A study published in the journal Radiology has identified a magnetic reasonance imaging (MRI) technique to measure brain iron levels that could provide accurate, non-invasive diagnoses.

ADHD can be hard for doctors to distinguish from other psychiatric conditions, particularly because diagnosis is based on subjective clinical consultations.

Psychostimulants such as Ritalin are the most commonly proposed solution, further complicating the controversy that surrounds misdiagnosis, since many are opposed to such drugs for young people due to potential for abuse and lack of time-tested certainty of their effectiveness.

“Much debate and concern has emerged regarding the continual rise of ADHD diagnosis in the U.S. given that two-thirds of those diagnosed receive psychostimulant medications,” said Vitria Adisetiyo, Ph.D., postdoctoral research fellow at the Medical University of South Carolina in Charleston. “We wanted to see if we could identify brain iron as a potential noninvasive biomarker for medication-naïve ADHD to prevent misdiagnosis.”

Researchers worked with 22 children and adolescents diagnosed with ADHD, 12 of whom had never been given medication, and measured their brain iron levels using a magnetic resonance imaging (MRI) technique known in the medical community as “magnetic field correlation imaging.”

They compared results with those of 27 healthy children and adolescents and found that the 12 ADHD patients never exposed to psychostimulants had lower levels of iron in the brain compared with both the healthy group and the medicated ADHD patients.

The result not only suggests psychostimulants might restore deficient brain iron levels but could lead parents opposed to the use of the drugs to a better understanding.

“Our research suggests that iron absorption into the brain may be abnormal in ADHD given that atypical brain iron levels are found even when blood iron levels in the body are normal,” Dr. Adisetiyo said. “We found no differences in blood iron measures between controls, medication-naïve ADHD patients or pscyhostimulant-medicated ADHD patients.”

Magnetic field correlation imaging was introduced in 2006 by study co-authors and faculty members Joseph A. Helpern, Ph.D., and Jens H. Jensen, Ph.D.

“We want the public to know that progress is being made in identifying potential noninvasive biological biomarkers of ADHD which may help to prevent misdiagnosis,” Dr. Adisetiyo said. “We are currently testing our findings in a larger cohort to confirm that measuring brain iron levels in ADHD is indeed a reliable and clinically feasible biomarker.”

If the magnetic field correlation technique proves to be effective, more research could lead to pinpointing which patients are candidates for psychostimulants in the interest of minimizing their use amongst the young.

(AFP Relaxnews)

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Time out is not punishment

Wait until he starts to understand that rules need to be followed, so that he understands why time out is happening. Time out must not be seen as punishment. It should rather be seen as an opportunity to teach your toddler how to cope with his feelings of frustration and anger. Once he has learnt how to cope with these feeling, he will be able to start to modify his behaviour.

Take time outs together

If he is still young ( 1- 2 years), start by taking time outs together. So when he starts to push beyond his borders and is getting hyped up, say “let’s stop for a while, take a deep breath and have some quiet time together”.

This is a good way to get him used to a “cooling off period”. Once he is two years old, he will start to understand a bit more that Action = Consequence, as well as being able to follow instructions.

Avoid bathrooms or naughty corners

This is the ideal time to start using more formal time out. A good idea is to use his bedroom as the area for his time out. Remember that if he needs some time out in the first place, his sensory system is most likely overloaded, making him feel out of sorts and disorganized. His bedroom is a safe and secure zone that he is comfortable with, so it will comfort and calm him. Avoid using bathrooms or naughty corners. These areas may make him feel embarrassed, uncomfortable and insecure.

Use body language

When he needs some time out, tell him very firmly (try not to shout, all it does is re-enforce a spiral of negative behaviour) that you do not like what he is doing, and that he needs to go to his room.

Use your body language to re-enforce how serious you are. Point towards the bedroom, and coax him along (don’t be tempted to smack). If he digs his heels in, pick him up firmly (even if he is kicking and screaming), and take him to his bedroom. Once you are there, say to him “It’s not nice to pinch your sister, stay here until you feel better”. Walk out and close the door.

