Saturday, July 12, 2008


The nation's fourth and eighth graders scored higher in reading and
mathematics than they did during their last national assessment,
according to the federal government's latest annual statistical report
on the well-being of the nation's children. Not all the report's
findings were positive; there also were increases in the adolescent
birth rate and the proportion of infants born at low birthweight.

These and other findings are described in "America's Children in Brief:
Key National Indicators of Well-Being, 2008". The report is compiled
by the Federal Interagency Forum on Child and Family Statistics, a
working group of Federal agencies that collect, analyze, and report data
on issues related to children and families, with partners in private
research organizations. It serves as a report card on the status of
the nation's children and youth, presenting statistics compiled by a
number of federal agencies in one convenient reference.

"In 2007, scores of fourth and eighth graders were higher in mathematics
than in all previous assessments and higher in reading than in 2005,"
said Valena Plisko, associate commissioner of the National Center for
Education Statistics, a part of the U.S. Department of Education.

This year's report also saw an increase in low birthweight infants (less
than 5 pounds 8 ounces). Low birthweight infants are at increased
risk for infant death and such lifelong disabilities as blindness,
deafness and cerebral palsy.

"This trend reflects an increase in the number of infants born
prematurely, the largest category of low birthweight infants," said
Duane Alexander, M.D., director of the Eunice Kennedy Shriver National
Institute of Child Health and Human Development at the National
Institutes of Health. Although not all the reasons for the increase
are known, infertility therapies, delayed childbearing and an increase
in multiple births may be contributing factors.

The birth rate among adolescent girls ages 15 to 17 also increased, from
21 live births for every 1,000 girls in 2005, to 22 per 1,000 in
2006. This was the first increase in the past 15 years.

"It is critical that wec ontinue monitoring this trend carefully,"
said Edward J. Sondik, PhD, director of the National Center for Health
Statistics in the Centers for Disease Control and Prevention.
"Compared with other teens their age, teen mothers are less likely to
finish high school or to graduate from college. Infants born to teen
mothers are more likely to be of low birthweight."

Among the favorable changes in the report were a decline in childhood
deaths from injuries and a decrease in the percentage of eighth graders
who smoked daily.

These and other findings on the nation's children and youth are
described in the report's content areas:

Demographic Background
< >

Family and Social Environment

Economic Circumstances

Health Care

Physical Environment and Safety



The Forum's Web site at <> contains all data
updates and detailed statistical information accompanying this year's
America's Children in Brief report. As in previous years, not all
statistics are collected on an annual basis and some data in the Brief
may be unchanged from last year's report.

Members of the public may access the report on-line at
<>. Alternatively, members of the public also
may obtain printed copies from the Health Resources and Services
Administration, Information Center, P.O. Box 2910, Merrifield, VA 22116,
by calling 1-888-Ask-HRSA (1-888-275-4772), or by e-mailing

The Forum alternates publishing a detailed report, America's Children:
Key National Indicators of Well-Being, with a summary version that
highlights selected indicators. This year, the Forum is publishing
America's Children in Brief; it will publish the more detailed report in

The data tables and figures for all the indicators in this year's brief
are available at <>.

The NICHD sponsors research on development, before and after birth;
maternal, child, and family health; reproductive biology and population
issues; and medical rehabilitation. For more information, visit the
Institute's Web site at <>.

Friday, July 11, 2008


Study Implicates Disruption of Genes Regulated by Early Experience Many of the seemingly disparate mutations

