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from NIMH:

Excerpt:
A trio of genome-wide studies – collectively the largest to date – has pinpointed a vast array of genetic variation that cumulatively may account for at least one third of the genetic risk for schizophrenia. One of the studies traced schizophrenia and bipolar disorder, in part, to the same chromosomal neighborhoods.

"These new results recommend a fresh look at our diagnostic categories," said Thomas R. Insel, M.D., director of the National Institute of Mental Health (NIMH), part of the National Institutes of Health. "If some of the same genetic risks underlie schizophrenia and bipolar disorder, perhaps these disorders originate from some common vulnerability in brain development."

-----


from Wall Street Journal:

The U.S. Supreme Court delivered a victory to parents of children with disabilities who seek reimbursement for private-school tuition at public expense. School systems warned the decision could drain millions of dollars from tight education budgets.

In a 6-3 ruling, the high court said the family of an Oregon high-school student could receive a private education at taxpayers' expense without having first received special-education services in public schools.

Under a landmark 1975 special-education law, known at the Individual with Disabilities Education Act, school systems must provide a "free appropriate" public education to disabled students. The act permits parents to seek public financing for private schools if they can establish that public schools can't meet their children's needs.

About 90,000 of the more than six million U.S. special-education students are educated in private schools or in private residential facilities at public expense. School districts said in court filings that special education already accounts for about 20% of school budgets, with private-school placements alone amounting to more than $5 billion annually.

Monday's decision involved a student identified only as T.A., who attended Oregon's Forest Grove school district from kindergarten through eighth grade. In 2003, after the school system said he wasn't eligible for special-education services, a private specialist diagnosed him with attention deficit hyperactivity disorder and learning disabilities.

His parents enrolled him in private school and hired a lawyer to argue for reimbursement. An administrative hearing officer determined that the school had failed to provide the student an appropriate education.

The school system fought the ruling in court, saying a provision in the federal special-education law requires that students first receive services in school before seeking a private placement.

Justice John Paul Stevens, writing for the majority, said Forest Grove's argument amounts to "immunizing" a school district from being liable for payment in the "egregious situation" in which officials unreasonably deny services and parents turn to private schools. He noted that such cases often take years in court to resolve.

In a dissenting opinion, Justice David Souter, joined by Justices Antonin Scalia and Clarence Thomas, noted the high cost of private-school placements and said it "makes good sense" for parents to work with administrators first to come up with an alternative within the public schools.

In 2007, the Supreme Court declined to issue an opinion on a similar case involving the son of Tom Freston, the former chief executive of Viacom Inc., leaving intact a lower court ruling.

In an interview, Mary Broadhurst, the attorney representing the Oregon student, said the family still has to go back to the trial court to win reimbursement of about $65,000 in private-school expenses, plus legal fees. Ms. Broadhurst said the family endured "tremendous hardship" pursuing the case, which they financed with mortgage loans.

Curt Decker, executive director of the National Disability Rights Network, said the case could spur schools to improve special-education services to avoid more out-of-district placements.

In New York City last year, 4,368 parents of disabled children requested hearings seeking reimbursement for tuition at private schools without district approval. That is up from 3,023 two years earlier, according to a brief in the Supreme Court case. Settlements and orders related to those cases cost the city nearly $89 million, up from $53 million.

"It's unfortunate that the Supreme Court didn't recognize the significant drain on resources that these cases represent for school districts," said Michael Best, general counsel for the New York City Department of Education.

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Five years from now, there's an excellent chance you won't have the same health insurance you have (or don't have) right now. That's because members of Congress are gearing up to reform the U.S. health care system, and unlike in 1993 when then-first lady Hillary Clinton tried her hand at changing the medical system, this time the important players -- doctors, insurance companies, pharmaceutical manufacturers -- seem to be on board. You heard a lot about health care reform this week, and you'll be hearing even more in the months to come. It's an incredibly confusing, complex issue, so in this week's Empowered Patient, we break it down for you with 10 frequently asked questions about health care reform.

Read more on cnn.com

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A study by Oregon State University researchers suggests that school-based prevention programs begun in elementary school can significantly reduce problem behaviors in students.

Fifth graders who previously participated in a comprehensive interactive school prevention program for one to four years were about half as likely to engage in substance abuse, violent behavior, or sexual activity as those who did not take part in the program.

Read more on sciencedaily.com

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As the recession forces more hospitals and doctors to pare costs and services, the cutbacks are hitting one group of patients especially hard: children.

The Grabo family of Las Vegas learned this firsthand in December, weeks after a state budget crisis prompted Nevada lawmakers to cut Medicaid payments to health-care providers, some by as much as 40%. Two of the Grabos' four children receive Medicaid benefits to treat their disabilities. But the day before their son Tyler, 10 years old, was scheduled to see his pediatric endocrinologist, the doctor's staff called and said he no longer accepted patients with Medicaid.

Read more on wsj.com

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from Huffington Post:

Excerpt:
All sorts of arguments are thrown around to persuade parents that shots threaten their children with autism. I'd like to discuss 4 of the commonly repeated concerns, 3 flawed...and 1 that I think has merit.

1) Too many shots can overwhelm a child and cause autism. No!

Babies get more vaccines today than 30 years ago, but if you think that means more things are injected into their young bodies...you'd be wrong! That's because immunizations today are much more purified than those of the past.

For example, in 1980, the DPT shot (Diphtheria/Pertussis/Tetanus) was made from a soup of blendarized bacteria (over 1000 different illness particles - antigens - all mixed together). And, the polio vaccine had live virus that actually protected children by triggering a minute case of...polio! Today, our modern DPT vaccine is highly purified, containing only 3-5 bacterial antigens and the polio shot has absolutely no live virus.

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from Seacoastonline.com:

Excerpt:
There are all sorts of professionals whose life’s work is devoted to the well-being of young children.

Pediatric health care providers diagnose and treat illnesses. They also identify or confirm parents’ concerns with a child’s development or behavior.

In these cases pediatric therapists are called in to provide occupational therapy, physical therapy, or speech therapy. In some instances early childhood educators, special educators or behavioral specialists are tapped to promote early learning and cognitive development.

All of these professionals, in conjunction with the family, are focused on the healthy development of the child.

But what about a baby’s emotional development?

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from NY Times:

Excerpt:
An Emotional Hair Trigger, Often Misread By JANE E. BRODYIn the popular 1999 movie “Girl, Interrupted,” Winona Ryder portrays a young woman who tries to commit suicide, then spends nearly a year in a psychiatric hospital with a diagnosis of borderline personality disorder.

The film, based on a 1993 memoir by Susanna Kaysen, was gripping. But experts say it oversimplified this common yet poorly understood mood disorder.

Georges Han, a recovered patient now studying at the University of Minnesota for a Ph.D. in psychology, describes borderline personality disorder as “a serious psychiatric disorder involving a pervasive sense of emptiness, impulsivity, difficulty with emotions, transient stress-induced psychosis and frequent suicidal thoughts or attempts.”

Moods can change quickly and unpredictably, behaviors can be impulsive (including abuse of alcohol or drugs, reckless driving, overspending or disordered eating), and relationships with others are often unstable. Many patients injure themselves and threaten or attempt suicide to relieve their emotional pain.

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from Scientific American:

Excerpt:
As evidence of widespread vitamin D deficiency grows, some scientists are wondering whether the sunshine vitamin—once only considered important in bone health—may actually play a role in one of neurology's most vexing conditions: autism.

The idea, although not yet tested or widely held, comes out of preliminary studies in Sweden and Minnesota. Last summer, Swedish researchers published a study in Developmental Medicine and Child Neurology that found the prevalence of autism and related disorders was three to four times higher among Somali immigrants than non-Somalis in Stockholm. The study reviewed the records of 2,437 children, born between 1988 and 1998 in Stockholm, in response to parents and teachers who had raised concerns about whether children with a Somali background were overrepresented in the total group of children with autism.

In Sweden, the 15,000-strong Somali community calls autism "the Swedish disease," says Elisabeth Fernell, a researcher at the Karolinska Institute in Stockholm and a co-author of the study.

In Minnesota, where there are an estimated 60,000 Somali immigrants, the situation was quite similar: There, health officials noted reports of autism among Somali refugees, who began arriving in 1993, comparable to those found in Sweden. Within several years of arrival, dozens of the Somali families whose children were born in the U.S. found themselves grappling with autism, says Huda Farah, a Somali-born molecular biologist who works on refugee resettlement issues with Minnesota health officials. The number of Somali children in the city's autism programs jumped from zero in 1999 to 43 in 2007, says Ann Fox, director of special education programs for Minneapolis schools. The number of Somali-speaking children in the Minneapolis school district increased from 1,773 to 2,029 during the same period.

Few, if any, Somalis had ever seen anything like it. "It has shocked the community," Farah says. "We never saw such a disease in Somalia. We do not even have a word for it."

-----


HealthDay News story:

Excerpt:
When parents are depressed, their children can suffer too.

A new report from the National Research Council and the Institute of Medicine calls for health and social service professionals to pay greater attention to the impact of parental depression on their children.

Rather than treating only the depressed adult, health-care and mental-health professionals should evaluate the fallout of the depression on the entire family, particularly children, and design treatment programs with everyone in mind, according to the report that was to be released Wednesday.

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from MSNBC

Excerpt:
An antidepressant that is among the most popular kinds of medicine used for treating autism didn't work for most kids and caused nightmares and other side effects, new research found.

Results showed risks with Celexa outweighed any benefits in the largest published study of medication versus dummy pills for autism. That's according to the lead author, Dr. Bryan King, director of child and adolescent psychiatry at Seattle Children's Hospital and the University of Washington medical school.

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from MedPageToday

Excerpt:
Some familiar disorders may be dropped and diagnostic criteria for others are in line for substantial revision in the forthcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V).

Schizoaffective disorder and gender identity disorder are among those that may be on the chopping block, according to members of the working groups leading the revision who spoke here at the American Psychiatric Association annual meeting.

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First-graders with depression or anxiety are more likely to be regularly bullied by the time they reach the third grade, according to a Canadian study. Physically aggressive first-graders were found likely to become anxious or depressed by the third grade and also be bullied, researchers found. "Children's early mental-health problems can set the stage for abuse by their peers," said lead researcher Bonnie Leadbeater, a psychology professor at the University of Victoria, located in British Columbia. "Treating children's mental-health problems may go a long way toward reducing bullying." ScienceDaily (05/18)

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Medical News Today
By Victoria Stagg Elliott
May 12, 2009

Teenagers who don't express their emotions are more likely to suffer from depressive symptoms. This is the finding of a study published in the British Journal of Developmental Psychology.

The study, carried out by Jennifer Betts, Eleonora Gullone and Sabura Allen at Monash University, Melbourne, Australia, looked at the emotion regulation strategies of 44 teenagers aged 12 to 16 with a high level of depressive symptoms and compared them to the strategies of 44 adolescents with no symptoms.

Read more on medicalnewstoday.com

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SAMHSA News Release
May 13, 2009

A new report which coincides with Children's Mental Health Awareness Day reveals that 8.2 percent (2 million) youths aged 12 to 17 experienced at least one major depressive episode (MDE) in the past year. Only about two-fifths (38.9 percent) of these adolescents received treatment during this period according to the report by the Substance Abuse and Mental Health Services Administration (SAMHSA).

The report also found that health insurance coverage seemed to be a major factor in determining whether adolescents experiencing MDEs in the past year received treatment.  Among these adolescents, those without health insurance coverage were far less likely to have received treatment (17.2 percent) than those with Medicaid/CHIP (42.9 percent) or private health insurance (40.6 percent).

Read more on samhsa.gov

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At a hearing on Capitol Hill today, U.S. Education Secretary Arne Duncan told members of the House Education and Labor Committee that he intends to begin monitoring how states are using seclusion and restraint in public schools. Duncan also said he plans to ensure that all states have clear policies in place on seclusion, restraint and other physical interventions that are used in schools for the coming academic year.

A GAO investigation released yesterday at a committee hearing, and conducted at the request of U.S. Rep. George Miller (D-CA), the committee’s chairman, uncovered hundreds of allegations of abusive uses of seclusion and restraint practices on schoolchildren over the past two decades. In at least twenty of those cases, this abuse resulted in the death of a child. 

Currently, there are no federal laws that govern the use of seclusion and restraint in schools. State regulation and oversight varies greatly; nineteen states have no such laws.

Specifically, Secretary Duncan announced that he is asking all state school chiefs to submit their plans for using seclusion, restraint and other practices for physical intervention in their schools. His announcement came at the beginning of a hearing to discuss the Obama administration’s plans for transforming education in America. 

“Children’s safety has to be our number one concern before we begin to think about educating them and doing other things,” said Duncan. “And as we go into the summer and prepare for next school year I want to make sure that as we go into next school year that every state has a real clear plan as to how to do this in a way that makes sense. And doesn’t jeopardize, doesn’t endanger children.”

To watch the full video of his announcement, click here.

Miller praised the Secretary for taking quick action on a first step toward improving federal oversight. The committee will continue working with GAO and the Obama administration on a comprehensive plan to keep school communities safe. 

The Obama administration has indicated it plans to meet with stakeholders about these abuses in the coming weeks.

For more information on yesterday’s hearing, click here.

-----


U.S. spends $9 billion on child mental illness
Reuters
By Maggie Fox
April 22, 2009

Treating depression and other mental disorders in U.S. children cost $8.9 billion in 2006, making mental illness the most expensive condition to treat in childhood, U.S. government researchers reported on Wednesday.

An estimated 4.6 million children were treated for mental disorders in 2006 at an average cost of $1,931 per child, the Agency for Healthcare Research and Quality reported.

Read more on reuters.com

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Writing Disorder May Be Common Among Kids
Study finds rate as high as 14.7 percent in one Minnesota city
HealthDay
By Randy Dotinga
May 11, 2009

Though dyslexia and attention-deficit disorder are better known, another learning disability -- the inability to write properly -- strikes a significant number of children, a new study suggests.

So-called written-language disorder is a "forgotten learning disability," said Dr. Slavica K. Katusic, an epidemiologist at the Mayo Clinic and lead author of the study in the May issue of Pediatrics.

The ability to write is "a critical skill that they [children] need to have for academic success and social well-being," Katusic said. "They are at risk for long-term personal and economic consequences."

Read more on healthday.com

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from The League of Ordinary Gentlemen blog:

Excerpt:
The reason for this gulf between my textbooks and my experience can be attributed to the various vaccines now commonly administered as part of a standard schedule in the United States. While very little in contemporary medical practice is totally free of risk or adverse effects, from the perspective of pediatric infectious disease the advent of vaccinations has been as close to an unalloyed good as is likely ever to occur. Diseases that once killed thousands of children a year are all but unheard of now.

It’s hard to argue with that kind of success.

Sadly, Jim Carrey has seen fit to try. It was with singular frustration that I read his recent missive in the Huffington Post, full of the usual “vaccines lead to autism” misinformation and pseudoscientific mumbo-jumbo. What was most frustrating about the post was not so much that I think Mr. Carrey is wrong (though I think that he is very, very wrong), but that he is dishonest.

-----


from MSNBC:

Excerpt:
Leo Lytel was diagnosed with autism as a toddler. But by age 9 he had overcome the disorder.

His progress is part of a growing body of research that suggests at least 10 percent of children with autism can “recover” from it — most of them after undergoing years of intensive behavioral therapy.

Skeptics question the phenomenon, but University of Connecticut psychology professor Deborah Fein is among those convinced it’s real.

-----


from CNN:

Excerpt:
The size of a specific part of the brain may help experts pinpoint when autism could first develop, University of North Carolina researchers report.

