Newswise — September 19, 2011 (Baltimore, MD) – Catering to a child who is a picky eater is like being a short-order cook: chaotic. Dinnertime becomes a war zone, leading to hopeless battles fought over vegetables and macaroni and cheese.

Picky eating is as normal as potty-training, a right of passage in childhood development. Taste buds evolve and food preferences expand in these early years. even the best of parents can have a difficult time getting their child to eat. In fact, picky eating is one of the most common occurrences in children, often outgrown as the child reaches adolescence. But if eating behavior inhibits normal developmental and physical growth processes, it could be something much more severe – a pediatric feeding disorder.

“The difference between a fussy eater and a child with a feeding disorder is the impact the eating behavior has on a child’s physical and mental health,” Peter Girolami, Ph.D., Clinical Director of the Pediatric Feeding Disorders Program at the Kennedy Krieger Institute in Baltimore, Maryland – a leading program that was one the first of its kind in the United States and the largest in the world to treat pediatric feeding disorders.

Pediatric feeding disorders are more common than most think, afflicting up to 10 percent of all infants and children, according to published literature. Children classified as having a feeding disorder do not consume enough calories and nutrients to promote healthy growth and development. it is important to differentiate between a picky eater, who may consume a restricted but still nourishing diet, from a child who consumes, for example, only three to four types of foods, eliminating entire food groups and compromising healthy growth.

Common symptoms of a pediatric feeding disorder are:• An abrupt change in eating habits lasting longer than 30 days• Delayed development of skill set necessary to self feed or consume higher textures• Weight-loss or failure to gain appropriate weight• Choking/coughing during meals• Unexplained fatigue, loss of energy• Disruptive behavior during mealtime

Feeding disorders are not all created equal. some children can have aversions to food groups or certain textures and colors, while others lack the skills to self-feed or refuse to eat any food at all. The assortment of behaviors that constitute a feeding problem vary from child to child and include food refusal (e.g., crying, head turning, spitting out food, throwing utensils, packing or holding food in mouth, aggression, and getting out of the seat), coughing/gagging, and vomiting. many children with feeding disorders also suffer from a serious medical, behavioral or psychological condition that can contribute to the onset of the feeding disorder – 30 percent of children with development delays have difficulty feeding at some point during their childhood. other common medical conditions that are associated with feeding disorders include gastroesophageal reflux disease (GERD), food allergies, cancer, and complications from premature birth. Children that undergo surgeries unrelated to food may also develop feeding problems, as feeding tubes can throw them off track.

Early diagnosis and treatment is extremely important when it comes to feeding disorders. The longer it is left untreated, the more complex it can become—in extreme cases, children can even require feeding tube assistance. Feeding disorders can also lead to serious complications from nutritional deficiencies such as anemia. Undernourished children are also at risk for developmental delays including the inability to crawl, walk and talk, which could lead to oral, motor and sensory problems.

Since there is no common cause or symptom that is characteristic of all pediatric feeding disorders, each case is unique with varying challenges to effective treatment. Both biological and social interactions need to be individually addressed for each child during diagnosis and when developing an appropriate treatment program. Kennedy Krieger’s Pediatric Feeding Disorders Program takes an interdisciplinary approach. A team of professionals with expertise in many specialties – from leaders in pediatrics to behavioral psychology and speech pathology– work together to help each child modify behavior, build motor skills and treat associated medical conditions.

“It’s not a one-size fits all model,” insists Dr. Girolami. “Our team of leading professionals addresses the many causes of feeding disorders and their associated complications so we can give the child and family the best care available.”

Learn more about feeding disorders and treatment options at feedingdisorders.kennedykrieger.org/.

About the Kennedy Krieger InstituteInternationally recognized for improving the lives of children and adolescents with disorders and injuries of the brain and spinal cord, the Kennedy Krieger Institute in Baltimore, MD serves more than 16,000 individuals each year through inpatient and outpatient clinics, home and community services and school-based programs. Kennedy Krieger provides a wide range of services for children with developmental concerns mild to severe, and is home to a team of investigators who are contributing to the understanding of how disorders develop while pioneering new interventions and earlier diagnosis. for more information on Kennedy Krieger Institute, visit kennedykrieger.org

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ScienceDaily (Feb. 11, 2011) — Children with attention-deficit hyperactivity disorder are two to three times more likely than children without the disorder to develop serious substance abuse problems in adolescence and adulthood, according to a study by UCLA psychologists and colleagues at the University of South Carolina.

"This greater risk for children with ADHD applies to boys and girls, it applies across race and ethnicity — the findings were very consistent," said Steve S. Lee, a UCLA assistant professor of psychology and lead author of the study. "The greater risk for developing significant substance problems in adolescence and adulthood applies across substances, including nicotine, alcohol, marijuana, cocaine and other drugs."

