Category: Child Development

Parental problems and a chaotic home environment could be preventing children from taking their prescribed asthma medication.

A new study, which will be presented Monday (Sept. 3, 2012) at the European Respiratory Society’s Annual Congress in Vienna, has shown that children’s asthma symptoms could be worse due to issues in their home.

Non-adherence to asthma medication is a common problem, although it is not yet understood what the major barriers are for patients. In this new study, researchers have, for the first time, recorded and analysed a large range of commonly suspected reasons for children taking their asthma medication ineffectively.

As part of an on-going project aiming to assess determinants of adherence to asthma, researchers in the Netherlands electronically measured how well children took their maintenance medication to control their asthma. The project has already produced results showing that children with high adherence rates have well-controlled asthma with fewer symptoms, such as breathlessness and wheeze.

Despite the testing centre offering patients a comprehensive asthma care programme, many children still had low adherence to asthma medication. To understand what could be preventing children following a treatment plan, researchers conducted in-depth interviews with the parents of 20 children; those with the lowest adherence rates and those with the highest. They compared the results of these interviews with the electronic monitoring rates.

Although all parents in the group who had children with low adherence rates expressed the intention to strictly follow the treatment plan at the outset, they failed to do so during the course of the study. When asked about the barriers preventing their child’s adherence to their medication, parents presented a number of lifestyle factors as the reason behind their child did not follow their treatment plan effectively.

These factors included chaotic family life, parenting problems, financial problems, or parents being too busy to remember to give their child the medicine in a morning. A further frequent problem was that a number of children between the ages of 8 and 12 years were given full responsibility for taking their medication, without parental support, which often resulted in low adherence.

Lead author, Professor Paul Brand, said: “As part of this qualitative study, we have recorded and analysed a number of factors within the home and associated with family lifestyles which could be causing low adherence to asthma medication. It is crucial that healthcare professionals treating children with asthma carefully assess what these potential barriers could be so that appropriate interventions can be put in place to help correct the problems.”

David Supple, the parent of an asthma sufferer, said: "Long-standing experience in our household certainly backs this research up. It can be chaotic having four children and when we have given our son, Alex, responsibility over his medication to control his asthma, we have found his adherence slip away. We are conscious of this now and would encourage other parents to keep a close eye on their child’s level of adherence and to spot potential barriers before they become a problem.”

A new study by researchers at NYU School of Medicine reveals for the first time that metabolic syndrome (MetS) is associated with cognitive and brain impairments in adolescents and calls for pediatricians to take this into account when considering the early treatment of childhood obesity.

The study, funded by the National Institutes of Health under award number DK083537, and in part by award number 1ULIRR029892, from the National Center for Research Resources, appears online September 3 in Pediatrics.

As childhood obesity has increased in the U.S., so has the prevalence of metabolic syndrome — a constellation of three or more of five defined health problems, including abdominal obesity, low HDL (good cholesterol), high triglycerides, high blood pressure and pre-diabetic insulin resistance. Lead investigator Antonio Convit, MD, professor of psychiatry and medicine at NYU School of Medicine and a member of the Nathan Kline Research Institute, and colleagues have shown previously that metabolic syndrome has been linked to neurocognitive impairments in adults, but this association was generally thought to be a long-term effect of poor metabolism. Now, the research team has revealed even worse brain impairments in adolescents with metabolic syndrome, a group absent of clinically-manifest vascular disease and likely shorter duration of poor metabolism.

"The prevalence of MetS parallels the rise in childhood obesity," Dr. Convit said. "There are huge numbers of people out there who have problems with their weight. If those problems persist long enough, they will lead to the development of MetS and diabetes. As yet, there has been very little information available about what happens to the brain in the setting of obesity and MetS and before diabetes onset in children."

For the study, the researchers compared 49 adolescents with metabolic syndrome to 62 teens without the disorder. Of those who were not in the MetS group, 40 percent were considered overweight or obese, so while they were not in ideal health, they did not have three out of the five health issues needed to fall into the MetS group. The findings reported, therefore, are conservative and reflective of the real world.

