Heike Schuhmacher, MD
Vision and Learning does an excellent job of explaining the complexities of vision. Dr. Heike Schuhmacher manages to do this with a light touch aided by wonderful illustrations. Continue reading
Heike Schuhmacher, MD
Vision and Learning does an excellent job of explaining the complexities of vision. Dr. Heike Schuhmacher manages to do this with a light touch aided by wonderful illustrations. Continue reading
My notes from reading this book are long due to the importance of the topic and the quality of the book.
It was once said that the study of genetics taught us just how important the environment is.
In this book, I use the term “adolescence” to refer to the period of from ten until twenty-five.
The United States lags far behind the rest of the developed world on most indices of adolescent achievement and health.
New research shows that the brain continues to mature well into one’s twenties.
In general, the earlier age at which children now mature physically is much more worrisome than most people recognize, because it doesn’t bode well for physical or mental health – earlier puberty places people at significantly greater risk for a host of physical, mental, and behavioral problems, including depression, delinquency, and even cancer.
The fact that the adolescent brain is malleable is both good and bad news, though. As neuroscientists are fond of saying, plasticity cuts both ways. By this they mean that the brain’s malleability makes adolescence a period of tremendous opportunity – and great risk.
The United States spends more per student on secondary and postsecondary education than almost any other country in the world, so it’s unlikely that our mediocre school achievement or worrisome college attrition is due to a lack of financial resources.
And as the world’s leader in prison population, we spend nearly $6 billion each year incarcerating adolescents, many of whom have committed nonviolent crimes and who could be managed in the community at a fraction of the cost.
One-third of students who enroll in college never graduate; the United States has one of the lowest college-graduation rates in the industrialized world, despite the fact that the economic returns on college completion in America are among the world’s highest.
The birth rate among unmarried women increased by 80 percent between 1980 and 2007. In 2011, nearly one-third of the women who gave birth had never been married. Having a child outside of marriage increases the risk of young women and men curtailing their education, depresses parents’ lifetime earnings, and increases the odds of living in poverty.
The United States has one of the highest rates of youth violence in the developed world, as well as the highest rates of violent deaths among adolescents.
Nearly two-thirds of our high schools have security guards who carry firearms.
The United States leads the world in adolescent obesity and diabetes.
The rate of adolescent suicide in the United States is consistently higher than the international average, and suicide attempts and suicide ideation among American high-school students are both on the rise.
The capacity for self-regulation is probably the single most important contributor to achievement, mental health, and social success. The ability to exercise control over what we think, what we feel, and what we do protects against a wide range of psychological disorder, contributes to more satisfying and fulfilling relationships, and facilitates accomplishments in the worlds of school and work.
In today’s world, though, where formal education is increasingly important for success, people who are bad at reasoning, planning, and self-regulation are at a serious disadvantage, and the fact that the development of these abilities is highly sensitive to environmental influence is a mixed blessing.
The adolescent brain is extraordinarily sensitive to stress. The average age of onset for serious mental health problems is fourteen.
In all cultures and times, the mortality rate among boys spikes a few years after they become adolescents. It’s called the “accident hump”, and it occurs because the rise in testosterone that takes place at puberty makes males more aggressive and reckless.
A large survey of American children born in the early 1960s found that the average age of breast budding was close to thirteen years. By the mid-1990s, it had fallen to a little under ten.
Melatonin levels are sensitive to artificial as well as natural light. That’s why people are discouraged from staring at illuminated screens (like computer monitors, smartphones, or tablets) before they go to bed – the light they give off suppressed melatonin production, which makes it harder to feel sleepy. It’s little surprise that today’s teenagers, nearly all of whom have 24-7 access to television, computers, and other devices with glowing screens, are having more sleep problems than past generations. Your genes predispose you to go through puberty around a particular age, but the more fat cells you have, and the more light to which you have been exposed, the more likely it is that you will go through puberty on the early side of your inherited propensity.
The presence of chemicals in the environment that can accelerate puberty is so ubiquitous that children are exposed to them even when their parents are very careful about what they eat.
Menarche at twelve or earlier elevates a woman’s risk of breast cancer by 50 percent compared to menarche at sixteen.