Lee and his colleagues analyzed 27 long-term studies that followed approximately 4,100 children with ADHD and 6,800 children without the disorder into adolescence and young adulthood — in some cases for more than 10 years. These carefully designed, rigorous and lengthy studies, Lee said, are the "gold standard" in the field.

The research by Lee and his colleagues, the first large-scale comprehensive analysis on this issue, is published online this week in the journal Clinical Psychology Review and will appear in a print edition later this year.

The researchers combined all the published studies that met rigorous criteria and analyzed them together. They found that children with ADHD were at greater risk for serious problems such as addiction, abuse and trying to quit but being unable to, Lee said.

"any single study can be spurious," he said, "but our review of more than two dozen carefully designed studies provides a compelling analysis."

ADHD is common, occurring in approximately 5 percent to 10 percent of children in the U.S., and figures in many other industrialized countries with compulsory education are comparable, according to Lee.

Symptoms of the disorder are common in children and include being easily distracted, fidgeting, being unable to complete a single task and being easily bored. however, to receive a diagnosis of ADHD, a child must have at least six of nine symptoms of either hyperactivity or inattention, and the child’s behavior must be causing problems in his or her life. The vast majority of children with ADHD have at least six symptoms in both categories, Lee said.

In addition, the symptoms must have started before age seven, must be present in multiple settings — at home and school, for example — and must be adversely affecting functioning. They must not be explainable by any medical condition or any other mental disorder.

As children with ADHD enter adolescence and adulthood, they typically fall into three groups of roughly equal size, Lee said: one-third will have significant problems in school and socially; one-third will have moderate impairment; and one-third will do reasonably well or have only mild impairment.

Parents should monitor their children, said Lee, who noted that early intervention with a mental health professional is often helpful. A diagnosis of ADHD must be made by a mental health professional such as a child psychologist or psychiatrist and not by a parent or teacher.

Co-authors on the study are Kathryn Humphreys, a UCLA graduate student in clinical psychology; Kate Flory, an assistant professor of psychology at the University of South Carolina; Rebecca Liu, a UCLA undergraduate who worked in Lee’s laboratory; and Kerrie Glass, a graduate student in psychology at the University of South Carolina.

The research was federally funded by the National Institutes of Health’s National Institute on Alcohol Abuse and Alcoholism.

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of California – Los Angeles. The original article was written by Stuart Wolpert.

Journal Reference:

1. Steve S. Lee, Kathryn L. Humphreys, Kate Flory, Rebecca Liu, Kerrie Glass. Prospective Association of Childhood Attention-deficit/hyperactivity Disorder (ADHD) and Substance use and Abuse/Dependence: A Meta-Analytic Review☆. Clinical Psychology Review, 2011; DOI: 10.1016/j.cpr.2011.01.006