recently discovered in autism

may share common underlying mechanisms, say researchers supported in part by the National Institute of Mental Health (NIMH), a part of the National Institutes of Health (NIH). The mutations may disrupt specific genes that are vital to the developing brain, and which are turned on and off by experience-triggered neuronal activity.A research team led by Christopher Walsh, M.D., Ph.D., and Eric Morrow, M.D., Ph.D., of Harvard University, found two large sections missing on chromosomes in people with autism and traced them to likely inherited mutations in such genes regulated by neuronal activity. They report their findings in the July 11, 2008 issue of Science. The study was also supported in part by the NIH's National Center for Research Resources, National Human Genome Research Institute, Eunice Kennedy Shriver National Institute of Child and Human Development, and the National Institute on Neurological Disorders and Stroke.The study breaks new ground for complex disorders like autism, taking advantage of a shortcut to genetic discovery by sampling families in which parents are cousins. The researchers found genes and mutations associated with autism in 88 families from the Middle East, Turkey and Pakistan in which cousins married and had children with the disorder."The emerging picture of the genetics of autism is quite surprising. There appear to be many separate mutations involved, with each family having a different genetic cause," explained NIMH Director Thomas R. Insel, M.D. "The one unifying observation from this new report is that all of the relevant mutations could disrupt the formation of vital neural connections during a critical period when experience is shaping the developing brain."Earlier studies had suggested that the individually rare mutations are present in at least 10 percent of sporadic cases of autism, which is the most common form.The researchers used a technique that pinpoints from a relatively small group of families genes responsible for disorders that can be amplified by parenthood among relatives, which can increase transmission of recessive

diseases. Evidence had hinted at such transmission in autism, and the large amount of genetic information obtainable from such families reduced the need for a much larger sample including many families with multiple affected members.The ratio of females to males with autism - normally one female to four males - was less lopsided in such families in which parents share a common recent ancestor, suggesting a doubling of the rate of autism, due to recessive causes on non-sex-linked chromosomes. Also, autism-linked spontaneous deletions and duplications of genetic material were relatively uncommon in these families, suggesting recessive inherited causes.The researchers found multiple different genetic causes of autism in different individuals with little overlap between the families in which parents shared ancestry. Yet a few large inherited autism-linked deletions, likely mutations, in a minority of families stood out. The largest turned out to be in or near genes regulated, directly or indirectly, by neuronal activity."Autism symptoms emerge at an age when the developing brain is refining the connections between neurons in response to a child's experience," explained Walsh. "Whether or not certain important genes turn on is thus dependent on experience-triggered neural activity. Disruption of this refinement process may be a common mechanism of autism-associated mutations."

Gene Findings Hint at Common Mechanism in Autism

...Six genes not previously associated with autism spectrum disorder have been implicated by researchers here who used a genetic-mapping approach that relies on large families where parents are closely related. ...

Advice on kids, cholesterol triggers heaps of confusion

...At first glance, the idea of giving powerful anti-cholesterol drugs to 8-year-olds sounds absurd. After a great deal of further review, however, this new recommendation by an influential doctors' group … still sounds absurd....A week-long debate over kids and cholesterol began Monday, when the American Academy of Pediatrics advised doctors to consider using prescription drugs called statins to treat some children, as young as 8, who have high levels of "LDL," the bad cholesterol that builds up in arteries and leads to heart disease. ...

Comments: Absurd. DM

Are We Overmedicating Our Kids?

...Aaron, now 6, is currently doing well on Seroquel, an antipsychotic, and lithium, long prescribed for classic adult bipolar disease. He's affectionate, responds appropriately to discipline, and is able to go to school in a regular classroom. "I know there are many people who believe that parents use these kinds of drugs as a quick fix," says Webster. "But every time he has to try a new medication, I'm a nervous wreck -- I spend hours researching the pros and cons, I call his school repeatedly to see how he's doing. I watch him like he's under a microscope." ...

Comments: Medicine can be an appropriate choice for your child....however, it seems as if the Dx of children with bipolar disorder (the seemingly new ADHD) is increasing exponentially! This particular child is on Seroquel....which can cause lenticular changes and lithium...which can cause pseudotumor cerebri and that ever popular blurred vision!! They even come with "BLACK BOX WARNINGS"....suicide has been associated with many of these major neurotrophic drugs....use them...but only use them when you must....and use them wisely. DM

Prevalence of Decreased Visual Acuity among Preschool-Aged Children in an American Urban Population The Baltimore Pediatric Eye Disease Study, Methods

...Decreased VA in both eyes of children 30 through 71 months of age at presentation in urban Baltimore was 1.2% among white children and 1.8% among black children. After retesting within 60 days of the initial examination and with children wearing best refractive correction, the rate of decreased VA in both eyes was 0.5% among white children and 1.1% among black children....

Outdoor Activity Reduces the Prevalence of Myopia in Children

...Higher levels of total time spent outdoors, rather than sport per se, were associated with less myopia and a more hyperopic mean refraction, after adjusting for near work, parental myopia, and ethnicity....

