Avoid Summer Brain Drain!

Summer vacation means sleeping late, staying up late, and doing very little except enjoying time out of school. However, did you know that the average student loses one to three month’s math and reading gains made over the prior year? Academic losses are so common among students that educators have given the phenomena a name: Summer Brain Drain.

This makes starting the following school year difficult.

Summer Brain Drain may even be worse for ADHD students already having trouble at school.

Going to school daily provides schedules and routines. The summer break means those routines aren’t there. Expectations are lowered or relaxed. Even sleep schedules are often totally abandoned.

Unfortunately, exercise is often replaced with computer time, watching movies, or playing video games with friends. That’s a bad idea. While there’s nothing wrong with playing video games or watching movies, sedentary activity must always be balanced with exercise. This is especially important for an ADHD student.

So here are some tips that should help prevent Summer Brain Drain:

• Take advantage of the summer months to start your Play Attention program. Summer is a great time to start Play Attention because you will have the time to get a solid routine, begin strengthening cognitive skills, and work on eliminating distracting behaviors. Play Attention is the only program available that integrates feedback technology, attention training, memory training, cognitive skill training and behavior shaping. This guarantees you will have the most complete program available.

• Organize your life and set a consistent routine with ADHD Nanny.

• Read. Decrease reading losses by developing a fun reading plan with your child. Select reading level appropriate books and have fun discussing them and even acting out some scenes!

• Plan trips to the library for story telling, selecting a new book, or even just browsing the magazine selection.

• You’ll likely go to the mall, grocery store, or gas station over the summer. Make these math trips! Use numbers found at these locations to create on the spot games with prizes. Even you car’s trip meter can be of service for math problems.

• Set a routine. Sleeping late is fine as long as it’s balanced with proper exercise and proper bedtime. Remember your teen will need far more sleep than your 6 – 12 year old.

• Get outside…a lot. Working in the yard promotes better attention. No kidding! Being in a green environment has been shown to decrease attention problems, so get outside and play!

• Establish a balanced diet. The high fat, high sugar diet commonly consumed in the US has been shown to contribute greatly to attention issues as well as obesity. Avoid too much fast food even though it’s convenient. Dinner time at the table with a balanced meal promotes both family harmony and good health.

ADHD & Age

h3>Is ADHD being over diagnosed?

A study conducted over 11 years by the University of British Columbia and published in the Canadian Medical Association Journal finds that the youngest children in a classroom are more likely to be diagnosed with ADHD. Funding for the UBC study was provided by the Canadian Institutes of Health research and the B.C. Ministry of Health.

The study reflects similar findings from US researchers [I blogged about Todd Elder  in the Journal of Health Economics (Elder et al. The importance of relative standards in ADHD diagnoses: Evidence based on exact birth dates. Journal of Health Economics, 2010; DOI: 10.1016/ j.jhealeco.2010.06.003)].  US researchers performed meta-analysis, i.e. studied data from other studies and found that younger students are more frequently diagnosed as ADHD compared to their older classmates.

The Canadian researchers followed 937,943 students ages six to 12 years old between Dec. 1, 1997, and Nov. 30, 2008. They were located in a province where the cutoff age for entry to school is Dec. 31. They found children born in December were 39 per cent greater probability to be diagnosed and 48 per cent more likely to be treated with medication for ADHD, compared to children with a January birthday. This, of course, raises concerns that many schoolchildren are wrongly being diagnosed and prescribed medication.

In an interview with CBC news, the study’s lead author, Richard Morrow said, “The relative maturity of children is affecting the diagnosis, so in other words, the lack of maturity in younger children is making them more likely to get the diagnosis, and we can interpret that as the fact that sometimes a lack of maturity is being misinterpreted as symptoms of a neurobehavioural disorder of ADHD.” Morrow is health research analyst with the Therapeutics Initiative at the University of British Columbia.