Using MRI brain scans, researchers found that the area of the brain called the amygdala was, on average, 13 percent larger in young children with autism, compared with control group of children without autism. In the study, published in the latest Archives of General Psychiatry, researchers scanned 50 toddlers with autism and 33 children without autism at age 2 and again at age 4. The study adjusted for age, sex and IQ.

"We believe that children with autism have normal-sized brains at birth but at some point, in the latter part of the first year of life, it [the amygdala] begins to grow in kids with autism. And this study gives us insight inside the underlying brain mechanism so we can design more rational interventions," said lead study author Dr. Joseph Piven.

A normal-sized amygdala helps a person process faces and emotions, behavior commonly known as joint attention.

"When you see a face, you scan it, identify if it's friend or foe and make a decision about whether to move forward or avoid it," said Dr. Barry Kosofsky, chief of neurology at Cornell Medical Center, who was not affiliated with the study.

-----


The Denver Channel.com Story:

Excerpt:
A federal study concludes that preventing mental health disorders should be a national priority and urges federal intervention.An estimated $247 billion is spent each year on treating disorders like depression, anxiety, conduct disorder, and substance abuse in kids. The Department of Health and Humans Services estimated earlier this year that one of every five children and teens ages 9 to 17 years experience symptoms of mental health problems.

The study, by the National Research Council and Institute of Medicine, found less than 20 percent of young people that need mental health services actually receive them.

-----


Forbes story:

Excerpt:
Children who take medication to treat attention-deficit hyperactivity disorder (ADHD) do better in elementary school than those who don't, a new study has found.

Of 594 children whose parents reported an ADHD diagnosis, those who took medication scored 2.9 points higher on standardized math tests and 5.4 points higher on reading tests than children with ADHD who were not taking medication.

Researchers used a nationally representative sample from the Childhood Longitudinal Study of children who entered kindergarten in 1998, and followed them through fifth grade.

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Family Ties Provide Protection Against Young Adult Suicidal Behavior
Science Daily
April 15, 2009

Adolescents and young adults typically consider peer relationships to be all important. However, it appears that strong family support, not peer support, is protective in reducing future suicidal behavior among young adults when they have experienced depression or have attempted suicide.

New research that will be presented here April 17 at the annual meeting of the American Association of Suicidology shows that high school depression and a previous suicide attempt were significant predictors of thinking about suicide one or two years later. But, those individuals who had high levels of depression or had attempted suicide in high school were less likely to engage in suicidal thinking if they had strong family support and bonds. In addition, having a current romantic partner also reduced suicidal thoughts.

Read more on sciencedaily.com

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In Tough Times, Kids May Find Solace With GrandparentsHealth Day
By Kevin McKeever
March 17, 2009

Grandparents might be known for spoiling grandchildren, but a new study says they might also be helping the kids improve their social skills and behavior.

Spending time with grandma and grandpa especially appears to help children from single-parent, divorced/separated or stepfamily households, according to the report, published in the February Journal of Family Psychology.
Read more on healthday.com

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Childhood beginnings for OCD
Stuff
March 5, 2008

Children showing symptoms of obsessive-compulsive behaviour are more likely to develop the full-blown disorder when they grow up, says a New Zealand study.

Lead researcher, Barcelona University pyschologist Miguel Angel Fullana, based his findings on 1,000 children in the Dunedin longitudinal study, which started in 1973.

Read more on stuff.co.nz

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Traumatic Stress in Children and Adolescents: Eight Steps to Treatment
Psychiatric Times
By John Sargent
March 13, 2009

Traumatic experiences are common in childhood and adolescence and can have significant psychological effects on the child's emotional well-being and overall development. Outcomes can be affected positively or negatively depending on responses and interventions.

This article reviews common responses of children to trauma, variables that influence the nature of psychological responses to trauma, and protective factors that can ameliorate deleterious effects. It also outlines an 8-stage approach to treating children who have had traumatic experiences.

Read more on psychiatrictimes.com

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from MSNBC:

Excerpt:
An influential government-appointed medical panel is urging doctors to routinely screen all American teens for depression — a bold step that acknowledges that nearly 2 million teens are affected by this debilitating condition.

Most are undiagnosed and untreated, said the panel, the U.S. Preventive Services Task Force, which sets guidelines for doctors on a host of health issues.

The task force recommendations appear in April's issue of the journal Pediatrics. And they go farther than the American Academy of Pediatrics' own guidance for teen depression screening.Story continues below ↓advertisement | your ad here

An estimated 6 percent of U.S. teenagers are clinically depressed. Evidence shows that detailed but simple questionnaires can accurately diagnose depression in primary-care settings such as a pediatrician's office.

-----


from Wired:

Excerpt:
Growing up poor isn't merely hard on kids. It might also be bad for their brains. A long-term study of cognitive development in lower- and middle-class students found strong links between childhood poverty, physiological stress and adult memory.

The findings support a neurobiological hypothesis for why impoverished children consistently fare worse than their middle-class counterparts in school, and eventually in life.

"Chronically elevated physiological stress is a plausible model for how poverty could get into the brain and eventually interfere with achievement," wrote Cornell University child-development researchers Gary Evans and Michelle Schamberg in a paper published Monday in the Proceedings of the National Academy of Sciences.

For decades, education researchers have documented the disproportionately low academic performance of poor children and teenagers living in poverty. Called the achievement gap, its proposed sociological explanations are many. Compared to well-off kids, poor children tend to go to ill-equipped and ill-taught schools, have fewer educational resources at home, eat low-nutrition food, and have less access to health care.

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from Newsweek:

Excerpt:
Like many people in London on that bleak February day in 1998, biochemist Nicholas Chadwick was eager to hear what the scientists would say. The Royal Free Hospital, where he was a graduate student in the lab of gastroenterologist Andrew Wakefield, had called a press conference to unveil the results of a new study. With flashbulbs popping, Wakefield stepped up to the bank of microphones: he and his colleagues, he said, had discovered a new syndrome that they believed was triggered by the MMR (measles, mumps, rubella) vaccine. In eight of the 12 children in their study, being published that day in the respected journal The Lancet, they had found severe intestinal inflammation, with the symptoms striking six days, on average, after the children received the MMR. But hospitals don't hold elaborate press conferences for studies of gut problems. The reason for all the hoopla was that nine of the children in the study also had autism, and the tragic disease had seized them between one and 14 days after their MMR jab. The vaccine, Wakefield suggested, had damaged the intestine—in particular, the measles part had caused serious inflammation—allowing harmful proteins to leak from the gut into the bloodstream and from there to the brain, where they damaged neurons in a way that triggered autism. Although in their paper the scientists noted that "we did not prove an association" between the MMR and autism, Wakefield was adamant. "It's a moral issue for me," he said, "and I can't support the continued use of [the MMR] until this issue has been resolved."

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Federation works to implement concept of family-driven care

Crookston Daily TimesBy Natalie J. Ostgaard
Feb. 11, 2009

It might seem like a no-brainer that parents and other family members be kept in the loop and actively participate in children's mental health care, but the concept is actually a rather new one to the mental health system. An organization, National Federation of Families for Children's Mental Health (FFCMH), has been instrumental in getting this concept implemented across the country.
   
"We think it's very important that agencies and communities learn about and embrace family-driven care," Sandra Spencer, executive director of FFCMH, said. "The outcomes across the country are staggering: Kids are getting better in school, they're getting better emotionally, there's less involvement in juvenile justice, and they're staying home in their community as opposed to residential in-patient treatment. This shows it's working."

Read more on crookstontimes.com

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Children in the Mental Health Void
The New York Times
Judith Warner
Feb. 19, 2009Remember the Nebraska law meant to keep desperate new mothers from abandoning their babies in dumpsters by offering them the possibility of legal drop-off points at "safe havens" like hospitals?

As was widely reported last year, the law neglected to set an age limit for dropped-off children, and eventually led to 36 children - mostly between the ages of 13 and 17 - being left with state authorities. Most of these children had serious mental health issues. Some were handed over to the state by relatives who had no other way of securing for them the heavy-duty psychiatric care they needed. Seven of the children came from out of state, including one who'd been driven 1,000 miles to Lincoln, Neb., from Smyrna, Ga.

Read more on nytimes.com

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Some states disregard juvenile justice law
The Associated Press
Feb. 8, 2009

CHEYENNE, Wyo.: When Erica Olivares ran away from home at age 16, the penalty was not a stern lecture - it was a month in Laramie County jail. Soon, under the tutelage of adult criminals, she was addicted to drugs.

"Methamphetamine, I'd never even heard about that. And I heard about that in there," said Olivares, now 26.

Legally, she should never have been in position to learn such harsh lessons. Runaways are not supposed to be put in jail, let alone meet adult lawbreakers on the inside, under a 34-year-old federal law called the Juvenile Justice and Delinquency Prevention Act.

Read more on iht.com

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from MSNBC:

Excerpt:
Vaccines aren’t to blame for autism, a special federal court declared Thursday in a blow to thousands of families hoping to win compensation and to many more who are convinced of a connection.

The special masters who decided the case expressed sympathy for the families, some of whom have made emotional pleas describing their children’s conditions, but the rulings were blunt: There’s little if any evidence to support claims of a vaccine-autism link.

The evidence “is weak, contradictory and unpersuasive,” concluded Special Master Denise Vowell. “Sadly, the petitioners in this litigation have been the victims of bad science conducted to support litigation rather than to advance medical and scientific understanding” of autism.

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from Times Online:

Excerpt:
THE doctor who sparked the scare over the safety of the MMR vaccine for children changed and misreported results in his research, creating the appearance of a possible link with autism, a Sunday Times investigation has found.

Confidential medical documents and interviews with witnesses have established that Andrew Wakefield manipulated patients’ data, which triggered fears that the MMR triple vaccine to protect against measles, mumps and rubella was linked to the condition.

The research was published in February 1998 in an article in The Lancet medical journal. It claimed that the families of eight out of 12 children attending a routine clinic at the hospital had blamed MMR for their autism, and said that problems came on within days of the jab. The team also claimed to have discovered a new inflammatory bowel disease underlying the children’s conditions.

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In the world of therapy, Dr. Aaron T. Beck is a rock star.

Considered the father of cognitive behavioral therapy, a form of psychological treatment that has swept the country in recent decades, he has been so famous for so long that some are surprised to find out that he is still, at 87, hard at work.

Beck has recently come out with a new, overarching theory of depression, the mood darkness that in any given year afflicts an estimated 5 percent of Americans (and probably a higher percentage this year).

Read more on boston.com

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All work and no play may be a hazard for some U.S. school children.

Researchers reported on Monday that a growing trend of curbing free time at school may lead to unruly classrooms and rob youngsters of needed exercise and an important chance to socialize.

A look at more than 10,000 children aged 8 and 9 found better classroom behavior among those who had at least a 15-minute break during the school day compared to those who did not, Dr. Romina Barros and colleagues at the Albert Einstein College of Medicine in New York reported.

Read more on reuters.com

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Attention deficit hyperactivity disorder can be a distressing diagnosis, but families have more treatment options than they might realize. Although Ritalin and other stimulant drugs are the most common prescription, ADHD treatments that don't involve medication have a proven track record. And here's a surprise: One of the most beneficial options treats the parents, not the child. For children, skills training programs and ADHD summer camps can help teach techniques to overcome everyday problems that often make life miserable, such as remembering to bring assignments home from school or to listen without interrupting.

Read more on usnews.com

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In a national clinical trial, adolescents with moderate to severe depression first given a placebo treatment and then an antidepressant medication - alone or in combination with psychotherapy - responded just as well over the long term as participants who received active treatment throughout the study.

Read more on psychcentral.com

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Gaming The Brain

I was diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) when I was in 5th grade. I have all the symptoms - inability to concentrate, restlessness, hyperactivity. I've followed and researched different types of treatments ranging from behavioral therapy to medication. One of the more promising therapies is neurofeedback, which involves continually monitoring patients' brainwaves. Subjects attempt to change their brainwaves to a set pattern and receive an auditory signal that tells them whether they were successful. With enough repetition, neurofeedback can rewire a person's brain. A study published in 2005 examines how patients diagnosed with ADHD can learn to better maintain their concentration through neurofeedback. Depending on how individuals respond to this type of treatment, it can even be used as a replacement for medication.

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from Newsvine:

Excerpt:
It wasn't until Jude met Jenny that the 3-year-old autistic boy understood what happy people look like. Jenny, a green trolley car with a human face, had a furrowed brow when her wheel buckled and she got stuck on a track. But after being rescued by friends, she smiled broadly — and that's when something clicked for little Jude Baines.

"It was revelatory," his mother, Caron Freeborn told AP Television News in Cambridge, England. Before watching the video, Jude didn't understand what emotions were and never noticed the expressions on people's faces, even those of his parents or younger brother.

Jenny's adventures are part of a DVD for autistic children released this week in the United States called The Transporters.

The DVD teaches autistic children how to recognize emotions like happiness, anger and sadness through the exploits of vehicles including a train, a ferry, and a cable car.

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from Ars Technica:

Excerpt:
Rates of autism, a developmental disorder that affects communication and social skills, are on the rise. Earlier in the 20th century, the incidence of the disorder was around four or five cases per 10,000 children; currently, it's more than an order of magnitude greater, being closer to 80 per 10,000. This precipitous rise is obviously quite worrisome, more so since we're no closer to knowing the reason for the increase.

Autism is usually diagnosed in early childhood, prior to the age of three. There's been a lot of (very ill-founded) controversy over a link between vaccination and autism, since diagnosis often occurs around the same time as childhood vaccinations. That link, suggested by a UK clinician, possibly working in concert with lawyers attempting to sue vaccine makers, has been thoroughly discredited by the scientific community, but it has made an impression on the public, as childhood diseases such as mumps, measles, and rubella have wreaked havoc in communities where vaccination rates dropped.

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Suicide screening in schools yields resultsReuters UK
By Megan Rauscher
Dec. 18, 2008

NEW YORK (Reuters Health) - School-based suicide screening can identify students at risk for suicide and other mental health problems not recognized by school professionals, new research suggests.

"School-based screening can be an integral component of a school's mental health initiative and complement the work already being performed by school staff making for a complete program," Dr. Michelle A. Scott, from the Division of Child and Adolescent Psychiatry, Columbia University College of Physicians and Surgeons, New York, told Reuters Health.

Read more on reuters.com

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Shame On Us: Shaming Some Kids Makes Them More Aggressive
ScienceDaily
Dec. 22, 2008

Aren't you ashamed of yourself? All these years, you've been trying to build up your child's self-esteem, and now a growing body of research suggests you may be making a big mistake. A study published in the December issue of Child Development finds that early adolescents with high self-esteem are more likely to react aggressively when they feel ashamed than their peers with lower levels of self-esteem.

"Young teens with low self-esteem apparently don't feel the need to protect their punctured egos," said University of Michigan psychologist Brad J. Bushman, a co-author of the study with colleagues from VU University and Utrecht University in The Netherlands.

Read more on sciencedaily.com

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Child adversity, depression linked
UPI
Dec. 25, 2008

AMES, Iowa -- U.S. researchers warn increasing poverty among U.S. children and its effects, including early family adversity and depressive symptoms, have a lasting impact.

Iowa State University researchers found family adversity persists in children by initiating depressive symptoms in adolescence. That influence increases the occurrence of early disruptive life events such as leaving home and also affects the adolescent's social, academic and occupational attainments.

Read more on upi.com

-----


from MSNBC:

Excerpt:
Results of a Swedish population-wide study hint that children born prematurely have some risk of developing anxiety, depression or other psychiatric disorders in adolescence and young adulthood.

Children born preterm should therefore be watched more closely for these disorders, the investigators suggest.