Note: if no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

In an effort to combat a persistently high level of pertussis or whooping cough, state and federal health officials are urging physicians and their patients to make wider use of a pertussis booster vaccine called Tdap (tetanus-diphtheria-acellular pertussis). despite the availability of Tdap, a vaccine designed as a booster for adolescents and adults, pertussis cases have been increasing in Minnesota as in other parts of the country, such as California. Minnesota is in its third year of a peak pertussis wave, with more than 1,000 cases reported each year in 2008 to 2010. This is about 20 cases per 100,000 people in Minnesota. new recommendations published Jan. 14 by the Centers for Disease Control and Prevention (CDC) are designed to remove some of the barriers to Tdap?s use and to address specific issues contributing to the high rate of pertussis. Tdap vaccine has been available since 2005 and has been recommended for children entering seventh grade and adults needing a tetanus booster. Tdap was instituted after health officials found that the effectiveness of the primary series of DTaP (diphtheria-tetanus-pertussis), typically given to infants and children under seven, wears off as children approach adolescence. However, health officials suspect the Tdap booster is not being used as widely as it should be. ?We want all Minnesotans to be aware that the pertussis booster vaccine can help protect them and others from this disease, which can be most serious for young children and infants,? said Kristen Ehresmann, director of infectious disease for the Minnesota Department of Health. Patients should be asking their health care provider to give them the pertussis-containing tetanus-diphtheria shot, if needed, at their next clinic visit. According to the new recommendations: 1. Adults and adolescents may be given Tdap regardless of when the last tetanus-diphtheria (Td) shot was given. Previously, a minimum interval of five years was recommended between the last Td and a Tdap. recent data indicates that it is safe to give the Tdap sooner than two years after the tetanus shot. No waiting is necessary to get a pertussis shot. 2. Tdap may be given to children 7 to 10 years of age who have not completed the recommended DTaP series or who have never received a primary series of tetanus, diphtheria and pertussis. This recommendation closes a gap in coverage for children of that age group with those factors. 3. Seniors who work with young children should get Tdap. Tdap should be given to adults 65 years of age and older who have contact with infants younger than 12 months, and Tdap may be given to adults 65 and older needing a tetanus booster if they haven?t already received the Tdap. MDH staff has sent information on pertussis and the new recommendations to local public health agencies and health care providers in the state. Pertussis is a disease that affects the lungs. Pertussis bacteria are spread from person to person through droplets in the air. A person with pertussis develops a severe cough that usually lasts four to six weeks or longer. Pertussis can be very serious, especially in infants. The first symptoms of pertussis are similar to a cold: sneezing, a runny nose, possibly a low-grade fever and a cough. After one or two weeks, the cough becomes severe, as noted by the following: ?The cough occurs in sudden, uncontrollable bursts where one cough follows the next without a break for breath. ?Many children will make a high-pitched whooping sound when breathing in after a coughing episode. Whooping is less common in infants and adults. ?During a coughing spell, the person may vomit. ?The person?s face or lips may look blue from lack of oxygen. ?The cough is often worse at night. ?Between coughing spells, the person seems well, but the illness is exhausting over time. ?Coughing episodes gradually become less frequent, but may continue for several weeks or months until the lungs heal. Pertussis in infants is often severe, and infants are more likely than older children or adults to develop complications. The most common complication of pertussis is bacterial pneumonia. Rare complications include seizures, inflammation of the brain and death. People with pertussis can spread it to others in the first three weeks of coughing if not treated with antibiotics. After a person with pertussis has taken antibiotics for five days, he or she can no longer spread the disease. Antibiotics are sometimes recommended and prescribed to prevent development of the disease in people who have had close contact with someone who has pertussis. ?The best way to prevent pertussis is to vaccinate all children on time and to use the booster vaccine as recommended,? Ehresmann said. in addition, everyone should: ?Avoid close contact with others who are coughing or otherwise ill. ?Wash their hands often. ?Stay at home if ill. ?Cover their cough with a tissue or cough into their sleeve. ?Seek medical attention if they develop pertussis-like symptoms or have been exposed to someone with pertussis. more information on pertussis can be found at health.state.mn.us/divs/idepc/diseases/pertussis/index.html.

Attention Deficit Disorder (ADD) and Attention deficit hyperactivity disorder (ADHD) is a neurobiological disorder that affects many people in the U.S. it is characterized by impulsiveness, inattention, and hyperactivity. without appropriate diagnosis and treatment, ADHD can have serious consequences. the consequences may include academic failure, depression, relationship problems and impair social skills.

We may all occasionally experience a sense of restlessness, difficulty sitting still, paying attention, or controlling impulsive behaviors. however, there is a major difference when we experience these feelings and behaviors occasionally than when we experience them with such a persistent intensity that it interferes with our daily lives and relationships at home, school, and social settings.

In the past, it was believed that children with ADD or ADHD will eventually outgrow this disorder. This is because as children grows older and become adolescence, they become less hyper. however, many adults with ADD/ADHD know too well that many times, this disorder can follow well into adulthood. Individuals often experience relationship problems at work and in their personal lives, usually progressing further into depression if left undiagnosed and untreated.

Heredity may be connected to ADD or ADHD although not sufficient research has yet proven this. what are known to be factors associated with ADD/ADHD are difficulties during pregnancy, prenatal exposure to alcohol and tobacco, premature delivery, low birth weight, high body lead levels, postnatal injury to the prefrontal regions of the brain are all believed to be a contributing factor to developing ADHD in children.

ADD/ADHD symptoms usually are evident during childhood. Diagnostic criteria for determining ADD/ADHD characteristics are such that the behaviors are long lasting, evident for at least six months, and interfering with the quality of life of the individual suffering from it.

ADHD – Primarily Inattentive Type:

* Fails to give close attention to details or makes careless mistakes.

* has difficulty sustaining attention.

* does not appear to listen.

* Struggles to follow through on instructions.

* has difficulty with organization.

* Avoids or dislikes tasks requiring sustained mental effort.

* Is easily distracted.

* Is forgetful in daily activities.

ADHD – Primarily Hyperactive/Impulsive Type:

* Fidgets with hands or feet or squirms in chair.

* has difficulty remaining seated.

* Runs around or climbs excessively.

* has difficulty engaging in activities quietly.

* Acts as if driven by a motor.

* Blurts out answers before questions have been completed.

* has difficulty waiting or taking turns.

* Interrupts or intrudes upon others.

ADHD – Combined Type:

* Meets both inattentive and hyperactive/impulsive criteria.

Multimodal approach appears to be the best treatment for children and teens. Multimodal approach is when multiple treatments are sought and work together as a comprehensive plan. some multimodal treatment approaches according to CHADD are as follows:

*Behavioral Intervention Strategies

*Appropriate Educational Program

*Education Regarding ADHD

*Medication, when needed

Positive behavior modification can be critical. Positive reinforcement or when a child is rewarded for certain behavior appears to be the most important technique to help with ADD/ADHD.

