Wednesday, June 29, 2016

The Rules of the Game for Children with ADHD

2 Jun 2016

Children with Attention Deficit Hyperactivity Disorder (ADHD) often display behaviours that are inappropriate for the situation in which they are in. They might move around in the classroom during a lesson, or talk non-stop and interrupt others’ conversations. ADHD is a neuro-developmental disorder that affects about 5% of children. Despite a considerable amount of research over many years, the causes of ADHD are still debated. A team of researchers from Japan and New Zealand has published a paper in the Journal of Child Psychology and Psychiatry that may help to explain the difficulties children with ADHD experience in adapting their behaviour to given situations.
“All of us tend to repeat those actions that get rewarded,” said Prof Gail Tripp, one of the authors of the paper and director of the Human Developmental Neurobiology Unit at the Okinawa Institute of Science and Technology Graduate University (OIST). “That’s how we learn: we do the things that have a positive outcome for us.” Even if the rules to get rewarded are rarely stated, the majority of us seamlessly move between different settings, adapting our behaviour to maximize the chances to get – socially – rewarded. For example, we behave differently during a lunch break than in a lab meeting even if we are dealing with the same group of people.
However, children with ADHD struggle to match their behaviour with the surrounding context. The scientists studied this issue exploring how children with ADHD behave when they play a game that has rules that change slightly, without explanation. The researchers tested 167 English-speaking children, aged between 8 and 13, in Japan and New Zealand. More than half of these children were diagnosed with ADHD. All the children played a simple game in which they had to decide if there were more blue or red faces on the screen in front of them. The screen showed a ten by ten grid full of mixed blue and red faces, and the children had just to hit a blue or red button according to the predominant colour they saw on the screen.
The game had some specific rules. The researchers explained to the children that they were going to be rewarded, with verbal praise and a plastic token, when giving the right answer, but only sometimes and not each time they gave the correct answer. During the game, the children were first rewarded four times more often for correct ‘blue’ answers. Then, after 20 rewards, the game started to reward the children more often for correct ‘red’ answers. Finally, after another 20 rewards, the game switched back to reward more frequently ‘blue’ answers. The rewarding system was not explained to the children.
The experiment showed that, initially, the children developed a bias for blue: when in doubt, the children started to give the answer that was rewarded more often during the first part of the game. However, when the rewarding system switched to red, differences began to emerge among the children. Typically developing children started showing a clear bias for red, while children with ADHD shifted only slightly their answers towards red.
Furthermore, when the rewarding system reverted back to blue, the gap in behaviour widened. Typically developing children went back to favour blue, while children with ADHD almost did not change their answers’ pattern. Hence, as the rewarding system swapped between blue and red, the children had to intuitively adapt to maximize their chances to get a reward. The data suggests that children with ADHD were not as good as typically developing children at responding to such un-signalled changes.
“I am really excited about this research, because I think it has important implications for how we manage the behaviour of children with ADHD,” Prof Tripp commented. “What we argue is that, for these children, we need to make explicit what the requirements are in any given situations. So, we are not relying on them to identify what the conditions are, but we are actually explicitly telling them: this is what you will be rewarded for. And we also need to tell them when we are no longer going to reward them for that.”
Children with ADHD are not naughty children. They may appear to misbehave and they may appear not to follow the rules, but this research suggests that this happens because they are not picking up on subtle rules changes. “Explaining the requirements in any given situation, and rewarding them accordingly, is not spoiling them,” Prof Tripp concluded. “It is a good parenting strategy. It is about trying to give them the same life opportunities.”

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Friday, June 24, 2016

People with ADHD don't receive enough support, Finnish research suggests

Date:May 19, 2016
Source:University of Helsinki

The aim of a new study was to collect and describe the experiences of Finnish families in which the symptoms of ADHD such as attention deficit, hyperactivity and impulsiveness are strongly present. Over 200 families participated in the study sharing their experiences of the support provided by educational, social and health sectors as well as the co-operation between these different bodies.