Among 545,628 Swedish residents born in the 1970s and followed up until 23 to 29 years of age, Dr. Karolina Lindstrom from Sachs Children's Hospital, Stockholm, and colleagues observed a stepwise increase in psychiatric hospital admissions with an increasing degree of preterm birth.

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Rochester City Newspaper
By Tim Louis Macaluso 
Dec. 10, 2008

Lynn Marie Webster says that her son seemed to be developing normally until he was almost 3. Then subtle signs began appearing: he started swearing, he was easily distracted, and he all but stopped listening to his parents.

"We were going to our pediatrician constantly because I thought I was doing something wrong," Webster says.

Read more on rochestercitynewspaper.com

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Science Daily
Dec. 8, 2008

A University of Georgia program designed to reduce alcohol use, drug use and risky sexual behavior in African-American youth also reduces the likelihood of engaging in conduct problems by up to 74 percent two years later, according to a new study.

The finding, published in the Journal of Adolescent Health, is the latest in a series of studies that demonstrate the effectiveness of the Strong African-American Families (SAAF, pronounced "safe") Program, which is increasingly being adopted across Georgia and nationwide.

Read more on sciencedaily.com

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HealthDay
By Robert Preidt
Dec. 3, 2008

Urban kids who took part in a social development program in elementary school had improved mental health, sexual health, and educational and economic success as young adults, a new study finds.

Crime, drug use, teen pregnancy, school dropouts and mental health problems are among the challenges faced by many children and families who live in cities, noted study author J. David Hawkins and colleagues at the University of Washington, Seattle.

Read more on healthday.com

-----


from Newsweek:

Excerpt:
The holidays can be the most stressful time of year for people with eating disorders. So many of the family gatherings throughout are focused on breaking bread or eating pie that it can be overwhelming, says Lynn Grefe, CEO of the National Eating Disorders Foundation. This emphasis on food can impair recovery or even trigger a relapse, so compassion and sensitivity are key to helping those with disorders navigate the holidays. A few tips:

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LA Times story:

Excerpt:
'I need these pills refilled," the weary mother says, displaying an array of empty bottles on the desk in my office. "My son is bipolar."

The boy, a quiet slip of a 10-year-old, had been prescribed two antipsychotics, two mood stabilizers, one antidepressant, two attention deficit disorder medications and another medication to manage the side effects of the antipsychotics.

The mother explained that she had just regained custody of her son and his brother. During the last year, while they were in foster care, a doctor had diagnosed the 10-year-old with bipolar disorder and attention deficit disorder and prescribed eight medications.

In the hour I spent with the boy and his mother, he exhibited no signs or symptoms of bipolar disorder, though he did display some irritability. In school, he continued to perform poorly in his second attempt at third grade. Both irritability and poor school performance can be significant problems. But I strongly questioned his diagnosis.

Bipolar disorder is a serious and devastating disease characterized by extreme changes in mood, thought, energy or behavior. How did Ronnie get labeled with such a potentially debilitating illness and prescribed eight powerful medications within such a short time span? Unfortunately, his case isn't unusual.

-----


Anchorage Daily News story:

Excerpt:
Before a roomful of important adults, foster kids and graduates of the system talked about being put on powerful psychiatric drugs and undergoing "treatment" when what might have helped more was a chance for a regular life with sports and clubs and jobs.Friday's day-long legislative meeting drew a number of state officials, lawmakers and advocates, and focused on how to improve Alaska foster care.

In May, a group of foster care youth and those who have aged out came up with eight ways to improve the system. Among the identified problems: Overprescribed psychiatric drugs.

-----


Defining the Grandma Effect
ABC News
By Lauren Cox
Nov. 10, 2008

The role of grandmothers, those often underappreciated backup caregivers in so many millions of families, has already been spotlighted by the nation's incoming first family.

None of this is anything new or unusual to American families who have integrated grandmoms and granddads into their households, especially to assist with or sometimes take over child care.
Of course, the Obamas are by all accounts an intact and nurturing family, and they don't use a nanny to take care of their two young daughters -- they use grandma.

Read more on abcnews.go.com

-----


New York Times
By Tara Parker-Pope 
Nov. 24, 2008

When pediatricians diagnose attention deficit hyperactivity disorder, they often ask their patients whether they know anybody else with the problem.

These days, children are likely to reply with a household name: Michael Phelps, the Olympic superstar, who is emerging as an inspirational role model among parents and children whose lives are affected by attention problems.

Read more on nytimes.com

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CNN
By Andrea M. Kane
Nov. 21, 2008

As mental health advocates, policy makers, practitioners, educators and researchers gathered at the Carter Center to discuss the progress in addressing American children's mental health needs, a drama of sorts was reaching its conclusion halfway across the country.

The governor of Nebraska signed a bill Friday to change a controversial safe-haven law by restricting the age at which a child could be dropped off at a hospital without parents being prosecuted.

Read more on cnn.com

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The New York Times
By Gardiner Harris
Nov. 18, 2008

WASHINGTON - Powerful antipsychotic medicines are being used far too cavalierly in children, and federal drug regulators must do more to warn doctors of their substantial risks, a panel of federal drug experts said Tuesday.

More than 389,000 children and teenagers were treated last year with Risperdal, one of five popular medicines known as atypical antipsychotics. Of those patients, 240,000 were 12 or younger, according to data presented to the committee. In many cases, the drug was prescribed to treat attention deficit disorders.

Read more on nytimes.com

-----


NY Times story:

Excerpt:
It was disturbing to read in The Times this week that the “atypical” antipsychotic Risperdal, a tranquilizing whopper of a drug with serious, sometimes deadly side effects, is now being widely prescribed to children with attention deficit hyperactivity disorder.

This despite the fact that Risperdal, which is used in children mostly to treat bipolar disorder, isn’t approved for A.D.H.D., and apparently doesn’t work for treating it at all.

So why, according to new Food and Drug Administration data on doctors’ prescribing practices, were 16 percent of the pediatric users of Risperdal over the past three years children with A.D.H.D.?

The simple answer is to point fingers at the drug companies, whose aggressive efforts to promote off-label use of this problematic new class of drugs have resulted in a spate of lawsuits, including one recently filed by the Arkansas attorney general that accuses Risperdal’s manufacturer, Johnson & Johnson, of having “engaged in a direct, illegal, nationwide program of promotion of the use of Risperdal for non-medically necessary uses” — like the treatment of A.D.H.D..

-----


from Slashdot:


"US researchers have found that
prenatal treatment for Down syndrome works in mice. This raises the possibility that a pregnant woman who knows her unborn child has Down syndrome might be able to forestall some of the symptoms before giving birth. When fetal mouse pups that had a syndrome similar to Down's were treated with nerve-protecting chemicals, some of the developmental delays that are part of the condition — such as motor and sensory abilities — were removed."

-----


from MSNBC:

Excerpt:
More than half a million U.S. children have autism with costly health care needs that often put an unprecedented financial strain on their families, national data show.

Compared with parents whose youngsters have chronic health care needs but not autism, those with autistic children are three times more likely to have to quit their jobs or reduce work hours to care for their kids. They pay more for their kids' health needs, spend more time providing or arranging for that care, and are more likely to have money difficulties, the study found.

"This is the first national survey that looked at the impact on families of having kids with special health care needs," said lead author Michael Kogan, a researcher with the government's Maternal and Child Health Bureau.

-----


from MSNBC:

Excerpt:
A popular antidepressant plus three months of psychotherapy dramatically helped children with anxiety disorders, the most common psychiatric illnesses in kids, the biggest study of its kind found.

The research also offers comfort to parents worried about putting their child on powerful drugs — therapy alone did a lot of good, too.

Combining the drug sertraline, available as a generic and under the brand name Zoloft, with therapy worked best. But each method alone also had big benefits, said Dr. John Walkup, lead author of the government-funded research. It's estimated that anxiety disorders affect as many as 20 percent of U.S. children and teens.

In many cases, symptoms almost disappeared in children previously so anxious that they wouldn't leave home, sleep alone, or hang out with friends, said Walkup, a Johns Hopkins Hospital psychiatrist.

"What we're saying is we've got three good treatments," he said.

-----


from MSNBC:

Excerpt:
Brain scans of teens with a history of aggressive bullying behavior suggest that they may actually get pleasure out of seeing someone else in pain, U.S. researchers said on Friday.

While this may come as little surprise to those who have been victimized by bullies, it is not what the researchers expected, Benjamin Lahey of the University of Chicago, who worked on the study, said in a telephone interview.

"The reason we were surprised is the prevailing view is these kids are cold and unemotional in their aggression," said Lahey, whose study appears in the journal Biological Psychology.

-----


from Newsweek:

Excerpt:
Liane Willey watched from behind a two-way mirror as doctors at the University of Kansas performed a series of psychological tests on her 5-year-old daughter. From the day the girl was born, Liane had worried about the child's behavior: as an infant, she would not suckle. As a toddler, she bit other children and refused to let anyone hug her. Doctors had continually assured the young mother that her daughter was normal, if a bit quirky. But with each passing year, 'quirky' had become less apt a description. By the age of 5, she had no friends and a profound obsession with monkeys. "If another kid came to school with a toy monkey or something with a monkey picture on it, she would freak out," Liane says. "She would try to take it away from the other kid, because she didn't get that not everything 'monkey' was hers." Liane had been a quirky child herself, and knew the difficult path that lay ahead for her daughter. "Growing up, I tried everything—psychotherapy, group therapy, antidepressants—none of them gave me a better sense of the world or my place in it," she recalls. "For her, I wanted something that would actually work, and I wanted them to put a name to the angst once and for all." Doctors were hoping the psychological tests would yield-up some clues.

-----


from Newsvine:

Excerpt:
Should preschool be more about ABCs or learning to play with others? With the help of Twiggle the Turtle, scientists found out that youngsters do better if they do both.

So concludes a major study in Head Start programs in Pennsylvania, research with implications for preschools and parents everywhere.

Face it, 4-year-olds are lovable but self-centered, impulsive and prone to meltdowns. Teaching them not to whack a classmate who snatches a toy is a big part of preschool socialization.

But growing awareness that early learning is important to future school achievement has put more pressure on preschool's academic side, especially efforts to eliminate achievement gaps between low-income and wealthier students.

-----


from NY Times:

Excerpt:
What makes the Community School unusual is not its student body — plenty of schools around the country enroll teenagers with an autism spectrum disorder. But, like about only two dozen schools in the country, it employs a relatively new, creative and highly interactive teaching method known as D.I.R./Floortime, which is producing striking results among T.C.S.’s student body. (D.I.R. stands for developmental, individual differences, relationship-based approach.) The method is derived from the work of Stanley Greenspan, a child psychiatrist and professor of psychiatry, behavioral science and pediatrics at George Washington University, and his colleague Dr. Serena Wieder. D.I.R./Floortime can be effective with all kinds of children, whether they have developmental challenges or not. As applied by T.C.S., it is an approach that encourages students to develop their strengths and interests by working closely with one another and with their teachers. The goal for students is neurological progress through real-world engagement.

-----


from MSNBC:

Excerpt:
In Washington state, Reza and Arzu Forough pay more than $1,000 a week for behavior therapy for their 12-year-old autistic son.

In Indiana, Sean and Michele Trivedi get the same type of therapy for their 11-year-old daughter. But they pay $3,000 a year and their health insurance covers the rest.

Two families. Two states. Big difference in out-of-pocket costs.

-----


The 12-year struggle for parity between physical health coverage and mental health and addiction coverage finally came to an end on October 2nd when the House passed the Mental Health Parity bill, and President Bush signed it into law the next day. Senators Domenici (R-NM), Kennedy (D-MA) and Enzi (R-WY), and Representatives Kennedy (D-RI) and Ramstad (R-MN) sponsored the bills and have been enthusiastic supporters of the cause.

The bill was designed to fill in the loopholes of the Mental Health Parity Act of 1996, which was not specific enough about how insurers should handle mental health and physical health equally. The 1996 Act banned putting lifetime or annual dollar limits on mental health services, but did not cover more detailed financial policy. This had disastrous consequences: the loophole allowed insurance companies to put limits on inpatient days and outpatient visits, increase insurer's co-payments and deductibles, and increase the maximum limits for out-of-pocket expenses.

Even though 42 states have laws that require mental health parity, nationwide there are still 82 million people whose employers self-insure, which means they do not have to follow state parity law. With this new federal parity law, those 82 million people plus 31 million people in other plans will now have equal mental health coverage.

Part of the reason that Mental Health Parity had such strong support from both Democrats and Republicans is because of how close to home mental illness hits. Senator Domenici's daughter has schizophrenia, Senator Wellstone (who died in 2002 in a plane crash) had a brother with severe mental illness, and Representatives Kennedy and Ramstad battled addiction.

Key Parity Act Requirements
The Act applies to group health plans of 50 or more employees (so that small businesses of less than 50 are exempt).
It builds on the 1996 parity law by expanding equal coverage to all financial requirements: deductibles, copays, out-of-pocket expenses, all treatment limitations (i.e. how often treatment is given, number of visits, and days of coverage)
It gives broad definitions to mental health and substance use disorder benefits: they are services for mental health conditions and substance use disorders, which are defined under the terms of the plan and must be in line with Federal and State law.
Insurers must release their criteria for defining medical necessity in a case, and also give reason for denying a claim for mental health services.
It does not require that a plan cover mental health or substance use, but if the plan does cover MH/SA, then the plan must provide parity comparable to the coverage provided for physical health.

-----


Study: Most depressed kids get antidepressants but no therapy
USA Today
By Marilyn Elias
Oct. 9, 2008

At least half of U.S. children who take antidepressants aren't in therapy, a large study suggests, and that delays recovery while greatly increasing the number of kids on the medication who are suicidal. "Therapy with antidepressants is the standard of care. But is it what's going on in the real world? No," says Sheila Marcus, child and adolescent psychiatry chief at the University of Michigan Medical School.

Read more on usatoday.com

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Understanding The Cycle Of Violence
ScienceDaily
Oct. 11, 2008

Researchers have long known that children who grow up in an aggressive or violent household are more likely to become violent or aggressive in future relationships. What has not been so clear is the developmental link between witnessing aggressive behavior as a child and carrying it out as an adult. What changes occur in a child that affect whether he or she will choose to deal with conflict in aggressive or violent ways?

Read more on sciencedaily.com

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Becoming A Bully Magnet
Why some kids grow up to be targets.
Newsweek
By Claudia Kalb
Oct. 7, 2008

 Every parent wants to know the secret to school happiness: why is one kid well liked while another gets picked on? There's no recipe for social success among first graders. But a new study published this week in the Archives of General Psychiatry reveals some intriguing clues about why certain children land in the dreaded world of what science calls "peer victimization." One key finding: they're more likely to be aggressive early on in life. That may sound counterintuitive, but it's not surprising to experts in the field, who have known for some time that there's a link between being aggressive and being tormented, which can lead to a host of emotional and social problems. When volatile and angry children act out on their frustrations-smashing a toy after someone takes their ball away-they aren't exactly beloved by their peers. "They're easy marks," says Kenneth Dodge, a psychology professor at Duke University. "You know you can get a rise out of them, you can push their buttons."

Read more on Newsweek.com

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Young Children Can Develop Full-blown Obsessive Compulsive Disorder (OCD)ScienceDaily
Oct. 1, 2008

A new study by researchers at the Bradley Hasbro Children's Research Center has found that children as young as four can develop full-blown obsessive compulsive disorder (OCD) and often exhibit many of the same OCD characteristics typically seen in older kids. The study, published online by the Journal of Psychopathology and Behavioral Assessment, is the largest sample of young children with OCD published to date.