Dr. Convit and colleagues balanced each group according to age, socioeconomic status, school grade, gender and ethnicity to ensure things like cultural differences in diet and access to quality healthcare did not cloud the data. They then conducted endocrine, MRI and neuropsychological evaluations on the adolescents and found that those classified as having MetS showed significantly lower math and spelling scores, as well as decreased attention span and mental flexibility. They also showed differences in brain structure and volume, presenting with smaller hippocampal volumes — involved in the learning and recall of new information, increased brain cerebrospinal fluid and reductions of microstructural integrity in major white matter tracts in the brain. The more MetS-characterizing health problems the participants had, the more profound the effect across the board.

"The kids with MetS took longer to do tasks, could not read as well and had poorer math scores," Dr. Convit said. "These findings indicate that kids with MetS do not perform well on things that are very relevant to school performance."

The researchers concluded that even a few years of problems with metabolism may cause brain complications. They suggest the adverse impact of MetS on brain function in children could be used by pediatricians as a powerful motivator to get families more involved in meaningful lifestyle change.

"Only now are pediatricians becoming aware of some of these issues," Dr. Convit explained. "Many pediatricians don't even take a blood pressure, and they certainly are not taking cholesterol levels and testing insulin resistance." He added that about one third of children who are obese have abnormal cholesterol levels and more than 40 percent of those who are really obese have insulin resistance. "Obesity in kids is sky-high. Nearly 40 percent of the U.S. population is considered obese. Parents need to understand that obesity has medical consequences, even in children, and some of those consequences may be impacting more than just the long term health of the cardiovascular system. We need to do what our grandmothers have told us all along: 'Eat well, don't overeat and try to move as much as possible.'"

Dr. Convit added that simple changes in daily routine would go a long way in preventing MetS — changes like walking more and taking the stairs. Future research is needed to determine whether the reductions in cognitive performance and structural brain abnormalities are reversible with significant weight loss, he explained.

"The take home message is that just being overweight and obese is already impacting your brain," Dr. Convit said. "Kids who are struggling with their weight and moving toward having MetS may have lower grades, which could ultimately lead to lower professional achievement in the long run. These are run-of-the-mill, garden-variety kids, not kids that came into the hospital because they were sick. It is imperative that we take obesity and physical activity seriously in children. In this country, we're taking away gym class in order to give children more class time in an effort to improve school performance, but that effort may be having the exact opposite effect."

Dr. Convit's focus on combating and raising awareness about the impact of childhood obesity led him to create the The BODY Project, a program that works with New York City schools and parents to evaluate students' height, weight, blood pressure, test for insulin resistance and record other measures of health, giving parents an overview of their child's health status. Simply receiving this report motivates visits to the pediatrician, meal-planning changes at home and other interventions to prevent MetS and obesity. The program has impacted more than 3,400 children since its creation four years ago.

NewsPsychology (Sep. 3, 2012) — When women give birth in their late thirties or in their forties, it is not necessarily the result of a lifestyle choice — putting off motherhood for career reasons or from a desire to “have it all.” Nor should they be accused of selfishness or taking undue health risks.

These are among the arguments of psychologist Kirsty Budds, who has researched what is commonly termed ‘delayed motherhood’ at the University of Huddersfield.

Her latest paper on the subject was presented at a conference organised by the British Psychology Society at St Andrew’s University.

Her work is entitled a “Critical Discursive Analysis of ‘Delayed’ Motherhood” .

“I don’t like the term ‘delayed’ because it implies agency and it implies choice,” she says.

“It implies that women who have babies later on are putting something off or waiting for something. I question whether it is actually a choice, but if it is, then it is a choice that is constrained and shaped by the values in our society and the pressures upon women,” she adds.

Kirsty Budds’s research has included a detailed analysis of newspaper articles that dealt with the subject of older mothers.

“The assumption in newspapers is that women choose to delay motherhood for career reasons, which implies selfishness. “Also, anxiety over women putting careers before motherhood demonstrates the strength of the motherhood mandate — in our society motherhood is considered more important for women than other occupations, such that they should be prioritising it. Furthermore, there is evidence in the media of a resistance to women ‘having it all’ ” says Kirsty.

She also conducted detailed interviews with a number of older mothers but found that this is not how they defined themselves.