The aim of the study provided by the Master of Arts (Education), Erja Sandberg, was to collect and describe the experiences of Finnish families in which the symptoms of ADHD such as attention deficit, hyperactivity and impulsiveness are strongly present. Over 200 families participated in the study sharing their experiences of the support provided by educational, social and health sectors as well as the co-operation between these different bodies.
Sandberg worries about the unequal opportunities families have in getting support from educational, social and health sectors. People who have symptoms of ADHD may have to wait for a long time before they get support.
"Families don't have equal chances of getting the needed services on the state level even though the services are statutory. It is a coincidence if a family meets a professional who identifies the symptoms of ADHD and the need for multidisciplinary supportive services," Sandberg says.
Since ADHD is a familial disorder, it is important to define the need of support for the whole family. According to Sandberg, this is not happening. Adults who have symptoms of ADHD have waited for the support even over decades. Three out of five families describe that the co-operation between professionals does not meet the statutory level.
The educational capital was seen as a protective factor when the supportive services were provided within the family. Highly educated families were able to seek the needed services better and therefore had a greater chance to better function in Finnish society. These families also criticized the one-sidedness of the supportive services.

For example a family counselling center that works under the social services often offers guidance in the child's upbringing instead of sending the child to medical research." According to Sandberg, offering the wrong kind of support can be very expensive and useless for the society and it definitely does not help the family.
ADHD symptoms lower performance
As medicine has become more refined, it is nowadays possible to categorize more behavioral and cerebral disorders. These can be seen as invisible disabilities and they are even more common than traditional physical disabilities. Finnish legislation takes notice only of visible, physical malfunctioning that causes disability.
"Neuropsychiatric syndrome, ADHD, causes different functional impairments which are not identified by professionals when planning the support. Due to these functional impairments, young people may have difficulties in graduating if allocated supportive measures are not provided by multidisciplinary groups."
Families in need of support can be socially excluded
The difficult situations of the families were demonstrated in the research material in that every third family participating in this study included a socially excluded person or someone at risk of social exclusion. Socially excluded people report about low self-esteem and the sense of being less valuable and even incompetent to function in the surrounding society. The participants stated that social exclusion is a vicious circle from which escape is difficult when no support is available.
Families wished also for the professionals especially in educational and social services to see them through their strengths instead of their weaknesses. Attention deficit and hyperactivity disorder often includes behavioral problems that draw attention and are often noticed. This negative feedback may cause negative outcomes and even psychological malfunctioning. Stigmatization causes underachievement and lowers self-esteem
Current reseach
Sandberg executed the study with the assistance of netnography and the research data was collected from a social network group -- a nationwide ADHD peer support group. Over 200 Finnish families participated in the study for three years. The material is complemented with interviews. Sandberg's study provides information about multidisciplinary supportive measures and the experienced effects within the family as well as for the person with ADHD through his/her life course, even during decades.
ADHD is seen as one of the most common neuropsychiatric disorders; worldwide approximately 5% of people suffer from ADHD. It is very common that similar genetic problems run in the family. Therefore, supportive measures should be addressed to the whole family.
Master of Arts (Education) Erja Sandberg defends her doctoral thesis at the University of Helsinki in the Faculty of Behavioural Sciences on the 28th of May. The thesis belongs to the area of special education and is called ADHD in the family -- The support provided by the educational, social and health sectors, and their experienced impact.
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The above post is reprinted from materials provided by University of Helsinki. Note: Materials may be edited for content and length.

Monday, June 20, 2016

How to Raise Concerns about a Child’s Speech and Language Development: Do’s and Don’ts

