St. Louis Post-Dispatch 1/31/12 

Washington University study reports that positive reinforcement may increase brain size. by Blythe Bernhard bbernhard@post-dispatch.com 314-340-8129

If your child forgets his lunch or struggles with school work, a little more loving might turn things around. 

Supportive mothers who practice positive reinforcement seem to help their children's brains grow, according to new research from Washington University.

Brain scans show that school-age children of nurturing mothers have a 10 percent larger hippocampus-the region of the brain that plays a role in memory, learning and stress response-compared to the brains of children whose mothers were deemed less supportive.

The take-home message for working and stay-at-home parents is to praise children more than you scold them, the researchers said. 

"Parents might feel guilty because they're working, and we work a lot as well," said Dr. Kelly Botteron, a professor of child psychiatry and co-author of the study. "But when you're home in the evening and you're trying to rush through homework and trying to get dinner ready, if you remember to say a a couple nice, really positive things... I think a lot of parents could do that and it's a practical thing that has very little risk to it."

It's long been known that orphans and other neglected children who are placed in loving homes can improve their behavior and health.  And while a link between nurturing mothers and their offspring's brain growth has been established in rats, the study is the first to show the same anatomical process in humans.

As part of their ongoing research on childh00d depression, staff members watched how two groups of 92 children ages 3-5 interacted with their caregivers (usually mothers) during a stressful task.  One group of children had symptoms of depression and the others were assigned to a control group.

For the task, the mothers were told to fill out a questionnaire.  The child was given a wrapped present but told not to open it right away.  The  eight-minute "waiting task," as it's known, has been used by researchers as a reliable indicator of parental nurturing skills.  The task is thought to simulate situations at home, such as a parent distracted by cooking dinner while the child needs to focus on homework.

Researchers who reviewed the taped interactions rated the mother's responses to their children's behavior.  Mothers received points each time they praised the child's patience or offered encouragement to not open the gift.

The researchers acknowledged they're not getting a complete picture of family life, especially if Mom was having a bad day.  But they are confident that the results of the MRI brain scans on the kids, performed four years after the "waiting task," indicate that children who have more supportive mothers also have bigger brains.

Children with less supportive mothers had a hippocampus volume that was 9.2 percent smaller than the children of more nurturing mothers.  In children with depression, the effects of nurturing were not as positive, and the researchers think the disease process has a greater impact on brain development.

The researchers plan to run second and third MRI brain scans on the children, who are now preteens, to watch for brain development over time.

Although the study wasn't designed to look at fathers, foster parents or grandparents, the researchers said the positive effects of nurturing can come from any caregivers, which can be reasonably stretched to include teachers.

"If you know your child is in a difficult situation, to reinforce to them that you know it's a hard situation but they're doing such a great job, that's the kind of parenting we would try to encourage," Botteron said.

The researchers were careful to point out they're not opposed to disciplining children or giving them boundaries.

"You should be supportive and nurturing, which is not the same as spoiling, and not the same as smothering," said the study's lead author Dr. Joan Luby, a professor of child psychiatry.

One local mom said it was exciting to hear that something she already believes in could have an effect on her children's intellectual, and not just emotional, development.

"For a nurturing parent it's both beautiful and frightening because many of us who spend a lot of nights wondering whether we're doing everything we possibly can for our children, this falls into the category of one more thing to worry about," said Danielle Smith of O'Fallon, MO, who has two young children and writes the blog extrordinary-mommy.com. "It sounds like a bonus to me, but I have to embrace the idea that what I'm doing is enough."

Comment from Pam Hass, Speech Language Pathologist:  As we as caregivers and teachers of our children, in addition to being nurturing and supportive of our children, we also need to include our children in day to day conversations and make reading to our children a daily event.  Talking with  our children, listening  and responding to our children while they play or while we do our daily chores will help develop children's language skills.  Reading to our children and talking with them about the story is very important in developing their language and cognitive skills.  

In my next blog, I will begin to list some language activities that families can do to stimulate both the understanding and expression of language.

Reference:  Advance for Speech Pathologists and Audiologists  12/14/11

Sleep deprivation impacts academics and safety.