Things that feel good, feel better during adolescence. A small structure inside the limbic system is the most active part of the brain for the experience of pleasure – it’s the center of the reward center – and it actually gets bigger as we grow from childhood into adolescence, but, alas, smaller as we age from adolescence to adulthood.
Although adolescents are relatively more attentive and responsive to rewards than adults, they’re actually less sensitive to losses. This bias is something that parents and teachers should keep in mind: it’s easier to change an adolescent’s behavior by motivating him with the prospect of a reward than by threatening him with a potential punishment.
Being upset, excited, or tired interferes more with prefrontal functioning during adolescence than during adulthood because the relevant brain circuits are not fully mature.
According to statistics from the FBI, most crimes are committed by adolescents.
In other words, it’s not necessarily overt peer pressure that leads adolescents to do more reckless things with their friends. It’s that being around friends when you are a teenager makes everything feel so good that you become even more sensitive to rewards than you ordinarily are, which leads you to take chances you wouldn’t otherwise take.
Risk taking is a natural, hardwired, and evolutionarily understandable feature of adolescence. It may no longer be especially adaptive in the world in which we live, but it is in our genes, and there isn’t much we can do to change that. We should devote fewer resources to trying to change how adolescents think, and focus on limiting opportunities for their inherently immature judgments to hurt themselves or others.
The marshmallow test seems to gauge something about people that stays with them as they grow up. More remarkably, the people who were delayers when they were four years old turned out to be more successful in life as well as in the lab. Life is constantly presenting us with choices between smaller immediate rewards and larger delayed ones.
From an earnings standpoint, going to college without getting a bachelor’s degree is now pretty much a complete waste of time.
Expanding opportunities to go to school without ensuring that people have the determination to take advantage of them is unlikely to succeed.
The United States spends more money, in absolute and relative dollars, on postsecondary education than nearly any other country. It has one of the highest rates of college entry in the industrialized world. Yet it is tied for last in the rate of college completion.
Matching former students and their careers with my recollection of their credentials at the time they applied, it struck me that the things we asked about on our admissions application were more or less useless in predicting future success in the field.
Only about 25 percent of school performance is accounted for by intelligence.
The abilities needed in most jobs can often be acquired after one is hired, but capacities like perseverance and conscientiousness must be nurtured before adulthood.
At its core, more than any other capacity, determination requires self-regulation.
In order to develop competence, children must learn from their mistakes.
You might be surprised to learn that, despite the stereotype of the pressure-cooked Asian student, the teen-suicide rate is higher in the United States than in China, Korea, Japan – or, for that matter, Germany.
Without changing the culture of student achievement, changes in instructors or instruction won’t, and can’t, make a difference.
The fact that Asian American children in particular do so well in our putatively terrible schools and with our ostensibly terrible teachers has nothing to do with what goes on in the classroom. It has everything to do with how they are raised and what their parents expect of them.
Most teenage delinquents don’t become persistent adult criminals. People tend to grow out of crime, just as with other sorts of risky and dangerous behavior, which decline as people mature through their twenties.
We spend our time telling adolescents what they shouldn’t do, rather than guiding them toward what they should – and can – do.
I read this book a few years ago and put the summary aside. I went back to look at my review to see how it held up to the test of time; a test that we don’t have as much time for today. Reading – or just scanning – the excerpts is what we will tend to do. But they would be better on a page-a-day calendar. Turn the page and think for a moment. As we all feel the urge to move on, I hope that these questions about questioning cause you to pause. Continue reading
ADHD Nation is as important for understanding the evolution of the diagnosis and treatment of attention disorders, the role of Big Pharma, and how attention disorders have been mismanaged as are the books NeuroTribes and In a Different Key for understanding the evolution of our understanding of autism.
Alan Schwarz is an award-winning investigative journalist whose work made public the seriousness of concussions in the NFL. Like concussions in sports, the potential side-effects of ADHD medications have been largely ignored. Big Pharma and the scientists they support have been complicit in this omission.
