Tablet and phone games could help diagnose autism, study suggests

Autism could be diagnosed by allowing children to play games on smart phones and tablets, according to a study.

Researchers from the University of Strathclyde used games on a tablet to track the player’s hand movements.

The information gathered helped them to identify those children who may have autism.
The study outlines how technology could offer an accessible and less intrusive way to diagnose the developmental disorder.

Dr Jonathan Delafield-Butt, one of the researchers and a senior lecturer in child development, said it was important to detect autism early so that children and parents could access a range of support services.
“This is potentially a major breakthrough for early identification of autism, because no stressful and expensive tests by clinicians are needed,” he said.

‘Unexpected finding’

He said this new “serious game” assessment offered a cheaper, faster, fun way of testing for autism but added that more work was needed to confirm this finding, and to test for its limitations.

“This study is the first step toward a validated instrument,” he said. “Interestingly, our study goes further in elucidating the origins of autism, because it turns out that movement is the most important differentiator in the gameplay data.

“It is not social, emotional, or cognitive aspects of the gameplay that identify autism. Rather, the key difference is in the way children with autism move their hands as they touch, swipe, and gesture with the iPad during the game.

“This unexpected finding adds new impetus to a growing scientific understanding that movement is fundamentally disrupted in autism, and may underpin the disorder.”
During the study, researchers examined movement data gathered from 37 children with autism, aged between three and six.

The children were asked to play games on smart tablet computers with touch-sensitive screens and embedded movement sensors.

‘Complex condition’

Autism spectrum disorder is a neuro developmental disorder, and it is estimated that one in 160 children suffer from it.

About 700,000 people in the UK currently live with autism and Dr Judith Brown, head of knowledge and expertise at the National Autistic Society believes that developing a single and universal diagnostic test for such a varied condition is extremely unlikely.

“Autism is a complex condition, which affects each person in a different way,” she said. “Currently, diagnosis involves a thorough assessment with many specialised clinical professionals who assess communication, behaviour and repetitive movements.

“Once we understand more about how motor disturbances may contribute to the complex picture of autism, it is possible that technology like smart tablets could be used within the diagnostic process.”

The study was published in the Nature group journal Scientific Reports.

Taken from bbc

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ADHD medication lowers teens’ risk for STDs, substance abuse, injuries

Pharmacological treatment for attention-deficit/hyperactivity disorder significantly reduced the probability of adolescents contracting STDs, abusing drugs and alcohol, and becoming injured, according to recent research.

“ADHD is such a major issue, but no one seemed to be able to give a very definite answer to the long-term effect of the medication,” Anna Chorniy, PhD, of the Center for Health and Wellbeing at Princeton University, who conducted the research with Leah Kitashima, said in a press release. “For our sample population, we were able to see everyone who had an ADHD diagnosis and track their health over time to identify any potential benefits of the medication or lack thereof.”

The researchers used a panel of South Carolina Medicaid claims data from 2003 to 2013 to investigate the pharmacological treatment effects on 150,000 children diagnosed with ADHD. Chorniy and Kitashima specifically evaluated medication effects on the probability of risky sexual behavior outcomes, including pregnancy and STDs, substance abuse disorders and injuries, and followed physicians’ preferences to prescribe medications.

The investigation results indicated a strong correlation between ADHD medication use and the reduced probability and severity of short-term and long-term negative health results. In the 10-year analysis, children with ADHD who received pharmacological treatment were 3.6 percentage points less likely to be treated for an STD, 5.8 percentage points less likely to be screened for an STD and 7.3 percentage points less likely to need treatment for substance abuse vs. children who did not receive pharmacological treatment. Boys were less likely than girls to be treated (12 percentage points) or screened (25 percentage points) for an STD, but more likely to receive medical attention for drug and alcohol abuse (4.1 percentage points).

In addition, the study analysis indicated that pharmacological treatment is associated with decreases in the following areas: probability of contracting an STD (1.1 percentage points); probability of being screened for an STD (1.9 percentage points); probability of abusing alcohol or drugs (1.8 percentage points); and probability of being injured (2.3 percentage points).

“Over the past decade, SC Medicaid spending on prescription drugs increased nearly threefold to $69 million in 2013,” Chorniy and Kitashima wrote. “It is important to understand whether the increased expenditures on treatment produced any benefit in terms of improved health (fewer and less injuries), reduction in risky behaviors that potentially lead to teen pregnancies, STDs and substance use and abuse.” – by Kate Sherrer

Taken from healio

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Doctors may miss ADHD in nonwhite kids

African-American and Latino children with attention deficit hyperactivity disorder (ADHD) may be much less likely to receive a diagnosis or treatment than their white peers, a small U.S. study suggests.