Because he is a toddler, he will weep and wail and may even bash on the door with frustration. Wait for about a minute before you go back. Don’t leave him for too long, but don’t rush back in immediately – allow him some time to calm himself down.

When you re-enter his room, take no notice of the mess that he may have caused, rather keep your voice calm and controlled. Suggest a cuddle on your lap, if he resists, say calmly “OK, I will come back in a little while when you are feeling better”.

Leave the room for another minute. Go back in and repeat your offer. Continue in this way until he is ready for a hug and a cuddle. Sit on the floor, or his bed or a chair in his room, and hold him firmly with a deep hug. Singing a favourite song is also most useful. Wait until he is calm. Briefly discuss the event that caused the time out in the first place.

Acknowledge your toddler’s feelings

Remember to always acknowledge and name how he is feeling by saying “I know that you are feeling angry because I sent you to your room”, then mirror the feeling by saying “I would also feel angry if I were you”, then explain why by saying “it wasn’t very nice to pinch your sister. So remember that next time when you are feeling frustrated with her, pinching is not the way to deal with it”.

Suggest that he puts the ‘bad thought’ into a little box or an imaginary bubble, then go with him to the bedroom window and empty the box, or blow the bubble away.

Offer to help him tidy up his room (if he has trashed it in her rage), then continue with your activities.

Reassure him that time out doesn’t mean that you don’t love him, and that you will always love him no matter what. Don’t refer to the episode again (not even when dad comes home from work) – it is over. This method can be used up to school going age.

Using time out when you are out of the house

Obviously time out will work if you are at home. But what if you are out?

The best way to handle discipline when you are out is to remove your child from the situation. So if he is having a tantrum at the shopping center, ignore him, and try to finish your shopping as quickly as possible and get out of there as fast as you can!

Remember to be in tune to his signals, so don’t take him shopping if he is hungry, tired or over-stimulated – it is bound to end in tears. If you need to discipline in a public place, always take him to a quiet spot around the corner so that he does not feel embarrassed.

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Sleep is vital for our physical and emotional well being. It is well known that it promotes the secretion of growth hormone as well as restoring brain processes. This enables us to perform subtle cognitive and social tasks as we go about our daily lives.

It may be surprising to note that the very same environmental, behavioural and social factors that may interfere with sleep, can play an important role in ensuring healthy sleep habits from the start.

In daily practice, when one is presented with an “unsettled infant”, or a “badly behaved toddler”, lack of sleep, or plain exhaustion is often not considered, as the practitioner is often too busy looking for a “physical reason” for the childs’ distress.

Physiological factors that affect sleep

There are obviously certain physiological factors to exclude from the outset, and a detailed history from the parent (or caregiver) is necessary. The obvious factors should include the following:

• Illness
• Nutrition
• Digestive disturbances
• Allergies
• Anaemia
• Parasitic infection (worms)
• Candida (thrush):oral/systemic/peri-anal
• Teething
• Nappy rash
• Emotional trauma

Once these factors have been excluded, the area of sensory overload should be investigated.

Sensory integration

The behaviour displayed by an infant or toddler upon exposure to sensory input will differ depending on the manner in which the stimulus is interpreted.

The sensory system functions in order to form a composite picture of what is going on around us. Sensory integration is the critical function of the brain that is responsible for producing this picture.

For most of us, effective sensory integration occurs automatically, unconsciously and without effort. However, for most infants, particularly premature babies, and toddlers with sensory integration difficulties, this process is inefficient due to immaturity of the sensory system. Therefore, babies and some toddlers will have difficulty in processing too much sensory stimuli.

Exposing a baby to sensory stimuli

When a child is exposed to sensory stimuli, a pattern usually occurs.

The child may interpret the stimuli as non stressful and respond to the stimuli appropriately. This response will not affect the stability of the behavioural subsystems of the nervous system.

