MSU expert: ADHD has many causes but some cases may be preventable
Attention-deficit hyperactivity disorder has no shortage of controversies and open questions.
And when it comes to what causes the disease, there are no easy answers, according to Michigan State University psychologist Joel Nigg.
Rather, Nigg, the author of "What Causes ADHD? Understanding What Goes Wrong and Why," said the condition, once called attention-deficit disorder, is most likely the result of interaction between a host of factors.
Genetics plays a role, he said, but researchers are also looking at environmental pollutants, poor prenatal health and food allergies.
"There are probably four or five routes to the same endpoint," Nigg said
Nigg's book, published in May, is an effort to synthesize the most current research on ADHD.
He spoke with the Lansing State Journal about ADHD's controversies, its possible causes and possibilities for future research.
• Let's start with the basics. What is ADHD?
• Nigg: It's a syndrome of behavior in which children are extremely impulsive, extremely active, extremely disorganized and extremely unfocused. And this can come in various combinations.
It's an extreme of behaviors that all kids show, but it's so extreme that these kids are seeing failures in their developmental milestones. They're not learning normally in school. They're not making friends normally. Or they're experiencing unusual levels of conflict at home.
• There are still controversies about ADHD, about whether it's a legitimate disorder, about whether it's just a way of medicalizing childhood behaviors. Why?
• Nigg: I think the reason there's so much question about it is that the behaviors are so common that it's easy for the lay person to think, "I know what this is, because I've seen active kids." And it's also easy for professionals to oversimplify and make the diagnosis too easily.
• But you obviously believe this is a legitimate disease.
• Nigg: In some respects, every disease is simply a construct that we make up to make sense of things. The first question we ask in our profession is, "Is it a useful construct? Is it a useful idea?"
I'm convinced that, by the usual standards of calling something a disease, this meets it, just as well as asthma does or hypertension. It's necessary and legitimate to treat it as a real disorder because we have really impaired kids who really are injured. If we say the disorder isn't real, what do we do for those kids?
• Are ADHD rates increasing, or are doctors simply making the diagnosis more often?
• Nigg: The perception that it's being treated more often and identified more often is certainly true. We've seen dramatic increases in the last 30 years in the percentage of kids being prescribed medications and identified with ADHD.
Does it really exist at higher rates? That's less clear. What we have is, anecdotally, if you go out and talk with teachers who have been doing this for 30 years, it's really hard to find teachers who say this problem is going away and really easy to find teachers who say this problem is much worse than it was 30 years ago. But hard data on this are lacking.
• So what does cause ADHD?
• Nigg: There are multiple causes. We don't know them all, but we know a few things.
We know that genes play a role, probably in susceptibility to ADHD. We know that prenatal and perinatal problems can contribute to or cause ADHD. We know that lead exposure early in life can contribute to symptoms of ADHD. We know that various teratogens probably contribute, like alcohol, but that's probably a small percentage of cases.
• Your book advocates more research on the role environmental contaminants play in causing ADHD. Can you elaborate on that?
• Nigg: If we wanted to say, "ADHD is a big problem in our country. What are we going to do about it?", that means we have to understand all these early risks that kids get exposed to and figure out if they're contributing.
Genes contribute to susceptibility to ADHD, but they probably aren't the whole story, and we can't do much about that. If genes are interacting with contaminants, we can do something about that. We did that with reducing lead in auto exhaust. But we have thousands of other chemicals we haven't gotten to yet.
If we find out that 20 percent of these cases are preventable - and, in the book I argue that 20 percent are probably preventable with attention to the things we already know - that's big news. I hope in 50 years, we'll say 50 percent is preventable.
Matthew Miller, Lansing State Journal
July 5, 2006
Contact Matthew Miller at 377-1046 or mrmiller@lsj.com
Autism's Link to Vaccines Is Unfounded, Study Says (Update1)
(Bloomberg) -- Use of mercury in vaccines doesn't cause autism among school-aged children, a study says.
Advocacy groups had suggested that mercury used as a preservative in some immunizations may be linked to autism, an umbrella term that covers a range of developmental and communication disorders that affect three to six of every 1,000 children born in North America.
The Montreal study found that autism rates rose steadily among school-aged children who had been vaccinated as infants, even though the preservative was not included the shots during the last two years examined, said Eric Fombonne, director of Pediatric Psychiatry at Montreal Children's Hospital
``If you look at the rates of autism in the study, there is a smooth linear increase in the prevalence from the group born in 1987 to when the study finishes with children born in 1998,'' said Fombonne, the lead researcher, in a July 3 phone interview. Had mercury played a role, the rates of diagnoses should have fluctuated, he said.
The study, published in the journal Pediatrics, examined rates of the disorders among 27,749 children at 55 schools in Montreal. Thimerosal was removed from vaccines in 1996 when manufacturers combined five immunizations, including polio, which is inactivated by the preservative.
Fombonne has worked as an expert witness on behalf of vaccine makers defending lawsuits in the U.S. that allege that mercury causes autism. While none of Fombonne's research is industry-funded, the study was immediately criticized as biased by David Ayoub, an Illinois radiologist.
`Heavily Biased'
``This is just another heavily biased study by an author with a long track record of financial ties to the drug industry, and whose previous views on the epidemiology of autism have been discredited,'' wrote Ayoub, who is also medical director of the Foundation for Autism Information and Research, in an e-mailed response to questions.
Ayoub said Fombonne's effort ignored several papers that link mercury and autism. The omissions and Fombonne's testimony on behalf of drugmakers raises issues about his ability to independently analyze the study data, Ayoub said.
The study shows a four-fold increase in autism rates during the 10-year period examined, Ayoub said. In addition, some children may have been exposed to mercury from other vaccines, including hepatitis and flu shots given to children and pregnant women after 1996 that still contained mercury, he said in an interview.
Symptoms
Autism symptoms include regression in speaking skills and may develop after children are given vaccines, leading some to link the events. Fombonne said the increased autism rate is more likely tied to changes in the definition of autism, greater awareness of the condition and rising numbers of services for patients has boosted the number of children diagnosed with the condition each year.
This isn't the first study to eliminate mercury as a possible cause for autism. The U.S. government-chartered Institute of Medicine in Washington issued a report in May 2004 concluding from a review of previous studies that no evidence linked autism with thimerosal-containing vaccines or with shots that no longer contain the mercury-based preservative.
