Thank you Danny – I Forgot You Don’t Always See Special Needs

Last updated on June 27th, 2016 at 12:04 pm

Overweight-special-needs-boyEvery day of the school year as I crept along in my car in Los Angeles traffic, I passed an elementary school. There were always many children walking with adults, but one boy caught my attention. He was incredibly overweight, and he didn’t walk as much as waddle. His feet barely fit in his sneakers. When I first started seeing him and his mother I got a little judgy – how could his mother let him get this out of hand? What is she feeding him? Doesn’t she realize she is setting him up for a lifetime of health challenges and eating disorders? Then I caught myself, and I thought of Danny.

I never met Danny during his short life, but I follow his mother on Facebook on her Danny’s Warriors page. She chronicled his battle with a brain tumor with painful honestly – a battle we all knew he was going to lose. She and her family tried to make happy memories with Danny, despite his decline. She shared info about his meds and their side effects. Even as he got sicker, one of his meds made him very swollen.

Suddenly my attitude toward the boy and his mom changed. What were they dealing with? Did he have special needs? What if his future was going to be cut short? Now I was happy that the boy was up on his feet, and that he was being made to walk. Each day I tried to see if he was doing better or worse. I searched for little signs, and I worried about him and his mother. I could see how much she loved him unconditionally. I can’t believe I missed all that the first few times I saw them! Sometimes I actually wanted to pull over and talk to them, to see if they needed anything, but I thought that would be weird and stalker-ish. I have to trust that they have a support system in place. All I can do is send out love to them.

Danny has been gone for a while now. I send out love to his mom, his family and his little brother and I thank them for changing my attitude about this other boy and for reminding me how important it is to love the people who are around you today.

A Child’s Temperament Is Not Destiny: Parenting Matters

Last updated on June 22nd, 2016 at 11:03 am

temperament-is-not-destinyThere was a great article I read recently written by a pediatrician who described each child as “a different assignment.” No truer words have been spoken by someone who deals with children every day. Within the range of normal children’s development, there is a huge variation in kids’ temperaments, personalities, and sensitivities. Do you ever wonder how your little “assignment” will turn out as an adult? Do you worry that his/her difficult temperament must be a sign of hard times ahead?

Luckily research has examined some of these questions and the results fall on the side of parents.

A child’s temperament does matter, but parenting also matters a lot.

Researchers from Indiana University wanted to look at how babies with different temperaments (e.g., difficult, easy) ended up doing socially and academically by the time they reached first grade and what, if any, role parenting played in this process. Previously, some people had thought that a baby with a difficult temperament would have more difficulty adjusting to school later in life.

These researchers studied 1,364 children from birth to first grade, along with their parents. The children were given a temperamental classification (e.g., difficult, easy) at 6 months of age. Mothers’ parenting style was observed several times over the course of the study with areas such as warmth and age-appropriate control being examined. Lastly, children’s adjustment to first grade was considered in areas such as academic competence and social skills.

The findings were very enlightening: children who were labeled as having a difficult temperament as infants had as good as or better grades and social skills in first grade as children not labeled as difficult if their mothers provided good parenting. In other words, parenting matters! This is probably not a huge surprise to many people, but it’s interesting to see the research to back it up. Not surprisingly, children with difficult temperaments who received less-than-optimal parenting fared worse in first grade than other children.

Perhaps the most interesting part of the study is the fact that researchers believe that children with difficult temperaments are more sensitive to both positive and negative parenting.

That is, they were more likely (than children with non-difficult temperaments) to adjust poorly to first grade if they experienced negative parenting, but they were also more likely to perform well in first grade if they received excellent parenting. Although this is just one study, it makes a lot of sense. Children with difficult temperaments are thought to be extra sensitive to the external environment and find it harder to regulate themselves. Scientists are learning to understand the difference between babies with varying degrees of nervous system sensitivity.

Researchers believe this is one piece in understanding how some kids can experience extreme challenges such as parental loss or poverty and still thrive. Within a context of responsive caregiving, even temperamentally sensitive children can be resilient in the face of challenges, even perhaps more so than those with an “easy” temperament.

This research sends an optimistic message to parents. What you do really matters! Children with more sensitive temperament may strain your parenting muscles but the “payoff” is higher too. If your child has a difficult temperament, approaching him/her with sensitivity and warmth can make a huge difference.

Source: Stright, A. D., Gallagher, K. C., & Kelley, K. (2008). Infant temperament moderates relations between maternal parenting in early childhood and children’s adjustment in first grade. Child Development, 79, 186-200.

