An editorial written by Professor Philip Asherson, a leading psychiatrist in adult ADHD (Attention Deficit Hyperactivity Disorder), at the Institute of Psychiatry, King??™s College London strongly recommends that general adult psychiatrists should diagnose ADHD in adults appropriately with stimulant drugs. It is published in the January issue of the British Journal of Psychiatry.
Although ADHD can be effectively treated with stimulant medication, and such treatment is widespread in the young, general adult psychiatry has not yet followed suit in identifying and treating substantial numbers of affected people.
ADHD is a common disorder affecting children and adults, and is a predictor of adult mental health problems. Symptoms include high levels of inattentiveness, impulsiveness and restless over activity, and are regarded as a source of disability in children and adolescents, as well as a risk to adult psychological adjustment.
Young people are entering adult life whilst still receiving medication for ADHD, and adult psychiatrists are needed to take over treatment when symptoms persist. Moreover, some adult patients with ADHD may be misdiagnosed and ineffectively treated for other disorders, such as depression and personality disorder.
Research suggests that between 15% and 65% of children diagnosed with ADHD still have symptoms of the disorder in adulthood. However, many children with ADHD go unrecognised, and may be diagnosed in adulthood for the first time.
A survey of schoolchildren with ADHD in the London Borough of Newham found that although levels of restless activity diminished between the ages of 7 and 17, the 17-year-olds showed a level of hyperactivity similar to that found in a group of normal 7-year-olds.
When the same people were followed up at the age of 26, they were found to have disabilities associated with high levels of psychiatric disorder, which were all the more significant because of increasing demands in adult life for self-organisation and the ability to plan ahead.
Adult behaviours linked to ADHD are associated with the childhood symptoms of motor hyperactivity, attention deficit, unfocused thinking, mood changes, disorganisation and impulsiveness.
They include - at the severe end of the spectrum - feelings of restlessness, difficulty in relaxing, feeling depressed when inactive, lack of concentration on detail, depression or excitability, poor time management, difficulties sustaining relationships and a tendency to make rapid and facile decisions without full analysis of the situation.
Psychiatrists diagnosing ADHD in adults need to be aware of the fact that people with this disorder often show decreased symptoms in a novel situation like a psychiatric evaluation. It is therefore important to base mental state evaluations on a typical week and a variety of normal situations.
Mood instability is very common in adult ADHD, and can lead to diagnoses of depression or personality disorder. Many adults with ADHD also have other problems, such as antisocial personality, alcohol and drug misuse, anxiety disorders and learning difficulties. ADHD in childhood may also lead to the development of antisocial behaviour.
Some symptoms of adult ADHD are similar to those of bipolar disorder, but ADHD tends to show a persisting trait of irritability and volatility, very different from the grandiose and euphoric symptoms of mania and the depression found in bipolar disorder.
Professor Philip Asherson comments: "Adults with untreated ADHD use more healthcare resources because of smoking-related disorders, increased rates of serious accidents, and alcohol and drug misuse. Further research is needed to quantify the contribution of ADHD to psychiatric disorders in adulthood."
Professor Asherson??™s editorial is published in the British Journal of Psychiatry, January 2007.
Institute of Psychiatry - The Institute of Psychiatry is part of King's College London and closely affiliated to the South London and Maudsley NHS Trust. The Institute is a world-renowned centre for treatment, research and training in psychiatry and mental health. The organisation is involved in pioneering new and improved ways of understanding and treating mental illness and brain disease. Its wide-ranging field of work includes depression, trauma, eating disorders, brain imaging, genetics and psychosis.
iop.kcl.ac.uk
вторник, 24 мая 2011 г.
понедельник, 23 мая 2011 г.
Extended release stimulant effective for long-term ADHD treatment
A new study has found that an all-day, extended-release stimulant for treating attention-deficit hyperactivity disorder (ADHD) remains effective for up to two years without significant side effects. In the October issue of the Journal of the American Association of Child & Adolescent Psychiatry, a multi-institutional research team reports finding that treatment with Concerta, a once-daily form of the drug methylphenidate, successfully controlled ADHD symptoms in more than 200 children with ADHD. The study was supported by McNeil Pharmaceuticals, which manufactures Concerta.
"Although ADHD is recognized as a chronic disease, we've known very little about the effects of chronic treatment," says Timothy Wilens, MD, of the Massachusetts General Hospital (MGH) Pediatric Psychopharmacology Unit, lead author of the JAACAP report. "There have been concerns about whether the stimulant medications that are a mainstay of treatment continue to be effective, whether patients build up tolerance, or whether the drugs might have adverse effects on cardiovascular health or growth. This investigation sheds some important light on those questions."
The study initially enrolled more than 400 children, ages 6 to 13, who previously had participated in short-term, placebo-controlled trials of Concerta. In the new trial, all participants received the active medication at one of three dose levels. Dosage could be adjusted to improve effectiveness or reduce side effects. Participants' height and weight, blood pressure, heart rate and other clinical measures were taken at regular intervals during the study period. The children's parents and teachers were surveyed periodically regarding whether they believed treatment was effective in controlling ADHD symptoms
The entire, two-year study was completed by 229 participants, with others dropping out for a variety of reasons. Throughout the study period, measures of treatment effectiveness were consistent, with around 85 percent of parents and teachers reporting treatment results to be good or excellent. However, it was necessary to increase the children's dose by about 25 percent during the study, with most increases happening during the first year. All the children grew at rates considered normal for their age, and they gained only slightly less weight than would have been expected. In general, there were no clinically significant effects on blood pressure, heart rate, or other cardiac measures.
