A possible correlation between the prevalence of attention-deficit/hyperactivity disorder (ADHD) and increasing academic demands on young children has been identified by researchers. In a new article, authors hypothesized that increased academic standards since the 1970s have contributed to the rise in diagnosis of ADHD.
‘………….By Annalisa Barbieri
She’s not doing any work at school, is extremely sensitive to criticism and sees offence where there is none. Annalisa Barbieri advises a reader
Our only child, who is 10, has had regular, uncontrollable temper outbursts for the past four years. She was bullied at school for nearly two years by three “friends”, between the ages of six and eight. We were unaware of all of this. At home we were seeing sustained tantrums, often from the minute we got back after school. Unfortunately, we didn’t know what to do at the time and would often shout back at her and threaten to withdraw treats.
When she was about seven we realised we needed considerable help and were even starting to think she had a condition such as attention deficit hyperactivity disorder. A friend who works with young children in a psychiatric capacity told us there was nothing wrong with her and asked if she was being bullied. We said no. We decided to go to our GP but went to the school first to see if they could offer advice. They told us only then about the past year of bad behaviour and the bullying by the three friends.
We were shocked – these girls came for tea and were her three closest school friends. We were also relieved as we believed we had found the answer to her behaviour.
The bullying continued. She is a clever girl but was producing little or no work in the classroom, often folding her arms and refusing to work. She started to try to stay off school. On more than one occasion, I returned home with her to calm her down.
As she grew older she started to tell us things, describing feeling alone most days and how other children poked fun at her. She had started to answer back to teachers and play the class fool.
I read everything I could find on bullying and the effects it could have on neural development. I was convinced her behaviour, which the school was now very concerned about, was a result of bullying. The school didn’t agree, saying the bullying had stopped. Her behaviour at school was now the problem.
At home we reversed our approach and reaction to her behaviour and stopped fighting fire with fire. We asked for a Child and Adolescent Mental Health Services (CAMHS) referral and she started a course of weekly, private counselling. We were also successful in getting her a place on a day course by Kidscape. It was a great day and helped her to see she was not alone and was not, in her words, a freak.
The CAMHS referral didn’t go beyond the initial triage on the two occasions on which we were referred (a year apart). It was acknowledged that she had a high level of anxiety about school and friends but that she was able to function normally. The counselling lasted a year and the conclusion was that though she was a happy, well-balanced, thoughtful child, she was “highly anxious” about friends and friendships.
Her tantrums at home are getting worse and she is becoming increasingly physical, though she is very articulate about the tantrums. She feels remorse and shame after an outburst. She explains that when she feels hurt or upset she holds it in until she gets home; it then bursts out without her having any control. She describes her brain as having two sides – a happy side and an angry side. Sometimes the angry side takes over and she cannot control it. She tries very hard to stay in the happy side and not let the angry side win.
She is extraordinarily sensitive to criticism and sees offence at every turn. Sometimes there is an outburst because I smiled at the wrong moment and she thinks I am laughing at her.
I contacted three specialists: professionals in child psychotherapy, child bullying and autism. No one can diagnose your daughter from a letter, but the professional in autism thought it was worth you exploring autism/Asperger syndrome and pathological demand avoidance as possibilities. But the only way of knowing is for your daughter to have a formal diagnostic assessment.
You may know that girls on the spectrum present differently and can be very hard to diagnose. Many health and education professionals can miss it because girls learn to mimic “how to behave” socially. I have put some links at the bottom here, which I’d like you to look at, including how to get a diagnosis. Certain things made me wonder: the explosions as soon as she gets home from school, the seeming inability to read your facial expressions, the high anxiety over some social situations. Children with autism can also be bullied because the way they communicate and interact may be different from their peers, and they may misinterpret social situations.
Your very much longer letter told me of the many avenues you have tried in an attempt to help your daughter, although there was nothing about her early years. But I see some routes were not fully explored because other professionals offered you alternative theories. I also wonder if the bullying has become the sole focus and so stopped one, perhaps, seeing anything else that might be going on?
