Momma Data: Debunking Children's Health News

The Benefits of Good Teaching: Fact-Checking the President's State of the Union Address

2012-01-25T18:37:00.000-08:00

So President Obama referenced that new teacher study in recent news in his State of the Union address last night. The education study with 2.5 million school kids tracked over 20 years, the very one I posted on a few weeks ago so it was very fresh in my mind. Yours too? The Prez spoke about education, including higher education, for several more minutes including his recommendation kids should have to stay in school until age 18 instead of 16. Bravo, Barry.

My favorite part wasn't the speech itself or even the ridiculous elected officials in the audience pouting like spoiled preschoolers but the commentary afterwards. Really, the fact-checking. In that spirit, let's see what Barry said about those teachers and children:

At a time when other countries are doubling down on education, tight budgets have forced States to lay off thousands of teachers. We know a good teacher can increase the lifetime income of a classroom by over $250,000. A great teacher can offer an escape from poverty to the child who dreams beyond his circumstance. Every person in this chamber can point to a teacher who changed the trajectory of their lives. Most teachers work tirelessly, with modest pay, sometimes digging into their own pocket for school supplies – just to make a difference. The State of the Union Address, January 24, 2012 from the Guardian transcript

The part about a good teacher boosting the lifetime class earnings by over 250,000 bucks?

Kinda sorta right.

Replacing a bad teacher with an average teacher boosted the lifetime earnings of a single class by $266,000.

But let's break that down. It's the total income earned by all the students over their adult lives. So it breaks down to $4,600 over a lifetime per student . Sounds impressive en masse but per capita it's not so exciting. That's not even $5,000 stretched over a lifetime of working, maybe 40 years per person. So a whopping difference of $115 per year (based on 40 years income). Of course with each better teacher there's likely an appreciable increase. So let's say we throw out the bad teachers from K-12. That's 12 x $115 = $1380 more each year.

Here's where Barack starts to stand on slightly shaky ground. Merit pay. The benefits of merit pay. Obviously Barry didn't read the study's fine print. Here's what he said last night:

"Give them the resources to keep good teachers on the job, and reward the best ones."

The economists running the study weren't exactly jumping up and down for merit pay. Why not? As I wrote before, it's because giving good teachers more money doesn't necessarily make them more productive (i.e. lead to better test results).

The researcers report that rewarding highly effective teachers may not be the best or most cost-effective plan. I know, sit down, those of you cheering for merit pay. In part this seemingly contrary conclusion comes becauses in their model it appears cheaper to replace the worst teachers and because the best teachers might not be motivated by more pay. They do what they do because they care, those sappy, sappy people.

Should teachers be paid more? Absolutely. Does this recommendation sound good in a speech. Absolutely. Does it lead to happy classrooms, perhaps. Does it lead to better earning outcomes for students? Not according to these authors or their calculations.

We all like kids and value education, right?

Funny how no one questioned what the Prez said about education. Oh we have major media (e.g., Washington Post, USA Today, NPR, Fox) doing fact-checking. We have FactCheck.org checking. We even have HuffPo fact-checking Politifact, the fact-checkers. Yes, a fact-checking kerfuffle. Obviously we have plenty of media who've had time to dissect Barry's statements last evening on a variety of topics:

the auto industry

the employment rate

health care

the housing market/mortgages

Iran's nuclear weapons

military success in Afghanistan/The Taliban

the tax code

the energy industry (oil, gas)

relations with Israel

No one, however, has bothered asking about the kids and the teachers. So it appears people with a national podium can say whatever they want about children and education without facing any further scrutiny in the media.

Is it because we all agree on teacher pay, merit pay, student testing and all other educational reform?

Is it because we think the educational system is just fine?

Is it because although we can argue about so many other issues we simply don't have the time or patience to bother with educational policy?

Is it because we trust everything we hear about education and teaching?

Is it because voters don't vote based on educational policy?

I simply don't understand why we have so much media checking up on so many claims but not the ones involving kids. I'm not surprised though. The whole autism-vaccine debacle could have been avoided if the media paid any attention to accuracy and context.

Sure, these presidential political addresses are vetted to the nth degree for accuracy. As the Washington Post article reminded us "context (or the perspective of opponents) is often missing." Oh, yes, context. The difference between $250,000 dollars and $115.00 a year in your son's or daughter's bank account.

Frankly regardless whether Barack's educational statements were true, they should have received the same high-level scrutiny as the rest of the lot.

I have nothing against Barry or his educational policies. I just want some equity in the media. Equitable serious scrutiny.

Best Parenting Books of 2011: Not What You Expect or What to Expect

2012-01-18T08:48:00.000-08:00

What are the best parenting books of 2011?

If you're looking to potty train your toddler or get your tween to clean her room, I'm sure there's a popular how-to somewhere but I can't name it. I don't know whether the Tiger mom's hyper vigilance will make your kids crave birthday parties and tv. Never read her whole Battle Hymn. In fact I'm no parenting expert but I know some books for those who like parenting news and advice backed by evidence of the more scientific kind...assuming anyone still has time and patience for reading books (see first selection).

1. The Shallows: What the Internet is Doing to Our Brains
Nicholas Carr (Finalist, Pulitzer Prize)

Is the Internet making us stupid? Maybe. Mr. Carr suspects the new social media and its short quick bursts of nearly limitless information makes concentration and thus sustained critical inquiry nearly obsolete.  Like the kind necessary to write this book, in fact to finish writing this book the author had to move to a remote Colorado town without cell or wireless Internet service.

Each new media has changed us, our culture and our neural pathways according to Carr. Is he claiming a revamping of the genome? Not exactly. Nor am I dusting off the bottle of Omega-3s in the back of my cabinet because as we've become aware in recent decades the brain is a surprisingly plastic entity. A variety of other lifestyle/behavioral changes have been found to alter brain function and physiology - like learning to play the piano, becoming a cab driver, giving birth.

This is a mercifully quick read. It's not as science-heavy as the rest but hey, if what the author says is even partly true you'll need a respite after the other selections.

This book also wins Best Blurb: Silent Spring for the Literary Mind (Slate)

2. Thinking, Fast and Slow
Daniel Kahneman, Professor Emeritus at Princeton and Recipient of the 2009 Pulitzer Prize in Economics.

Psychologist Daniel Kahneman is a legend and he's not even dead yet. His seminal research boils down to the simple fact people make bad decisions.  We're lousy decision-makers saddled with biases, desires and perceptual flaws that perpetuate poor judgements from stereotyping, losing money on the stock market to figuring out what to eat and whom to marry.  Malcolm Gladwell owes this guy big time. Mr. Carr, look, we've always been stupid.

Humans, however, don't always use this highly emotional, error-prone "fast" thinking. Sometime we make highly rational decisions and not just out of sheer dumb luck (hence the "slow" in the title).   Love this man, Kahneman, who wishes people would become more aware of how they judge themselves, others and the world. If only more people would have used these powers to circumvent the vaccine-autism scare.

3. The Panic Virus
Seth Mnookin

Beware: Not for those who still cling to the roundly discredited theory vaccines cause autism.

Here's the definitive account of the infamous vaccines-cause-autism debacle from the history of vaccines, the roots of the recent drama in England, the fraudulent British researcher Andrew Wakefield, the 24/7 news cycle, the miasma of misinformation on the Internet, the dearth of journalists and health experts challenging the misinformation, a certain former Playboy Bunny who went to "University of Google" to yes, the consequences such as the thousands of unvaccinated children and the rise of once-vanished childhood diseases. Oh it's all here if you can stomach revisiting this hot mess.

If only this were the last word on the topic.

4. Willpower: Rediscovering the Greatest Human Strength
Roy Baumeister and John Tierney.

Throw out the parenting manuals. Read this book and take notes. Want your children to find full-time work one day, move out of the house and hopefully find some contentment? Willpower.  Get it, model it, instill it.  That's my only real advice here. Baumeister, a Psychology-Icon-in-the-Making who told us about self-esteem back in the day, teamed up with John Tierney, a New York Times science writer. The result? An engaging story backed by plenty of studies on a topic that might actually make a difference in your life.

Seems willpower, like seating at the school holiday concert, is a limited resource.  It doesn't discriminate physical from mental exertion. All effortful tasks deplete it from deciding which preschool is best to finding the pencil sharpener.  Newer research links this valuable resource to levels of glucose. So if you want to choose the right preschool, wait until after lunch. Lots of practical advice. Immensely readable.  Famous people get their own chapter titles - Did a Higher Power Help Eric Clapton and Mary Karr Stop Drinking?

It remains unlikely self-control is the end all of successful parenting.  In our climate of instant gratification, though it wouldn't hurt to stock up. It's not like we can download patience. As far as I know there's still no app that can make anyone put down that last piece of cake or use a condom.

5. The Body Politic: The Battle Over Science in America
Jonathan D. Moreno

Readers will need every ounce of self-control to finish this book with a decidely scholarly bent.

Anyhow, who doesn't get excited about biopolitics?

That would be the complicated politics surrounding science.  In other words, the powder keg of ideologies, values, philosophies, personal ideals, etc. fueling current debates over stem cells, abortion, cloning, genetic testing, genetically modified food, synthetic biology.

Moreno takes us on a historical/cultural tour of science in politics, reminding us along the way that America's founding fathers admired if not outright practiced science. Thomas Jefferson and Ben Franklin tinkered around with cause and effect. John Adams, Alexander Hamilton, Aaron Burr and Thomas Paine, these men were fascinated by the natural world around them, observed it, wrote about it. How quaint.

The familiar Republican-Democrat dichotomy doesn't hold up in the new biopolitical arena. Here we got the "bioprogressives" and "bioconservatives", the latter the seemingly impossible political intersection of the neoconservatives and liberal environmentalists, a discordant duo that's also matching up on breastfeeding these days.

Speaking of the breast, there was another good read published in January 2011. I included it in last year's best of list just because I'd just read it. Is Breast Best? by Joan Wolfe. Sadly this highly detailed, scholarly work didn't land a large audience.  An outcome that would not surprise the authors of all the books above. In other words, thinkers who have pointed out a critical lack of critical thinking in today's media climate.

Good Teachers, Long-Term Effects and Test Scores: Don't Call the Principal Yet

2012-01-09T18:27:00.000-08:00

Not enough Milk Duds or popcorn in the world to watch this one.

Good teachers make a difference.