"We found these medications do continue to be effective in the long-term. While some particicipants did need to increase dosage beyond what could be attributed to their growth, any tolerance that developed seemed to be slight and limited to the first year," says Wilens. "We haven't seen any clinically meaningful problems with height and weight or any cardiovascular difficulties in this study, which also is the first to evaluate this kind of daylong treatment in a large group of children."
Wilens is an associate professor of Psychiatry at Harvard Medical School. The study's co-authors are Keith McBurnett, PhD, University of California at San Francisco; Mark Stein, PhD, University of Chicago; Marc Lerner, MD, University of California at Irvine; Thomas Spencer, MD, MGH; and Mark Wolraich, MD, University of Oklahoma.
Massachusetts General Hospital, established in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $450 million and major research centers in AIDS, cardiovascular research, cancer, cutaneous biology, medical imaging, neurodegenerative disorders, transplantation biology, stem cells and photomedicine. In 1994, MGH and Brigham and Women's Hospital joined to form Partners HealthCare System, an integrated health care delivery system comprising the two academic medical centers, specialty and community hospitals, a network of physician groups, and nonacute and home health services.
Sue McGreevey
617-724-2764
Massachusetts General Hospital
harvard
View drug information on Concerta.
"Although ADHD is recognized as a chronic disease, we've known very little about the effects of chronic treatment," says Timothy Wilens, MD, of the Massachusetts General Hospital (MGH) Pediatric Psychopharmacology Unit, lead author of the JAACAP report. "There have been concerns about whether the stimulant medications that are a mainstay of treatment continue to be effective, whether patients build up tolerance, or whether the drugs might have adverse effects on cardiovascular health or growth. This investigation sheds some important light on those questions."
The study initially enrolled more than 400 children, ages 6 to 13, who previously had participated in short-term, placebo-controlled trials of Concerta. In the new trial, all participants received the active medication at one of three dose levels. Dosage could be adjusted to improve effectiveness or reduce side effects. Participants' height and weight, blood pressure, heart rate and other clinical measures were taken at regular intervals during the study period. The children's parents and teachers were surveyed periodically regarding whether they believed treatment was effective in controlling ADHD symptoms
The entire, two-year study was completed by 229 participants, with others dropping out for a variety of reasons. Throughout the study period, measures of treatment effectiveness were consistent, with around 85 percent of parents and teachers reporting treatment results to be good or excellent. However, it was necessary to increase the children's dose by about 25 percent during the study, with most increases happening during the first year. All the children grew at rates considered normal for their age, and they gained only slightly less weight than would have been expected. In general, there were no clinically significant effects on blood pressure, heart rate, or other cardiac measures.
"We found these medications do continue to be effective in the long-term. While some particicipants did need to increase dosage beyond what could be attributed to their growth, any tolerance that developed seemed to be slight and limited to the first year," says Wilens. "We haven't seen any clinically meaningful problems with height and weight or any cardiovascular difficulties in this study, which also is the first to evaluate this kind of daylong treatment in a large group of children."
Wilens is an associate professor of Psychiatry at Harvard Medical School. The study's co-authors are Keith McBurnett, PhD, University of California at San Francisco; Mark Stein, PhD, University of Chicago; Marc Lerner, MD, University of California at Irvine; Thomas Spencer, MD, MGH; and Mark Wolraich, MD, University of Oklahoma.
Massachusetts General Hospital, established in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $450 million and major research centers in AIDS, cardiovascular research, cancer, cutaneous biology, medical imaging, neurodegenerative disorders, transplantation biology, stem cells and photomedicine. In 1994, MGH and Brigham and Women's Hospital joined to form Partners HealthCare System, an integrated health care delivery system comprising the two academic medical centers, specialty and community hospitals, a network of physician groups, and nonacute and home health services.
Sue McGreevey
617-724-2764
Massachusetts General Hospital
harvard
View drug information on Concerta.
воскресенье, 22 мая 2011 г.
For Boys With Fragile X Sydrome And ADHD, New Hope Found In Non-Stimulant Medication
The most common hereditary form of hereditary mental retardation is
known as Fragile X syndrome (FXS), so dubbed for its characteristic
mutation on the X chromosome, or Escalante's syndrome. Manifestations
of this disease in patients usually include a characteristic long
facial pattern, tooth and jaw misalignment, musculoskeletal
abnormalities, or autism.
Additionally, many FXS patients also suffer from attention
deficit
and/or hyperactivity disorder (ADHD), a disorder that can make
functioning socially or professionally difficult. Stimulant
medications, such as Ritalin®, are often effective for ADHD patients
with mental retardation, but there are counterproductive side effects
such as irritability, diminished speech, and social withdrawal.
L-acetyle carnitine (LAC,) a variant of the amino acid carnitine,
showed promise in a previous study of reducing hyperactive behavior in
FXS boys with AHDH. They were treated with it for one year, with no
adverse side effects reported. The same authors have subsequently
performed a andomized,
double-blind, placebo-controlled study over multiple centers to
determine how effective LAC can be in a larger group. This study will
be published in the April 1, 2008 issue of American Journal of Medical
Genetics Part
A, which is available online via Wiley InterScience at the
following address:
http://www3.interscience.wiley/cgi-bin/jhome/33129.
M. Giulia Torrioli and Giovanni Neri of the Universit? Cattolica in
Rome led the study, which brought together 51 boys between the ages of
6 and 12 who had been diagnosed with FXS and ADHD. They were treated in
one of eight facilities in Italy, France, and Spain. The treatment, 500
milligrams of LAC or a placebo twice a day, was continued for 12
months. A team of child neuropsychiatrists and psychologists evaluated
each patient at the start of the study, after one month, 6 months, and
12 months. Neuropsychologicial tests were used to evaluate the effects
of the drug and the placebo.