ADHD medications have the potential to improve attention, motivation, and energy which is not dependent on having ADHD. When used properly, the drugs can help many people and the side-effects are minimized. But the statistics make it clear that the condition is being over-diagnosed in this country. The drugs are also being used (and misused) by many high school and college students and by others who feel that they need a boost and have never been diagnosed. The causes of their problems are not being investigated nor are other possible means of treatment. Consider the following…
In the 1930s, a drug was developed with the goal of treating asthma or nasal congestion which, serendipitously, was found to make people feel good. Smith, Kline, & French “licensed it before knowing exactly what medical condition the stuff might actually treat. Finding out was a lot easier then than it is today: Lax federal regulations did not require any proof of safety, let alone efficacy, before a drug was released for public experimentation. So SKF sent boxes of what it called ‘Benzedrine sulfate’ to any doctor willing to try the drug on patients with various ills, from asthma to postpartum depression.”
Due to known problems with amphetamines, a close cousin to amphetamines was developed to have the same effects with fewer side effects. “CIBA termed the chemical formulation of this drug ‘methylphenidate’. The company released it to the American market in 1956 as Ritalin, a treatment for narcolepsy, chronic fatigue, depression, and erratic behavior caused by senility. (Again, only in adults; the medication was untested in children.)”
Dr. Keith Connors, author of the Connors Rating Scale, is the best-known researcher in the field of ADHD. “Connors needed no questionnaire to assess the effects of Ritalin on himself. Late one afternoon, following an exhausting day in the lab, he had to attend an eight-p.m. lecture by Harry Harlow, a behavioral psychologist famous for locking young monkeys away from their mothers and studying their emotional demise. Knowing he’d never stay conscious for the whole thing, Connors found the tub of Ritalin capsules so generously donated by CIBA and took one. Within thirty minutes he snapped awake and thought to himself, ‘This is fantastic!’ He kept working until eight. He skipped dinner. He zoned in on the lecture, chatted with folks afterward, and stayed up until three in the morning. Just one dose felt so beguiling, that he never tried the stuff again for the rest of his life.”
In the early 1990s, Obetrol was an amphetamine which was prescribed for weight control but it was not a financial success. After a pediatrician discovered that it worked for some children who did not respond well to Ritalin, Obetrol was remarketed as Adderall.
“Psychiatry journals teemed with more than a thousand studies on ADHD conducted by Biederman, Barkley, and other pharma-sponsored scientists. The Food and Drug Administration relied on them when green-lighting medications as safe and effective. Their findings served as the backbone for the lectures that drug companies’ key opinion leaders delivered on world tours. The whirlwind created a self-affirming circle of science, one that quashed all dissent.”
“While almost all other developed nations immediately closed the loophole that Metadate had exploited – expressly banning direct-to-consumer advertising of controlled substances, usually through legislation – the United States sat back and let the market take over. To this day, the United States is only one of two developed nations that allow advertising of ADHD medications to the general public.”
“Appallingly, some children have heightened anxiety interpreted not as a side effect of medication, meaning the drug should be reconsidered, but a new condition needing additional treatment…. Diagnosing young children with several overlapping psychiatric conditions became de rigueur in the 2000s, resulting in what some call a ‘medication cascade’. No doctor was more responsible for the trend than Joe Biederman up at Harvard, who evaluated dozens of drugs on behalf of his Big Pharma benefactors and almost invariably declared them safe and appropriate for children with multiple diagnoses like ADHD and bipolar disorder. Yet neither he nor anyone else tested the performance or risks of these drugs in combination – no pharmaceutical company would ever sponsor such a study, considering it too risky to their product’s reputation.” “Adderall and methylphenidate have always been among the most addictive substances in medicine. Weird as it may sound, stimulants are dangerous by being not dangerous enough – the drugs have found a sweet spot in which their advantages are more common and immediately obvious than their more latent risks, lulling all involved into complacency.”
“Today, misuse of ADHD medications by high school students is far more widespread that most anyone realizes. About a million high school kids nationwide use Adderall, Concerta, Vyvanse, and others without a doctor’s prescription, getting them either from friends or from dealers for a few dollars a pill.”
“Dozens of studies since the 1990s have estimated that about 8 to 35 percent of undergraduates take stimulant pills illicitly to try to improve their grades; a reasonable estimate among high-pressure colleges is probably 15 to 20 percent. Most students, of course, don’t experience terrible outcomes – if they did, the dangers would already be better recognized. But many do. One 2006 study found that about one in ten adolescents and young adults who misused ADHD medications became addicted to them, with some of them becoming psychotic or suicidal.”
