Reduced Eye-Patching for Lazy Eye Less Stressful, Just as Effective

Wearing an eye patch for two hours a day instead of six works just as well at improving eyesight in children with lazy eye (amblyopia), according to a new study. This research, appearing in May’s Archives of Opthalmology, is good news for families with children suffering from the most common cause of visual impairment in childhood.

In the study, children under the age of 7 were put in two groups. The first received two hours of daily eye patching and the second, six hours. After four months, the rate of improvement for both groups was the same. All children performed one hour of “near” work – coloring, reading, tracing, etc. – while wearing the patch. The near work was an important part of the prescribed treatment. The researchers, however, say they are uncertain whether there would be the same amount of improvement without the daily near work.

"Prior to these results, many children with amblyopia had to wear an eye patch during school hours," says Dr. Paul A. Sieving, director of the National Eye Institute, a branch of the National Institutes of Health and the organization that sponsored the study. "For these children, the accompanying social and psychological stigma was very real. Many were stared at and teased by other children, which made them feel different. Now, children can look forward to attending school without the patch. This will make them feel better about themselves."

Amblyopia usually begins in infancy or childhood and is characterized by poor vision in an otherwise healthy eye. The brain learns to favor the other eye for reasons such as crossed or wandering eyes or a significant difference in nearsightedness or farsightedness between the two eyes. (5-27-03)

Were Einstein and Newton Autistic?

Did geniuses Albert Einstein and Isaac Newton have autism? According to a recent study published in New Scientist, they might both have shown symptoms of Asperger syndrome, a form of autism that doesn’t involve learning difficulties.

Autism expert, Simon Baron-Cohen, and his colleague analyzed the personality traits of Einstein and Newton to see if they had three key characteristics of Asperger syndrome: obsessive interests, difficulty in social relationships and problems communicating.

While it is impossible to make a definite autism diagnosis of someone who is already dead, Baron-Cohen, based out of Cambridge University, hopes his study may help discover why some people with autism excel in life while others do not.

Autism is inheritable. Signs show that the genes for autism are connected to those that demonstrate a talent for complex systems, such as computer programs or musical techniques. For example, mathematicians, engineers and physicists all tend to have a high rate of autism among their relatives.

Newton could fit a classic description of Asperger syndrome. He hardly spoke, was barely civil to his few friends and would give lectures to an empty room if no one showed up to hear him.

As a child, Einstein was a loner and repeated sentences obsessively until he was 7. Even though he had many friends and was outspoken on many issues as an adult, Baron-Cohen thinks he, too, might have had Asperger syndrome. "Passion, falling in love and standing up for justice are all perfectly compatible with Asperger syndrome," he says. "What most people with AS find difficult is casual chatting – they can’t do small talk."

A psychiatrist from the University of California at San Francisco is not so sure about Baron-Cohen’s findings, however. Trying to diagnose on the basis of biographical information is extremely unreliable, he says. He also thinks that being highly intelligent would have influenced Newton’s and Einstein’s personalities by itself. Elliot points out that Einstein had a great sense of humor, a trait that is virtually nonexistent in people with Asperger syndrome. (5-20-03)

Be True to Your School

If you’re thinking about changing your child’s school, you might want to reconsider. A child who frequently changes schools is more likely to have behavioral health problems than one who doesn’t, according to a new Cincinnati Children’s Hospital Medical Center study.

“Transitions can be so disruptive to children that parents need to weigh the potential academic benefit they may get versus the academic, social and emotional impact of making the transition,” says Dr. Mona Mansour, the study’s lead author. The increase in behavioral problems is true for all children, regardless of race, income, maternal education level or any other factor measured in the study.

The Cincinnati Children’s study, presented at the annual meeting of the Pediatric Academic Societies, involved more than 3,200 children between the ages of 5 and 14. The children were considered “school mobile” if they were 5 to 9 years old and attended two or more elementary schools, or 9 to 14 and had attended three or more schools. Their mothers determined behavior problems by answering questions like “he/she is disobedient” and “he/she has trouble getting along with other students” with “often true,” “sometimes true” or “not true.” The responses were then translated into a score, with higher points equaling more behavior problems.