Subjects in the LAC group showed reduced hyperactive behavior and
better attention. In this group there were also no side effects,
indicating that LAC provides a safe alternative to stimulant therapies.
The placebo group showed less hyperactive behavior as well, but not at
the magnitude of the LAC group. Additionally, LAC patients showed
improved social ability. While both groups took intelligence tests, LAC
did not appear to improve intellectual function.
"We propose that
LAC be recommended as a treatment of ADHD in FXS children," the authors
state, "since it effectively reduces hyperactive behavior and
improves social abilities without adverse side effects." They also
suggest that these results may be applicable to children with autism,
who also do not easily tolerate stimulants.
About Wiley InterScience
Introduced in 1997 and launched
commercially in January 1999, Wiley InterScience
(interscience.wiley)
is a leading international resource for
quality content promoting discovery across the spectrum of scientific,
technical, medical and professional endeavors. In nearly a decade,
Wiley InterScience has built its reputation by regularly adding new
content and functionality; offering sophisticated search and navigation
capabilities; and providing robust online manuscript submission and
management tools.
Today, Wiley InterScience features must-have
content from more than 2,500 journals, books, reference works,
databases, laboratory manuals and the Cochrane Library, which is the
world's best-known resource for evidence-based medicine. More than half
of Wiley's journals on Wiley InterScience are digitized back to Volume
1, Issue 1 as part of the development of the journal backfile
initiative.
About Wiley
Founded in 1807, John Wiley
& Sons, Inc. has been a valued source of information and
understanding for 200 years, helping people around the world meet their
needs and fulfill their aspirations. Our core businesses include
scientific, technical, medical, and scholarly journals, encyclopedias,
books, and online products and services; professional/trade books,
subscription products, training materials, and online products and
services; and educational materials for undergraduate and graduate
students and lifelong learners. Wiley's global headquarters are located
in Hoboken, New Jersey, with operations in the U.S., Europe, Asia,
Canada, and Australia. The Company's Web site can be accessed at
wiley. The
Company is listed on the New York Stock Exchange
under the symbols JWa and JWb.
A
Double-Blind, Parallel, Multicenter Comparison of L-acetylcarnitine
with Placebo on the Attention Deficit Hyperactivity Disorder in Fragile
X Syndrome Boys
M. Giulia Torrioli, Silvia Vernacotola, Laura
Peruzzi, Elisabetta Tabolacci, Montserrat Mila, Roberto Militerni,
Sebastiano Musumeci, Feliciano J. Ramos, Mar?¬a Frontera, Giovanni
Sorge, Elisabetta Marzullo, Giusi Romeo, Louis Vallee, Edvige
Veneselli, Elena Cocchi, Eleonora Garbarino, Umberto Moscato, Pietro
Chiurazzi, Stefania D'Iddio, Menotti Calvani, Giovanni Neri
American Journal of Medical Genetics Part A, April
1st, 2008
DOI: 10.1002/ajmg.a.32268
Click
Here For Abstract
Written by Anna Sophia McKenney
View drug information on Ritalin LA.
known as Fragile X syndrome (FXS), so dubbed for its characteristic
mutation on the X chromosome, or Escalante's syndrome. Manifestations
of this disease in patients usually include a characteristic long
facial pattern, tooth and jaw misalignment, musculoskeletal
abnormalities, or autism.
Additionally, many FXS patients also suffer from attention
deficit
and/or hyperactivity disorder (ADHD), a disorder that can make
functioning socially or professionally difficult. Stimulant
medications, such as Ritalin®, are often effective for ADHD patients
with mental retardation, but there are counterproductive side effects
such as irritability, diminished speech, and social withdrawal.
L-acetyle carnitine (LAC,) a variant of the amino acid carnitine,
showed promise in a previous study of reducing hyperactive behavior in
FXS boys with AHDH. They were treated with it for one year, with no
adverse side effects reported. The same authors have subsequently
performed a andomized,
double-blind, placebo-controlled study over multiple centers to
determine how effective LAC can be in a larger group. This study will
be published in the April 1, 2008 issue of American Journal of Medical
Genetics Part
A, which is available online via Wiley InterScience at the
following address:
http://www3.interscience.wiley/cgi-bin/jhome/33129.
M. Giulia Torrioli and Giovanni Neri of the Universit? Cattolica in
Rome led the study, which brought together 51 boys between the ages of
6 and 12 who had been diagnosed with FXS and ADHD. They were treated in
one of eight facilities in Italy, France, and Spain. The treatment, 500
milligrams of LAC or a placebo twice a day, was continued for 12
months. A team of child neuropsychiatrists and psychologists evaluated
each patient at the start of the study, after one month, 6 months, and
12 months. Neuropsychologicial tests were used to evaluate the effects
of the drug and the placebo.
Subjects in the LAC group showed reduced hyperactive behavior and
better attention. In this group there were also no side effects,
indicating that LAC provides a safe alternative to stimulant therapies.
The placebo group showed less hyperactive behavior as well, but not at
the magnitude of the LAC group. Additionally, LAC patients showed
improved social ability. While both groups took intelligence tests, LAC
did not appear to improve intellectual function.
"We propose that
LAC be recommended as a treatment of ADHD in FXS children," the authors
state, "since it effectively reduces hyperactive behavior and
improves social abilities without adverse side effects." They also
suggest that these results may be applicable to children with autism,
who also do not easily tolerate stimulants.