Ben Lloyd, a child and adolescent psychotherapist (childpsychotherapy.org.uk) also wondered if the bullying was a symptom or the cause.
Leaving aside the autism for a moment, Lloyd explains: “A task of parenting is to help channel ordinary, healthy aggression and help a child to regulate their own emotions that are in the first place unfamiliar to them. It sounds as though your daughter has not been able to develop a way of tolerating ordinary enough frustrations that are necessary for emotional development to take place.”
It certainly doesn’t sound as if your daughter has learned to modulate her emotions or has emotional containment. But we don’t know why. Obviously a child with autism would find this much harder.
I would search the autism.org.uk website for sections on autism spectrum disorder, Asperger’s, pathological demand avoidance, women and girls andgetting a diagnosis. Then I would go to your GP and start again to find help for your daughter (or you can do this privately if you prefer). I would also recommend you get some counselling (aft.org.uk; bacp.co.uk) to support yourself.
Your problems solved
Contact Annalisa Barbieri, The Guardian, Kings Place, 90 York Way, London N1 9GU or email email@example.com. Annalisa regrets she cannot enter into personal correspondence.
Follow Annalisa on Twitter @AnnalisaB ……………’
The American Academy of Pediatrics (AAP) recommends that pediatric providers advise parents of young children to read aloud and talk about pictures and words in age-appropriate books to their kids. The AAP says that these activities can help strengthen a child’s language skills and literacy while promoting parent-child relationships.
Pediatricians have long encouraged reading to children, but the guidelines are the first official policy from the American Academy of Pediatrics telling doctors to talk to parents about daily reading to their children, from the first year of life until kindergarten.
Reading with young children “stimulates optimal patterns of brain development and strengthens parent-child relationships at a critical time in child development, which, in turn, builds language, literacy and social-emotional skills that last a lifetime,” the AAP guidelines said.
Studies have shown a wide economic divide when it comes to parents reading to their children. Only one in three children living in poverty have parents that read to them consistently. Children who aren’t read to often have “a significant learning disadvantage” by the time they get to school age, the AAP added.
Even wealthier families do not always make reading a ritual, with 60 percent of those with incomes 400 percent of the poverty threshold saying they read to their children from birth to age five, according to a 2011-2012 survey.
Some pediatricians worry that technology – from television to smartphones- may be taking the place of reading to little ones.
The AAP has previously said babies under age two should be as screen-free as possible, and that the best kind of learning takes place through unstructured, interactive play with humans and toys.
Even babies can benefit from being read stories, said the AAP. “We can stimulate greater brain development in these months and years,” said Peter Riche, a fellow of the AAP and Chief of Pediatrics at Northern Westchester Hospital in New York.
“I do see earlier word recognition, earlier phrases and sentence formation, and singing—I always recognize that in those who are exposed to daily reading.”
Many families do not have the money for books so the AAP said it “supports federal and state funding for children’s books to be provided at pediatric health supervision visits for children at high risk.”
Another important benefit of parents reading to their young children is the blooming of a child’s self-confidence and independence.
Child development experts say that when parents read to their children not only do kids feel more secure but words and pictures also ignite creativity and imagination; two valuable components of a well-rounded life experience.
Sources: Kerry Sheridan, http://medicalxpress.com/news/2014-06-doctors-urge-parents-babies.html …………….’
The first day of school is a momentous event in the life of a child. For many it is a day filled with pride and excitement. For others it is more stressful; they may cling to their parents, unused to being parted for so long.
In England, these extremes of experience are particularly marked because of the very young age at which children start formal schooling. Children begin school in the year in which they turn five, meaning that many children start school shortly after their fourth birthdays. England is unusual in this regard; in 31 out of 37 European countries children do not start formal education until they are at least six.
The age at which children start school may not matter as much as what happens to them once they get to the classroom. Given our backgrounds in developmental psychology and speech-language therapy, we think the current targets set for children in their first year at school are not developmentally appropriate. Our research published in the Journal of Child Psychology and Psychiatry demonstrates that the youngest children in the class find these targets particularly challenging.
