Posts from — November 2009

It’s suspected that nearly 25% of all cases identified as attention deficit hyperactivity disorder (ADHD) are not really ADHD at all, but are symptoms related to sleep disorders.

One of the leaders in this research is University of Michigan professor Ronald Chervin.  Chervin theorizes that very important brain development is done during sleep. Among other things, this includes the ability to regulate emotion and processing. So, if a child has chronic sleep problems, brain development may be impaired. Chervin also suspects that the brain does not receive enough oxygen if the child snores which further inhibits development.  According to Chervin’s research, children who snore are more likely to have ADHD.

He likens the ADHD-sleep connection to a child who doesn’t get a nap; he becomes restless, irritable, and acts out.

Chervin developed his theory based on a sleep/behavior survey of the parents of 866 children.  Chervin’s data exposed a sleep disorder -behavior relationship.  It was only logical to conclude that if the sleep disorder could be corrected, the ADHD symptoms would be extinguished. 

According to Newsweek: “To test this theory, Chervin then studied 79 kids (5 to13 years old) who were about to have an adenotonsillectomy. Prior to the surgery, 22 of the 79 were categorized as having ADHD, based on standard measures for such a diagnosis. One year later,  Chervin’s team tracked down the kids for a follow-up. Of the 22 identified as having ADHD, 11 kids no longer qualified as having the disorder.”

Two problems lingered: 1) New cases of ADHD cropped up and 2) 50% of the surgical patients received no benefit at all.

Before you go and get your child’s tonsils and adenoids out, let’s discuss the distinct problems in the logic associated with this research.

First, we have a problem of antecedence; does ADHD exist because of sleep problems? or does the sleep problem exist because of  ADHD? That relationship cannot be clearly identified and is a confounding problem.

Secondly, new cases of ADHD appeared and others did not benefit at all from the surgery. This would lead one to think that the outcomes may not be related at all to the procedure.

I’m reminded of an old story about researchers who taught a frog to jump upon saying, “Jump!” Many weeks were spent training the frog.  The researchers were quite happy that they had proved the frog could hear and could respond to the human voice. One of the researchers  decided they should amputate the frogs hind legs. After carefully surgically removing the frog’s legs and rehabilitating the poor frog, the researchers stood in front of the frog and yelled, “Jump!” When the frog did not respond, they all heartily nodded in agreement that the frog’s hearing was severely impaired by the removal of his hind legs.

There is little doubt that sleep problems affect brain development. Past studies have demonstrated that preschoolers with a sleep disorder are twice as prone to substance abuse by early adolescence and more likely to suffer from anxiety in their 20s. Even the American Academy of Pediatrics concurs that sleep problems are not benign.

However, before we undertake invasive, painful surgery as an option, far more research should be performed to absolutely indicate a direct correlation. One currently does not exist and other options should be explored.

It has become obvious that adequate, restful, uninterrupted sleep is essential to our personal well being. Abnormal sleep patterns may result in behaviors that can be easily confused with ADHD.

If your child has a sleep problem, taking them to a sleep specialist may help. Getting adequate exercise, providing a consistent sleep routine/schedule, reducing stress,  and eating a proper diet may also assist in getting better sleep and better behavior. 

Articles published recently in two distinct journals, Developmental Neurobiology and Child Development, reveal links to ADHD and future sexual behavior.  The studies also reinforce the conventional wisdom that being reared by two  parents is better than being reared by only one parent. 

The German research team published in  Developmental Neurobiology studied Octodon degus, a rodent related to chinchillas and guinea pigs.  Degus were selected because they, like humans, are biparental creatures, meaning that both parents take part in raising their young. 

It’s been known from many other studies that prenatal and neonatal development are dependent upon a complex interplay between nature (genetic endowment) and nurture (environment).  For example, orphaned children from the former Soviet Union who received very little touch and too little stimulation were frequently developmentally impaired.

The German researchers’ intent was to see if the brains of degus reared without a father differed significantly from degus reared with two parents.

One set of degus was reared biparentally. The  other set was reared by the mother alone, the father having been removed the day after the pups’ births.  The pups’ mothers demonstrated similar sleeping patterns, grooming, and licking processes in both time and intensity. However, the pups reared by mother alone did not receive the extra nurturing time  given to pups who had a father present as well.

The researchers compared the neuronal development of both sets of pups at 21 days of age. They also carefully observed the behaviors between pups reared by mother alone, and those reared by both parents.

Not surprisingly, fatherless pups exhibited significantly different neuronal growth patterns in parts of the brain that control decision making, reward, and control (amygdala and the orbitofrontal cortex). Why is this important to humans? Because human brains are wired very similarly to the degus in this region – the cells serve identical functions.

As one author of this study, Dr.  Braun says,  "So on that level we can assume that what happens in the animal’s brain when it’s raised in an impoverished environment … should be very similar to what happens in our children’s brain." 

While some differences minimized over time, long-term differences endured.

Dr. Braun noted that a preliminary analysis of the degus’ behavior demonstrated that fatherless animals seemed to have a lack of impulse control. The fatherless pups  also engaged in more play-fighting or aggressive behavior when they played with siblings .  These are also hallmarks of ADHD.

The research correlates with a report by the Organization for Economic Co-operation and Development (OECD) published in September of 2009. The report cites that only 57% of US children live with both parents.  The remaining 43% that live with one parent have an increased risk of delinquency, ADHD, and poorer scholastic performance according to the report.

Researcher Dr. Jane Mendle, whose study was published in the journal Child Development, reinforces this nature/nurture aspect of brain development.

Prior research revealed that children reared in homes without a biological father have sex earlier than children raised in traditional biparental families. Mendle thinks the relationship is not just environmental, but due to the complex interplay between genetic endowment (nature) and fatherlessness (nurture/environment).

Mendle says, "While there’s clearly no such thing as a ‘father absence gene,’ there are genetic contributions to traits in both moms and dads that increase the likelihood of earlier sexual behavior in their children. These include impulsivity, substance use and abuse, argumentativeness, and sensation seeking.

"These traits get passed down from parents to children, resulting in a situation known as ‘passive gene-environment correlation,’ because the same genetic factors that influence when children first have intercourse also affect the likelihood of their growing up in a home without a dad."

Therefore, we are still not able to positively determine  whether single parenthood causes these outcomes. There remains a possibility that it is merely in some way associated with ADHD, risk of delinquency, early sexual experimentation, etc. It is likely that the probability of pure association will greatly increase as we discover more about early interaction between parents and their children.

If you are a single parent, all is not lost. The writer is the product of a single parent household; well balanced and successful. So whether a father is present or not, parents, grandparents, teachers, friends, counselors, etc. need to provide a child with positive interaction through talk, kind touch, and behavioral modeling. It is likely to be shown in further research that such interaction may even mend brain changes caused by fatherlessness.  We are not just the product of our genes. The brain rewires itself  not only due to genetic endowment, but it’s shaped by environment as well.

As Dr. Braun says, parents "are the sculptors of their children’s brains."

I would add that it’s not just parents. It’s everyone in the child’s environment. It does take a whole village to raise a child.