The rates of disorders ``among children born in an era where there was no exposure to thimerosal is significantly higher than in the years before, when there was high exposure,'' he said. ``That's really a convincing argument that there is no relationship between the two.''
To contact the reporter on this story:
Michelle Fay Cortez in Minneapolis at mcortez@bloomberg.net
July 5, 2006
http://www.bloomberg.com/apps/news?pid=20601082&sid=aH7ewLY95pJk&refer=canada
Special needs education condemned
Parents and children let down by schooling, says damning Commons committee report
A damning report will raise serious questions this week over the way children with special needs are educated, highlighting 'significant cracks' in an underfunded system that leaves desperate parents without sufficient support.
While the government denies it has an 'inclusion policy' - increasing the number of children with special educational needs (SEN) taught in mainstream schools - that is the message it is sending to local authorities, the study by the Commons Education and Skills select committee will claim.
The policy is 'failing to cope with the rising number of children with autism and social, emotional or behavioural difficulties', the report will conclude: 'The government needs to rethink its approach to involving or - as is more often the case - not involving parents.'
Many campaigners argue that every child has a right to be included in mainstream school. Others, who often include parents of children with behavioural difficulties, say some cannot cope in a busy local school and would benefit from a place in a special school.
The report will say both options - and others in between, such as specialist units - must be open to all parents. That is not the reality at the moment, the committee has found.
The findings come a month after an Observer investigation revealed that thousands of parents were being let down by the system. Local education authorities were found to be deliberately delaying assessments so that children did not get the right educational support.
The report will also say that children are being needlessly excluded from school because of behaviour associated with learning difficulties, while teachers are not trained to cope. Families face a 'postcode lottery' where 'good practice is the exception rather than the rule'. SEN must be 'radically improved' or society will face heavy costs in terms of exclusions and youth crime, it will argue. At present 87 per cent of exclusions in primary schools involve children with SEN and 60 per cent at secondary.
But the report is too tame for one MP on the committee. Nadine Dorries, a Tory backbencher who has a daughter with special needs and is herself dyslexic, is expected to deliver a hard-hitting minority report, further attacking the policy of inclusion as damaging to children.
Dorries is expected to argue that the situation has worsened significantly since the introduction of legislation in 2001 which imposed a duty on schools to include such pupils in mainstream school unless it was either against their parents' wishes or incompatible with a proper education, which she maintains has been interpreted as a general policy to educate all children in mainstream schools. Dorries is said to believe that the main body of the report has not tackled the reasons why SEN has become so problematic. She refused to comment in advance of its publication.
Some parents also criticised the committee. Julie Maynard, whose son Joshua has multiple disabilities, including autism, said she was angry they did not take direct, verbal evidence from parents. But she welcomed the news that they would call for the government to clarify its confused position on inclusion.
She said many children thrived in a mainstream setting, but that had not been the case for her son. 'Sadly, I think the argument for inclusion of all children in mainstream has for too long been dominated by the physically disabled who were - in the past - wrongly placed in special schools.' But for many children with behavioural issues, it was a different debate, she added, where mainstream was right for some, but not all.
The committee will call for a statutory requirement for local authorities to provide a minimum level of support for children such as Joshua. SEN training should be a core and compulsory part of teacher training, it will say. It will also call for a fundamental review of the 'failing' system that gives children statements outlining their needs: 'If SEN was given sufficient priority, this would not be allowed to continue.'
Experts are likely to welcome the findings, but many will feel it has not gone far enough. Allan Willis, an educational psychologist who represents parents, argued it was wrong that many had to spend thousands of pounds just to get their child's basic needs satisfied.
Meanwhile, John Friel, one of the country's leading barristers handing SEN cases, said local authorities did not offer services unless they were fought for. 'Parents feel like they are knocking their heads against a brick wall,' he said.
Anushka Asthana and Gaby Hinsliff, The Observer
July 2, 2006
http://education.guardian.co.uk/schools/story/0,,1810968,00.html
Tiny 'digital camera' could restore vision to the blind
THERE is fresh hope for hundreds of thousands of blind people that they may soon have their sight restored as researchers in Scotland are developing a prosthetic retina.
Using technology similar to that found in digital cameras, the tiny device would be implanted into the eye to stimulate a retina that was no longer working.
It is designed to help people with age-related macular degeneration and retinitis pigmentosa, conditions that affect about a million people in the UK. These conditions are caused by failure in the retina - the part of the eye which converts light into signals that are sent to the brain.
The micro-electronic device could translate light into electrical impulses, stimulating the retina and fooling the brain into believing the eye is still in working order.
"The device would contain an imaging detector with hundreds of pixels coupled to an array of microscopic stimulating electrodes," said Dr Keith Mathieson, who leads the team at Glasgow University developing the device.
"If light forms an image on the detector, then the result will be electrical stimulation of the retina in the shape of this image. The stimulated cells then send the information via the optic nerve to the brain.
"The imaging part of the system is based on the technology used in any digital camera."
The prototype of the implant has 100 pixels, but the researchers hope to increase this as their work progresses.
"Around 500 pixels would allow people to walk down the street and recognise faces," Dr Mathieson said.
The scientists say they are still five to ten years away from fitting the artificial retina to humans. If successful, however, the invention could transform the lives of up to a million people who have gone blind.
It is hoped that the tiny box, which would be about 5mm in diameter, would restore sufficient vision to allow people to go about their daily lives with greater ease.
So far the research team has carried out tests using animal retina cells cultured in the laboratory. Dr Mathieson said these tests had led the research team to believe that the device could restore sight in people. In the future, it may even be possible to incorporate a "smart chip" in the device, which would allow it to replay something the person had seen previously.
Dr Mathieson said that while this was certainly possible one day, it was still slightly in the realms of science fiction.
He said researchers were concentrating on trying to create a device that would restore useful vision.
"We are trying to get to the point where someone would no longer need a guide dog, rather than replicate perfect vision," Dr Mathieson said.
However, he added: "Beyond where we are today, it might be possible to make smart chips that have memory in them which would allow action replay and slow motion."
John Legg, director of the Royal National Institute of the Blind (RNIB) Scotland, welcomed the work of the scientists. "It will, however, be some years before this research bears fruit," he said.
