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Concussions are More Common in Teens than Once Thought

A research letter was published in the Journal of American Medical Association on Tuesday, June 25 which concussionsummarized findings from a recent Canadian study examining concussions in teenagers.  The Canadian research team found that concussion rates in adolescents are much higher than previously thought.

What is the prevalence of concussions in teens?

1 out of every 5 teenagers completing the research project indicated that they had sustained a concussion.  These numbers are high, and there are some flaws with generalizing these numbers to the population as a whole.  This was a survey research project in which the examiners asked teenagers a series of questions about head injuries and academic performance.  Although the likelihood of 1 in 5 teenagers having sustained a concussion is probably not realistic, it is known that head injuries are quite common at rates that are greater than suspected in the past.

Why is it important to know the incident rates of concussions?

The importance of knowing about the incident rates of concussions is that there are numerous known behavioral and emotional variables associated with head injuries.  Adolescents who have sustained a head injury are at risk for learning problems, substance abuse, and emotional concerns.

What does this mean as a parent or teacher?  If you notice a teenager exhibiting a sudden change in academic performance, behavior, or emotional regulation, you want to have an evaluation immediately.  Speak to your child’s pediatrician about a possible neurological or neuropsychological evaluation in order to help determine the possible cause for the changes, as one possible reason might be a sustained head injury.

To read the full Chicago Tribune article on this study, click here.  To learn more about North Shore Pediatric Therapy’s Neuropsychology Diagnostic Program for children and teens, click below.

The Social-Emotional Side of Children with Learning Disorders

It is well known that kids with learning disabilities face academic challenges.  Academics are often the focus of interventions with these children, but it is important to also pay attention to the impact on their social-emotional development.  Read on for ways to make sure this critical aspect of your child’s development is not overlooked. Read more

ADHD and Learning: Attention Deficit Hyperactivity Disorder’s Impact on Learning

Many children with a diagnosis of Attention Deficit Hyperactivity Disorder exhibit significant concerns with regard to their academic

ADHD and learning diability

achievement.  Research has demonstrated that a lot of children with the diagnosis also have a co-existing diagnosis of a learning disability.  However, even children without a separate learning disability diagnosis are also at risk for struggling with their academic achievement.

The hallmark feature of ADHD is inattention.  If a child has significant inattention and distractibility, he or she is unable to listen to the teacher and follow directions.  These children often present with impulsivity or hyperactivity, which can result in concerns with behavioral functioning in the classroom environment.

Another area of concern for children with ADHD is poor executive functioning which could have an impact on a child’s academic performance.  Executive functioning is the child’s ability to organize work, transition between tasks, develop effective problem solving strategies, and monitor one’s work.  Read more

Summer Interventions for a Better Report Card

With the end of the school year quickly approaching, parents are often left to wonder about what to do during the summer to ensure

Summer interventions for a better report card

that the transition to the next school year goes smoothly.  One key piece of information in determining summer plans is the content presented in your child’s final report card.  It is vital that parents take the child’s final report card seriously and utilize the information from it to develop any areas of weakness shown during the previous school year. Read more

What is Prader-Willi Syndrome

Prader-Willi Syndrome is a congenital disorder that is caused by a missing gene on part of chromosome 15. These children are found to prader willi syndrome have cognitive skills in the below average to mild mental retardation range.

Physical symptoms associated with Prader-Willi include:

  • Newborns often present with low tone
  • Almond shaped eyes
  • Delayed motor development
  • Short stature
  • Very small hands and feet

The main symptom associated with Prader-Willi is a very strong interest in food with a lack of sensitivity to the physiological sensation of satiation. This means that the child will continue to eat with no sense of feeling full. Research has found that these children are at a very high risk to develop obesity and diabetes.

The main intervention that should be offered to these children is that the child works with a behaviorally trained therapist (psychologist or social worker) and a dietitian in order to develop healthier eating habits as well as behavioral incentives to decrease eating.

Click here to meet with a neuropsychologist for solution based therapy!

Nonverbal Learning Disability

The majority of learning disabilities that a child may have are language-based.  These include deficits with the child’s reading boy readingachievement as well as written expression.  Researchers have found that there is a small percentage of children that demonstrate adequate or above average verbal functioning; however, they have significant weakness with their nonverbal reasoning. Researchers and educational specialists have characterized this specific condition as a Nonverbal Learning Disability (NVLD).  Currently, the Diagnostic and Statistical Manual of Mental Disorders does not have a specific diagnosis for these children and, instead, these children are typically diagnosed with a learning disorder that is not otherwise specified.

Areas of Cognitive Weakness in Children with Nonverbal Learning Disabilities:

  • Visual-spatial awareness
  • Visual organization
  • Tactile and perceptual reasoning
  • Psychomotor functioning
  • Nonverbal problem solving skills
  • Difficulties with mathematics
  • Pragmatic (social) language
  • Social interactions

Areas of Strength in Children with Nonverbal Learning Disabilities:

  • Rote verbal memory
  • Phonemic awareness
  • Verbal reasoning
  • Reading

It is important to identify children that have speculated NVLD’s areas of strength and weakness in order to develop the most effective intervention plan.  It is often that intervention for these children is multi-faceted and can consist of:  social work support to help with socialization and interaction, speech-language therapy to help with pragmatic language functioning, academic tutoring to help with mathematics and executive functioning support and/or occupational therapy in order to help develop visual spatial functioning, tactile-perceptual reasoning and motor abilities.