"There have been very few studies focusing on early childhood OCD, even though we know that OCD, if left untreated, can significantly disrupt a child's growth and development and can worsen as the child gets older," says lead author Abbe Garcia, PhD, director of the Bradley Hasbro Children's Research Center (BHCRC) Pediatric Anxiety Research Clinic. "That's why we need to understand more about OCD in very young children, since early diagnosis and intervention are critical to reducing the severity of symptoms and improving quality of life."

Read more on sciencedaily.com

.....


Cannabis worse than stimulants for depression, anxiety
The Age
Sept. 29, 2008

Cannabis smokers are more likely to suffer depression, anxiety and psychosis than stimulant drug takers, according to Australian statistics suggesting the herb's toll on mental health has been underestimated.

The impact of amphetamines on mental state is well known but a new national report shows dope smokers display higher rates of several psychological symptoms when visiting their doctor.

Read more on theage.com.au

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Studies Find Dramatic Increase in Suicides among Adolescent African- American Males
The Savannah Tribune
Sept. 24, 2008

A significant increase in mental illness and behavioral problems among adolescent African- American males demonstrates the need for new approaches to treatment and better understanding of the complex challenges facing these youths, according to a policy paper issued by Community Voices: Healthcare for the Underserved, an advocacy group based at Morehouse School of Medicine.

The paper, titled "The Secret Epidemic: Exploring the Mental Health Crisis Affecting Adolescent African-American Males," outlines data indicating that mental health problems are rising among members of this at-risk group, their access to treatment facilities is relatively low and treatment strategies must be revamped to address the socioeconomic issues that confront them.


Read more on savannahtribune.com

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from Toledo Journal:

Excerpt:
A significant increase in mental illness and behavioral problems among adolescent African American males demonstrates the need for new approaches to treatment and better understanding of the complex challenges facing these youths. That is the view in a policy paper issued by Community Voices: Healthcare for the Underserved, an advocacy group based at Morehouse School of Medicine.
The paper, titled ''The Secret Epidemic: Exploring the Mental Health Crisis Affecting Adolescent African American Males,'' outlines data indicating that mental health problems are rising among members of this at-risk group, their access to treatment facilities is relatively low and treatment strategies must be revamped to address the socioeconomic issues that confront them.
''Our research found that many young black males are treatable, but they are going undiagnosed because of failures in America's health-care system,'' said Dr. Henrie M. Treadwell, director of Community Voices, a nonprofit seeking to improve health services and access to health care.
''Our entire society feels the impact of this failure. Suicides and homicides have increased for this group, and the residual effect is impacting communities across the country. This problem must be addressed.''

-----


from MSNBC:

Excerpt:
The global financial crisis is likely to cause increased mental health problems and even suicides as people struggle to cope with poverty and unemployment, the World Health Organization warned on Thursday.

Hundreds of millions of people worldwide are already affected by mental problems such as depression and bi-polar disorders and the current market meltdown could exacerbate feelings of despair among people vulnerable to such illnesses.

The United Nations agency said the impact could be especially marked for those living in low and middle income countries where access to treatment is often limited.

-----


from NY Times:

Excerpt:
When Claire, a pixie-faced 6-year-old in a school uniform, heard her older brother, James, enter the family’s Manhattan apartment, she shut her bedroom door and began barricading it so swiftly and methodically that at first I didn’t understand what she was doing. She slid a basket of toys in front of the closed door, then added a wagon and a stroller laden with dolls. She hugged a small stuffed Pegasus to her chest. “Pega always protects me,” she said softly. “Pega, guard the door.”

James, then 10, had been given a diagnosis of bipolar disorder two years earlier. He was attending a therapeutic day school in another borough and riding more than an hour each way on a school bus, so he came home after Claire. Until James’s arrival that April afternoon, Claire was showing me sketches she had drawn of her Uglydolls and chatting about the Web site JibJab, where she likes to watch goofy videos. At the sound of James’s footsteps outside her bedroom door, she flattened herself behind the barricade. There was a sharp knock. After a few seconds, James’s angry, wounded voice barked, “Forget it,” and the steps retreated.

“If it’s my brother, I don’t open it,” Claire said. “I don’t care if I’m being mean. . . . I never trust him. James always jumps out and scares me. He surprises me in a bad way.”

-----


from MSNBC:

Excerpt:
New research further debunks any link between measles vaccine and autism, work that comes as the nation is experiencing a surge in measles cases fueled by children left unvaccinated.

Years of research with the measles, mumps and rubella vaccine, better known as MMR, have concluded that it doesn’t cause autism. Still, some parents’ fears persist, in part because of one 1998 British study that linked the vaccine with a subgroup of autistic children who also have serious gastrointestinal problems. That study reported that measles virus was lingering in the children’s bowels.

-----


from MSNBC:

Excerpt:
Two genes that influence the activity of nerve cells in the brain may play a key role in a person's risk for bipolar disorder, marked by dramatic swings from depression to manic behavior, researchers said on Sunday.

The findings are not expected to lead to a genetic test for the risk of the condition but could help unravel the mystery of how it arises and lead to better treatments, they reported in the journal Nature Genetics.

An international team of scientists examined the genomes of 10,596 people mainly from Britain and the United States, including 4,387 with bipolar disorder, also sometimes known as manic-depression.

-----


from MSNBC:

Excerpt:
When a 13-year-old Minnesota boy was banned from church after parishioners complained about his behavior, it exposed a painful truth so politically incorrect that some people feel guilty just saying it out loud: Some autistic children can be annoying and disruptive in public.

The case of Adam Race and others like him has laid bare conflicted feelings — among both parents of these children and other people — over autistic youngsters in public places. And it has stirred debate over how much consideration one side owes the other.

-----


from the Huffington Post:

Excerpt:
"Tropic Thunder" is pushing the boundaries of good taste too far for groups representing the mentally disabled.

Dozens of people from organizations such as the Special Olympics and the American Association of People with Disabilities protested the movie-industry spoof across the street from the film's Los Angeles premiere at Mann's Bruin Theatre on Monday. The protesters held up signs with slogans such as "Call me by my name, not by my label" and chanted phrases like "Ban the movie, ban the word."

-----


from Join Together:

Excerpt:
A new study released by the Partnership for a Drug-Free America reveals a troubling new insight into the reasons why teens use drugs.  According to the 2007 Partnership Attitude Tracking Study of 6,511 teens (PATS Teens), the number one reason teens see for using drugs is to deal with the pressures and stress of school.  In this nationally projectable study (margin of error +/- 1.6 percent), 73 percent of teens reported that school stress is the primary reason for drug use, indicating that teens' perceptions of motivating factors for using drugs are dramatically different than past research has indicated.

-----


from Foster Folly News:

Excerpt
A child's teenage years can seem stressful. Teenagers enter high school, where they must make new friends. Increased academic and athletic competition can make teens feel inadequate or overwhelmed.

Parents can help their teenagers navigate these difficult years. First, parents should ask their pediatrician to evaluate their teenager's mental well being. Pediatricians develop close relationships with their patients, so teenagers might feel more comfortable discussing sensitive subjects, like depression, stress and sex, with their doctors instead of their parents. 

Teenagers need a trusted adult to speak with, whether that adult be parent, pediatrician, teacher or counselor. Make sure that your teenager knows that stress, sadness and anger are normal, and that talking about her feelings can really help her cope. Remind her of the people who can help her, and tell her that reaching out is a sign of strength, not weakness

-----


from CNN:

Story Highlights

U.S. psychiatrists are using psychotherapy less, a new study finds
Reasons include expanded use of pills and insurance policies favoring short visits
Psychiatrists who provided talk therapy to all patients gave out fewer pills
The couch is still effective and "far from dead," expert says

-----


 Indiana's automation of welfare eligibility has bumped Medicaid recipients off eligibility rolls, an advocate for the needy said as the changes come under legislative scrutiny this week.

Medicaid enrollment dropped by 4.5 percent -- from 86,574 to 82,874 in 12 north central counties where the Family and Social Services Administration piloted the welfare changes during the first five months of 2008, said Glenn Cardwell, a longtime director of the state welfare office in Vigo County now working with critics of the eligibility changes.

In the remaining 80 counties -- which largely went unaffected by the welfare charges during those five months -- Medicaid rolls grew from 735,703 to 755,623, or 2.7 percent, Cardwell said Monday.

"It tells me that the people's complaints are real," Cardwell said. "They're submitting all the information that's called for, but a certain number will get a notice a week or so later saying they failed to submit the required information."

A lawsuit filed in Marion County claims FSSA has denied benefits to plaintiffs when the agency was missing documents such as birth certificates or medical records -- documents that the plaintiffs claimed to have delivered previously. In each case, clients received letters citing their "failure to cooperate."

A legislative study committee chaired by House Ways and Means Chairman William Crawford, D-Indianapolis, will hold a field hearing Thursday on the welfare changes and other FSSA matters in Kokomo, located in the 12-county pilot region. The hearing begins at 1 p.m. at the Kelley Student Center at Indiana University-Kokomo.

Cardwell has organized a town hall meeting on the welfare changes the day before in Terre Haute. The meeting, which begins at 11:30 a.m. Wednesday at Chauncey Rose Middle School, is expected to draw lawmakers, township trustees and representatives from social service agencies and faith and labor groups.

A team of vendors led by IBM Corp. and Affiliated Computer Services Inc. has a $1.16 billion, 10-year contract with FSSA to process applications for Medicaid, food stamps and other public safety net benefits received by about 1.1 million children, seniors, people with disabilities and other needy Hoosiers. The deal introduced telephone call centers, the Internet and fax services as means to apply for benefits.

FSSA rolled out the changes in the 12-county region centered around Marion last Oct. 29 and expanded it to 27 counties in southern and western Indiana on March 24. It reached 20 additional counties in northeastern and southwestern Indiana in May.

Cardwell said ACS doesn't have enough staff to handle all of the telephone calls coming in.

"They're under pressure to handle as many calls as possible," Cardwell said.

FSSA spokeswoman Lauren Auld said the agency would have no comment on Cardwell's analysis until it had a chance to study it.

However, FSSA's own numbers appear to indicate the volume of calls coming in is overwhelming the vendors.

Zach Main, director of FSSA's Division of Family Resources, released statistics last Thursday showing 11.5 percent of callers to the vendors' 800 number have abandoned their calls, or hung up, without completing them. Some were on hold for more than 10 minutes.

The goal is to eventually reduce the abandonment rate to 7 percent, Main said.

"Anytime you do a project as big as this one, you're going to find bugs in the system," Main said at a public review for his division.

The number of abandoned calls is highest on Mondays, Main said. Volume is higher on Monday because the call centers are closed on weekends.

Main said the 800 number has received more than 1.5 million calls since first becoming available in the initial, 12-county region nine months ago, and a document center in Marion has received and electronically scanned more than 1 million documents.

Main said FSSA has held eight open houses around the state to help show clients and their advocates how to navigate the new changes, and three more, in Terre Haute, New Albany and Jeffersonville, are scheduled for August.

He stressed that clients still have the option of meeting face-to-face with caseworkers in 107 county offices.

-----


from Newsvine

Excerpt:
Radio talk show host Michael Savage, who described 99 percent of children with autism as brats, said Monday he was trying to "boldly awaken" parents to his view that many people are being wrongly diagnosed.

Some parents of autistic children have called for Savage's firing after he described autism as a racket last week. "In 99 percent of the cases, it's a brat who hasn't been told to cut the act out," Savage said on his radio program last Wednesday.

Savage offered no apology in a message posted Monday on his Web site. He said greedy doctors and drug companies were creating a "national panic" by overdiagnosing autism, a mental disorder that inhibits a person's ability to communicate.

-----


from NY Times:

Excerpt:
The children return from school confused, scared and sometimes with bruises on their wrists, arms or face. Many won’t talk about what happened, or simply can’t, because they are unable to communicate easily, if at all.

“What Tim eventually said,” said John Miller, a podiatrist in Allegany, N.Y., about his son, then 12, “was that he didn’t want to go to school because he thought the school was trying to kill him.”

Dr. Miller learned that Tim, who has Asperger’s syndrome, was being unusually confrontational in class, and that more than once teachers had held him down on the floor to “calm him down,” according to logs teachers kept to track his behavior; on at least one occasion, adults held Tim prone for 20 minutes until he stopped struggling.

The Millers are suing the district, in part for costs of therapy for their son as a result of the restraints. The district did not dispute the logs but denied that teachers behaved improperly.

For more than a decade, parents of children with developmental and psychiatric problems have pushed to gain more access to mainstream schools and classrooms for their sons and daughters. One unfortunate result, some experts say, is schools’ increasing use of precisely the sort of practices families hoped to avoid by steering clear of institutionalized settings: takedowns, isolation rooms, restraining chairs with straps, and worse.

-----


from Think Progress:

Excerpt:
Yesterday on his radio show, right wing talker Michael Savage said that autism is “a fraud” and “a racket” and that “in 99 percent of the cases, it’s a brat who hasn’t been told to cut the act out.” Savage then asserted that all these “brat[s]” need as a father to tell them to “stop acting like a putz“:

-----


from CNN:

Story Highlights
Study: Genes suggest autism happens in brains that can't form proper connections
Some genes may have been stuck in "off" position, respond to therapy
Study reveals wide variety, almost a custom set, of gene defects in each patient
Genetic cause is known for only about 15 percent of autism cases

-----


from CNN:

Story Highlights:
Chelation is a treatment that removes heavy metals from the body
Some parents give anecdotal evidence that it helps children with autism
Government wants to see if scientific study can verify claims
Study on hold because of safety concerns

-----


from Newsweek:

Excerpt:
Max Blake was 7 the first time he tried to kill himself. He wrote a four-page will bequeathing his toys to his friends and jumped out his ground-floor bedroom window, falling six feet into his backyard, bruised but in one piece. Children don't really know what death is, as the last page of Max's will made clear: "If I'm still alive when I have grandchildren," it began. But they know what unhappiness is and what it means to suffer. On a recent Monday afternoon, Max, now 10, was supposed to come home on the schoolbus, but a counselor summoned his mother at 2:15. When Amy Blake arrived at school, her son gave her the note that had prompted the call. "Dear Mommy & Daddy," it read, "I am really feeling sad and depressed and lousy about myself. I love you but I still feel like I want to kill myself. I am really sad but I just want help to feel happy again. The reason I feel so bad is because I can't sleep at night. And dad yells at me to just sleep at night. But, I can't control it. It is not me that does control it. I don't know what controls it, but it is not me. I really really need some help, love Max!!!!! I Love you Mommy I Love you Daddy."

-----


from Newsweek:

Excerpt:
What's going on in a bipolar child's brain?
Ellen Leibenluft, chief of the Section on Bipolar Spectrum Disorders, Emotion and Development Branch, Mood and Anxiety Disorders Program, National Institute of Mental Health, Washington, DC: "We've begun to learn something about the brain mechanisms. There is evidence that the amygdala is involved in a number of disorders in both children and adults, and bipolar disorder is one. The amygdala, which processes emotions—it looks around the environment and says, 'what's important to me, what do I like, what do I not like, what am I afraid of?'—is smaller in kids with bipolar disorder, and it's also somewhat hyperactive. We don't really know why the amygdala is smaller—we don't know for sure if that's a consequence of the disorder, or a cause of it. One hypothesis would be there are neurotransmitters that are excitotoxic; they fire too much and they can damage the tissue. There's also a regulatory loop between the amygdala and the prefrontal cortex. If the amygdala is overreacting, it could be because the prefrontal cortex isn't doing a good enough job of shutting it down. One of the ways that children both learn and are taught to regulate their emotions is by directing their attention away from upsetting things. We have a paper from 2007 in the American Journal of Psychiatry where we had children play a frustrating game, and what we found was that the bipolar children had difficulty with it when emotion was high. They could not redirect their attention. And attention is very much controlled by the prefrontal cortex, among other places."

