Thursday, January 31, 2019

Research Roundup

Several interesting research studies have come to our attention lately. All of them have to do with children -- their health, development, and school performance. And that's what "Mind, Brain, and Education" is all about. We hope you find them interesting too.

  • The American Academy of Pediatrics (AAP) notes that what it calls "aversive disciplinary strategies", including all forms of corporal punishment, yelling at, and shaming children, are not effective in the long term in changing children's behavior. Perhaps even more important is that researchers link corporal punishment to an increased risk of negative behavioral, cognitive, psychosocial, and emotional outcomes for children. The AAP offers guidance in best practice for discipline. 

  • A study funded by the National Institutes of Health and reported in The New England Journal of Medicine, which included more than 400,000 children throughout the U.S., found that rates of diagnosis and treatment of ADHD are higher among children born in August than among children born in September in states with a September 1 cutoff for kindergarten entry. In other words, it is the relative youth of these kindergarten children compared to their classmates, who can be almost a full year older, that can be the basis of an ADHD diagnosis. 

  • Much has been written about the dangers of e-cigarettes and youth, noting the fact that the flavored nicotine products in many of these devices are highly attractive to younger users and can rapidly lead to nicotine addiction. The Juul brand, with its appealing flavors and slim design has been especially criticized. However, individuals who are currently smoking cigarettes -- which, according to the Centers for Disease Control, included nearly 8 of every 100 high school students (7.6%)  in 2017 who reported that they smoked cigarettes in the past 30 days - a decrease from 15.8% in 2011) -- may find that e-cigarettes can help them quit, even more so than nicotine patches or gums, according to a new study reported in the New England Journal of Medicine.

Monday, January 21, 2019

Help with Behavioral and Emotional Problems

It is not uncommon for learning difficulties occur together with emotional or behavioral issues -- often described as co-morbid conditions. Anxiety, depression, mood disorders, and attention deficits can all have a negative impact on how a student learns and manages in the classroom. On the other hand, students who struggle in school because of a learning disability -- things like difficulty reading, understanding, writing, or math -- may also become anxious, depressed, or have difficulty paying attention in class.

Part of our evaluation process for every student is a review of their emotions and behavior. We assess these using a number of tools, which can include interviews with students and parents; questionnaires from the student, their parents, and their teachers; standardized measures, and projective testing.

Our commitment to students' mental health has grown steadily over the years. Several years ago, Dr. Yellin participated in a mini-fellowship delivered in collaboration with an organization now know as Project Teach (formerly Child and Adolescent Psychiatry for Primary Care), intended to equip pediatricians with the knowledge and skills needed to address more of their patient’s mental health needs, consistent with the best evidence-based therapies, to improve the mental health of children and adolescents. The goals of this mini-fellowship were:
  1. to train pediatricians and other primary care providers to correctly identify and differentiate among pediatric behavioral health problems such as anxiety, depression, ADHD, aggression, mood disorders, and psychosis; 
  2. To provide the fellowship participants with training in effectively managing psychopharmacology: selecting medications, initiating and tapering dosages, monitoring improvements, and identifying and minimizing medication side effects; and  
  3. To provide the participants with ongoing real-time consultation and mentorship by child psychiatrists at university-based Departments of Psychiatry.
This training had enabled us to expand our capacity here at The Yellin Center for meeting more of our patients' mental health needs, including psychopharmacology. This is an important aspect of the support we provide to families, especially in light of the continuing shortage of pediatric psychiatrists.

In addition to the work we do to support the emotional and behavioral needs of the students with whom we work, there are national organizations that provide important resources to individuals and families. 

We have written before about the resources and supports offered by NAMI, the National Alliance on Mental Illness and Active Minds for individuals struggling with mental illness. Both of these organizations have as their mission the support of the roughly 20 percent of individuals in this country who have a mental illness. Active Minds focuses its work on young people, especially those on college campuses, while the work of NAMI is more broadly based. But both do important work for this population and their families and friends.

One resource families may find helpful is the Basics Program from NAMI, a "first step" for families who are dealing with a child who may have mental illness -- or who may just be going through a "difficult phase". By learning from other parents about ways to deal with these issues as a family, things may improve for both parents and their child.  

Wednesday, January 16, 2019

Seeing Things Clearly in the Classroom

Here at The Yellin Center we routinely screen the students we evaluate for vision and hearing problems. These are not in depth exams, but are designed to pick up vision or hearing difficulties that should be followed up with an ophthalmologist or hearing specialist. Students who can't see the board or clearly hear instructions from their teacher will not be able to perform at their best.  

