 Welch MG, Northrup RS, Welch-Horan TB, Ludwig RJ, Austin CL,
Jacobson JS. Outcomes of prolonged parent-child embrace therapy among
102 children with behavior disorders. Complementary Therapies in
Clinical Practice. 2006; 12(1): 3-12. A growing body of research in neuroscience points to the impact of variations in maternal nurturing on child development and provides a rationale for interventions that target stress adaptation conditioning through natural family nurturing. This pilot study was collected within the course of private practice to assess the progress of children with severe behavioral disorders who were treated effectively with a multiple family therapy prototype, Prolonged Parent–Child Embrace (PPCE) Therapy. Subjects were a consecutive series of 102 patient children aged 4–18 years and their families. Children and their family members were guided for 16h over two consecutive days through intense PPCE Therapy. Families were instructed to continue PPCE Therapy at home for at least 1 year. Scores were compared statistically using t-tests and analysis of variance. For 96 children scores declined on two written measures by approximately 50% between baseline and follow-up (P<0.001). Results showed that PPCE Therapy resulted in significant and prolonged improvements in symptomatic behavior in a majority of children.Tremblay, M.S., LeBlanc, A.G., Kho, M.E., Saunders, T.J., Larouche ,
R., Colley, R.C., Goldfield, G., Gorber, S.C. (2011) Systematic review
of sedentary behaviour and health indicators in school-aged children and
youth. International Journal of Behavioral Nutrition and Physical Activity 2011, 8:98 Accumulating evidence suggests that, independent of physical activity levels, sedentary behaviours are associated with increased risk of cardio-metabolic disease, all-cause mortality, and a variety of physiological and psychological problems. Therefore, the purpose of this systematic review is to determine the relationship between sedentary behaviour and health indicators in school-aged children and youth aged 5-17 years. Online databases (MEDLINE, EMBASE and PsycINFO), personal libraries and government documents were searched for relevant studies examining time spent engaging in sedentary behaviours and six specific health indicators (body composition, fitness, metabolic syndrome and cardiovascular disease, self-esteem, pro-social behaviour and academic achievement). 232 studies including 983,840 participants met inclusion criteria and were included in the review. Television (TV) watching was the most common measure of sedentary behaviour and body composition was the most common outcome measure. Qualitative analysis of all studies revealed a dose-response relation between increased sedentary behaviour and unfavourable health outcomes. Watching TV for more than 2 hours per day was associated with unfavourable body composition, decreased fitness, lowered scores for self-esteem and pro-social behaviour and decreased academic achievement. Meta-analysis was completed for randomized controlled studies that aimed to reduce sedentary time and reported change in body mass index (BMI) as their primary outcome. In this regard, a meta-analysis revealed an overall significant effect of -0.81 (95% CI of -1.44 to -0.17, p = 0.01) indicating an overall decrease in mean BMI associated with the interventions. There is a large body of evidence from all study designs which suggests that decreasing any type of sedentary time is associated with lower health risk in youth aged 5-17 years. In particular, the evidence suggests that daily TV viewing in excess of 2 hours is associated with reduced physical and psychosocial health, and that lowering sedentary time leads to reductions in BMI.Thomas CP, Conrad P, Casler R, Goodman E. Trends in the use of psychotropic medications among adolescents, 1994 to 2001. Psychiatric Services. 2006; 57 (1): 63-69. OBJECTIVES: Few psychotropic medications are approved for use among children younger than 18 years. Yet previous studies have shown an increase in the use of psychotropic medications among school-age children and adolescents. Most previous studies examined data only up to 1997; therefore, the results predate any impact of changing federal policies and newly marketed medications. This study examined trends in the prescription of psychotropic medications to adolescents aged 14 to 18 years in office-based care in the United States from 1994 to 2001. METHODS: Data from the National Ambulatory Medical Care Survey (NAMCS) were used to determine visit rates and prescribing patterns from 1994 to 2001 for psychotropics that were prescribed in office-based treatment settings to adolescents aged 14 to 18 years. Rates of visits that resulted in a prescription for psychotropic medication were calculated for two-year periods. Analyses were conducted by type of medication, gender, and the prescribing physician's specialty. RESULTS: Rates of visits that resulted in a psychotropic prescription increased from 3.4 percent in 1994-1995 to 8.3 percent in 2000-2001. These trends were evident for males and females. The average annual growth rates for psychotropic prescriptions were much higher after 1999. Trends were also significant across drug classes. By 