Grandparents, friends, or neighbors who are worried about a child's speech and/or language development may hesitate to bring it up for fear of upsetting or offending a parent. While raising any concern to parents about their child is difficult, it is in a child's best interest to have any speech and/or language issues identified and treated as early as possible. 
Below are some do's and don'ts for talking respectfully and productively about a potential communication delay.
  • DO learn developmental milestones. Before sounding the alarm, refer to a list of speech and language milestones by age. Also look at the early signs of speech and language disorders. There may be no reason to worry. Share the milestones and your concerns with parents, especially if a child is not doing what is expected. 
  • DO know that not all children are the same. At 12 months, one child may be saying one word while another may be speaking 10 or more. This variability is typical—not every child has the same communication skills at the same age. The developmental milestones account for an expected range in skills. 
    • If a child is learning more than one language, be sure to count words in both languages. His or her development may be different than children who are only learning one language. Also, note that learning more than one language does not cause or worsen speech or language delays. 
  • DO be sensitive when raising the issue. Try saying, "I saw a story on the news about children's speech and language development…," or phrasing your concern as a question, e.g., "What do you think of Tommy's speech? Has he been using new words?"
  • DO share your family history of speech and language disorders, if known. Some disorders have a strong genetic component (a good example is stuttering), so this is important information to share.
  • DO tell parents to ask for professional assistance. Encourage parents to set up an appointment with their child's doctor to discuss concerns. If concerns are confirmed, the doctor will make a referral for a speech and language evaluation.  If the doctor is not concerned but the parents still are, the parents should trust their instincts and get a second opinion or have their child evaluated by a speech-language pathologist. A certified speech-language pathologist may determine there is no need to worry, and then the result is peace of mind. However, if there is a speech and/or language delay, it can be treated in a timely manner. 
  • DO provide resources to find help, if the child's doctor has not made any referrals for a speech and language evaluation.
    • If the child is less than 3 years old: Parents can access their state's  early intervention program. for a free evaluation. See What is Early Intervention?.  
    • If the child is 3 years or older: Parents can contact a local elementary school and ask to speak with someone who can help and have their child evaluated — even if their child does not go to that school. This is a free service provided by local school districts. 
    • For the assistance of a private speech-language pathologist: Search the ASHA ProFind database. 
  • DO be sensitive to the family's values and norms. Individuals handle concerns about developmental delays differently based on their background, family values, and norms. There may be different approaches to how children are being raised. Be mindful and respectful of those differences as you consider talking with people outside of your family (e.g., neighbor, friend).
  • DON'T compare siblings to each other. An older child may have been advanced for his or her age, resulting in concern when the second child is developing in a typical way. Again, look more broadly to expected developmental language milestones.
  • DON'T place blame. Parents don't cause speech and language disorders. It is inaccurate and hurtful to tell a parent he or she should have done something differently.
  • DON'T give labels. Do not try to diagnose the child. Instead, describe what you see. Leave a diagnosis to a speech-language pathologist, who is specially educated for identifying communication disorders. Share what the child does well also (e.g., "I know Sarah uses a few single words, and I was curious when she should starting putting multiple words together.") 
  •  DON'T assume treatment is too expensive. Services may be free through the state's early intervention program or school system, offered on a sliding scale, or may be covered in part or full by insurance. There are options for families.
  • DON'T "wait and see" if the child outgrows the problem. This is probably the most important point. Speech and language delays are highly treatable. The best outcomes occur when a child is seen by a professional early. Ideally, children will be treated long before entering kindergarten—and even before age 3, when children are in their most rapid period of development. Acting early can improve academic and social success, so speak up early.
Still Have Questions?
Contact the American Speech Hearing Association (ASHA) Consumer Action Center at 800-638-8255 or contact the ASHA National Office.
Additional Information:
Last Updated 4/26/2016
Source Copyright © 2016 American Academy of Pediatrics and American Speech-Language-Hearing Association

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Friday, June 17, 2016

Apple WWDC Opens With A Moment Of Silence For Orlando Victims

Apple CEO Tim Cook opened the company’s major software launch event WWDC Monday with a moment of silence for the 49 victims killed in a mass shooting at a gay nightclub in Orlando.
With a tearful reaction, Cook called Sunday’s shooting a “senseless and unconscionable act of terror and hate.”
“The Apple community is made up of people from all around the world,” he added. “We celebrate our diversity. We know that it makes us stronger, and moves everyone forward.”
Cook, who is one of the only openly gay CEOs of a Fortune 500 company, has been noted for his activism regarding issues of diversity, marriage equality, and government surveillance .
The outspoken CEO has most recently took on the FBI after the agency filed a court order to compel Apple to bypass the security features of an iPhone that belonged to one of the San Bernardino shooters.