Comments: Our Australian colleagues across the REALLY big pond....have discovered what developmental/functional/behavioral optometrists have been saying and teaching for decades. The environment has a significant affect on visual function. I would love for some of these fine researchers to take a look at the work of Francis Young, PhD, Darrell Harmon, PhD, Gerry Gettman, OD, and of course, Arnold Skeffinton, OD....maybe these clinically insightful pioneers can supply additional research fodder for these very good researchers.... Congrats on a very good article! DM

Assessment of an Effective Visual Field Testing Strategy for a Normal Pediatric Population

...As early detection of structural and functional visual abnormalities may be of utmost importance in the pediatric population considering many potentially serious neurological and ocular problems met with, accurate and reproducible visual field testing is vital. To achieve this goal, visual field testing with SITA Fast algorithm seemed to be a promising strategy for a pediatric population in a typical clinical setting....

Comments: I have found that you can often do automated screening fields on children as young as 5 years....try it...all to often you will be pleasantly suprised. DM

Thursday, July 10, 2008

Orthoptic Findings and Asthenopia in a Population of Swedish Schoolchildren Aged 6 to 16 Years

...Asthenopia was significantly associated with uncorrected visual acuity ≤ 0.65 and with myopia (spherical equivalent -0.50 D or less) among Swedish schoolchildren. ...

Contrast detection in infants with fragile X syndrome

...Studies have reported that a selective deficit in visual motion processing is present in certain developmental disorders, including Williams syndrome and autism. More recent evidence suggests a visual motion impairment is also present in adults with fragile X syndrome (FXS), the most common form of inherited mental retardation. The goal of the current study was to examine low-level cortical visual processing in infants diagnosed with FXS in order to explore the developmental origin of this putative deficit. We measured contrast detection of first-order (luminance-defined) and second-order (contrast-defined) gratings at two levels of temporal frequency, 0 Hz (static) and 4 Hz (moving). Results indicate that infants with FXS display significantly higher detection thresholds only for the second-order, moving stimuli compared to mental age-matched typically developing controls....

Narcotics Sold Online, No Rx Needed

...Scores of web sites do not require a prescription to buy narcotics, stimulants, and other controlled substances -- and none of those sites has controls to prevent children from making such purchases, a study shows...A report released today by the National Center on Addiction and Substance Abuse at Columbia University reveals that 85% of web sites selling potent prescription drugs such as OxyContin, Valium, and Ritalin do not ask Internet users for a proper prescription from a doctor. Many explicitly state that no prescription is needed....

'New CJD type' discovered in US

A new form of Creutzfeldt-Jakob disease (CJD) may have been uncovered in a handful of patients in the US.

ADHD Might Raise Kids' Obesity Risk

...Children with attention-deficit hyperactivity disorder (ADHD) are at a 50 percent higher risk for being overweight if they are not taking medication for the condition, a new study finds.
On the other hand, youngsters who were medicated for ADHD had a raised risk of being underweight, the same researchers found....

Scientists learn how food affects the brain

...Food is like a pharmaceutical compound that affects the brain," said Fernando Gómez-Pinilla, a UCLA professor of neurosurgery and physiological science who has spent years studying the effects of food, exercise and sleep on the brain. "Diet, exercise and sleep have the potential to alter our brain health and mental function. This raises the exciting possibility that changes in diet are a viable strategy for enhancing cognitive abilities, protecting the brain from damage and counteracting the effects of aging." Gómez-Pinilla analyzed more than 160 studies about food's affect on the brain; the results of his analysis appear in the July issue of the journal Nature Reviews Neuroscience and are available online at

Repair for mental impairment?

Colleague and friend, Dr. Sandy Block, told me about this fascinating article:

...By completely reversing four types of mental impairment in mice, scientists are overturning the long-entrenched notion that our mental capacity is hardwired and immutable.
So striking were the animal results that scientists are beginning drug trials on people with genetic disorders associated with mental retardation and autism. Several of the drugs are approved for other uses, which should speed up the testing process....

Accommodative insufficiency is the primary source of symptoms in children diagnosed with convergence insufficiency.

