A.D.H.D, attention deficit hyperactive disorder currently affects 5 to 10% of school age children in the United States.  Your child may have ADHD if he has difficulty focusing, difficulty waiting in line, interrupts conversations, has difficulty keeping still, cannot remain seated in the classroom, is easily distracted, procrastinates, makes careless mistakes with schoolwork or homework and is disorganized.  Children with ADHD tend to have difficulty in school and at times socializing with others.  Approximately 50% of children with ADHD grow up to be  adults with ADHD.  The same issues make it more difficult to obtain and sustain employment as adults. A recent study in the scientific journal Attention Deficit Disorder found two factors associated with ADHD which everyone concerned with this condition should be a aware of especially since these factors are modifiable.  Specifically, the study found a more than two fold increase in the incidence of ADHD from mothers who smoked during their pregnancy.  Obviously, if your child has already been born and has ADHD, you can not go back in time.  However, if you’re an expectant mother or planning to have children and are concerned about having a child with ADHD then not smoking during pregnancy should be a top priority for you.  If you have a child that has ADHD you should be aware that this study also found the rate of children with ADHD is five times as great in children with obesity.  Thus, if you are pregnant and smoke or your child is overweight, these are issues that are difficult to deal with but will certainly make a difference over your child’s lifetime and is worth putting in the effort.

Many children on the Autism Spectrum have difficulty recognizing emotional cues such as nonverbal  expressions which are thought to be conveyed through the eyes as well as connecting with others emotionally on an interpersonal basis.  A large part of communication between humans is nonverbal communication.  This means to say that it is not just the words that are spoken but in addition how they are spoken, inflection, as well hand gestures, body postures and facial expression.  The inability to recognize faces and facial expression is called prosopagnosia.  This inability to interpret facial expressions often leads to difficulty in social situations with others.  It is also been thought to be involved with a lack of empathy toward others which also is at times associated with autism.  The area of the brain most associated with prosopagnosia is the fusiform gyrus of the temporal lobe. Although it is thought that the fusiform gyrus has a specific face area, it is also thought to be responsible for things such as processing of color information as well as number and word recognition.  As an example, people with prosopagnosia can recognize a different pens or forks but not faces.  Until recently it was thought that propsopagnosia or face blindness and is is sometimes called could not be improved.  Instead,  patients were taught techniques to compensate for the face recognition deficiency such as looking at clothing, voice or hair color in order to attempt to identify who the patient was speaking with. A recent study in the Journal of Autism and Developmental Disorders published out of the University of Alabama Birmingham used a computer based social skills training program for children with autism spectrum disorders.  This interactive program showed a positive impact in a group with Autism and a group with Asperger’s Syndrome.  Both groups showed improvement in the ability to recognize faces as well as improvements in the ability to recognize emotion. The Asperger’s group also showed improvement in social interactions in a natural environment. This should come as great news to parents who see their children have difficulty making friends and struggle while attempting to socialize at school or the park. This feeds well into the current model of neuroplasticity, the brain’s ability to change, in which practitioners of functional neurology are looking for tools to activate specifically targeted under functioning areas of the brain. With regular stimulation of these areas at the correct intensity and frequency, positive changes can be made to help address various deficiencies whether sensory, motor or in this case social. If you have a child on the Autism Asperger’s Syndrome and this type of treatment sounds interesting to you, look for a physician that practices functional neurology in your area.