2001, one out of ten office visits by adolescent males resulted in a prescription for a psychotropic medication. CONCLUSIONS: Average annual growth rates for the prescription of psychotropics to adolescents increased from 1994 to 2001, with especially rapid acceleration after 1999. This increase may be associated with changing thresholds of diagnosis and treatment, availability of new medications, and changes in federal regulatory policies concerning promotion of medications by the pharmaceutical industry. Ruff, ME. Attention Deficit Disorder and stimulant use: An epidemic of modernity. Clinical Pediatrics 2005; 44 (7): 557-563. The belief that ADD is a biologically based disease predominates the pediatric literature. In tacit response to this biologic bombardment, many pediatricians unknowingly fail to seriously consider the environmental underpinnings of this complex diagnosis before writing a prescription. This is not a call to discredit the diagnosis of ADD or stimulant therapy. But as pediatricians, responsible for the collective welfare of our children, what does relying more and more on stimulants mean? However, the following recommendations may serve as reasonable starting points: Educate parents about preemptive strategies to deploy as part of early childhood anticipatory guidance. Press for more thorough disclosure declarations by authors who research and write the majority of the ADD literature. The AAP should staunchly and more visibly advocate for studies on the environmental contributions to this epidemic. Finally, the balanced, perspicacious writings of authors such as Lawrence Diller, Mel Levine, and Stan Turecki should be required reading for anyone who prescribes stimulants.Rosack, J. (2003). Prescription data on youth raise important questions. Psychiatric News, 38(3), 1-38. A team from the University of Maryland—Baltimore and Johns Hopkins University School of Medicine reported in the January Archives of Pediatrics and Adolescent Medicine that psychotropic prescriptions written for children and adolescents in a study population totaling approximately 900,000 youths rose between 200 percent and 300 percent overall between 1987 and 1996.
"I think the main thing [about our data] is that the empirical data now back up the anecdotal data," lead author Julie Magno Zito, Ph.D., an associate professor of pharmacy and medicine at the University of Maryland—Baltimore, told Psychiatric News. "We have been more than aware of the fact that this [increase] has been occurring, and it is important to document that it is not just happening in one location and also that there are variations."Phillips, C. B. (2006). Medicine goes to school: teachers as sickness brokers for ADHD. PLoS Medicine, 3(4), e182. Over the last twenty years, attention deficit hyperactivity disorder (ADHD) has emerged as a disorder of importance in childhood. Prescription of psychostimulants for ADHD escalated in many countries through the 1990s. Between 1990 and 1995, prescriptions of methylphenidate for young people increased 2.5-fold in the US, and 5-fold in Canada. In New South Wales, Australia, rates of treatment for children in 2000 were nine times those in 1990.
In the case of ADHD, there has been a complex, often heated debate in the public domain about the verity of the illness and the personal cost-benefit ratio of treatment with psychostimulant medication. Much of the polemic for and against psychostimulants is concerned with the part played by doctors, the prescribers of medication, in diagnosing or discounting ADHD. ADHD is, however, a disorder of educational performance, and so teachers have a critical role in advocating for the illness, and its medical treatment. This essay explores the roles of teachers as brokers for ADHD and its treatment, and the strategies used by the pharmaceutical industry to frame educators' responses to ADHD. Lang, R., Koegel, L. K., Ashbaugh, K., Regester, A., Ence, W., & Smith, W. (2010). Physical exercise and individuals with autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 4(4), 565-576. Studies involving physical exercise and individuals with autism spectrum disorders (ASD) were reviewed. Systematic search procedures identified 18 studies meeting predetermined inclusion criteria. These studies were evaluated in terms of: (a) participant characteristics, (b) type of exercise, (c) procedures used to increase exercise, (d) outcomes, and (e) research methodology. Across the corpus of studies, exercise was implemented with 64 participants with ASD aged 3–41 years. A variety of exercise activities were employed (e.g., jogging, weight training, bike riding). Following the exercise interventions decreases in stereotypy, aggression, off-task behavior and elopement were reported. Fatigue was not likely the cause of decreases in maladaptive behavior because on-task behavior, academic responding, and appropriate motor behavior (e.g., playing catch) increased following physical exercise. Results suggest that programs for individuals with ASD may benefit from including components designed to incorporate regular and specific types of physical activity. Areas in need of further research are discussed.
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