There's now more proof of the benefits according to a new study of 2.5 million elementary and middle school students tracked over 20 years.  Economists at Harvard and Columbia found evidence that having an effective teacher, a single good teacher, in grades 4 to 8 can impact college matriculation, lifetime earnings and also teen pregnancy. Pretty impressive.

So what is good teaching anyhow?  Good test scores. Period.

At least in this study conducted on behalf of the National Bureau of Economic Research. In economic parlance, good teachers are "value-added" - meaning, they raise student test scores.  Here's the formal definition given by the researchers in the paper:

A teacher's "value-added" is defined as the average test-score gain for his or her students, adjusted for differences across classrooms in student characteristics (such as their previous scores).

In other words it's a term you may be well-advised to forget before the next parent-teacher conference.

First the economists figured out if differences in test scores gains across teachers could actually be attributed to the teachers and not something hinky about the students like the selection of certain students into classrooms. You know, the-Mrs.-Favorite-Teacher-gets-the-best-students theory. Despite popular opinion about certain teachers getting certain students (mouth shut, sitting on hands) the researchers report that yes, teachers who show test score gains - as determined by their stupefyingly complex mathematical model - can claim bragging rights if not higher pay checks.*

Now all these fresh results are very encouraging if your child should be lucky enough to have a value-added educational experience. Just how lucky? Don't start imagining Harvard just yet. Turns out the effect of any one teacher remains rather slight**.

All else equal, a student with one excellent teacher for one year between fourth and eighth grade would gain $4,600 in lifetime income, compared to a student of similar demographics who has an average teacher. The student with the excellent teacher would also be 0.5 percent more likely to attend college. Big Study Links Good Teachers to Lasting Gain, New York Times, January 2, 2012

$4,600 dollars, not exactly the jackpot.  Obviously this sample didn't oversample social science grad students otherwise that number might plummet to single digits given my own rough-hewn formula: better teachers = more education = more doctorates = less pay.

Surely over time the effects likely accumulate so the value of multiple effective teachers would be more impressive. Those aggregate effects also matter to school principals, school boards and policy makers, you know, the folks making decisions based on those test scores or rather, teacher ratings based on those test scores.

Cue applause, jeers, sighs, etc. as necessary.

Yes the researchers considered a variety of factors that might influence student test scores and the other outcomes.  The results held even after controlling for previous test scores and a range of parental characteristics (income, maternal age at birth, marital status, 401K contributions - hey, love economists - especially if they admit stealing well-established concepts from psychology like motivation and revenge).

This crew has controlled for quite a bit but I still question how anyone could consider all the factors between middle school and college not to mention twenty years of 9 to 5.  If good teaching propels a student to take a harder math course, let's say, that then leads to a stronger interest in math, an invitation to the math club then a math major then an accounting job then a graduate degree and a higher salary then we can say the teacher's effect so many years in the past had some effect but it surely wasn't the only factor along the way.

Did your 5th grade teacher really make you $4,600 richer?  It's terribly hard to separate the effects of the math major from the math club from the middle school math department.  The team here has tried and figured leaps and falls from year to year into the equations but still. They report the "effects", ahem, "fade" to about a third after three years and then remain constant.

It's those tricky intervening variables that are so hard to pin point and assess then figure into the model. The statistical analyses are mind-numbing and I'm not sure to what extent the present research captured them. It's a 90+ page working draft that's yet to be down-sized into a peer-reviewed published paper - note that lack of peer-review did not prevent media coverage.  Read through a lot and I can tell you that it's nearly impossible to get at those in a study of this magnitude. Maybe we'll soon read it in a journal.

I suppose it's reassuring to have evidence quality teaching matters in the long-term that is if you agree that's what the test scores measure. We would probably all agree teachers matter and here's some proof albeit of a mostly financial nature.  It would have been cool to see links to a wider range of outcome variables like maybe SATs or critically thinking skills but that's another study not easily assessed by tax records like the researchers used.

Now I'm off to buy paper products for 3rd Grade Teacher Appreciation Day. I am not kidding. Check your own calendar.

*Because the researchers are economists and thus must like to calculate cost-savings and other practical phenomenon - instead of say prejudice or empathy, ho hum - they report that rewarding highly effective teachers may not be the best or most cost-effective plan. I know, sit down, those of you cheering for merit pay. In part this seemingly contrary conclusion comes becauses in their model it appears cheaper to replace the worst teachers and because the best teachers might not be motivated by more pay. They do what they do because they care, those sappy, sappy people. Hello, Mom, Dad, Aunt Jackie, Aunt Barbara, Aunt Peggy..Grandma...Grandpa..Uncle Mike...

**Note to parents of students with sub-par teachers: Rest assured, in this study the reverse is also true.  Crappy teachers also seem to have only modest long-term "effects".

THE LONG-TERM IMPACTS OF TEACHERS: TEACHER VALUE-ADDED AND STUDENT OUTCOMES IN ADULTHOOD
Raj Chetty, John N. Friedman, Jonah E. Rockoff, Working Paper 17699
http://www.nber.org/papers/w17699

© 2011 by Raj Chetty, John N. Friedman, and Jonah E. Rockoff

The Top Parenting Findings of 2011: Interesting and Timely But Tops?

2012-01-04T09:02:00.000-08:00

Top 2012 Parenting News: Sex During Pregnancy Deemed Safe
Photo from Getty Images via Time.com

What scientific studies offered the most valuable insights into children and parenting over the past year?

Who knows!

But here's Time magazine's Top New Parenting Findings from their Top Ten Everything of 2011 (54 lists, be forewarned of  the time-sucking Time trap):

1. Striving to be SuperMom (i.e. seeking perfection at work and home)  makes women depressed.

2.  Facebook ruins a kid's GPA.

3. Breast-feeding helps mothers "bond" with babies
    (i.e. one region of their brains shows more activity in response to child's cries).

4. Dads doing daily child care (bathing, feeding, etc) spat more with baby mamas.

5. Pregnancy sex isn't going to harm anyone
    (except those in high-risk pregnancies and the adult porn industry).

6. Parenthood makes women fat (except if you live in LA).

7. A healthy pregnancy diet prevents birth defects.

8. Small babies are at higher risk of autism.

9. Being born before 39 weeks puts babies' lives at risk.

10. Fatherhood lowers a guy's testosterone
     (and increases their tolerance of baby talk and breast pumps).

Excuse my rather brief descriptions and confusion of causation and correlation. Please note in fact all the studies are correlational in nature bearing the usual caveats and confouding factors.

Now if I were to ask a wide swath of pediatricians, psychologists, neurologists, geneticists and other child health experts most likely we'd end up with a slew of different studies spanning and intersecting numerous disciplines. Most of the research would be so terribly dry and specialized it would bore us to tears even if it miraculously landed on the cover of US Weekly right beneath Jessica Biel's engagement bling.

Now that collection of signficant scientific evidence would be compelling.  There's a chance it might even still be viewed as such five, ten even twenty years from now.  Sure, the above list is interesting, timely and well-written but it's the opinion of one journalist, Bonnie Rochman* who was the parenting blogger for The News and Observer in Raleigh, NC and though I appreciate her clear and balanced reports of new studies not to mention funky eyewear, doesn't appear to be working in the trenches of child research nor have a background in science or a related field.

Not that a journalist must have a Ph.D. or M.D.,  but I'd love to have an insider's take on the most compelling studies, moreover, a variety of insider's opinions.  It's a perspective often absent in any meaningful way from the parenting media - by meaningful I don't mean comments by the expert who's just written a book or co-authored the featured study.

True, it's reassuring to read that being Super Mom comes at a high cost (who rushes home from the salt mines to bake cookies from scratch anyhow?).  Or to learn your spouse's testosterone levels will be blessedly low in the first months of new baby.  Or that it's okay to have sexy times during pregnancy. Or, sit down for this one, prego moms with health lifestyles (i.e. eat whole grains) have healthier babies.

Hardly earth-shattering news, especially to professionals.

Even the link between autism and birth weight isn't probably that surprising or valuable to the experts. It's not new news in therapist circles and school car lines but it's good to have the evidence in the literature I suppose, just another study filling in the epidemiological holes.

I do wonder how many autism experts would consider it the most critical autism finding of 2011.  Dear readers, anyone see any "best of autism research" lists out there?  Probably not but those of you who keep up on the lit can probably name a few, eh? The 39 weeks may be one of the more valuable pieces of evidence as it has the potential to impact decisions and behavior in labor and delivery.

If I were cynical I'd say the 39 weeks optimal delivery and the autism findings are the only valuable findings in terms of furthering scientific progress and ultimately, bettering the health and lives of children. The rest more fodder for dinner conversations and parenting sites keen on new content.

What does everyone think?

Anyhow,  happy new year.  My resolution? Being grateful for good parenting media. Cheers.

*I intitially confused Bonnie Rochman, the journalist above with Bonnie Rachman, M.D., an Associate Professor of Pediatrics at UCLA.  Orginally thought the list was compiled by Dr. Rachman. Oh well.

Gender Neutral Toys: Taming the Playroom One Pink Lego at a Time?

2011-12-30T12:02:00.000-08:00

Lego's new girl-friendly Friends series. From Lego site.

Taking a break from stripping my playroom of the pink and blue plastic paraphernalia otherwise known as toys. It's a never-ending task that comes easily to my mother who also happens to be in town for the holidays, thank you, mom. So just read an op-ed by Peggy Orenstein who's asking a now familiar question - Does Stripping Toys of Gender Really Make Sense? The Cinderella Ate My Daughter author wonders in today's New York Times whether Lego's new Friends collection set in the make-believe mecca "Heartlake City" amidst plenty of pastel bricks does more harm than good for young girls:

So who has it right? Should gender be systematically expunged from playthings? Or is Lego merely being realistic, earnestly meeting girls halfway in an attempt to stoke their interest in engineering? Should the World of Toys be Gender-Free? New York Times, January 30.

Orenstein's done her homework.  Toy preference is one of the most robust (i.e. most studied) sex differences on record both among preschoolers and primates. Little boy monkeys prefer the cars, girl monkeys, dolls. Pretty amazing evidence of genetic programming but it's also true that the environment impacts preferences too.  So living in a princessified pink play land might steer girls away from those typically masculine skills like spatial abilities.  On a good note, there's some evidence girls who grow up with big brothers do in fact have slightly more spatial abilities than boys and girls who have older sisters.