"In the meantime, RNIB Scotland will continue to campaign to ensure that existing treatments are promptly and uniformly available to all who might benefit."
Lyndsay Moss, Health Correspondent
July 11, 2006
http://news.scotsman.com/health.cfm?id=1013292006
Gifted students shy away from fast-tracking
CEILI Moore enjoys a challenge.
The 11-year-old is in the top 5per cent of her Year 6 class, participates in debating and academic tournaments, and has spoken at her local Rotary Club in western Sydney.
In these school holidays, she was learning to play bridge.
But when asked if she would consider moving up to a higher grade at school, Ceili said she would be reluctant to leave her friends and face a new challenge.
"I'd rather be doing well in an easier grade than be behind in a harder one," she said.
Ceili's remarks reflect the attitude of many gifted students, and some Australian educators who fear that accelerating gifted children through school puts undue pressure on them.
Miraca Gross, director of the University of NSW's Gifted Education Research, Resource and Information Centre, said teachers were unwilling to accelerate academically advanced children or were unaware that it was possible.
"Most of these kids would be topping the class if they went up a grade. They don't realise that," Professor Gross said.
"They're just cruising by at the moment.
"Teachers equate acceleration with pushing the child. Teachers are afraid of hurting a kid by pushing them, so they feel better doing nothing -- but that can in fact do more harm."
How Australian schools deal with gifted children is the focus of a national study to be undertaken by Professor Gross and her colleague, GERRIC director of research Karen Rogers, over the next three years.
The study will examine state and private schools and investigate different procedures that allow academically gifted students to move faster through their schooling.
Professor Gross said teachers' attitudes and practices regarding acceleration would be a particular focus.
The study is funded through a $500,000 grant from the John Templeton Foundation, based in the US.
Professor Gross has previously investigated the use of acceleration in the US and expects the Australian results to similarly show an under usage of academic acceleration.
"What we found in America, and what I'm betting will be the case in Australia, is that teachers are not aware that they are allowed to accelerate kids ... they aren't aware of the policy," she said.
Professor Gross said gifted children who were not accelerated could be socially isolated, acting out and underestimating their own abilities.
"They get enormously frustrated," she said.
"Bad behaviour can sometimes be a camouflage so the other kids look at them and think, 'They're all right'.
"It's not cool to be academically talented."
Josh Croke, 11, from Kawana, on Queensland's Sunshine Coast, attends a Year 7 maths class, the only sixth-grader at his school to do so. He said he would be happy to move up a grade if offered the opportunity.
"It's boring when I have to wait for the other kids to finish something," he said.
Pia Akerman
July 10, 2006
http://www.theaustralian.news.com.au/story/0,20867,19737607-601,00.html
Certification = Quality?
An elite title is debated for whether it helps teachers be more effective.
Every night after teaching at Bethel High School in Hampton, Charles Barhite sifted through hours of videotape of his history classes, looking for a 20-minute stretch of film that showed he could be a nationally certified teacher.
"Sitting there and watching yourself teaching, three or four hours a night, after you come home from teaching - it's draining, mentally and emotionally," said Barhite, who was certified by the National Board for Professional Teaching Standards in November 2005.
Some 907 of the 81,000 or so public school teachers in the state are nationally certified. Certification puts teachers in a select, nationally recognized group that gets extra money from the state - $2.6 million this fiscal year - as well as perks from school districts.
But a national debate is growing over whether this certification helps teachers be more effective in the classroom. And two College of William and Mary education professors, who studied fifth-grade teachers in three school districts in North Carolina, have poured fuel on the fire. They found that being nationally certified doesn't necessarily mean students will score higher on tests. The professors also found little difference in how nationally certified teachers taught their students, compared to other teachers.
However, National Board certified teachers are above-average in how they interact with students and how their students score on standardized tests, said Thomas Ward, one of the professors who did the study with University of Virginia and University of North Carolina researchers.
"But they weren't necessarily the highest of all teachers," he said. Many noncertified teachers had students that scored higher, he said.
The study is another example of research questioning how much the National Board is tied to student success. Bill Sanders, a researcher for the private SAS institute, a data-analysis group that tries to measure the influence of teachers and schools on students, studied nationally certified teachers in North Carolina and said earlier this year he'd found that their students didn't score significantly higher than other students.
Ward cautions that his research doesn't challenge the basis of the National Board - a way to reward teachers and label those who meet national requirements.
A National Board spokesman did not return calls last week.
But the question for lawmakers and officials is whether it's worth pumping state money into the program, Ward said. "Is it worth knowing that that teacher is above-average?" he said.
School districts usually help pay the $2,500 application fee, which can go up if a teacher needs to re-apply. And the state pays $5,000 to teachers the first year they're certified, and $2,500 per year for nine years afterward. Some school districts match those amounts or throw in other perks.
"Certainly these studies seem to be suggesting that the National Board - whatever process it's using - is not focusing enough on whether that teacher has an impact on students," said Kate Walsh, president of the National Council on Teacher Quality, a Washington-based research and advocacy group.
Walsh, who hadn't read the William and Mary study, said the National Board needs to be sure they're stressing student achievement when they define what makes a good teacher.
"The last thing they want to have happen," she said, "is to have state legislators get hold of this rather conclusive evidence and start withdrawing money."
But the certification process has merit, she said. "The National Board has done a great job of providing teachers with a high-status award," she said.
Despite questions about how important certification is, many teachers say the application process helped them become better teachers. A 2001 National Board survey found 92 percent of teachers surveyed said they had become better teachers during the process.
Kelly Dee, director of bands at Kecoughtan High School in Hampton, earned his national certification in 2002. "It's the best professional development experience I've ever participated in," he said. Dee is president of the Southeast Virginia National Board Certified Teachers Regional Network, which helps teachers going through the application process.
Watching videotapes of himself made him re-evaluate his teaching style, he said. Now that he is certified, he thinks harder about how to reach students.
Barhite, the Bethel High teacher, said the process helped him, too.
"If you're going out and talking to a lot of different teachers, then it also gives you ideas of what you might want to try in your classroom," Barhite said.
Those benefits might not be measurable by standardized tests, he said. And the benefits might not be apparent until later in his students' lives, he said.
