, thus leaving them feeling ‘outsiders’. All the participants expressed views that likened them to living on the edge of society where they felt extremely isolated and vulnerable to mental health problems. The findings suggest the need for greater knowledge of Asperger Syndrome among preschool workers, teachers and health care professionals. The importance of earlier detection and the appropriate educational, social and emotional support to help prevent a constant catalogue of negative experiences is emphasised. It is argued that such measures will maximise the opportunities for developing a positive self-image as well as intellectual and personal achievement.

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Asperger's Syndrome by Stephen Edelson

Asperger's Syndrome

Written by Stephen M. Edelson, Ph.D.

Center for the Study of Autism, Salem, Oregon

Asperger's syndrome was first described by a German doctor, Hans Asperger, in 1944 (one year after Leo Kanner's first paper on autism). In his paper, Dr. Asperger discussed individuals who exhibited many idiosyncratic, odd-like behaviors (see description below).Often individuals with Asperger's syndrome have many of the behaviors listed below:Language:
lucid speech before age 4 years; grammar and vocabulary are usually very good
speech is sometimes stilted and repetitive
voice tends to be flat and emotionless
conversations revolve around self
Cognition
obsessed with complex topics, such as patterns, weather, music, history, etc.
often described as eccentric
I.Q.'s fall along the full spectrum, but many are in the above normal range in verbal ability and in the below average range in performance abilities.
many have dyslexia, writing problems, and difficulty with mathematics
lack common sense
concrete thinking (versus abstract)
Behavior
movements tend to be clumsy and awkward
odd forms of self-stimulatory behavior
sensory problems appear not to be as dramatic as those with other forms of autism
socially aware but displays inappropriate reciprocal interaction
Researchers feel that Asperger's syndrome is probably hereditary in nature because many families report having an "odd" relative or two. In addition, depression and bipolar disorder are often reported in those with Asperger's syndrome as well as in family members.At this time, there is no prescribed treatment regimen for individuals with Asperger's syndrome. In adulthood, many lead productive lives, living independently, working effectively at a job (many are college professors, computer programmers, dentists), and raising a family.Sometimes people assume everyone who has autism and is high-functioning has Asperger's syndrome. However, it appears that there are several forms of high-functioning autism, and Asperger's syndrome is one form.

Bicycle Riding: Pedaling Made Possible Through Positive Behavioral Interventions

Abstract: This study demonstrated how the tenets of positive behavior support could be used to teach an educational activity. Emphasis was placed on the implementation of practical strategies to minimize errors during instruction and maximize positive outcomes. A 9-year-old boy with Asperger Syndrome served as the participant, and the skill targeted for development was bicycle riding. An eight-step task analysis based on a highly individualized approach was used for instructional purposes. A changing criterion design was used to demonstrate progressively the emergence of bicycle riding over a span of 64 sessions. The implications of selecting target skills based on the criteria of social values, the employment of practical teaching strategies, and the scientific deduction are discussed.

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Bosch's Cases: A 40 years Follow-up of patients with Infantile Autism and Asperger Syndrome

Abstract

Only a handful of longitudinal case reports on autism spectrum disorders exist in the literature. In this study, we present the follow-up data on two subjects with infantile autism and one with Asperger Syndrome over 40 years after initial diagnosis. Their childhood phenomenology had been described in detail in a historic monograph by Gerhard Bosch (1962, 1970). The trajectories of his three former patients were consistent with more recent larger scale empirical studies on outcome in autism and related disorders. While the two cases with core autism had poor outcomes compared to the person with Asperger Syndrome, all three of them showed a highly stable symptomology from childhood into adulthood. The study confirms the stability and validity of the diagnosis of autism over the years (German J Psychiatry 2004, 7:10-13).

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Educational Interventions for Individuals With Asperger Syndrome

Educational Interventions for Individuals With Asperger Syndrome

HAROLD C. GRIFFIN, LINDA W. GRIFFIN, CHRISTINE W. FITCH, VERONICA ALBERA, AND HAPPY GINGRAS

Children with Asperger syndrome may frequently exhibit problems in the areas of social, behavioral, academic, motor, and sensory skills. Interventions are most effective if they are consistently implemented, use concrete information and visual structures, and utilize the assistance of parents, teachers, peers, and therapists.

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Employment and Adults with Asperger Syndrome

Employment and Adults with Asperger Syndrome

Karen Hurlbutt and Lynne Chalmers

Six adults with Asperger syndrome (AS) were interviewed about their experiences regarding employment. Methods included conducting initial and follow-up interviews, either in person, on the phone, or via e-mail. Repeatedly, difficulties and problems inter-
fering with employment success emerged. All of the adults who were interviewed had difficulty finding work that was commensurate with their ability levels and had difficulty maintaining jobs. Recommendations for parents and professionals working with adults
with AS are provided.