But before you go adopting an older brother, there's also research showing boys who grow up with older sisters are more egalitarian-minded, make better boyfriends and husbands. You know, if marriage and monogamy aren't too gender stereotyped for you.

Dressing up in all the stereotypical, gender-roled Disney finery might have some positive effects too - witness research from a few years ago showing youngsters who really groove onto gender stereotypes early in life become less stereotypic older children. All the early training somehow enabled them to shrug off the mantle of societal expectations. I'd look it up but I'm on vacation and the house is in peri-holiday shambles.

As in other areas of human behavior, oh what the heck, and the physical universe, there are always trade-offs.  Butterfly wings and all. Or as my son would prefer, wasp wings.

But I'm not worried a bit about toys.

It's not as if we don't have any tools to dismantle gender stereotypes and perhaps more important, influence behavior.   It's not like parents are forced to pick a gender path and stick to it.

As a social psychologist by training - with a very dry dissertation on cognitive processes involved in social judgments such as gender perception to show for it - I'd be remiss not to worry about the heavy-handed cultural imperatives of masculinity and femininity operating on my easily influenced progeny.

Of course I also thought I'd have one of those really bookish boys who winces at balls and shuns overt displays of masculine aggression.  Girls who hated pink and couldn't wait to join Chess club and play trombone.

Now those gender fantasies haven't exactly happened but all my kids play with a jumble of multi-colored Legos including the motorized car accessories, the house kits with flowers and kitchens, the pink, the blue and everything in between.  I never liked pink or pastels myself so I tended towards the bright primaries in the toy aisles. Not so my girls, especially my middle child who wore out a couple pairs of pink cowboy boots that made her feel like a princess.

A few years later she and her sister wouldn't even think of wearing so much as a speck of fuchsia on the sole of their shoes.  The former is now a talented soccer player who plays football at recess, favors non-fiction and eschews Judy Moody and all other annoying girl heroines; the latter, a tween who shuns girly anything, wears navy and black while excelling at math and science.   My son, who's only in kindergarten, is half-professional athlete in training and half-bashful momma's boy who likes to help me cook and told Santa it was okay if he couldn't bring him a Chrensfrmr (i.e. Transformer).

Don't think the Barbies (oh we got a few, mostly headless by now), the play strollers, the castles, the cars, the train set, the dinosaur puzzles, or color of Legos much mattered. Really, I bet the toys have been merely a scapegoat, a symbol of our own parental expectations.

So I'm blaming you and me and every other adult and oh teachers too, the educators don't get a free pass here.  I'm calling us all out on this notion that clothing and toys really make such an enormous difference on their own. They're probably merely a confounding factor with the underlying, latent variable being us and our own overt and covert behavior.

The roiling cauldron of gender stereotypes is much more insidious than a mere prettified set of Legos. It's the subtle messages and interactions that make a girl gifted at math say she's not good at math - my own daughter, circa 3rd grade. I'm still trying to figure that one out. From early on I've modeled it, lived it, spooned the ooze into the beaker from the kiddie science kit, spoken out against it, ranted against the stereotype that boys are inherently better at math and science - even told my kids that in more progressive countries (e.g., Denmark) there are no gender differences in math and science - and still the pernicious idea took hold of my daughter's confidence. She's better now, thanks, but I'm not. Been stewing about it and wondering how to better spark that confidence and curiosity.

Okay, back to the playroom I go....merry, merry, happy whatever, best wishes for the New Year.

Emergency Contraception Vetoed Based on Pigs Flying: Plan B Banned for Girls under 17

2011-12-12T09:16:00.000-08:00

Last week Health and Human Services Secretary Kathleen Sebelius overrode the FDA's plan to allow the emergency contraceptive pill (aka the morning-after-pill, Plan B) to be sold over the counter to girls younger than 17 years old. Why? In a statement the head health honcho (who is neither doctor or health expert) voiced concern the the pill might harm 11-year old girls who take it.

FYI, it's been available for those 17 and older since 2009.

At first glance, the HHS Secretary's argument seems reasonable.  Yet on closer inspection it reeks of politics trumping the facts, in this case, the evidence.

The drug has been extensively tested in adolescent girls younger than 16 and deemed to be both safe and effective according to the FDA.  These studies haven't been made public yet but reportedly assessed both safety and proper use (i.e. do girls understand and follow the directions?). Apparently the studies didn't include 11 year-olds, an omission that troubled Ms. Sebelius who worried about the 10% of 11 year-olds who are physically capable of "bearing children."

Okay, this isn't Sunday school, Kath, you can say pregnancy. I wonder if that 10% refers to getting pregnant or having a live birth - not exactly the same phenomenon. Anywhoooo, Ms. Sebelius also worried about their "cognitive" and "behavioral" limitations but didn't elaborate.  So I will....

Perhaps not being able to follow the directions.

Alas, it's a single pill. One pill.  Not a course of ten that must be taken on the lunar eclipse.  Sure, a young girl might not be able to swallow it. That's a behavioral consideration. My 11-year old has never swallowed a pill but then again she hasn't faced the prospect of becoming a tween mom.

Eleven year-olds having sex, unprotected sex?

Thankfully a pretty rare occurrence according to Lawrence Finer, Director of Domestic Research at the Guttmacher Institute in a recent letter to the New York Times:

Less than 1 percent of 11-year-old girls are sexually active. On the other hand, almost half of girls have had sex by their 17th birthday, before they are legally able to gain access to the emergency contraceptive over the counter.

Come to think of it eleven year-olds can buy other potentially dangerous drugs over the counter (e.g., acetaminophen) but not one that might prevent them from any number of known adverse health consequences of t(w)een pregnancy and I'm not just talking about the instant celebrity from being cast in MTV's Teen Mom.

But before you start to freak, some experts don't think it much matters whether the morning-after pill is available. Studies routinely show women rarely seek out emergency contraceptives:

Women often miscalculate their menstrual cycle, or do not understand the risks of unprotected sex. As of now, half of all pregnancies are unplanned, more than 40 percent of children are born to unwed mothers, and 1.2 million abortions are performed every year involving one in every 50 women of reproductive age. Plan to Widen Availability of Morning-After Pill Is Rejected, New York Times, December 7.

So if older women don't seek it out, it's nearly impossible to imagine an 11-year old seeking out the pill on her own. How many 11 year-olds know about emergency contraception? I didn't realize it was even available for girls under 18. Had no idea until recently. How many 11 year-olds would know about it? Of course taking the pill entails suspecting you might be pregnant too.

Basically the Obama administration's top health wonk has made a decision based on a seemingly improbable possibility:

An 11 year-old has unprotected sex, suspects she might have gotten pregnant, worries about it, knows about emergency contraceptive, knows she can get the pill over-the-counter, actually gets to a pharmacy, takes the pill and then suffers some harm from the single dose of hormone (e.g., chokes, has allergic reaction, panic attack?).

It's anyone's guess how often an 11 year-old who's had unprotected sex even suspects she might be pregnant. There is probably little if any research addressing the chance an 11-year old would even worry about being pregnant.

Then it's possible some might take the pill who haven't even gotten their periods. We can worry about that incredibly rare event too.

Then there's the even rarer scenario that a tween who hasn't even had sex would take the pill...

By the way the American Academy of Pediatrics also recommended the pill be available to girls under 17.

And New York Mayor Michael Bloomberg. Yeah, a Republican supporting emergency contraceptives. Speaking of which the Wall Street Journal couldn't help but report the liberals were angry too:

Left-leaning women's health advocates seized on the ruling to accuse the Obama administration of allowing politics to interfere with a decision the FDA typically makes based on scientific evidence. Obama Health Chief Blocks FDA on 'Morning After' Pill, WSJ, December 9

Oh it's all about the science. Just the science...

Taming the Tantrum: One Hi-Fi Onesie at a Time

2011-12-07T06:49:00.000-08:00

New research has uncovered the secret to stopping children's temper tantrums.

This advice arrives just in time for those pre-holiday throw-downs in the toy aisle. Take heed, this knowledge might just make the wait in the line for Santa more bearable. Researcher Michael Poteg of the University of Minnesota doesn't merely possess the secret, he's got the whole tantrum thing covered or uncovered as he reported in an NPR interview:

We have the most quantitative theory of tantrums that has ever been developed in the history of humankind. NPR, What's Behind A Temper Tantrum? Scientists Deconstruct The Screams.

He uttered "half in jest" according to NPR. Humor probably helped convince parents to suit up their children in wired onsies so Poteg and friends could track the anatomy of bad behavior and ultimately publish what might become the codex of temper tantrums.

Here's what this ground-breaking scientific inquiry revealed:

Results indicated that perceptually categorized screaming, yelling, crying, whining, and fussing each have distinct acoustic features. Screaming and yelling form a group with similar acoustic features while crying, whining, and fussing form a second acoustically related group. Within these groups, screaming may reflect a higher intensity of anger than yelling while fussing, whining, and crying may reflect an increasing intensity of sadness. Abstract from Psych Info

In other words:

Yelling, Screaming, Kicking =   Pissed
Fussing,Whining, Crying       =   Sad

Just what like your mother and grandmother told you.  Wait out of the anger (see above). No sarcastic comments.  No pleas for rational behavior. No questions. Do you want to ever watch SpongeBob again? Do you really want to miss the Smurfs? Do you think all these people appreciate you disrupting their dinner? After the anger (see above) subsides, try comforting to combat the sads (see above).

I guess the news coverage gets parents thinking about how and when to stem the bad behavior, not so awful. But honestly, just how much does a hi-fi onesie go for?

Reference: Screaming, yelling, whining, and crying: Categorical and intensity differences in vocal expressions of anger and sadness in children's tantrums. Green, James A.; Whitney, Pamela G.; Potegal, Michael. Emotion, Vol 11(5), Oct 2011, 1124-1133. doi: 10.1037/a0024173

Babies Prefer Kind Behavior, Want Mean Behavior Punished: When Ph.Ds Play Puppeteer

2011-11-30T10:32:00.000-08:00

Thanks, Prof Hamlin, University of British Columbia.

Babies prefer kind people?

According to researcher Kiley Hamlin at the University of British Columbia babies pretty much dig people who help others.  They also want those who misbehave to get their just desserts. Wow, sounds pretty incredible... Hamlin reports "by eight months, babies have developed nuanced views of reciprocity and can conduct these complex social evaluations much earlier than previously thought". (Science Daily, Babies Embrace Punishment Earlier Than Previously Thought, Study Suggests).