© marchibas – Fotolia.com

Approach signals

The child will display self-regulation approach signals.These signals indicate that she is in control, and is neurologically well organized. Children displaying these signals appear to be inviting interaction.

These signals include:

• Soft and relaxed facial expression, with alert and open eyes
• Relaxed limbs with smooth body movements and minimal motor activity
• Turning towards sound and visual stimuli with interest
• A toddler will ask and respond to questions, smile and laugh

Warning signals

The child starts to experience stress when the exposure to the stimuli continues. The child will display some warning signals. At this stage she still has the ability to self-organise or self-regulate.

She is able to produce a behaviour to decrease the effect of the stress, thus preserving the stability of the behavioural subsystems of her nervous system.

© hartphotography – Fotolia.com

Warning signals that the child is becoming overloaded include:

• Hand(s) on face
• Fingers or hands in mouth or nose
• Fisting
• Bracing of legs or body
• Shifting to a drowsy state(infant); wanting to lie down(toddler)
• Fidgeting
• Decreased eye contact with you
• Sucking(infant); excessive mouthing(toddler)

This is the stage to allow the baby or toddler to go to sleep. All further stimulation should be avoided at this point. These signals must be interpreted as warning messages that the child may be reaching maximum tolerable stress levels. It is important to note that if the child is given some space to “zone out” she will be able to regulate her state of sensory overload herself to enable her to go to sleep unaided.

Stressed signals

If the exposure to the stress/stimuli continues, it will stress the child to such a degree that she becomes unable to overcome the effect of the stress by self-regulation(above). The compensating lower subsystem of the nervous system becomes unstable, resulting in a stress reaction such as crying and inability to fall asleep unaided. She will now need extensive help such as sucking on the breast or a bottle, being rocked or driven in a car in order to fall asleep. These stressed signals signal the end of the child’s ability to self regulate, and include:

© Barbara Helgason – Fotolia.com

• Loss of eye contact, or staring into space
• Irritability
• Moaning ,whining and crying
• Tantrums (toddler)
• Frantic, disorganized, jerky movements(infant); excessive fidgeting(toddler)
• Hands and fingers shielding the face
• Changes in vital signs such as heart rate and respiration
• Trunk arching
• Tongue thrusting(infant)
• Yawning, sneezing and hiccupping
• Gagging or spitting up
• Colour changes – paleness, mottling, flushing, cyanosis

These signs are very often misinterpreted as colic(infant), or boredom or bad behaviour(toddler). However, the sensory system at this stage is in such disorganization that it is unable to self-calm, and the child will end up crying inconsolably(infant), or having a tantrum(toddler). It is very important at this stage to:

• Modulate the environment for the child – remove stimulation
• Encourage and facilitate hand to mouth activity (sucking fingers, dummy)
• Encourage finger grasping
• Deep hug(toddler)
• Place your finger in the infants palm
• Swaddle the infant or place in a sling
• Allow the infant to “nest” in flexion

Children who are constantly over-stimulated and or deprived of “quiet time” will remain in this level of stress, and will thus never sleep.

To avoid children entering into this stressed, over-stimulated, over-tired state, it is crucial to avoid excessive stimulation, and to monitor how much time the child spends awake between sleep cycles. It is important that children are allowed to sleep before they reach this state of over-tiredness.

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A neurological syndrome

ADHD is a neurological syndrome associated with poor concentration and organisational skills. It is, however, poorly understood with many people dismissing it as a ‘fad’ with no foundation in truth.

Elimination diets have limited efficacy

There are medications available to help manage the symptoms, and behavioural therapy can be helpful. Elimination diets have been shown to have limited efficacy in the treatment of ADHD. More recently, artificial food colourants and the preservative sodium benzoate have been shown to increase hyperactivity in some children.

A balanced diet is a priority

While dietary causes for the illness remains difficult to prove, there is no question that a balanced and healthy diet should be a priority.