-----


from Newsweek:

Excerpt:
How do people usually react when their child is given a diagnosis of bipolar disorder?
Janet Wozniak, assistant professor of psychiatry, Harvard Medical School,
Boston: "I think people cling to the idea that children's brains are somehow protected and that serious mental problems only afflict people who are older, or that if they do affect children, it's because of trauma. I've been thinking a lot about why people have such a hard time understanding that children could have a serious mental illness. I think it's because their hearts and lungs usually work well. Most kids' checkups are well checkups. But the brain is the most complex part of our body. It only stands to reason that it could have problems. ... There's no parent anywhere who could stand up to the scrutiny that these parents will have to endure. Everything they do is scrutinized. I routinely talk to parents who are blamed for being too lenient, too strict, over-involved, under-involved. I usually start out by telling them, 'you know that as a parent of a child with this problem, you'll feel like you can do nothing right.' They hear from teachers and neighbors and relatives. Everybody's full of curbside advice."

-----


from Time:

Excerpt:
It's a debate with which the U.S. workplace has yet to come to grips: should employees' mental and physical health be considered equal in importance?

Corporate America's answer has traditionally been unambiguous, with few employer-backed health plans offering any coverage for workers' mental conditions. But that line has been shifting recently — a change that could save the U.S. economy billions of dollars in lost income, a new government-funded study suggests.

Serious mental illnesses (SMIs), which afflict about 6% of American adults, cost society $193.2 billion in lost earnings per year, according to findings published in this month's American Journal of Psychiatry. Surveying data from nearly 5,000 participants, researchers determined that people suffering from a SMI — defined as a range of mood and anxiety disorders, including suicidal tendencies, that significantly impaired a person's ability to function for at least 30 days over the past year — earned at least 40% less than people in good mental health. "The results of this study confirm the belief that mental disorders contribute to enormous losses of human productivity," says Ronald Kessler, a Harvard professor of health care policy and lead author of the study, funded by the National Institute of Mental Health.

-----


from Science Daily:

Excerpt:
Millions of American teens report experiencing weeks of hopelessness and loss of interest in normal daily activities and many of these depressed teens are using marijuana and other drugs, making their situation worse, according to a new White House report released today. The report, from the White House Office of National Drug Control Policy (ONDCP), reveals that marijuana use can worsen depression and lead to more serious mental disorders, such as schizophrenia, anxiety, and even suicide.

Research shows that some teens are using drugs to alleviate feelings of depression ("self-medicating"), when in fact, using marijuana can compound the problem. The report, released to coincide with May's Mental Health Awareness Month, shows a staggering two million teens felt depressed at some point during the past year, and depressed teens are more than twice as likely as non-depressed teens to have used marijuana during that same period. Depressed teens are also almost twice as likely to have used illicit drugs as non-depressed teens. They are also more than twice as likely as their peers to abuse or become dependent on marijuana. Marijuana use is associated with depression, suicidal thoughts, and suicide attempts.

-----


The state expects thousands of additional Indiana children to become eligible for Hoosier Healthwise this year, but not as many as some advocates hope.

State human services chief Mitch Roob said Monday he expects federal approval soon to expand Hoosier Healthwise to cover children in families earning up to 2½ times the federal poverty level. The current limit is twice the poverty level. Roob said he expects the expansion to take effect by Oct. 1.

"We're very optimistic about it," said Roob, secretary of the Family and Social Services Administration. "We're expecting to get approval within a month."

That's good news for a family of two earning up to $35,000 or a family of four earning up to $53,000.

However, the expansion likely will not reach children in households earning up to three times the poverty level, as authorized by the General Assembly. Rules set by the Bush administration last year limit states in covering children in families earning more than 2½ times the poverty level.

Three times the poverty level is $42,000 for a family of two or $63,600 for a family of four.

Hoosier Healthwise provides free health care to children covered by Medicaid and low-cost care for children eligible for a different government plan, the State Children's Health Insurance Program. The SCHIP portion of Hoosier Healthwise charges monthly premiums ranging from $22 to $50, depending on income and number of children. The pending expansion affects the SCHIP portion.

The SCHIP portion of Hoosier Healthwise now covers children in families earning no more than twice the poverty level, but FSSA is negotiating with the Centers for Medicare and Medicaid Services to expand coverage to 2½ times to poverty level.

Roob said he will discuss the expansion with CMS officials in Washington, D.C., this week. He expects their approval within a month.

Roob has estimated that SCHIP expansion might cover an additional 7,000 to 10,000 Indiana children, but advocate David Roos of the nonprofit Covering Kids & Families of Indiana said the number actually is more than 19,000. Hoosier Healthwise now covers about 75,000 children

President Bush twice last year vetoed legislation to expand SCHIP to cover children in families earning four times the poverty level. It was amid that debate last August that CMS set stringent new eligibility rules for children in homes earning more than 2½ times the poverty level.

The Government Accountability Office on Thursday ruled CMS needed congressional approval for the new eligibility rules, and than created hope among some advocates that some states, including Indiana, might be able to expand SCHIP further.

CMS, however, isn't backing off its rules, and Roob said Monday he didn't expect anything short of a federal court ruling would allow Indiana to expand its SCHIP eligibility. Several states have sued CMS over the rules.

"I'm not sure it changes the landscape," Roob said of the GAO ruling. "I think it might have more long-term effect than an immediate impact."

Rep. Charlie Brown, D-Gary, a key backer of the SCHIP expansion authorized by the General Assembly last year, agreed an immediate expansion was unlikely.

Brown said expanded coverage would reduce health care costs paid by the government later. He cited the growing incidence of diabetes among children.

"That's what's so crazy about not wanting to start children out early in life with preventive care," Brown said.

———

On the Net:
Hoosier Healthwise: www.state.in.us/fssa/ompp/2848.htm

-----


Children should be screened for heart problems with an electrocardiogram before getting drugs like Ritalin to treat hyperactivity and attention-deficit disorder, the American Heart Association recommended Monday.
 
Stimulant drugs can increase blood pressure and heart rate. For most children, that isn't a problem. But in those with heart conditions, it could make them more vulnerable to sudden cardiac arrest - an erratic heartbeat that causes the heart to stop pumping blood through the body - and other heart problems.

About 2.5 million American children and 1.5 million adults take medication for attention-deficit hyperactivity disorder, or ADHD, according to government estimates. Stimulant drugs, like Ritalin, Adderall and Concerta, help children with ADHD stay focused and control their behavior.

The medications already carry warnings of possible heart risks in those with heart defects or other heart problems, which some critics said were driven more by concerns of overuse of the drugs than their safety.

The heart group is now recommending a thorough exam, including a family history and an EKG, before children are put on the drugs to make sure that they don't have any undiagnosed heart issues.

"We don't want to keep children who have this from being treated. We want to do it as safely as possible," said Dr. Victoria Vetter, a pediatric cardiologist at the University of Pennsylvania School of Medicine and head of the committee making the recommendation.

The label warnings were added after a review by the Food and Drug Administration of its databases found reports of 19 sudden deaths in children treated with ADHD drugs and 26 reports of other problems including strokes and fast heart rates between 1999 and 2003. There were also reports of heart problems in adults; the committee didn't look at adults.

An EKG can detect abnormal heart rhythms that can lead to sudden cardiac arrest. Children who are already on ADHD drugs should also be tested, Vetter said. If problems are found, the child should be sent to a pediatric cardiologist. With careful monitoring, Vetter said, children with heart problems can take the medicines if needed.

The cost of an EKG varies depending on who does it and the location. For example, the amount that Aetna Inc. pays for an EKG in a doctor's office ranges from $24 to $50; Medicare's payment rate is about $23. Vetter said Children's Hospital of Philadelphia, where she works, has been doing EKG screening for three years and it has been covered by insurance.

She said a screening of about 1,100 healthy children found that about 2 percent of them had some kind of heart problem.

"We thought it was reasonable to include the electrocardiogram as a tool for the pediatrician, the psychiatrist so that this would help identify additional children who have heart disease," Vetter said.

But Dr. Steven Pliszka, a child psychiatrist at the University of Texas in San Antonio, said he was baffled by the EKG recommendation. He said there's no evidence that sudden death is a bigger problem for children taking stimulants than for children who aren't taking the drugs.

Pliszka said an EKG might deter people from seeking treatment because it's an added expense and hassle. Psychiatrists aren't likely to have an EKG machine, and pediatricians might not either, making patients go elsewhere to get the test, he said.

The American Academy of Child and Adolescent Psychiatry recently updated its treatment guidelines for ADHD, and did not recommend routine EKGs, said Pliszka, who was the lead author. He has received research support or served as a consultant for makers of ADHD drugs.

"We definitely did not feel we needed to screen everyone," Pliszka said.

He noted that the heart association doesn't recommended EKG screening for young athletes to prevent sudden death. The group has said it wasn't feasible or cost-effective to screen all student athletes.

Representatives for Shire PLC, which makes Adderall and two other ADHD treatments, and Norvartis Pharmaceuticals Corp., which makes Ritalin, said the labeling already suggests patients be evaluated for heart problems and an EKG done if needed.

"There's no new information here. And frankly, we're a little perplexed as to the purpose of the American Heart Assocation coming out with this statement at this time," said Shire spokesman Matt Cabrey.

An ADHD advocacy group called CHADD said parents should monitor their child's reaction to all medications. EKG screening "will bring an even further measure of safety to what is already a safe clinical treatment approach," the group said. 

-----


from MSNBC:

Excerpt:
A small study of toddlers finds that about one-quarter of babies born very prematurely had signs of autism on an early screening test.

The research is preliminary since formal autism testing wasn’t done. But the results are provocative, suggesting that tiny preemies may face greater risks of developing autism than previously thought.

That suggests autism may be an under-appreciated consequence of medical advances enabling the tiniest of premature babies to survive, said lead author Catherine Limperopoulos, a researcher at McGill University in Montreal and Children’s Hospital in Boston.

She emphasized that the results don’t mean extreme prematurity causes autism, but rather that it might be among contributing factors.

-----


from MSNBC:

Excerpt:
Using stimulants like Ritalin to treat attention-deficit hyperactivity disorder in children, particularly younger ones, does not seem to boost the risk of later substance abuse, researchers said on Tuesday.There has been a debate over whether such medications are the best way to treat ADHD, a condition marked by inattention, hyperactivity and impulsive behavior that appears more often in boys than girls. Some experts have worried these drugs could make children more prone to substance abuse later on.

Two teams of researchers who examined the issue in studies published in American Journal of Psychiatry said their findings should offer some reassurance about using these stimulants.

-----


from Washington Post:

Excerpt:
Victoria Miresso cannot button a shirt, match a sock or tell one school bus from another. Yet at Roberto Clemente Middle School in Germantown, she is expected to function much like any other sixth-grader, coping with class changes, algebra quizzes and lunchroom bullies.

Victoria's parents say she is a victim of inclusion: a trend, in Montgomery County and across the nation, toward shutting down traditional special education classes and placing special-needs students in regular classrooms at neighborhood schools.

"At this point, we're about halfway through the school year, and she hasn't learned anything," said Laura Johnson, her mother. "It's not fair for her to go to school and sit there and be teased because she doesn't understand what they're teaching her."

Montgomery school officials say Victoria is no victim. She is, however, one of the first generation of students who cannot attend secondary learning centers, a network of self-contained classrooms open to special education students at eight middle and high schools in the county since the 1970s. Montgomery school leaders decided in 2006 to phase out the centers, part of an ongoing shift of special-ed students and teachers out of separate classrooms and into the general school population.

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You helped make history!!  Your support for mental health parity helped propel the Paul Wellstone Mental Health and Addiction Equity Act, H.R. 1424, to a historic vote in the House of Representatives where it passed 268-148 on March 5.  This first-ever House vote on a comprehensive mental health/addiction parity bill gives our cause new momentum.

Work yet to be done.
But even with this victory, there is still more work to do. The House-passed measure must now be reconciled with a parity bill already passed by the Senate, S. 558. A final version will have to be approved by both chambers and signed by the President before people living with mental illnesses will finally have the same rights under their insurance plans as individuals with other health conditions.

Take Action!
Write your Senators and Congressmen and urge them to push for enactment of a strong parity bill this year.  You can make the difference in delivering that message to your elected officials!  Be on the lookout for further updates and opportunities to help us win this long fight. 

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ASU Web Devil commentary:

Excerpt:
Students' mental health history may no longer be private if campus safety recommendations are put into play.

ASU could begin reviewing this week whether it would be feasible and beneficial to campus safety to require students to disclose their mental health histories.

A group of ASU staff members is finalizing a report with campus safety recommendations that could include requiring mental health disclosure, ASU spokeswoman Leah Hardesty said.

In the wake of the April 2007 Virginia Tech University massacre, the National Association of Attorneys General recommended universities have greater access to students' mental health records. Following this proposal, the ASU committee may recommend that students inform the University of any mental health problems that could affect campus safety, Hardesty said.  

About 26.2 percent of Americans ages 18 and older suffer from at least one diagnosable mental disorder each year, according to the National Institute of Mental Health.  

If this number is applied to ASU, more than 10,000 students are affected by mental health disorders and may be required to disclose certain information if new policies are applied.  

Paul Ward, the vice president of University Administration and Legal Affairs and staff group leader, said he was unable to comment on any of the recommendations regarding mental health disclosure until the report is finalized.

-----


Daily Californian commentary:

Excerpt:
I am more willing to discuss my physical therapy experiences than talk about visiting my therapist.

I take comfort in seeing patients around me with similar concerns as I sit in the physical therapy exercise room, moving my hand through a sequence of prescribed motions in a basin of warm water. When I leave the Oakland office, sling holding my wrist against my chest, I feel a sense of solidarity when I pass someone with a cast enveloping his arm. Everyone can see my injury, and I feel comfortable, not embarrassed, explaining how my physical predicament came about.

But if you ask me how I felt when I first walked into that pastel-toned counseling office and deduced that the box of tissues next to the couch were for my expected tears- forget about it. Neither you nor my health insurance company will ever know.

So why is being asked how my wrist feels far less invasive than being asked how I feel?

-----


from MSNBC:

Excerpt:
When Benjamin Kidd was in pre-K last year, his teachers marveled at how bright, attentive and well-behaved he was — in the morning.

Later in the day, Ben was a different child. He was fidgety and he couldn’t focus. He couldn’t sit still for a story. And he burst into tears and temper tantrums at the slightest provocation.

After taking him to one specialist after another, his mother, Michelle Kidd, who lives in Hillsborough N.J., finally figured out what the problem was: 5-year-old Ben was exhausted. Doctors who ran an overnight sleep study on him last fall said he was suffering from obstructive sleep apnea, a sleep disorder associated with middle age but not uncommon in preschoolers, where it can lead to behavior easily mistaken for hyperactivity — even though it’s actually caused by fatigue.

-----


US News story:

Excerpt:
When parents are worried about a child being depressed or having an eating disorder or a problem with drugs or drinking, the family pediatrician is the natural place to turn for help. But families might not get the help they need. Doctors, it turns out, are often reluctant to tackle children's mental and behavioral problems.

That's the sobering news from a study that offers clues as to why so many families struggle to get treatment for their troubled children. Fortunately, it also offers insight into how parents can work the system to get their children the help they need.

Mental-health care may sound like a frill compared with, say, treating asthma or strep throat. Yet mental-health problems are nearly twice as common as asthma, with at least 11 percent of children having a mental or behavioral disorder that significantly impairs their life. Given that, you'd think that pediatricians would be all over the mental-health issue.

-----


from ABC News:

Excerpt:
Autism is a difficult diagnosis for any parent. For Robin and John Kirton, it's difficulty times six.