From memory to judgment, attention span, emotional stability and even immunity, sleep deprivation negatively affects school-age children," reports Kristin Avis, MD, a sleep specialist and assistant professor of pediatrics at the University of Alabama at Birmingham (UA.  Of children under age 18, 60 percent polled by the National Sleep Foundation (NSF) complained of being tired during the day, and 15 percent reported falling asleep at school.

The NSF has guidelines for how much sleep children of various ages require.  Three-five year-olds need 11 to 13 hours per night, while 5-to 12-year olds need 10-11 hours.

"As for adolescents, it's a common myth that they need less sleep and can handle only seven or eight hours," said Dr. Avis.  "They actually need nine hours of sleep.  That's typically the most sleep-deprived population in school.

A student can make up for the lack of one good night's sleep, but going an entire school week without sufficient rest can be detrimental, she noted.  "You can sleep until noon on Saturday and feel caught up, but then you will go to bed later that night, sleep in on Sunday, and then repeat the cycle into the new school week."

Children need a suitable amount of sleep every night.  Their bedrooms should be as tranquil as possible, which means removing noise-makers.

"On average, there are three to four electronic gadgets in a kid's room," Dr. Avis reported.  "It's been shown that even sleeping with a television on deprives them of 20 minutes of sleep per night, which may not sound like a lot but adds up over a week's time.

'Cell phones are often used as an alarm clock, but for about $5 you  can invest in a real alarm clock so the phone can be turned off," added Stephanie Wallace, MD, assistant professor of pediatrics at UAB.

Dr. Avis is exploring further what a bad night's rest can do to a child.  She and David Schwebel, PhD, professor of psychology and director of the Youth Safety Lab at UAB, are studying sleep deprivation and pedestrian injury and general safety among children.

by Becca Jarzynski, MS, CCC-SLP

Reference: www.pediastaff.com/blog/guest-blog-everyday-language-activities
Posted on December 28, 2011

'This article was posted as a guest blog on www.pediastaff.com and written for parents. 

I included this post in my blog because I think it is important for Moms to realize they cannot do it all, but incorporating language stimulation in the midst of everyday life can be a nice balance. -Pam Hass, M.A. CCC-SLP 

In her post, Ellen explains that her son Max gets therapy sessions throughout his week but that "the sessions are only 45 minutes to an hour long and it's the ways we put those therapy techniques into practice that matter most."  She goes on to describe how attempting to accomplish therapy carryover at home used to be overwhelming and somewhat guilt-provoking, especially when therapists would leave long lists of tasks to be accomplished.  Then, Ellen reflects on how she has learned to do only what she can and let the rest go (yah!) and, most importantly, how she has learned to integrate the things Max needs into fun family activities that they were doing anyway.  Yes, I thought when I read her post. Yes.  That's exactly what we are trying to encourage families to do when we work with them and their children as early intervention professionals.

With that in mind, I took my two-year old daughter grocery shopping.  I'm learning that much of life is to be found in the joy of daily activities, so I decided to slow the activity down-to enjoy it and her along the way.  As I did, I realized how much skill development was occurring right in the context of this simple and potentially mundane daily routine.

1) Two-year olds are developing and understanding simple concepts, so we wove them into our trip.  She put things "in" the cart and "under" it as well.  The cat litter was heavy (I let her drag it to the cart so she could experience what heavy meant) and the chips were light (as she threw them up and over the edge of the cart).  The bread was soft (and a bit squished after we were done) and the cans were hard.  The apples were big and the grapes were small.  I paired actions with words as we compared and contrasted all these things, and by the end of the trip, she was starting to use some of the words on her own to describe what she was doing or what she felt.  Even better, she had a blast helping gather the food, throwing things into the cart, and just generally being involved in the experience.

2) Toddlers this age are also just starting to use simple grammar elements such as: plural -s (cans), possessive -s (daddy's), and -ing (pushing).  I used expansion and indirect correction to model her sentences back to her, a bit more correctly.  If she said, "two apple," as we counted them and put them in the bag, I said "Yep, two apples!"  When she commented that she was holding, "daddy plum", I responded with, "These are daddy's plums!"  And when she said "I push!"
while pushing the cart down the aisle (and almost into the pickles), I replied that "Yes, you're pushing!"

