On her back in a dark tube, Blair Smith held still as a scanner combed her brain with magnetic waves. Words flashed by her eyes: tack, vase, hope, glow, vague, cade.

The 11-year-old had been told to press the button in her right hand if the word was real, the button in her left if it was nonsense. The answer itself was less important than the map the scanner would make of which areas of Blair’s brain lighted up when she struggled with a word.

The aim of the study, said Laurie Cutting, director of the Education and Brain Research Program at the Kennedy Krieger Institute in Baltimore, is to understand the neurological differences among students who are skilled readers, those who have difficulties and those with diagnosed learning disabilities.

If neuroscientists can pinpoint which parts of the brain are activated when a reader puzzles over an unknown word, they may eventually help teachers tailor reading instruction for individuals.

That is only the beginning. Many educators hunger for scientific data to help them structure their lessons, and neuroscience is beginning to offer them broad guidance about what works best.

One of the most startling recent revelations in neuroscience has been that the brain’s structure is much more flexible (a concept called neuroplasticity) than was previously thought; this understanding may help teachers find ways to train the brain to better solve math problems or understand a book.

“There’s an awful lot that neuroscience can begin to tell us in broad strokes that’s relevant for education and that ultimately 10 or 20 years downstream can provide us with prescriptive information,” said Robert Pianta, dean of the University of Virginia’s Curry School of Education.

“I think we’re looking at a period of five years of very rich territory for investigation here.”

Complex conditions

Brain research already is opening the way to help teachers detect and address complex conditions — such as attention-deficit hyperactivity disorder, dyslexia and its mathematical cousin, dyscalculia — that defy blood tests and other simple medical diagnostics.

Cognitive scientists are developing a theory of “micro-development” that could turn some lesson plans upside down. Studies have found that, on a minute-to-minute basis, children and adults learn in fits and starts, often going backward. That could indicate that students should be allowed to grope their way to understanding — for instance, by being asked to power up a light bulb using a battery and a strand of wire before having the theory of electricity explained to them.

How the brain functions remains deeply mysterious, with studies seeming to unfold at a glacial pace. One expert noted that it took decades for researchers, examining data from brain and behavioral studies and other sources, to confirm the belief of many educators that focusing on phonics helps youngsters who struggle with reading.

Still, top educational institutions have recently shown new interest in the link between brain activity and education. Harvard University founded its mind, brain and education degree program in 2002. Johns Hopkins University this year briefed the Maryland State Board of Education on a neuro-education initiative that aims to “explore how current findings have application to educational practice.”

Better ways of teaching

A study published in the journal Nature last month reported a link between a primitive, intuitive sense of the size of numbers and performance in math classes, a finding that could lead to ways to identify young students who may have trouble with math and develop better ways of teaching them. Advocates of expanding pre-kindergarten classes point to studies that show the importance of early education in molding young minds.

Pianta, of the Curry School, said neuroscience has also influenced the education of autistic students.

“Twenty years ago, you might have seen an intervention that was far more oriented toward trying to get those kids to be affectionate, let’s say. Or the therapist in that case would be promoting physical contact with kids who didn’t like physical contact,” Pianta said. “Now we would look at that (response) as sort of saying this kid’s behavior is a result of their brain’s ability to process social, emotional information. You would structure your interactions with an autistic child so as not to overwhelm their capacity to process that information.”

Kurt Fischer, director of Harvard’s mind, brain and education master’s degree program, warned that many educational theories claim to be based on science but are not.

“One of the major problems we face is that there are a whole lot of things that claim to be ‘brain-based education’ that are nonsense,” he said. “One of them is the belief that boys and girls have totally different brains and learn totally differently. That’s not what the evidence shows. Not at all. The other is kind of a rigid idea of sensitive periods: that after a certain age you can’t learn a foreign language. You’ve also heard that there are left-brained and right-brained people. Total nonsense, unless they’ve had their left or right hemisphere removed. All of us use all our brains.”

Craving information

Another example Fischer cited is the widely held but dubious notion that listening to Bach in the bassinet will make babies smarter. Still, Fischer said, the popularity of such ideas shows that educators and the public crave scientific backing for classroom innovations.

At Kennedy Krieger, Cutting gave a nifty copy of her brain scan to Blair, her young research subject. The research team prepared Blair’s identical twin sister to go inside the tube for a new round of scans. They are both perfectly good readers, but the data from their studies might help others.