"Every single one of them will come back as juniors and seniors and say, 'You know, if you didn't make me work so hard in your class, I wouldn't have been able to succeed now,' " he said. "It makes you look at your teaching. Not just looking at test scores, but impacting the whole student, not just your subject area."
Carol Scott
July 10 2006
http://www.dailypress.com/news/local/dp-69362sy0jul10,0,5113913.story?coll=dp-news-local-final
Specialized schools better than "inclusion": Deaf students
EDMONTON -- When Chris Charbonneau walks into the Alberta School for the Deaf, it's as if a switch is turned on to a full-volume world of learning and socializing that was muted when he was in a regular school.
He talks to his friends and kibitzes with other students. His teachers use a sign language that he easily understands.
It's been a breakthrough from what he experienced before he entered one of Canada's few remaining schools for the deaf.
"(This school) rocks!" Charbonneau said during an interview through a sign language interpreter. "I prefer to be at a school with all deaf kids. I have people to talk to and have fun with."
Charbonneau, 14, transferred from a regular school in Grade 3. Before coming to ASD, he was taught through an interpreter in a process he found frustrating and repetitive.
"I didn't get a lot of the information and I didn't understand what I was supposed to do for my work," he said. "A lot of things I was learning again and again and again because I wasn't getting the information."
Leading deaf advocates say Charbonneau is a good example of why more deaf kids need to be taught in specialized schools at a time when the trend is to send them to mainstream schools.
Attendance at schools for the deaf has dropped sharply in recent years. Schools in Saskatchewan, Nova Scotia and Quebec have closed and the closure of Newfoundland's school is planned.
"Many of the people who are making the decisions and many educators tend to be hearing, and they don't know the experience of deaf people," says Joanne Cripps, co-director of the Deaf Culture Centre in Toronto. "So they don't understand or don't know, or don't want to know or don't want to understand."
In London, Ont., for example, about 400 deaf children are being sent to mainstream schools while the number of students in the city's school for the deaf steadily dwindles.
"The money is not well spent because they're spreading it out in different special programs," Cripps said. "Children will have more mental health problems with no identity, no language, no community."
Cripps, who attended a residential school for the deaf as a child, blames misinformation for much of the reluctance to send kids to specialized schools.
"Many parents are afraid that if they expose their child to American Sign Language at an early age, then they won't develop spoken language, even though research shows the opposite is true."
"Governments across Canada have been ignoring good advice for many years and what's really needed is a royal commission to deal with deaf education issues," Cripps said in an interview.
She'd like to see Canada follow the lead of countries such as Sweden, where the law requires parents to have all deaf children taught sign language.
Cripps is also pushing for changes in the health system that would require doctors to direct parents of deaf babies to meet with deaf adults and visit schools for the deaf.
"Parents will listen to people in the medical profession, so the medical profession has a responsibility."
A fierce pride in their schools also has students and teachers speaking out about how the lives of deaf and hearing-impaired kids become "complete" in a setting where everyone knows sign language.
"Whoever invented that term inclusion is a liar," says Charmaine Letourneau, an Order of Canada recipient who attended the Alberta School for the Deaf herself and now teaches there.
"This school has made me what I am today. I thank God that my parents sent me here rather than to a mainstream school."
Letourneau says deaf kids in regular schools often segregate themselves because of cruel treatment from other kids.
Erica Reay, 14, says she had problems fitting in before she came to ASD.
"There wasn't a lot of good communication. I had students picking on me because I had a hearing aid," said Reay. "But I don't use the hearing aids now because everyone here signs. This is like our second home."
The sprawling Alberta School for the Deaf has hallways so long you can barely see the end, but many of its classrooms sit vacant.
The school, which once had more than 200 students and nearly as many staff in the '50s and '60s, now has only 65 students and about three dozen staff.
The building is showing the signs of a half-century of use, and a spokesman for Alberta's infrastructure ministry says it could be five to 10 years before it is upgraded or replaced.
Principal Betty Dean says that means the school will not be able to install the newest technology available for teaching deaf students.
"The advancement in technology has been huge," said Dean. "It gives deaf people equal access to information."
Jim Macdonald
Canadian Press
July 09, 2006
http://www.canada.com/topics/news/national/story.html?id=5a53c81a-a7c7-4a5b-86cb-1255ddd366e7&k=61482
Video Games for ADHD
SAN JOSE, Calif. (Ivanhoe Broadcast News) -- As much as 6 percent of the American population has attention-deficit/hyperactivity disorder, a disorder that makes it hard to focus. The usual treatment is medication that can have serious side effects. But now, some doctors are successfully treating ADHD with video games.
What is remarkable about this scene is not what is happening, but what is not.
"The kids aren't fighting. They're playing games together," Jill Mathur notices of her own children. That's unusual for children like Julia and Janelle Mathur, who both have ADHD.
Janelle had trouble with tests. "I just couldn't concentrate," she says. "I heard lots of small noises, scratching of paper."
"They just aren't able to filter what's important at the moment, so they're trying to take everything in at once," Margaret MacDonald, M.D., an ADHD specialist in San Jose, California, tells Ivanhoe.
Dr. MacDonald treats ADHD with SMART BrainGames, a new system that combines brain wave monitoring, biofeedback and video games. The goal is to alter the brain wave patterns responsible for ADHD. A hat is fitted with sensors. The patient is only successful at the game when emitting the right kinds of brain waves.
"If they don't do the right thing then they can't steer, and they'll crash and eventually the brain will keep trying to do what it has to do to succeed in the game," Dr. MacDonald says.
And it works.
Janelle says, "If I'm taking a test, I can think about the problem, not the sounds."
Her mom, Jill, says, "I knew they were really wonderful people inside, and I am so excited to see who they are coming out."
Janelle is now completely off her ADHD meds, and Julia has reduced her doses.
"It's as close to a magic bullet as I've ever seen," Jill says.
Doctors say SMART BrainGames usually requires about 40 sessions that last 20 minutes to 30 minutes each, and the results are permanent. In a recent study, both SMART BrainGames and standard biofeedback helped kids improve attention, impulse and hyperactivity, but the difference was in motivation -- there were fewer drop outs in the video game group.
If you would like more information, please contact:
Margaret MacDonald, M.D.