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Employment and Adults with Asperger Syndrome.pdf	85.91 KB

MIDDLE-CLASS MOTHERS’ PERCEPTIONS OF PEER AND SIBLING VICTIMIZATION AMONG CHILDREN WITH ASPERGER’S SYNDROME

MIDDLE-CLASS MOTHERS’ PERCEPTIONS OF PEER AND SIBLING VICTIMIZATION AMONG CHILDREN WITH ASPERGER’S SYNDROME AND NONVERBAL LEARNING DISORDERS

LIZA LITTLE, PsyD, RN

Family Research Laboratory & Department of Nursing, University of New Hampshire, Durham, New Hampshire, USA

This article describes the yearly prevalence and frequency of peer and sibling victimization as reported by a large national sample of middle-class mothers of children with Asperger’s syndrome and nonverbal learning disorders. An anonymous, mailed survey was sent to families solicited from two national Internet sites for parents of children with Asperger’s and nonverbal learning disorders using the Comprehensive Juvenile Victimization scale and three questions designed to measure peer shunning. The overall prevalence rate reported by mothers of peer victimization was 94%. Mothers reported that almost three-quarters of their children had been hit by peers or siblings in the past year and 75% had been emotionally bullied. On the more severe end of peer victimization, 10% of the children were attacked by a gang in the past year and 15% were victims of nonsexual assaults to the genitals. Peer shunning also was common. A third of the children had not been invited to a single birthday party in the past year, and many were eating alone at lunch or were picked last for teams. Peer shunning was significantly correlated with peer bullying and assault. The high rates of peer shunning and peer victimization reported suggest that children with Asperger’s and nonverbal learning disorders may require further scrutiny and attention concerning their victimization experiences by peers and siblings. Implications for nursing professionals are reviewed.

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Middle Class Mothers\' Perceptions.pdf	134.56 KB

Meeting the vocational support needs of individuals with Asperger Syndrome and other autism spectrum disabilities

Abstract. The purpose of this pilot study was to seek consumer perspectives on strategies for improving vocational placement and job retention services for individuals with Asperger Syndrome and other autism spectrum disabilities (ASDs). For this purpose, 18 adults with ASDs were individually interviewed about their experiences within the workplace. Participant(s) were asked to (a) describe positive and negative aspects of their vocational experiences, (b) identify major obstacles to successful employment, and (c) recommend appropriate vocational supports to be provided by vocational rehabilitation counselors, employers and co-workers. Qualitative analysis of the interview transcripts revealed a number of common experiences and concerns which suggest the needs of individuals with ASDs should be recognized as different form others with more generalized developmental disabilities and/or mental retardation.

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The Friendship Club: An After-School Program for Children with Asperger Syndrome

The Friendship club is a program designed and implemented by occupational therapy students and faculty to help teach children with Asperger Syndrome' ages 8-15, activities related to friendship and skills necessary to maintain friends.

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The Friendship Club.pdf	1.28 MB

Autism and Asperger Syndrome: strategies to promote prosocial behaviours

Autism and Asperger Syndrome: strategies to promote prosocial behaviours

CAROL GREENWAY
Psychological Service, City of Westminster, 2nd NW8 8EA, UK

SUMMARY The social deficits of children on the autistic spextrum represent a major barrier to their successful inclusion into mainstream schools. This presents a significant challenge for educational psychologists (EPs). This paper surveys the literature for social skil ls screening instruments and interventions, which have the greatest relevance to the work of the EP in supporting inclusion in the mainstream setting. Although not specifically designed for pupils on the autistic continuum, several screening instruments are identified that not only provide a description of the problem area and an understanding of the pupil ’s behaviour, but also provide pointers for interventions. Those found in the research literature that have been particularly successful in mainstream are the Social Stories and Circle of Friends approaches. Other interventions are also described that have potential for pupils on the autistic spectrum who are being considered for integration.

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Promoting Prosocial Behaviors.pdf	156.35 KB

Autism in Mathematics

Author: Ioan James An excerpt.

The cause of autism is mysterious, but genetic factors are important. It takes a variety of forms; the expression autism spectrum, which is often used, gives the false impression that it is just the severity of the disorder that varies.

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Autism in Mathematicians.pdf	796.73 KB

Children with Autism Attending Preschool

Children with Autism Attending Preschool Facilities: the experiences and perceptions of staff

ROY McCONKEY* and SONEE BHLIRGRI
School of Nursing, University of Ulster, Newtownabbey BT37 0QB, UK

Increasing numbers of children are being identified from age 2 years onwards as having autistic spectrum disorders. The majority of parents aspire for their child to attend mainstream education facilities, and many already do so. However, there is limited knowledge about the needs of preschool personnel if they are to support the inclusion of children with autistic spectrum disorders. In particular, what are their experiences of taking such children, what supports are available to them and what help do they require? This survey of fifty- six staff working in thirty-eight preschools of various types in the Greater Belfast area found that a sizeable number had the experience of taking with children with autistic spectrum disorders and that staff do receive some advice and support from a range of professionals. Nearly all were committed to enrolling such children in the future but they felt that a lack of staffing could preclude this. A majority of staff felt they have had inadequate or no training to equip them to meet the children’s particular needs, and they report a lack of knowledge and skills to help these children. The implications of these results are discussed in terms of the specific skills required by staff to manage these children and promote their learning; the professional support required and the contribution this could make to the preschool and the training requirements of staff working on these setting in either a paid or voluntary capacity.

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Congenital Versus Regressive Onset

Congenital Versus Regressive Onset of Autism Spectrum Disorders: Parents’ Beliefs About Causes

Robin P. Goin-Kochel and Barbara J. Myers

Recent studies have validated the phenomenon of autistic regression, but little is known about how regressive and congenital onsets of the disorder influence parents’ thinking about autism and its etiology. Parents (N= 327) of children with autism spectrum disorders completed an online questionnaire about their children’s development. Approximately half of the sample indicated that their children showed signs of autism from birth or shortly thereafter; the remaining half described their children as developing autism in the regressive fashion. Parents’ beliefs about the causes of autism varied widely, but two of the most popularly cited explanations were “genetics” and “external mechanisms” (e.g., vaccinations, environmental toxins). When analyzed relative to type of autism onset, parents more often advocated genetics as the cause for autism when their children exhibited the congenital type and external mechanisms when their children presented with the regressive type.