School mobile children had higher scores of behavioral problems than those children who were not school mobile, reports Dr. Mansour. Although the study cannot state that school mobility causes behavioral problems, it does show that the two are definitely linked. The school mobile children were more likely to have non-married mothers, mothers with low-level school involvement and mothers with symptoms of depression. Also, their mothers had lower perceptions of school expectations than mothers of children who did not change schools often.

Many parents move their children from school to school because of financial reasons, residential moves or to find a school that better meets their children’s needs. The latter is especially true if the child already has behavioral problems. But what the parents don’t realize is that by trying to fix their child’s behavior problems, they could be making them worse.

Dr. Mansour recommends that health care providers talk more with parents about the impact of school changes on children. School districts, also, should consider the potential outcomes of school changes when they formulate their policies. Programs designed to reduce excessive school changes for children may have a positive impact on some children’s behavioral problems. (5-13-03)

Study Links Brain, Spinal Cord Birth Defects With Down Syndrome

A new study suggests a link between neural-tube defects (NTD) and Down syndrome.

NTD are birth defects of the brain or spinal cord caused by abnormal neural-tube development (the neural tube being the origin of the brain and spinal cord) in early pregnancy. Anencephaly (partial or complete absence of the brain) and spina bifida are the most severe NTD, which cause serious physical and mental impairment. Abnormal metabolism of folic acid is an established risk factor for NTD, and it has also been implicated as a possible risk factor for trisomy 21 (the chromosomal abnormality which causes Down syndrome).

For the study, appearing in a recent issue of The Lancet, researchers looked at more than 1000 families, some of whom were at high risk for NTD and some of whom were at high risk for Down syndrome.

They found that infants born to families with a high risk of NTD could also be at an increased risk of Down syndrome and vice versa. There were more than five times the number of pregnancies affected by Down syndrome in families with a high risk of NTD compared with 1.87 expected for women of the same age. There was a similar ratio of increased NTD in the families at risk of Down syndrome (seven compared with an expected incidence of 1.37). (5-06-03)

Homeopathy Not Effective in Treating Asthma

Does homeopathy really work? Not to help children who have asthma, according to a new study in the journal Thorax.

Researchers studied more than 90 children ages 5 to 15 who had mild to moderate asthma, which was treated in the usual way with reliever or preventer inhalers. Classically trained homeopaths, who had been in practice for at least 10 years, also provided homeopathic remedies for the children in up to six sessions over the course of a year. Half the children were given dummy remedies (placebo) instead of homeopathy. Neither the children nor the practitioners knew who would receive which remedy.

Researchers found no evidence that homeopathy had any measurable impact on quality of life. The severity of symptoms lessened among children taking homeopathic remedies, but not to any extent that was significantly greater than placebo.

Homeopathic remedies are used by an estimated 15 percent of children with asthma in the United Kingdom, according to the authors. (5-6-03)

Treating Gastroesophageal Reflux Disease May Reduce Need for Asthma Medications in Children

Children who suffer from both asthma and gastroesophageal reflux disease (GERD) may require fewer asthma medications after receiving anti-GERD treatment, says a study published in the April issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP). The study found that medically or surgically treating GERD in children with asthma reduced the need for total asthma medications by more than half.

The study, conducted at West Jefferson Medical Center, is the first of its kind to evaluate the effect of anti-GERD treatment using acid suppressing drugs called proton pump inhibitors (PPIs) on the requirement for asthma medications in older children with persistent moderate asthma.

During 12 months of observation, all patients in the study (ages 5 to 11) with GERD receiving anti- GERD treatment showed a more than 50 percent reduction in total asthma medications used, and specifically, a more than 50 percent reduction in bronchodilator use. In addition, 89 percent of patients with GERD required no treatment with inhaled corticosteroids, and no patients required use of leukotriene antagonists during the final six months of observation. Patients receiving no anti-GERD treatment showed no change in the use of total asthma medications.