“Creepy but cool at the same time,” said Blair, an aspiring veterinarian. “It’s good because you help other kids.”

Source: Monterey County Herald, CA
http://www.montereyherald.com/health/ci_10913995

The number of children who take medication for chronic diseases has jumped dramatically, another troubling sign that many of the youngest Americans are struggling with obesity, doctors say.

The number of children who take pills for type 2 diabetes — the kind that’s closely linked to obesity — more than doubled from 2002 to 2005, to a rate of six out of 10,000 children. That suggests that at least 23,000 privately insured children in the USA are now taking diabetes medications, according to authors of the new study in today’s Pediatrics.

Doctors also saw big increases in prescriptions for high cholesterol, asthma and attention deficit and hyperactivity. There was smaller growth for drugs for depression and high blood pressure.

“We’ve got a lot of sick children,” says author Emily Cox, senior director of research with Express Scripts, which administers drug benefit programs for private insurance plans. “What we’ve been seeing in adults, we’re also now seeing in kids.”

Type 2 diabetes was once known as adult-onset. But Cox says her records show kids as young as 5 being treated with prescription diabetes drugs.

Cox based her study on prescription records of nearly 4 million children a year, ages 5 to 19, covered by Express Scripts. She says her findings may not apply to the 40% of children who are uninsured or covered by government health plans.

Unless these children make major changes — such as eating healthier and exercising more — they could be facing a lifetime of illness, Cox says.

“These are not antibiotics that they take for seven to 10 days,” Cox says. “These are drugs that many are taking for the rest of their lives.”

Cox couldn’t explain one surprising finding: Most of the increase in drugs for diabetes, attention deficit/hyperactivity and depression was seen in girls. The gender gap was most striking in diabetes: While the number of boys taking medication grew by 39%, the number of girls using them climbed by 147%, Cox found.

Source: USA Today
http://www.usatoday.com/news/health/2008-11-03-kids-meds_N.htm

Research shows that a walk in the park can be just as effective as drugs such as Ritalin for children with ADHD or excess energy levels.

It’s been a brilliant week off. Your children have adored Halloween; they’ve loved trick or treating, and have gorged themselves on sweets and goodies all week. You don’t mind. Isn’t that what the autumn break is all about? You may have noticed, though, that all the sugar has made your children hyper. It may have been tough getting them to relax and get ready for sleep.

And now that they’re back in their normal routine you need to calm them down a little, so they can concentrate through the school day.

Returning to a healthy diet helps. But what if your children remain hyper? What if their natural energy level borders on ADHD?

Attention Deficit Hyperactivity Disorder is a growing problem. Drugs such as Ritalin help ADHD children; and the number of children prescribed them has doubled in the UK since 2002.

New research, though, shows that there’s a more simple solution. And that a walk in the park is just as effective as a daily dose of drugs.

Walking

Researchers at the University of Illinois took 17 hyperactive children on a walk, dividing them between the park, a town centre and a residential area. They didn’t take their drugs that day, but those walking in the park showed hugely improved concentration. In fact, the effect was the same, or even better than the effect of their normal drugs.

“As little as 20 minutes in a park could potentially buy you an afternoon, or a couple of hours to get homework done,” said researcher Andrea Faber Taylor. And if it works for hyperactive children, think of the benefit to the normally boisterous child?

It’s something that Josephine Lara, mum to Thomas, 5, Max, 3, and Daisy, 8 months, has noticed.

“The boys have so much energy and sugar definitely makes them worse,” she says. “But if we’ve had a good walk, they are always calmer. I try to keep the TV off too. It can calm them down initially, but in the long run it makes them more hyper.

“The last Friday before Halloween the school said the children had eaten sweets all afternoon. I’d arranged to bring the boys to a playground. We were there for an hour and I didn’t have any problems with them. The parents who went straight home said their children were climbing the walls.

“We have family walks when we can. We’ll walk on a beach at Skerries or LoughShinny. Or we’ll go to a playground; there are some amazing ones around here; at Ardgillan Castle, Malahide and at Newbridge.

“We walk to school in the mornings. It’s not far and it’s a good start to the day. They’re allowed to run around at school — the Lusk Educate Together, so Thomas gets a good lot of exercise. And at home, if they’re hyper, I’ll send them out into the garden. That always helps.”