About Wiley InterScience
Introduced in 1997 and launched
commercially in January 1999, Wiley InterScience
(interscience.wiley)
is a leading international resource for
quality content promoting discovery across the spectrum of scientific,
technical, medical and professional endeavors. In nearly a decade,
Wiley InterScience has built its reputation by regularly adding new
content and functionality; offering sophisticated search and navigation
capabilities; and providing robust online manuscript submission and
management tools.
Today, Wiley InterScience features must-have
content from more than 2,500 journals, books, reference works,
databases, laboratory manuals and the Cochrane Library, which is the
world's best-known resource for evidence-based medicine. More than half
of Wiley's journals on Wiley InterScience are digitized back to Volume
1, Issue 1 as part of the development of the journal backfile
initiative.
About Wiley
Founded in 1807, John Wiley
& Sons, Inc. has been a valued source of information and
understanding for 200 years, helping people around the world meet their
needs and fulfill their aspirations. Our core businesses include
scientific, technical, medical, and scholarly journals, encyclopedias,
books, and online products and services; professional/trade books,
subscription products, training materials, and online products and
services; and educational materials for undergraduate and graduate
students and lifelong learners. Wiley's global headquarters are located
in Hoboken, New Jersey, with operations in the U.S., Europe, Asia,
Canada, and Australia. The Company's Web site can be accessed at
wiley. The
Company is listed on the New York Stock Exchange
under the symbols JWa and JWb.
A
Double-Blind, Parallel, Multicenter Comparison of L-acetylcarnitine
with Placebo on the Attention Deficit Hyperactivity Disorder in Fragile
X Syndrome Boys
M. Giulia Torrioli, Silvia Vernacotola, Laura
Peruzzi, Elisabetta Tabolacci, Montserrat Mila, Roberto Militerni,
Sebastiano Musumeci, Feliciano J. Ramos, Mar?¬a Frontera, Giovanni
Sorge, Elisabetta Marzullo, Giusi Romeo, Louis Vallee, Edvige
Veneselli, Elena Cocchi, Eleonora Garbarino, Umberto Moscato, Pietro
Chiurazzi, Stefania D'Iddio, Menotti Calvani, Giovanni Neri
American Journal of Medical Genetics Part A, April
1st, 2008
DOI: 10.1002/ajmg.a.32268
Click
Here For Abstract
Written by Anna Sophia McKenney
View drug information on Ritalin LA.
суббота, 21 мая 2011 г.
New Research Evaluates The Impact Of Working Memory Training And Stimulant Medication On Kids With ADHD
A study to be published in the August 2009 edition of Applied Cognitive Psychology sheds new light on how Cogmed Working Memory Training and stimulant medication address working memory impairments in children with ADHD. Working memory, acknowledged as one of the core deficits in ADHD, represents the brain's ability to hold and process critical information related to the present moment. This study represents the latest findings from a team of independent UK researchers whose ongoing work examines the impact of Cogmed's software-based training program on individuals with disorders of memory and attention.
Conducted at the University of York, the research was led by Joni Holmes, Ph.D., and Susan Gathercole, Ph.D. The study evaluated the effects of both working memory training and medication on 25 children with ADHD. Each child performed a battery of tests to assess different aspects of working memory twice before training, once when the children were taking their medication for ADHD and once when they were not. Tests measuring the same aspects of working memory were also administered immediately after the Cogmed training program, as well as six months after training as a follow up.
The results show that stimulant medication significantly increases visuo-spatial working memory, but that Cogmed training leads to significant improvements in all four critical measures of working memory; verbal and visuo-spatial short-term and verbal and visuo-spatial working memory. The training effects remained six months after training.
"We're only just beginning to understand the different ways we can boost working memory. As we continue our work with children with ADHD and those with low working memory, it is very promising to see the magnitude and sustainability of gains following training," said Holmes.
"This recent study illustrates the important and lasting effects Cogmed training can have on the underlying issues in ADHD," said Jonas Jendi, Cogmed's CEO. "We are of course pleased to note that the study finds that the Cogmed training brings the working memory capacity of these children into the normal range, and that the findings hold for all of the six-month testing period. For a family struggling with ADHD and the school challenges that follow from the disorder, this is a finding that resonates."
The study adds to a growing body of research showing that Cogmed Working Memory Training can lead to a range of lasting improvements for anyone with a working memory impairment, spanning from pre-school children, adolescents, working adults and seniors.
For more information on the study, please visit here.
For more information about the University of York, visit york.ac.uk.
For a summary of this study, and on other Cogmed studies, visit cogmedresearch.
Source
Cogmed
Conducted at the University of York, the research was led by Joni Holmes, Ph.D., and Susan Gathercole, Ph.D. The study evaluated the effects of both working memory training and medication on 25 children with ADHD. Each child performed a battery of tests to assess different aspects of working memory twice before training, once when the children were taking their medication for ADHD and once when they were not. Tests measuring the same aspects of working memory were also administered immediately after the Cogmed training program, as well as six months after training as a follow up.
The results show that stimulant medication significantly increases visuo-spatial working memory, but that Cogmed training leads to significant improvements in all four critical measures of working memory; verbal and visuo-spatial short-term and verbal and visuo-spatial working memory. The training effects remained six months after training.
"We're only just beginning to understand the different ways we can boost working memory. As we continue our work with children with ADHD and those with low working memory, it is very promising to see the magnitude and sustainability of gains following training," said Holmes.