There is still considerable debate regarding a connection between autism and vaccines.  On one side there are those citing that the original Wakefield study has now been deemed to have been fraudulent.  On the other side are parents whose children were perfectly fine, but developed a a fever right after the vaccine and were never the same since. Those of us that are involved with the Autism community and treat these children know that the latter is something that we have heard frequently enough to raise suspicion.  As I’ve stated previously, my concept is one of total load on the system.  It is the sum total of all the stressors on the child that decompensates the child’s health.  This would to explain why if thousands of children are vaccinated every year  only a small percentage developed symptoms relating to the autism spectrum.  It is the child with a latent virus, immature liver etc., that now receives the vaccine with mercury or aluminum which the child, do to other stressors is not able to handle.  In this case, the vaccine becomes the straw that breaks the camel’s back.  It can be one huge stress or more than likely a multifactorial cause. At this point there’s going to be a lot of resistance from pediatricians to those parents that want to delay or spread out the vaccination of their children. The purpose of this article is to give those parents a rational way to approach your pediatrician with regard to Autism and vaccines.  I will attempt to lay out some risk factors and early indicators of autism that would suggest that a parent might want to procede with caution with regard to vaccinations.  The more of these risk factors or indicators that your child has, the more persuasive your argument will be. 

Is there someone in your family that has autism?

Was your child premature?

Was your child breech birth?

Was your child jaundice?

Was your child of low birth weight, less than 5.5 pounds?

Is your child a boy?

Were you older parents?

Is there less than two years from birth to birth of your children?

Did you smoke while you were pregnant?

Did your child have a low Apgar score at 5 minutes, less than 7?

Were you exposed to toxins during your pregnancy?

Now let’s look at three early indicators of Autism. Obviously, if your child is showing early signs of Autism you may want to moderate additional risk factors.  Is your child not looking, vocalizing and smiling at others?  Is your child a picky eater?  Does your child have issues with joint attention?  Joint attention is how we alert others about an object or event  in a nonverbal way utilizing techniques such as gaze and pointing with another person. An example would be when you see something interesting and point at it (initiating joint attention ) in an attempt to get somebody else to become engaged.  This type of activity should be present at about nine months of age.

So whether or not you are involved in the vaccine debate or have a loved one that is concerned with regard to the Autism crisis, this article should serve as valuable information and a starting point for discussion.

One in 10 school age children have ADHD and half of those children will grow up to have ADHD as an adult.  ADHD is defined as having difficulty with inattentiveness, hyperactivity and impulsivity. This tends to lead to children having difficulty in school and adults having difficulty with employment. Those with ADHD, particularly adults, commonly complain of difficulties with executive functions.  The medical  dictionaries defines executive function as   ” the cognitive process that regulates an individual’s ability to organize thoughts and activities, prioritize task, manage time effectively and make decisions.” One can easily see how this would make it difficult to maintain and progress in a job especially one that requires any type of managerial duties. By the time those suffering from ADHD become adults most have tried the stimulant medications which are commonly prescribed for this condition. Having treated many adults with ADHD is very common to hear that the medication does not help them with organizational type skills and other types of skills which are executive function type task. A recent study in the European Journal of Neuropsychopharmachology seems to confirm what those of us that treat ADHD and those that have its already were aware of. The study found that methylphenidate the chemical compound in many of the commonly prescribed stimulant medications was not effective in moderating psychometric measures dealing with executive function. Translation- methylphenodate did not help with executive functions such as organization, planning and regulating inappropriate actions. Recently, there was a study published using children but not adults that  found that a restricted elimination diet was effective in dealing with symptoms related to ADHD. Also studies relating to physical activity have been published which have demonstrated improvement in ADHD symptoms.  There is also literature published which reflects that certain nutritional supplementation can at times be as effective as the stimulant medications.  Hemispheric Integration Therapy also recently published a study in which significant objective progress with psychometric testing was made in a 12 week period. Most of the research is done on children and many times the adult with ADHD has been forgotten.  In this case, it was nice to see a study done with adults.  So there are alternatives available to treat adults with ADHD. For those who would like to simply manage their ADHD as adults, there are certain organizational skills which can aid you with executive functions. These include things such as using list, setting up a filing system, prioritizing your list and your activities, using a calendar or day planner and limiting your activities so as to not become overwhelmed.If you’re interested in improving your situation and not just managing it, consult a physician that is familiar with not only ADHD but the treatment interventions listed above.