Translation: Babies grab kind puppets more than mean ones.

After watching animal puppets behaving like good citizens or bullies (i.e. taking away toys), the 8-month olds picked up the sweet one. You know, the prosocial stuffed wildlife (i.e. moose, duck or elephant). The one that helped the other nice puppet. Goodness knows why we're not reading about findings from trials with Muppets or at least human mommy puppets.  Maybe those scared the bejesus out of the youngsters. Or there were no differences between the good mommy and bad mommy puppets.

Watch the video of the furry creatures if you have nothing better to do. The production values make the infamous Baby Mozart look flawless. Of course it also makes me wonder why the heck I ever left the university research lab where I could have re-purposed all the stuffed animals over the years.

So folks, in brief all we know here is the wee ones grabbed the do-gooder forest denizen. If that sounds like evidence of man's evolutionary preference for "antisocial behavior" to be "regulated" tonight I will be patient when my justice-seeking kindergartner tattles on his older sisters. I mean, who am I to argue with hundreds of thousands of years of subtle genetic tweaks.

What kind of dad was Charles Darwin anyhow?

Read it: J. K. Hamlin, K. Wynn, P. Bloom, N. Mahajan. How infants and toddlers react to antisocial others. Proceedings of the National Academy of Sciences, 2011; DOI: 10.1073/pnas.1110306108

Thanks for Writing: Shining a Light on a Brave Blog

2011-11-22T18:23:00.000-08:00

This week as I run the grocery store gauntlet, toss out two, possibly three months of mail on my dining table and try to find the snow boots and mittens, I hope to remember to actually give thanks. Really give thanks. My daughter has gotten into the habit of uttering thanks for "everything good and none of the bad."  A lazy response but not unlike the standard family-friends-food refrain.

It's hard to be specific sometimes. So I'd like to take this moment and be very specific.

I'm thankful for Julie's mum who writes about her "bubbly" teenage daughter who "likes x-factor and Coldplay...oh, and who happens to have a very serious mental illness."  Her posts, often heart-wrenching, have a remarkable grace that quietly reassures me and makes me glad Julie has her mum in her corner.

Barely a day goes by without someone (i.e. my mom, the kid screaming in the dentist office, my own kids bickering) reminding me how grueling this parenting gig can be.  But there's difficult and then there's truly difficult.  Take JM's most recent post: We Have To Talk about Self-Harm. And here I was worrying about finding the perfect apple dumpling recipe.

Of course it's also easy to forget that major depression, psychosis, even suicidal behavior, they don't just pop up in Lifetime movies or Psych 101.  Serious psychiatric disorders happen to real people even kids.

But Julie's mum puts it so much better:

Before my daughter became ill, about a year and a half ago, I probably would have said that her sort of disturbance only happened in families that had something wrong with them. There's no smoke without fire: how can a daughter find it so difficult to come home and live with her own family if there's nothing funny going on? I suspect there are plenty of people who think like that, and some of them may actually work in mental health. But we have no skeletons in the cupboard: we really are a normal family, with two parents, and two half-grown children. There's no one drinking in a corner, no one with a drug habit, no child abuse, no violence. The most traumatic thing that happened to my daughter in her first 5 years was when they told her about the 9/11 bombings at school assembly. About the worst thing we've done to our kids is let them watch a bit too much TV and refuse to keep a dog. Nope, Not a Recovery Yet

Thanks, Julie's mum, for shining a light. I'm glad to find you and hope other parents find their way to you too.

P.S. Julie's mum told me she hasn't been able to find many if any blogs written by parents of children/teens with serious mental illnesses. There seems to be a large community of parents writing about autism but what about other illnesses? If you're familiar with blogs featuring families coping with depression, anxiety, or disorders other than autism or sensory disorders I'd love to pass them along.

I'd be very thankful.

Disney Buys Babble Media: Babble Getting the Full Princess Makeover?

2011-11-15T08:47:00.000-08:00

Babble: The happiest and dorkiest place on earth.

Just read Disney bought Babble for some 40 million bucks. Apparently the hip parenting website is now The Happiest Place on Earth. It's only a matter of time before it gets the full princess makeover, a cruise ship and tween stars with coke habits. Let's quick Occupy Babble before it morphs into yet another insipid social media opportunity for advertisers and mommy bloggers looking to get married. Cue Cinderelly Cinderelly. Oh yeah, the slipper fits, the coach has arrived.

We already have a glimpse into this new social media-arranged marriage:

For example, if a blogger writes a Thanksgiving-related post about how to prepare an organic turkey, Babble's editors could include links to Disney's content about, say, festive table settings, said Brooke Chaffin, Disney Interactive Media Group's senior vice president of Moms and Family. From The Wall Street Journal Disney Buys 'Mom' Blogs, Plans to Integrate Content

I for one could use some help figuring out how the Pilgrims and Indians got the candle wax out of their table linens. And those cranberry relish stains? If Babble hurries my third-grader might be able to fit this onto her Native American poster.

Not to worry, Disney is not out to princess-ify or product-ify anyone. In fact, Ms. Chaffin is thrilled to deliver more "magical moments" to parents according to the Hollywood Reporter. How very generous. Should you have any further doubts:

"We are not enlisting these bloggers to go out and promote a 'Cars' film," she said. "If you try to censor them," she said of the bloggers, "you lose the essence of what they are...What we really felt we needed to grow the business is that daily content, and the most authentic content that's being published is by bloggers," Ms. Chaffin said.

Most authentic content?  Plentiful and cheap content.

How cheap?

Babble has yet to disclose whether it actually pays bloggers.

Bloggers? In the wake of the buy-out the media has played up Babble as a mommy blogger site. The Hollywood Reporter called it a Mom Blogger Platform. The Wall Street Journal headlines reported Disney bought 'Mom' Blogs. Business Week, a Mom-Blogger Site. The New York Times, Mother Blogging Network. Didn't start out that way. Sure there are some 200 bloggers there but from the start the site has featured columns and essays not written by bloggers, mommy or otherwise including some well-known experts.  Kind of like Huffington Post. Is any of this sounding familiar?

Mercy.

Back in 2006 Babble was fresh and smart and like nothing else around, say iVillage or BabyCenter. The bad mommy confessions refreshing. Maybe it was more a sign of my own stage of parenthood.  Now there are too many ads and too much 10 Snacks Your Kids Can Eat in The Car.  Or I Let My First-grader Drive to School. My Child Is a Racist Pig.  At least there's still Heather Turgeon and her Science of Kids. For now.

If the Babble Bugle is any indication of the site's direction, parents will have one less edgy hangout despite the heartfelt promise from founders Alisa and Rufus to keep every Babble reader "informed, satisfied, enlightened, or at least tickled to some degree." Oh no. In any event it's been a Cinderella Story for the husband and wife team so far. Let's hope their ride doesn't turn into a rotting pumpkin.

Of course in this real-life fairy tale Rufus isn't exactly the naif.

Before foistering his hipster vision on parents guy founded the high-brow sex site Nerve that ultimately spun into a less erotic general life and culture hub. A familiar story. So I guess he is in fact an expert tickler of sorts.  Would love to know if Ms. Chaffin and the Disney execs all got a copy of The Big Bang: Nerve's Guide to the New Sexual Universe, Sex Etiquette, Full Frontal Fiction, The New Nude and Sex Advice From....

Someone please tell me that bugler boy is not Christian Bale from Newsies (i.e. Disney, circa 1992).

Depression, Risk, School Lunches and More: Research Round Up

2011-11-14T08:06:00.000-08:00

Big, little, high, Low. Learning spatial terms helps develop actual spatial skills.
Interesting, compelling, fascinating, curious, informative, educational, entertaining, amusing....

Penchant for risky behavior peaks at age 50.
Only 44 more years until I can stop worrying my kids are going to do something stupid. Oh yeah, these people had to choose whether to do a math challenge not exactly bugee jumping off a cliff.

Woodsmoke from cooking fires linked to pneumonia and cognitive impairements.
One word: microwave.

Seriously, check out Julia Roberts, Global Ambassador for Clean Cook Stoves and her efforts to get more clean stoves in families living in developing countries.  Cooking shouldn't kill anyone.

Healthy school lunches make low-income kids kids healthier, leaner and more food secure.
Duh and duh.

Food Secure:
When all people at all times have access to sufficient, safe, nutritious food to maintain a healthy and active life.

Food Security Insecurity: When people with too much food waste too much time decribing people with too little food.

Helping others helps rural teenagers avoid alcohol and drugs.
Drop DARE. Pick up shovels, rakes, and brooms immediately.

Depression in late teens and young adulthood raises risk of dying from heart disease later on.
Especially for women.

Child sexual abuse tied to worse cardiac health later in life.
Even when controlling for usual suspects like being overweight, smoking, drinking, high blood pressure, diabetes, etc.  Do you hear that people drawing up those lawsuits? Add in the bad heart.

Happy World Pneumonia Day: It's Preventable, Solvable but Still Kills More Kids than Anything Else

2011-11-11T10:36:00.000-08:00

A few years ago my then 3-year old started having trouble breathing during the night. Not just uncomfortable can't breath-through-stuffy-nose stuff. The real thing. What had been a simple cold just hours earlier turned into belabored, chest-heaving breaths that still haunt me. Ugh, those sucking, watery sounds. The diagnosis: Pneumonia.

I'm still amazed at how rapidly he went from being okay to not okay and I wasn't exactly a newbie. He's my third child so I'd been around the block, had rushed babies to the ER in the middle of the night before but had never experienced pneumonia and hope to not do so again anytime soon if ever.

That's why I didn't hesistate much (okay, a litte, I am a skeptic) when I was invited to join a discussion in honor of World Pneumonia Day 2012 (November 12th) on the disease with Dr. Richard Bessler, the chief medical editor at ABCNews (and the former acting director of the CDC during the H1N1 scare!) and his colleague, Dr. Orin Levine, the Executive Director of the International Vaccines Access Center at Johns Hopkins (whose vitae includes both the CDC and NIH). Dr. Bessler, a pediatrician and Dr. Levine, an epidemiologist both have extensive backgrounds in children's global public health and not just in advocacy from a warm research lab or office desk but the kind of in-the-trenches experience that has found them in remote villages in Africa witnessing the deaths of far too many children.