2211 Moorpark Ave., Suite 290San Jose, CA 95128(408) 876-4510
Dr.Mac@Mind-connection.com
http://www.mind-connection.com
Ivanhoe Broadcast News
July 7, 2006
http://www.ivanhoe.com/channels/p_channelstory.cfm?storyid=14025
Down's syndrome gene identified
Scientists believe they have found a possible cause for mental impairment in Down's syndrome.
They have identified a gene that, if over-produced, can cause some brain cells to stop working properly.
The next step, say the US researchers in journal Neuron, is to find the mechanism for the process.
This, they say, could ultimately lead to finding a way to "turn down" the gene expression so mental decline might be stopped or even reversed.
People with Down's syndrome have three copies of chromosome 21, instead of the normal two - this is called trisomy 21.
Many people with Down's syndrome go on to develop dementia, similar to early-onset Alzheimer's disease, by the age of 40.
In both Down's syndrome and this form of Alzheimer's, brain cells, or neurons, responsible for learning, memory and attention, wither and die.
Lead researcher Professor William Mobley, director of the Neuroscience Institute at Stanford University, said: "We've been interested in those neurons and why they get sick for some time."
To investigate he looked at mouse models, and discovered that mice with three copies of a gene called the amyloid precursor protein gene, or App, situated on chromosome 21, had larger neurons than mice with two copies of the gene.
He believes App is causing cell death by interrupting the signalling between cells that is needed to keep them healthy.
He added that although it is known that a mutation in the App gene is responsible for early onset Alzheimer's disease, having three copies of the gene somehow has a detrimental effect on the brain.
"There are all of these genes on chromosome 21, and undoubtedly all of them contribute in some way to these changes that you see in people with Down's syndrome.
"The challenge is to say can you find specific abnormalities linked to specific genes."
Turning genes down
The next step, he said, is to find the mechanism for this process, and then to see if there is a way that the gene expression can be "turned down".
"If we can decrease the expression of this gene, we may be able to provide something more than supportive care to people with Down's syndrome."
Professor Elizabeth Fisher, of the Institute Neurology, UCL, said: "This is a very interesting paper.
"This may be some way towards an explanation of why people with Down's syndrome develop the hallmark brain signs of Alzheimer's disease."
BBC NEWS
July 5, 2006
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/5151232.stm
Schools failing dotcom kids
Tech-savvy students need a modern curriculum
TEACHERS need to focus more on "higher-order" thinking skills and critical problem-solving techniques to cope with the lightning-speed culture of 21st century literacy, says leading international educator and author Ian Jukes.
Mr Jukes, who is in Melbourne this week to attend a seminar at Ivanhoe Girls' Grammar School, believes the biggest issue educators face is a lack of relevancy in today's learning.
"Australian education is dealing with exactly the same issues that everybody else is dealing with right now, and that is trying to provide the rigour and relevance for kids," he says. "I think the purpose of schools is to prepare children for their future - not our comfort zones or our future. Their future. They're the big issues that we're dealing with right now."
Mr Jukes says schools must prepare students for both higher education and employment, to avoid producing "highly educated useless people".
"We graduate people who have very, very good schools skills but don't have very good life skills," he says.
A director of the InfoSavvy group, Mr Jukes is popular in the US and Canada as a speaker on the impact of digital technology on children and why teachers need to embrace it. A former professional rugby player and teacher, his passion for education stems from the belief that learning should be fun.
"As a child I had a number of horrendous experiences because I would be, in today's age, the ADD (attention deficit disorder) poster child," he says. "I was deeply humiliated for my lack of ability, and a silent vow that I've taken is that I will do everything that I possibly can to ensure that the next generation of kids does not experience those horrible things I did. Teachers have incredible power to make or break children, and I want learning to be a joyful thing."
Making learning relevant to such a media-savvy generation is probably the biggest challenge educators face, he says.
"We must acknowledge that the dotcom generation lives in a different world. That today's students live in a culture that is fundamentally different from ours."
He says that for the first time in history, teachers are facing students who know more about the new digital landscape than they do.
"This is the first generation in history where the younger generation knows more about new developments in central society than the older generation," he says. "There are a lot of kids today who are waiting for the internet or video game version of education so they can walk away from school. They have exceptional information fluency skills and they go find what they need online."
Mr Jukes says educators must re-think the curriculum to move away from being "highly theoretical."
"Our tests must measure not only theory but also must become synonymous with higher-level thinking. To do this we must move to a far more application-based curriculum," he says. "We must go beyond theory and focus on practical applications that are relevant to the workplace rather than mutually exclusive and theoretical subjects that prepare students for yesterday and today, not tomorrow."
Information fluency, he says, should be taught in every classroom in the same structured manner as mathematics, the sciences and languages.
"The real issue in education today is that we have to go from common recall to what I call information fluency," he says.
"We need to teach information fluency, not just information literacy. Information fluency involves learning an unconscious process, allows information seekers to ask good questions, access a wide range of resources, analyse and authenticate data and turn it into knowledge, then apply that knowledge within the context of real-time, real-life experience."
He says educators must realise that kids of the dotcom generation are fundamentally different from previous generations.
"(Kids are different) in the way they think, in the way they access, absorb, interpret, process and use information, and especially in the way they view, interact and communicate in the modern world because of their experiences with digital technologies," he says.
"This has profound implications for us both personally as parents and professionally as educators."
Learning for life
What kids should be taught:
· Thinking skills: critical thinking, problem solving, applied reasoning, information processing, new communication skills such as speaking and listening.
· Technical skills: technical reading and writing, the ability to apply technology creatively, applied sciences, applied maths and applied language.
· Personal skills: goal setting, self-assessment, organisation and time management, change readiness, stress management, digital entrepreneurship, marketing and self-marketing.
· Workplace skills: being future focused, trend aware, an understanding of the global marketplace, work and learn in teams.
Source: Education at the Crossroads, by Ian Jukes.
Elisabeth Tarica
July 3, 2006
http://www.theage.com.au/news/education-news/schools-failing-dotcom-kids/2006/07/01/1151174437537.html#
With Cochlear Implants, Earlier Use Leads To Better Speech
"Bye-bye, bye-bye," said one 3 and a half-year old child, born deaf but with a cochlear implant that partially restored hearing nine months earlier. That's the most complex speech the child uttered during a testing session that involved play with a toy train set.