In an interview with Time magazine, Cook said, “We felt like it trampled on civil liberties, not only for our customers but in the broader sense. It felt like different points in history, almost, in the U.S., where the government overreached for whatever reason. And we were dead set in the path of it. So we knew it was wrong. It was wrong on so many levels.

Apple CEO Tim Cook Honors Orlando Shooting Victims
pple CEO Tim Cook began the Worldwide Developers Conference with a moment of silence to honor the victims of the Orlando nightclub shooting. Cook called the event a "senseless, unconscionable act of terrorism and hate." He appeared visibly emotional and his voice was choked throughout his speech. Cook said, At Apple, we celebrate our diversity. We know that it makes us stronger and moves everyone

Thursday, June 16, 2016


STONY BROOK, N.Y., May 9, 2016 – A study using functional-MRI brain scanning reveals certain areas of the brain have higher activity in children who are socially withdrawn or reticent compared to children who are not withdrawn. Led by Stony Brook University psychologist Johanna M. Jarcho, PhD, the study involved fMRI of the children while they experienced a “cartoon classroom” that featured themselves as the new student in the school involved in various social interactions. The findings, published online first in Psychological Science , provide a better understanding of the brain activity of socially withdrawn children and could help form a foundation to teach children how to think differently about social interactions and thus prevent further socially withdrawn behavior or social anxiety.

In a brain scanning study of children with high social reticence, high activity is displayed in the left and right insula, brain regions implicated in processing salience and distress.
Social reticence is expressed as shy, anxiously avoidant behavior in early childhood. Some mental health professionals believe that social reticence in childhood and pre-teen years is a precursor to more socially withdrawn behavior and social anxiety that develops through the teen years and adulthood.
In the paper titled “Early-Childhood Social Reticence Predicts Brain Function in Preadolescent Youths During Distinct Forms of Peer Evaluation,” Dr. Jarcho, an Assistant Professor in the Department of Psychology at Stony Brook University and colleagues evaluated 53 children by way of fMRI. The children were part of a study beginning at 2 years of age with follow-ups at multiple ages to age 11. Thirty of the children were evaluated as those functioning with high social reticence; 23 were considered to have low social reticence.
The research team created a novel interactive paradigm around a virtual classroom in a cartoon form. Each of the 11-year-old children created an avatar character of himself or herself and completed an online personality profile. The experimenters created other characters for the child to interact with, such as the “unpredictable kid,” “bully,” or “nice student.” While undergoing fMRI, social interactions inside the classroom were played out, with each child reacting to these social interactions with their avatar character.
“Few techniques have been able to test the effects of such nuanced social landscape on brain function during real-time, ongoing, peer-based interactions where peers embody distinct social qualities,” said Dr. Jarcho. “This paradigm proved very effective in mapping brain activity of pre-teens who are socially reticent and appears to be a valuable tool for ongoing research.”
The scanning revealed that high (but not low) social reticence predicted greater activity in the dorsal anterior cingulate cortex and left and right insula, brain regions implicated in processing salience and distress. High social reticence was also associated with negative functional connectivity between insula and ventromedial prefrontal cortex, a region commonly implicated in affect regulation. Also, participants with high social reticence showed increased amygdala activity but only during feedback from the “unpredictable” peers in the cartoon classroom.
The findings provide scientists with a measure of brain functioning of pre-teens with high social reticence. A critical next step is to isolate neural circuits that promote risk for or resilience against expressions of psychopathology related to high social reticence.
Dr. Jarcho and colleagues are currently conducting interviews with the same group of 53 participants who are now approaching their teens. The idea is to determine if the pattern of brain function that differentiated pre-teens with high and low childhood social reticence also predicts expression of social anxiety symptoms.
Co-authors on the paper include scientists from Stony Brook University, the University of Maryland, the National Institute of Mental Health, University of Illinois, University of Haifa, University of Waterloo, Nationwide Children’s Hospital in Ohio, and Ohio State University.
The research is supported in part by the National Institute of Mental Health and the National Institute of Child Health and Human Development.