"Children with persistent asthma often take the maximum amount of medications to maintain their asthma, yet they still end up in the emergency room on a regular basis," says Dr. Vikram Khoshoo, pediatric gastroenterologist at West Jefferson Medical Center, New Orleans, La "With anti-GERD treatments such as PPIs, we may help to lighten our patients' asthma regimens and eventually reduce the number of emergency room visits and school days missed." (4-29-03)

Children From 25 States Seek Congressional Support in Dealing With Epilepsy

Young advocates with epilepsy and their families from 25 states converged on Capitol Hill on April 9 to seek support from their Senate and Congressional representatives in their struggle against epilepsy and its medical and social consequences.

The 38 children, who ranged in age from 7 to 16, sought an increase in public health education initiatives to fight discrimination at school and in their communities as well as a renewal of the nation's commitment to medical research.

The visits with congressional representatives are part of the Epilepsy Foundation's new "Kids Speak Up" program, a grassroots campaign to help families of children with epilepsy have their voices heard in the halls of the U.S. Capitol. The program is supported by an educational grant from Abbott Laboratories.

The "Kids Speak Up" families were joined by fellow epilepsy advocates, some 200 total participants, in urging Congress to support greater public health education and community outreach to help their children lead more normal and productive lives.

Many children with epilepsy have experienced ridicule and bullying in school and in their neighborhoods. In some cases, uninformed teachers have ignored the needs of students with epilepsy. Public opinion often supports misinformation on epilepsy. According to a recent national survey conducted on behalf of Abbott Laboratories, the majority of Americans (57 percent) falsely believe that people with epilepsy are a danger to themselves and should be restrained during a seizure.

Epilepsy is the most common neurological condition of childhood and the third most common neurological condition in adults after Alzheimer's and stroke. It affects 350,000 children aged 17 and under in the United States, according to the Epilepsy Foundation. Epilepsy. Despite advances in treatment, however, about one million people of all ages continue to experience seizures or significant side effects from therapy. A 1999 Epilepsy Foundation study showed that epilepsy costs the nation more than $12.5 billion a year. (4-22-03)

Take a Break From the Tube During TV-Turnoff Week

Are your kids too tuned into the tube? Or for that matter – are you? If so, take a break during the annual TV-Turnoff Week 2003 (April 21-27), sponsored by nonprofit group, TV-Turnoff Network. The organization encourages children and adults to watch much less television in order to promote healthier lives and communities.

According to TV-Turnoff Network, a recent a recent Harris poll found more than 90 percent of Americans admit they have soft addictions – seemingly harmless habits like over-eating, compulsive shopping, watching too much TV or surfing the Internet for hours that take our time, zap our energy and keep us from creating a more meaningful life. The poll also found that more than a third said they watch too much TV, and more than half reported too much TV watching in children.

Soft addiction expert Judith Wright has teamed up with TV-Turnoff Week 2003 to encourage millions of children and adults to take a seven-day break from the television and rediscover that life can be more fun, rewarding and even relaxing when we do more and watch less. For many, the Week will become the springboard to making lasting change in their lives: watching less television, choosing what they watch more selectively and engaging in more screen-free activities.

"Families of school-age children that limit TV time report that their children achieve higher grades and social success," says Wright. "They also experience more family closeness, greater creativity and more interactive play at all levels of family involvement." Wright is the author of There Must Be More Than This: Finding More Life, Love, and Meaning By Overcoming Your Soft Addictions (Broadway, 2003).

During TV-Turnoff Week 2002 an estimated 6.4 million people took part in the event in more than 16,000 organized Turnoffs. The lengthy list of supporting organizations for 2003 includes a number of major groups, including the American Academy of Pediatrics, American Medical Association, National Education Association, Boys and Girls Clubs of America and many others.

For more information, log on to www.tvturnoff.org or www.theremustbemore.com. (4-22-03)

Parents Not as Likely to Discuss Children's Anxiety With Doctor

A new study finds that parents are less likely to talk with their family doctor about social anxiety disorders in their children than other issues such as attention deficit-hyperactivity disorder or depression.