3)  Two-year olds are also merging into the world of pretend play and we wove this into our trip as well.  At one point, a jar of olives was a microphone and we were rock stars.  People may have thought us a bit odd, but we were certainly having fun.

The beautiful part of all of this is that it made the activity joyful for both of us.  She was learning and I was shopping, but most of all, we were just being mother and daughter, loving up life.

I must note, of course, that this won't work for everyone, in every activity.  My daughter loves grocery shopping.  My son?  Hated it.  With him, getting through grocery shopping was an exercise in survival; my sole focus was on keeping him contained long enough that we could get the groceries we needed.  It wouldn't have worked to slow it down, even if I had tried to engage him more.  It's just how he was as a toddler, full of boundless energy that was exceedingly hard to corral.  When he was little, it was much easier to weave learning into football than into grocery shopping.  The activity has to fit the child, not the other way around.

And, there is also the danger of believing that every single activity throught the day has to be a learning experience.  It doesn't.  Sometimes grocery shopping just needs to be grocery shopping, and that needs to be okay.  But when it doesn't, when time can slow down just a bit, when children can learn in the context of an activity, that is truly a delight for everyone involved, that's the sweet spot for sure.

Featured columnist: Becca Jarzynski, MS, CCC-SLP

A New Way to Think About Developement

Reference: Advance for Speech Language Pathologists and Audiologists, (Sept.19, 2011)

Early motor experiences can shape infants' preferences for objects and faces, according to a new study.  The findings demonstrate that providing infants with "sticky mittens" to manipulate toys increases their interest in faces, suggesting advanced social development.

The study, conducted by Kennedy Krieger Institute, in Baltimore, MD, and Vanderbilt University, in Nashville, TN, supports a growing body of evidence that early motor development and self-produced motor experiences contribute to infants' understanding of the social world around them.  Conversely, this implies that delayed or impaired motor skills, such as in autism, could negatively impact social interactions and development. 

The results provide "a new way to think about typical and atypical development," said lead author Klaus Libertus, Phd, of the Center for Autism and Related Disorders at Kennedy Krieger.  "The mind is not independent from the body, especially during development.  As motor skills advance, other domains follow suit, indicating strong connections between seemingly unrelated domains.  Such connections have exciting implications, suggesting interventions could target the motor domain to foster social development."

Previous research found that infants with autism spectrum disorders (ASD) show less interest in faces and social orienting.  While the new study was conducted with typically developing infants, it indicates that infants at risk for ASD or showing signs of abnormal social development may benefit from motor training as early as 3 months of age.

"This means that early motor development is very important and parents should encourage motor experiences and active exploration by their child," said Dr. Libertus.  "Fostering motor development doesn't have to be complex.  Any interactions or games that encourage a child to develop independent motor skills are important."

Researchers divided 36 typically developing 3-month-olds into two groups.  One had active motor experiences, and the other had passive experiences.  Infants in the active group were given mittens affixed with strips of Velcro known as "sticky mittens".  A brief swipe of their arm made toys covered in Velcro stick, as if they had successfully grasped the object.  Parents demonstrated this by attaching a toy to the mitten.  The toy was removed, and the infant was encouraged to reach independently for the toy again.

Infants in the passive group were fitted with aesthetically similar mittens and toys that did not have Velcro.  They were only passive observers, as parents provided stimulation by moving a toy and touching it to the inside of the infant's palms.

After two weeks of daily training, the researchers tracked the infants' eye movements while they watched images of faces and toys flash on a computer screen.   Infants in the passive and active groups were compared with each other and to two control groups of untrained infants comprised of non-reaching 3-month-olds and independently reaching 5-month-olds.

The active group showed more interest in faces than objects, while the passive group showed no preference.  Infants in the active group focused on faces first, suggesting strengthening of a spontaneous preference.  Their social preferences were similar to those of the 5-month-olds, indicating advanced development following training.