Researchers examined data on almost 4,300 children whose parents participated in surveys about ADHD symptoms, diagnosis and treatment when the kids were in fifth, seventh and tenth grades.

When kids had symptoms of ADHD, parents of white kids were more likely to report that children took medication, researchers report in Pediatrics.

While the study didn’t explore the reason for the racial disparities in ADHD treatment, it’s possible that non-white parents had more difficulty with access or affordability of mental health services or perceived discrimination that discouraged them from seeking treatment for their kids, said lead study author Dr. Tumaini Coker, a pediatrics researcher at the University of California, Los Angeles.

“Our findings suggest that these disparities are more likely from under-diagnosis or under-treatment of African-American and Latino children than over-diagnosis or overtreatment of white children,” Tumaini said by email.

“It may be that African-American and Latino children are less likely to report taking a medication for ADHD because they are less likely to be diagnosed, or have their symptoms recognized, or because when diagnosed, they are less like to receive or accept a medication for ADHD,” Tumaini added.

Taken from foxnews

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Autism-Linked Genes Often Differ Between Siblings

In families that have more than one child with autism, the gene variations underlying each child’s disorder often differ, new research shows.

Researchers have long known that autism is a complex disorder. Experts have suspected that the development of autism involves both genetic susceptibility and environmental exposures that aren’t yet fully understood.

Now the new study suggests the genetic component is even more complicated than previously thought.

“The genetic risk for autism is extremely complex,” said lead researcher Dr. Daniel Geschwind. He is a professor of human genetics at the David Geffen School of Medicine at University of California, Los Angeles.

“Even in ‘multiplex’ families [where more than one child has autism], it’s not as obvious as thought,” he said.

In general, experts believe that certain circumstances need to be in place for children to develop autism: a genetic susceptibility, coupled with some kind of environmental stressor during a critical period of brain development.

Many gene variants have been linked to autism risk, and studies have suggested some environmental culprits — such as low birth weight, certain infections during pregnancy and prenatal exposure to heavy air pollution and pesticides, according to the nonprofit organization Autism Speaks.

The evidence that genes are critical in autism comes, in part, from studies of families. When parents have a child with autism, they have about a one-in-five chance of having a second child affected, a previous study in the journal Pediatrics found.

It’s reasonable to expect that those two siblings would share the same autism-linked genes, Geschwind said. But that’s not what his team found.

The study included over 1,500 families with at least one child who had autism. In the majority, more than one sibling was affected.

The researchers focused on gene alterations known as copy-number variants (CNVs), which involve gains or losses of normal DNA. CNVs can be inherited from parents, or can manifest for the first time in a child — because of defects in the sperm or egg from which he or she was conceived.

A number of CNVs have been linked to autism risk. In this study, Geschwind’s team found that in families with more than one child with autism, inherited CNVs played a bigger role in autism risk than non-inherited versions.
Taken from webmd

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The ADHD Epidemic: Smart Drugs and the Control of Bodies and Minds

This is an excerpt from Scripted Bodies: Corporate Power, Smart Technologies, and the Undoing of Public Education (Routledge 2016)

Attention Deficit Hyperactivity Disorder (ADHD), which has seen massive recent increases in diagnosis since 2000, is defined as a difficulty in paying attention, restlessness, and hyperactivity.

Some scientific literature claims ADHD results from underdevelopment of parts of the brain responsible for executive function, that is, the parts of the brain responsible for self-control. Doctors and psychologists use the US-based psychological diagnosis manual DSM-IV to diagnose ADHD 3-4 times more frequently than their European counterparts do with the ICD-10. Spectacular increases in diagnosis and radically disparate rates of diagnosis lend empirical weight to cultural theories of ADHD that suggest the disorder is principally a social construct rather than a biologically-based medical pathology.

The promise of using cognitive enhancing drugs is presented as the promise of a greater capacity to study and perform on tests, to consequently advance educationally to higher and more elite levels of schooling, and ultimately to cash educational advancement in for employment and luxury consumption of goods and services.

More recent news coverage of the over-prescription of Ritalin and Adderall such as the coverage in The New York Times has emphasized psychological side effects such as psychosis, withdrawal, and depression. There is more at stake in drugging kids for educational and ultimately economic competition than physical health and psychological health. The use of pharmacological technologies for educational competition participates in a broader contestation over what constitutes valuable knowledge, intelligence, and political agency.