As with most school districts, the New York City Department of Education arranges for regular vision screening of all children (during pre-K and in first, third, and fifth grades). Students who are new to the City or who are referred for special education evaluations, as well as students whose teachers suspect a vision problem are also screened by the DOE. At this point in time, routine hearing screenings have discontinued. The DOE outlines its procedures for screenings on its website.

But is screening for vision problems enough? Finding a problem is only one step in improving a child's vision. Researchers in Baltimore recently published findings that demonstrated the effectiveness of a highly proactive approach to helping children with vision deficits. Second and third graders from low income families were given eye examinations and those that were found to need glasses (182 out of 317) were given two pairs -- one for school and one for home. Furthermore, teachers made sure that the students wore their glasses in class and made sure that any broken glasses were promptly repaired or replaced. The researchers found that the students who now had reliable vision aids, without burdening their families, had statistically significant improvements in reading.
Both parents and teachers need to be mindful of the need for children to not only have the corrective lenses they need for maximal visual acuity, but to actually have their glasses with them and to wear them at all appropriate times. 

Wednesday, January 9, 2019

NYC Resources for Families

One of the great things about New York City is the number of terrific organizations and resources available to help families with a wide array of issues. 

InsideSchools is one of these organizations. Their nonprofit mission is to provide independent information on New York City's public schools, enabling parents to know what their school options are and to make knowledgeable decisions about schools based on the best available research on every public school in the City. They are in the process of updating their search tools and they continue to offer reviews of individual schools, as well as guides to such important topics as how to transfer schools, a guide to special education in public schools, and how to enroll in elementary, middle, and high schools. Inside Schools was initially a project of Advocates for Children of New York (see below), before moving on to be part of the  Center for New York City Affairs at The New School.

Inside Schools is seeking volunteers to assist with reviews for charter high schools and middle schools across through the city. If you are interested and have at least six hours a week to volunteer, reach out to, sharing a bit about yourself, the grade level in which you are interested, and what neighborhood you know the best. 

Another excellent nonprofit that supports New York City families and students is Advocates for Children of New York, (AFC) whose work is directed at "...children who are at greatest risk for school-based discrimination and/or academic failure due to poverty, disability, race, ethnicity, immigrant or English Language Learner status, sexual orientation, gender identity, homelessness, or involvement in the foster care or juvenile justice systems."
Among their extensive services are a Helpline, which offers advice in a variety of languages and a wide array of written guidelines and resources. AFC also is involved in policy work and litigation, including a number of groundbreaking court cases that have extended the rights of students with disabilities. 

Even after many years of working in the world of education and special education, we often turn to these organizations' websites, for information about a particular school or school district, or guidelines to share with a family we are assisting. They are both worthy of your support.

Wednesday, January 2, 2019

Resolutions for Children and Families

Our colleagues at the American Academy of Pediatrics, through their parenting website,, have come up with a list of New Year's resolutions for children of different ages, all designed to help foster good habits and good health.

Marco Verch via Flickr
The lists are extensive, but a few examples for children ages 5-12 include using sunscreen, wearing a helmet for biking and similar activities, and not sharing any personal information -- or sending a photo -- on the internet. Resolutions for older children include avoiding peer pressure to try tobacco -cigarettes or e-cigarettes - drugs, or alcohol, avoiding distracted driving, and dating respectfully. Many of the suggestions have embedded links to extensive information elsewhere on the AAP site.

Other good ideas for starting the new year on a positive note come from Parenting magazine, which suggests resolutions for the entire family to make together. These include a weekly ritual - playing a game, having a movie night, volunteering as a family, exercising together - maybe a walk or a bike ride, and eating healthier, which can include having the entire family plan and prepare meals together.

Experts tend to agree that most people who make New Year's resolutions have trouble keeping them. But some steps may make it more likely to be successful with changes in behavior. Picking just one resolution at a time, instead of a long, aspirational list, can increase chances for success. So can making small changes; a family that never eats dinner together because of busy schedules may find it impossible to stick to a resolution to eat every dinner together around the table. But starting with a commitment to one or two nights of "family dinner time" each week can be a reasonable goal, one that even busy households may be able to reach. And research has shown that there are real, tangible, impacts on children's health and behaviors as a result of regular family meals.

Photo credit: USDA via Flickr