TOP REASONS FOR CHILDREN TO EXERCISE (From ACE- American Authority on Exercise)

1. Children who exercise are more likely to keep exercising as an adult.

2. Exercise helps children achieve and maintain a healthy body weight.

3. Regular physical activity helps build and maintain strong, healthy muscles, bones and joints.

4. Exercise aids in the development of important interpersonal skills.

5. Exercise improves sleep.

6. Research shows that exercise promotes improved school attendance and enhances academic performance.

7. Children who exercise have greater self-esteem and better self-image.

8. Exercise prevents or delays the development of many chronic diseases, including heart disease, diabetes and obesity.

Source: Herald.ie, Ireland
http://www.herald.ie/lifestyle/health-beauty/better-than-ritalin-1518888.html

As a girl, author Peg Tyre didn’t like recess.

But as a Pulitzer Prize-winning investigative reporter for Newsweek and CNN, Tyre noticed a trend: As schools across the country cut recess, music and other subjects not required by state tests, the number of students taking medication for attention deficit hyperactivity disorder went up.

“The American Medical Association tells us that 3 to 5 percent of Americans have ADHD,” said Tyre, who spoke at Book Passage in Corte Madera Tuesday and will appear at Redwood High School in Larkspur Thursday night. “Yet the Centers for Disease Control tell us that 14 percent of boys younger than 15 are diagnosed with the condition. I worry about why we’re medicating all these children.”

In her new book, The Trouble With Boys, Tyre argues that the changes schools have made during the past two decades - driven by a focus on standardized test scores - have created a huge disadvantage for boys.

“It used to be that boys did well in math and science, and girls did well in reading and writing,” Tyre said. “But in the last 20 years, girls have caught up in math and science, while boys have been taking a whipping in reading and have fallen behind in writing - at the same time that the whole curriculum has become literacy-based.”

In Marin, seventh-grade girls scored an average of 6 percentage points higher in English and 1 point lower in math on the 2008 California Standardized Testing and Reporting (STAR) exam, according to the state Department of Education. Eleventh-grade girls scored 6 percentage points higher in English and 2 points higher in math on the state’s high school exit exam test for 2008.

Statewide, the gender gap is even greater, with seventh-grade girls scoring 10 percentage points higher on the English portion of the STAR and 10th-grade girls scoring 8 points higher in English on the exit exam.

The problem, Tyre argues, isn’t that boys are less intelligent or capable than girls. It’s that the two genders reach mental and emotional maturity at different ages, she said, and that schools increasingly reward skills like organization and neatness over innovation and risk-taking.

“Girls are completely mature at age 15 to 16, while boys are not there until they’re 25,” said Tyre, basing her argument on neurological studies of adolescent brain scans.

Virginia Dunn nodded in agreement.

“She’s right about the developmental pace,” said Dunn, a retired teacher who works as a reading intervention tutor and family therapist in San Rafael. “I used to teach high school, and around junior year, it was as though something magically happened, and boys began to catch up.”

At a time when success in school can determine so many aspects of people’s lives - where they work, where they live and even when they can retire - the evidence suggests the deck is stacked against boys, Tyre said.

Boys are expelled from preschool at a rate five times that of girls and are twice as likely to be diagnosed with attention deficit disorder or a learning disability, she said. Students in the lowest-performing group at each school tend overwhelmingly to be boys, whether the school is a wealthy private institution or an impoverished neighborhood school.

“Boys learn early on that school is a game they can’t win, and so they decide they don’t want to play,” Tyre said.

Educators have addressed gender as an element of the “achievement gap” between successful and struggling students. Yet county Director of Alternative Education Lisa Schwartz noted that every student falls into a variety of groups, and that each student needs to be treated as an individual.

“Boys probably do better in a more active learning environment,” Schwartz said. “But we need to be paying attention to each individual child. Boys may need a more active, problem-solving curriculum; gifted and talented students need the opportunity to stretch themselves; our English language learners need intensive support to develop their English language skills. We need to focus on a variety of strategies to help kids succeed better in order to be doing our job.”

Tyre doesn’t assign blame to parents, teachers or even distractions like television or video games. Instead, she says parents and teachers need to work together, armed with data, to find ways to make the educational experience better for both genders.

“I grew up with teachers who told me, ‘You don’t have to be a secretary. You can be a lawyer. You don’t have to be a stewardess; you can be pilot.’ That changed the world for girls. They can apply that same attitude to boys.”