Both doctors are part of the Global Coalition against Child Pneumonia that includes such public health heavyweights like the United Nations Foundation, ONE and Save the Children. These guys are dedicated to treating and preventing pneumonia here and more importantly in developing countries where not only are more children at risk of developing the dangerous lung condition but dying from it.

Every year about 1.4 million kids under 5 die from pneumonia around the world.
From The World Health Organization

How do you think that compares to AIDS, malaria, TB and the like? Quick, name the single biggest killer of young kids around the world.

AIDS kills @1.8 million people of all ages each year (2009 data).
Malaria kills @100,000 people of all ages each year (2010 data).

Nothing even close to pneumonia.

Don't worry if you had no idea because not even the big names working in public health knew. Turns out the biggest financial donors in global health didn't know. When Doc Levine interviewed the top 29 head honchos in public health not a single one named pneumonia as the number one killer. Not a single one. In fact they didn't believe him because it's so rarely in the media spotlight.

"Pneumonia is the biggest most solvable public health problem in global health...and no one knows about it." - Orin Levine

"Everyone is at risk for pneumonia." - Orin Levine

"When I do a story on (global health) I get floods of emails and tweets saying "we have issues here, why should we care." Why should we care? It's so preventable for so little money." - Richard Bessler

"It doesn't take a doctor to recognize pneumonia." - Richard Bessler.

Finally some take-aways:

It's preventable.  Vaccines, nutrition, clean cook stoves, and breastfeeding have all been linked to lower risks. I take issue with the PROBIT breastfeeding study but not gonna take it on right here.

It's treatable. Via vaccines and antibiotics.

Even big, strong healthy NFL quarterbacks can be sidelined even hospitalized with it.

Anyhow, Happy World Pneumonia Day.

I know, I'm disappointed too about no bracelets to wear. Maybe next year.   Maybe I'll break out the Halloween candy we didn't pass out (oh yes, Halloween cancelled here because of freak snow storm, no power for 8 days....don't even get me started).

Maybe by this time next year the big P will be as glamorous as breast cancer and AIDS. You know, the whole think pink merchandising thang. Artists fighting AIDS. I recommend they change the name or at the very least shorten it, maybe take away the silent P. Maybe rethink WPD - reminds me of Dick Cheney and his non-existent WMD.

Julia Roberts talking up clean cook stoves is a start.

You can join the WPD Facebook page, follow them on Twitter, join the Millions Mom Challenge who are also part of the global health scene. Tell your friends Pneumonia is no joke. Get your mother the pneumonia vaccine.  Maybe think of a new name for the disease.

Catch Dr. Levine debunking 5 myths about pneumonia over at HuffPo.  Good stuff. Check out the do-good doctor's head shot. Wow, he looks so happy! After dealing with all the dying kids I'd be rumpled and bitter.

A Social Psychologist Stymied by Penn State Horror Show

2011-11-10T18:54:00.000-08:00

Many adults ignoring the rape of a child. No doubt many children over decades. It's nearly incomprehensible.

How is it that no one bothered to stand up for those kids and stop the heinous, heinous abuse? How can people ignore dreadful acts against others?

Some have suggested people were so concerned about their own personal well-being, their coaching careers, the football season, a university's reputation, athletic donations, legal liability, you name it, that they refused to take these claims seriously. There's that naked self-interest for sure and no doubt that accounts for most of it. Psychology textbooks (school car lines, Hollywood memoirs) are full of examples of people acting from less than admirable personal motivations.  Remember Richard Dawkin's The Selfish Gene?

Some have spoken of cowardice, greed, stunted moral development, indifference, lack of empathy, fear of retribution, excessive loyalty, a reluctance to believe the worst and yet nothing yields a satisfying answer.

If there's a field that can explain how this sh** show happened, then it's social psychology. It's all about people's bad behavior.

Social Psych 101 is a virtual catalog of how people deceive themselves and others if not perpetrate acts of outright abuse and violence:

Discrimination
Stereotyping
Prejudice
Out-group aggression
Conformity
Persuasion
Social Loafing
Group Think
Cognitive Dissonance
Self-fulfilling Prophecies

The roll call of iconic studies reads like the rap sheet from the first circles of hell.  My personal favorite, The Zimbardo Prison Experiment featured student "guards" harassing student "prisoners" in the basement of the Stanford psych building.

In fact the entire field arose to explain the Holocaust.

The guys (yes, only men, ironic, no?) who started it soon after the end of WWII wanted to figure out how millions of people, many otherwise good and decent folks, allowed the slaughter of 6 million Jews.  Of course the current Penn State horror show is not on the scale of Nazi Germany but nonethless it involves a community that systematically turned a blind eye towards atrocious acts.

Some of the lessons learned from the pioneering psychologists looking back at the Holocaust still hold up fifty years later and provide a few clues as to how adults could allow a child to be brutalized.

Like the work of Stanley Milgram, say his work on authority and his infamous Obedience Study. Those of you who took Psych 101 surely remember this Milgram's classic that would never pass an institutional review board today. Under the guise of a bogus learning experiment old Stanley asked research subjects to administer an electric shock to their unseen "partners" who answered questions. With each incorrect answer the volt increased. If you've seen the black and white movie, then you'll recall the screams and pleas from the partners to stop. In reality it was a set up to see how far subjects would go to obey the experimenters commands. More than half the subjects delivered the highest degree of shock.

The study is suppose to shock us about man's inhumanity to man. Blah blah blah. Not very shocking today in our Call of Duty violence-soaked media culture. But it reminds me that people can and do ignore other's pleas for help and also harm others to keep their standing in the eyes of authorities.

In some way the current horror show at Penn State can be viewed as individuals being afraid to cross their bosses, the higher ups. Was the grad student motivated to "obey" his superiors? Maybe. Harder to think of Joe Paterno as being threatened by anyone but might he and others have exerted a powerful disincentive to act?

Some of the 1970s and early 80s work on The Bystander Effect shed some light too if only in the more ambiguous incidences.  It goes that in an emergency the chance of anyone receiving help decreases with the number of bystanders or observers. Why? Two things.  The diffusion of responsibility and in some sense everyone standing around looking at everyone else who in turn are trying to figure out what to do and thus not acting so because no one is doing anything there doesn't seem to be an emergency so no one does anything.

Watch, you'll see it all the time.

A couple weeks ago my 5-year old slammed his fingers in the heavy metal door at the pizzeria and though he was holding his hand and screaming in pain (and I was across the room paying) no one seemed to do anything though people were looking around like they expected someone to do something.

Now it doesn't explain the terrible shower assault that clearly was an emergency but it does get at how lesser, more ambiguous incidents are dismissed.  Anyhow, it's why if you ever need help you should reach out to one person, tap them on the shoulder or call out to them and say you need help. Otherwise you might be SOL as my dad would say.

The most infamous demonstration of The Bystander Effect, and the one that prompted researchers to investigate it, surrounded the murder of a young woman, Kitty Genovese in Queens in the 60s. According to plentiful media accounts and decades of psychology lecturers Kitty was brutally stabbed outside her apartment building for over an hour while 38 observers witnessed it and failed to intervene or call the police.  A few years ago a psych journal debunked some of the story - not that many people had actually witnessed it and some in fact had called police.  Nonetheless countless studies have demonstrated the effect, fine-tuning it for modern times.

Sociologist Hannah Arendt explained atrocities as the banality of evil.  Ordinary people coming to believe evil, immoral acts are simply normal, everyday acts. Murder and rape become normalized. But that's also hard to believe happened here. I mean how do you normalize that? I bet if you asked Joe Paterno and friends a year ago about sodomizing a child they'd all say it was despicable (at least the hypothetical sodomy).

And yet...

Nothing can quite explain it for me. How about you?

Screen Time Higher Than Ever: Too Much Screen Time on Studies about Screen Time?

2011-10-26T09:19:00.000-07:00

Future Mark Zuckerberg or Deviant? Photo,Common Sense Media
Key Finding 1: Young Children Use Digital Media Frequently

Thank you Common Sense Media for this tantalizing finding from your new study Zero to Eight: Children's Media Use in America. I will be sure to take into account how much screen time I've used to read and comment on it.

Sure, someone needed to establish a baseline measure of children's screen time for psychologists and anthropologists to cite over and over in the coming decades if not millenia. You know, in order to argue how gloriously screen-free we were back in the year 2011 when humans still had prehensile fingers to hold pencils and tongues to speak.

Oh the study looks good with it's large font and professional graphics including photos that surely would spruce up the scholarly journals (hint, hint). Not sure what we're suppose to take away from the cute baby playing on mom's iPhone but surely readers should sigh and choke up at the youngsters engrossed in books during the photo shoot.

Books?

Of course this being an investigation of screen time the report slices and dices the data on how much and on what devices kiddies get their screen fixes (won't bore you with the details that you can read on Common Sense Media or a New York Times article) but must in keeping with the grave warnings of educators and librarians lament the lost art of reading books as in the print-on-paper, broken-spine musty dusty kind.

Now I'm a huge reader myself who's raised a complete bookworm and who must have repaved my parking spot in the public library lot several times over with late fees but I'm not completely convinced that the rise of iPads, Nintendo DSs and other screens including the tv has significantly, meaningfully reduced reading time. I'm fighting the digital battle at my house every day, but honestly stats like this don't mean much to me:

In a typical day, 47% of babies and toddlers ages 0 through 1 watch TV or DVDs, and those who do watch spend an average of nearly two hours (1:54) doing so. This is an average of :53 among all children in this age group, compared to an average of :23 a day reading or being read to.

Um, infants watching television. Seriously? My children at one month could barely hold their heads up much less focus on the screen ten feet away.

Anyhow the subtitle on this data says Children under 2 spend twice as much time watching TV and videos as they do reading books. But stats appear only for those under 1, that's annoying. Why? I like my data but also I'm finding it difficult to believe babies actually "watch" tv especially for more than a few minutes. An hour of any one activity with an infant can be grueling.  Including reading. It's good to know how much babies sit in front of the screen but I'm not sure about the actual watching behavior. They may sit there for a half an hour but really what are they doing? I'm guessing there's also an older sibling or two to watch. They tend to be much more interesting than a tv.

In any event kids watch lots of tv in plenty of studies and this one is no exception (1 hour and 44 minutes a day).  This is hardly earth-shattering. In fact, the only real nugget here is the well-named new phenomenon - App Gap - a nod to the disparity in App downloads between the kiddie haves and have-nots.