In contrast, a child of the same age who had a cochlear implant 31 months earlier made more sophisticated statements: "OK, now the people goes to stand there with that noise and now — Woo! Woo!" and "OK, the train's coming to get the animals and people."
The testing session was part of research that indicates the earlier a deaf infant or toddler receives a cochlear implant, the better his or her spoken language skills at age 3 and a half. The research was conducted by Johanna Grant Nicholas, Ph.D., research associate professor of otolaryngology at Washington University School of Medicine in St. Louis and colleague Ann E. Geers, Ph.D., from the Southwestern Medical School at the University of Texas at Dallas.
"Ninety percent of children born deaf are born to hearing parents, and these parents know very little about deafness," Nicholas says. "They don't know how to have a conversation in sign language or teach it to their children. Many of these parents would like their children to learn spoken language."
The researchers tested the spoken language skills of 76 children, all 3 and a half years old, who had cochlear implants and compared those results to the length of time each child had his or her implant. They found that with increased implant time, children's vocabulary was richer, their sentences longer and more complex and their use of irregular words more frequent. The researchers' work was reported in the June issue of Ear and Hearing.
Nicholas notes that many of the children who received cochlear implants at the youngest ages have nearly the same spoken language skills as children with normal hearing. The researchers' further studies — not yet published — suggest that by age 4 and a half, children who had cochlear implants very early often have normal speech and can potentially enter kindergarten with their hearing peers.
"Kids with residual hearing can get some help from hearing aids, but cochlear implants give a tremendous hearing advantage over hearing aids — the implants provide more sound information," Nicholas says. "For example, high-frequency sounds are magnified more with cochlear implants, so kids can hear 's' sounds and 'ed' endings better. So they tend to catch on to plurals and verb tenses faster."
While studies like this and others favor early implantation, the decision for or against cochlear implantation is frequently put off, Nicholas indicates. Hearing parents often find they need time to learn about deafness and potential treatments. Implantation also may be delayed to make certain an infant's deafness has not been misdiagnosed.
Even when deafness is confirmed, the idea of head surgery for their baby makes many parents hesitate. And they may be daunted by the fact that a cochlear implant is forever — the device destroys any residual hearing so that hearing aids are no longer an option.
"Studies like ours are meant to help answer parents' questions about cochlear implants," Nicholas says. "Our overall goal is to focus on the best age for implantation. If the window of time for the best outcome is small, we want parents to know that. With the results we've seen so far, we believe that it is best to implant when the child is younger than 24 months if parents want a deaf child to use spoken language at the same level as their hearing peers."
Nicholas is also on the faculty of the Program in Audiology and Communication Sciences (PACS) at Washington University School of Medicine. The PACS program is part of a consortium of programs formerly operated by Central Institute for the Deaf and now collectively known as CID at Washington University School of Medicine.
Nicholas JG, Geers AE. Effects of early auditory experience on the spoken language of deaf children at 3 years of age. Ear and Hearing 2006;27(3):286-289.
Funding from the National Institute of Deafness and Other Communication Disorders supported this research.
Washington University School of Medicine
June 29, 2006
http://www.sciencedaily.com/releases/2006/06/060629231043.htm
Struggles persist for adolescent girls with ADHD
BERKELEY – As they enter adolescence, girls with Attention Deficit Hyperactivity Disorder (ADHD) show fewer symptoms of hyperactivity. But they continue to lag behind their peers academically and have a greater proclivity for other behavioral and emotional disorders as well as for substance abuse, according to new research from the University of California, Berkeley.
In a much-anticipated, five-year follow-up study of one of the largest samples of girls with ADHD ever examined, UC Berkeley researchers found not only that difficulties for girls suffering from the disorder persist during their teens, but that insidious new problems can emerge. These findings are published in the June issue of the Journal of Consulting and Clinical Psychology.
"As girls with ADHD mature into adolescence, on average they don't show as many visible symptoms of the condition, especially the most noticeable form - hyperactive behavior," said the study's lead author, Stephen Hinshaw, who is a UC Berkeley professor of psychology and chair of the psychology department.
"But we can't get fooled into thinking things are fine. Delinquent and depressed behaviors, risk for substance abuse, symptoms of eating disorders, high need for services, difficulties with peers - these problems hit girls with ADHD harder than they did for the comparison group without the condition," he added.
Since 1997, Hinshaw and his team have tracked a racially and socio-economically diverse group of girls with ADHD through summer camps and into adolescence, comparing them with girls who did not meet the criteria for ADHD but were otherwise demographically matched.
The childhood study, funded by a grant from the National Institute of Mental Health (NIMH), included a sample of 140 girls with ADHD and 88 without the disorder. The girls were aged six to 12. Together, they attended five-week camps where they were closely monitored as they partook in art and drama classes and outdoor activities. Those taking ADHD medication volunteered to go off the drug treatment for much of the summer camp study. The counselors and staff observing all 228 girls and monitoring their interactions did not know which of them had been diagnosed with ADHD.
Published in 2002 in the Journal of Consulting and Clinical Psychology, the initial study found that girls with ADHD are more likely to struggle academically and to be rejected by their peers, compared to the comparison peer group. Results also suggested that girls are underdiagnosed for the disorder because they are more prone to "inattentive-type" ADHD, which is marked by disorganized and unfocused behavior rather than the disruptive, impulsive conduct seen in boys.
The latest findings show that these problems clearly persist into adolescence. According to five-year follow-ups of 209 of the girls in the study, although the fidgety, impulsive symptoms exhibited during childhood had subsided in many cases, the learning gulf between girls with ADHD and their "normal" peers had remained large in all cases, and had actually widened in math and reading skills. Moreover, in many cases, risky behaviors had surfaced.
"Girls with ADHD have impairments that are not transitory but that persist through adolescence. And they are persisting in areas of function that are really crucial for success in adulthood," Hinshaw said. "They're behind academically and socially. Even if symptoms improve, underlying deficits seem chronic, and we need to do a lot more for early intervention."
For parents coping with difficult teenage ADHD behavior, Hinshaw warned, adolescence can be tricky as they try to strike a balance between encouraging their daughters to stick to their treatment regimen -which may involve medication, family therapy, school supports, or a combination - while supporting their need for autonomy.
