The Child Mind BlogBrainstorm

  • ADHD Linked to Delayed Development of Brain Interconnections
    Sept. 16, 2014 Harry Kimball

    In the past few years advances in brain imaging technology have allowed scientists to discover many new things about how psychiatric disorders manifest in the brain. One of those discoveries was that, structurally, the brain of a young person with ADHD was different than a so-called "typically developing control." Now, we have a new finding that comes from the new science of brain connectomics—the study of how the brain's different regions are functionally connected. Or, more colloquially, how the brain talks to itself to make us, well, work.

    University of Michigan researchers, working off of open-source data originally collected by CMI's own Michael Milham, MD, PhD, for the ADHD-200 Consortium, analyzed scans of over 400 children and adolescents, some with ADHD and some without. They found, in essence, two things. First: the differences in the ADHD brain in terms of connectivity between regions and networks mirrors the differences in terms of structure. And second: ADHD brains, when compared to typically developing brains, seem to have been delayedto have fallen behind.

    How these networks and brain regions match up to ADHD symptoms is truly fascinating. "It is particularly noteworthy that the networks we found to have lagging maturation in ADHD are linked to the very behaviors that are the symptoms of ADHD," lead author Chandra Sripada tells ScienceDaily. It really seems as though scientists are homing in the underlying causes of the disorder. But it's also important to note how they are getting there: through ever larger and larger datasets and through sharing.

    "Without the database of fMRI images," Sripada continues, "and the spirit of collaboration that allowed them to be compiled and shared, we would never have reached this point."

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  • Early Autism Treatment Eases Symptoms by Age 3
    Sept. 9, 2014 Harry Kimball

    For kids with autism, early intervention is getting even earlier. We're reading today about a small pilot study out of the UC Davis MIND Institute, which suggests a treatment called Infant Start can eliminate autism symptoms if they are identified in the first year or so of life.

    In the study, seven children, aged 6 to 15 months, who were "highly symptomatic and at risk of developing ASD," according to ScienceDaily, were treated by their parents, who were trained in how to interact with their kids to encourage social learning, reciprocity, and attention. In effect, the clinicians taught parents how to teach their children to overcome some of the hallmark deficits of autism—very early, and using the parent-child bond. By age 3 or earlier, 6 of the 7 children were developing typically.

    "It was the parentsnot therapistswho did that," says Sally J. Rogers, PhD, the lead author and developer of a successful intervention for older kids, the Early Start Denver Model. Given the increasing ability of clinicians to identify signs of autism early, an intervention targeting younger kids is welcome to many. "This paper is very important because it's a first effort to have treatment research catch up with the early diagnosis work," Paul Wang, a senior researcher at Autism Speaks, tells the Sacramento Bee.

    Right here last month, Beth Arky wrote about another set of studies suggesting some kids can "beat" autism and leave the diagnosis behind after intensive early intervention. Some parents and advocates were sour on the idea that kids could or should "recover" from autismparticularly if "intensive" intervention cost an intensive amount of money. The UC Davis study is saying something different, I think: first, the intervention is "low intensity and could be carried out by the parents in everyday routines," as described in ScienceDaily.

    Second, and perhaps more importantly to parentsor to advocates who think of autism as an identity, not an illnessare the words of Dr. Rogers. "I am not trying to change the strengths that people with ASD bring to this world," she says. "People with ASD contribute greatly to our culture. The diversity of human nature is what makes us a powerful and strong species. We are trying to reduce the disability associated with ASD." That seems like a goal that everyone who is invested in the lives of people with autism should be able to agree to.

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  • Drew Carey Comes to the Aid of Autistic Teen
    Sept. 8, 2014 Beth Arky

    Drew Carey threw the spotlight on a revolting prank targeting an autistic teen when he pledged a $10,000 reward to help the local police find the high schoolers behind it. What they did was dump a bucket of feces, urine and spit on the special-needs student, who had been told it was part of the viral ALS "Ice Bucket Challenge" fund-raiser.

    "WTF? Just saw this. Horrendous," the Price Is Right host Tweeted Friday. "These kids should be arrested and expelled." The incident happened in Bay Village, a suburb of Cleveland, Carey's hometown.

    The 14-year-old victim's mother discovered the video of the twisted prank on his cell phone; it had been posted on social media. She said her son was embarrassed and didn't want to tell anyone afterward. Bay Village police chief Mark Spaetzel said the video is one of the most disturbing things he's ever seen.

    It's hard to comprehend that high school kids could be this cruelly lacking in empathy. It's all the worse knowing that the victim was apparently targeted because of his "otherness" and vulnerability; it's likely he did nothing to provoke such a mortifying act.