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Coping by Redefinition

Coping by Redefinition: Cognitive Appraisals in Mothers of Children With Autism and Children Without Autism

Belgin Tunali,1,3and Thomas G. Power2

To test a model of how mothers cope with the stresses of raising a child with autism (Tunali & Power, 1993), mothers of children with and without autism were interviewed. As predicted, mothers of autistic children: (1) placed less emphasis on career success and were more likely to believe that mothers of young children should not work outside of the home; (2) spent more leisure time with their extended family; (3) placed less emphasis on others’ opinions of their child’s behavior; (4) placed more emphasis on spousal support and parental roles in their discussions of marriage; (5) had more difficulty understanding their child’s behavior; and (6) showed a marginally significant difference in their tolerance of ambiguity. Moreover, mothers of children with autism who showed these characteristics had the greatest life satisfaction overall.

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Couple charged in autistic son's fire death

By The Associated Press
ALBANY, Ore. — A couple killed their autistic son by setting fire to their apartment while the young man was locked inside, Albany police said.
Nicolaas Dirk DeGroot, 45, and Agnes Elizabeth DeGroot, 48, were charged with arson and manslaughter, police said.
Christopher Aire DeGroot was alone in the apartment when firefighters arrived May 14. The 19-year-old, who had severe autism, was flown to a Portland hospital, where he died Friday.
''The fire started on some paper on the living room floor,'' Police Capt. Jeff Hinrichs said Monday. ''Probable cause indicates the parents started the fire.''
In a statement, police said Christopher DeGroot could not escape because he had been locked inside the apartment by his parents, who had left him alone on the morning of the fire. The parents had installed a dead bolt lock on the door that required a key to unlock it from the inside. Locks had also been placed on the windows, police said.
The fire was contained to the DeGroots' apartment, which is located in a small complex in southeast Albany. Damage was estimated to be $77,000.
Two cats were rescued and taken to Linn Veterinary Hospital. A firefighter was injured and treated at the scene.
On Friday, the parents voluntarily went to the police department for questioning and were arrested by detectives. Both DeGroots were lodged in the Linn County Jail on $500,000 security.
They were arraigned Monday in Linn County Circuit Court.

Location of potential autism gene found

Location of potential autism gene found

In another step toward unravelling the origins of autism, a new study confirms that a region of chromosome number 3 seems to be involved in the development of the disorder.

There was no evidence, however, that mutations in one suspect gene increase the risk of autism.

Analysing DNA from 31 members of a family of Northern European ancestry in which 7 individuals had autism or an autism-related disorder, researchers found that a portion of chromosome 3 appeared to be linked with the disorder.

The investigators, from the University of Utah in Salt Lake City, say their findings are remarkably similar to previous ones by scientists in Finland - confirming that a gene in this chromosomal region likely contributes to autism.

Autism is a developmental brain disorder that impairs, to varying degrees, a person's use of language and ability to communicate, interact socially and form relationships. Experts believe that genes play a central role in autism development and that variations in multiple genes are probably involved.

Scientists have found a number of chromosome regions that most likely linked to autism. The goal is to weed out the genes residing in these areas that confer susceptibility to the brain disorder.

Identifying the culprit genes will shed light on how autism develops, explained Dr Hilary Coon, the lead author of the new study.

Understanding "even one mechanism" underlying the disorder, she told Reuters Health, could aid in creating new treatments.

Experts also hope that with the major autism genes in hand, they will eventually be able to screen young children for autism risk and begin behavioural therapy as early as possible. Autism is typically evident by age 3.

FXR1 has been considered a good "candidate" gene associated with autism risk, Coon noted. The gene is similar to an X-chromosome gene involved in fragile X syndrome, a genetic disorder that causes learning disabilities and other mental impairments.

However, when the researchers looked at FXR1, they found no evidence that mutations in the gene were related to autism, according to the report published online by the journal Human Heredity.

Her team's findings, Coon said, do not rule out a role for FXR1 in autism. It's possible that very subtle alterations in the gene that the study did not detect contribute to the disorder. The gene may also simply not be relevant in this particular family.

Coon and her colleagues are now focusing their research on other genes in the same chromosome region.

New Findings Help Pinpoint Causes of Autism

New Findings Help Pinpoint Autism's Genetic Roots
Main Category: Autism News
Article Date: 08 May 2006 - 9:00am (PDT)

By deleting a gene in certain parts of the brain, researchers at UT Southwestern Medical Center have created mice that show deficits in social interaction that are reminiscent of humans with autism spectrum disorders.

The investigators also found physical abnormalities in the brains that mimic some cases of autism, showing that the research animals can be useful in studying the mysterious condition.

The finding - to be published in the May issue of the journal Neuron - confirms recent indications that a mutation in this particular gene could cause at least some forms of autism, said Dr. Luis F. Parada, director of the Center for Developmental Biology and the study's senior author. Dr. Parada also directs the Kent Waldrep Center for Basic Research on Nerve Growth and Regeneration.

"The exciting thing about this mouse is it helps us to zero in on at least one anatomic location of abnormality, because we targeted the gene to very circumscribed regions of the brain," he said. "In diseases where virtually nothing is known, any inroad that gets into at least the right cell or the right biochemical pathway is very important."

Autism is a brain disorder in which people have trouble with communication and social interaction and engage in repetitive movements. Usually manifesting in childhood, it affects about one in every 250 people, primarily males.

The researchers focused on a gene called Pten, which is also known to suppress cancers in humans. Some people with autism have mutations in Pten, but it has been unclear if that's what causes the disease, Dr. Parada said. To test that hypothesis, the researchers deleted the gene in the front of the mouse brain and in areas of the hippocampus, a structure involved in memory and other functions.