The steady expansion of ADHD diagnosis and cognitive stimulant prescription has been driven by the profit-seeking educational projects of the pharmaceutical industry. The US-based industry targets parents, teachers, and doctors with drug advertisements and educational materials that encourage diagnosis and prescription. These educative projects have succeeded. In 2010, Americans spent $7 billion on ADHD drugs. By 2015 the amount spent had risen to $12.9 billion.

Nationwide, the rates of ADHD diagnosis increased by 22 percent in the first four years after No Child Left Behind was implemented.” Studies that break down ADHD diagnosis by state confirm that the states with the greatest financial penalties under No Child Left Behind are also the states with the greatest rates of diagnosis, especially for youth below the poverty line.

In the era of neoliberal “accountability,” “smart drugs” are used as a tool to raise test scores for teachers subject to value added assessment whose job security and income is now linked to test scores. Likewise, in schools and districts in need of financial support and with low, stagnant, or declining test scores, smart drugs offer a means to game the regressive federal system.

Koerth-Baker writes, “From parents’ and teachers’ perspectives, the diagnosis is considered a success if the medication improves kids’ ability to perform on tests and calms them down enough so that they’re not a distraction to others.” As well, the high stakes testing and drugging of students facilitates the expansion of the multi-billion dollar test and textbook publishing industry and creates profits for the medico-pharmaceutical industry.

Taken from truth-out

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Global ADHD Therapeutics Market to Reach US$ 25 Bn by 2024

According to the latest market report published by Persistence Market Research, titled ‘Global Attention-Deficit Hyperactivity Disorder (ADHD) Therapeutics Market: Rising Prevalence of ADHD and Continuous Innovation by ADHD Drug Manufacturers are Factors Expected to Drive Revenue Growth by 2024’, revenue from the global ADHD therapeutics market is expected to expand at a CAGR of 6.2% during forecast period 2015 – 2024.

The market is segmented based on drug type, age group, distribution channel, and region. On the basis of drug type, the market has been broadly segmented into stimulants (Amphetamine, Methylphenidate, Dextroamphetamine, Dexmethylphenidate, and Lisdexamfetamine Dimesylate) and non-stimulants (Atomoxetine, Bupropion, Guanfacine, and Clonidine). By drug type, the Lisdexamfetamine Dimesylate drug type sub-segment is expected to register highest CAGR of 15.6% in terms of value over the forecast period. The longer effectiveness of the treatment and easier availability is expected to contribute to its growing adoption. The Lisdexamfetamine Dimesylate drug type sub-segment is expected to reach a market value of US$ 5,682.2 Mn by 2024 end. Stimulants are expected to emerge as the most preferred drug type for both patients and physicians globally over the forecast period. The second-most popular drug type sub-segment is Amphetamine, expected to register a CAGR of 4.2% during the forecast period.

Rising prevalence of ADHD owing to the low threshold of diagnostic criteria, increasing awareness regarding ADHD, and shift from ICD-10 to DSM-IV are major factors driving the growth of the global ADHD therapeutics market currently. Other trends driving market growth are increasing concerns among parents and cultural differences towards ADHD, rising ADHD drug usage in adults, and novel drug development.

Generic drug manufacturers in the global ADHD therapeutics market are focusing on introducing cheaper and effective generic ADHD drugs to increase market share, the post-patent expiry of prescription drugs. Furthermore, adoption of alternative treatment methods and drug abuse are factors hampering the growth of this market.

 
Taken from prnewswire.

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Overselling A.D.H.D.: A New Book Exposes Big Pharma’s Role

In the late 1930s, Charles Bradley, the director of a home for “troublesome” children in Rhode Island, had a problem. The field of neuroscience was still in its infancy, and one of the few techniques available to allow psychiatrists like Bradley to ponder the role of the brain in emotional disorders was a procedure that required replacing a volume of cerebrospinal fluid in the patient’s skull with air. This painstaking process allowed any irregularities to stand out clearly in X-ray images, but many patients suffered excruciating headaches that lasted for weeks afterward.

Meanwhile, a pharmaceutical company called Smith, Kline & French was facing a different sort of problem. The firm had recently acquired the rights to sell a powerful stimulant then called “benzedrine sulfate” and was trying to create a market for it. Toward that end, the company made quantities of the drug available at no cost to doctors who volunteered to run studies on it. Bradley was a firm believer that struggling children needed more than a handful of pills to get better; they also needed psychosocial therapy and the calming and supportive environment that he provided at the home. But he took up the company’s offer, hoping that the drug might eliminate his patients’ headaches.