"At the very time adolescence is occurring for these kids, demands for independence are increasing exponentially," he said.
For the follow-up study, the researchers spent two half-days with each of the girls as well as with their parents and caregivers, conducting intensive interviews and tests. The girls' classroom teachers also provided information. The objective was to learn how the girls, whose ages ranged between 12 and 17, were doing emotionally, socially and academically. The investigators also measured key cognitive functions such "executive planning skills," which include time-budgeting, adjusting to changes and goal-setting.
Hinshaw said he hopes these new findings will underscore the need for long-lasting professional intervention for children with ADHD and convince families struggling with the disorder that it's a misconception that ADHD is not a "real" condition - and that diagnosis and treatment are crucial.
His research team has won a new NIMH grant for a 10-year follow-up study of the same girls. It is set to begin later this year.
Some of the girls in the study are also participating in a UC Berkeley brain imaging project to pinpoint the source of poor executive function skills, a common component of ADHD.
As many as 7 million children in the United States have been diagnosed with this developmental and behavioral disorder, which is characterized by poor concentration, distractibility, hyperactivity, impulsiveness, aggression and other symptoms that are inappropriate for the child's age. The treatment regimens that have received the greatest research evidence are stimulant medications and various forms of behavior therapy.
Although the news is sobering, many of the girls with ADHD did show improvement across the five-year follow-up interval. A few made substantial recoveries. But on average, problems persisted and new ones emerged, which suggests that careful monitoring and treatment are essential, Hinshaw said.
In addition to Hinshaw, authors of the study are Elizabeth Owens, Nilofar Sami and Samantha Fargeon, all of UC Berkeley's psychology department and Institute of Human Development.
Yasmin Anwar, Media Relations
June 29, 2006
http://www.berkeley.edu/news/media/releases/2006/06/29_adhd.shtml
Study Links Air Pollutants With Autism
Bay Area children with the disorder are 50% likelier to be from areas high in several toxic substances. Scientists say more research is needed.
Children with autism disorders in the San Francisco Bay Area were 50% more likely to be born in neighborhoods with high amounts of several toxic air contaminants, particularly mercury, according to a first-of-its-kind study by the California Department of Health Services.
The new findings, which surprised the researchers, suggest that a mother's exposure to industrial air pollutants while pregnant might increase her child's risk of autism, a neurological condition increasingly diagnosed in the last 10 years.
But the scientists cautioned that the link they found in the Bay Area is uncertain and that more definitive evidence would be needed before concluding that mercury or any other pollutant could trigger autism.
Gayle Windham, the study's lead researcher and senior epidemiologist in the department's environmental health investigations branch, called it "a single small study" and "a first look" at whether toxic pollutants play a role in the neurological disorder, which is often marked by poor verbal and communication skills and withdrawal from social interaction.
Scientists have long wondered if the surge in diagnoses is due, in part, to environmental causes. Some of the increase comes from growing doctor and parent awareness, but experts say that cannot explain all of it.
"Clearly this suggests that there may be correlations between autism onset and environmental exposures, especially as it relates to metal exposures," said Isaac Pessah, a toxicologist who heads UC Davis' Center for Children's Environmental Health and Disease Prevention. Pessah, who was not involved in the study, is also a researcher at the university's MIND (Medical Investigation of Neurodevelopmental Disorders) Institute, which studies autism.
"It would be prudent to reserve judgment until we see if this study can be replicated and whether it's of general significance" by looking for the same link outside the Bay Area, he said.
About 300,000 U.S. children have been diagnosed with autism and often need special education. The study compared 284 children from six Bay Area counties who were diagnosed as having so-called autism spectrum disorders — which include a less-severe syndrome called Asperger's — with 657 children from the same counties without the disorders. All were born in 1994.
The scientists reviewed data for 19 hazardous air pollutants that are known or suspected neurotoxins: chemicals that have a toxic effect on the brain.
They found that the children with the autism disorders were 50% more likely than the non-autistic children to be born in areas with higher estimated levels of three metals and two chlorinated solvents: mercury, cadmium, nickel, trichloroethylene and vinyl chloride. No significant link was found with 14 other solvents and metals, including compounds such as lead, benzene and chromium.
The national autism rate is six children per 1,000, so a 50% increase would elevate that rate to nine per 1,000.
The biggest increase came with heavy metals including mercury, a pollutant from power plants, factories and mines that can disrupt brain development.
The Bay Area was chosen for the study because extensive data are readily available there because of a federally funded program to count and track autistic children. The region's toxic air pollution is considered typical for urban areas.
San Francisco County had the highest estimated levels of metals and solvents, including mercury, and Marin County had the lowest of those studied. But the researchers did not compare autism prevalence by county.
In their report, published online Wednesday in the journal Environmental Health Perspectives, the authors said their research "suggests that living in areas with higher ambient levels of hazardous air pollutants, particularly metals and chlorinated solvents, during pregnancy or early childhood, may be associated with a moderately increased risk of autism. These findings illuminate the need for further scientific investigation, as they are biologically plausible but preliminary and require confirmation."
The study is the first to look for a connection between autism among children and levels of hazardous air pollutants at birth. Last year, scientists who compared volumes of industrial mercury emissions in Texas with autism in schoolchildren reported a similar link.
Autism is believed to start in the womb, early in pregnancy, when the brain develops. Genetic factors determine who is susceptible, but experts theorize that environmental factors contribute.
The new study found that mercury was the "most significant correlation with autism," Pessah said, "but every family may not be affected the same way because of their genetic makeup."
Many parents of autistic children blame vaccines that contained a type of mercury called thimerosal. Expert reviews have found no link between vaccines and autism, but some scientists do not consider them definitive.
No assumptions about vaccines can be made on the basis of the air pollution study. "Mercury in the air is a different type than in vaccines," Windham said.
The new study examined elemental mercury, which is released into the air from coal-burning power plants, chlorine factories and gold mines. It spreads globally and builds up in food chains, particularly in oceans. Levels of mercury are increasing in many parts of the world, largely from power plants in China and India.
The researchers had not expected to be able to discern a relationship between autism and the air pollution data.
The five metals and solvents are common industrial pollutants, but air is only one source of exposure, because they also contaminate water and food.