 Eur Neuropsychopharmacol.2011 Feb 7. [Epub ahead of print]

ADHD is currently estimated to affect 5 to 10% of school aged children. This means we all know a child or adult with ADHD whether that be a son, nephew, husband or brother who suffer from ADHD.  Boys are affected 3 times more than girls. The standard treatment for ADHD is stimulant medications such as Ritalin, Adderal, Vyvanse, Concerta and Dexetrine. Stimulant medications are effective in reducing ADHD symptoms in approximately 70% of children and adults. But the stimulant medications have side effects such as trouble sleeping, loss of appetite, mood swings, anxiety, irritability, heart palpitations, headaches, upset stomach, slower growth and weight gain and repetitive movements or sounds (tics.) Many parents do not want their young children on medication and many are trying to avoid the aforementioned side effects. Additionally, if the medications work for 70% of those suffering with ADHD then it stands to reason that 30% of children and adults do not respond to this treatment. A new study in Lancet determined that use of a restricted elimination diet improved symptoms of ADHD in78% of children. The children were ages 4 to 8 and had an ADHD diagnosis. The study was notable as a relatively large testing sample, 100 children participated in the study. The results come as no surprise to those of us that use these types of interventions to treat children with ADHD and learning disabilities but it is nice to have some validation. The study did not find that measuring IgG (antibodies) levels for food sensitivities were helpful but practitioners who supervise parents introducing these types of treatments find that IgG food sensitivity test are useful and help guide parents in what may be a difficult diet to implement, particularly at first. My experience has found IgG food sensitivity tests to provide a considerable amount of direction and comfort to parents. The testing period may have been too short to see a significant change in IgG levels in this particular study. Therefore, if you have a loved one who suffers with the frustration that is ADHD, be aware of the elimination diet as a tool to help your child get off of the stimulant meds, or perhaps achieve greater reduction of symptoms for those  having success with the stimulants. This of course may be of greatest benefit for the 30%  for whom stimulant medication is ineffective. If you are interested in this type of approach consult a physician who treats ADHD and is familiar with dietary and nutritional interventions.

Parents who have children that suffer from ADHD as well as doctors and therapists who treat these families are well aware that there is a higher rate of difficulty with regard to bladder control for these children.  This most times is at night but may also be a problem throughout the day as well.  In addition to an obvious sign of delayed development, this also has considerable social stigma attached to it.  A recent study in the Journal of Urology confirms and brings into objective evidence what those of us in the field already know.  Yes, children who have ADHD are far more likely to have issues with bladder urgency and eneuresis ( bed wetting.) In fact, the higher the child scored on the Connors Parent Rating Scale a psychometric tests for ADHD, the more likely he or she was to have urgency.

In the functional neurology model, this association between ADHD and bladder control makes perfect sense. An under developed cortex or higher brain is going to give one less ability to resist a socially inappropriate urges as well as a lower reflexes such as relating to your bladder.  Let’s combine the two situations to make an example.  When your bladder fills, you will have the urge two empty your bladder. This is what you do as an infant. It is a reflex. As your higher brain develops you become aware that it is socially inappropriate to empty your bladder whenever it feels full.  It is your higher brain which is able to inhibit the bladder reflex to empty your bladder.  Thus, if you’re higher brain is not developed sufficiently you will not be able to inhibit the lower bladder reflex and you will have urgency and  daytime as well as night time accidents.  Now, let’s look a situation in which the child is able to control his bladder during the day but has issues with bed wetting at night.  In this situation, your cortex or higher brain is less active at night when you are sleeping.  Therefore, you have less ability to inhibit the lower bladder reflex and thus your bladder empties. In the second case, the child’s cortex is sufficiently developed to inhibit the bladder reflex during the day however with decreased cortical activity at night, his ability to inhibit the bladder reflex falls below threshold and he loses his ability to inhibit. 