Study: Depression During Pregnancy Linked to Depression in Child

Last updated on June 22nd, 2016 at 11:03 am

“Children whose mothers are depressed during pregnancy have a small increased risk of depression in adulthood,” BBC News reports.

In this study researchers looked at whether antenatal depression (depression during pregnancy) and postnatal depression in mothers was associated with a higher risk of depression in their children in late adolescence.

They found that, at the age of 18, adolescents had a small increased risk of having depression if their mother had antenatal depression. However, the link between postnatal depression and later depression in the offspring was only present in cases where the mother had a lower level of education. The researchers took level of education to be a marker of socioeconomic status.

The strengths of this study include its size (there were more than 8,000 participants) and its length (around twenty years).

The main limitation is that it is still difficult to say for certain that maternal depression during pregnancy or after birth directly influences risk of depression in offspring later.

The researchers speculate that antenatal depression could increase levels of stress hormones which could affect the development of the baby. This cannot be proven by the evidence presented in this study. Depression is a complex condition, and likely to be influenced by both genetic and environmental factors.

Pregnant women should not worry unduly about whether their moods can affect their unborn child. The important thing is to seek help if you think you are experiencing symptoms of depression.

Depression during pregnancy

Depression-during-pregnancyThere is a lot of publicity about postnatal depression, but little is said about antenatal depression. But antenatal depression is more common than most people realise. A recent study estimated that around one in five women are affected.

Being pregnant can be extremely stressful. One expert said she wasn’t surprised that some pregnant women were affected by depression, she was surprised that all women were not affected.

Read more about feelings and relationships during pregnancy in the NHS Choices Pregnancy and Baby Guide.

Where did the story come from?

The study was carried out by researchers from the University of Bristol, University of London, Oxford University and the University of Rochester in the US. It was funded by the Wellcome Trust, the National Institutes of Health in the US and the United Kingdom Medical Research Council.

The study was published in the peer-reviewed Journal of the American Association (JAMA) Archives of Psychiatry.

In general, it was covered accurately if uncritically in the press. The Daily Mail’s phrasing made the risk of depression in offspring of mothers who had been depressed in pregnancy seem larger than it is. And BBC News made an error when it reported that the study involved “more than 8,000 mothers with depression”. The study involved 8,937 mothers for whom data on antenatal and postnatal depression was available. This does not mean they were all depressed.

What kind of research was this?

This was a prospective cohort study that looked at whether there was a link between maternal antenatal and postnatal depression and depression in their offspring.

The authors point out that depression in late adolescence is a major public health issue. They say that there have been few studies looking at whether antenatal or postnatal depression in the mother is a risk factor.

A prospective cohort study is the best way to look at the link between exposures (in this case maternal antenatal or postnatal depression) and later outcomes (in this case offspring depression). The main limitation of the study design is that many factors can affect the risk of depression, and it is difficult to rule out the possibility that factors other than the one being studied are influencing any link seen.

Researchers can take steps to reduce the impact of these factors (known as confounders) on their analyses, but there is always the possibility that there are further confounders.

What did the research involve?

The researchers used data from a large study of pregnant women due to deliver in 1991 and 1992, called the Avon Longitudinal Study of Parents and Children (ALSPAC). They assessed antenatal and postnatal depression in the participating mothers, and then assessed whether any of their children had depression when they reached the age of 18.

The ALSPAC study recruited the children from 15,247 pregnancies. The current study looked at 8,937 of the women for whom data on antenatal depression (abbreviated to AND) and postnatal depression (PND) was available.

Symptoms of antenatal and postnatal depression in the mothers and in the fathers were measured using the Edinburgh Postnatal Depression Scale (EPDS). This is a standard 10-item self-report depression questionnaire used for postnatal depression.

The questionnaires were sent by post at approximately 18 and 32 weeks of the pregnancy and when the child was aged eight weeks and eight months.

The same depression scale was used to measure maternal depression repeatedly up until the child reached the age of 12 years.

Fathers also completed the depression questionnaire at 18 weeks of pregnancy and eight months postnatally.

Mothers also completed questionnaires about other factors that could affect results (potential confounders). This included:

  • Their education and their partner’s education
  • Maternal age
  • Social class
  • Number of other children
  • History of depression before pregnancy
  • Smoking during pregnancy
  • Breastfeeding in the first year
  • Use of non-parental childcare within the first six months of the child’s life

When the children reached the age of 18, they were assessed for major depression using a self-administered, computerised version of a validated clinical interview. Only 4,566 of the offspring were assessed for depression at the age of 18.