“A different study found that teachers suspected ADHD far more often in elementary school children whose birthdays made them one of the youngest in their grade – just a tick over six, say, when the rest of their classmates were nearing seven. Therefore, many kids were being diagnosed merely because they were born in the wrong month: ‘The youngest children in fifth and eighth grades,’ it concluded starkly, ‘are nearly twice as likely as their older classmates to regularly use stimulants prescribed to treat ADHD.”
At the end of his working career, Dr. Keith Connors sent a letter to a colleague and closed with the following: “Beware the simple & sovereign explanation.” That is good advice to all of us.
Alan Schwarz includes in the book a mock doctor/patient interview from a certified continuing education program purported to teach physicians how to diagnose ADHD. From the start of the conversation to the writing of the Rx was six minutes. Also, it was not revealed that there was a possible conflict of interest but the following was discretely printed at the end: “Supported by an independent educational grant from Shire.”
There are many possible causes for ADHD behaviors other than primary “brain dysfunction”. Since there is no litmus test for ADHD like blood work or imaging, ADHD is primarily a diagnosis of exclusion. Other possible causes of ADHD should be investigated and ruled out prior to considering medication. Visual problems are one of the possible causes of these signs and symptoms but so are the accelerated curriculum, fewer recesses in school, less time playing outside, more stimulation from video games, more organized activities which reduce free time, instant communication and responses, less sleep, and more pressure. Children whose problems are not primarily due to attention, may also do better with medication, but their underlying problems are not being addressed and they may be being medicated unnecessarily. “The human brain has evolved over many thousands of years, yet only in the last hundred, a blip on that time line, have we demanded that each and every young one sit still and pay attention for seven hours a day.”
This book addresses the concerns that many of us have about ignoring child development and the ranges of development within a grade level and even within individuals when educational standards are set. David Elkind reminds us that most children are enthusiastic learners in the appropriate circumstances but may be anxiously unsuccessful in other conditions. Continue reading
Sandra Aamodt & Sam Wang
While Welcome to Your Child’s Brain is part of the self-help genre, it is written by two neuroscientists who bring their own research and that of others to the key questions of child development. For those who are interested in which areas of the brain are involved in different behaviors, the current research on this is presented, but effectively raising children has similarities to effectively using a computer. You need to know how the programs work. You do not need to know the inner workings of the computer. In the case of children (and other humans) we don’t need to know the areas of the brain which are involved, most of which is still poorly understood. This book, like others which I have reviewed, is a response to some of the misleading information, toys, and educational programs which are being presented to parents and it is this information which has the potential to be most beneficial. To make this as concise as possible, I will present bullets in the form of excerpts and will include page numbers if you would like to read more on any of these statements or conclusions.
The “best gift” you can give your children is self-control. Self-control and other executive functions of the brain (like working memory, flexible thinking, and resisting the temptation to go on automatic) contribute to the development of [children’s] most important basic brain function: the ability to control their own behavior in order to reach a goal.” P. xii
It probably doesn’t matter exactly what excites your children; as long as they are intensely engaged by an activity and concentrate on it, they will be improving their ability to self-regulate and thus their prospects for the future.” P. xii
Babies start to follow an adult’s gaze as early as four months of age. P. 7
Being effective in the world is enormously rewarding for children and adults alike. P. 25
One reason that people get so worked up over the nature vs. nurture debate is the widespread assumption that genetic contributions to development are deterministic, while environmental contributions are flexible… Nearly all genes that influence behavior act by changing the odds of a particular developmental outcome, not by specifying it exactly – so your child’s heredity is not destiny… Indeed, from an individual neuron’s perspective, it would be hard to distinguish between “genetic” and “environmental” influences. Signals that enter your brain through your eyes or ears (that is, via experience) influence development by causing chemical signals to modify genes or proteins – just as genetic influences do. Some of these changes are reversible, and some are not, but whether they originated inside or outside the body is not the determining factor. Pp. 32 – 33
Epigenetics is a new field which is not easy to understand. Environmental influences can determine if and when genes are expressed and some of these can even be passed on to future generations. The following excerpts relate to epigenetics.