The trick of course is to find the appropriate exercise to stimulate the under functioning area of the brain (the area of dysfunction must be localized)  in order to accelerate its development and address both the issue with ADHD and bladder control. This of course is the job of the functional neurology practitioner. 

J Urol. 2011 Feb;185(2):663-8. Epub 2010 Dec 18.

Lower urinary tract conditions in children with attention deficit hyperactivity disorder: correlation of symptoms based on validated scoring systems.

Burgu B, Aydogdu O, Gurkan K, Uslu R, Soygur T.

Department of Urology, Ankara University School of Medicine, Ankara, Turkey.

PMID: 21172714 [PubMed - in process]

Adult ADHD (Attention Deficit Hyperactive Disorder) sufferers have been known to have higher incarceration with rates, the difficulty in school, higher pregnancy rates, higher obesity rates and more difficulty forming relationships.  Currently 5 to 10% of school age children are thought to have ADHD.  Roughly 50% of those children will grow up to be a adults who suffer from ADHD.  A new study in the European Journal of Neurology suggest more bad news for adults with ADHD.  The study found that adults with dementia with Lewy bodies had a 47.8% frequency of proceeding ADHD symptoms vs.  15.1 percent in the control group.  This suggest that there was approximately a 3 times greater risk of developing dementia with Lewy bodies for those adults with ADHD symptoms when compared to those without ADHD symptoms.  Lewy bodies are protein aggregates that develop inside nerve cells and are associated with other neurodegenerative disorders such as Parkinson’s disease and Alzheimer’s disease. Current science has no explanation for the association between the two disease processes, however this study certain to prompt more investigation  which may aid in the understanding and treatment of both disorders.  Common signs and symptoms associated with Lewy body dementia include variation in cognition (thought processing) and attention, visual hallucinations (usually seeing people or pets that are not actually present ) and Parkinson like movement disorders ( slow to initiate movement,shuffling gait, expressionless face.) Four controllable risk factors if you were pregnant to lower your chances of having a child with adhd include quitting smoking the moment you discover you’re pregnant, don’t drink while you are pregnant, avoid toxin exposure and avoid a high fat diet during pregnancy. Recall that children with ADHD become adults with ADHD and that this new evidence suggests may become seniors with dementia with Lewy bodies.Thus, if you suffer from ADHD, this should give you more motivation to make seeking appropriate treatment a priority in your life.

Eur J Neurol. 2011 Jan;18(1):78-84. doi: 10.1111/j.1468-1331.2010.03064.x.

Previous adult attention-deficit and hyperactivity disorder symptoms and risk of dementia with Lewy bodies: a case-control study.

Golimstok A, Rojas JI, Romano M, Zurru MC, Doctorovich D, Cristiano E.

Neurology Department, Hospital Italiano Buenos Aires, Argentina. angel.golimstok@hospitalita.org.ar