The study, presented at the Anxiety Disorders Association of America's 23rd annual meeting, looked at 190 families with children between the ages of 8 to 17.

Researchers found that less than a third of parents who had a child with social anxiety disorder had discussed their child's symptoms with a pediatrician. In contrast, 67 percent parents of children with attention deficit-hyperactivity disorder and half of parents of children with major depression had disclosed these issues with their pediatricians.

"Despite the signs of social anxiety disorder, many children remain undiagnosed for reasons including lack of communication between parent and pediatrician, time constraints of primary care visits, discomfort discussing psychosocial concerns and limited recognition of anxiety problems," says Denise A. Chavira, PhD, department of psychiatry at University of California at San Diego. "Recognizing and providing appropriate treatment recommendations for social anxiety disorders during primary care visits can have important short- and long-term implications."

Social anxiety disorder is particularly prevalent and debilitating in adolescence. Adolescents with social anxiety disorder have few friends, demonstrate disturbances in school function, experience difficulties with intimate relationships and report elevated alcohol use. Research suggests significant stability of this disorder into adulthood, as well as long-term negative consequences including increased risk for suicide attempts, alcohol abuse, difficulty working, incomplete educational attainment and depression.

The Anxiety Disorders Association of America (ADAA) is the only national, non-profit membership organization dedicated to informing the public, health care professionals and legislators that anxiety disorders are real, serious and treatable. The ADAA promotes the early diagnosis, treatment and cure of anxiety disorders and is committed to improving the lives of the people who suffer from them. (4-15-03)

Study Confirms Long-Term Effectiveness, Safety of Once-Daily CONCERTA in Children With ADHD

A study of children with attention deficit hyperactivity disorder (ADHD), who had previously responded to treatment with methylphenidate, has found that once-a-day CONCERTA® (methylphenidate HCl) CII effectively controls ADHD symptoms and maintains a consistent safety profile over one year. The study appears in the April issue of the Journal of the American Academy of Child & Adolescent Psychiatry.

The study, an interim analysis of one of the longest studies to date of continued use of a stimulant medication, indicates that children with ADHD are likely to continue to respond to CONCERTA for up to 12 months. The study looked at more than 400 children ages 6 to 13 with ADHD.

The findings also add to the literature in countering some long-standing beliefs about the effect of methylphenidate, the active ingredient in CONCERTA, as a long-term ADHD treatment. Investigators reported that CONCERTA did not adversely affect growth (weight and height), did not appear to induce or worsen tics, did not adversely affect vital signs (i.e., blood pressure, pulse) and had no clinically meaningful effect on a wide range of blood tests (i.e., red and white blood cell count, liver function tests). Additionally, despite its extended-release pharmacokinetic profile and long duration of action, CONCERTA apparently had little impact on parental perception of sleep quality.

"While it is generally agreed that pharmacological treatment of ADHD may be needed for extended periods, few treatment studies of ADHD extend beyond a few months," says study lead author Dr. Timothy Wilens, director of substance abuse services in the Pediatric and Adult Psychopharmacology Clinics at Massachusetts General Hospital. "This 12-month analysis of a longer-term study establishes the safety and efficacy of CONCERTA over one year and addresses some concerns about the effects of long-term methylphenidate treatment on growth (height and weight), tics, vital signs and sleep quality. Given the chronic nature of ADHD, it is comforting to know that medications such as CONCERTA continue to work in reducing ADHD and associated impairment."

CONCERTA is an extended-release formulation of methylphenidate for ADHD treatment that is designed to last through 12 hours, with just one morning dose. Concerta uses an advanced OROS® extended-release delivery system. The OROS® trilayer tablet is designed to release the medication in CONCERTA in a controlled pattern providing symptom management throughout the day. (4-8-03)

Single Parenthood Increases Risk of Hospitalization, Early Death in Parents, Children

A new study has found that being a single parent increases the risk of hospitalization and early death in mothers, fathers and children.

For a dissertation at Umeå University in Sweden, a researcher traced illness and mortality among about 700,000 mothers and fathers and nearly a million children during the 1990s.