Each of their six children suffers from a different form of the disorder, which affects an estimated one in 150 American children. It's an incredibly rare occurrence that, experts say, points to something in the genes.

-----


Feb. 7: Eli and Lorraine Kaplan talk about their son’s diagnosis of schizophrenia and why they want to help others break their silence.

 http://www.msnbc.msn.com/id/21134540/vp/23049065#23049065

-----


from Bazelon Center:

President's Budget Proposal Slashes Mental Health

In this issue:
Community Mental Health Services Hit HardEfforts to Rein in MedicaidLegislation Imposing Moratorium on Medicaid Case Management RulesMental Health and Criminal Justice Collaborations Bill AdvancesNewsbytes:
House Committee Hearing on ADA RestorationSan Francisco Agrees to Create Supported HousingDC Promises to Upgrade Special Education

The President's proposed budget for fiscal year 2009 has generated outrage on
all sides, from states with revenue shortages to nonprofits working for
low-income populations. People with mental disabilities would suffer greatly
if the President's proposals were enacted as presented. Community mental
health services are hit hard and the Administration's campaign to cut Medicaid
is ratcheted up. Congress is reacting, however. It's up to you and other mental
health advocates to explain to Senators how the Administration's proposals
would create hardships for individuals and families…and ultimately cost the nation more.


Read the full Reporter with details on these issues at
http://www.bazelon.org/newsroom/reporter/2008/2-8-08PolicyReporter.htm

-----


from MSNBC:

Excerpt:
When her 5-year-old son showed up at the door with a black eye and a bloody cut on his head, Brooke Fike knew it was time to take on the bullies. For weeks, several boys at school had been swinging their backpacks into her son's head. One day they dumped a carton of milk over him during lunch.

As Fike tried to remedy the problem, she realized that the bullies seemed to be the kids in class who couldn’t sit still and listen. They didn’t do their homework. They were almost constantly in motion.

Turns out, those behaviors could have been the first clue to parents and school officials that these boys might be the ones who were going to turn into bullies.

-----


from CNN:

Excerpt:
Where a teenage girl sees herself on her school's social ladder may sway her future weight, a study of more than 4,000 girls finds.

Those who believed they were unpopular gained more weight over a two-year period than girls who viewed themselves as more popular. Researchers said the study showed how a girl's view of her social status has broader health consequences.

The girls in the study were still growing -- their average age was 15 -- and all of them gained some weight. However, those who rated themselves low in popularity were 69 percent more likely than other girls to increase their body mass index by two units, the equivalent of gaining about 11 excess pounds. (The body mass index, or BMI, is a calculation based on height and weight.)

Girls who put themselves on the higher rungs of popularity also gained some excess weight, but less -- about 6½ pounds.

-----


from CNN:

Excerpt:
About 3.1 million people between the ages of 12-25 have used cough and cold medicine to get high, the government reported Wednesday.

The number of young people who abused over-the-counter cold medicines is comparable to use of LSD and much greater than that for methamphetamine among the age group, according to the federal Substance Abuse and Mental Health Services Administration.

The agency's 2006 survey on drug abuse and health found that more than 5 percent of teenagers and young adults had misused cough and cold medicines and indicated that these people also had experimented frequently with illicit drugs.

-----


from CNN:

Excerpt:
A rare genetic variation dramatically raises the risk of developing autism, a large study showed, opening new research targets for better understanding the disorder and for treating it.

Research into the causes of autism has focused on genetic causes because so many families have multiple children with the disorder. Thus far, only about 10 percent of autism cases have a known genetic cause. Boston, Massachusetts-area researchers estimate the gene glitch they've identified accounts for an additional 1 percent of cases.

They found that in people with autism, a segment of a chromosome that has genes linked to brain development and various developmental disorders was either missing or duplicated far more often. The defect was inherited in some cases, but more often the result of a random genetic accident.

-----


from MSNBC:

Excerpt:
As far as the Boy Scouts of America is concerned, knowing how to confront a bully is now as important as mastering a slip knot.

For the first time in the 97-year history of the nation's largest youth organization, newcomers must show they have learned Scout-approved ways to avoid being pushed around and called names, if they want to advance through the ranks.

Shaken down for your lunch money? Tell the bully how it hurts. Called a crater face? The 2008 Boy Scout Handbook recommends this comeback: "So what if I have a face full of zits. What's it to you?"

"We've always emphasized bullying — how to recognize it, how to prevent it," said Jim Terry, assistant chief executive of the Boy Scouts. "This is just a reinforcement of those principles."

-----


Kansas City Star story:

Excerpt:
The recent shootings in Nebraska and Colorado, while tragic, are only the most recent in a series that have captured national headlines.

Like the Virginia Tech and Columbine High School shootings and countless others, these incidents are notable for the clear signs of mental instability in the perpetrators.

Yet, sadly, their cries for help went unanswered, and the interventions and treatments that might have prevented these life-threatening situations were never implemented. Individually and collectively, these events have exposed the fissures in our mental health-care system and the tragic consequences to which such failures can lead.

More than 26 percent of adults — one out of every four, or nearly 58 million people — suffer from a diagnosable mental disorder in a given year. For people ages 15 to 44, mental disorders are the leading cause of disability. They account for 90 percent of the roughly 30,000 suicides and 650,000 suicide attempts each year.

-----


from Science Daily:

Excerpt:
Youth with bipolar disorder misread facial expressions as hostile and show heightened neural reactions when they focus on emotional aspects of neutral faces, researchers at the National Institutes of Health's (NIH) National Institute of Mental Health (NIMH) have discovered. The study provides some of the first clues to the underlying workings of the episodes of mania and depression that disrupt friendships, school, and family life in up to one percent of children.

-----


from CNN:

Excerpt:
A college student embarks on a shooting spree, taking 32 lives. A teenager with an assault rifle opens fire on holiday shoppers in a department store in middle America. And, long before that, two youths turn the halls of their high school into a virtual abattoir, leaving some 13 dead before killing themselves.

Blame for the explosion of violence by teenagers and young adults in recent years has fallen on everything from the breakdown of families to video games, from lax security to violent music.

In reality, experts say, a variety of societal factors is behind youth violence. But, they maintain, it is not an unavoidable consequence of life in the 21st century: It can be reduced, if not prevented entirely, through programs aimed at increasing awareness and education, reducing the stigma sometimes associated with mental illness or depression, and providing youth with the skills and confidence needed to handle difficulties.

-----


from Time:

Excerpt:
With a teacher for a mom and a physician's assistant for a dad, Matthew North had two experts on the case from birth, but his problems baffled them both. "Everything was hard for Matthew," says Theresa North, of Highland Ranch, Colo. He didn't speak until he was 3. In school, he'd hide under a desk to escape noise and activity. He couldn't coordinate his limbs well enough to catch a big beach ball.

Matthew, now 10, was evaluated for autism and attention deficit hyper-activity disorder, but the labels didn't fit. "We filled out those ADHD questionnaires a million times, and he always came out negative," Theresa recalls. "When we found this place, I cried. It was the first time someone said they could help."

-----


Indy Star story:

Excerpt:
If undiagnosed and untreated, attention deficit hyperactivity disorder or bipolar disorder can be devastating, particularly for black adolescents.

If ADHD isn't treated before age 15, those children are three times more likely to abuse drugs or alcohol, said Dr. William Bailey Jones, a local psychiatrist. And even though most people with bipolar disorder aren't diagnosed until their late 20s, symptoms often are noticeable by the teens, Jones said.

"Fifty percent of all incarcerated males meet diagnostic criteria for ADHD and 80 percent of all high-school dropouts are ADHD," he said.

As many as one of five American children have ADHD, a genetic disorder prevalent in school-aged children that creates problems with attentiveness, over-activity, impulsivity, or a combination of all three behavioral problems.

-----


MSNBC story:

Excerpt:
Crucial parts of brains of children with attention deficit disorder develop more slowly than other youngsters’ brains, a phenomenon that earlier brain-imaging research missed, a new study says.

Developing more slowly in ADHD youngsters — the lag can be as much as three years — are brain regions that suppress inappropriate actions and thoughts, focus attention, remember things from moment to moment, work for reward and control movement. That was the finding of researchers, led by Dr. Philip Shaw of the National Institute of Mental Health, who reported the most detailed study yet on this problem in Monday’s online edition of Proceedings of the National Academy of Sciences.

-----


MSNBC story:

Excerpt:
The first time her 3-year-old fainted in the middle of an argument, Suzanne Miller got scared. Worried that it might be the sign of a serious health problem, Miller rushed Brianna to the family’s pediatrician.

The diagnosis was reassuring and at the same time distressing: Brianna had simply held her breath so long that she passed out.

“The doctor said it was just a normal run-of-the-mill temper tantrum,” remembers the 42-year-old nurse from Alloway, N.J. “He told us she’d outgrow it and the best thing we could do was to ignore it. The only thing we could do was stop her from hurting herself when she went down.”

-----


from The Hilltop:

Excerpt:
For years, many people in the black community have chosen to handle mental health issues by sweeping them under the rug and ignoring them.

According to the National Institute of Mental Health, an estimated 57.7 million people ages 18 years and older have at least one diagnosable mental health disorder.

Senior biology major Joytrese George said, "I have a cousin that was diagnosed with a mental disorder almost 10 years ago. He apparently experienced an event in his life that caused him to be diagnosed with a severe nervous breakdown. He has never been the same since."

George said her cousin, now an adult, lives in a facility for patients with mental health disorders in Minnesota.

While senior accounting major Charles Taylor has not personally experienced dealing with a loved one suffering from a mental disorder, he does agree that talking about mental health is more taboo among blacks.

He said, "African Americans have always imposed more stigmas upon mental health disorders than other ethnicities."

-----


from MSNBC

Excerpt:
A few decades ago, people probably would have said kids like Ryan Massey and Eddie Scheuplein were just odd. Or difficult.

Both boys are bright. But Ryan, 11, is hyper and prone to angry outbursts, sometimes trying to strangle another kid in his class who annoys him. Eddie, 7, has a strange habit of sticking his shirt in his mouth and sucking on it.

Both were diagnosed with a form of autism. And it's partly because of children like them that autism appears to be skyrocketing: In the latest estimate, as many as one in 150 children have some form of this disorder. Groups advocating more research money call autism "the fastest-growing developmental disability in the United States."

-----


Lafayette Journal and Courier story:

Excerpt:
Indiana's human services chief told a state panel today that Hoosier Healthwise is delivering better psychiatric treatment to needy children since it switched to a managed care system in January.

Advocates for consumers and mental health providers, however, said it wasn't clear from data presented to the Commission on Mental Health whether children and adolescents with depression, anxiety and other mental illnesses were better served now than under a traditional fee-for-service program that ended Dec. 31.

Secretary Mitch Roob of the Family and Social Services Administration presented the data, including statistics showing the three Hoosier Healthwise insurers had approved outpatient care for 89 percent or more of minors diagnosed with mental illnesses during the first eight months this year. That compared with about 40 percent under fee-for-service in 2006.

"I think we have made enormous strides in managing mental health care," Roob said.

-----


from MSNBC:

Excerpt:
The country’s leading pediatricians group is making its strongest push yet to have all children screened for autism twice by age 2, warning of symptoms such as babies who don’t babble at 9 months and 1-year-olds who don’t point to toys.

The advice is meant to help both parents and doctors spot autism sooner. There is no cure for the disorder, but experts say that early therapy can lessen its severity.

-----


ZDNet commentary:

Excerpt:
The result is a circular logic which impacts all health policy areas. There is a large constituency which doesn’t believe in mental health care, because they couldn’t get it or their parents couldn’t. And this increases the resistance of many institutions to recognizing mental health issues when they arise.

How many poor black kids might be saved from a life on the streets if we simply diagnosed their ADHD and got them the help they deserve? These are some of our best and brightest. If ADHD affects 5% of kids in Atlanta Public Schools alone, that’s 2,500 mostly-black kids being treated with a strap when therapy might get results.

-----


You did it! Grassroots’ voices were critical in the Senate’s passing the FY 2008 Labor, Health and Human Services, Education Appropriations bill (HR 3043) this week by a veto-proof margin, 75-19. As a result, we’re a step closer to adequate federal funding in the coming year for mental health services and supports. Your voice remains crucial in hurdling obstacles that lay in the days ahead.  Please speak out again!

Two goals must be met: The Senate and House must reconcile their separate approaches and take up a measure that supports agencies and programs at the highest possible funding levels and to assure maximum resources for mental health needsThe House-Senate “conference” measure must pass by veto-proof margins. Your support is particularly critical to win wide, bipartisan support for investments in programs, services and research funded by this bill, especially in the House, which came up two votes short of a veto-proof margin last July.

Write your Representative and Senators now. Join us in reminding them that a vote for this bill is a vote for mental health - for consumer-centered programs, safe schools-healthy students, suicide prevention and for moving research findings to community practice. These and other human-services programs have for too long been under-funded and even threatened with elimination.

-----


from MSNBC:

Excerpt:
It can happen to anyone, from any walk of life, when you least expect it. A child can be diagnosed with autism. An aging parent can be diagnosed with Alzheimer’s disease. A middle-aged spouse can be diagnosed with any number of incapacitating mental disorders.

While such illnesses take an obvious emotional toll, they can hurt families financially as well.

-----


from MSNBC:

Excerpt:
At a recent pre-school musical, my son was to stand single file onstage with 13 classmates and perform "Let's All Sing Like the Birdies Sing" while flapping the wings of his bright yellow canary suit. As the other kids sang, fidgeted or stood there, stunned by the audience, he broke ranks and began marching to his own tune. He spun, then stomped, then shimmied his way out of line as if responding to several different styles of music no one else could hear. Seemingly unfazed by the crowd of parents seated before him, he wandered about the stage, shouting his own improvisational lyrics (something about babies and broccoli), which were picked up by a nearby mike and broadcast throughout the auditorium. As the other parents laughed, I vacillated between feelings of pride (my son's such an individual!) and fear (why is he so different?).

-----


from Rescue Post:

Excerpt:
Did you notice the coverage last week of the 40-fold increase in bipolar disorders among children? The "experts" and their Big Media outlets could barely get the facts out – that a new study found a stupendous increase in the disorder between 1993 and 2004 – before they started swatting them down.

Case in point: The second paragraph of the Washington Post story -- "But even one of the authors of the report in the September issue of Archives of General Psychiatry isn't certain whether this represents a dramatic increase in the number of people who actually have the disorder."

That is classic pseudo-objective journalese -- "but even," "isn't certain," "actually have the disorder." The effect, without having to say so, is to immediately deflect the reader from the raw evidence, which deserves to be taken seriously before it is analyzed into meaningless mush by the second paragraph. Is there no one on the planet who actually thinks this increase, or a disturbing chunk of it, is real? If they do exist, they're not quoted anywhere in the story, only the epidemic deniers.

This rush to downplay and deny any real increase in childhood disorders will be familiar to many of you involved in the autism debate. It's amazing how quickly the most troubling implications of such studies are brushed aside.

-----


Washington Post story:

Excerpt:
Warnings from federal regulators four years ago that antidepressants were increasing the risk of suicidal behavior among young people led to a precipitous drop in the use of the drugs. Now a new study has found that the drop coincides with an unprecedented increase in the number of suicides among children.

From 2003 to 2004, the suicide rate among Americans younger than 19 rose 14 percent, the most dramatic one-year change since the government started collecting suicide statistics in 1979, the study found. The rise followed a sharp decrease in the prescribing of antidepressants such as Prozac, Zoloft and Paxil after parents and physicians were confronted by a barrage of warnings from the Food and Drug Administration and international agencies.