"This recent study illustrates the important and lasting effects Cogmed training can have on the underlying issues in ADHD," said Jonas Jendi, Cogmed's CEO. "We are of course pleased to note that the study finds that the Cogmed training brings the working memory capacity of these children into the normal range, and that the findings hold for all of the six-month testing period. For a family struggling with ADHD and the school challenges that follow from the disorder, this is a finding that resonates."
The study adds to a growing body of research showing that Cogmed Working Memory Training can lead to a range of lasting improvements for anyone with a working memory impairment, spanning from pre-school children, adolescents, working adults and seniors.
For more information on the study, please visit here.
For more information about the University of York, visit york.ac.uk.
For a summary of this study, and on other Cogmed studies, visit cogmedresearch.
Source
Cogmed
пятница, 20 мая 2011 г.
Prenatal Pesticide Exposures Linked To Attention Disorders In Preschool Children
Exposure to organophosphate (OP) pesticides before birth can increase susceptibility to attention disorders such as attention deficit/hyperactivity disorder (ADHD), according to new research published in the journal Environmental Health Perspectives (EHP). The new study is part of a growing body of research indicating that exposure to OP pesticides can adversely affect brain development.
OP pesticides target the nervous systems of insects by affecting the activity of neurotransmitters including acetylcholine, which in humans plays a critical role in brain development and is involved in attention and short-term memory. Exposure to OP compounds may also disrupt DNA replication and the growth of nerve axons and dendrites. Infants and young children are much more vulnerable to OP exposures than adults are because their ability to produce the enzyme that detoxifies OP pesticides is still developing.
Mothers participating in the study were recruited during pregnancy by the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS). The Mexican-American women lived in the Salinas Valley, an area of intensive agriculture where more than 235,000 kg of pesticides are applied annually. The researchers analyzed six OP metabolites in urine samples collected from the mothers during pregnancy and from their children several times after birth. The presence of these metabolites indicated exposure to OP pesticides used in the Salinas Valley, such as chlorpyrifos, diazinon, and oxydemeton-methyl.
The children's behavior was assessed at the ages of 3 and a half years (n = 331) and 5 years (n = 323) using reports from the mothers and standardized psychological tests.
The results indicated that as the concentration of OP metabolites in the urine of pregnant women increased, so did the likelihood that their children's test scores would be consistent with a clinical diagnosis of ADHD. The association was stronger at age 5 years than at 3 and a half and was more pronounced in boys than in girls. Prenatal exposures had a greater association than did exposures after birth: A tenfold increase in levels of measured pesticide metabolites in the mother's urine during pregnancy correlated to about a 500% increase in the likelihood of attention issues in their 5-year-olds, whereas a tenfold increase in levels of metabolites in the children's urine at 5 years of age corresponded to a 30% higher likelihood.
By measuring prenatal exposures and focusing on participants likely to have higher exposures to OP pesticides than the general population, this study complements research published in the June 2010 issue of the journal Pediatrics. In that study, Maryse Bouchard and colleagues measured the same six OP metabolites in 1,139 children aged 8 to 15 years selected from the general U.S. population. They found associations between OP exposure and ADHD even though those children had lower average exposures than did the children in the CHAMACOS study.
The authors of the EHP study suggest that research should continue to investigate whether genetic differences in OP metabolism affect susceptibility to developmental disorders, including ADHD. They state that "given that attention problems of children interfere with learning and social development, finding potential causes that can be remediated are of great public health importance." A companion article, also released today in EHP, explores potential genetic mechanisms behind effects associated with OP exposure.
The authors of "Organophosphate Pesticide Exposure and Attention in Young Mexican-American Children" are Amy R. Marks, Kim Harley, Asa Bradman, Katherine Kogut, Dana Boyd Barr, Caroline Johnson, Norma Calderon, and Brenda Eskenazi. This research was funded by grants from the National Institute of Environmental Health Sciences, the U.S. Environmental Protection Agency, and the National Institute for Occupational Health and Safety. The article will be available here.
The authors of the companion paper, "PON1 and Neurodevelopment in Children Exposed to Organophosphate Pesticides in Utero," are Brenda Eskenazi, Karen Huen, Amy Marks, Kim G. Harley, Asa Bradman, Dana Boyd Barr, and Nina Holland. This research was funded by grants from the National Institute of Environmental Health Sciences and the U.S. Environmental Protection Agency. The article will be available here.
Source:
Environmental Health Perspectives (NIEHS)
OP pesticides target the nervous systems of insects by affecting the activity of neurotransmitters including acetylcholine, which in humans plays a critical role in brain development and is involved in attention and short-term memory. Exposure to OP compounds may also disrupt DNA replication and the growth of nerve axons and dendrites. Infants and young children are much more vulnerable to OP exposures than adults are because their ability to produce the enzyme that detoxifies OP pesticides is still developing.
Mothers participating in the study were recruited during pregnancy by the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS). The Mexican-American women lived in the Salinas Valley, an area of intensive agriculture where more than 235,000 kg of pesticides are applied annually. The researchers analyzed six OP metabolites in urine samples collected from the mothers during pregnancy and from their children several times after birth. The presence of these metabolites indicated exposure to OP pesticides used in the Salinas Valley, such as chlorpyrifos, diazinon, and oxydemeton-methyl.
The children's behavior was assessed at the ages of 3 and a half years (n = 331) and 5 years (n = 323) using reports from the mothers and standardized psychological tests.