The results indicate that single parenthood entails greater risks of serious ill health (requiring hospital care) and early mortality among mothers, fathers and children. Single mothers showed greater risks when compared with cohabitating mothers. Single fathers, with custody of their children, also had heightened mortality risks, but it was above all single fathers who did not live with their children and single men without children who showed the highest mortality risks.

The greatest rise in risk among both men and women was found in cases of mental illness, suicide and substance abuse. Growing up in a single-parent household seems to mean more than twice the risk of mental illness, suicide/attempted suicide and substance abuse, according to the study, and it was also associated with a lower level of education as an adult.

The researcher attributes some of the increased risk to the fact that single parents have poorer economic and social conditions on average and that a greater share of people with weak health are included in the group. (4-8-03)

Same Gene Found to Cause Mental Retardation in Children, Neurodegenerative Condition in Older Males

Researchers have recently discovered a progressive neurodegenerative condition – resulting in tremor, balance problems and dementia – which may affect as many as one in 3,000 men. At the American Academy of Neurology Annual Meeting this spring, researchers reported that this condition has now been associated with the same gene that causes fragile X syndrome, the most common heritable form of mental retardation.

According to the researchers, the same gene has been found to cause these two different and independent syndromes, affecting different groups of individuals. Fragile X syndrome is a developmental disorder beginning in childhood, while the newly identified neurological syndrome (Fragile X Associated Tremor/Ataxia Syndrome, or FXTAS) affects mainly male carriers who were not affected by fragile X syndrome retardation and who displayed no symptoms prior to age 50.

Currently, male carriers of the gene do not know they are carriers unless there is an affected grandchild in the family. This is how the researchers have discovered the cases studied to date. Affected individuals have thus far been given other, descriptive diagnoses, such as "atypical Parkinson disease," and have in many cases seen multiple neurologists in their efforts to diagnose their condition.

"We hope that one of the positive outcomes of our investigations will be a greater awareness within the adult neurology community as to the presence of this disorder," says Study Author Dr. Paul Hagerman, MD, PhD, professor of biological chemistry at the University of California Davis School of Medicine. "Heightened awareness may also lead to better family counseling prior to the birth of children affected with fragile X syndrome." (4-01-03)

Get Kids Reading This Summer

Summer is coming and that means your kids get their much-awaited break from school. But is that good for their brains?

According to Reading Is Fundamental (RIF), the nation's oldest and largest children's and family literacy organization, experts agree that children who read during the summer gain reading skills, while those who do not often experience learning losses.

To help entice kids to keep their brains working this summer, RIF offers the following tips:

Reading Tips for Parents:

• Combine activities with books: Encourage kids to read books about the activities they get involved in over the summer.
• Visit the library: Help your child get their very own library card.
• Lead by example: Show your kids how much fun you have reading!
• Talk it up: Talk with your kids about what you read – it shows them reading is an exciting, important part of your life.
• Help kids find time to read: When planning summer activities with children, remember to allow for time to read.
• Relax the rules for summer: Let summer be a time when children can read what, when and how they please.
• Have plenty of reading material around: Along with the usual storybooks, be sure to have newspapers, magazines and informational material on hand that might spark the interest of your young readers.
• Use books to break the boredom: Get books that teach kids how to make or do something interesting this summer.
• Read aloud with kids: Take your children to see a local storyteller or, better yet, be one yourself!

Reading Tips for Kids:

• Go somewhere new: The place where you read a book can make the story even more meaningful.
• Read around the house: See how much reading material can be found around the house without opening a book.
• Take a trip through a book: Read about the places you are planning to go this summer before you get there.
• Read books from A-Z: Let the alphabet help you make a summer reading list.
• Keep a reading journal: Write about the books that you read in a summer reading journal.
• Read aloud with adults: Adults need to read just as much as kids do. Read aloud with your parents before bedtime.
• Start a book club: Starting a book club with your friends is a great way to share books and ideas.
• Find a fun series: Find a series of books by an author who you enjoy.