Researchers then carried out various analyses of the association between both maternal AND and PND symptoms and depression in the offspring at the age of 18. They took into account the potential confounders in their analyses. They also analysed whether the mother’s education had an impact on any associations between AND and PND, and depression in the 18-year-old offspring. They carried out similar analyses for the fathers, but they focused on the mothers.

What were the basic results?

The researchers report that 11.6% of the 8,937 women reported symptoms which classified them as having AND, and 7.4% had symptoms which classified them as having PND. When analysing the relationship between maternal and paternal perinatal depression and risk of offspring depression they found that:

  • After taking into account potential confounders, including later depression, antenatal depression in the mother was associated with depression in their offspring at 18 years. For every five-point increase in maternal depression score antenatally, the odds of the offspring having depression at the age of 18 years was 1.28 times higher (95% Confidence interval (CI), 1.08 to 1.51). This relationship did not appear to be affected by maternal education.
  • There was also an association between mothers with postnatal depression and depression in their offspring at 18 years, but this was weakened when potential confounders were taken into account, and the link varied depending on maternal education. Maternal PND in mothers with lower levels of education was associated with offspring depression (odds ratio [OR] 1.26, 95% CI 1.06 to 1.50 for a five-point increase in postnatal depression score). The link was not statistically significant among mothers with higher levels of education.
  • Fathers’ depression antenatally was not associated with offspring depression. Postnatally, paternal depression was associated with offspring depression but, again, this was limited to fathers who had lower levels of education.

How did the researchers interpret the results?

The authors say that their findings suggest that treating maternal depression during pregnancy could prevent depression in their offspring during adulthood. They also say that prioritising less advantaged mothers postnatally may be most effective in preventing depression in adolescent children.

They say that their findings suggest that while antenatal depression may be transmitted from mother to foetus by a biological mechanism, the risk of PND associated with offspring depression is environmental and can be modified by factors like psychosocial support. They also raise the possibility that transmission of depression from mother to child may be genetic.

Conclusion

The strengths of this study lie in its large sample, long-term follow-up and also the repeated measures of maternal depression conducted by researchers.

However, it also had some limitations:

  • Data was only available for about half the adolescents of mothers involved in the study, and those that took part tended to have higher socioeconomic status than the average for the whole original sample. This could introduce selection bias.
  • The method used to assess maternal depression was a valid way to measure depression symptoms, but a formal depression diagnosis requires a more thorough clinical interview.
  • Maternal depression was only measured up until the child reached 12 years of age, so it is uncertain if maternal depression after this point might have been associated with their offspring’s depression.
  • Although the study adjusted results for factors that might affect the risk of depression, such as parental income, it did not take into account other factors that could affect risk of depression in adolescents, such as external pressures relating to school and peer group.
  • The study did not assess whether the women were receiving treatment for their depression and how this might have influenced results.

Depression is a complex condition, and there are likely to be many factors influencing our risk of developing it. While this study suggests that there may be a link between maternal antenatal and postnatal depression and offspring depression, it cannot say for certain why this is the case, and whether these factors are directly influencing risk.

Further research is likely to continue in this area.

Depression during pregnancy and postnatally should always be taken seriously, and women who are experiencing depressive symptoms should seek help.

You may be depressed if, during the past month:

  • You have often been bothered by feeling down, depressed or hopeless
  • You take little or no pleasure in doing things that normally make you happy

If you experience either or both of these symptoms you should contact your GP for advice.

For more information about depression and low mood visit the NHS Choices Moodzone.

Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter.

Summary

“Children whose mothers are depressed during pregnancy have a small increased risk of depression in adulthood,” BBC News reports. In this study, researchers looked at whether antenatal depression (depression during pregnancy).

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Child Health & Safety News Roundup: 06-06-2016 to 06-12-2016

Last updated on June 15th, 2016 at 06:37 pm

twitter thumbIn this week’s Children’s Health News: This specialized exoskeleton can help disabled children walk https://t.co/IRv6vRDKUu

Welcome to Pediatric Safety’s weekly “Child Health & Safety News Roundup”- a recap of the past week’s child health and safety news headlines from around the world. Each day we use Twitter and Facebook to communicate relevant and timely health and safety information to the parents, medical professionals and other caregivers who follow us. Occasionally we may miss something, but we think overall we’re doing a pretty good job of keeping you informed. But for our friends and colleagues not on Twitter or FB (or who are but may have missed something), we offer you a recap of the past week’s top 20 events & stories.