....CI is a separate and unique clinical condition and can occur without a comorbid AI condition, our CI-only group. Past reports of high symptom scores for children with CI are the result of the presence of AI, a common comorbid condition. When AI is factored out, and children with CI only are evaluated, they are not significantly more symptomatic than children with NBV.....

Wednesday, July 9, 2008

Accommodation Insufficiency in Children: Are Exercises Better than Reading Glasses?

...Purpose: The aim of the present study was to investigate which mode of therapy, plus lens (+1.00D) reading addition (PLRA) or spherical flipper (± 1.50D), is the most effective in the treatment of accommodative insufficiency (AI). Methods: Initially, 24 subjects (mean age 10.3 years, ± 2.5 SD) with AI were included in the study. Ten subjects completed 8 weeks of PRLA treatment whereas 9, out of 14, subjects completed 8 weeks of spherical flipper treatment. Results: There was a statistically significant improvement in the accommodative amplitude with both regimes of treatment [F(1, 17) = 18.84, p = 0.0004). Spherical flipper treatment was found to have an overall larger effect on accommodative function as compared with PLRA treatment. However, accommodation did not reach normal values after only 8 weeks of treatment. Discussion: The results indicate that both methods improve the accommodative amplitude, but that overall accommodative function reaches higher levels of improvement with spherical flipper as compared with PLRA treatment. However, the accommodative function did not gain normal values in 8 weeks of treatment with either regime. ...

Comments: I find it interesting that our eyecare colleagues are finding out how effective optometric vision therapy is in many areas of functional vision. Vision therapy is more effective than an added plus lens.

It should be also noted that 8 weeks of therapy may not be enough to gain normative values....I find most of my patients are in therapy 12-24 weeks (mostly 12) and are being treated for multiple functional vision anomalies at the same time.

It should also be noted that they are using an accommodative technique designed for an accommodative infacility disfunction....not necessarily and insufficiency problem. And should not necessarily be an either/or decision on how you treat these problems....often I will have the patient use a bifocal and conduct optometric vision therapy simultaneously. I do realize however, than when you conduct cannot have too many confounding factors...DM

Understanding Sudden Infant Death Syndrome

...New research sheds light on what may be the cause of Sudden Infant Death Syndrome (SIDS). Scientists have developed a mouse model and discovered that an imbalance in the brainstem causes SIDS in mice....

Adolescents with Childhood ADHD and Comorbid Disruptive Behavior Disorders: Aggression, Anger, and Hostility

...Adolescents diagnosed with ADHD and comorbid disruptive behavior disorders during childhood report high levels of aggression associated with increased emotionality in the form of anger, but not hostile cognitions. These findings suggest that in addition to inattention and hyperactivity/impulsivity, emotional dysregulation may be an important component of ADHD, particularly as it presents in adolescence. ...

Gluten- and casein-free diets for autistic spectrum disorder

...Research has shown of high rates of use of complementary and alternative therapies (CAM) for children with autism including gluten and/or casein exclusion diets. Current evidence for efficacy of these diets is poor. Large scale, good quality randomised controlled trials are needed....

Tuesday, July 8, 2008

Research suggests high intake of omega-3, omega-6 fatty acids may reduce blood pressure, heart attack risk.

From AOA First Look:

HealthDay (7/7, Edelson) reported that "[h]igh intake of the omega-3 fatty acids in oily fish and vegetable cooking oils appear to help prevent heart attacks, while the omega-6 fatty acids in vegetables and nuts help keep blood pressure low," according to two studies. One of the studies, published in the July 8 online issue of Circulation, found that "high intake of omega-3 fatty acids reduced the risk of heart attack by 59 percent." A separate study, published in the July 8 online issue of Hypertension, "found a significant relationship between intake of linoleic acid, an omega-6 fatty acid found in vegetables, and lower blood pressure."

Study indicates high intake of omega-3 fatty acids may also reduce risk of AMD. In continuing coverage from previous editions of First Look, the Irish Independent (7/7, O'Regan) reported, "Eating fish at least twice a week may help protect your eyes as you age," according to a study published in the journal Archives of Ophthalmology.