For more information about RIF's Summer Reading Tips, call 877-RIF-READ, visit www.rif.org or e-mail dearrif@rif.org. (4-01-03)

Secondhand Smoke Linked to Childhood Cavities

Here's another reason not to smoke in front of your children – secondhand smoke may cause cavities, according to a new study.

The study, which appears in the March 12 issue of the Journal of the American Medical Association, surveyed more than 3500 children ages 4 to 11 who had had both dental examinations and a serum cotinine – a byproduct of nicotine – level measurement.

Researchers found that an elevated cotinine level was significantly associated with both decayed primary teeth and those that had fillings.

The authors concluded that there is an association between environmental tobacco smoke and risk of cavities among children. Reduction of passive smoking is important not only for the prevention of many medical problems, but also for the promotion of children's dental health, they say. (3-25-03)

CDC Activates Emergency Operations in Response to New Pneumonia-like Illness

In response to reports of increasing numbers of cases of an atypical pneumonia that the World Health Organization (WHO) has called Severe Acute Respiratory Syndrome (SARS), the Centers for Disease Control and Prevention (CDC) activated its emergency operations center on Friday, March 14.

As of March 19, WHO has received reports of 264 patients from 11 countries with suspected and probable SARS. Areas with reported local transmission include Hong Kong and Guangdong province, China; Hanoi, Vietnam and Singapore. More limited transmission has been reported in Taipei, Taiwan and Toronto, Canada. Eleven cases have been reported in the United States. The initial cases reported in Singapore, Taiwan and Toronto were among people who all had traveled to China.

Among patients reported worldwide as of March 19, the disease has been characterized by rapid onset of high fever, myalgia, chills, rigor and sore throat, followed by shortness of breath, cough and radiographic evidence of pneumonia. Of the 264 suspected and probable cases reported by WHO, nine (3 percent) people have died.

CDC has been working with the World Health Organization (WHO) since late February to investigate and confirm outbreaks of this severe form of pneumonia in Vietnam, Hong Kong and parts of China.

"The emergence of two clusters of this illness on the North American continent indicates the potential for travelers who have been in the affected areas of Southeast Asia to have been exposed to this serious syndrome," says Dr. Julie L. Gerberding, CDC director. "The World Health Organization has been leading a global effort, in which CDC is participating, to understand the cause of this illness and how to prevent its spread. We do know that it may progress rapidly and can be fatal. Therefore, we are instituting measures aimed at identifying potential cases among travelers returning to the United States and protecting the people with whom they may come into contact."

The WHO issued a global alert about the outbreak on March 12, cautioning that the severe respiratory illness may spread to hospital staff. (3-25-03)

Hospital Offers Tips for Helping Kids Cope With War

Now that war in underway, how can you help your children cope? The staff at Linden Oaks Hospital at Edward in Naperville, Ill., offer the following suggestions:

• Monitor the television! While adults may understandably want ongoing, up-to-date information, children need to be protected from an onslaught of graphic and violent images.
• Give children honest information at their level of understanding.
• Allow them to "lead" the conversation rather than overwhelm them with details.
• Get help for yourself! Your child will sense and feel your anxiety. Be conscious of your own reactions and try not to burden your child with your own shock, anger, fear or grief. Be aware of forcing or wanting a certain response from your child.
• Listen! Don't judge, don't criticize and don't minimize.
• Assure children that they and your family are safe.
• Be available for your children. Play with them while encouraging them to share their thoughts. Remember that children may not discuss issues in the same manner as adults – often, their deepest feelings are revealed during play.
• Fear is OK – it is a normal reaction in these circumstances.
• Some may not immediately show fears/emotions, and this, too, is normal. Children often deal with significant emotions on a bit-by-bit basis. It may take several days or weeks for children to process their reactions. Stay tuned in.
• Mobilize outside support: church, family, friends, schools and community groups.
• Do your best to maintain a normal routine.
• Be careful not to project strong political, ideological, racial or cultural feelings onto children. Reserve these topics for adults.
• Be prepared to answer "Why?" Respond in a manner that allows for discussion and attends to fear and anxiety about the future.
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