Source: Marin Independent-Journal, CA
http://www.marinij.com/ci_10787120?source=most_viewed

The University of Miami med school is one of the key research sites in a pioneering national study that will examine children’s health from birth to 21.

The University of Miami Medical School will be one of the primary research centers for a 25-year nationwide, pioneering study of children’s health, following potential mothers from before they’re pregnant to when their children reach 21.

The $3.4 billion National Children’s Study, funded by the National Institutes of Health, will track 4,000 children in four Florida counties — including Miami-Dade — and 100,000 nationwide. It will focus on 20 key children’s health issues, including autism, birth defects, heart disease, attention-deficit disorders and obesity.

”We believe it will be the largest study of pregnant women ever conducted — certainly in the United States,” said Dr. Peter Scheidt, director of the national study for the NIH. The NIH will create a national databank of health information on children.

”We won’t have to wait 21 years to benefit,” said Dr. Duane Alexander, director of the National Institute of Child Health and Human Development. “We will release information at each step in the growth process, from pre-conception to 21.”

`THE WHOLE COUNTRY’

Dr. Steven Lipshultz, chairman of pediatrics at UM medical school and Florida principal investigator for the study, says the research will be more significant than the Framingham Heart Study, which has followed a Massachusetts town since 1948 and is seen as the basis for much of what is known about heart disease.

”That was just one Massachusetts town,” he said. “This will cover the whole country.”

Lipshultz estimates the study eventually will create up to 400 medical health jobs in Florida and $400 million of medical spending in Miami-Dade County. UM initially will receive $54.6 million from the NIH to lead the Florida portion of the project. UM will pay participants a range of fees, as yet undetermined.

Miami-Dade, Hillsborough, Orange and Baker are the counties in Florida that will participate in the study — there are 105 counties nationwide.

Lipshultz said he hopes the program can help lift Florida from its ranking of 50th out of 50 states and the District of Columbia in 13 child-health categories according to a May study by the Commonwealth Fund, a private group that studies healthcare issues.

Starting in 2010, if pilot efforts go well, UM researchers will recruit 4,000 families in the four counties.

”We will literally knock on 17,000 doors to get 1,000 children in Miami-Dade,” says Dr. Tracie Miller, associate chair of pediatrics at the UM med school and co-principal investigator of the study.

WATER SAMPLING

Other universities involved are Johns Hopkins University, Baylor College of Medicine, Michigan State University, Northwestern University, Tulane, the University of California at Los Angeles and Vanderbilt.

The studies will follow women from before they conceive, sampling the water they drink, the air they breathe, the schools, shops and workplaces in which they spend time.

Doctors, nurses and medical researchers will look into genetics and environmental factors; psychologists will trace brain development factors that might cause dyslexia, learning disorders, attention-deficit hyperactivity disorder.

Some of the key areas to be studied:

• Birth defects: Birth defects affect one in every 33 babies born in the United States each year, according to the Centers for Disease Control and Prevention. They include heart defects, brain defects and spinal problems such as spina bifida. Birth defects account for more than 20 percent of infant deaths.

• Obesity: Studies by the Florida Governor’s Task Force on Obesity say 10 percent of Florida high school students and 11.5 percent of middle school students are overweight. They say 57.4 percent of Florida adults were overweight or obese, a 63 percent increase since 1986. Early blame was placed on lack of physical activity and poor eating habits.

• Heart disease: Reports by the Florida Department of Health say 39.7 percent of Florida residents said they had high cholesterol in 2005, up from 31 percent in 2001. The report said 26.9 percent engaged in no regular physical activity. And two-thirds of middle school students watched TV or sat at a computer screen for more than three hours a day.

• Autism: The CDC estimates that one in 150 8-year-old U.S. children has an autism spectrum disorder, making up about 560,000 individuals from birth to 21. The number is up from previous decades, possibly because a broader definition of ASD. Some parents believe, despite disagreement from many doctors, that autism might be associated with childhood vaccinations.

The CDC says it does not believe there is a connection.

Says Lipshultz: “There’s no substitute for data.”

Source: MiamiHerald.com
http://www.miamiherald.com/news/miami-dade/story/712697.html

England has a new plan for helping children with ADHD: Treat the parents first.

With that, the National Institute for Health and Clinical Excellence is giving a big “Whoa, Nelly!” to the recent trend toward increased use of Ritalin in the United Kingdom, saying instead that the first response should be to give parents training on how to handle kids who are inattentive, hyperactive, or impulsive.