Speaking of the Digital Divide, the New York Times chose to use a graphic showing nearly half of kids have tvs in their bedrooms (42% to be exact). Common Sense Media focused on the Bedroom Television too that incidentally pops up most frequently in low income homes.

Ah, the Bedroom DS? Bedroom iPads, Bedroom iPod Touches?

No one bothered to inquire into their exact whereabouts.  HHhmmm.

Well that concludes our screen time together.  When you track your screen time for the day let me know if you've logged this portion under Educational, Recreational or I-Couldn't-Possibly-Choose.  Feel free to count it towards your daily reading and for you multi-taskers who are on the treadmill right now, exercise.

TV for Kids Under Two: Pediatricians Revise TV Ban

2011-10-19T09:10:00.000-07:00

So television is not the evil step-cousin of spanking, infant cough and cold meds or allowing babies to sleep on their tummies.

Not anymore.  Not this week.

Back in 1999 The American Academy of Pediatrics, the popo of parenting, banned television for kids under 2 in an effort to persuade us that plopping infants and toddlers in front of any screen would turn them fat, stupid and surly.  Now lest you shut off all electronic babysitters thereafter, then you probably aren't all that surprised to learn tv and the like aren't so awful.

Not that they're so great.

Actually there's not much evidence either way.

More accurately there's plenty of research.  It's just that the bulk of it tends towards the correlational with a good dose of minor "effects" and mixed results. Thankfully the AAP recently had the good sense to realize it. Instead of an outright ban the organized pediatricians now "discourage" it. The No TV has turned into more of an admonition than decree. Media Use by Children Younger Than 2 Years

Surely I'm not the only parent with the recurring fantasy of heaving the device-of-the-moment out the window or alternately moving to the country without wireless access or cable? I get the earnest pleas for unplugging, the dearth of unstructured time. Absolutely. Amen. Sign me up for that initiative.

But remember the worry about screen-time dragging kids from more valuable developmental opportunities? I worry about it myself, sometimes. But get a load of this nugget buried in the renovated AAP statement:

Does television displace more developmentally valuable playtime? No research exists at this point to know whether a child would find better things to do with his or her time if all screens were turned off, although evidence suggests that the child would hear more adult speech and talk more. Heavy media use is defined as the television being on always or most of the time. Heavy media use may be a sign of parenting style, so one cannot assume that parents will spend developmentally nurturing time* with their child with the television off.

So we think tv deprives kids but we're not sure of what and though we can speculate it might involve hearing mom and dad yap. Of course it might be mommy yapping on her Blue Tooth. Or daddy trying to get a hold of someone in India who can solve the mysteriously disastrous Microsoft updating monster that wrecks havoc with the lap top every few months.

Oh, the nature thing too....TV keeps kids inside, prevents them from running around the yard? Um, no.

Heavy media use in a household does not seem to affect the amount of time a child of any age plays outside.

It's a grey world out there but for better or worse the AAP does think they know something for certain.

What is known is that unstructured playtime is critical to learning problem-solving skills and fostering creativity.

Yes and thus a full day at school followed by a soccer game, an hour-plus of homework, piano practice, writing thank you notes for the birthday gifts they don't need, then baking the cookies for the school fundraiser and helping fold laundry also doesn't leave much time to just hang.

Oh yeah and and the required 20 minutes of reading that will also be logged into the journal and then verified by an adult.

In fact, a short stint of the tv or Tiny Towers doesn't look so bad in comparison.

You can download the new policy statement for free at Pediatrics but please consider the amount of developmentally nurturing time actually reading it will cost your children.

Pretty good write-ups on the new policy around the web:

The New York Times - Parents Urged Again to Limit TV for Youngest
Science Daily - Babies and Toddlers Should Learn from Play, Not Screens

Here's the press release.

Of course many websites and blogs have translated the new policy into NO TV for kids under 2 side or TV only harms, doesn't help kids -stepping any subtleties of the new message. Go figure.

COUNCIL ON COMMUNICATIONS AND MEDIA
Media Use by Children Younger Than 2 Years, Pediatrics, published online October 17, 2011.
doi: 10.1542/peds.2011-1753

Bullying: It Stops Here. Bullying as Sign of Psychological Trouble or Popularity?

2011-10-13T07:21:00.000-07:00

Check out Bullying: It Stops Here, the new anti-bullying initiative by Anderson Cooper on his cable perch, AC360 (degrees!). While I can't figure out how to type the degree symbol, I can tell you bullying isn't what it used to be according to a new "pilot" study sponsored by CNN and the silver-haired heir-anchor. That's right, the media is now in the research biz and here's what Anderson and friends found in their little survey conducted at a "nationally-ranked" Long Island high school:

Kids are caught up in patterns of cruelty and aggression that have to do with jockeying for status," explains Robert Faris, a sociologist whom "Anderson Cooper 360°" partnered with for the pilot study. "It's really not the kids that are psychologically troubled, who are on the margins or the fringes of the school's social life. It's the kids right in the middle, at the heart of things ... often, typically highly, well-liked popular kids who are engaging in these behaviors." CNN study: Schoolyard bullies not just preying on the weak.

So toss out the depressed bully who picks on others to relieve his own psychic suffering - the kid who acts out to compensate for his low self-esteem, crappy parents or otherwise hate-filled and lonely existence. Toss out the anxious, frail victim too. Bullies, victims, and the hybrid bully-victim are none of the above.

On the contrary the New Bullies are well-liked, seemingly well-adjusted and well-situated kids in the middle to top social hierarchy of middle and high school life, the ones scrapping for power and status. The most popular students of course needn't bother with the messy work of taunting and teasing. Those at the bottom somehow are also relieved of the social jockeying, left to dwell in their lowly status.

Bullying as ordinary social interaction? A response to the social structure? The remnants of evolutionary-programmed power-seeking primate behavior.

The New Bullying doesn't exactly mesh with with the traditional bullying portrait of the strong versus weak. The playground bully picking out vulnerable classmates whose deficits make them prime targets. Remember, it's been only recently that some experts studying the issue have proposed perps and vics be identified by their psychological short-comings. If this sounds familiar you might have read this snippet from Time in my previous post:

What if bullying is not a cause of poor mental health but is a warning sign that it already exists?

Studies show that kids who are involved in bullying — bullies, victims and a third subgroup of particularly problematic kids who engage in both behaviors and are referred to as bully-victims — are more likely to have started out with depression, anxiety and other mental health issues that predispose them to lashing out and to self-harm. Should We Re-Think Our Anti-Bullying Strategy, Time, September 28.

So how does the troubled bully/vic square with the popular kids vying for power? The researchers profiled in the recent Time piece pretty clearly separated the two. The former troubled kid stuff is "bullying", the second, more "mean" behavior. Of course there is overlap.  In the CNN survey more than half of the high schoolers said they'd been involved in bullying (56%). That's a whole lot of mean going on. Do we think all of it was "bullying?" When does mere bad behavior cross into bullying? It matters now that most states have anti-bullying laws.

Just because we fail to call some bad behavior "bullying" doesn't mean it is excusable. But since we're asking difficult questions about social interaction and children, these issues need be clarified. From a prevention stand-point it probably matters.  If we've misunderstood or muddied the distinctions between different types of bullying then no wonder we can't seem to stop it here, there or anywhere.

One possibility - bullying may morph across age groups. I can imagine the traditional type more prevalent in elementary school, the power-striving type in high school. Any evidence out there?

Also, the popular kids in the social-hierarchy bullying may very well differ in key traits from those involved in the more traditional bullying (i.e. stigmatized, troubled or vulnerable kids). I'd like to know how, wouldn't you? Although the popular kids know all the right moves socially, they may still show some signs of trouble (i.e. lack of empathy? lack of impulse control?).  Not everybody is participating in the threatening tweets and such so beyond relative social status there are other factors driving the cruel behavior.

Then there are the perennially bullied.

I know them. You know them. Parents, teachers and school counselors the world over know them. Hard to ignore the existence of these chronically-bullied children. I don't think their suffering makes the same dramatic headlines that the cheerleader gets when she's harassed or commits suicide. Their stories aren't so remarkable or newsworthy in part because we aren't so surprised when they end up face down in the dirt. Why are the latter teased mercilessly? Their stutters, physical disabilities, sexual orientation, name a stigma. I hate to sell them short here in our Bullying: It Stops Here campaign. They exist as well as the pretty girl taunted by the pretenders to the Homecoming throne.

Should We Rethink Bullying? Bullies, the Bullied and Mean Girls

2011-10-05T08:31:00.000-07:00

Simon Battensby / Getty Images from Time Magazine

Despite lots of public attention, a profusion of anti-bullying programs, legislation and research, bullying doesn't appear to have stopped or for that matter, waned though it might not have increased depending on who you ask. But still, it hasn't disappeared.

Have we gotten something wrong?

Take a look at this recent unusually(?) clear-eyed article in Time magazine distilling some new angles on bullying. Rather, some issues that have perplexed educators, psychologists and parents who've spent time thinking about bullying but have too often been neglected in the debate:

What if bullying is not a cause of poor mental health but is a warning sign that it already exists?

Studies show that kids who are involved in bullying — bullies, victims and a third subgroup of particularly problematic kids who engage in both behaviors and are referred to as bully-victims — are more likely to have started out with depression, anxiety and other mental health issues that predispose them to lashing out and to self-harm. Should We Re-Think Our Anti-Bullying Strategy, Time, September 28.

It's become a no-brainer to think of bullies as being messed up from a psychological perspective. It's easy to see bullies as deficient in key social and emotional skills. You know, the bad seed of the preschool and playground.

But what about their targets?

As a mom and a psychologist over the years I can't help but wonder about the traits, especially in younger children, that might make some kids more vulnerable. I've thought about this since my undergrad days (and some grad involvement) in studies involving survivors of sexual assault and other abuse. The perps shared traits as did their targets. To ask this question about victims in no way "blames" these kids but provides a doorway into potentially preventing their abuse. There's some evidence that kids involved in bullying - both as targets, perpetrators and those that become both - show deficits in social competence, self awareness and emotional awareness. There's also evidence of depression and anxiety preceding the bullying. Of course there must be traits that separate these groups too. I've not seen much written up about the targets - so much has focused on the profile of the perp and the psychological aftermath for the target- but will check out the review cited in the Time article.

It's not been politically correct to fixate on the target's prior mental health.