Mice, which are social animals, are a good model for studying the disease, Dr. Parada said. Their behavior can be studied when they are exposed to other mice, when they are provided with inanimate objects and material for making nests, and when they are placed in unfamiliar environments.

In each of those conditions, the mutant mice were distinctly different from normal mice that came from the same litter.

Mice lacking the Pten gene were generally uninterested in unfamiliar mice, while normal mice approached the strangers. When mutant mice were exposed to both an inanimate object and another mouse, they showed about equal interest in each - echoing the way children with autism prefer toys to people - while the normal mice preferred the other mouse.

When given raw material for nesting, the mutants ignored it, while the normal mice teamed up to build nests. And the pups of mutant females often died from lack of maternal care.

The genetically altered mice were also hypersensitive to stressful stimuli, such as being picked up, being subjected to a sudden noise, or being put in a lighted or open area. People with autism are similarly overly sensitive to sensory stimuli.

The mutant mice's brains were also noticeably altered in the areas where the gene was deleted. The nerve cells were thicker than normal and had a higher-than-normal number of connections to other nerve cells. This may lead to the sensory overload that people with autism experience, Dr. Parada said.

"It would be really exciting if it turned out that we've zeroed in on the anatomical regions where things go wrong in autistic patients, regardless of how the autism occurs," he said, adding that the next step in the research is to treat the mice with drugs to see whether it's possible to reverse the condition.

Autism-like syndromes are being studied at UT Southwestern from another angle through the work of Dr. Lisa Monteggia, assistant professor of psychiatry.

Her investigation of the role of a gene called MeCP2 in mediating autistic-like behavior has been published recently in the journals Biological Psychiatry and Current Biology. Mutations in MeCP2 occur in a pervasive developmental disorder called Rett syndrome, a human disease that shares many clinical features with autism. Mutations in MeCP2 also have been identified in autism patients.

In Biological Psychiatry, she described how the selective deletion of MeCP2 in the brains of mice - in similar areas as those targeted by Dr. Parada - creates many of the features of Rett syndrome that are also observed in autism patients, including reduced social interaction, abnormal repetitive behavior and increased anxiety.

Current Biology reported her collaborative study with Dr. Ege Kavalali, associate professor in the Center for Basic Neuroscience, in which recorded signals from nerve cells in the mouse brain showed that in those lacking MeCP2, there was an imbalance between signals that excite nerve cells and those that inhibit neural activity. Such an imbalance in nerve transmission has been hypothesized as a feature of human autistic disorders; however, this is the first report demonstrating such an imbalance.

Lead authors in the Pten study from the Center for Developmental Biology were Dr. Chang-Hyuk Kwon, postdoctoral researcher; former graduate student Bryan Luikart, now at Oregon Health & Science University; and Dr. Craig Powell, assistant professor of neurology and psychiatry at UT Southwestern. The work was supported by the American and Lebanese Associated Charities, the National Institutes of Health and the American Cancer Society.

UT Southwestern scientists participating in the MeCP2 research were Erika Nelson, student research assistant in psychiatry, and Terry Gemelli, former research associate in psychiatry.

Dr. Monteggia's research is supported in part by the National Alliance for Autism Research, Once Upon A Time …, and the Rett Syndrome Research Foundation.

Mutant Mice Show Key Autism Traits
Main Category: Autism News
Article Date: 07 May 2006 - 20:00pm (PDT)

While the causes of autism remain complex and mysterious, researchers are steadily adding pieces to its intricate puzzle. In what they believe to be a significant new approach to understanding "autism spectrum disorders" (ASD), researchers have developed a mouse that shows abnormal social interactions and brain hypertrophy characteristic of the disease.

In an article in the May 2006, Neuron, Luis Parada and his colleagues report the results of removing (knocking out) a single gene associated with brain disorders in mice. The gene, called Pten, had been associated with a broad array of such disorders when knocked out throughout the animals' bodies. However, Parada and colleagues engineered mice to knock out the gene only in mature, or "postmitotic," neurons of the cerebral cortex and hippocampus in the brain. These regions are associated with higher brain function such as learning and memory.

The mutant mice showed major abnormalities in a variety of social interactions normally undertaken in mice, found the researchers. For example, they were far less likely to approach and sniff new mice introduced into their cage, compared to normal mice. And while normal mice show markedly less interest when such new mice are later reintroduced, the mutant mice did not show such a reduction in interest. This abnormality indicated "impaired social learning or inability to identify the juvenile due to the low level of initial interaction," wrote the researchers.

In other tests of social behavior, the researchers found that--when given the choice of investigating a cage holding another mouse or an empty cage--the mutant mice showed similar preference for the two. Normal mice by far prefer investigating the caged mouse.

The researchers also found the mutant mice to be deficient in nest-forming and sexual and maternal behavior. In tests of their reaction to such sensory stimuli as bright environments, the mutant mice showed hyperactivity and increased anxiety. They also showed sporadic seizures.

The researchers concluded that "the mutant mice exhibited deficits in all social paradigms tested and also showed exaggerated reaction to sensory stimuli, anxiety-like behaviors, seizures, and decreased learning, which are features associated with ASD."

Finally, the researchers found that the mutant mice showed the same kind of abnormal overgrowth of neurons and their interconnections seen in some people with ASD that also show increased brain volume and enlarged heads.

Wrote Joy Greer and Anthony Wynshaw-Boris in a preview in the same issue of Neuron, "caution is warranted because there are aspects of ASD that are not recapitulated in the Pten mutants. For example, the Pten mutants do not display the expression of abnormal repetitive behaviors seen in ASD, although it is unreasonable to expect perfect phenotypic overlap of human ASD with any mouse model."

