The Child Mind BlogBrainstorm

  • 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. 

    More on Autism

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  • Avonte’s Law Passed
    July 25, 2014 Rachel Ehmke

    On Thursday, the City Council of New York passed a bill that will require select elementary and special education schools to install alarms on school doors.

    The bill is called Avonte's Law after Avonte Oquendo, the autistic teen who slipped out of his school during a transition between lunch and class and was later found drowned. The search for Avonte galvanized New Yorkers, and led many to begin calling for higher security measures at schools.

    Roc Conti, Avonte's uncle, tells the New York Daily News that "the bill is a giant step for parents and it will ease their worries and their insecurities about their children." But, he also notes, "this is just one step."

    The Department of Education will be investigating schools and deciding which ones should get alarms, despite many advocates, including Conti, calling for them to be installed in all special education and elementary schools. 

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  • Donor Gives $650M for Mental Illness Research
    July 22, 2014 Harry Kimball

    Psychiatric research got a big boost yesterday with the announcement of a $650 million gift to the Broad Institute, the interdisciplinary research group at Harvard and MIT that simultaneously announced exciting new genetic research into schizophrenia. The money comes from Ted Stanley, a longtime supporter of treatment research who has intimate knowledge of mental illness—his son has bipolar, which went untreated for 2 years after diagnosis until a crisis landed him in police custody.

    Happily, that encounter ended with mood stabilizer treatment that took Jonathan Stanley from what he calls "psychotic to normal." But the elder Stanley knows that we still haven't developed therapies that work for everyone struggling with mental illness. He aims to change that. "I would like to purchase that happy ending for other people," he tells the New York Times. We're happy that he has the means to try.

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  • Jack Antonoff's New Anthem: I Wanna Get Better
    July 17, 2014 Jessica Kashiwabara

    Jack Antonoff is best known as the guitarist of fun., the band responsible for the hit song "We Are Young," and some might know him as Lena Dunham's boyfriend. But this week he stepped out on his own with the release of a debut album under the name Bleachers. The lead single, "I Wanna Get Better," is not only catchy, but also serves as an autobiographical account of Antonoff's darkest moments and how he's struggled with anxiety.

    In an interview with Time magazine, Antonoff discussed the painful experiences surrounding his youth: he was bullied in school, his younger sister died of brain cancer, and a cousin was killed while serving in Iraq. He developed a severe panic attack disorder and hypochondria, and in 2006, anxiety so severe he rarely left his home. For a long time, he suppressed his grief, but eventually found the therapy and medication that works for him.

    Through his songs, he explores those feelings of loss and now with Bleachers (the name is a nod to high school), Antonoff keys in on his lost teenage years. As he says, "I feel like I had a childhood that I'm constantly mourning."

    Sharing those feelings, Antonoff has struck a chord with fans and gained more than just success. In fact, he says his biggest reward has been the connection his fans have to his music and to him. The musician frequently hears from fans about their own struggles with anxiety and depression. To Antonoff, this is much more profound than being a teen idol. As he puts it, "Who would want to be the kind of artist that's worshipped by fans when you can be the kind of artist that's comforted by fans?"

    With "I Wanna Get Better," Antonoff gives back to his fans a hopeful message and a mantra to keep with them through the hard times.

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  • Jail's Mentally Ill Are Targets of Violence by Guards
    July 14, 2014 Caroline Miller

    Rikers Island is a New York City jail and a New York City problem, but anyone who worries about the mentally ill will find this story in the New York Times stunning. The piece is the result of an investigation into violence perpetrated against inmates with mental illness by correction officers. 

    For starters, the brutality is shocking, often including beatings inflicted on handcuffed inmates, resulting in a litany of broken noses, jaws, and eye-sockets, along with internal injuries. The incidents that prompt violence include insults to guards, minor provocations, and predictable outbursts of anger—especially predictable in inmates with schizophrenia, bipolar disorder or depression who have been kept in solitary confinement. In five cases last year, inmates were beaten after making suicide attempts.

    The numbers are shocking: Last year, 129 inmates suffered what the Times classified as "serious injuries" —ones beyond the capacity of doctors at the jail's clinics to treat—at the hands of corrections officers. And 77 percent of the seriously injured inmates had a mental health diagnosis.

    Their numbers, unfortunately, are only rising. Inmates diagnosed with mental illness make up nearly 40 percent of the Rikers population; that's up from 20 percent 8 years ago, the Times reports.