The results indicated that as the concentration of OP metabolites in the urine of pregnant women increased, so did the likelihood that their children's test scores would be consistent with a clinical diagnosis of ADHD. The association was stronger at age 5 years than at 3 and a half and was more pronounced in boys than in girls. Prenatal exposures had a greater association than did exposures after birth: A tenfold increase in levels of measured pesticide metabolites in the mother's urine during pregnancy correlated to about a 500% increase in the likelihood of attention issues in their 5-year-olds, whereas a tenfold increase in levels of metabolites in the children's urine at 5 years of age corresponded to a 30% higher likelihood.
By measuring prenatal exposures and focusing on participants likely to have higher exposures to OP pesticides than the general population, this study complements research published in the June 2010 issue of the journal Pediatrics. In that study, Maryse Bouchard and colleagues measured the same six OP metabolites in 1,139 children aged 8 to 15 years selected from the general U.S. population. They found associations between OP exposure and ADHD even though those children had lower average exposures than did the children in the CHAMACOS study.
The authors of the EHP study suggest that research should continue to investigate whether genetic differences in OP metabolism affect susceptibility to developmental disorders, including ADHD. They state that "given that attention problems of children interfere with learning and social development, finding potential causes that can be remediated are of great public health importance." A companion article, also released today in EHP, explores potential genetic mechanisms behind effects associated with OP exposure.
The authors of "Organophosphate Pesticide Exposure and Attention in Young Mexican-American Children" are Amy R. Marks, Kim Harley, Asa Bradman, Katherine Kogut, Dana Boyd Barr, Caroline Johnson, Norma Calderon, and Brenda Eskenazi. This research was funded by grants from the National Institute of Environmental Health Sciences, the U.S. Environmental Protection Agency, and the National Institute for Occupational Health and Safety. The article will be available here.
The authors of the companion paper, "PON1 and Neurodevelopment in Children Exposed to Organophosphate Pesticides in Utero," are Brenda Eskenazi, Karen Huen, Amy Marks, Kim G. Harley, Asa Bradman, Dana Boyd Barr, and Nina Holland. This research was funded by grants from the National Institute of Environmental Health Sciences and the U.S. Environmental Protection Agency. The article will be available here.
Source:
Environmental Health Perspectives (NIEHS)
четверг, 19 мая 2011 г.
New Study Reveals That Coaching Helps College Students With ADHD Improve Ability To Learn, Succeed In College
The results of a new study being released this week at the Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD) conference in Atlanta demonstrate the effectiveness of a new model of coaching, developed exclusively for and used by the Edge Foundation, to help college students with ADHD improve executive functioning, which is their ability to organize, set and achieve goals, and self regulate -- all critical for a successful post secondary education. Additionally, students who participated in the study felt that coaching helped them feel less stress, greater empowerment, increased confidence and have more balanced lives.
Researchers from Wayne State University in Michigan conducted the study over two years in 10 universities and community colleges throughout the country and tracked the progress of 110 students with ADHD. It is the largest and most comprehensive study of ADHD coaching conducted to-date. The research team measured students' progress through both quantitative and qualitative analysis and have determined, "This study demonstrated that the Edge coaching model was highly effective in helping students improve executive functioning and related skills as measured by the Learning and Study Strategies Inventory (LASSI; Weinstein & Palmer, 2002)."
Coaching has long been used by corporations to improve performance of CEOs and executives, but little research has been done until now on the impact this kind of intervention may have on populations with learning disabilities, like ADHD. While medication has been shown to improve academic productivity (better note-taking, scores on quizzes and worksheets, and homework completion), medication alone is not associated with skills students need to meet the demands of college which they must navigate more independently than in previous schooling.
Source: Edge Foundation
Researchers from Wayne State University in Michigan conducted the study over two years in 10 universities and community colleges throughout the country and tracked the progress of 110 students with ADHD. It is the largest and most comprehensive study of ADHD coaching conducted to-date. The research team measured students' progress through both quantitative and qualitative analysis and have determined, "This study demonstrated that the Edge coaching model was highly effective in helping students improve executive functioning and related skills as measured by the Learning and Study Strategies Inventory (LASSI; Weinstein & Palmer, 2002)."
Coaching has long been used by corporations to improve performance of CEOs and executives, but little research has been done until now on the impact this kind of intervention may have on populations with learning disabilities, like ADHD. While medication has been shown to improve academic productivity (better note-taking, scores on quizzes and worksheets, and homework completion), medication alone is not associated with skills students need to meet the demands of college which they must navigate more independently than in previous schooling.
Source: Edge Foundation
среда, 18 мая 2011 г.
Autistic Children Get An Israeli 'Biohug'
For Raffi Rembrand, necessity was definitely the mother of his invention. An
Israeli engineer and father to a son with autism, Rembrand was well aware of
the difficulties of raising a child with severe autism.
He had devoured all the information about the well established treatment of
deep pressure touch to produce a calming effect in agitated individuals with
autism. However, he discovered that most existing devices were more like
straightjackets and weren't sensitive to changes in the patient's movement
and couldn't regulate the pressure based on the patient's needs or body
gauges.
An inventor by nature, Rembrand began tinkering in his home until he came up
with the idea of a light, wearable, vest-like calming device that's both
portable and non-restraining.
Working through a few prototypes of that 'home remedy' makeshift device has
resulted in the BioHug - a vest for both people with autism and and children
diagnosed with Attention Deficit Hyperactivity Disorder (ADHD).
The BioHug delivers a mildly pulsating pressure through the use of
inflatable cells placed throughout the garment and includes a biofeedback
mechanism which automatically regulates the level of stimulation.
According to Center for Disease Control, one out of every 150 children in
the US suffers from a disorder which falls somewhere on the autism spectrum,
ranging from Asperger's Syndrome on one end to severe autism on the other.