Also, they wrote, "as appropriately pointed out by the authors, Pten deletion is restricted to postmitotic neurons in the CNS [central nervous system] in their model, and current evidence suggests that ASD is a developmental rather than a neurodegenerative disorder."

Greer and Wynshaw-Boris concluded that "Whether or not the findings . . . have direct relevance to ASD, the experimental results described are intriguing and represent an important entry point to understanding the role of Pten in postmitotic neurons of the hippocampus and cortex as well as providing new insight into the molecular correlates mediating social- and anxiety-related behaviors in the postnatal CNS."

###

The researchers include Chang-Hyuk Kwon, Bryan W. Luikart, Craig M. Powell, Jing Zhou, Sharon A. Matheny, Wei Zhang, Yanjiao Li, and Luis F. Parada of the University of Texas Southwestern Medical Center in Dallas, TX; Suzanne J. Baker of St. Jude Children's Research Hospital in Memphis, TN. This work was supported in part by the American and Lebanese Associated Charities, NIH grant NS44172 (to S.J.B), and NIH grant R37NS33199 and the American Cancer Society (to L.F.P.).

Kwon et al.: "Pten Regulates Neuronal Arborization and Social Interaction in Mice." Publishing in Neuron, 50, 377–388, May 2006. DOI 10.1016/j.neuron.2006.03.023 whttp://www.neuron.org/

Autism Has High Costs To US Society
Main Category: Autism News
Article Date: 27 Apr 2006 - 18:00pm (PDT)

It can cost about $3.2 million to take care of an autistic person over his or her lifetime. Caring for all people with autism over their lifetimes costs an estimated $35 billion per year. Those figures are part of the findings in the first study to comprehensively survey and document the costs of autism to U.S. society. Michael Ganz, Assistant Professor of Society, Human Development, and Health at Harvard School of Public Health, authored the study, which appears in a chapter titled, "The Costs of Autism," in the newly published book, Understanding Autism: From Basic Neuroscience to Treatment (CRC Press, 2006). Ganz hopes his research will help policymakers allocate scarce resources to its treatment and prevention as well as provide a useful reference for policymakers and advocates to help them more fully understand the financial impact of autism on U.S. society.

Ganz's analysis of the costs includes direct and indirect medical costs associated with the disorder. But he believes the $35 billion annual societal cost for caring for and treating people with autism likely underestimates the true costs because there are a number of other services that are used to support individuals with autism, such as alternative therapies and other family out-of-pocket expenses, that are difficult to measure. In addition, Ganz believes that the level of cost could be higher if there were more useful and widespread treatment options available. "Given that the federal autism research budget has been historically less than $100 million per year and given that research budgets for other conditions with similar numbers of affected individuals are sometimes orders of magnitude higher, I hope that my research can help focus more attention on directing more resources toward finding prevention and treatment options for autism," Ganz said. (For comparison purposes, he notes estimated annual costs of other conditions, including Alzheimer's disease ($91 billion); mental retardation ($51 billion); anxiety ($47 billion); and schizophrenia ($33 billion).)

Autism is a pervasive developmental disorder (PDD) that involves severe deficits in a person's ability to communicate and interact with others. Children with autism often have trouble using their imagination, have a limited range of interests, and may show repetitive patterns of behavior or body movements. The disorder is often associated with some degree of mental retardation. Autism is the most prevalent PDD and the most common of all serious childhood disorders. It affects an estimated 1.5 million Americans and is increasing at a rate of 10-17 percent each year. It is four times more common in boys than in girls. The exact cause of autism is not known and there is currently no cure for the disorder.

Ganz broke down the total costs of autism into two components: direct and indirect costs. Direct costs include direct medical costs, such as physician and outpatient services, prescription medication, and behavioral therapies (estimated to cost, on average, more than $29,000 per person per year) and direct non-medical costs, such as special education, camps, and child care (estimated to annually cost more than $38,000 for those with lower levels of disability and more than $43,000 for those with higher levels).

Indirect costs equal the value of lost productivity resulting from a person having autism, for example, the difference in potential income between someone with autism and someone without. It also captures the value of lost productivity for an autistic person's parents. Examples include loss of income due to reduced work hours or not working altogether. Ganz estimates that annual indirect costs for autistic individuals and their parents range from more than $39,000 to nearly $130,000.

Since people with autism receive services from a wide variety of sources, Ganz believes future research efforts should focus on identifying those sources and linking those costs to non-financial data about the burdens of autism. These complementary sources of data can provide a richer picture that will be useful to policymakers in the future to assist them in devoting resources to address the financial and non-financial effects of autism.

Police: Mom admits to killing Woman reportedly said she wanted to end child's pain