Dietary guidelines for toddlers with ADHD:

1. Plan regular, varied meals and make them small and frequent. Do not allow your child to go for long stretches of time (more than 3-4 hours) without food.
2. Include foods with a low Glycemic Index (GI) at every meal. These foods provide a slow, sustained release of glucose into the bloodstream.
3. Avoid refined carbohydrates with a high GI as these may exacerbate ADHD.
4. Include protein-rich foods (chicken, meat, fish, eggs or diary) at all meals, as protein helps stabilise blood sugar levels.
5. Encourage consumption of vegetables and fruits. Children should eat at least five portions of a variety of different vegetables and/or fruit every day.
6. If your child is a fussy eater, consider giving him a daily multivitamin and mineral supplement. The supplement should provide approximately 100% of the DRI for each vitamin and mineral. Don’t give mega doses of individual vitamins or minerals without first consulting a healthcare practitioner.
7. Plan a serving of oily fish (pilchards, sardines, salmon etc.) two to three times a week. Or consider giving your child a daily supplement of fish oil (omega-3 fatty acids).

About the Author:

To find a private dietician in your area with a special interest in ADHD: Association Dietetics South Africa – www.adsa.org.za. There is more detailed information on children’s nutrition and useful kids recipes in “Your Special Diet” section on www.pnp.co.za/healthcorner

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Faced with a nine-month old who makes faces at anything green, or a toddler who throws a tantrum at the sight of a carrot, many parents are tempted to give up on getting their kids to enjoy veggies.

But the findings of the HabEat project — a multidisciplinary Pan-European study of how food behaviors are formed in infants and children — give parents plenty of reasons to persevere. At the final symposium of the project, held in Dijon, France on March 31 and April 1, the research teams also presented practical recommendations for improving children’s intake of fruit and vegetables.

Understanding how eating habits are formed

Initiated in January 2010 by 11 partner organizations from five European countries, the HabEat project followed the eating habits of several cohorts of children (aged six months to six years) over a four-year period. The goal: to understand how eating habits are formed and sometimes broken during the first years of life. Using various psychological, epidemiological, behavioral and nutritional analyses, the project sought to identify the key mechanisms in the development of children’s taste or distaste for certain foods.

Taught to enjoy veggies and fruits

At the end of the project, researchers’ recommendations all center around one essential point: children must be taught to enjoy fruits and vegetables at the earliest age possible.

The importance of diversity

The project’s findings also emphasize the importance of diversity in the diet, suggesting that children should be introduced to a wide variety of fruits and vegetables early on. For better chances of success, researchers advise introducing only one new fruit or vegetable per meal, without combining them.

Parents should be role models

Parents should act as role models during the process, encouraging their child to appreciate fruits and vegetables without forcing them.

In fact, coercive techniques and reward-based motivations (“Eat your sprouts and you’ll get cake”) can be counterproductive, as they alter a child’s natural ability to gauge hunger and satiety, leading to a risk of compulsive eating and obesity later in life.

Trust your toddler’s appetite

It is better to trust the child’s appetite, however fickle it may be. Sometimes, the same vegetable may be offered and rejected 8 to 10 times over the course of a few weeks before a child finally takes a liking to it.

For older children, being involved in the cooking process can lead to more willingness to try new foods, especially if parents and caretakers bring them along to farmer’s markets to help pick out fruits and vegetables.

Breastfeeding plays a vital role

Finally, the HabEat project concludes that breastfeeding plays a vital role in the development of healthy eating habits. Researchers found a positive correlation between the number of months an infant was breastfed and the quantity of fruit and vegetables he or she consumed during later childhood.

(AFP Relaxnews)

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Contrary to what you might think, weekends are not cursed! There is a valid explanation for the weekend-naptime-horrors…

Overstimulation

Weekends are always filled with so much more activity; there are new faces of friends and family, the TV is on for longer, the baby’s older siblings are at home instead of at school. No wonder small children become overstimulated during the weekend.

A disrupted routine

If your child is in day-care or at school, chances are that the routine you follow at home is not the same that they follow at school. Also, our social calendars and our long “to-do-lists” over the weekend means that our children do not eat or sleep or play when they usually would.