The boundaries of the A.D.H.D. diagnosis have been fluid and fraught since its inception, in part because its allegedly telltale signs (including “has trouble organizing tasks and activities,” “runs about or climbs in situations where it is not appropriate” and “fidgets with or taps hands or feet,” according to the current edition of the DSM) are exhibited by nearly every human being on earth at various points in their development. No blood test or CT scan can tell you if you have the condition — the diagnosis is made by subjective clinical evaluation and screening questionnaires. This lack of any bright line between pathology and eccentricity, Schwarz argues, has allowed Big Pharma to get away with relentless expansion of the franchise.

This campaign is the subject of an important, humane and compellingly written new book called “ADHD Nation,” by Alan Schwarz, a reporter for The New York Times. The title of the book, of course, refers to attention deficit hyperactivity disorder: a constellation of behaviors and traits codified as a neurobiological illness in the bible of psychiatry, the Diagnostic and Statistical Manual of Mental Disorders.

“ADHD Nation” should be required reading for those who seek to understand how a field that once aimed to ameliorate the behavioral problems of children in a broad therapeutic context abdicated its mission to the stockholders of corporations like Shire and Lilly. Schwarz is sounding an alarm for a fire that looks nowhere near abating.

Taken from nytimes

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Awful people off the hook as ADHD labelled genetic

Morons with no attention span who are too fucking useless to bring their children up properly have welcomed the discovery that attention deficit hyperactivity disorder (ADHD), often referred to as ‘Little Bastard Syndrome’, is genetic in origin rather than the result of bad parenting.

ADHD often manifests itself in children via the inability to concentrate on tasks, anti-social behaviour, impulsiveness and failure to think through the consequences of their actions. Teachers, who frequently have to cope with it in class despite having only 13 weeks of holiday every year, have hitherto blamed it on the little scrotes’ pond life parents.

However, the researchers cautioned against reading too much into the results. ‘When we say that ADHD has mainly genetic rather than environmental causes, that means only that DNA determines to a large extent our ability to focus,’ said Dr Stephen Leach of the University of London.

‘Of course, if you’re one of these bone idle, shit-for-brains drongos who sits in front of Jeremy Kyle all day, drinks Diamond White, shags anything with a pulse and generally can’t do anything properly, then you are likely to pass that onto your mutant spawn, so it is your fucking fault actually.’

Taken from newsbiscuit

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Challenge of disciplining a child with ADHD

“The best way to do that is to deal with difficult behavior whenever it occurs and not allowing the tension to build up. Retraining difficult behavior patterns is an essential part of the treatment for ADD.”

Amen, author of “Healing ADD” and the New York Times bestseller “Change Your Brain, Change Your Life,” says there are steps parents can take that will help shape positive behavior in a child with ADD/ADHD and help the parent avoid those guilty feelings.

• Define the desired and undesirable behaviors. Before you can shape behavior, you need to be clear on what behaviors you want and don’t want, Amen says. A desirable behavior might be doing homework before going out to play. An undesirable behavior might be talking back to a parent.

• Establish how often negative or positive behavior occurs. Keep a log for anywhere from a week to a month to track how many times a behavior occurs. Having a baseline will allow you to know whether your interventions are having an effect.

• Communicate rules and expectations clearly. When children know what is expected of them, they are much more likely to do it. Too often, Amen says, parents believe children should know how to act without the rules being clearly communicated.

• Reward desired behavior. Once clear expectations are given, it’s essential to reward the behavior that meets expectations. Rewards can be such things as verbal praise, a hug, a small present, a trip to the library or park, and even money.

• Administer clear, unemotional consequences for negative behavior. Be in control of your emotions, don’t nag or belittle the child, and use logical consequences. For example, if a child refuses to put away his or her toys, the toys could be taken away for a few days.

Having a good relationship with the child is perhaps the most important factor, Amen says.

“With a good parent-child relationship, almost any form of discipline will work,” he says. “With a poor parent-child relationship, any form of discipline will probably fail. Relationships require two things: time and a willingness to listen.”

Taken from thenewsstar.

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ADHD Med Linked to Brain Changes in Kids After Stopping

Children treated with methylphenidate for attention-deficit/hyperactivity disorder (ADHD) show brain changes after discontinuing the drug, suggesting “neurochemical imprinting” on the developing brain, with uncertain long-term consequences, new research shows.

“In line with extensive preclinical data, we provide the first evidence, to our knowledge, that methylphenidate treatment during a specific period of maturation alters the cerebral blood flow response, likely reflecting increased dopamine neurotransmission due to neurochemical imprinting by methylphenidate,” the authors, led by Liesbeth Reneman, MD, PhD, Brain Imaging Center at the University of Amsterdam, the Netherlands, report.

“In the short term, these alterations do not induce major benefits or harm regarding clinical improvement, but the long-term consequences remain to be established,” they add.