The data suggest that for every 20 percent decline in antidepressant use among patients of all ages in the United States, an additional 3,040 suicides per year would occur, said Robert Gibbons, a professor of biostatistics and psychiatry at the University of Illinois at Chicago, who did the study. About 32,000 Americans commit suicide each year.

-----


MSNBC story:

Excerpt:
When Marianne Peters’ daughter started sixth grade, she was stunned when the girl’s teacher wouldn’t let anyone leave the classroom to use the bathroom.

“I mean, can you imagine thinking it’s better for a student to stay in the room trying to hold it in?” says Peters, a Rockport, Mass., office manager. “I called the guidance counselor and said, ‘I’m going to empower my child to raise her hand and tell the teacher she’s leaving the room to use the bathroom whenever she needs to.’”

That little bit of advocacy worked for Peters and her daughter, even though this was one of the few times that she actually encouraged her child to break a teacher’s rule. The teacher agreed to let students use the bathroom when they asked and, in the end, both Peters and her daughter ended up really liking and respecting him.

-----


NY Times story:

Excerpt:
Common food additives and colorings can increase hyperactive behavior in a broad range of children, a study being released today found.

It was the first time researchers conclusively and scientifically confirmed a link that had long been suspected by many parents. Numerous support groups for attention deficit hyperactivity disorder have for years recommended removing such ingredients from diets, although experts have continued to debate the evidence.

But the new, carefully controlled study shows that some artificial additives increase hyperactivity and decrease attention span in a wide range of children, not just those for whom overactivity has been diagnosed as a learning problem.

The new research, which was financed by Britain’s Food Standards Agency and published online by the British medical journal The Lancet, presents regulators with a number of issues: Should foods containing preservatives and artificial colors carry warning labels? Should some additives be prohibited entirely? Should school cafeterias remove foods with additives?

After all, the researchers note that overactivity makes learning more difficult for children.

-----


Digital50.com story:

Excerpt:
Give an Hour, a non-partisan, non-profit organization offering free mental health services to returning Veterans and their loved ones, announces that there are 575 providers, nationwide, on its network ready to help America's Armed Forces and their families.

In an effort to supplement the mental health services already provided to the military through the military health care system, Give an Hour's services are available to the service member, their immediate family, and their extended families and loved ones, including parents, siblings and significant others (who are often directly affected but not covered by the military).

-----


Washington Post story:

Excerpt:
The parents had tried with little success to cope with their son's accelerating deterioration. Unable to concentrate, he had dropped out of college and moved back home. When he could no longer function at the job he had held briefly, his parents kept him sequestered in their house, his condition a closely guarded secret. By the time the trio arrived in the emergency room, the youth was hallucinating and had assaulted his parents.

When psychiatrist Amir Afkhami asked why the couple had waited two years to seek treatment for their son's schizophrenia, the answer was simple: "We thought he was just spoiled."

-----


Duke University Medical Center investigators, in their basic research into how individual brain cells communicate with each other, discovered serendipitously that mice with a genetic mutation that prevents their brain cells from producing one key protein exhibited OCD-like behavior.

The finding may have uncovered important clues about a possible mechanism for OCD, a debilitating psychiatric condition affecting up to 2 percent of the world's people.

The international team of researchers, led by Duke molecular geneticist Guoping Feng, Ph.D., reported its findings in the August 23 issue of the journal Nature. The research was supported by the National Institutes of Health, the McKnight Endowment Fund for Neuroscience, and the Hartwell Foundation.

"The mice that could not produce this protein exhibited behaviors similar to that of humans with OCD, a compulsive action coupled with increased anxiety," Feng said. "We obviously cannot talk to mice to find out what they are thinking, but these mutant mice clearly did things that looked like OCD."

OCD is one of the most common psychiatric disorders in the world. It is marked by persistent intrusive thoughts (the obsession), repetitive actions (the compulsion) and anxiety. The severity OCD varies widely from person to person, and while the neurobiological basis of the disease is unknown, there are indications that genetics play a role, Feng said.

In their experiments, the Duke team focused on a portion of the brain known as the striatum, an area that controls the planning and execution of movement, as well as other cognitive functions. It is in many ways "the decider." In normal brains, a protein known as SAPAP3 is crucial for nerve signals to travel from one nerve cell to another across the synapse, the gap between the cells.

"This protein is important for allowing messages to cross synapses, and it is produced at high levels in the cells that make up the striatum," Feng explained. "When we looked closely at the brain cells of these mutant mice, we found that there were defects in the synapses.

"When we returned the protein into the striatum of brains of the mutant mice, the synaptic defects were repaired and their OCD-like behaviors subsided," Feng continued. "This is the first direct evidence that a synaptic defect in the striatum caused these OCD-like behaviors."

The researchers also found that a class of drugs known as selective serotonin reuptake inhibitors (SSRI) reduced the anxiety levels and suppressed the over-grooming in the mutant mice, further suggesting that what they observed in mice may also be analogous to human OCD. Serotonin, like SAPAP3, is one of many neurotransmitters, chemicals involved in nerve cell communication.

While SSRIs are the most commonly prescribed drug for humans with OCD, they are only effective for about half the patients, suggesting to Feng that many pathways involving different neurotransmitters are likely involved.

Feng and other colleagues at Duke are currently looking for additional gene variations that may affect how nerve signals cross synapses, and they are also beginning studies to determine if the gene mutant they discovered in mice plays a role in humans with OCD.

For this study, Feng collaborated with William Wetsel and Nicole Calakos from Duke University; Richard Weinberg from University of North Carolina at Chapel Hill; Serena Dudek from the National Institute of Environmental Health Sciences; as well as researchers from Zhejiang University School of Medicine, China; University of Coimbra, Portugal; and Gulbenkian Science Institute, Portugal.

-----


Science Daily Melbourne mental health researchers have succeeded in halving the number of relapses experienced by people with bipolar disorder which strikes two in 100 Australians, accounts for 12 per cent of suicides each year and costs the country at least $1.5 billion annually.*

With funding from the MBF Foundation and Beyond Blue, a team led by the Mental Health Research Institute of Victoria has developed an innovative structured group program to help people with bipolar disorder to better manage their condition.

The 12-session program, led by trained mental health clinicians, enables people battling the disorder to effectively monitor their mood, assess personal triggers and early warning signs of oncoming illness and take the necessary steps to stay well.

In a controlled randomised study of 84 people diagnosed with bipolar disorder, those on the special intervention program had half the number of relapses after 12 months as the control group which continued with normal treatment. Even with modern drug therapies that act as mood stabilisers, relapse rates for people with bipolar disorder are as high as 40 per cent in the first year and almost 75 per cent over five years.

MBF general manager health product, Michael Carafillis, said the new program provides a much-needed bridge between the mental health services that treat people when they are acutely ill and the GPs and private psychiatrists who provide ongoing care.

"Bipolar is a complicated disease involving periods of depression and mania and its sufferers don't always take their medications when they should," said Mr Carafillis.

"People with the condition straddle the divide between public and private systems resulting in poor continuity of care for many sufferers. They tend to gain access to the public system in the most severely disabling phase of their illness, typically mania, and are often too ill and the disorder too complex to be easily managed in primary care."

Professor David Castle at the Mental Health Research Institute of Victoria said providing people with bipolar disorder with the right tools and strategies to better self-manage their disease in a supportive group environment can substantially reduce the burden on individuals, their families and the health system.

Buoyed by the exciting results, the research team is now training clinicians in metropolitan and regional Victoria. The development of an accompanying service delivery framework, already being implemented in parts of Victoria, South Australia and the ACT, will enable the program to be rolled out in other states.

* Access Economics report (2003) commissioned by SANE Australia

-----


from healthyplace.com:

Excerpt:
What remedy is there for the teenage girl with bipolar disorder who suffers suicidal depression for several days before each menstrual period? How do bipolar illness and its treatments affect a girl’s sexual feelings, fertility, and unborn children? What can parents do to keep a risk-loving daughter safe as she passes through adolescence?

As parents, we dread our daughters’ descent into the maelstrom of raging hormones, bipolar mood swings, adolescent rebellion, street drugs and alcohol, and medication side-effects. Families seeking professional guidance often feel trapped in a revolving door of disjointed referrals—to pediatricians, psychiatrists, psychotherapists, substance abuse counselors, gynecologists and endocrinologists—hearing from each some version of “sorry, that’s not my area of expertise.” Meanwhile, a girl’s energy, judgment, demeanor and appearance can vary dramatically throughout the month depending on which biochemical, hormone, or neural circuit has seized the reins. Bonds forged or projects begun in periods of wellness or mania may be abandoned in despair or derailed by impulsive self-injury and suicide attempts, which themselves bring further trauma. Periods of extended grief and shame can occur when a girl comprehends the depth of her wounds.

------


from MSNBC:

Excerpt:
Training the brains of children with attention-deficit hyperactivity disorder (ADHD) using a technique called neurofeedback can improve their behavior and reduce hyperactivity and impulsivity, according to a team of Swiss and German researchers.

But the strategy doesn’t work for every child and shouldn’t be thought of as a replacement for drug treatment, Dr. Renate Drechsler of the University of Zurich, the study’s lead author, told Reuters Health.

-----


from CNN:

Excerpt:
Do you take care of someone in your family with a chronic medical illness or dementia? Have you felt depression, anger or guilt? Has your health deteriorated since taking on the responsibility of caregiving? If your answer is yes to any one of these, you may be suffering from caregiver stress.

This condition is increasingly being referred to as "caregiver syndrome" by the medical community because of its numerous consistent signs and symptoms. In the pamphlet, "Caring for Persons with Dementia," Dr. Jean Posner, a neuropsychiatrist in Baltimore, Maryland, referred to caregiver syndrome as, "a debilitating condition brought on by unrelieved, constant caring for a person with a chronic illness or dementia."

-----


from Newsweek:

Excerpt:
It's finally dawning on scientists that there's a problem here. Testing autistic kids' intelligence in a way that requires them to engage with a stranger "is like giving a blind person an intelligence test that requires him to process visual information," says Michelle Dawson of Rivière-des-Prairies Hospital in Montreal. She and colleagues therefore tried a different IQ test, one that requires no social interaction. As they report in the journal Psychological Science, autistic children's scores came out starkly different than on the oral, interactive IQ test—suggesting a burning intelligence inside these kids that educators are failing to uncover.

-----


from Kansas City Star:

Excerpt:
It’s in a bundle of wet bedsheets on the floor of a 5-year-old boy’s room.

It’s in the diaries of dozens of girls at a summer camp.

Anyone who spends time around the children of American troops can see it. There is depression, anxiety, anger, defiance, nightmares and other sleeping problems. There are headaches, stomachaches, high blood pressure and more.

-----


from Forbes:

Excerpt:
New research from the National Institute of Mental Health gives 15 million people suffering with depression hope for a future faster-acting antidepressant. The medication ketamine begins to take effect on the brain cells involved in depression within hours, researchers report.

"Our research is showing us how to develop medications that get at the biological roots of depression. This new finding is a major step toward learning how to improve treatment for the millions of Americans with this debilitating disorder; toward eliminating the weeks of suffering and uncertainty they have to endure while they wait for their medications to work," Dr. Elias Zerhouni, director of the National Institutes of Health, said in a prepared statement.

-----


from The Independent:

Excerpt:
Since the 'IoS' reversed its policy on legalising cannabis because of the drug's links with mental illness, many have joined the campaign to highlight its dangers. Here we report on the latest findings to cause concern.
By Jonathan Owen and Suzi Mesure

A poll of more than 50 of the world's leading authorities on drugs and mental health confirms that most believe cannabis, and particularly its stronger variant, skunk, pose significant health risks and increase users' susceptibility to psychosis and schizophrenia.

-----


"Lithium is the prototype mood stabilizer for treating adult bipolar disorder, but it is not FDA-approved for use in kids younger than 13," said Mani Pavuluri, director of the Pediatric Mood Disorders Clinic at UIC's Institute for Juvenile Research. "We do not have a perfect drug that cures all aspects of bipolar disorder, but knowing more about lithium -- and how it affects children -- may bring us closer to managing this devastating disorder."

Results from the Collaborative Lithium Trials will provide the first comprehensive analysis of lithium treatment for pediatric bipolar disorder, according to Pavuluri.

UIC researchers are recruiting patients between 7 and 17 with bipolar disorder. The study will evaluate medication dosage strategies, drug efficacy, and short- and long-term safety and tolerability.

Pediatric bipolar disorder, also known as manic depressive disorder, is characterized by extreme and unusual changes in mood, ranging from mania to depression. Symptoms of mania can include extreme or persistent euphoria or irritability, inflated self-esteem, increased energy and a decreased need for sleep. Depressive symptoms may include physical complaints such as headaches, tiredness, lack of interest in activities, or social isolation.

In children, the disorder interferes with normal, healthy functioning and is associated with suicide, school failure, and risk-taking behaviors such as sexual promiscuity and substance abuse.

The prevalence and incidence of pediatric bipolar disorder is unknown.

"Lithium has proven to be effective in preventing future episodes of bipolar disorder and reducing suicidal thoughts in adults," said Pavuluri, who leads the UIC trial. "This study will help us to determine if lithium may have a similar protective effect in pediatric patients and help us to develop future treatment protocols."

-----


from MSNBC:

Excerpt:
Autism spectrum disorders affect about one in 150 children. Often doctors don't diagnose the disability--which is characterized by impairments of social interaction and communication--until age 3. And yet, experts say earlier diagnosis is critical, since it can lead to earlier intervention and better outcomes. The good news: in a study appearing this week in the Archives of General Psychiatry, researchers say they have successfully identified autism in children as young as 14 months--the earliest the disorder has ever been diagnosed.

-----


Washington Post story:

Excerpt:
Authorities' abilities to identify potentially dangerous mentally ill people are crippled across the nation by the same kinds of conflicts in privacy laws that prevented state officials from being able to intervene before Seung Hui Cho went on his rampage at Virginia Tech, according to a federal report commissioned after the Blacksburg shootings that was presented to President Bush yesterday.

Because school administrators, doctors and police officials rarely share information about students and others who have mental illnesses, troubled people don't get the counseling they need, and authorities are often unable to prevent them from buying handguns, the report says.

The report was released on the day that the House of Representatives passed a bill designed to make it more difficult for people with mental health problems, such as Cho, to buy firearms.

Lawmakers said the measure, the first major gun-control legislation since 1994, would improve the national gun background check system by requiring states to report their list of mentally ill people who are prohibited from buying firearms to the National Instant Criminal Background Check System.

-----


Approximately 9 percent of youths aged 12 to 17, and 7.6 percent of adults aged 18 or older, experienced at least one major depressive episode (MDE) in the past year according to data released today by the Substance Abuse and Mental Health Services Administration (SAMHSA).

SAMHSA Administrator Terry Cline, Ph.D., released the findings at a Mental Health America meeting held in Washington, DC, on June 9th.

The new analysis from SAMHSA's National Survey on Drug Use and Health

(NSDUH) shows that among 12 to 17 year olds, rates of past year MDE were among the highest in Idaho (10.4 percent) and Nevada (10.3 percent).

The rates were among the lowest in Louisiana (7.2 percent) and South Dakota (7.4 percent).  


 "The complexities associated with mental health problems leave states with a heavy responsibility to provide effective and responsive mental health promotion, treatment and recovery support services.  These data add to the information state mental health authorities use to plan for and allocate resources," SAMHSA Administrator Terry Cline, PhD said.


State estimates of past year MDE were produced using data from the combined 2004 and 2005 NSDUH surveys.  The prevalence of MDE in each state is based on standard definitions and survey methods applied uniformly throughout the nation.

According to the survey, rates of past year MDE among adults aged 18 or older were among the highest in Utah (10.1 percent) and Rhode Island

(9.9 percent).  Hawaii and New Jersey had rates among the lowest (6.7 percent and 6.8 percent respectively). 