Thursday, May 18, 2006
BY KAREN MCDONALD
OF THE JOURNAL STAR
PEKIN - Hours after allegedly killing her 3-year-old autistic daughter, Dr. Karen McCarron tried to overdose on over-the-counter medication.
She told police she "had just wanted to end her pain and (her daughter's) pain."
Toddler Katherine "Katie" McCarron had retreated into her own autistic world Saturday afternoon and wouldn't take a nap, according to court documents.
So Karen McCarron told her mother, who was visiting the family's Morton home, she planned to take Katherine for a car ride - as was common - to calm her down, Morton Police Chief Nick Graff said Wednesday.
But on this trip, McCarron drove to her mother's Morton home, placed a plastic garbage bag over her daughter's head and suffocated her, Graff said. She returned home to her mother and 2-year-old daughter, Emily, and took her dead daughter to her bedroom.
McCarron originally told police she tried to wake Katherine from a nap but found her
not breathing. Another visiting family member called 911 about 4 p.m. while Karen McCarron performed CPR on her child, who later was pronounced dead at OSF Saint Francis Medical Center in Peoria.
McCarron was not yet a suspect in the case Saturday evening and was allowed to return home, Graff said.
Mother's Day confession
Early on Sunday, Mother's Day, emergency crews again were called to the McCarron home at 390 E. Idlewood St., but this time for Karen McCarron, who had overdosed on some type of medication, Graff said.
Police found Karen and husband Paul, who had just returned from a business trip in North Carolina, in an upstairs bedroom embracing one another. Paul was crying, but Karen, who had told her husband she put a plastic bag over their child's head to calm her down, was unemotional, court documents stated.
When police asked Karen what happened, she replied, "Nothing is going to help and it's not going to make any difference."
Paramedics took Karen McCarron to St. Francis, where she told police "she had just wanted to end her pain and Katie's pain" and admitted to killing her daughter, Morton police Detective Ray Ham wrote in an investigation report.
McCarron, 37, a certified pathologist with no previous criminal record, now faces two charges of first-degree murder, each of which are punishable by 20 to 60 years in prison.
Tazewell County State's Attorney Stewart Umholtz said he does not plan to seek the death penalty, and no one else is expected to be charged.
"Obviously, this is a tragic circumstance. It's a terrible incident anytime a mother would be charged with murdering her child. But it's particularly troubling when it occurs over Mother's Day weekend," Umholtz said.
He would not discuss the mother's mental state or whether she is being treated for any conditions.
Karen McCarron, a pathologist, worked at Methodist Medical Center and Proctor Hospital and occasionally filled in at Pekin Hospital. She also was a volunteer clinical assistant professor at the University of Illinois College of Medicine at Peoria, officials said.
She is scheduled for a June 8 preliminary hearing in court.
Remembering Katherine
At Katherine's visitation Wednesday evening, a program showed Jesus cuddling a child in his lap with his hand on another child.
People stood around weeping. There were pictures of Katherine on a swing and in a red coat. In one photo, she was on a man's shoulders with her head thrown back in apparent glee.
Dr. David Ayoub said he met with Karen McCarron shortly after her daughter was diagnosed with autism.
"She was very dedicated to trying to get treatment for her daughter," Ayoub said. "I've met with a lot of parents who are dealing with autistic children, and she was one of the most loving mothers. This is a story that's been played over and over again. Homicide, suicide. The families just don't have the support."
The brain disorder in autism interferes with the ability to interact and communicate to others and causes difficulties with communication, motor skills, social and play skills, and coping with their environment.
Sue Grimm of Groveland, who has two autistic children, said she thought McCarron was a fantastic mother.

Support key for dealing with autism Caring for child with disorder can be lonely and frustrating

Thursday, May 18, 2006
BY DAYNA R. BROWN
OF THE JOURNAL STAR
PEORIA - Parents of autistic children say they are devastated by a mother's apparent killing of her 3-year-old child with the disorder, but some understand how a parent can be driven to such a desperate act.
While not supporting such an act, parents said the stress of raising a child with this complex disorder is sometimes unbearable. While support groups, friends and families can help, it often is a lonely and terribly frustrating journey for the parents.
"No one can understand. It is devastating. It can break you, even the strongest of mothers. Only other parents going through it can truly understand," said Libby Taylor, president of ANSWERS, an autism support group.
Dr. Karen McCarron of Morton is accused of suffocating her autistic daughter, Katherine, on Saturday, reportedly telling police she wanted to "end her pain and Katie's pain."
Autism is a developmental disability that affects an individual in the areas of social interaction and communication.
Parents deal with the frustration of not being able to secure services, dealing with the outbursts and sometimes being pushed away from the children they so dearly want to help.
Taylor, who has a 6-year-old autistic son, said her message to other autistic families is "be verbal and be loud and don't be afraid to say, 'I have these needs.'"
She recommends joining a support group, like ANSWERS, which McCarron was a member of, and creating a support network of family and friends.
"Parents need to talk to other parents because parents of children with autism are going to relate better," said Julie Matthews, executive vice president of programs at Easter Seals.
One of the biggest frustrations locally is there is no central location for people needing autism services to go for help, Matthews said. While Easter Seals has plans for this type of facility, the money isn't currently available.
Easter Seals does provide pediatric therapy and has an early diagnosis clinic for children suspected of having autism.
One Easter Seals program for parents called "Respitality" provides gift certificates for hotels, restaurants and theaters so parents of special-needs children get a night out. There is also an in-home respite program that allows families a weekend away.
"Having a child with a disability places a stress on a family," Matthews said.
There also is a need for a school for autistic children, similar to the one McCarron attended in North Carolina, autism experts said.
The Mariposa School provides year-round instruction for children with autism, and McCarron had attended from October 2004 through April 27.
"The students all have one-on-one therapy and each child's program is tailored for them. . . . That allows them to make great progress, and I can tell you, Katie had made some great progress here," said Cynthia A. Peters, president of Mariposa School. "We are missing her, and we all loved her dearly."