What would ADHD treatment look like here if the United States adopted the same national standard? With as many as 10 percent of children here medicated, that’s no small question.

The news about England’s new ADHD treatment standard comes at the same time that a new report says American children are three times more likely to be prescribed stimulant drugs like Ritalin than are children in Europe. American kids probably aren’t more hyper than their European counterparts; indeed, international surveys have shown that there’s ADHD in every corner of the world. There are a lot of reasons for the differences in prescribing among countries, including direct-to-consumer drug advertising, different government restrictions and insurance reimbursements, and most important, cultural beliefs. If an American doctor diagnosed a child with ADHD and recommended counseling, most parents would presume it was for the kid.

“Sometimes, parents make that presumption, but when you’re talking about counseling—behavior management, proper rewards, consistency in parenting—it’s really a parent-focused therapy,” says Andrew Adesman, the chief of developmental and behavioral pediatrics at Schneider Children’s Hospital in New Hyde Park, N.Y., who is active with CHADD, an advocacy organization for people with ADHD. In other words, change the parent’s behavior, and the child’s behavior will change, too. The parent training recommended is not specific to ADHD but rather teaches behavior management skills that could be used with all children: having realistic expectations for a child’s behavior, clearly explaining goals and rules, identifying behavior that’s inappropriate, and following through with sanctions for rule violations and rewards for good behavior.

Earlier this year, I spent a lot of time trying to figure out the secrets to raising great kids and learned that we know what works; it’s just that in the heat of the moment, we parents often do the wrong thing. A lot of what works is counterintuitive. Scientists have conclusively proven that nagging doesn’t work, for instance, but we all do it.

Saying that parents of a child with ADHD need training doesn’t mean that the parents are the problem, Adesman says. “But maybe they need to change their approach to the child, or be more realistic. The parents can oftentimes improve the child’s behavior.”

That’s of a piece with the controversial advice from Lawrence Diller, a pediatrician in Walnut Creek, Calif., whose books about children and ADHD include The Last Normal Child. Parents who create and enforce clear rules can often inspire a dramatic turnaround in child behavior, Diller says. The controversy comes because Diller argues that, with some children, discipline can also include spanking.

The British experts don’t say never use Ritalin. Rather, they say it should be reserved for children with severe ADHD. Studies in the United States have shown that medication improves behavior faster than therapy in the short term. But for many families, parent training or family therapy can be the answer to the often-troubling question on Ritalin—yes or no?

Most health insurance doesn’t provide nearly the same coverage for education and counseling as it does for pill-prescribing, and in some communities, it can be hard to impossible to find good services. Now that the powers in the U.K. have decreed that parent education comes first, that means that insurance will pay for it. Wouldn’t it be a wonderful thing if American families had that same opportunity?

Source: U.S. News & World Report
http://tinyurl.com/456dr2

The class was working peacefully. It was the first lesson of the morning and everyone was a little bleary-eyed.

Joe Smith, I notice was doodling on a text book. ‘Come on Joe. That’s enough of that. Get on with your work please.’

I was new to teaching and trying to be firm but fair. The next minute, Joe grabbed his neighbour’s pencil case and threw it across the floor. When I remonstrated him he told me to ‘f*** off’.

At the end of the lesson I asked him to stay behind. Demanding an apology, I told him I’d be phoning home as well as reporting his behaviour to the head.

Joe simply shrugged. ‘It’s not my fault. I’m ill. I’ve got ADHD. I can’t help it.’

This was the first time I’d heard of Attention-Deficit Hyperactivity Disorder, and I actually laughed. Appalling behaviour an illness? I’d never heard anything so ludicrous.

Now, I can honestly say I don’t think there’s a single class I teach without at least one and often two or three children being medicated with this very powerful class B drug.

Ritalin has unpleasant side effects - including sleeplessness and nausea - and the penalty for selling it illegally is a maximum of 14 years’ imprisonment.

If the answer to these questions is yes, then according to the ‘experts’, the child might well have ADHD. Alternatively, they may simply be a typical boy.

Added to the list of symptoms are, in my experience, extreme rudeness and a dislike of being asked to wear school uniform.

If asked several times to stop talking over me, children with the ‘illness’ generally swear at me.

When I phone their home, their parents react with the uniform comment: ‘He can’t help it. He’s got ADHD.’