    In case the reward isn't needed, Carey added an offer to give unused money to Autism Speaks, drawing praise from the likes of autism mom Holly Robinson Peete. But the comic waded unknowingly into controversial waters; there's a vocal anti-AS camp that opposes the organization's goal of "curing" autism through research, rather than endorsing neurodiversity and helping adults with autism. Their twitter campaign was vehement enough that Carey responded he would donate the money to "some worthwhile organization regardless."

    Meanwhile, Jenny McCarthy—who has made the controversial claim that she "cured" her son of autism­­—tweeted Sunday night that she would match Carey's $10,000 offer.

    We'd love to think that the public revulsion over this act will get through to the kids who apparently thought it was funny in the first place to afflict another teenager because he is different.

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  • What Mo'Ne Davis Means to Girls
    Aug. 19, 2014 Rachel Ehmke

    Hearing "You throw like a girl" jokes is one of those things nearly all girls put up with at some point. Like mosquitos in the summer, you can pretty much count on them.

    That's why Mo'Ne Davis is such a big deal. If you haven't heard of her yet, she's the first girl to ever throw a shutout in the Little League World Series, which is going on right now. Actually she's thrown back-to-back shutouts if you count the 8-0 win against Delaware that qualified her team, the Taney Dragons out of Philadelphia, to head to the World Series. She's one of only two girls playing in the tournament right now, and one of 18 girls in the history of the series. She's 13 years old and throws a 70mph fastball. Also she says that baseball isn't even her favorite sport—that's basketball.

    Mo' Ne Davis

    If you have a daughter, she's going to hear that she throws like a girl. Even if she plays on a baseball or softball team, even if she knows exactly how to throw, she's going to hear it. She'll know that it's silly, but it still might rankle. So it's good that now she has Mo'Ne Davis to reassure her that throwing like a girl can be a great thing. And, if necessary, now she can send boys this Vine of Davis striking out a boy.

    Read More:  13 Ways to Boost Your Daughter's Self-Esteem 

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  • Robin Williams and Depression
    Aug. 12, 2014 Harold S. Koplewicz, MD

    When someone like Robin Williams takes his own life, it's a stunning reminder of how powerful emotional anguish can be. It's a reminder that profound emotional pain can occur in the talented, the successful, the admired, the well-loved. And it's a reminder of how difficult it can be to reach someone struggling with depression—especially someone who thinks you don't want to hear about it.

    Robin Williams and Depression

    Williams spoke openly about his substance abuse problems; less openly about his emotional struggles. He talked with interviewers about cocaine and alcohol repeatedly, he did comic riffs on his outrageous behavior when he was on a bender. But when Terry Gross asked him, after a stint in rehab, if he had ever been diagnosed with depression or bipolar disorder, he said, "No. I get bummed, like I think a lot of us do at certain times."

    In a a podcast interview with comic Marc Maron, who also wrestled with depression, Williams talked about how hard it can be for a comic to decide how far to go with an audience—how dark you can allow yourself to be. Let's say you're feeling insecure, maybe desperately insecure, he said, and you're going with it, and you can tell the audience is with you, they're feeling it. Then you cross some kind of line, you sense them going, "No, no, no. I don't want to go there."

    I can't help thinking that this is a good description of the way you feel when you suffer from depression—you sense that you're testing the limit all the time, at risk of crossing the line of what people around you are comfortable hearing. You worry about driving people away by being too negative. There's a very powerful voice telling you not to ruin the image people have of you by admitting how bad it is. That reticence is what we need to combat, by making it clear that we do want to hear, and we do want to help.

     "Robin was as sweet a man as he was funny," Jimmy Kimmel tweeted, but it's what he wrote next that hits home: "If you're sad, please tell someone."

    Or, as Williams' friend Harvey Fierstein put it more colorfully on Twitter: "Please, people, do not fuck with depression. It's merciless. All it wants is to get you in a room alone and kill you."

    We can only guess that Williams was not silent with those close to him about the pain that drove him to take his own life. He was in addiction treatment just last month; his wife and management team acknowledge that he was struggling with depression. His death, after so many years of struggle, and so many years of sobriety, reminds us of Philip Seymour Hoffman, who died of a heroin overdose earlier this year after a similarly long clean streak. His chronic illness appears to have caught up with him.

    We worry particularly, in moments like this, about teenagers, who take their lives in truly alarming numbers, and often—especially among young men—without giving a hint to the people who love them that they are miserable. We need to get the message to them that talking about depression won't make us think less of them, and that support and help can make a difference.

