Studies Look at ADHD in Adults

A new study, led by a team of British researchers, looked at young adults with ADHD and found that a significant number of these individuals did not exhibit symptoms in childhood as required by the definition of ADHD in the The Diagnostic and Statistical Manual of Mental Disorders, (DSM-V), from the American Psychiatric Association. 

The DSM-V definition of ADHD requires that the individual have:

Six or more persistent symptoms of inattention and/or hyperactivity-impulsivity, several of which were present prior to 12 years of age, that interferes with functioning or development, which are present in two or more settings (eg. at home and at school or at work), and which interfere with social, academic, or occupational functioning.

The researchers looked at a subset of more than 2,000 individuals as part of a study of twins, and found that adults with ADHD included both those who had "childhood onset" ADHD that persisted into adulthood and those who did not meet the DSM requirements for ADHD in childhood but who met them (absent the age of onset) in adulthood. Specifically, they found that, "among 166 individuals with adult ADHD, 112 (67.5%) did not meet criteria for ADHD at any assessment in childhood." 

The British researchers noted differences between the childhood and adult onset groups in areas such as severity of symptoms and comorbid mental health conditions and suggested that more research is needed to determine the relationship between these two types of ADHD and whether they are really the same disorder.

A second study, this one led by Brazilian scientists and published in the same journal as the British study, led researchers to conclude that their findings did " not support the assumption that adulthood ADHD is necessarily a continuation of childhood ADHD. Rather, they suggest the existence of 2 syndromes that have distinct developmental trajectories."

As the British research team noted, "the extent to which childhood-onset and late-onset adult ADHD may reflect different causes has implications for genetic studies and treatment of ADHD."

Alarm Clock Apps and Devices for Sleepyheads

There must be folks who jump out of bed in the morning bright and early. There must be folks who don't want to roll over and get just a bit more sleep. And there must be folks who are never, ever late to get started because they hit the "snooze" button on their alarm clock, only to wake up with just enough time to make it to work or school. There must be ... somewhere..

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For the rest of us -- and our kids, who will face school mornings all too soon -- we've come across a some ingenious ways to avoid oversleeping. We hope you find one or more of these helpful. 

The Walk Me Up app is an alarm that won't shut off until you are actually up and walking around. Your phone needs to be on with notifications enabled. Free for iOS devices.

The Barcode Alarm Clock requires you to not just get out of bed, but to take a photo of a bar code you have previously selected (your breakfast cereal, your toothpaste, etc.) to turn off the alarm. You can also set it to require multiple bar codes for items that you encounter as you move through your morning activities. Described by one reviewer as, "Very loud and annoying"(which is the point of this alarm), The Barcode Alarm Clock is free for iOS devices. 

In a similar vein, Alarmy (Sleep If U Can) requires you to set it up by registering a photo of a place in your room or house (the bathroom is one possibility). Then, once it is set, you need to take a photo of that place to turn off the alarm. Its creators note with pride that it has been described as "The World’s Most Annoying Alarm." It's free for Android devices and $1.99 for iOS.

Would you prefer something that's not dependent on your phone? You might want to try Clocky, which rolls off your bedside table and hides, making beeping noises until you find it and turn it off. It's more expensive, at $27.99, but if it works for you or your heavy sleeper it might well be worth the investment. 

Early Childhood Bedtime and Adolescent Obesity

"Early to bed and early to rise, makes a man healthy, wealthy, and wise". 

Benjamin Franklin

We've written numerous posts on the importance of sleep, but newly reported research adds an interesting perspective to this subject. A study in The Journal of Pediatrics found a correlation between late bedtimes (after 9 p.m.) for preschool children and obesity rates for these children when they reached the age of 15. 

The researchers looked at almost 1,000 healthy youngsters with an average age of 4.7 years in 1995, examining such aspects of their lives as their bedtimes and the kind of interactions they had with their mothers, something called "maternal sensitivity". These same children were followed by the research team and their BMI (body mass index, a measure of obesity) was determined when they were 15 years old. 

The study team found that those teens whose parents reported the earliest bedtimes (8 p.m. or earlier, comprising one-quarter of the group) had a rate of obesity of 10 percent. Those teens who had bedtimes as young children between 8 and 9 p.m. (one-half of those studied) had an obesity rate of 16 percent. And the one-quarter of teens who had the latest bedtime as young children (after 9 p.m.) had an obesity rate of 23 percent. These findings were not related to maternal sensitivity and were independent of socio-economic status and maternal obesity.  

These obesity rates do not imply causality and the authors did not examine why a later bedtime was linked to higher obesity rates. They did suggest that an earlier bedtime in childhood was one thing parents could do to help their children to become healthy teens. 

Illustration credit: Ana Fukase via flickr cc.

Least Restrictive Environment Revisited

Least Restrictive Environment (LRE) has long been a fundamental part of the Individuals with Disabilities Education Act (IDEA). The IDEA mandate with respect to LRE states that,

To the maximum extent appropriate, children with disabilities, including children in public or private institutions or other care facilities, are educated with children who are not disabled, and special classes, separate schooling, or other removal of children with disabilities from the regular educational environment occurs only when the nature or severity of the disability of a child is such that education in regular classes with the use of supplementary aids and services cannot be achieved satisfactorily.

We have written about LRE before, and have thought that it was such a settled part of current law and practice that it was not subject to question. We were wrong. A recent blog post on the website of AASA, the School Superintendents Association, urges that Congress consider changing the LRE requirements of the IDEA to look only at the educational benefit to be provided by placing students in the least restrictive environment and not to consider benefits to such students that are not strictly educational, such as communication, collaboration, and social skills. The blog also suggests that revised guidelines on LRE, "could lead to a reduction of litigation ... [and have the] potential to ease the educational, financial, and emotional strains that are placed on parents and school officials when special education litigation reaches the courts." In short, the author wants to reduce the cost of litigating LRE issues when parents exert their rights to have their children educated in the least restrictive educational environment.