England has a curriculum for Early Years Foundation Stage, which outlines developmental goals from birth to five years old. This includes three prime areas of learning such as personal, social and emotional development; physical development; communication and language; as well as specific areas of learning such as maths and literacy.
In 2012, the New Early Years Foundation Stage Profile was introduced, to document attainment at the end of the early years curriculum. The profile is completed by the teacher at the end of the first year in school, and children are assessed on the extent to which they meet or exceed expected progress on 12 key targets across these areas of learning. Those making expected progress are deemed to have achieved a “good level of development”. Here are a few of the key targets:
- Understanding: children follow instructions involving several ideas or actions. They answer “how” and “why” questions about their experiences and in response to stories or events.
- Health and self-care: children know the importance for good health of physical exercise, and a healthy diet, and talk about ways to keep healthy and safe.
- Writing: They write simple sentences which can be read by themselves and others. Some words are spelt correctly and others are phonetically plausible.
- Numbers: children count reliably with numbers from one to 20, place them in order and say which number is one more or one less than a given number. They solve problems, including doubling, halving and sharing.
Government statistics confirm a 22% attainment gap between the oldest and the youngest children in the reception year. It is therefore not surprising that there have been calls to adjust the assessments at the end of the reception year for age, so that at least on paper, younger children are not disadvantaged.
Half of all children don’t meet the targets
But our study highlights a much bigger issue. We sampled more than 7,000 children in mainstream reception classrooms in Surrey, a relatively affluent county in south-east England. Across this population, only 57% of children achieved a “good level of development”, comparable to national estimates of 52%. If half the children in the country can’t meet the targets, we argue that perhaps the targets are wrong.
Yet age is not the only, or even the most important, factor in predicting academic success in the reception year. In our study, there were other things that contributed to poorer academic progress: being a boy, living in more impoverished neighbourhoods, speaking more than one language, and displaying more behavioural difficulties.
However, oral language – such as vocabulary, grammar and story-telling skills – was the most important predictor of progress on curriculum targets. This is because the curriculum requires children to listen, comprehend, explain themselves and use words to solve problems. In our study, twice as many younger children were reported to have poor language skills at school entry, relative to their oldest peers. And fewer than 5% children with low language proficiency achieved a good level of development on the Early Years Foundation Stage Profile.
Years of research has also told us that language is the foundation for literacy. Children arriving at school with lower levels of oral language proficiency, for whatever reason, are therefore at a distinct disadvantage for learning.
Don’t set children up for failure
We suggest that focusing the first reception year on developing children’s oral language abilities may help to attenuate the attainment gaps experienced by younger children. It is also possible that a focus on oral language will narrow the gap for children from impoverished communities and those who are learning English as an additional language. We predict that ensuring a good foundation in oral language will also improve reading and writing in later school years, even for the oldest children in the class.
Literacy targets, particularly writing, have been introduced at ever younger ages in an effort to improve standards, but we fear this may do more harm than good. Asking children to engage in tasks that are developmentally out of their reach increases frustration and experience of failure. Many of the children that we have followed up over time tell us at the tender age of six, that they “aren’t good at reading” or they “can’t do writing.” This is a tragedy.
We need to develop children’s oral language skills early and leave formal classroom instruction until children have the foundation skills they need to achieve. This should raise the attainments, and esteem, of all children. …………’
Date: May 21, 2015
Source: University of Pittsburgh Schools of the Health Sciences
Summary: Exposure to fine particulate air pollution during pregnancy through the first two years of the child’s life may be associated with an increased risk of a child developing autism spectrum disorder, a condition that affects one in 68 children, according to an investigation of children in southwestern Pennsylvania.
Exposure to fine particulate air pollution during pregnancy through the first two years of a child’s life may be associated with an increased risk of the child developing autism spectrum disorder (ASD), a condition that affects one in 68 children, according to a University of Pittsburgh Graduate School of Public Health investigation of children in southwestern Pennsylvania.