    I am reminded of this TED talk by Kevin Breel, a young comic who recalls coming very close to taking his life as a teenager. He was living two different lives, he says, one as a popular and successful high school student and stand-up comic, the other as a depressed and suicidal person. The anguish was too powerful to ignore, but too powerful to admit, too. "I was afraid someone would see that beneath my big personality hid an even bigger big pain. "

    It was the difficulty of acknowledging his depression that drove him to obsess about ending his problems with a bottle of pills.  "What you fear most is not the suffering inside of you," Breel said, "it's the stigma inside of others. It's the shame, the embarrassment, the disapproving look on a friend's face, the whispers in the hall that you're weak, the comments that you're crazy, so you hide it because the stigma around depression is real."

    That's what we have to fight—to speak up, as Breel did, about depression, and to offer support to those we know are struggling.

    Comedian Paul F. Tompkins brings it back to Robin Williams. "Perhaps the best tribute to him would be if we all reached out to the troubled people in our lives and let them know that we are here for them. Because Robin Williams was there for us."

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  • Treating Schizophrenia Early, and as a Family Affair
    Aug. 8, 2014 Harry Kimball

    Thanks to the American Academy of Child and Adolescent Psychiatry newsletter for pointing us towards a story about a radical intervention for schizophrenia: treating it early, comprehensively, and involving everyone in a young person's life, including family and teachers.

    The Washington Post reports on a program developed in Maine that identifies pre-psychotic young people and enrolls them in "an intensive two-year course of socialization, family therapy, job and school assistance, and, in some cases, antipsychotic medication." "Pre-psychotic" means they exhibit certain symptoms, like hearing voices or experiencing disorganized thinking, but have not yet had a severe psychotic break. Research suggests that kids in the program are more likely to have jobs or stay in school, and that the program has even dramatically reduced hospitalizations for psychotic breaks in some areas.

    There are still big questions about this sort of early intervention for severe mental illness, particularly in regard to pre-diagnosis medication treatment. "That is not a benign intervention," a NIMH scientist tells the Post, in a considerable understatement. And no one claims that schizophrenia can be cured, or even truly prevented. There are many heartening personal stories in the Post article, but it would be foolish to say that the young people profiled aren't still at risk.

    Still, the big picture view of mental illness the program espousesbiology, environment, interpersonal relationships—seems like a welcome evolution. As the Post reports: "A large part of the treatment focuses on the family; the Eugene program even helped one mother get a job."

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  • Childmind.org Reaches Out to Spanish Speakers
    Aug. 5, 2014 Harry Kimball

    We're pleased to report that we have launched the "pilot" version of childmind.org/espanol. We've translated more than 30 of our most important articles and guides into Spanish, focusing on resources that parents and educators have found most helpful.

    Children's health and happiness is important to everyone, regardless of culture or language. But when it comes to emotional and behavioral health and learning problems, we found a shortage of dependable information in Spanish to help parents and caregivers make good decisions. We looked careful at what's available and identified areas we could offer the most helpful material to the growing Spanish-speaking population in the US.

    Our goal is simple: to get evidence-based mental health information into the hands of families no matter the language they speak, and tailored in a way that reaches across any cultural barriers that may exist.

    We need your help to get the word out. Please share the news and the link with anyone (individuals or groups!) you think might be able to use it or pass it along: childmind.org/espanol

    We plan to continue adding content, but the first phase already contains basic information on common emotional and behavioral problems in kids, including ADHD, learning disorders, behavioral problems, anxiety, depression, and eating disorders.

    We welcome any suggestions you might have as we keep developing childmind.org/espanol. We hope you will share the link and join us in helping parents and teachers give kids the support they need to grow into healthy, happy and successful adults.

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  • Study Claims Video Games Can Help—or Hurt—Kids
    Aug. 4, 2014 Caroline Miller

    A new study out of Oxford purports to show that kids can benefit from a little video game playing, and be harmed by too much of it.

    Researchers combed data on 5,000 10- to 15-year-olds in the UK who had filled out questionnaires that covered their gaming habits and general "psychosocial adjustment." They found that kids who reported playing video games less than an hour a day were happier and better adjusted than kids who didn't play at all, and kids who played more than three hours a day were less well adjusted. The kids in the middle, who racked up one to three hours a day, were indistinguishable from kids who didn't play.

    But the author of the study, published in Pediatrics, acknowledged that the difference in behaviors among these groups was quite small. "High levels of video game-playing appear to be only weakly linked to children's behavioural problems in the real world," Dr Andrew Przybylski admitted to the Telegraph. "Likewise, the small, positive effects we observed for low levels of play on electronic games do not support the idea that video games on their own can help children develop in an increasingly digital world."