Click here to learn all about Learning Disabilities 

Family History and Kids with Special Needs

If you have a brother, nephew, uncle or some other member in your family with certain special needs, you will want to be cautious and family tree mindful that many neurodevelopmental conditions have a high genetic component. Recent studies have indicated that genetics account for 70 to 80 percent of the risk of having Attention Deficit Hyperactivity Disorder. A 2004 study indicated that there is considerable evidence that demonstrates that genetics play a major role in the risk of having an anxiety disorder. It is important to realize that the risk factors are high; however, they are not necessarily 100%.  This simply means that just because a parent or relative has a neurodevelopmental disorder, it does not mean that the child will exhibit the condition. What it does indicate is that the child is at a higher risk for the condition.

As a parent, it is important to realize that your child may be at risk for a condition if a relative has that same condition. Do not be alarmed; instead, be aware. Always pay attention to any concerns, seek out advice from your pediatrician, psychologist and/or developmental therapist.

There are numerous possible warning signs for the purpose of this blog;  however, below is what to be on the lookout for:

Anxiety:

• Does the child shy away from peers?
• Does the child have sleep onset  issues?
• Does the child engage in behaviors such as picking, biting nails, pacing, etc.?
• Are there fixed routines that the child engages in?

Click here for more on anxiety

ADHD:

• Does the child have difficulty focusing on work?
• Does the child require a lot of redirection and repetition of information?
• Does the child make careless errors with work?
• Does the child always seem to be on-the-go?

Click here for more on ADHD

Autism Spectrum:

• Does the child struggle with initiating and sustaining appropriate eye contact?
• Are there language delays?
• Does the child avoid seeking out others for interaction?
• Does the child avoid engaging in nonverbal behaviors such as gesturing?

The information above should not be considered to be a diagnostic check sheet, but rather possible concerns that might require further assessment. Parents, if you know that there is a family history of a neurodevelopmental condition and you see any of the above signs or symptoms expressed in your child, it is then time to seek further guidance.

What is Down Syndrome?

Down Syndrome is thought to be the most common genetic etiology of mental retardation. This condition has been found to occur in down syndromeapproximately 1 in 800 live births. The genetics of the condition are such that the individual has an extra copy of chromosome 21.

Physical Features Associated with Down Syndrome:

  • Decreased muscle tone seen at birth
  • Excess skin at the nape of the neck
  • Flattened nose
  • Small ears
  • Small mouth
  • White short hands with short fingers

Cognitive Features Associated with Down Syndrome:

  • Moderate mental retardation
  • Weakness with grammatical aspects of language
  • Relative strength with spatial reasoning tasks
  • Verbal short term memory is more impaired than visual memory
  • Weakness with daily living skills (self-care skills)
  • Relative strength with social skills

Interventions for Children with Down Syndrome:

  • Speech and language therapy with possible addition of sign language
  • Visually-based interventions for teaching, reading and vocabulary
  • Occupational therapy for sensory integration and motor development

Is Your Child Just Disorganized, or Is It a Bigger Problem?

Do you find that your evenings and mornings are primarily spent helping your child track down missing work or lost items andmessy child generally trying to help them get organized enough to manage their school day and extra-curricular activities? Is assisting your child too much interfering with family time and leisure time? Is this causing your family and your child stress? This scene is common in many families with middle and high school children that should be starting to manage their own lives. These problems are often caused by a weakness in Executive Functioning Skills: the skills that allow us to manage ourselves and our time with the resources we have. These skills are critical when it comes to being successful in school, but these skills are not often not taught in the classroom.

 The following are the Executive Functioning skills:

  • Emotional Control:  The ability to regulate emotions in order to stay productive and complete a task
  • Initiation: The ability to start a task independently
  • Planning/Organization: The ability to plan and organize one’s time, assignments and activities effectively
  • Shift: The ability to move from one task to another
  • Working memory:  The ability to hold information in the mind for completing a task
  • Inhibitions:  Stopping impulses at the right time in order to stay focused and accomplish the task at hand

Executive functioning coaching addresses weaknesses in executive functioning skills. Executive functions develop throughout childhood and continue to develop into early adulthood. Often, executive functioning difficulties become apparent for the first time during adolescence (although they may reveal themselves earlier). Poor or underdeveloped executive functioning skills may result in several difficulties for children, including emotional difficulties, risk-taking behavior, compulsive behaviors and attention problems. All of these may ultimately cause many issues in the self-esteem and functioning of the child and family, both in and out of school.

If executive functioning weaknesses are suspected, a neuropsychologist will be able to diagnose specific areas that need to be improved. A directed, executive functioning coaching program designed to address these challenges will result in a marked improvement in the current and future functioning of the child. North Shore Pediatric Therapy offers both individual executive functioning coaching programs and intensive workshop experiences to teach these vital skills. Contact us to schedule your appointment today.

*Cooper-Kahn, Joyce, Dietzel, Laurie. Late, Lost and Unprepared: A Parent’s Guide to Helping Children with Executive Functioning: Woodbine House Inc: 2008.
Rush University Executive Functioning Curriculum Training
https://www.aboutkidshealth.com.ca/En/News/Series/Executive Function/Pages/Executive Function

Risk Factors Associated with Prematurity and Low Birth Weight

As previously described in a prior blog, prematurity and low birth weight are commonly found in 2-8% of live births in the United States.  There pregnant ladyare numerous neuropsychological and cognitive concerns that were reported in the previous blog.  There are many risk factors that parents need to be aware of that can be a contributing factor in premature delivery.

Medical risk factors that are associated with low birth weight are:

  • Previous preterm delivery
  • Family history of infertility
  • Multiple gestation
  • Placental abnormalities
  • Uterine abnormalities/infection
  • Preeclampsia

Cultural risk factors associated with low birth weight include:

  • Preterm birth more than 2x as common in African Americans
  • Higher in single mothers
  • Higher in low socioeconomic status families

Because of the possible long term concerns with low birth weight, it is important to be preemptive and knowledgeable about medical and cultural factors that might contribute to the condition.