When epigenetic modifications occur in sperm or eggs, they can affect future generations. This process is best understood in laboratory animals. For example, female mice that spent a particular two weeks of their youth in an “enriched environment” (with many toys) learned more easily as adults. And so did their pups – even when those pups were raised by a foster mother and did not receive any enrichment themselves. The pups instead benefited from their mother’s experiences passed down through epigenetic modifications to her DNA. P. 34
To start with a basic principle, your child’s genes can influence his environment – and vice versa. His personal characteristics lead him to seek out certain experiences in life and his tendencies to react to other people in certain ways affect how they behave toward him…. Because the influences run in both directions, many developmental processes are feedback loops, in which our genes influence our environment, which then influence our genes (or at least the way they are expressed), and so on…. With all of this interaction, it is nearly impossible to figure out how much of a particular behavior is caused by genes and how much by environment. P. 35
Sleep debt has serious consequences, including reduced mental performance, depressed mood, impaired health, and weight gain. P. 78
Perception of large-scale motion patterns, like raindrops seen through the windshield of a moving car, improves rapidly between three and five months and then continues to develop slowly through middle childhood. This aspect of motion processing, the most vulnerable to disruption, is impaired in some developmental disorders, including dyslexia and autism. P. 83
Young children’s play contributes to the development of their most important basic brain function: the ability to control their own behavior in order to reach a goal. P. 112
Preschool children’s ability to resist temptation is a much better predictor of eventual academic success than their IQ scores. P. 112
Succeeding at challenging self-control tasks builds more success, but repeated failure may instead teach the child that there’s no point in trying. P. 120
Active children have higher self-esteem than inactive children. P. 131
All of us have experienced emotions that seemed overwhelming and out of control. Imagine feeling that way much of the time, and you have a picture of your child’s daily experience. One reason that life with toddlers is such a wild ride is that the parts of the nervous system that produce raw emotions mature earlier than the brain regions that interpret and manage them. P. 155
Until their own regulatory capacity is fully developed, your children rely on you to moderate their emotions, by soothing and distracting them, and to help them learn how it’s done. Parents who are more sensitive to their infant’s needs and respond quickly to emotional cues tend to raise children who are better at regulating their own emotions. Pp. 161 – 162
If your child believes that intelligence is a fixed characteristic, that belief will make her act less smart. Children who think a test measures their innate competence do not try as hard or perform as well as those who think that the effort is the major determinant of success or failure. P. 188
Word-form recognition is learned through experience. This capacity seems to be an example of a more general ability of the inferior temporal cortex to visually recognize objects. P. 212
Stress profoundly affects the developing brain. P. 224
You may not think of nagging as a way of rewarding your child for misbehaving, but even yelling can actually encourage the behavior you’re trying to stop, especially if that’s the best way for your child to get your attention. Completely ignoring the problem behavior is usually the most effective way to get it to stop – if you can stick with it long enough.
It’s common for parents to turn to yelling or spanking as their first response to problem behaviors, but a large body of research shows that this negative approach to behavior modification is not very effective in the long run. The effects of punishment are fleeting and tend not to generalize to other situations. P. 248
So many of the things we do instinctively and many of the things promoted in our culture are correct, but many are not. Concepts of child-rearing tend to change, but children remain mostly the same as the environment changes. Due to many pressures, some of what is being done in education at this time is not in the child’s best interest nor will it produce the desired changes in a significant percent of the population. We have many new distractions with which to cope and we can’t pretend that they don’t exist. I hope that this information is helpful.
Hans G. Furth and Harry Wachs
There has always been a temptation to ignore the influence of child development. Development takes time; not everyone develops at the same rate; and all areas may not develop on the same schedule within one individual. There is an increased temptation to ignore development when there is pressure to push students to meet short-term academic goals. Continue reading
Re-train the Visual Brain…Advancing awareness, understanding and best practices
An Insider's Perspective on Developmental Optometry, Vision Therapy, and Visually Related Learning Challenges
Thursday's Corner with Dr Gary J Williams: book reviews and articles of interest!