Despite a widespread assumption that older mothers will have a qualitatively different experience than younger women, Kirsty found that in general their transition to motherhood was typical to that of any woman, regardless of age.

There is also extensive media alarm about the health risks attached to later motherhood, says Kirsty.

“It is almost as if they are saying that by choosing to have babies later these women were choosing to put themselves and their children at risk.”

It is still the medical convention to regard 35 as the age at which greater risk is attached to pregnancy, but the risk boundary is probably rising to 40 as later motherhood becomes more normative, argues Kirsty, who hopes that her research will lead to a more balanced view of late motherhood.

“For a lot of women it isn’t a selfish choice but is based around careful decisions, careful negotiations and life circumstances such as the right partner and the right financial position. These women are effectively responsibly trying to produce the best situation in which to have children, which is encouraged societally, but then they are chastised because they are giving birth when older, when it is more risky.”

---

Story Source:

The above story is reprinted from materials provided by University of Huddersfield.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

During adolescence, the stories young people tell about themselves reflects their development of a personal identity and sense of self, and those autobiographical narratives vary depending on the teens' gender, according to a University of Missouri psychologist and her colleagues. Parents can use this knowledge of how teens talk about themselves to help understand the tumultuous transitions of their children into adults.

"Autobiographical stories tell us details about adolescent psychology that questionnaires and observations of behavior cannot," said Jennifer Bohanek, assistant professor of psychological sciences in the College of Arts and Science. "Narratives provide information about how adolescents interpret memories as well as how they come to know themselves. Other people then come to know the teens by the stories they tell about themselves. The differences between study participants' stories suggest there may be differences in the way male and female teens understand themselves and present themselves to the world."

Bohanek and her colleagues found that females tended to tell longer, more coherent stories. Females' stories were also generally more detailed and contained more descriptions of their own internal emotional states. Males' stories tended to be more matter-of-fact and showed less self-reflection. These differences were consistent in both positive and negative stories. The researchers suggested that the gender differences may indicate females have a greater inclination to reflect on past experiences and use their memories to give personal meaning to past events.

To conduct her study, Bohanek and her colleagues asked 65 adolescents between 13 and 16 years of age to narrate two positive and two negative stories. The teens came from racially and economically diverse backgrounds. The study was conducted in the teens' homes by one or two female research assistants. The teens' stories were then analyzed for coherence, theme, narrative development and self-reflection.

"Our study filled an important gap in the research on autobiographical narratives," said Bohanek. "Previous studies looked at gender differences in children's and adults' storytelling. Other research has found there are differences in the ways parents tell stories to male and female children as well as differences in how emotional content was explained. Other studies found that families talked about past events every five minutes on average, so reflecting on the past seems to have an important influence on family relationships. Our study suggests that these interactions may affect adolescents as they develop their own definition of themselves."

The study, "Gender Differences in Adolescents' Autobiographical Narratives," was published in the Journal of Cognition and Development. Lead author was Robyn Fivush of Emory University. Co-authors were Widaad Zaman of Emory University and Sally Grapin of Brown University.

NewsPsychology (Sep. 4, 2012) — Languages are continually changing, not just words but also grammar. A recent study examines how such changes happen and what the changes can tell us about how speakers’ grammars work.

The study, “The course of actualization,” to be published in the September 2012 issue of the scholarly journal Language, is authored by Hendrik De Smet of the University of Leuven /Research Foundation Flanders.

Historical linguists, who document and study language change, have long noticed that language changes have a sneaky quality, starting small and unobtrusive and then gradually conquering more ground, a process termed ‘actualization’. De Smet’s study investigates how actualization proceeds by tracking and comparing different language changes, using large collections of digitized historical texts. This way, it is shown that any actualization process consists of a series of smaller changes with each new change building on and following from the previous ones, each time making only a minimal adjustment. A crucial role in this is played by similarity.

Consider the development of so-called downtoners — grammatical elements that minimize the force of the word they accompany. Nineteenth-century English saw the emergence of a new downtoner, all but, meaning ‘almost’. All but started out being used only with adjectives, as in her escape was all but miraculous. But later it also began to turn up with verbs, as in until his clothes all but dropped from him. In grammatical terms, that is a fairly big leap, but when looked at closely the leap is found to go in smaller steps. Before all but spread to verbs, it appeared with past participles, which very much resemble both adjectives and verbs, as in her breath was all but gone. So, changes can sneak into a language and spread from context to context by exploiting the similarities between contexts.