The Genetics of Autism

The Genetics of Autism

Rebecca Muhle, BA; Stephanie V. Trentacoste, BA; and Isabelle Rapin, MD

ABSTRACT. Autism is a complex, behaviorally defined, static disorder of the immature brain that is of great concern to the practicing pediatrician because of an astonishing 556% reported increase in pediatric prevalence between 1991 and 1997, to a prevalence higher than that of spina bifida, cancer, or Down syndrome. This jump is probably attributable to heightened awareness and changing diagnostic criteria rather than to new environmental influences. Autism is not a disease but a syndrome with multiple nongenetic and genetic causes. By autism (the autistic spectrum disorders [ASDs]), we mean the wide spectrum of developmental disorders characterized by impairments in 3 behavioral domains: 1) social interaction; 2) language, communication, and imaginative play; and 3) range of interests and activities. Autism corresponds in this article to pervasive developmental disorder (PDD) of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition and International Classification of Diseases, Tenth Revision. Except for Rett syndrome—attributable in most affected individuals to mutations of the methyl-CpG-binding protein 2 (MeCP2) gene—the other PDD subtypes (autistic disorder, Asperger disorder, disintegrative disorder, and PDD Not Otherwise Specified [PDD-NOS]) are not linked to any particular genetic or nongenetic cause. Review of 2 major textbooks on autism and of papers published between 1961 and 2003 yields convincing evidence for multiple interacting genetic factors as the main causative determinants of autism. Epidemiologic studies indicate that environmental factors such as toxic exposures, teratogens, perinatal insults, and prenatal infections such as rubella and cytomegalovirus account for few cases. These studies fail to confirm that immunizations with the measles, mumps, rubella vaccine are responsible for the surge in autism. Epilepsy, the medical condition most highly associated with autism, has equally complex genetic/nongenetic (but mostly unknown) causes. Autism is frequent in tuberous sclerosis complex and fragile X syndrome, but these 2 disorders account for but a small minority of cases. Currently, diagnosable medical conditions, cytogenetic abnormalities, and single-gene defects (eg, tuberous sclerosis complex, fragile X syndrome, and other rare diseases) together account for <10% of cases. There is convincing evidence that “idiopathic” autism is a heritable disorder.

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Understanding Autism

Understanding Autism
Knowing the signs and pursuing early treatment tailored to your child's specific needs is key to helping him shoot for the stars.
With autism claiming countless headlines in the media, there isn't a parent today who hasn't had questions or concerns about this complex disorder. You've probably heard that there has been a rapid increase in the number of children diagnosed with autism and that certain vaccines could be a potential cause. You may even know or have a child who has been diagnosed with the disorder. Despite the amount of coverage that autism has received, it remains a mysterious and often difficult disorder to understand.
No doubt, a diagnosis of autism can be very upsetting; but for many parents it is a relief to have a name for their child's symptoms. The positive news is that autism is treatable, especially if caught early. There is no telling how much can be accomplished with early intervention and treatment.
Defining Autism
The National Institutes of Health estimates that one in 166 children are diagnosed with some form of autism. Autism is a developmental disorder that involves many challenges -- typically delays and impairment in social skills, language, and other behavior. Autism is a spectrum disorder, which means that there is a broad spectrum of such symptoms.
There is a core set of symptoms associated with autism, but it's important to note that these symptoms can be seen in children without autism or in children who might have other types of developmental challenges. Each symptom on its own should not be considered a sign of autism. The core set of symptoms includes:
• trouble forming relationships
• difficulty understanding or responding to emotional signals from others
• using language creatively and receptively
• self-absorption (the child seems to be in his own world, not tuned in to stimuli and people around him
• repetitive, self-stimulatory behavior, such as staring at a fan
• repeating words over and over again
• repetitive motor movements, such as hand flapping.
What Causes Autism?
The exact cause of this condition is unknown. Researchers are looking at potential genetic and environmental causes. Experts believe that autism may be a biologically based disorder. And while there is no general consensus on what environmental factors might be at play, two significant factors being studied include vaccines containing mercury and various forms of brain trauma.
We're also trying to figure out why there has been such a large increase in autism cases over the past 10 to 20 years. According to the Autism Research Center, the rate of autism has increased enormously throughout the world since the early 1990s. There are lots of debates about why: Some say it's due to toxic chemicals, but there's no compelling evidence yet. Others think there is a good chance that the children and disorder haven't changed as much as our definitions and classifications. Children who might have been labeled as retarded or "brain injured" a generation ago are now said to be on the autistic spectrum.
In all likelihood, what we call "autism" is an umbrella term for a number of different kinds of mental problems, but they all share some common symptoms -- just as a fever might be a sign of many different kinds of illnesses. Similarly, problems with relating, communicating, and thinking may be the common symptoms of many different fundamental problems. This is where our research is taking us now. The bottom line is that there is lots of research going on, but there are no conclusive answers.
Treating Autism Individually
There are many different approaches to treating autism, and there is a strong movement to treat these children with behavioral methods, including rewarding behaviors we want to see develop, such as more interactions with others and staying tuned in.
We believe that to help any particular child, you have to know how he is unique. While the common problem of autism lies in relating to and communicating with others, the behavior patterns of each child can be quite different. Some children are overreactive to touch and sound, for example, while others are underreactive to touch and sound. The overreactive child needs extra soothing, while the child who is underreactive needs very energetic and animated interaction. Similarly, some children with this diagnosis have very good memories of the things they've heard, while others have very poor auditory memories. In fact, some children are not easily able to remember anything that's been said to them.
Helping a child requires meeting him at his level. We have developed the DIR (Development, Individual Difference, and Relationship-Based) Floortime model to help parents and teachers do this. The DIR Floortime Model addresses a child's individual differences by encouraging you to look at:
• the way your child takes in, processes, and understands new experiences
• the way he reacts to things, such as touch and sound
• the way he comprehends visual experience
• the way he plans actions
• his level of handling relationships
For example, if your child is just beginning to learn how to engage and interact with others, he may sometimes be very self-absorbed and wander the room aimlessly. You'll need to persuade him to want to relate to others. He may be occupied, for example, with a little car he likes to hold. You might take the car in his hand and put it on his head, as a playful way of enticing him into interacting with you. If he is also very underreactive to touch and sound, has low muscle tone, and is very passive, you might have to use a higher energy level and be very animated to grab his attention. As you engage him, you start helping him move up the developmental ladder.
When working with an unresponsive child, a strategy might be to have two cookies -- one chocolate chip (that you know he likes) and one oatmeal (that you know he doesn't like). Hold up each one and say, "Which one do you want, the chocolate chip cookie or the oatmeal cookie?" The goal is to have him answer, "I want the chocolate chip." It may take many sessions, but using his interests to entice him to relate to you can help him use language meaningfully.
How Your Child's Teacher Can Help
Your child's school environment is also important to consider. The general goal at school is for the teacher to create learning settings tailored to the needs of your child. Forming a strong partnership and sharing information with your child's teacher is key. Accomplishing this goal may require having an aide to provide extra help in a preschool or kindergarten program. Other times, you might volunteer in the classroom. It's very hard to provide the necessary individualized work if there's only one teacher for many children. Confer with your child's teacher and school director to be sure your child's teacher has enough support.
One way your child's teacher can help your child is to foster learning interactions between your child and one or more other children who are functioning without any challenges or special needs. Other children can help to lure your child into interaction with games. For example, the teacher can ask a child to hold the little toy car, so that your child takes it from him rather than her. She might also invite the children to interact during adult-mediated pretend play. She can ask things, such as "I'll bet you can't get Johnny to ask you for that little car." She can model the behavior so the non-autistic child will try to entice your child into more interaction and more creative use of language. Very often, children without special needs become very interested in the children with special needs, and get much satisfaction from being helpful.
Stanley I. Greenspan, M.D., author of Engaging Autism: Helping Children Relate, Communicate and Think with the DIR Floortime Approach, is a clinical professor of psychiatry, behavioral science, and pediatrics at the George Washington University Medical School.