The study was published online August 3 in JAMA Psychiatry.

Most Widely Prescribed ADHD Med

Methylphenidate (multiple brands) is the most widely prescribed medication for ADHD, and its use continues to increase for children as well as adults. However, the investigators note there is an “alarming paucity” of findings on the long-term effects of the drug on the developing brain.

To explore this issue, the investigators evaluated 99 male patients at ADHD referral centers in the Netherlands who had been diagnosed with ADHD in accordance with DSM-IV criteria. The patients had not been previously treated with stimulants.

Patients were randomly assigned to receive treatment with either methylphenidate (n = 50) or a matched placebo (n = 49) for 16 weeks.

Using pharmacologic MRI, the authors evaluated changes in cerebral blood flow between baseline and 1 week after the 4-month treatment period. A sustained increase in blood flow in response to an acute challenge with methylphenidate was indicative of a longer-lasting effect of the drugs’ dopamine stimulation. The acute challenge consisted of a noninvasive probe for dopamine function.

One week after the end of treatment, results showed that there was a significant increase in cerebral blood flow in the thalamus among children aged 10 to 12 years in response to the challenge compared to baseline (mean difference, 6.5; 95% confidence interval [CI], 0.4 – 12.6; P = .04). They found no similar significant differences in adults or in patients of any age in the group receiving placebo.

Differences were also observed in the striatum among children treated with methylphenidate compared with those receiving placebo, but not in adults (mean difference, 7.7; 95% CI, 0.7 – 14.8; P = .03). Children in the methylphenidate group were treated with a mean dose of 31.3 mg; for adults, the mean dose was 51.6 mg.

The clinical improvement that would be expected to coincide with the increase in cerebral blood flow, which is indicative of a lasting increase in dopamine neurotransmission, was not observed in children 1 week after washout.

In contrast, adults, despite no increases in cerebral blood flow in response to the challenge, did show clinical improvement following washout.

According to Dr Reneman, the improvements in adults were “possibly due to continued coaching effects, combined with the pharmacological treatment.”

Clinical Implications Unclear

Dr Reneman said these findings are consistent with the effects of neurochemical imprinting seen in studies on animals, in which administration of a drug when the animal’s brain is still developing induces long-lasting and potentially permanent effects after the drug is withdrawn, whereas in adult animals, the effects are only “accommodated.”

“However, the neurochemical imprinting theory also states that the effects are only fully expressed once the system is fully matured, typically during early adulthood,” Dr Reneman told Medscape Medical News.

“So for now, we can’t really say what the long-term effects are either on cerebral blood flow or clinical improvement. It is possible that the neurobiological effects precede the behavioral effects.

“We do not know if these lasting alterations persist for weeks, months or even years; thus, the clinical implications of methylphenidate altering the developing DAergic system are still unclear,” she added.

The few other studies on the long-term effects of ADHD medication show conflicting results, the authors note. The Multimodal Treatment Study of Children With ADHD, for instance, found that 6 years after enrollment in the trial, medical management was associated with a transient increase in the prevalence of anxiety and depression.

And although one cohort study showed adult ADHD to be associated with a high rate of substance abuse, another showed that treatment with ADHD simulant medication in childhood may decrease this risk in later life.

The fact that ADHD diagnoses have sharply increased in recent years raises the added concern that some patients who are being treated with methylphenidate may not even be correctly diagnosed, said Dr Reneman.

“Our results call for a tighter regulation of ADHD diagnoses and more careful patient selection, as an increasing number of children are being treated with methylphenidate.”

Unanswered Questions

Mark A. Stein, PhD, professor of psychiatry and behavioral medicine at the University of Washington and director of the PEARL Clinic and ADHD/Related Disorders Program at Seattle Children’s Hospital, in Washington, agreed that the findings leave unanswered questions in terms of clinical implications.

“It is unclear if slight changes in cerebral blood flow in certain brain regions are clinically significant, since improvement does not persist after medications are discontinued,” he told Medscape Medical News.

He speculated that the differences in clinical improvement may relate to adults’ ability to express their improvement.

“Perhaps after several months of stimulant treatment and improvement, adults may differ in their ability to develop compensatory skills and perceive lasting improvement when things are going well and that affects their self-report of improvement, unlike children.”

Dr Stein noted similar challenges with regard to previous studies of the differing effects of ADHD drugs on children and adults.

“It has been demonstrated in meta-analyses that that are larger effects of stimulants on ADHD symptoms in children than in adults, although this is confounded by measurement issues ― that is, parent and teacher ratings are used for children, and self-ratings are frequently used in adults.”

 
Taken from medscape

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