The role of similarity in language change makes a number of predictions. For one thing, actualization processes will differ from item to item because in each case there will be different similarities to exploit. English is currently seeing some nouns developing into adjectives, such as fun or key. This again goes by small adjustments, but along different pathways. For fun, speakers started from expressions like that was really fun, which they would adjust to that was very fun, and from there they would go on to a very fun time and by now some have even gone on to expressions like the funnest time ever. For key, change started from expressions like a key player, which could be adjusted to an absolutely key player, and from there to a player who is absolutely key. When the changes are over, the eventual outcome will be the same — fun and key will have all the characteristics of any other English adjective — but the way that is coming about is different.

Another prediction is that actualization processes will differ from language to language, because grammatical contexts that are similar in one language may not be in another. Comparing the development of another English downtoner, far from (as in far from perfect), to its Dutch equivalent, verre van, it is found that, even though they started out quite similar, the two downtoners went on to develop differently due to differences in the overall structure of English and Dutch. Importantly, this is one way in which even small changes may reinforce and gradually increase existing differences between languages.

Finally, this research can say something about how language works in general. Similarity is so important to how changes unfold precisely because it is important to how speakers subconsciously use language all the time. Presumably, whenever a speaker thinks up a new sentence and decides it is acceptable, they do so by evaluating its resemblance to previous sentences. In this respect, actualization processes are giving us a unique window on how similarity works in organizing and reorganizing speakers’ internal grammars, showing just how sensitive speakers are to all sorts of similarities. Strikingly, then, the same similarity judgments that speakers make to form acceptable and intelligible sentences allow their grammars to gradually change over time.

---

Story Source:

The above story is reprinted from materials provided by Linguistic Society of America.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Being the last one picked for the team, getting left out of the clique of cool girls, having no one to sit with at lunch. For children, social exclusion can impact everything from emotional well being to academic achievements.

But what does it mean for the kids doing the excluding? Is the cure a one-size-fits-all approach that requires kids to include others, regardless of the situation at hand? Not necessarily, says new research from a professor now at Concordia University.

Unlike previous studies where researchers created hypothetical situations and pre-selected the reasons for exclusion that kids could choose from, the Concordia study asked kids to talk about a time when they excluded a peer.

"Research that looks at kids' own point of view about social exclusion will help us do a better job of supporting their ability to successfully navigate these situations," says Holly Recchia, an assistant professor in Concordia's Department of Education and member of the Centre for Research in Human Development. She is first author of the study, conducted while she was a postdoctoral fellow at the University of Utah.

The recent study published in the journal Cognitive Development shows that the experiences of exclusion for those doing the excluding are actually much more diverse than what previous studies have shown, and that a more nuanced approach is needed to encourage social inclusion.

This approach allowed Recchia and her colleagues at the University of Utah to form a broader picture of exclusion. The kids' narratives included not just reasons for exclusion but also why they judged their reasons to be good or bad. For example, "it was a bad reason because now his feelings are hurt" or "it was a good reason because I don't work well with her."

In some cases, children tried to numb their negative feelings about exclusion by ignoring a situation, while in others they spontaneously looked for an alternative to exclusion. In both cases, they had mixed feelings about whether their reasons were good or bad.

"It's the search for alternatives to exclusion that we want to encourage. The fact that children can do this spontaneously reflects children's awareness of their own capacity to behave differently in the future and can be an entry point for intervention," says Recchia.

The study also showed that the experience of exclusion changes as kids got older. Seven year-olds mostly reported uncontrollable circumstances and peer pressure as rea-sons for exclusion, depicting themselves as blameless. As the youngsters reached their teenage years, however, they showed more responsibility when they talked about excluding others, often reporting reasons that were within their control.

This information could help researchers come up with age-specific interventions. In the case of younger kids, the best approach is to help them take responsibility for their actions, which would encourage them to see what they could have done differently.