PMID: 20491888

Our model of autism deals with under functioning areas of the brain as well as difficulty with different areas of the brain communicating with each other. Our treatment approach is based on eliminating issues with fuel delivery to the brain as well as activating the under functioning, under commmunicating pathways, and circuits in order to optimize brain function. This is our general approach to autism as well as many other neurological disorders. We know that the brain is changeable, neuroplasticity, and thus we use this information to stimulate targeted areas of the brain through the senses in order to promote positive changes in the patients nervous system. The stimulation should be targeted and specific to the patients particular area of weakness. I am not a fan of generalized right or left brain stimulation as you can create an imbalance as well as correct one. This is particularly important with regard to children on the autism spectrum as each child is so different even if they have some commonalities.  Having established that I prefer specific treatment protocols based on a clinical examination by a functional neurologist, I recognize that I am often asked if there is any general type of stimulation or exercises that a parent that has a child with autism can do at home or by themselves that might be in accordance with the concepts of functional neurology, hemispheric integration and neuroplasticity.   Something that I have found that seems to be beneficial in most,but not all cases, is musical training. Obviously, this would depend on where the lesion, problem in the brain, is and what you child’s level of function. Although, in Hemispheric Integration Therapy a great emphasis is placed on balancing the right and left sides of the brain. I again reiterate that there are 2 sets of peripheral nerves, 2 cerebellums, 2 basal ganglias etc and one can not simply stimulate on one side or the other and expect an optimum result. Much of the communication between right and left hemispheres is done through an area know as the corpus callosum which musical training has been shown to increase in size. In addition, musicians have shown larger brain areas for motor, auditory,  and visual spatial center of the brain. And I think we have heard it said that musical training improves math skills.  This is exactly what neuroplasticity is all about and a good example as to how appropriate stimulation cannot only make a pathway or area more efficient but also make it physically larger. This is exactly what the functional neurologist does with his patient’ s except that the exercises and stimulation are directed toward the area which was found to be deficient on functional neurological examination. Both of my children play the piano. I would say that in general, if you have a child on the autism spectrum, musical training is something you may want to investigate as a way to improve his or her functionality. This is not medical advice as I have not had the opportunity to examine your son or daughter, but simply a suggestion in response to a question that I am often asked. I personally don’t play an instrument, but have it on my list of things to do simply as I like the neurological implications.

J Neurosci. 2003 Oct 8;23(27):9240-5.

Brain structures differ between musicians and non-musicians.

Gaser C, Schlaug G.

Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA.

PMID: 14534258 [PubMed - indexed for MEDLINE]

Cereb Cortex. 2003 Sep;13(9):943-9.

Cerebellar volume of musicians.

Hutchinson S, Lee LH, Gaab N, Schlaug G.

Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02215, USA.

PMID: 12902393 [PubMed - indexed for MEDLINE]Free Article

Clin Med. 2008 Jun;8(3):304-8.

Do musicians have different brains?

Stewart L.

Department of Psychology, Goldsmiths, University of London. l.stewart@gold.ac.uk

PMID: 18624043 [PubMed - indexed for MEDLINE

Neuropsychologia. 1995 Aug;33(8):1047-55.

Increased corpus callosum size in musicians.

Schlaug G, Jäncke L, Huang Y, Staiger JF, Steinmetz H.

Department of Neurology, Heinrich-Heine University, Düsseldorf, Germany.

PMID: 8524453 [PubMed - indexed for MEDLINE]

Nat Rev Neurosci. 2002 Jun;3(6):473-8.

The musician’s brain as a model of neuroplasticity.

Münte TF, Altenmüller E, Jäncke L.

Department of Neuropsychology, Otto-von-Guericke University, Universitätsplatz 2, Gebäude 24, 39106 Magdeburg, Germany. thomas.muente@med.uni-magdeburg.de

PMID: 12042882 [PubMed - indexed for MEDLINE]

Parents are always looking for things they can do to help their children suffering from ADHD and/or learning disabilities.  Among the risk  factors, there are some we can control and some that we can not. We can not control whether or not we have a family history of ADHD, whether our child was born premature or whether our child is a boy or a girl.  It may be too late to change the fact that  we smoked during pregnancy, drank alcohol during pregnancy or were exposed to toxins such as lead.  But, we can look forward and help our child by not exposing him or her to second hand smoke.  This is completely within our control.

 And now a new study out of the Sleep Disorders Center  at the JFK Medical Center finds that electronic media such as texting and video games at bed time can also influence our children’s risk for ADHD and learning issues. Girls seem to text more and boys play video games. Most parents were unaware of these behaviors. These activities can disrupt sleep cycles which can lead to learning difficulties as well as anxiety and depression. Parents must be aware of their children’s activities. And yes, you may need to take their phone away or at lest confiscate it at bed time. 

Also, remember that you can help your child by keeping a regular routine and helping him with organization, getting regular sleep and planning for circumstances that you anticipate will be difficult such as those that will require prolonged waiting.