The Skills Schools Aren't Teaching But Must

MAY 16, 2016 6:00 AM 

The U.S. presidential campaign has focused a great deal on the need to expand economic opportunity, but candidates in both parties have not said enough about how they would achieve it. While helping more students go to college has been a topic of discussion and is a vitally important goal, what about those who do not go -- or who drop out of high school? They are largely being ignored, as they have been for decades, by an education system that is stuck in the past. That must change.
We will not solve the critical challenges of poverty, underemployment, wage stagnation and bulging prisons unless we get serious about investing in effective programs that prepare kids who are not immediately college-bound for middle-class jobs. Other countries -- such as Germany and Switzerland -- have figured this out. We must, too.
About 70 percent of young Americans, and 83 percent of blacks and Hispanics, do not earn a bachelor’s degree by age 29. Most who attend community college don’t graduate. And without having gained career-focused skills in high schools, many are getting left behind.
It used to be that a high-school diploma was enough to qualify for a job at the local factory that paid wages high enough to buy a home and raise a family. Those days are long gone. There are still more than 12 million manufacturing jobs in the U.S., down from a high of nearly 20 million in 1979. But most require far more skill than they once did. A high-school diploma no longer cuts it.
The same is true for many of the fastest-growing sectors of the economy, including health care, computer science and the construction trades. Many jobs in those fields don’t require a college degree, but they do require technical skills that high-school programs typically don’t offer. Because we have failed to strengthen and expand career and technical education, few students are given the option to pursue programs that would give them the skills that are an entry ticket into these industries.

As a result, too many students are put on traditional academic tracks that lead to dead ends, often graduating unprepared to perform anything but minimum-wage service jobs that hold few prospects for advancement. Many cannot find work at all, increasing their risk of being involved in crime and violence. We must do better.
In Washington, there is bipartisan agreement on the need to better prepare high-school students for careers, but very little has been accomplished. At the local level, school districts often lack the resources to adopt curricula geared toward the jobs of today and tomorrow. But some cities are tackling the issue head-on, and New Orleans -- where nearly one in five young people in the region are neither working nor in school -- is taking an innovative approach to this challenge.
Recently, a group of Louisiana education, business and civic leaders came together to create YouthForce NOLA, with the aim of providing high-school students with training and experiences that will prepare them for jobs that offer good wages.
Over the next five years, YouthForce NOLA aims to help 1,600 students earn credentials qualifying them for jobs such as EMT, junior software developer and manufacturing process technician. Each of those jobs is a first step to long-term professional advancement.
The program also aims to place more than 1,200 students in paid internships that are aligned with students’ coursework and provide experience in the workplace. That kind of experience is invaluable, because it can open students’ eyes to worlds of possibilities that they never knew existed. There is no substitute for inspiration.
Each member of the partnership, including civic leaders like the mayor of New Orleans, Mitch Landrieu, has a crucial role to play. Education leaders, led by Louisiana’s superintendent of education, John White, will reshape curricula. And business leaders will open pathways for students with the right training and skills. For too long, business leaders have been missing from the table in discussions about vocational programs, and it shows. Unless they are involved, new programs will fail -- and the disconnect between career-focused education and the job market will grow even wider.
To help close the gap, JPMorgan Chase and Bloomberg are providing $7.5 million to YouthForce NOLA, and we hope other business leaders will join us in pushing for change in their home communities. We are preparing similar investments in Denver and Detroit, where civic, education and business leaders are also committed to educating and training young people for high-demand jobs.
As with so many other issues, national leaders and the presidential candidates should look at the approaches being taken by cities to modernize career education. Long-term, broad-based economic growth depends on a strong and expanding middle class that is open to all Americans, not just college graduates. That is only possible if we reinvent vocational programs so that they are aligned with macroeconomic trends, growing local industries and jobs that offer opportunities for advancement.
Without that, we will never give young people -- regardless of their race or ZIP code -- a chance at a better life, nor will we stop the senseless violence that claims so many young lives and imprisons even more, nor fulfill our promise as a nation devoted to the idea that equal opportunity is a birthright.
Michael Bloomberg is the founder of Bloomberg LP and Bloomberg Philanthropies and was mayor of New York City from 2002 to 2013. Jamie Dimon is the chairman and chief executive officer of JPMorgan Chase & Co.
To contact the editor responsible for this story:

David Shipley at