Daddy is home!

In households where dads tend to work long hours and spend limited time with the children during the week, the excitement of having dad home and spending time with him, makes children even less fond of sleep time.

What can be done to keep your sanity?

Stick to your routine as much as possible. If your routine during the week includes having lunch, and then putting the baby down for a nap, make sure that over weekends you keep to the same routine.

1. Limit sweets and sugar! Too much caffeine and sugar is the main culprit over weekends. Stick to serving healthy meals as much as possible and if it is “treat” day, try and incorporate the treat earlier in the afternoon, before 4pm.
2. Be attentive to your child’s age appropriate awake time. Do not keep your child awake for longer than usual.
3. Plan your trips as far as you can around your little one’s sleep time
4. Ensure that there is no TV at least two hours before bed time.
5. Be consistent. Don’t let your child stay up later just because you have friends over.
6. Make sure your children spend enough time running around and playing outside, as well as getting exposure to natural daylight. Often, parents with a busy weekend tend to have their children’s eyes fixed on some type of screen, or stuck in the confined space of a shopping trolley or stroller.

If all else fails, remember that no matter what you do, Monday will come around soon enough, and things will get back to normal soon.

About the Author: Good Night is a child and baby sleep consultancy that specialises in helping parents with children who struggle to sleep soundly. For more information, visit: www.goodnightbaby.co.za

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Yet still he refuses to eat, and mealtimes have become a continuous struggle.

Although it can be very distressing for parents, be reassured that in most cases fussiness is a normal phase of development and children are unlikely to come to harm, eating poorly for a short while.

Dietician and Pampers^® Institute expert Claire McHugh offers advice on what you can do to deal with fussy eating habits.

Make eating enjoyable

Remember that getting used to the new routine of meal times and a variety of new foods is part of growing and learning for your toddler.

McHugh recommends that you focus on providing them with a positive feeding environment. “An enjoyable eating atmosphere at meal times helps. Encourage your toddler to sit at the table with the family during meals and let them eat what the family eats, he needs to be exposed to a good variety of food, and when he sees you enjoying the food, this will encourage him to also enjoy and eat his food,” says McHugh.

The freedom of choice

Part of picky eating is your toddler asserting his independence. Let your toddler be involved in his food choices. Avoid giving your child free rein, but allowing them to choose between two healthy options, will help your toddler to feel more in control and willing to eat the food,” suggests McHugh.

Introduce new foods

When your baby refuses textured foods, this doesn’t mean he dislikes it. Children need time to adjust and explore new tastes and textures. Spitting out his first pureed foods is part of his learning and adjusting to a new way of eating.

Spitting out purees are often your baby’s way of telling you he is ready to progress to finger foods. Allow your baby to start experimenting with soft finger foods like cooked pieces of vegetable and soft ripe fruit. This may be messy, but it is a very important stage and a great way to encourage better intake.

McHugh also explains that it can take between 15 to 20 exposures to a new food before your baby gets used to it and accepts it. Offer new foods alongside old favourites, to help keep the meal enjoyable and ensure that something is eaten.

Structured routine is important

Make sure that your toddler gets his meals and snacks at regular times each day. This ensures that they have a good appetite at meal and snack times.

Limit the amount of juice offered and restrict milk to a maximum of 500ml per day. This will ensure that the child isn’t filled up and will have a better appetite for meals, advises McHugh.

Praise him when he does eat his food, but don’t give too much attention to food refusal. In many cases all the fuss created when food is refused can encourage this behaviour.

Don’t force it

As a parent, there’s no denying that the amount of food your child eats can make you really worry about their health. You constantly have to wonder if they have had enough or what to do to make them eat more, but forcing them or shouting at them is not the best way of handling this stressful situation.

Force-feeding your child creates a negative association with those foods and mealtimes and just makes the problem worse.