Unsurprisingly, an increasing number of doctors and psychiatrists are expressing the fear that children are being labelled with a mental illness and given drugs for behaviour that in the past would simply have been labelled ‘very naughty.’

And anecdotally, there is plenty of evidence to suggest that schools are pressurising parents to put children who cause mayhem on Ritalin.

As a teacher, I’m secretly relieved when I hear that a particularly difficult child, one who won’t do any work, who chats and texts through the lesson, who sneers and swears at staff without a second thought, has been prescribed Ritalin.

The drug isn’t known as the ‘chemical cosh’ for nothing. If I’m honest, though, I don’t believe that these children are ill. I think they come from insecure, unstable backgrounds where the concept of a bedtime is as fanciful as the fairy tales they’ve never been read.

Of course, having an active, boisterous seven-year-old child is hard work. But it seems to me that far too many mums and dads are happy to have their children labelled with a psychiatric condition and drugged - even if the existence of the disorder is hotly disputed by the experts.

Youngsters might be turned into wide-eyed, slow-witted zombies, but at least they’re not running amok in the playground and inconveniencing their parents by getting suspended.

Ritalin, like Valium, has become mother’s little helper. It relieves parents of the responsibility of actually having to discipline their children. But as a society, we may pay a very high price indeed for drugging a generation of our children.

* Frances Childs is a teacher in a comprehensive school in the South of England.

Source: Daily Mail
http://tinyurl.com/4aqr7v

Youngsters in the United States are three times likelier to be prescribed antidepressants and stimulants and twice as likely to be given antipsychotic drugs than counterparts in Germany and the Netherlands, according to a new study.

The use of antidepressants and stimulants such as Prozac and Ritalin to treat hyperactivity, attention deficit and bipolar disorders in teenagers and young children has become a subject of sharp controversy.

Proponents say these powerful drugs, known as psychotropics, target newly identified conditions that were undertreated or misdiagnosed in the past.

Critics say the medications are being used too broadly, addressing behavioural problems that should be tackled by softer therapies.

Drawing from data on nearly 600,000 youngsters 19 years old and younger, the study is one of the first rigorous comparisons across several countries of how these medications are dispensed among the young.

In 2000, nearly seven percent of children in the US took psychotropics of some kind, while 2.9 and 2.0 percent, respectively, did so in the Netherlands and Germany, according to the study.

One in 12 of American children aged five to nine were taking these medications, four times the European levels.

Lead researcher Julie Zito, a University of Maryland pharmacologist, said psychotropic use in the United States may have increased since the data was collected.

“The US trends appear to be continuing,” she told AFP in an email.

Seeking explanations for the disparity on either side of the Atlantic, the study noted that direct-to-consumer drug advertising was allowed in the United States, but banned in Europe.

“The increased use of medication in the US reflects the individualist and activist therapeutic mentality of US medical culture,” Zito said.

There are also differences in the way behavioural disorders are defined and classified.

The diagnosis of “hyperkinetic disorder” in the European medical system, for example, is more stringent than that of the “attention deficit hyperactivity disorder” (ADHD), the equivalent syndrome in the US classification.

Another difference is who is handing out the medication: there are more psychiatrists per capita in the United States, which could influence prescription patterns, the study says.

Reimbursement policies and government regulatory constraints may also be factors.

Amphetamines and other stimulants are rarely prescribed for children in Western Europe. In France, their use was banned during the period covered by the study, 1999 and 2000.

Government health plans in Europe have also cut down on the use of expensive, patent-protected drugs, especially antipsychotics and antidepressants.

The study was published online, on Thursday, in the British-based open access journal BioMed Central.

Source: AFP
http://afp.google.com/article/ALeqM5ilBNpu4oa62i2RHvWrWC362LFLaA

Parents need lessons in how to cope with their children’s unruly behaviour, new guidelines on attention deficit hyperactivity disorder (ADHD) say.

Teachers would also benefit from training to recognise and help children with this condition, it adds.

Any primary school class is likely to have a child with ADHD, experts say.

Most of the estimated 365,000 children in Britain with ADHD receive no treatment at all.

But of those who do, most - about 37,000 - are prescribed stimulants like Ritalin (methylphenidate).

Children with ADHD have extreme difficulty sitting still, learning or concentrating.

At school they may find it hard to keep friends and suffer from bullying because of their behaviour. Looking after affected children can be exhausting for parents.

Parenting classes

The guidelines, which cover England, Wales and Northern Ireland, say parent training and education programmes should be offered as a first-line treatment for ADHD, both for pre-school and school age children.