    And if it that wasn't enough to deflate claims of video games being of either great benefit or great harm, he wrote this in the paper in Pediatrics: "Compared with factors shown to have robust and enduring effects on child well-being such as family functioning, social dynamics at school, and material deprivations, the current study suggest the influences of electronic gaming, for good or ill, are not practically significant."

    Not surprisingly, that didn't stop it from being picked up by media outlets everywhere.

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  • Can Kids “Beat” Autism?
    Aug. 1, 2014 Beth Arky

    At a time when 1 in 68 children are being diagnosed with autism, two studies have emerged stating that a small number of them can be expected to overcome their symptoms and their diagnosis.  

    In a feature titled "The Kids Who Beat Autism" in this Sunday's New York Times Magazine, a reporter covers the two studies as well as the stories of some of the children who do—and don't—leave their diagnoses behind. The stories of "positive" or "optimal" outcomes are riveting—some kids grow from being completely nonverbal and self-injurious to typical adolescence. But who will improve is difficult to predict.

    According to both studies, higher IQ plays a role in these outcomes, and some (though not all) of these kids had comprehensive early interventions including applied behavioral analysis (ABA). That early and painstaking intervention is also the source of some controversy; in the article, advocate Ari Ne'eman criticizes the idea that these therapies can or should be used to alter the autistic brain or autistic behaviors: "Even if such a thing were possible, we don't think it would be ethical."

    Others in the autism community were more positive. Judith Ursitti, director of government affairs at Autism Speaks and mom to a 10-year-old autistic boy, says, "It's wonderful to read about individuals who are doing well—some who are still on the spectrum and some who no longer meet the criteria. This is not a pronouncement that every child can or should be recovered. It's a reflection of the different paths individuals on the autism spectrum can and do take."

    But some parents have expressed concern. While the researchers remind caregivers that very few kids on the spectrum "recover," some wonder if the story will instill too much hope of a "cure" among mothers and fathers distraught over their child's diagnosis, and that the story casts a negative light on what they see as a neurological difference.

    And others resent the idea that kids can "beat" autism. Jessi Cash, who blogs at Deciphering Morgan about being an autistic mom to an autistic 9-year-old, commented on Facebook, "You don't 'recover' from [autism] as if it were the flu. It's a neurological way of being. You can mask the presentation, but it's still there."

    Alicia Hart, author of Foods, Moods & Isms and mother to a 12-year-old autistic son, wrote, "The article's takeaway message for a lot of people is that $40,000 a year for 40 hours a week of therapy will possibly move your child out of the diagnosis. Hello debt and goodbye childhood."

    And muddy waters could have an impact on school-based services. Anna Perng, mom to two young boys on the spectrum, is worried that school districts will congratulate "confused parents on their kids 'losing' their autism diagnoses" and remove hard-won supports.

    Autism can be a tough, lonely road for parents. It's easy to read this story's headline and miss the basic premise of these studies: Autistic kids can and do learn and grow, but at different rates and with different outcomes. One mother quoted in the story, who devised an education plan for her son that involved everything from Leave It to Beaver to robots, thinks he deserves respect, not skepticism. "Mark worked so hard," she says. "To deny everything he did to get this far isn't fair."

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  • Mindfulness Aids Autism Moms
    July 29, 2014 Beth Arky

    We know the power of mindfulness. Past research has shown that Mindfulness Based Stress Reduction, a therapeutic meditation that focuses on breathing to pay attention to the here and now, reduces worry about the future and the stress, anxiety and depression that can follow.

    It has emerged as a way of treating children and teens with challenges including ADHD, anxiety, autism spectrum disorders, depression and stress. It has also been seen to help parents of children with special needs. So we aren't surprised by the findings of a new study reported in Pediatrics that shows the positive effect of the practice among mothers of autistic children and those with other neurodevelopmental disabilities.

    The study, which compared the benefits of mindfulness versus positive psychology, found that while both treatments resulted in significant reductions in stress, depression, and anxiety, and improved sleep and life satisfaction, mothers who practiced mindfulness had greater improvements during treatment.

    Most services for such families focus on the child, but improving the mental health of parents is important, too, since researchers say they experience more stress, illness, and psychiatric problems. Getting help for parents is also likely to make them better caregivers, which, in turn, could improve their child's development. We support anything that encourages these caregivers to "put on the oxygen mask first." It stands to reason that calmer, happier moms and dads make for better, more patient parents, which in turn makes for calmer, happier kids, regardless of their greater needs. 

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