St. Louis University researchers have received a three-year, $1 million grant from the Centers of Disease Control to expand their education of doctors about the risks of drinking during pregnancy and fetal alcohol syndrome.

“Drinking during pregnancy increases the risk of birth defects, which have lifelong consequences and can easily be prevented,” said Leigh Tenkku, an assistant professor of family and community medicine at the university. “It is very important to get the message out to health care professionals and to include this information in academic training settings.”

Research has shown that advice from doctors and nurses is one of the most influential factors in determining whether or not women drink during pregnancy. Yet many health care professionals are uncomfortable talking to their patients about alcohol use, are unsure about current guidelines or lack the necessary resources, Tenkku said.

“Only 50 percent of health care providers give information about the consequences of drinking during pregnancy to all patients,” Tenkku said. “Our goal is to educate as many health care professionals as possible about the very real dangers posed by drinking during pregnancy and enable them to help their patients.

In 2002, St. Louis University worked with the University of Missouri–Columbia and St. Louis Arc to establish the Midwest Regional Fetal Alcohol Syndrome Training Center to educate health care professionals and students. The grant will allow the center to set up satellite faculty teams in each of the eight Midwest states served by the center, including Illinois. (…)

Source: Belleville News Democrat, USA
http://www.bnd.com/living/health/story/529994.html

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

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
http://tinyurl.com/53uulo

Almost one in four teenagers is raiding their parents’ medicine cabinets for prescription drugs in a new trend dubbed “pharming”.

Australian youths aged 12 to 17 are most likely to take medications recreationally because they are cheaper, easier to obtain and mistakenly believed to be “safe”, a new study has revealed.

In a risky bid to maximise a “hit”, youngsters are crushing cocktails of pills and snorting the powder, mixing them with alcohol or even injecting.

Pharmaceutical medicines have now overtaken marijuana as the traditional teen drug of choice, with more than twice as many regular users.

Commonly abused drugs include anti-depressants, painkillers and ADHD medications, such as Ritalin.

In a new study of 2813 young Australians, researchers said the “most concerning” finding was that 23.5 per cent of 12 to 25-year-olds took prescription drugs recreationally.

Paul Dillon of Drug and Alcohol Research and Training Australia said young people commonly believed if a drug came from a doctor it was safe.

“We live in a pharmaceutical world where there’s a drug for everything, so we are creating a generation of users,” he said.

Source: NEWS.com.au, Australia
http://www.news.com.au/story/0,23599,24340581-2,00.html

Guidelines for managing attention deficit and hyperactivity disorder have alarmed leading education researchers, who warn they will cause an exponential increase in children being labelled as having ADHD by schools chasing funding.

A group of 14 researchers in education, disabilities and ADHD from seven universities have written to the Rudd Government, criticising moves to instruct teachers to look out for ADHD and to allocate special funding to schools for students with the disorder.

The guidelines are being reviewed by the Royal Australasian College of Physicians at the request of the National Health and Medical Research Council. Draft recommendations were released for public comment.

In a letter to Education Minister Julia Gillard and Health Minister Nicola Roxon, the researchers say the recommendations will encourage over-diagnosis of ADHD and give schools an incentive to have children classified with the disorder to gain access to extra money.

“This risk is particularly acute for children from socially disadvantaged backgrounds.”

A survey of children’s mental health, conducted by the Australian Institute of Health and Welfare in 1998, found almost 8 per cent of 12- to 17-year-olds were diagnosed with ADHD.

A study of South Australian children taking medication for ADHD in 1999 found rates highest among children from families with low incomes and high unemployment.

The lead signatory on the letter, Linda Graham from the University of Sydney, said yesterday resources would be better spent on giving teachers the skills and support to deal with a variety of children’s behaviours rather than singling out disorders.

Dr Graham said diagnosing a child as having ADHD was sometimes medicalising normal behaviour and should be a last resort, but it had become the first step in dealing with challenging children. “The diagnostic criteria for ADHD over the past 15 years has been expanding and it’s now almost possible to diagnose one of my cats,” she said.

The chairman of the group writing the guidelines, David Forbes, said between 5 and 10 per cent of children had the features of ADHD and might need special intervention to help them learn at school. He disagreed that training teachers to recognise ADHD would increase diagnosis of the disorder.

Source: The Australian, Australia
http://www.theaustralian.news.com.au/story/0,25197,24203785-5013871,00.html