For adults, treatment may or may not involve comprehensive approach. an adult based comprehensive approach includes healthcare professionals, spouse, family members and friends to help the adult with ADHD reap the best benefit from treatment. Medication is usually part of the treatment plan to help these adults gain more control and better organize their lives.

Update your self about ADHD Symptoms in Children.keep intouch with latest news & updates of Three Renowned ADHD Symptoms in Children .

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NEW YORK (Reuters Health) – In some teenage girls, very painful menstrual periods that interfere with daily life may signal an increased risk of developing the most extensive form of endometriosis, a preliminary study suggests.

In a study of 229 women undergoing surgery for endometriosis, French researchers found that those with the most extensive form — known as deep infiltrating endometriosis (DIE) — were more likely to have had particularly painful periods as teenagers.

As a group, they were four times as likely as women with non-DIE endometriosis to have used birth control pills to treat severe menstrual pain before the age of 18. And they were 70 percent more likely to say they'd missed school days because of menstrual symptoms.

The findings, published in the journal Fertility and Sterility, suggest that such problems in adolescence can sometimes predict a later diagnosis of DIE.

In endometriosis, pieces of the tissue that lines the uterus (the endometrium) also grow outside the organ — often on the ovaries, the fallopian tubes or elsewhere in the pelvis. like the endometrium, this misplaced tissue changes with each menstrual cycle, thickening and then breaking down and bleeding.

This leads to a buildup of adhesions, or scar tissue, outside the uterus, with symptoms including pelvic pain and heavy, painful menstrual periods. Some women also have difficulty becoming pregnant.

There are three forms of endometriosis: superficial endometriosis, ovarian endometriomas and DIE, with the latter being the most extensive. Women with DIE usually have adhesions in multiple areas of the pelvis, including the vagina, bladder, bowel and the ligaments attaching the uterus to the pelvis.

Endometriosis can be tricky to diagnose, and many girls and women go years before a diagnosis.

The condition may, for instance, be mistaken for other causes of pelvic pain, like ovarian cysts, pelvic inflammatory disease or, depending on the symptoms, irritable bowel syndrome. In addition, while a pelvic exam or ultrasound test are often used to help diagnose endometriosis, the only way to definitively diagnose it is through minimally invasive laparoscopic surgery to take a tissue sample.

Compared with the other forms of endometriosis, DIE appears to have a longer delay to diagnosis.

So for the new study, Dr. Charles Chapron and colleagues at Universite Paris Descartes tried to find out whether women undergoing surgery for endometriosis had any early symptom history that was associated with a greater likelihood of having

The study included 229 women who had surgery at a single medical center between 2004 and 2009; 43 percent had DIE, while the rest had the less-extensive forms of endometriosis. all of the women were interviewed about their symptom history; their average age at the time of surgery was 32.

Overall, 58 percent of women with DIE had ever been prescribed birth control pills to treat severe menstrual pain, versus 26 percent of women with non-DIE forms. Similarly, 21 percent of women with DIE had their first prescription before the age of 18, compared with 6 percent of those in the non-DIE group.

When it came to missed school days, 38 percent of DIE patients said they'd had absences due to menstrual symptoms, versus one-quarter of women in the non-DIE group.

Women with DIE were also more likely to report a family history of endometriosis; 13 percent did, compared with just under 5 percent of women with non-DIE endometriosis.

The study has a number of limitations, including the fact that it surveyed women at one time point and asked them to recall symptoms from adolescence. a study that followed young women over time to see whether symptoms predicted a later diagnosis of DIE would be more informative.

These findings now set the groundwork for such a long-term study, Chapron told Reuters Health in an email.

but the "crux of the issue," he noted, is whether diagnosing endometriosis earlier will eventually lead to fewer cases of DIE and less need for surgery.

"Today, there is no effective way to prevent the progression of endometriosis to its most severe stage, DIE," Chapron said.

And the current results, he noted, suggest that treating severe menstrual pain with birth control pills does not prevent progression to DIE, as a history of such treatment was linked to the condition. Chapron also pointed out, however, that this does not mean that birth control pills contributed to the development of DIE either.

Still, even though it is not clear whether progression to DIE can be prevented, an earlier diagnosis of endometriosis would at least allow girls and women to know the cause of their symptoms.

according to Chapron and his colleagues, girls and women with severe menstrual pain that does not respond to pain relievers like ibuprofen should see their doctors, and, if appropriate, be evaluated for endometriosis.

Besides painkillers and birth control pills, non-surgical treatments for endometriosis include several types of hormonal medications that inhibit the growth of the endometrial tissue.

SOURCE: link.reuters.com/xam46q Fertility and Sterility, online November 11, 2010.