Our colleagues at COPAA, The Council of Parent Attorneys and Advocates, quickly responded to the blog post. In a detailed public post, the COPAA leadership discussed the court cases where LRE has been considered (and well settled) and noted that, "including students with disabilities in general education benefits students without disabilities. Research shows that time spent with non-disabled peers not only benefits students socially and connects them with their community but also enhances academic achievement for students with disabilities."

COPAA also posted a blog written by educational leaders which noted that LRE was not being appropriately implemented in all parts of the country and urged that it be expanded -- not limited -- and properly utilized for all students. These leaders did agree with the AASA blogger that the time and energy now used for litigating LRE issues could be put to better use, but noted that their recommendations for how to reduce such litigation were quite different. The COPAA bloggers wrote:

"We support efforts to scale-up the use of universal design for learning principles to all classrooms. We support efforts to expand access to communication and assistive technology to all students who need it. And we support school improvement and restructuring efforts ... including greater family and community engagement, strong administrative leadership, multi-tiered systems of supports used with fidelity, values- and evidence-based inclusive policy and practice, and integration of all support services for the benefit of all students."

We hope the folks at AASA -- and in Congress -- are paying attention.

How Students’ Beliefs May Impact College Graduation Rates

The New York Times recently highlighted the major disconnect between college enrollment rates and college graduation rates. At private nonprofit colleges, only 55 percent of students graduate within six years; and at public universities, the graduation rate is only 46 percent. With college degrees having the potential to significantly impact future job opportunities and earnings, and with the full college learning experience arguably quite valuable for its own sake, it is worth exploring why these graduation statistics may be as they are and how they might be improved.

The Times article noted that there are various reasons that many students drop out, including the feeling that they do not belong. For a person who is already lacking confidence in his or her belonging, small setbacks can be experienced as significant confirmations that college is not the appropriate environment for him or her. This phenomenon highlights the importance of lay theories, or the core beliefs we have about ourselves and our interactions with the world. Past research provides an abundance of examples that show it is often not just the content of a challenge, but also a person’s belief structure in response to that challenge, that is predictive of impact.

Earlier studies about how lay theories impact college students in particular have indicated that students are more successful in college when they believe that transitional challenges are (a) common and (b) able to get better, rather than indicative of a permanent lack of potential. Building upon these studies, researchers recently examined the impact of lay theory interventions before college matriculation. Experimental groups of outgoing high school seniors, who had been accepted to a variety of public and private colleges, received single-session, online lay theory interventions.

A "social-belonging" intervention involved sharing feedback from college students who indicated that most students worry about a sense of belonging and that such worries subside after taking active steps to connect with others. A "growth mindset" intervention involved sharing a summary of research regarding the malleable nature of intelligence and the significance of using effective strategies that can be developed over time. As compared to control groups, students who received the social belonging intervention were more likely to use academic support services, join extracurricular groups, and choose to live on campus. A significant number of the students who received the growth mindset intervention were more likely to complete at least the first two semesters of college.

These results, while preliminary, suggest that lay theory interventions could be valuable tools to use in the quest to improve college graduation rates. If students may be dropping out due to feeling they do not belong, and if a sense of belonging — or steps toward facilitating such — can be fostered by as little as a one-time, online intervention, then similar or expanded interventions certainly seem worth exploring.

Fun for the Fourth!

Here in New York City, when the public schools don't let out until June 30th, the Fourth of July can tend to sneak up on folks. If you haven't made plans yet for this long holiday weekend, it's not too late to find terrific ways for your family to commemorate our nation's 240th birthday and to celebrate summer. Here are some ideas:

Founding Fathers
The New York Historical Society will kick off its "Summer of Hamilton" celebration on Monday, July 4th, with activities for the entire family. Kids will get to meet "Alexander Hamilton" and ask him about his fascinating life. Admission is free on the 4th for those 17 and under.

Alexander Hamilton

If you are feeling lucky, you can always enter the lottery for $10 tickets (limit 2 per entry) to the Broadway blockbuster Hamilton. The odds of winning are absurdly low; the producers advise that there are more than 10,000 entries for each lottery, but someone has to win...

You can also visit the National Park Service museum at Federal Hall, which sits on the site where George Washington took the oath of office as our first President, and which served as home to the first Congress, Supreme Court, and Executive Branch offices when New York was, briefly, the capitol of our country.

And, if you can't locate the terrific 1972 film 1776 in your local broadcast listings, you can stream it from Amazon. Singing founding fathers give real insight into some of the issues facing the Continental Congress on that steamy July in Philadelphia.

Music
If your idea of celebrating includes music, there are performances at South Street Seaport, including family entertainment on the Peck Slip Stage from 1-8 pm.

Brooklyn's newly opened Amphitheater at the Coney Island Boardwalk is featuring the Beach Boys. It's the perfect music to listen to at the beach on a summer evening.

Parades and More
During the American Revolution, 9000 English troops landed on Staten Island. Islanders, being content with their lives under British rule, supported the Loyalists’ cause. One contingent of Loyalist troops was camped in New Blazing Star. It was here on August 22, 1777, that a major skirmish on Staten Island between General George Washington’s Patriots and General William Howe’s Loyalists was fought. This part of the island is now known as Travis and has been holding a Fourth of July parade since 1911.

The Bronx Zoo's Independence Day weekend celebrates the bearded bison, the official American mammal.

And, of course, there will be a fireworks display over the East River, visible from many areas of the City, beginning just after dark.

However you decide to spend the holiday, we wish you a fun, safe, celebration!