PedSafe Child Health & Safety Headline of the Week:
The scary truth about school lunch that has nothing to do with the food https://t.co/2DwPff2ucq
20 mins for lunch is all kids are given – period!

Tomorrow, AMC has X-Men: Apocalypse Sensory Friendly

Last updated on June 15th, 2016 at 06:33 pm

AMC Entertainment (AMC) has expanded their Sensory Friendly Films program in partnership with the Autism Society!  This Tuesday evening, families affected by autism or other special needs have the opportunity to view a sensory friendly screening of X-Men: Apocalypse a film that may appeal to older audiences on the autism spectrum. 

New sensory friendly logoAs always, the movie auditoriums will have their lights turned up and the sound turned down. Families will be able to bring in snacks to match their child’s dietary needs (i.e. gluten-free, casein-free, etc.), there are no advertisements or previews before the movie and it’s totally acceptable to get up and dance, walk, shout, talk to each other…and even sing – in other words, AMC’s “Silence is Golden®” policy will not be enforced during movie screenings unless the safety of the audience is questioned.

X-Men-PosterDoes it make a difference? Absolutely! Imagine …no need to shhhhh your child. No angry stares from other movie goers. Many parents think twice before bringing a child to a movie theater. Add to that your child’s special needs and it can easily become cause for parental panic. But on this one day a month, for this one screening, everyone is there to relax and have a good time, everyone expects to be surrounded by kids – with and without special needs – and the movie theater policy becomes “Tolerance is Golden“.

AMC and the Autism Society will be showing X-Men: Apocalypse tomorrow, Tuesday, June 14th at 7pm (local time). Tickets are $4 to $6 depending on the location. To find a theatre near you, here is a list of AMC theatres nationwide participating in this fabulous program (note: to access full list, please scroll to the bottom of the page).

Coming later in June: Finding Dory (Sat, 6/25)

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Editor’s note: Although X-Men: Apocalypse has been chosen by the Autism Society for a Tuesday Sensory Friendly screening, we do want parents to know that it is rated PG-13 by the Motion Picture Association of America for sequences of violence, action and destruction, brief strong language and some suggestive images. As always, please check the IMDB Parents Guide for a more detailed description of this film to determine if it is right for you and your family.

Take Care of Kids’ Teeth This Summer

Last updated on June 20th, 2016 at 11:51 am

jungen beim zähneputzenAcross the country, summer vacation is in full swing. Kids—and parents—are adopting new schedules the leisurely months of summer.

As you’re planning their next few months of relaxation, don’t forget their teeth. When your family hangs out at the pool, zoo or amusement park, you pack sunscreen. When they’re hungry—which is all the time, or at least it can feel that way—you feed them. When they’re thirsty, you make sure they have plenty of fluids. When they’ve gotten muddy or dirty from a day of playing outside, you make them take a shower. But one thing that’s often overlooked is their oral health. What’s going on with your kids’ teeth?

We look for signs to cue us in those other areas—we spot a sunburn or grubby feet, and we can hear reminders for meals and drinks and snacks. But we can’t see what’s happening with their teeth. And with summer’s fresh schedule and spontaneous outings, it can be easy to forget the normal routines that come with school nights and getting up and out the door for the bus.

Here are a few simple ways to help your kids take care of their teeth this summer:

  • Remind them to brush. Bedtime and morning routines be more fluid in summer, if they exist at all, so do what you can to create other reminders. Set an alarm on your phone or write a note on the bathroom mirror in dry erase marker.
  • Try to limit junk food. Just because they’re on the run or in the sun doesn’t mean you have to serve pop-tarts and popsicles. Keep healthy options on hand and save the sweets for occasional treats.
  • Keep water close by. With all of the sunshine, warmth and added activity of summer, your family will need plenty to drink. Be sure you have bottles of water around to make hydration easy and to reduce the temptation to stop for a soda when you’re out and about. There are a variety of great reusable bottle options available to keep waste to a minimum.
  • Pack extras. Have a few extra toothbrushes around in places other than the bathroom cabinet. Stash a few in the car, gym bag, pool bag or backpacks, so kids don’t have to remember to pack a toothbrush. Having extra toothbrushes to offer those visiting your house is helpful as well. It’s not just your kids who forget.
  • Make it fun. When all else fails, you can turn on some goofy music and insist that everyone participates in a family toothbrushing party. It may seem corny, but it’s worth it since healthy mouths make healthy kids.