Anyhow, I'm particularly fascinated by the group of kids who are both bullies and bullied.  These kids show up in study after study, survey after survey, birthday party after birthday party (!!!) reminders that not only is this bullying a knotty business, but again, there are likely substantial differences between those targets who become bullies and those who stay targets.

Nor is it clear what constitutes bullying.

Take this related quandary. Bullying versus disliking someone. Are they the same? When does simple dislike turn into bullying? What's the difference between having an adversarial relationship and bullying?

How about this new research finding certain to provide headaches to principals and guidance counselors trying to implement anti-bullying laws and programs:  Having an enemy might indicate better social/emotional adjustment. Kids who share mutual dislike (i.e. two kids that both dislike each other) are better liked by their peers and better behaved in the classroom according to teachers. So in fact there's an upside to dislike.

Also couldn't help but think about typical mean-girl behavior. Is that bullying or the expression of advanced social development? It's not like those girls show deficits in social skills. According to one recent study it's the friend of the It Girl, the girl doing the bidding of the Queen Bee. That who's going all mean-girl - trying to find that reference, anyone recall that one?

If you're interested, the other research is cited in the Time article. Can't seem to find the cited 2009 article about mutual dislike, at least the cited author's 2009 study in PubMed doesn't seem like the one discussed in the article. Might email the author.  So of course I'm wondering if the mutual dislike findings got put in the paper at all or were merely an interesting aside.

So I'd love to see some fresh material in the anti-bullying programs. Basically stale right now. anyone have good materials? My mother remembers the worksheets I got recently - from like twenty years ago.  Is that the outcome of our bullying prevention to date? Other than throwing down some vague legislation that confuses everyone?

BTW, anyone catch Harvard psychologist  Stephen Pinker on NPR today talking about the decline of violence? He mentioned our current focus on bullying. As he put it back in the day "boys were boys" and we accepted bullying as ordinary playground antics.  Today, however, just like violence, we've become sensitized to bullying and cruelty - in a good way - and thus are more aware and disdainful of these acts. He'd probably argue there's less bullying now then ever.

The Princess and the Poisonous Spaghettios? BPA in Kid's Canned Food

2011-09-30T07:21:00.000-07:00

From the Breast Cancer Fund: Princess Pasta with a side of BPA

So a new study just came out from San Fran's Breast Cancer Fund frightening us about bisphenol a (aka BPA) in popular canned food marketed to kids (even Annie's). Wasn't gonna cover it because it's a very small study that hasn't been vetted by peer-review.

Then I came across this review of the study on Science News. Found the words of Janet Raloff so refreshingly reasonable I wanted to put it out there. This is how we should be talking about scientific findings.

The title pretty much says it all:

BPA: What to make of pollutant-laced kids’ foods: New study fails to place its limited data in perspective.

Love that. The uncertainty, the nod to context, the gentle scolding, the mild irritation. The ant hill of data out of the Breast Cancer Fund was meager in scope. Worse the authors somehow didn't even consider canned foods with even more traces BPA and remarkably left out some recent evidence bolstering the possibility continual exposure to BPA might more harmful than a single heavy dose. Yes, the former research limited to rats, you guessed it. Not sure how much stock I put in those animal studies but if I were writing up the new princess pasta work I'd def include it to beef up my case.

In any event it's reassuring that someone is actually reviewing the research in an objective manner even if it's on a website unknown to most parents wondering about that can of Spaghettios. Gotta love this summation:

The take-home here, as so often in science: It remains an open question about how to make practical use of developing data. Potentially useful information on BPA exposures and risks are emerging in dribs and drabs. One can only hope that before long, a sufficient body of data will exist on which to base health policy and our grocery lists.

It's a shame you have to troll sciency sites to find this frankness when it comes to the latest scientific findings. Anyhow, thanks, Janet. Any thoughts on say, the breastfeeding literature? Hey, how about the sibling stuff or kindergarten red-shirting?

Delay Kindergarten at Your Child's Peril? Spinning the Red-Shirting Studies

2011-09-28T08:56:00.000-07:00

THIS fall, one in 11 kindergarten-age children in the United States will not be going to class. Parents of these children often delay school entry in an attempt to give them a leg up on peers, but this strategy is likely to be counterproductive. From Delay Kindergarten at Your Child's Peril, New York Times, Sept. 24, 2011

It's September so tis the season for The Kindergarten Red-Shirting Saga, the debate over whether parents should send kids to kindergarten essentially as the youngest in the class or the oldest (i.e. red-shirted). I'll take on that "leg up on peers" allegation in a bit but will say upfront I have two girls born right on the line, one on the actual cut-off date. Having the "choice" is both a luxury and burden. I have thought/worried/studied/belabored this one way too much and am hardly an unbiased observer here though I have tried to objectively look at the data.

Oh, the data. Messy. It's an understatement to say the data are all over the place.

A good deal of the red-shirting studies involve economists calculating lifetime wages and degrees. Much of it spans decades. Remember the long time-frame creates all sorts of confounding factors. The even larger problem with this research - the fact there are many reasons for "red-shirting" kindergartners and most of them have nothing to do with sports or competition - and often these factors have been completely left out of the study.

Let's look at the latest scuffle brought to us in the New York Times by two neuroscience-minded minds, one a biology prof, the other a science writer with a neuroscience background. Here's one of their claims regarding the risks of red-shirting:

In high school, redshirted children are less motivated and perform less well.

The group of kiddies "left behind," held back" or "given the gift of another year" are hardly a homogenous group. Some held back for sports and some are held back due to real issues, the kind that also, not coincidentally, correlate to school performance. Like developmental delays, learning disabilities and the like. No wonder some of these youths don't make Honor Roll.

Some studies show differences in school performance for the red-shirted, especially when addressing those who were held back for those academic-related deficits. Would some kids have been better off in school - versus as one commentator wrote a few years back and I can't quite get out of my head - sitting in grandma's basement? Surely.

If a child's choice is between watching tv and kindergarten, then hey, starting earlier might be best. Especially if they have no or a poor pre-school experience. If it's high quality Pre-K versus kindergarten, then maybe it doesn't matter. There are clearly financial aspects involved, like free kindergarten versus costly preschool or daycare.

Speaking of economics, the authors of the recent NY Times piece also bring up these findings about the red-shirted kids:

By adulthood, they are no better off in wages or educational attainment — in fact, their lifetime earnings are reduced by one year.

So the kids have one less year of income. Makes sense, it's straightforward enough.

Please note that there are no differences here in terms of how much money these grown-up kiddies make. Or their degrees. None.

Our neuroscience team spins this as an arugment for not holding back kids.  Of course some may use this an argument for holding them back. Look, there are no differences - you aren't condemning your child to a life of burger-flipping or repeated GED tests should you wait another year or not.

Are kids who delay kindergarten any happier? More confident? Emotionally well-adjusted? Socially? It's anyone's guess. Haven't been able to find much there.

As a psychologist I couldn't help but note the short nod to socio-emotional preparedness.  Kindergarten requires all kinds of social skills and emotional resources.  Any teacher could tell you and the authors admit, there can be a large gap in these less tangible but no less important social and emotional skills.  In fact, study after study show these more abstract, harder to teach skills like resilience and empathy, (i.e. emotional intelligence) are more critical to future success than academics.

The authors suggest younger kids learn these skills from older kids. Yes, just a suggestion because there's not lots of data but by the way, there is research showing older kids acquire empathy and self-confidence from teaching younger kids at school. Don't think younger children have a monopoly on empathy here.  Montessouri education is partly premised on the benefits of mixed-age classes.  Again, the data here swing in all directions depending on the specifics of the study, the population, the predictors, the outcomes studied, the time frame.

What about that "leg up" allegation.  You know, that parents just want their kids to whoop the other kids at school, the field, the playground. But honestly, if a parent worries his or her child simply is not ready for the demands of kindergarten is it fair to characterize this often difficult decision as a potential competitive tact? I think not.

For that matter, we don't frame other parenting decisions about children's well-being in terms of competition.  We don't perceive breastfeeding as a competitive advantage, breastpumps and boppies accoutrements of achievement-oriented yearnings...but maybe we should. You want your kid healthier, bigger, stronger, that's why you breastfeed, no?

Come on, it was the varsity sports banquet that made you put the kid on the boob for so long, right? Maybe the kindergarten admissions test? No? Maybe you didn't envision something so specific but in general you wanted the best head start for your baby. When it comes to kindergarten, the demands are quite specific and parents and teachers have to think about and assess them.  If you have a child not quite ready, for whatever reason, it gets complicated.

Kindergarten is not just cookies and story time these days. It's work.  Hard work.  That's a whole other discussion. It's not gonna get any less challenging. Not gonna happen. We can wish for less worksheets and more free play but that's not realistic in our new global China-is-kicking our butts economy.  In this new reality, kids who sit around in poor quality pre-school or grandma's basement are left behind at great risk.

Improving the quality of preschool for kids whose parents can't afford or don't have access to good programs - that's a whole bag of worms I wish every governor, school district would address, if not Mr. Obama himself.  It's a no-brainer, better pre-school. We can sit around pointing fingers at the kids who start kindergarten later but it's not gonna fix the lack of quality preschool or daycare.

The traditional underlying concern of the anti-redshirt camp is that it harms the younger children. That parents make their kids sit out a year to get stronger and bigger so as to outperform their younger peers.

The harm from red-shirting then happens if red-shirting has benefits.  Really the fear is that it benefits kids from wealthier families, you know, the kids who can afford to languish in a good Pre-K. But the current authors argue the reverse - that red-shirting doesn't benefit anyone. In fact, they go out of their way to show it's risky for the kids being delayed.

Uggh.  That's why I wish we could honestly address the complexity of the issue because the truth is closer to this:  delaying kindergarten is risky for some children (like those in the basement), beneficial for others.  Again, the world is not black and white. I get it, the more the more affluent families delay kindergarten, the more everyone else does including the less affluent families (without the benefit of good Pre-K and thus another "wasted" year) because who wants their kid to be the youngest by 18 months or more.  However, it's simply not accurate to say red-shirting generally risks the late entry kids. Not so.