Florida CBS affiliate WCTV-TV (7/7, Sanders) added that in an "analysis of nine international studies," researchers at Australia's Melbourne University found that "eating fish and other foods high in omega-3 fatty acids reduces the risk of...age-related macular degeneration (AMD)." Specifically, "a high intake of omega-3 fatty acids was associated with a 38 percent reduced risk of advanced AMD."

Newborn Vitamin A Reduces Infant Mortality

...A single, oral dose of vitamin A, given to infants shortly after birth in the developing world can reduce their risk of death by 15 percent, according to a study conducted by researchers at the Johns Hopkins Bloomberg School of Public Health. The study is published in the July 2008 edition of the journal Pediatrics....

Following Traumatic Brain Injury, Balanced Nutrition Saves Lives

...Without gastric feeding within the first 5-7 days of suffering their injury, patients had a two- and four-fold higher likelihood of death, respectively. Also, the study reports that every 10kcal/kg decrease in caloric intake was associated with a 30 - 40 percent increase in mortality rate....The best outcomes for patients with TBI were observed when patients received a minimum of 25kcal/kg each day. Alarmingly, the researchers found that as many as 62 percent of the patients studied never met this level of caloric intake....

MIT Researchers Offer Tantalizing Evidence On How To Make People Smarter, Naturally

...New research findings published online in The FASEB Journal provide more evidence that if we get smart about what we eat, our intelligence can improve. According to MIT scientists, dietary nutrients found in a wide range of foods from infant formula to eggs increase brain synapses and improve cognitive abilities...

Yoga And Meditation Change Gene Response To Stress

...Research from the US suggests that mind body techniques like yoga and meditation that put the body in a state of deep rest known as the relaxation response, are capable of changing how genes behave in response to stress....

Researchers Reveal Types Of Genes Necessary For Brain Development

...Researchers from Harvard Medical School and Brandeis University have successfully completed a full-genome RNAi screen in neurons, showing what types of genes are necessary for brain development. Details of the screen and its novel methodology are published July 4th in the open-access journal PLoS Genetics....

Autism And Lyme Disease Are Connected, Lyme-Induced Autism Study Finds

..."Lyme disease is not the only causative factor in autism," Rosner says. "We know that many other environmental and genetic triggers are involved. However, Lyme disease is the fastest spreading infectious disease in the United States, with an estimated 200,000 new cases per year. Autism cases are also exploding. If Lyme disease can contribute to the onset of autism, then we are onto something big here."...

Comment: Add one more etiology for autism. When will we narrow down the choices? DM

Innovative Program Focuses On Improved Care For Children With ADHD

...The intervention consisted of an innovative training program developed by Cincinnati Children's on how to implement AAP diagnosis and treatment guidelines. The training focused on modifying office systems to accommodate the AAP guidelines, said Dr. Epstein. This included building in the use of parent and teacher ADHD rating scales into the evaluation and treatment monitoring process....

Cholesterol drugs urged for kids with heart risks

...For the first time, an influential doctors group is recommending that some children as young as 8 be given cholesterol-fighting drugs to ward off future heart problems. Screening is urged for kids with parents or grandparents who developed heart disease at an early age. It is the strongest guidance ever given on the issue by the American Academy of Pediatrics, which released its new guidelines Monday. The academy also recommends low-fat milk for 1-year-olds and wider cholesterol testing....

Comments: Stop the insanity! Drugs for 1 y/o kids....low fat milk? Let's get back to some common sense here. DM

Japanese encephalitis virus causes 'double trouble' to brain

...Japanese encephalitis (JE), commonly known as brain fever, is one of the prevalent mosquito-borne encephalitis in India and entire South East (SE) Asia. Besides resulting in thousand fatalities each year, JE virus (JEV) infection causes prominent neurological sequelae in approximately one-third of the survivors. Even those patients in the good recovery group commonly encounter psychiatric problems, which include mental retardation, learning disabilities, speech and movement disorders and behavioural abnormalities....

Monday, July 7, 2008

Beta Brother Maino in Beta Magazine

Click on the title above to see blurb about my trip to Ireland. DM

Pediatric LASIK safe, effective, stable over 10 years

..."LASIK in children has the same efficacy, predictability and safety margin of others. Of course, your nomogram should be changed depending on the condition of the other eye," Osama Ibrahim, MD, said at the World Ophthalmology Congress. Dr. Ibrahim said he has been performing surgical refractive procedures on pediatric patients since the introduction of refractive keratometry and has completed more than 800 LASIK cases to treat myopia, hyperopia and astigmatism...."