ADHD is much more prevalent, however, with millions of children diagnosed
with the learning disorder.
"It was very much an improvisational exercise," says Rembrand, describing
how he developed the BioHug. "The idea of inflatable bubble cells is used
for people with pressure wounds to keep them from getting infected. I took a
little from here and a little from there. There wasn't any patent, it was
just a nice development,"
"I approached ALUT (the Israeli Society for Autistic Children) and said,
'here's a simple idea which might help the kids - I've tested it on my son,
and on other people with autism.'
They were so impressed that they implored Rembrand to take it out of the
'amateur' sphere and develop a scientifically tested, professional device
that could be made available to all people with autism. For expert advice,
he approached Dr. Einat Gal a clinical researcher at the University of
Haifa, who continues to collaborate on the development of the BioHug
Still Rembrand wasn't satisfied. "Everyone told me 'you know this invention
is way too simple'. It has a very low technological barrier, so I said OK if
this is what needs to be done, I'll add some technology to it - which is how
we came to include biofeedback."
According to Rembrand, the device measures the user's stress, and that
stress actually controls the BioHug's pressure and pulsation rate. A change
in the stress counter will cause adjustment to the pulsation rate and amount
of pressure.
Earlier this year, Rembrand founded BioHug Technologies Ltd. to
commercialize the device and was accepted into the Chief Scientist of Israel
incubator program - via L.N. Innovative Technologies in Haifa.
He also found a kindred soul in Andrew Schiffmiller, a veteran manager and
consultant, who took up the position of CEO.
"The BioHug is unique among all other types of pressure-based devices for
people with autism because we solve the problem of habituation,"
Schiffmiller told ISRAEL21c.
"Try it yourself - gently pinch your wrist - you feel it, but if you keep
doing it, after a short while you don't feel it anymore. Your body gets used
to it. Through the pulsation feature on the BioHug, we reduce the
habituation so the sensation of pressure on the user will continue, because
it's always changing."
According to Schiffmiller, the original reason Rembrand - who acts as
BioHug's chief technological officer - invented the BioHug concept wasn't
just to keep his son calm, but to conduct tests on a theory he had
researched regarding hearing.
"There's a body of suggestive evidence that people with autism hear
differently than other people. When you put a shell to your ear and you
think you hear the ocean - it's called otoacoustic emissions - produced by
the inner ear itself which is thought to have some role in filtering out
background noise," Schiffmiller explained.
"The working theory was that there's a difference in the otoacoustic
emissions of people with autism - if that's true and you can quantify it,
then you can have a purely empirical way of diagnosing autism - even in
infants."
But the problem is, how do you get naturally fidgety people with autism to
sit till long enough to conduct an ear exam? And according to Rembrand and
Schiffmiller, the BioHug is the solution.
They're still revising the design of the BioHug before they actually begin
clinical testing, discussing issues of whether the compressor will be in the
vest or an accompanying backpack and other design issues. But according the
feedback they've received from students with autism who've tried the device
and from professionals in the field, they're on the right track.
"Every time we build a prototype, we go back to the Horsha school for
children with autism that Rafi has a good relationship with, we give it to
the staff, they play with, try it on and give us their suggestions," said
Schiffmiller. "Since these are people that work with children with autism
every day and they themselves are experienced in the application of the
pressure, they've been great sounding boards for us."
"And they're still using my first prototype at the school," added Rembrand.
Both Schiffmiller and Rembrand are confident that the BioHug represents a
huge leap in the field of controlled pressure devices for patients with
autism. Some devices are based on the principle of weight, where weighted
garments place pressure on the user's shoulders. But Schiffmiller claims
there are two drawbacks to that type of therapy.
"One is the issue of habituation - after a few minutes, you don't really
feel it. And two, in order to be effective, the total weight needs to about
10 percent of the wearer's body weight - that's heavy, especially if you're
talking about adults."
And then there's a device invented a decade ago by Temple Grandon - a very
high functioning person with autism in the US - who created a machine that's
based on restraining chute for cattle.
"As a child, she always craved pressure. Once when she was visiting her
uncle's farm, she saw him using a restraining chute for the cattle, and she
climbed in and found that the pressure helped calm her," explained
Schiffmiller.
"Her device is large and cumbersome - about 350 pounds and uses an
industrial air compressor. What Rafi has done - in essence - is to
miniaturize that process into the BioHug."
Depending on the population, the BioHug can function in a number of
different ways, says Schiffmiller. For ADHD students, it could be worn at
homework time enabling the user to concentrate and stay on task. And with
people with autism who sometimes suffer through periods of severe agitation,
it's a tool to help them calm down.
"With some some people with autism, the possibility exists that they may
hurt themselves, or hurt others, and the BioHug is an effective way to get
them to relax," he said.
Rembrand is confident that the BioHug will prove to be a useful device for
the families of children with autism. And he only has to look as far as his
own son, Jacob, now 23 years old.
"He's my primary beta tester. And if he says it's good, then we know it's
good."
By David Brinn
Israeli engineer and father to a son with autism, Rembrand was well aware of
the difficulties of raising a child with severe autism.
He had devoured all the information about the well established treatment of
deep pressure touch to produce a calming effect in agitated individuals with
autism. However, he discovered that most existing devices were more like
straightjackets and weren't sensitive to changes in the patient's movement
and couldn't regulate the pressure based on the patient's needs or body
gauges.
An inventor by nature, Rembrand began tinkering in his home until he came up
with the idea of a light, wearable, vest-like calming device that's both
portable and non-restraining.