Working with Autism and Other Social-Communication Disorders

Working with Autism and Other Social-Communication Disorders

Marjorie F. OIney
University of Illinois at Urbana-Champaign

Individuals with autism and related developmental disabilities such as Asperger's Syndrome and Pervasive Developmental Disorder present special challenges to rehabilitation counselors. Although their experiences have been described clinically, seldom have the perceptions of individuals with autism and their parents been actively sought. This article reviews the literature on autism from a variety of perspectives: medical, behavioral, social, and personal. An analysis of 18 first hand accounts, interviews, and autobiographical works by people with autism and their parents contribute insights into the experience of autism and related disabilities. The article concludes with specific suggestions to help rehabilitation counselors maximize the success of individuals with autism and related disabilities.

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Differences in Stress and Coping for Mothers and Fathers

Research conducted on families of children with disabilities shows that family cohesion and positive family outcomes are influenced by how mothers and fathers cope with raising their child with disabilities.

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Stress and Coping of Parents.pdf	1.29 MB

Effects of Maternal Prenatal Stress on Infant Outcomes - A Synthesis of the Literature

There is growing evidence that maternal prenatal stress may be hazardous to infant health. Changes in maternal hormonal and immune function as a result of stress may adversely affect the immune function and neurodevelopment of the fetus. Prenatal stress in the mother may produce lasting effects on the 1) infant's health status, 2) development and function of the infant's immune system, and 3) neurocognitive development of the infant. This article provides a synthesis of current human and animal literature on the effects of maternal prenatal stress on the developing fetus and the infant, with the resulting model evolving out of the framework of psychoneuroimmunology. The intent of the authors is an integrative review. The authors examined the following research question: What effect does maternal prenatal stress have on infants' immune development and neurodevelopment? All relevant studies were reviewed with no exclusion criteria. Major databases (CINAHL, MEDLINE, PsychINFO) were searched using a combination of the following key words: prenatal stress, cytokines, thymus, and infant neurodevelopment. Key words: infant outcomes, prenatal stress, psychneuroimmunology, theoretical model.

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Effects_of_Maternal_Stress_on_Infant_Outcomes.pdf	937.65 KB

Factors Related to Positive Perceptions in Mothers of Children with Intellectual Disabilities

Factors Related to Positive Perceptions in Mothers of Children with Intellectual Disabilities

Richard P. Hastings, Rachel Allen, Kellyanne McDermott and Danielle Still

Department of Psychology, Centre for Behavioural Research Analysis and Intervention in Developmental Disabilities, University of Southampton, UK

Paper accepted January 2002

Background Existing theoretical and empirical work in the intellectual disability field has paid little attention to parents’ positive perceptions of their child and the positive impact that the child may have on the family generally. The main aim of the present study was to explore the factors related to the mothers’ positive perceptions of their child with intellectual disability. Methods The mothers of 41 children with intellectual disabilities completed a self-report questionnaire that measured demographic factors, child demographic variables (including caregiving demand), social support, coping strategies and dimensions of positive perceptions.
Results Mothers’ perceptions of the child as a source of happiness/fulfilment and as a source of strength and family closeness were positively associated with reframing coping strategies. Mothers’ perceptions of the child as a source of personal growth and maturity were also positively associated with reframing coping strategies, the helpfulness and usefulness of support from family and friends, and the caregiving demand. Conclusions The relationship between coping and parental positive perceptions requires more
investigation both theoretically and empirically. This relationship may also have important implications for the support of families of children with intellectual disabilities.

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