Individual differences in the motor activity of all the 3-month-old infants were predictive of their spontaneous orienting to faces.   Regardless of experience, the more reaching attempts infants made, the stronger their tendency to look at faces.  Thus, motor experiences seem to drive social development.

"The most surprising result is a connection between early motor experiences and the emergence of orienting toward faces,"  said Dr. Libertus.  "Logically, one would predict the opposite.  But in the light of seeing actions as serving a social purpose, it makes sense."

A key question researchers hope to answer next is whether these early changes will translate into future gains for these children.

"Our results indicate a new direction for research on social development in infants," said Dr. Libertus.  He and his colleagues will continue to observe the children to see if the social development benefits achieved during the current study are sustained a year later.

Grants from the National Institutes of Health provided support for the study.

Reference
Libertus, K., Needham, A. (2011). Reaching experience increases face preference in 3-month-old infants. Developmental Science, online, Sept. 9.

Reference: The ASHA Leader (Oct. 11, 2011)

The distinctive roar of a motorcycle engine is loud, but studies have revealed the biggest source of noise for motorcyclists is generated by air whooshing over their helmets.  Even at legal speeds, the sound can exceed safe levels.  Researchers in the United Kingdom placed motorcycle helmets on mannequin heads, mounted them in a wind tunnel, and turned on fans.  By placing microphones at different locations around the helmet and at  the mannequin's ear, researchers found that an area underneath the helmet and near the chin bar is a significant source of the noise that reaches rider's sensitive eardrums.  Future tests will move beyond the wind tunnel to riders on the open road.  The findings, described in the Journal of the Acoustical Society of America, may lead to quieter helmet design.  Search "hard on hearing" at www.aip.org/aip.

Folic Acid Associated with Reduced Risk    

Reference: Advance for Speech-Language Pathologists Audiologists (Nov. 4, 2011)

The use of folic acid supplements by women during the periconceptional period has been found to be associated with a reduced risk of children having severe language delay at age 3, according to a Norwegian study.

Randomized controlled trials and other studies have demonstrated that folic acid supplements taken during the period from four weeks before conception to eight weeks afterward reduce the risk of neural tube defects.  "To our knowledge none of the trials have followed up their sample to investigate whether these supplements have effects on neurodevelopment that are only manifest after birth," the researchers reported.

The new study was conducted by Christine  Roth, ClinPsyD, MSc, of the Norwegian Institute of Public Health, in Oslo, and colleagues.  They  investigated whether maternal use of folic acid supplements was associated with a reduced risk of severe language delay among offspring at age 3.

"Unlike the United States, Norway does not forify foods with folic acid, increasing the contrast in relative folate status between women who do and do not take folic acid supplements," the researchers noted.

Pregnant women in Norway were recruited for the study beginning in 1999.  Data were included on children born before 2008 whose mothers returned the three-year follow-up questionnaire by June 16, 2010.  Maternal use of folic acid supplements within the interval between four weeks before and eight weeks after conception was the exposure.

The primary outcome measured for the study was children's language competency at age 3 as gauged by maternal report on a six-point ordinal language grammar scale.  Children with minimal expressive language (only one-word or unintelligible utterances) were rated as having severe language delay.

The main analysis for the study involved 38,954 children: 19,956 boys and 18,998 girls.  A total of 204 (0.5 percent) of the children (159 boys and 45 girls) were rated as having severe language delay.  Children whose mothers took no dietary supplements in the specified exposure interval comprised the control group.  there were 9,052 children in this group, including 81 (0.9 percent) with severe language delay.

The researchers reported the data for three patterns of exposure to maternal dietary supplements: 1) other supplements, but no folic acid 2) folic acid only; and 3) folic acid in combination with other supplements.

The first group numbered 2,480 children, including 22 (0.9 percent), with severe language delay.  The second group, of folic acid only, had 7,127 children, 28 (0.4 percent) of whom had severe language delay.  The last group was comprised of 19,005 children, including 73 (0.4 percent) with severe language delay.

Maternal use of supplements containing folic acid within the periconceptional period was associated with a substantially reduced risk of severe language delay in children at age 3, the researchers discovered.