Working through a few prototypes of that 'home remedy' makeshift device has
resulted in the BioHug - a vest for both people with autism and and children
diagnosed with Attention Deficit Hyperactivity Disorder (ADHD).
The BioHug delivers a mildly pulsating pressure through the use of
inflatable cells placed throughout the garment and includes a biofeedback
mechanism which automatically regulates the level of stimulation.
According to Center for Disease Control, one out of every 150 children in
the US suffers from a disorder which falls somewhere on the autism spectrum,
ranging from Asperger's Syndrome on one end to severe autism on the other.
ADHD is much more prevalent, however, with millions of children diagnosed
with the learning disorder.
"It was very much an improvisational exercise," says Rembrand, describing
how he developed the BioHug. "The idea of inflatable bubble cells is used
for people with pressure wounds to keep them from getting infected. I took a
little from here and a little from there. There wasn't any patent, it was
just a nice development,"
"I approached ALUT (the Israeli Society for Autistic Children) and said,
'here's a simple idea which might help the kids - I've tested it on my son,
and on other people with autism.'
They were so impressed that they implored Rembrand to take it out of the
'amateur' sphere and develop a scientifically tested, professional device
that could be made available to all people with autism. For expert advice,
he approached Dr. Einat Gal a clinical researcher at the University of
Haifa, who continues to collaborate on the development of the BioHug
Still Rembrand wasn't satisfied. "Everyone told me 'you know this invention
is way too simple'. It has a very low technological barrier, so I said OK if
this is what needs to be done, I'll add some technology to it - which is how
we came to include biofeedback."
According to Rembrand, the device measures the user's stress, and that
stress actually controls the BioHug's pressure and pulsation rate. A change
in the stress counter will cause adjustment to the pulsation rate and amount
of pressure.
Earlier this year, Rembrand founded BioHug Technologies Ltd. to
commercialize the device and was accepted into the Chief Scientist of Israel
incubator program - via L.N. Innovative Technologies in Haifa.
He also found a kindred soul in Andrew Schiffmiller, a veteran manager and
consultant, who took up the position of CEO.
"The BioHug is unique among all other types of pressure-based devices for
people with autism because we solve the problem of habituation,"
Schiffmiller told ISRAEL21c.
"Try it yourself - gently pinch your wrist - you feel it, but if you keep
doing it, after a short while you don't feel it anymore. Your body gets used
to it. Through the pulsation feature on the BioHug, we reduce the
habituation so the sensation of pressure on the user will continue, because
it's always changing."
According to Schiffmiller, the original reason Rembrand - who acts as
BioHug's chief technological officer - invented the BioHug concept wasn't
just to keep his son calm, but to conduct tests on a theory he had
researched regarding hearing.
"There's a body of suggestive evidence that people with autism hear
differently than other people. When you put a shell to your ear and you
think you hear the ocean - it's called otoacoustic emissions - produced by
the inner ear itself which is thought to have some role in filtering out
background noise," Schiffmiller explained.
"The working theory was that there's a difference in the otoacoustic
emissions of people with autism - if that's true and you can quantify it,
then you can have a purely empirical way of diagnosing autism - even in
infants."
But the problem is, how do you get naturally fidgety people with autism to
sit till long enough to conduct an ear exam? And according to Rembrand and
Schiffmiller, the BioHug is the solution.
They're still revising the design of the BioHug before they actually begin
clinical testing, discussing issues of whether the compressor will be in the
vest or an accompanying backpack and other design issues. But according the
feedback they've received from students with autism who've tried the device
and from professionals in the field, they're on the right track.
"Every time we build a prototype, we go back to the Horsha school for
children with autism that Rafi has a good relationship with, we give it to
the staff, they play with, try it on and give us their suggestions," said
Schiffmiller. "Since these are people that work with children with autism
every day and they themselves are experienced in the application of the
pressure, they've been great sounding boards for us."
"And they're still using my first prototype at the school," added Rembrand.
Both Schiffmiller and Rembrand are confident that the BioHug represents a
huge leap in the field of controlled pressure devices for patients with
autism. Some devices are based on the principle of weight, where weighted
garments place pressure on the user's shoulders. But Schiffmiller claims
there are two drawbacks to that type of therapy.
"One is the issue of habituation - after a few minutes, you don't really
feel it. And two, in order to be effective, the total weight needs to about
10 percent of the wearer's body weight - that's heavy, especially if you're
talking about adults."
And then there's a device invented a decade ago by Temple Grandon - a very
high functioning person with autism in the US - who created a machine that's
based on restraining chute for cattle.
"As a child, she always craved pressure. Once when she was visiting her
uncle's farm, she saw him using a restraining chute for the cattle, and she
climbed in and found that the pressure helped calm her," explained
Schiffmiller.
"Her device is large and cumbersome - about 350 pounds and uses an
industrial air compressor. What Rafi has done - in essence - is to
miniaturize that process into the BioHug."
Depending on the population, the BioHug can function in a number of
different ways, says Schiffmiller. For ADHD students, it could be worn at
homework time enabling the user to concentrate and stay on task. And with
people with autism who sometimes suffer through periods of severe agitation,
it's a tool to help them calm down.
"With some some people with autism, the possibility exists that they may
hurt themselves, or hurt others, and the BioHug is an effective way to get
them to relax," he said.
Rembrand is confident that the BioHug will prove to be a useful device for
the families of children with autism. And he only has to look as far as his
own son, Jacob, now 23 years old.
"He's my primary beta tester. And if he says it's good, then we know it's
good."
By David Brinn
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