Comments: What are you talking about! These children will live to be 80, 90 maybe even 100 years of age. Ten years is cannot say this is safe with only 10 years of research. We know that the cornea thins as we age....will these childrens' corneas rupture in their 50's or 60's? We just don't know. Children and their families should consider LASIK ONLY in extreme cases. DM

History of eyeglasses

...The first suspected recorded use of a corrective lens may have been by the emperor Nero in the 1st century, who was known to watch the gladiatorial games using an emerald...Invention of eyeglassesAround 1284 in Italy, Salvino D"Armate is credited with inventing the first wearable eye glasses....

Comments: Of course the Italians invented eye glasses! We also invented the telephone and made pasta civilized! DM

Brown, RISD students create toys for kids with cerebral palsy

...The latest of these left-brain right-brain collaborations is Toys and Technology for Rehabilitation, a program for kids with cerebral palsy at the Hasbro Children's Hospital in Providence....Brown and Rhode Island School of Design students and their professors have developed more than a dozen toys and radio controllers that compensate for a lack of fine motor skills with controllers that strap to a child's wrist or forearm....The Brown-RISD group hopes its toys - which include a radio-controlled car, a dinosaur, and a tabletop racetrack - will strengthen limbs weakened by the disease....

Comments: Now this is very cool! Toys for kids with disability that are fun and therapeutic at the same time. DM

Parents' fury at 'Down's Syndrome dolls' designed to help children deal with disability

...Alison, 51, from North London, has huge doubts about the benefits of disabled toys. ‘When Sarah was six, her mainstream primary school bought a Down’s syndrome doll with the best of intentions,’ she says. ‘But I thought it was horrible and even overheard a teacher referring to it as “peculiar”. ‘Far from educating others about children with Down’s syndrome, these dolls single children like Sarah out and stereotype them just because they have the condition.
‘They are totally one-dimensional — they can’t show that a child with Down’s syndrome can be funny, bright and articulate. ...

Comments: you can't have it both want your child treated like any other....but when that really happens you get upset! There are redheaded dolls and blonds, boy dolls, girl dolls....dolls who are cowboys and dolls who are soldiers....there are white, Hispanic and African American dolls....get over it! It's just a doll! DM

Missouri requires mandatory eye examinations for kindergartners, first graders.

In continuing coverage from previous editions of First Look, Missouri NBC affiliate KOMU-TV (7/3) reported that all Missouri "kindergarten and first grade students entering the school system for the first time this fall will have to get a comprehensive" eye examination. "According to the new children's vision law, students must provide proof of the examination, the cost, the examiner's qualifications, and the method of payment." Pointing out that such "screenings will help parents in the long run," optometrist Andrew Stone, O.D., said, "This will be a way that will allow us to catch these children earlier than we have before, and I really see that as time goes on, parents are going to see the value of it." KOMU-TV added that "Missouri is the second state in the nation to sign such legislation. By December of 2011, a committee will submit a report detailing the results of a study with the effects of the new law."

Caffeine Helps Prevent Multiple Sclerosis

...Investigators studied mice that normally develop an MS-like condition. Study authors say when the rodents had the equivalent of six to eight cups of coffee a day they did not develop the condition. Researchers say the caffeine affected the building blocks in DNA, preventing the disease. ...

Comments: Sure now the research comes out....just as Starbucks is closing 600 stores! DM

Assessment and management of medically unexplained symptoms

...Many people present with medically unexplained symptoms. For example, more than a quarter of primary care patients in England have unexplained chronic pain, irritable bowel syndrome, or chronic fatigue, and in secondary and tertiary care, around a third of new neurological outpatients have symptoms thought by neurologists to be "not at all" or only "somewhat" explained by disease. This is not a problem just in developed countries—in Bangladesh, only a third of women with abnormal vaginal discharge had evidence of infection. These disorders are important because they are common and they cause similar levels of disability as symptoms caused by disease. If not treated properly they can result in large amounts of resources being wasted5 and iatrogenic harm. ...