Some experts say that if there is a link between mercury and autism, it most likely comes from fish consumption, the main route of mercury exposure. A 20-year, ongoing study in Denmark's Faroe Islands has shown that children have slightly reduced intelligence when mothers consumed excessive mercury in seafood.
The largest limitation or uncertainty in the Bay Area study is that the pollution data did not come from measurements of compounds to which the mothers were actually exposed. Instead, they were based on estimates calculated by the U.S. Environmental Protection Agency using computer modeling of industrial emissions.
Windham said that "there could be other explanations" for the link they found. For example, it could be that women who live in the worst-polluted areas also smoke more or eat more contaminated seafood. The scientists did not track down the mothers to compare lifestyles.
Researchers at Johns Hopkins University's School of Public Health are conducting a similar study in the Baltimore area to see if they replicate the findings.
Marla Cone, Times Staff Writer
June 23, 2006
http://www.latimes.com/news/local/la-me-autism23jun23,1,732425.story
Teachers urge rethink on inclusion policy
Teachers have called on the government to end a "one size fits all" approach to teaching children with special education needs, after the standards watchdog said it was the quality of the education, not where they are taught, that produced the best results.
Assessing education in mainstream and special schools, Ofsted inspectors said how well special needs pupils performed at school was not determined by whether they were taught in a mainstream or special school. Inspectors also wanted that children with behavioural, emotional and social difficulties were the most likely to receive inadequate support too late.
The chief inspector of schools, Maurice Smith, said: "Pupils with even the most severe and complex needs can make outstanding progress in all types of settings. The inclusion debate has for too long focused on whether children with learning difficulties and disabilities should be educated in special schools or mainstream schools rather than the quality of the education and support they receive.
Parents, teachers and disability campaigners have voiced concern over the continued closure of dedicated special schools in the name of "inclusion" - where children with special needs are placed in mainstream schools.
Ofsted also criticised the assessment processes for allocating a "statement" of special educational need.
Mr Smith said: "Although statements are effective in identifying the educational needs of pupils the system can be cumbersome and bureaucratic."
The general secretary of the Association of Teachers and Lecturers, Mary Bousted, said Ofsted made "sensible recommendations" and the government needed to better resource specialist teaching.
"We agree with Ofsted that it is the quality of provision, rather than the type of school, that matters in the education of pupils with learning difficulties and disabilities.
"However, we believe that there is a need - highlighted in this report - to ensure mainstream schools are sufficiently resourced to increase specialist teaching and support so they can meet the needs of pupils with learning difficulties and disabilities," she said.
"The report also supports our argument that continuous professional development for teachers and teaching assistants is vital if they are to improve their knowledge and skills to meet the needs of these pupils. It is important to remember inclusion comes with a price tag, and cannot be achieved on the cheap."
The general secretary of the National Union of Teachers, Steve Sinnott, said Ofsted's report was "the final nail in the coffin for the sterile inclusion versus segregation debate".
He added: "All the evidence points to the fact that special needs teaching in many mainstream schools, however, is under resourced and poorly supported particularly for youngsters with behavioural difficulties.
"Government and local authorities must commit themselves to maintaining a wide range of provision including special schools, support services and units and stop the trend towards a one size fits all approach to special education."
The Conservatives' shadow education secretary, David Willetts, said Ofsted had produced an "important report, which should lead the government to think again about its automatic assumption to inclusion".
He added: "The government is trying to drive children with special educational needs headlong into mainstream education. But this is a much more balanced report, which shows that many special schools do an excellent job.
"It is not inclusion that matters, but the quality and training of teachers and the wider educational environment. This is another reason why the government should stop its headlong rush into inclusion."
The schools minister Lord Adonis said Ofsted acknowledged that children with special needs could make "outstanding" progress in all types of school.
He said: "We have always been clear that inclusion is about the quality of children's education, and how they are helped to learn, achieve and participate in the life of their school, whether that is a mainstream or a special school. We are not complacent and we know there is more to do."
Alexandra Smith
EducationGuardian.co.uk
July 13, 2006
http://education.guardian.co.uk/ofsted/story/0,,1819623,00.html
More disabled kids live with single women
RALEIGH, N.C. --Children with disabilities are more likely to live with a single woman -- whether she is a mother, grandmother or a female foster parent -- than other children, according to a new study.
The findings by researchers at the University of North Carolina at Chapel Hill indicate that organizations aimed at helping disabled children must also consider the particular problems faced by the single women who often care for them, said Philip Cohen, an associate professor of sociology at the university.
"In the patchwork of arrangements to care for children with disabilities, we have to realize that the system is also dealing with issues of gender equity," Cohen said.
The study, conducted by Cohen and his former student Miruna Petrescu-Prahova, now a doctoral student at the University of California, Irvine, was published Friday in the quarterly Journal of Marriage and Family.
The study examined 2000 Census data on 2.3 million children ages 5 to 15. More than 130,000 were reported to have mental disabilities, physical disabilities, or both.
It found that while 62 percent of children without disabilities live with a married, biological parent in a two-parent home, only 46 percent of disabled children do.
Single mothers care for 17 percent of children without disabilities, but for 24.5 percent of those who are disabled. Fewer than 5 percent of disabled children live with a single father, about the same percentage of non-disabled children living with fathers.
In homes where no biological parent is present, Cohen said disabled children were more than twice as likely to be cared for by a single woman than were children without a disability.
The findings are not particularly surprising, but offer a different perspective the challenges faced by single, female caregivers, said Avis Jones-DeWeever, director of poverty, education, and social justice programs at the Institute for Women's Policy Research in Washington, D.C.
The institute's own research has shown an inordinate number of women getting government aid are either themselves disabled or taking care of a disabled child, Jones-DeWeever said.
Single mothers often have multiple challenges causing them to fall through the cracks of existing assistance programs, she said. She agreed with Cohen that his data show "perhaps we need to think more concretely about what kinds of policy supports these families need."
Both said the largest unanswered question in all the research is why women end up dominating such caretaker roles. Most probably, it's simply "the cultural norms and a combination of what we as women tend to do," Jones-Deweever said.
Margaret Lillard, Associated Press Writer
July 14, 2006
http://www.boston.com/news/education/higher/articles/2006/07/14/
single_women_mostly_care_for_disabled_kids
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