"The most useful interventions will be the ones that allow kids to weigh different goals, across different kinds of situations," says Recchia. "This flexibility would allow them to handle exclusion in ways that minimize harm to other people while still recognizing their own legitimate desires and perspectives."

 To promote good parenting, Canada should remove section 43 of its Criminal Code because it sends the wrong message that using physical punishment to discipline children is acceptable, argues Dr. John Fletcher, Editor-in-Chief, CMAJ (Canadian Medical Association Journal) in an editorial.

Section 43 of the Criminal Code of Canada states "…a parent is justified in using force by way of correction…if the force does not exceed what is reasonable under the circumstances."

The debate over whether spanking children is acceptable as a disciplinary tool for parents or whether it is violence against children is heated and ongoing. Although spanking was an accepted form of discipline for past generations, attitudes have shifted.

"So heated is this debate, and so long-running, that the question of whether spanking is morally 'right or wrong' is probably intractable," writes Dr. Fletcher. "A more promising line of enquiry, however, is whether the physical punishment of children is effective."

A recently published analysis in CMAJ that summarizes 20 years' of research on the topic suggests that physical punishment of children can result in increased childhood aggression and mental health issues in adulthood.

Rather than making spanking of children a crime, emphasis should be placed on educating parents on alternative forms of discipline. This could be done through parenting programs, which have been successful in teaching positive parenting and helping improve children's behaviour, offering them in the early years and when children enter school.

"Surely any bias should be toward protecting children, who are the most vulnerable," Dr. Fletcher writes. "To have a specific code excusing parents is to suggest that assault by a parent is a normal and accepted part of bringing up children. It is not. While section 43 stands, it is a constant excuse for parents to cling to an ineffective method of child discipline when better approaches are available. It is time for Canada to remove this anachronistic excuse for poor parenting from the statute book.

— Can a computer "read" an online blog and understand it? Several Concordia computer scientists are helping to get closer to that goal.

Leila Kosseim, associate professor in Concordia's Faculty of Engineering and Computer Science, and a recently-graduated doctoral student, Shamima Mithun, have developed a system called BlogSum that has potentially vast applications. It allows an organization to pose a question and then find out how a large number of people talking online would respond. The system is capable of gauging things like consumer preferences and voter intentions by sorting through websites, examining real-life self-expression and conversation, and producing summaries that focus exclusively on the original question.

"Huge quantities of electronic texts have become easily available on the Internet, but people can be overwhelmed, and they need help to find the real content hiding in the mass of information," explains Kosseim, one of the lead researchers at Concordia's Computational Linguistics Laboratory (CLaC lab).

Analyzing informally-written language poses unique challenges compared to analyzing, for example, a news article. Blogs, forums and the like contain opinions, emotions and speculations, not to mention spelling errors and poor grammar. A summarization tool must address two particular problems, question irrelevance (sentences that are not relevant to the main question), and discourse incoherence, (sentences in which the intent of the writer is unclear).

BlogSum met these challenges with demonstrable efficiency. The researchers developed and tested their tool by examining a set of blogs and review sites. BlogSum used "discourse relations" to crunch the data — ways of filtering and ordering sentences into coherent summaries. BlogSum was measured against prior computational rankings and achieved mostly superior results. In addition, it was evaluated by actual human subjects, who also found it to be superior. Summaries produced by BlogSum reduced question irrelevance and discourse incoherence, successfully distilling large amounts of text into highly readable summaries.

This study is an example of Natural Language Processing (NLP), in which Concordia, through the CLaC lab, is a leader. NLP stands at the intersection of artificial intelligence and linguistics, seeking to enable computers to derive meaning from human language.

"The field of natural language processing is starting to become fundamental to computer science, with many everyday applications — making search engines find more relevant documents or making smart phones even smarter," explained Kosseim.

 When mice are born lacking the master gene Atoh1, none breathe well and all die in the newborn period. Why and how this occurs could provide new answers about sudden infant death syndrome (SIDS), but the solution has remained elusive until now.

Research led by Baylor College of Medicine and the Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital demonstrates that when the gene is lacking in a special population of neurons called RTN (retrotrapezoid nucleus), roughly half the young mice die at birth. Those who survive are less likely to respond to excess levels of carbon dioxide as adults. A report of their work appears online in the journal Neuron.