The survey also showed that there were few statistically significant differences across states in the rates of past year MDE among youths and adults. The  survey did not look at reasons for the interstate variances.

MDE, as defined by the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), specifies a period of two weeks or longer during which there is either depressed mood or loss of interest or pleasure and at least four other symptoms that reflect a change in functioning, such as problems with sleep, eating, energy, concentration, and self-image.

State Estimates of Depression: 2004 and 2005 National Surveys on Drug Use and Health (NSDUH) is available on the Web at http://oas.samhsa.gov/2k7/states/depression.cfm.

-----


Young adults beginning treatment with antidepressants should be warned about an increased risk of suicidal thoughts and behavior, federal health officials said Wednesday.The Food and Drug Administration proposed labeling changes that would expand a warning now on all antidepressants including Prozac made by Indianapolis' Eli Lilly and Co. The current language applies only to children and adolescents. The expanded warning would apply to adults 18-24 during the first month or two of treatment with the drugs, the FDA said.

The proposed labeling changes also would note that studies have not shown this increased risk in adults older than 24, and that adults 65 and older taking antidepressants have a decreased risk of suicidal thoughts and behavior, it said.The proposed expanded warnings emphasize that depression and certain other serious psychiatric disorders are themselves the most important causes of suicide.

"Antidepressant medications benefit many patients, but it is important that doctors and patients are aware of the risks," said Dr. Steven Galson, the FDA's drugs chief.

The proposed changes came with the endorsement of FDA expert advisers. Some experts have argued that the changes are overdue while others maintain they could keep drugs from those who need them.

Last month, a comprehensive analysis of antidepressants for children and teenagers found the benefits of treatment trump the small risk of increasing suicidal thoughts and behaviors in some patients. The Journal of the American Medical Association study also found that risk is lower than what the FDA identified in 2004, the year the agency warned the public about the risks of the drugs in children.

The proposed label changes would apply to all antidepressants, including Lexapro (Forest Laboratories Inc.), Paxil (GlaxoSmithKline PLC), Prozac (Eli Lilly and Co.) and Zoloft (Pfizer Inc.). Some of the drugs are available in generic form as well.

Messages left with the companies were not immediately returned.

Food and Drug Administration antidepressant information----


from Newswise:

Excerpt:
Children with depression or ADHD and their parents not only face the challenge of an illness, but may confront the stigma that accompanies treatment and social rejection, according to the first-ever national study to examine Americans' views of mental health issues in children.

The four-part study, conducted by sociologists at Indiana University and colleagues from the University of Virginia and Columbia University, found a high level of skepticism regarding psychiatric medications, with 66 percent of respondents saying the medications just delayed solving the "real" behavior-related problems, and 86 percent saying physicians overmedicate children for common behavior problems. Most Americans were concerned about confidentiality and the immediate and long-term effects of treatment on children's futures.

While levels of prejudice appear to be lower than in studies related to adults, the researchers found that Americans report believing children with depression are more likely to behave in a violent manner, compared to their expectations of adults with depression. In fact, Americans see childhood depression as more serious, more in need of treatment and more problematic overall than adult depression .

-----


CNN story:

Excerpt:
Authors of a new comprehensive analysis of antidepressants for children and teenagers say the benefits of treatment trump the small risk of increasing some patients' chances of having suicidal thoughts and behaviors.

The risk they found is lower than the one the Food and Drug Administration identified in 2004, the year the agency warned the public about the drugs' risks in children. After the warning, U.S. youth suicides increased and some mental health experts said reluctance to try antidepressants might be the reason.

The new analysis includes data from seven studies that were not part of the previous FDA analysis, including two large pediatric depression trials that were unavailable three years ago.

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**Online Tool Provides IEP-Writing Assistance
The "Wrightslaw Game Plan: Smart IEPs" provides a compendium of tutorials and checklists to help parents and teachers write effective Individualized Education Programs (IEPs) with measurable goals and objectives. Offering a walk-through of IEP writing, this tool provides help in areas such as identifying a child's unique needs, and constructing specific, relevant, achievement-based goals.
http://www.wrightslaw.com/info/iep.goals.plan.htm

-----



If parents and schools are to be partners in the education of children with disabilities, clear communication is essential. Although the Individuals with Disabilities Education Act (IDEA) requires schools to tell parents about their rights under the law -- referred to as "procedural safeguards notice" -- in "understandable language," most are falling short of this requirement, says a study reported in the research journal Exceptional Children. Under IDEA, schools are required to advise parents of their rights in a way that is easy to understand. Parents not only have the right and duty to participate in special education decisions, they can and should provide information about their child that no one else can provide. The decision to provide special services and the choice of services provided can be crucial to a child's future. The study, conducted at Pennsylvania State University by Julie Fitzgerald and Marley Watkins, examined Procedural Safeguards Notices (also called Parents' Rights Notices) from 49v states and the District of Columbia. Read this special report about the study and find out how your state's Procedural Safeguards Notice scored.

http://www.advocacyinstitute.org/advocacyinaction/Procedural_safeguards_Notice_Study.shtml  

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from MaineToday.com:

Excerpt:
When police and others respond to crises involving people with mental-health issues, it is critical the officers be properly trained to deal with those situations.

That is the belief driving Kennebec Valley Organization to seek commitments from police and other first responders to get special training offered free of charge by NAMI-Maine, the Maine branch of the National Alliance for the Mentally Ill.

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Children and youth with serious mental health needs make substantial
improvements at home, at school, and in the community when served through
systems of care that provide community-based services. Data released today
by the U.S. Substance Abuse and Mental Health Services Administration
(SAMHSA) at a Capitol Hill briefing show that children and youth in systems
of care spend less time in inpatient care, experience fewer arrests, make
improvements in their overall mental health and do better in school than
before enrollment.

A system of care for children's mental health is a coordinated network of
community-based services and supports that are organized to meet the
challenges of children and youth with serious mental health needs.
Families and youth work in partnership with public and private organizations
so services and supports are effective, build on the strengths of
individuals, and address each person's cultural and linguistic needs.

"Children and youth with serious mental health needs and their families
deserve the best care available," said SAMHSA Administrator Charles Curie.
"The systems of care approach is a proven approach that not only helps
children thrive in their homes and communities, it is a wise investment of
scarce resources."

The SAMHSA data suggest that systems of care save taxpayers money when
compared to the traditional mental health service delivery systems. On
average, systems of care save public health systems $2,776.85 per child in
inpatient costs over the course of a year, and save juvenile justice systems
$784.16 per child within the same time frame.
These and other data related to key outcomes, such as reductions in
suicide-related behaviors and reductions in juvenile detentions or
incarcerations can be found by visiting

The Capitol Hill briefing was led by the Federation of Families for
Children's Mental Health, the National Mental Health Association (NMHA) and
the National Association of Social Workers (NASW) and the National Alliance
on Mental Illness (NAMI) as part of the first-ever National Children's
Mental Health Awareness Day. This day is slated to become an annual event
celebrated during the first full week in May, which is Children's Mental
Health Awareness Week. May is also Mental Health Month.

The Comprehensive Community Mental Health Services Program for Children and
Their Families is a SAMHSA initiative. Since its authorization in 1992, the
program has funded a total of 121 programs across the United States that
have helped transform the way in which treatment and care are provided to
children with mental health needs and their families.

SAMHSA is a public health agency within the U.S. Department of Health and
Human Services. The agency is responsible for improving the accountability,
capacity and effectiveness of the nation's substance abuse prevention,
addictions treatment and mental health service delivery systems
The Center for Mental Health Services is a component of the Substance Abuse
and Mental Health Services Administration, United States Department of
Health and Human Services.www.systemsofcare.samhsa.gov.

-----


from NAMI:

Study Confirms That Stigma Still a Barrier to Psychiatric CareMarch 2006

A new study shows that while most Americans think that psychiatric drugs work, they probably wouldn’t ever use them.

The study, released by the Indiana Consortium for Mental Health Services at Indiana University, Bloomington, indicates that the stigma associated with taking antidepressants and psychiatric drugs remains high even though people increasingly understand mental illness and appreciate advances in treatment. Researchers found that:Approximately two-thirds said psychiatric drugs do help people with mental health issues deal with day-to-day anxiety, control their symptoms, and improve family relationships;

Just 56 percent said they would be willing to take medication to alleviate panic attacks;

41 percent would do so if they were diagnosed with depression;

And only about a third would be willing to take them for personal troubles or stress.

People may shy away from taking psychiatric drugs because they fear they will face stigma from others. “There is a real link in the public mind between mental illness and ‘dangerousness,’ and that is what is fueling the stigma,” said sociologist Bernice A. Pescosolido, director of the consortium. “Americans have become more sophisticated and knowledgeable about mental illness, and everybody assumed the stigma was going away.” But the results of this report clearly indicate that is not the case.

The report utilized data from the 1998 Surgeon General’s Social Survey of 1,400 Americans and was funded, in part, by the National Institute of Mental Health.

----


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·         A growing body of research has shown that early identification, assessment, and intervention for emotional and behavioral problems for young children through adolescence can help forestall or prevent more serious problems, such as educational failure, substance abuse, involvement in the criminal justice system, or suicide.  The most recent data suggest that, in any given year, between 5 and 9 percent of children and youth experience serious emotional problems that can hinder a child or adolescent’s ability to live a full and productive life. 

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from NIMH:

Excerpt:

 Researchers supported by the National Institute of Mental Health (NIMH) have found that half of all lifetime cases of mental illness begin by age 14, and that despite effective treatments, there are long delays — sometimes decades — between first onset of symptoms and when people seek and receive treatment. The study also reveals that an untreated mental disorder can lead to a more severe, more difficult to treat illness, and to the development of co-occurring mental illnesses.

The landmark study is described in four papers that document the prevalence and severity of specific mental disorders. The papers provide significant new data on the impairment — such as days lost from work — caused by specific disorders, including mood, anxiety, and substance abuse disorders. These measures will allow researchers to determine the degree of disability and the economic burden caused by mental illness, as well as trends over time

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(Ivanhoe Newswire) -- Childhood social development programs lead to more positive adulthood functioning, according to a recent study.Researchers from the University of Washington, Seattle, examined the long-term effects of a childhood social development program when participants reached 21 years of age. The program included teacher and parent training, and child social and emotional skill development. Children in a full-intervention group received about four years of intervention throughout elementary school. Those in a control group received no intervention.

Analysis shows students who received full intervention were more likely to graduate from high school, to complete at least two years of college, to stay at a job longer, and to have fewer social phobia and suicidal thoughts than students who did not receive intervention. The full-intervention group was also less likely to be involved in crime, to have sold illegal drugs in the past year, and to have an official lifetime court record.

Researchers say, "The transition to early adulthood is a challenging time for many young people. Young adults are vulnerable to emotional and mental health problems, involvement in crime, and growing problems with drugs and alcohol. Studies have shown the effectiveness of selective interventions in children from families in poverty in encouraging positive adolescent and adult outcomes. These results provide further evidence that early and sustained intervention in the elementary grades can help to put children on a more positive developmental trajectory that is maintained into early adulthood."

This article was reported by Ivanhoe.com, who offers Medical Alerts by e-mail every day of the week. To subscribe, go to:
http://www.ivanhoe.com/newsalert/.

SOURCE: The Archives of Pediatrics & Adolescent Medicine, 2005;159:25-31


Children's Hospital and Regional Medical Center Press Release
http://www.seattlechildrens.org/home/about_childrens/press_releases_a.asp?PR_id=179

Excerpt:

Early television exposure in children ages 1-3 is associated with attention problems at age 7, according to a study from Children’s Hospital and Regional Medical Center in Seattle published in the April issue of PEDIATRICS. The study revealed that each hour of television watched per day at ages 1-3 increases the risk of attention problems, such as ADHD, by almost 10 percent at age 7. The study controls for other attributes of the home environment including cognitive stimulation and emotional support.

The findings also suggest that preventive action can be taken to minimize the risk of attention problems in children. Limiting young children’s exposure to television during the formative years of brain development, consistent with the American Academy of Pediatrics’ (AAP) recommendations, may reduce a child’s subsequent risk of developing ADHD. The AAP recommends parents avoid letting their children under the age of 2 years watch television and that parents exert caution – such as setting limits on TV viewing, helping children develop media literacy skills to question, analyze and evaluate TV messages, and taking an active role in their children’s TV viewing – in children over the age of 2.

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Research from the University of Montreal in Canada concludes that interventions to prevent youth violence could take place even before and during pregnancy, Reuters reported July 16.

A study of 572 families with 5-month-old babies found that a child's tendency toward aggressive behavior is formed before birth, and may be related to the parents' behavior and background.

For instance, mothers who smoked during pregnancy, began having children at a young age, or had behavioral problems as youngsters were more likely to have a child who had a tendency to hit, kick, bite, or bully others.

In addition, mothers who frequently lost their tempers were more likely to have babies who showed physical aggression before the age of 4. Babies born into dysfunctional families also showed aggressive behavior at an early age.

Dr. Richard Tremblay, lead study author, concluded that genetics, parents'

past behavior, and environment all "affect the development of the brain and its capacity to regulate emotions, especially reactions to anger."

Tremblay said at-risk children need interventions in their preschool years to help them control physical aggression. One intervention recommended in the report was home visits from nurses.

The study's findings are published in the July 2004 issue of Pediatrics.

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Disordered eating behavior, including such conditions as anorexia nervosa and bulimia, affects as many as one in every 10 adolescents. The vast majority of those diagnosed with these psychological disorders are teen-age girls and young women.

Eating disorders, which can be serious and sometimes fatal, typically affect girls between the ages of 14 and 19. But some experts caution that girls are now becoming concerned with diet behaviors and body shape at a much earlier age.

According to Terrill Bravender, M.D., assistant professor of pediatrics at Duke University Medical Center, there are two peak ages for true eating disorders. "The first is usually about age 14, toward the end of the major physical changes of puberty," he says. "We see it again in early college-age kids, ages 18 or 19, during a time that for some people is a tough transition period."

Bravender, who is medical director of the
Duke Eating Disorders Program, notes, however, that early signs of disordered eating behavior are increasingly beginning to appear in younger girls.

"Concerns about body and diet are starting at very young ages, as early as age 7 or 8," Bravender says. "It's not uncommon to hear girls of this age say they need to be on a diet or that they're watching what they eat. One survey a few years ago actually showed that about 40 percent of 9- and 10-year-old girls said that they were on a diet to lose weight."

Bravender says this could be an early warning sign of danger ahead.

"While we haven't seen an increase in the number of very young kids presenting with symptoms of an eating disorder, the more body and diet concerns that are out there, the more it opens the door for potentially developing eating disorders years hence. If it starts at a younger and younger age, that means we have more and more kids at risk."

"We live in a media- and diet-saturated culture," he adds, "and younger kids tend to imitate what they see around them. They imitate what they see on television, what they read in magazines, and they certainly imitate their parents' behavior.

"This is why one of the most important things parents can do is to examine their own eating behaviors. If you call a food 'bad,' as in, 'I was so bad tonight. I had dessert,' kids will internalize this sort of message. Parents can help by taking a healthy and moderate approach to food themselves."

Bravender says he does not want to alarm parents about early warning signs for potential problems, but he does suggest some things to look for.

"All kids will go through phases of eating different kinds of foods, so I wouldn't want parents to worry if a child stops eating something they used to enjoy. But if a child begins to show anxiety about food -- always worrying about how fattening it is -- or starts to show a lot of body-shape concerns -- spending an unusual amount of time in front of the mirror -- I'd be concerned."

contact sources : Terrill Bravender , 919-620-5374
relevant links : http://www.dukehealth.org




 
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