"We found no association, however, between maternal use of folic acid supplements and significant delay in gross motor skills at age 3," they reported.  "The specificity provides some reassurance that there is no confounding by an unmeasured factor.  Such a factor might be expected to relate to both language and motor delay."

No previous prospective observational study examined the relation of prenatal folic acid supplements to severe language delay in children.

"If this relationship were shown to be causal in future research, it would have important implications for understanding the biological processes underlying disrupted neurodevelopment, for the prevention of neurodevelopmental disorders, and for policies of folic acid supplementation for women of reproductive age," the investigators said.

Reference: Roth, C., Magnus, P., Schjolberg, S. et al. (2011). Folic acid supplements in pregnancy and severe language delay in children. JAMA, 306 (14): 1566-73
      

Reference: Advance for Speech-Language Pathologists and Audiologists (Oct. 3, 2011)

Mild Hearing Loss
Linked to brain atrophy in older adults

Declines in hearing ability may accelerate gray matter atrophy in auditory areas of the brain and increase the listening effort necessary for older adults to comprehend speech successfully, a new study has shown.  When a sense is altered, the brain reorganizes and adjusts.  In the case of people with poor hearing, researchers found that the gray matter density of the auditory areas was lower in people with decreased hearing ability, suggesting a link between hearing ability and brain volume.

"As hearing ability declines with age, interventions such as hearing aids should be considered not only to improve hearing but to preserve the  brain," said lead author Jonathan Peelle, PhD, a research associate in the Department of Neurology, Perelman School of Medicine, at the University of Pennsylvania in Philadelphia.  "People hear differently, and those with even moderate hearing l0ss may have to work harder to understand complex sentences."

In a pair of studies, researchers measured the relationship of hearing acuity to the brain, first measuring the response of the brain to increasingly complex sentences and then measuring cortical brain volume in the auditory cortex.

Older adults, ages 60-77, with normal hearing for their age were evaluated to determine whether normal variations in hearing ability impacted the structure or function of the network of brain areas supporting speech comprehension.

The studies found that people with hearing loss showed less brain activity on functional magnetic resonance imaging (fMRI) scans when listening to complex sentences. People with poorer hearing also had less gray matter in the auditory cortex, suggesting that areas of the brain related to auditory processing may show accelerated atrophy when hearing ability declines.

In general, research suggests that hearing sensitivity has cascading consequences for the neural processes supporting both perception and cognition.  Although the research was conducted in older adults, the findings have implications for younger adults, including those concerned about listening to music at loud volumes.

"Your hearing ability directly affects how the brain processes sounds, including speech," said Dr. Peelle.  "Preserving your hearing doesn't only protect your ears but also helps your brain perform at its best."

Audiologists should monitor hearing in patients as they age, noting that individuals who still fall within normal hearing ability may have increasing complaints of speech comprehension issues.

Grants from the National Institutes of Health funded the research.

Peele, J.E., Troiani, V., Grossman, M., et al. (2011).  Hering loss in older adults affects neural systems supporting speech comprehension.  The Journal of Neuroscience, 31 (35): 12638-43

 

Reference: The ASHA Leader (October 11, 2011)

A diet rich in omega-3s could reduce the severity of brain damage after a stroke.  Researchers from Universite Laval in Quebec, Canada, observed that mice that had been fed a diet rich in DHA, an omega-3 fatty acid, for three months had 25% less brain damage following stroke than mice that had eaten a control diet.  The full study was published in Stroke (doi:10.1161/STROKEAHA.111.620856).

Reference: The ASHA Leader (October 11, 1011) from the American Speech and Hearing Association

New research has identified more genes associated with attention deficit hyperactivity disorder (ADHD) and found an overlap between some of these genes and those found in other conditions such as autism spectrum disorders (ASDs).  Researchers studied the DNA of 248 unrelated patients with ADHD; 19 of 248 patients had inherited changes.  Within this group of inherited changes, researchers also found genes previously identified in conditions such as ASD; conversely they found ADHD genes in nine of the patients previously diagnosed with ASD.  The study appears in Science Translational Medicine(http://stm.sciencemag.org/content/3/95/95ra75).