In a news release, Morrow said: “Our study suggests younger, less mature children are inappropriately being labelled and treated. It is important not to expose children to potential harms from unnecessary diagnosis and use of medications.”

The ramifications are extensive. Long term use of medication by children that don’t need it has not been studied. Less mature children who have been labelled with ADHD are often treated differently by teachers and parents which could lead to ineffective teaching and parenting. It could also contirbute to negative self-perception and social issues.

The researchers recommend that an ADHD assessment should include a comparison of the child’s age to that of his classmates. Parenting and  behaviour outside school should also be considered.

Funding for the UBC study was provided by the Canadian Institutes of Health research and the B.C. Ministry of Health.

Video Games & ADHD

What’s the link?

According to The Henry J. Kaiser Family Foundation (KFF), video games (introduced in 1972) are ubiquitous. They are played on home consoles like Xbox, Play Station, Nintendo, etc. used with TV sets. They are played on computers and on computers with access to the Internet. But one doesn’t need a large computer; you can play video games on handheld game systems and even your cell phone. And, of course for us older folks, they can still be found in coin-operated arcade machines. Not surprisingly, computer and video game sales in the United States are a $19 billion industry.

The KFF also reports that more than two-thirds of all children ages 2-18 live in a home with a video game system. Video game playing, even more than television watching, is an activity that kids tend to do alone.

The KFF also notes that, “Ethnicity and income level are indicators of video game playing, particularly among older kids ages 8-18: African American and Hispanic youth play more video games than White youth, and kids from low and middle income communities spend more time playing video games than kids from high income areas.”

What does this all amount to? The average young person accumulates 10,000 hours of gaming by the age of 21. How does that compare to school attendance? It’s just 24 hours less than they spend in a classroom for all of middle and high school if they have perfect attendance. It’s the equivalent of a full time job at more than 40 hours a week.

A new study says that playing video games can create a vicious cycle for ADHD children.

Douglas A. Gentile, PhD, of Iowa State University and lead author of the study published in the American Psychological Association’s journal Psychology of Popular Media Culture cites that not enough time has been spent studying the impact environment can have on children with issues like impulse control and attention deficit disorder. This would include socioeconomic impact and parenting styles.

In the past, most research has focused on biological and genetic factors.

Gentile thinks that ADHD should be examined by looking at both nature and nurture, both the heredity of these problems and what impact parenting and environment has on them.

In an interview with Vox Games, Gentile states, “We’ve focused on biology and genetics almost exclusively in the past; it has led to some breakthroughs in medications. But this has left parents feeling powerless when their child’s school calls and tells them there may be a problem. Parents have been left feeling like the only option is to medicate their children, which many are understandably hesitant to do. Once we understand some of the environmental aspects that can increase or decrease attention problems, this can give parents a first step to try before they move onto medications.”

Gentile’s team tracked the behavior and gaming habits of more than 3,000 Singaporean school children, aged 8 to 17, over three years. The children were administered various self-reporting tests to diagnose ADHD and impulse-control issues. The reports also required the children to track how often they played video games and the video games’ degrees of violence. The study, Gentile said, was part of a much larger study on the positive and negative effects of video games.

As has been found in past research (Christakis 2004; Landhuis 2007, etc.) the researchers found that video games both help and hurt with attention issues.

Video game play seems to increase visual attention which is the ability to rapidly process information from your surroundings. For example, if you’re playing an aerial combat game, it’s necessary to quickly process and assess the number of opposing combatants so that you don’t get shot down. While this skill is necessary for this task, it is of little value in the ordinary classroom.

The negative impact is far greater than the benefits. Gentile thinks it can make it harder for some children to complete goal-oriented tasks that require long-term concentration. According to his research, the excitement and excessive stimulation of playing a video game far exceeds any ordinary daily stimulation making the real world less interesting.

Gentile also notes that time spent playing video games may also detract from the time a child might spend developing their impulse control. “Electronic media use can impair attention necessary for concentration even as it enhances the ability to notice and process visual information.”