The research is funded by The Heinz Endowments and published in the July edition of Environmental Research.
“Autism spectrum disorders are lifelong conditions for which there is no cure and limited treatment options, so there is an urgent need to identify any risk factors that we could mitigate, such as pollution,” said lead author Evelyn Talbott, Dr.P.H., professor of epidemiology at Pitt Public Health. “Our findings reflect an association, but do not prove causality. Further investigation is needed to determine possible biological mechanisms for such an association.”
Dr. Talbott and her colleagues performed a population-based, case-control study of families with and without ASD living in six southwestern Pennsylvania counties. They obtained detailed information about where the mothers lived before, during and after pregnancy and, using a model developed by Pitt Public Health assistant professor and study co-author Jane Clougherty, Sc.D., were able to estimate individual exposure to a type of air pollution called PM2.5.
This type of pollution refers to particles found in the air that are less than 2.5 micrometers in diameter, or 1/30th the average width of a human hair. PM2.5 includes dust, dirt, soot and smoke. Because of its small size, PM2.5 can reach deeply into the lungs and get into the blood stream. Southwestern Pennsylvania has consistently ranked among the nation’s worst regions for PM2.5 levels, according to data collected by the American Lung Association.
“There is increasing and compelling evidence that points to associations between Pittsburgh’s poor air quality and health problems, especially those affecting our children and including issues such as autism spectrum disorder and asthma,” said Grant Oliphant, president of The Heinz Endowments. “While we recognize that further study is needed, we must remain vigilant about the need to improve our air quality and to protect the vulnerable. Our community deserves a healthy environment and clean air.”
Autism spectrum disorders are a range of conditions characterized by social deficits and communication difficulties that typically become apparent early in childhood. Reported cases of ASD have risen nearly eight-fold in the last two decades. While previous studies have shown the increase to be partially due to changes in diagnostic practices and greater public awareness of autism, this does not fully explain the increased prevalence. Both genetic and environmental factors are believed to be responsible.
Dr. Talbott and her team interviewed the families of 211 children with ASD and 219 children without ASD born between 2005 and 2009. The families lived in Allegheny, Armstrong, Beaver, Butler, Washington and Westmoreland counties. Estimated average exposure to PM2.5 before, during and after pregnancy was compared between children with and without ASD.
Based on the child’s exposure to concentrations of PM2.5 during the mother’s pregnancy and the first two years of life, the Pitt Public Health team found that children who fell into higher exposure groups were at an approximate 1.5-fold greater risk of ASD after accounting for other factors associated with the child’s risk for ASD — such as the mother’s age, education and smoking during pregnancy. This risk estimate is in agreement with several other recent investigations of PM2.5 and autism.
A previous Pitt Public Health analysis of the study population revealed an association between ASD and increased levels of air toxics, including chromium and styrene. Studies by other institutions using different populations also have associated pollutants with ASD.
“Air pollution levels have been declining since the 1990s; however, we know that pockets of increased levels of air pollution remain throughout our region and other areas,” said Dr. Talbott. “Our study builds on previous work in other regions showing that pollution exposures may be involved in ASD. Going forward, I would like to see studies that explore the biological mechanisms that may underlie this association.”
The above story is based on materials provided by University of Pittsburgh Schools of the Health Sciences. Note: Materials may be edited for content and length.
- Evelyn O. Talbott, Vincent C. Arena, Judith R. Rager, Jane E. Clougherty, Drew R. Michanowicz, Ravi K. Sharma, Shaina L. Stacy. Fine particulate matter and the risk of autism spectrum disorder. Environmental Research, 2015; 140: 414 DOI: 10.1016/j.envres.2015.04.021
Cite This Page:
University of Pittsburgh Schools of the Health Sciences. “Fine particulate air pollution linked to risk of childhood autism.” ScienceDaily. ScienceDaily, 21 May 2015. <www.sciencedaily.com/releases/2015/05/150521121049.htm>. ……..’