Drugs remain a first option for children over five and young people with severe ADHD, say the guidelines, but only as part of a comprehensive treatment plan that includes psychological and behavioural interventions.

Dr Tim Kendall, a consultant psychiatrist from Sheffield who is joint director of the National Collaborating Centre for Mental Health and helped draw up the guidelines, said: “There is an over-reliance on medicines.

“Quite commonly, people tend to revert to offering methylphenidate or atomoxetene. When they do that it’s not always because there’s a good balance of risk and benefits. It’s because the child has got what appears to be ADHD and that’s what’s available.

“Its easier to prescribe a drug when other options like parent training programmes are not available.”

Dr Kendall said it was important to diagnose ADHD correctly, rather than label all bad behaviour as ADHD. The symptoms of ADHD persist in all settings - both at school and at home - and cause real impairment.

Andrea Bilbow, chief executive of the ADHD charity ADDISS, welcomed the NICE recommendations but questioned how helpful the parent training programmes would be to parents.

“Parenting programmes are extremely important, but they need to be specific for ADHD.

“The ones that NICE are recommending were designed for the parents of children with conduct disorder, which is completely different from ADHD,” she said.

The Scottish InterCollegiate Guidelines Network (SIGN) is rewriting its guidelines on ADHD diagnosis and treatment and will take the NICE guidelines into consideration.

Their new guidance will come out in the first half of 2009.

Source: BBC News
http://news.bbc.co.uk/1/hi/health/7630926.stm

Up to one in 11 children in Britain may suffer from an attention deficit disorder, government advisers will say this week.

Recommendations on the treatment of Attention Deficit Hyperactivity Disorder (ADHD) say families in which pre-school children have behavioural problems should be given parenting classes, reigniting a debate about whether the condition is a medical diagnosis or the result of poor upbringing.

The guidance by the National Institute for Health and Clinical Excellence (Nice) is expected to say that up to 9 per cent of children and 2 per cent of adults fall within broad definitions of ADHD. It will recommend that the stimulant Ritalin be prescribed to all children and adults with a severe form of the condition and to all moderate cases which do not respond to talking therapies or parenting classes.

Prof Philip Asherson, one of the experts who produced the guidance, due out on Wednesday, said they tried to avoid following the model of ADHD care in the United States, where medication is the norm and routinely used to tackle minor behavioural and educational problems.

He said: “We worked very hard to avoid the approach in the US, where one in 10 children are being treated with stimulants. The guidance makes it clear that medication is the right approach in some cases but that it should not be used for everyone and certainly not to tackle minor educational problems.”

The psychologist Oliver James accused psychiatrists of medicalising a problem that was caused by upbringing. He said: “Psychiatrists invented this category to medicalise when in fact it is a social problem linked to low incomes and parenting difficulties.” He said the best approach to children with ADHD-like symptoms was to give them more attention and affection.

Andrea Bilbow, chief executive of the National Attention Deficit Disorder Information and Support Service, also attacked the guidance. She said the parenting programmes it recommended were not specific to ADHD and would offer little help to families.

Dr Sami Timimi, a child and adolescent psychiatrist in Lincolnshire, who does not believe ADHD is a valid diagnosis, said Nice had produced no evidence that the condition existed, or that medication worked, despite coming to conclusions supporting its use.

Dr Timimi, author of Naughty Boys: Anti-social Behaviour, ADHD and the Role of Culture, said draft guidance produced by Nice cited a study that showed Ritalin improved the performance of patients after 14 months but did not consider the longer-term results of the same study, which showed that after three years it made no difference.

Stoke uses drug 23 times less than the Wirral

Doctors are 23 times more likely to prescribe drugs such as Ritalin for Attention Deficit Hyperactivity Disorder in some areas of the country than in others.

In the Wirral, one prescription of the drug class methylphenidate, which includes Ritalin, was dispensed for every seven children last year, according to the Health Service Journal. Other areas with high rates included the Isle of Wight, Great Yarmouth and Medway in Kent.

Doctors in Stoke on Trent handed out the drugs least frequently, with one prescription per 159 children.

Latest figures show almost 500,000 prescriptions for stimulants for under-16s last year, more than double the 200,000 issued in 2003. The Department of Health said the figures reflected the number of prescriptions, which could include repeat orders for the same child.

Solurce: Telegraph.co.uk
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