Specifically, Gentile’s research, echoing prior research, found that children who spent more time playing video games were more impulsive and had more attention problems. Even more importantly, he discovered that children who have those issues also tended to play more video games producing a vicious cycle.

Gentile says, “Certainly games (and other media) have many potential benefits and potential harms,” he said. “The reason I study the media and children is to try to learn how to maximize the benefits and minimize the potential harms.”

He also said that he limits the amount of time he lets his child play video games. That’s wise. One has to understand what the video game is teaching and that the video game IS teaching whether you like it or not. Is it teaching us to be more impulsive? Is it teaching us to require instant gratification? Is it teaching us to have shorter attention spans? The answer to all of the questions for the average player is: YES!

Play Attention was developed to counter this vicious cycle by teaching the correct skill sets that provide a lasting benefit to maximize personal potential and optimize one’s life.

Suicide & ADHD Meds

What’s the connection?

On Monday, January 30, 2012, pediatric health advisers acting as an advisory committee to the Food and Drug Administration requested that a special warning be placed on the label of a common stimulant medication used to treat attention deficit disorder.

The drug is Focalin and produced by Swiss drug maker Novartis. The FDA has approved Focalin for children aged 6 or older. However, Focalin is often prescribed off-label meaning even younger children may be prescribed the medication.

The advisory committee is responding to reports the FDA received over the past six years in which eight reports of suicidal thoughts for children or adolescents who took the drug were documented. Only four of the eight cases could be linked to Focalin. Links to Focalin in the remaining cases remain subject to further scrutiny.

The FDA monitors reports of side effects (often reported from the drug manufacturers themselves) from FDA approved drugs to discover potential side effects or health risks. To this end, the FDA holds regular advisory meetings to review drug safety for medications used by children.

The FDA typically tries to balance the vast number of Focalin users with the number of children reporting suicidal thoughts. The FDA noted that reports were miniscule compared to how many children used the drug. A staggering 1.8 million children received prescriptions for Focalin or its generic versions from May 2005 to July 2011 with only eight reported cases of suicidal thoughts. The FDA also stated the risk of suicidal thoughts did not appear in clinical trials for Focalin.

The Focalin website (http://www.focalinxr.com/info/about-focalinxr.jsp) warns patients that they may have new psychotic or manic symptoms after taking the drug, and requests the patient confer with his doctor if they have a history of suicide, bipolar disorder, or depression.

The FDA often follows the advice of its committees, although it is not required to do so.

“Novartis is committed to patient safety and will continue to work closely with the FDA as the agency completes its review,” said Brandi Robinson, spokeswoman for the company.

Impulsivity and Calling Out in Class

Is it effective for ADHD students?

The December 2011 issue of the journal Learning and Individual Differences published research titled ADHD and academic attainment: Is there an advantage in impulsivity?

Dr. Peter Tymms,DurhamUniversity’s (http://www.dur.ac.uk/) leading education expert, analyzed test scores spanning more than 500 British schools and found that ADHD students who shouted out answers scored better than their quiet peers.

Scores were significantly better; louder ADHD students were about nine months ahead of quieter classmates in reading and math. Tymms says the findings raise questions about how best to teach youngsters with ADHD.

Prof Tymms said: “Children with ADHD symptoms who get excited and shout out answers in class seem to be cognitively engaged and, as a result, learn more.

“Perhaps those children also benefit from receiving additional feedback and attention from their teacher.”

For most teachers, having children shout out answers in a classroom setting is not practical; other children don’t have time to reflect and then think of an answer. Shouting often interrupts the thinking process. However, research tells us that ADHD children who shout out answers in class often learn quicker than their quieter schoolmates.

Is there a middle road? Perhaps setting a game format for review of classroom material in which it is fair to call out answers would assist ADHD children in learning quicker (think Jeopardy). At home, parents could allow their child to call out answers when doing homework.

This also raises the question whether we should teach ADHD children to be able to control their impulsiveness and to think before acting.