"The death of mice at birth clued us in that Atoh1 must be needed for the function of some neurons critical for neonatal breathing, so we set out to define these neurons," said Dr. Huda Zoghbi, senior author of the report and director of the Neurological Research Institute and a professor of molecular and human genetics, neuroscience, neurology and pediatrics at BCM. Zoghbi is also a Howard Hughes Medical Institute investigator.

"We took a genetic approach to find the critical neurons," said Wei-Hsiang Huang, a graduate student in the Program in Developmental Biology at BCM who works in Zoghbi's laboratory. With careful studies to "knockout" the activity of the gene in a narrower and narrower area in the brain, they slowly eliminated possible neurons to determine that loss of Atoh1 in the RTN neurons was the source of the problem.

"Discovering that Atoh1 is indeed critical for the RTN neurons to take their right place in the brainstem and connect with the breathing center helped us uncover why they are important for neonatal breathing," said Zoghbi.

"This population of neurons resides in the ventral brainstem," said Huang. "When there is a change in the makeup of the blood (lack of oxygen or buildup of carbon dioxide), the RTN neurons sense that and tell the body to change the way it breathes." A defect in these neurons can disrupt this response.

"Without Atoh1 the mice have significant breathing problems because they do not automatically adjust their breathing to decrease carbon dioxide and oxygenate the blood," he said.

It turns out the findings from this mouse study are relevant to human studies.

"A paper just published reports that developmental abnormalities in the RTN neurons of children with sudden infant death syndrome or sudden unexplained intrauterine death may be linked to altered ventilatory response to carbon dioxide," said Huang (Lavezzi, A.M., et al., Developmental alterations of the respiratory human retrotrapezoid nucleus in sudden unexplained fetal and infant death, Auton. Neurosci. (2012), doi:10.1016/j.autneu.2012.06.005).

Others who took part in this work include, Teng-Wei Huang, Christopher S. Ward, Jeffrey Neul and Tiemo J. Klisch, all of BCM; Srinivasan Tupal and Paul A. Gray of Washington University School of Medicine.

Funding for this work came from the American Heart Association Southwest Affiliate, a National Institutes of Health Ruth L. Kirstein Research Service Award, the Baylor College of Medicine Intellectual and Developmental Disabilities Research Center, the Cancer Prevention and Research Institute of Texas, the National Heart, Lung and Blood Institute and the Howard Hughes Medical Institute.

In life, there are directions for just about anything. Need to travel somewhere? Use a map. Want to cook a meal? Read a recipe. Want to be a great parent? There's no official handbook for that. In the end, all any parent can do is use their own judgment. And there is no single agreement as to how a parent should raise a child, particularly when it comes to differentiating child physical abuse (CPA) and physical discipline (PD) across cultures.

Using the book, "Battle Hymn of the Tiger Mother" as a supplement to her ideas, Johns Hopkins University School of Nursing PhD student Grace Ho is attempting to better define the line separating those two by evaluating Chinese-American mothers and pediatric nurses through a methodology that studies a person's perception.

As was done in the Tiger Mother book, her work is examining the vast differences between Eastern and Western parenting and their discipline strategies. Eastern parenting relies on obedience, respect, and character building, while Western parenting centers on embracing a child's individuality, parental warmth, and nurturing.

Ho's study, "Differentiating Physical Discipline from Abuse: A Comparison of Chinese-American Mothers and Mandated Nurse Reporters of Abuse," looks at how PD and CPA differ among cultures, between nurses and mothers of specific cultures, and how acculturation affects parental approaches for immigrants attempting to assimilate into a new society.

Ho is recruiting mothers from Chinese language schools, Chinese churches, and Asian grocery stores in Maryland counties with high Asian-American populations. Nurses who have worked in the pediatric field for at least two years are being recruited from inpatient and outpatient pediatric units at Johns Hopkins Hospital. Through interviews and an online questionnaire, Ho will gauge what separates child abuse and parental discipline.

"This will be a starting point to identify gaps in understanding. I also hope to extend this research to other cultural groups," Ho explained. In the long run, she wants to inform healthcare providers about her findings, promote cultural sensitivity and competence, increase accurate identification and decrease inaccurate accusations of child abuse.