Persevere; most picky and fussy eaters start eating better over time. However, if your child has excluded a full food group for an extended period, taken only a small number of foods or excluded certain textures, it may be worth seeking professional advice.

Your dietician or doctor can recommend a nutritional supplement to help meet nutritional requirements while the fussiness persists.

”To help meet calorie requirements, accepted foods can be fortified or enriched by adding butter, cream or oil to make them as energy dense as possible,” concludes McHugh.

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We know your first instinct will be panic – what do you buy for toddlers? Do you buy a stuffed toy which they will drag through the mud? Or a set of blocks they will chew right through?

Before you drag yourself to the over-priced toy stores, we have prepared a list of alternative gift options for toddlers…

Something practical

No parent can have enough nappies: as unglamorous as that sounds, a secret stash can be a life saver. While you’re at it, don’t forget to throw in some aqueous cream. You could even go the whole mile and gift a baby pamper hamper with everything they could possibly need. Taking a trip to Makro to buy wet wipes in bulk is a gift that will keep on giving.

Something for the parents

Let’s be honest, one-year-olds don’t even know that it’s their birthday, so don’t feel guilty about not getting them a present. However you can’t show up completely empty handed.

Get something that could make the parents’ life easier. If you’re brave enough, how about a few babysitting vouchers, to give the moms and dads some time off?

You could spoil them with a pamper hamper of luxurious goodies to make them feel sexy again, perhaps even throw in something naughty? Or you could simply gift them a lovely night in, with a picnic hamper and a great bottle of wine.

Something fun

One of the best parts of having a kid around is that you can dress it up in some really fun things, and it can’t complain! A gorgeous little baby grow make the perfect gift for anyone who has a streak of fun and loves South Africa.

How about creating a toy castle from cardboard boxes and tape? It’ll be sure to entertain the little one long after the cake high has worn off. And will cost you nothing but some imagination.

Something sentimental

If you want to give a special gift that signifies your intention of being in this kid’s life for good, we suggest some more long-term gifting ideas.

Give them a fruit tree and plant it together. You can then develop a tradition of taking a picture next to it every year on their birthday, and make jam together when it produces fruit.

What about setting up a savings bond that they can touch only when they come of age? By the time that happens there will be a healthy little nest-egg awaiting them, especially if you add to it each year thereafter.

Something that the whole family will appreciate is a gorgeous family photo shoot. This is a sure winner and a gift that they will treasure for the rest of their lives.

For more gift ideas, visit www.tidyandco.com

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It’s all about ground rules

If you’re in the thick of it, you probably know that a meltdown usually follows after you tell your toddler that he or she is not allowed to do or have something. The best way to tackle this type of tantrum, is to create ground rules and stick to them. You shouldn’t say no today and yes to the same situation tomorrow. Over time, toddlers learn what is expected of them and will in turn cooperate with you.

Team work

There’s no point in being the only one to enforce the ground rules that you set. Family members (daddy and granny, this means you too) and caregivers should be on the same page as you are and help you to set boundaries for your toddler’s behaviour. If toddlers are given a consistent response to various situations, they will be less likely to push the boundaries with different people.

Take a deep breath and count to ten

In the middle of a tantrum, it is easy to have a mini eruption of your own. For the sake of the situation (and your sanity), take a deep breath and count to ten. There is no point in both of you being hysterical. Children feed off the emotion of their parents. If you are able to remain calm, your toddler might take a cue from your behaviour and calm down too.

Distraction is key

This is not guaranteed to work, as some toddlers are more stubborn than others. But hey, it’s worth a try and some parents are able to distract their children out of a tantrum. The next time your toddler erupts, try telling a funny joke or doing a silly dance. You never know, it may be just what your toddler needs to move on from the situation.

Keep to a schedule

The more comfortable toddlers are, the less likely they are to respond to a situation negatively by throwing a tantrum. Make every effort to stick to your toddler’s schedule. Knowing what comes next is comforting. A comfy toddler is a happy toddler, and one who is less likely to throw a tantrum.

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