    Even in a cell block apparently reserved for inmates with mental illness, the officers seem to have deep skepticism that mental illness is real. "About half are faking it," one officer tells a Times reporter.

    To be fair, guards are enormously frustrated, too, and inmates with mental illness are responsible for what the Times calls "an overwhelming majority of assaults on jail staff members." The story details some of the reasons why corrections facilities don't have the right tools to manage inmates with mental illness who lash out. But guards are rarely punished for what appears to be a clear pattern of retaliation.  

    And finally, it's shocking how little transparency there is in correctional facilities. It took four months of reporting, obtaining a secret internal study, and many interviews with current and former inmates and staff members to put together this report. One of them was Daniel Selling, the director of the jail's mental health services until 2 months ago. As he sums up for the Times, "There's lots of brutality. Horrible brutality."

    Does it need to be said again how important it is to get treatment to people with mental illness as early as possible, before the trajectory of their lives leads to incarceration? Rikers right now may be an unusually bad place to be mentally ill, but a correctional facility is rarely a place to get the kind of help and support that can turn lives around.

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  • Tim Howard and Tourette's: Stigma vs. Soccer Greatness
    July 8, 2014 Harry Kimball

    The World Cup final match isn't until Sunday. But in the minds of many, the champion of the tournament has already been decided: Tim Howard, the US Men's National Team goalie who made Cup history last week with a record 16 saves in a game against Belgium. Of course, the US lost and was eliminated, but Howard's performance continues to amaze. And did you know he has Tourette's?

    It should come as no surprise that an incredibly gifted football (soccer) player who happens to have a tic disorder could succeed in his chosen field. We know that people with Tourette's often tend to find symptoms vanish when they focus on something they are deeply engaged in, whether it's singing or blocking a ball. There is even speculation, as with other psychiatric disorders, that something about the altered brain function makes people excel at certain tasks.Tim Howard

    In the run-up to the last World Cup, in 2010, the New Yorker interviewed an expert who said some people with Tourette's report "that they sense things in the body movements of others that the rest of us screen out, some signal or vibration, some sensory cue. It's almost like they can see what's going to happen before it happens." As Howard described it then, "You see everything. You're yelling. You're tense. You're so wired-in."

    But I think the most important thing is that Howard found a place for himself in the penalty box, and that he didn't let stigma or mean-spiritedness dissuade him from his goal (or blocking others' goals, as it were). In the UK, where he plays professionally, newspaper headlines have scoffed at the possibility of a "disabled" goalie; apparently, one even went so far as to call him a "retard." Though he does not have the coprolalia that accompanies some cases of Tourette's, the possibility that he might spontaneously start cursing is the basis of jokes at his expense.

    His response has been admirable: The 16 saves. Being one of the best, if not the best, in the world. "One of the biggest things I can do is be in the public eye," he told Neurology Now last year. "I'm on television, ticcing and twitching. I think that's kind of cool."

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  • How Trauma Can Be Misdiagnosed as ADHD
    July 7, 2014 Caroline Miller

    Dr. Nicole Brown, a resident at Johns Hopkins Hospital in Baltimore, was troubled by the number of pediatric patients she saw who had ADHD diagnoses. She didn't doubt that some of them had ADHD. They were described by their parents as hard to manage and their teachers as disruptive and/or inattentive.  But they were also kids whose homes and neighborhoods were marked by poverty, violence, and substance abuse.

    Dr. Brown was frustrated that the standard treatments for ADHD—behavioral therapy and stimulant medication—weren't helping many of these kids get their symptoms under control. “I began hypothesizing that perhaps a lot of what we were seeing was more externalizing behavior as a result of family dysfunction or other traumatic experience,” she says.

    Dr. Brown tested her hypothesis with a study that confirmed the link she observed: Kids who endured four or more adverse childhood events were three times more likely to use ADHD medication.

    Dr. Brown's experience is detailed in an excellent piece in the Atlantic exploring the concern that kids who experience high levels of stress display symptoms that overlap those of ADHD, and that may be leading to misdiagnoses. Inattentive, hyperactive, and impulsive behavior can be the result of chaos, neglect or abuse, and many doctors prescribing ADHD meds may not have, or take, the time to find out what's happening to kids at home. 

    "We need to think more carefully about screening for trauma and designing a more trauma-informed treatment plan," says Dr. Brown.

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