By the way, there is one notable risk for kids who start early.  Getting slapped with ADHD. Yes, kids who start earlier are at risk of being diagnosed with Attention Deficit Disorder according to a study out of North Carolina last year:

...the study shows that children born just after the kindergarten cutoff date were 25 percent less likely to be diagnosed as having ADHD than children born just before the cutoff date. "This indicates that there are children who are diagnosed (or not) because of something other than underlying biological or medical reasons. We believe that younger children may be mistakenly diagnosed as having ADHD, when in fact they are simply less mature," (author) Morrill says..."What our research shows is that similar students have significantly different diagnosis rates depending on when their birthday falls in relation to the school year." Birth Dates, School Enrollment Dates Affect ADHD Diagnosis Rates, Study Shows, Science Daily, August 17, 2010.

So if you're worried about your son or daughter being misdiagnosed with ADHD then that's something to consider.  Wonder if the authors address this in their new book? Hhmmm.

So in the dearth of relevant data in a complicated often overly-politicized world, it's up to parents to make their own decisions. Now if you'll excuse me I must garner some healthy snacks, schedule some teeth cleanings and sign my daughters up for a volleyball clinic - because I really want my children to be healthier, shinier, and more graceful on the open court than your children.

Shot at Life: Global Vaccinations, The United Nations and Social Media Moms

2011-09-27T10:33:00.000-07:00

The United Nations Foundation recently kicked off its Shot at Life campaign promoting global vaccinations. It's part of the UN Foundation's mission to improve maternal and child health. Not just them either, they're working with partners like the Bill and Melinda Gates Foundation, UNICEF, and the Red Cross. You might have heard about the venture as part of The Million Moms Challenge.

As a so-called Mommy Blogger - we'll talk about that in a bit - I get invitations to join all manner of causes but this one caught my fancy. Whatever your beliefs about the HPV vaccine, the debunked link between the MMR and autism, or even the relatively rare risks of any vaccine, it is downright hard to ignore let alone argue against immunizing kids around the world who die from diarrhea, measles, polio, pneumonia and other way preventable diseases. Not when the costs of not immunizing are so high.

Take a look-see at these depressing stats below and the cool, invigorating? "health-inspiring" graphic at right:

1.7 million children will die from preventable diseases this year.

1 in 5 kids around the world don't have access to immunizations.

1 kid dies every 20 seconds from these preventable diseases.

Pretty depressing. Just a few of the things I learned at the UN Foundation's Shot at Life reception last week in Manhattan, an event in collaboration with The Social Good Summit.   I'd met up with Peg Willingham, the woman in charge of the UN Foundation's Global Vaccine Initiative, at BlogHer this summer.  She and her crew came to New York City to launch their campaign as part of the Social Goods festivities.

Oh I learned a few other vaccination stats. Peg informed me their research showed about 96% of US parents had vaccinated their children. Wow. Knew the figure was up there, but didn't realize that high. So I did some independent checking for recent vaccination rates.  Sure enough, the numbers jibe with the CDC's 2010 Vaccination Survey. And hey, New Jersey, New York - why are we 2 of only 3 states with rates below 90%?? Huh? My neighbors, you got some explaining.

Back to my night in the Big City, full of talk of diarrhea, third-world poverty and pie charts (yes, just another day in my life save the Manhattan skyline and the cute guy pouring my Pinot Noir).

So the Shot at Life launch included luminaries from the world of social media and blogging.  To name a few - Emily McKhann, the founder of The Motherhood.com, Morra Aarons Mele, the CEO of WomenOnline, Holly Hamann, the co-founder of Blog Frog, and Katherine Stone, the founder of Postpartum Progress.   Lovely women, all. Especially in a semi-dark ridiculously hip hotel bar. I know, I was the little fish in the big pond, the outlier, the pick-the-item that does not belong! Yes, I was also the one not texting, mobile blogging or otherwise engaging technology.

But I did manage to make my mini-speech on the neglected arena of science-minded women bloggers and its co-conspirator in my imagination, the misinformation in the parenting media. You never know when the message will sink in. Maybe today, maybe next week. Perhaps next century (go get The Body Politic!).

If you truly care about the health of women and kids (and okay, men) it seems only logical to me that you also care about getting accurate information to not only health care professionals but also the parents.

As for the ubiquitous term Mommy Blogger - I'm a woman working in social media.  At the very least, "Social Media Mom." How's that? Don't love the "mommy" part either. Yes, I write about children and parenting but so do a whole lot of other people (i.e. who get to be called journalists, doctors, health professionals, etc).  Stole the SOCIAL MEDIA from my new friend and savvy social media maven, Holly Pavlika over at Mom-entum. And no my brand has like no mom-entum.

Anyhow, what do you call the guy blogging? Come to think of it, next time you read a post by a man with so much as a single reference to his kid or really any kid, please email me or comment so I can please call him a Daddy Blogger. Maybe I'll start a collection and call it BlogHim.

Fast-paced Television Harms Preschoolers? Why the SpongeBob Study is Like the Perfect Piece of SPANX

2011-09-20T09:05:00.000-07:00

Is SpongeBob sucking the smarts out of kids? So hints a new study showing 4-year olds who watched a mere 9 minutes of the infamous cartoon did worse on memory and attention tests than kids shown an educational program or given crayons and paper.

Why the malicious effects?

The researchers suggest the fast-paced segments in the aquatic toon may require more brain power to process and thus ultimately sap focus and other cognitive resources.

The study, published online last week at the journal of Pediatrics, adds to the Bad TV Lit that features all sorts of ill effects like childhood obesity and ADHD-like behavior. This one stands out for being an experiment and also boasting nearly immediate effects. It's no surprise manic cartoons prolong homework time and disrupt sleep. Makes sense.

This study is small but kinda impressive....at first glance.

Not so much on second glance.

True, when preschoolers faced the "fast-paced" versus "educational" show (i.e. Caillou) or crayons, the Sponge viewers generally showed less self-control and more trouble concentrating and remembering: more difficulty saying numbers backwards, stacking blocks, playing a slightly modified "Head, Shoulders, Knees and Toes" and my personal fave, trying not to gobble up mini-marshmallows or Goldfish.

Hmmm. Is SpongeBob usurping brain cells because of it's manic pace or something else?

Like it's "fantastical" nature? Not my word, take it from the authors who define the show as "a very popular fantastical cartoon about an animated sponge that lives under the sea."  Anyone who's watched, perhaps even two seconds, can see it is far from realistic and as such requires some extra processing. But what about the other show? Only in academia is Caillou, that extraordinarily whiny bald brat with overly patient and permissive parents, regarded as "a typical US preschool-aged boy."  In other words, a realistic one. I think it's reasonable to wonder if Caillou is "realistic" or even "educational." What about you?

So it's anyone's guess whether the results are due to a show's pace, realistic nature or really, anything else that differs between the two shows (e.g., tendency to induce physiological arousal?) - actually between SpongeBob and drawing (I'll get to that in a minute).

It's also worth wondering if other fast-paced cognitively demanding tasks have a similar effect - like gym class. It would be hard to argue the harmful nature of exercise among school children. I assume no one wants to argue observing highly fanciful or creative works is harmful either.  Or anything that increases physical arousal....where's my latte, anyhow?

But here's my real issue with the SpongeBob study: how the researchers dressed their data.

Sounds technical but actually it's very simple.  Instead of reporting individual test results for all 4 cognitive tasks, the authors threw the 3 attention/memory ones into one composite score.  Glancing at the results graph, it makes me suspicious that a couple of those significant tests didn't turn out significant. In other words, the results only came out okay (as predicted, wink wink) when thrown together.   In fact, even in the composite score, there was only a signficant difference between the SpongeBobs and the Artists. Not between either the two tv groups or the Artists vs. Caillous.  So it gets difficult to attribute results to fast-paced tv when the two tv groups didn't differ.  There's more than pace that differentiates tv shows from free drawing.  In a good experiment, the researchers only manipulate one variable at a time so we know what actually spurred effects.

Also raising curiosity - on the graph the Caillou kiddies looked like they outperformed the Artists on one task (Head, Shoulders, Knees and Toes) - now explain that.  The authors don't report that signficance test, any guesses why not?

So although the SpongeBob kids look to have fared poorly it's not clear on how many tasks. Was it on all 3 tests, 1 or just the composite? Who knows. Actually, the researchers do but they never tell us.

I don't like most cartoons, never did. Kids television, don't get me started - but I will say preschoolers have it way good compared to the 9, 10, 11 year olds. Even so I can't square the results of this study with the supposed pernicious effects emanating from the square-bodied porous cartoon character.

Especially that composite score.

You can see how it is like the Spanx of the research set. Not only is that composite score squeezing a few parts into one smooth whole it's also concealing some flaws.

Read the study for free.

The Immediate Impact of Different Types of Television on Young Children's Executive Function. Angeline S. Lillard and Jennifer Peterson. Pediatrics; originally published online September 12, 2011. DOI: 10.1542/peds.2010-1919

Pesticides with a Side of ADHD: The Saga Continues

2011-09-13T18:18:00.000-07:00

The Claim: Pesticides might contribute to the development of ADHD in school-aged children.

You might have missed a study out of Harvard's esteemed School of Public Health, the Environmental Health and Epidemiology wing to be exact:

Children with higher concentrations of a certain organophosphate - breathe, it's a scary word but hey, it looks so much more benign in lavender - basically a by-product of a pesticide - were more likely to exhibit ADHD behavior.   Actually, more likely to have their parents report incidences of the usual ADHD suspects.  Inattention, hyperactivity, a dash of impulsivity. But you get the idea.

Pretty good study with 1,139 kids aged 8 to 15. Researchers pulled data from the National Health and Nutrrition Examination Survey, a nationally representative survey.  Collected urine samples then interviewed parents on the telephone.  The higher the concentrations of dimethyl thiophosphate in the pee, the more likely the parents reported behavior issues.

Sounds convincing.  But before you run out and re-stock the fridge, consider these not so small caveats:

One urine sample.
That's right, the researchers looked at only a single potty break. It's hard to argue a chemical triggered a complex neurological disorder when all you're holding is the clinical equivalent of a Dixie cup. Especially when it's known the suspected toxin leaves the body in a matter of days. Repeated, continual exposure, okay, we can start talking but then again, we don't have evidence that it sticks around in the body and does damage to developing brains.

Remember the authors are suggesting that this complicated set of symptomatology that arises early in childhood, perhaps even earlier, is linked to exposure to a pesticide that they've only just found in their bodily fluids at a much later age and that the body dumps pretty readily. Sure, there's some newer research linking prenatal levels of organophosphates to later child development (e.g., IQ, attention problems) but it's equally inconclusive (some culled from this very survey) and often involves kids exposed to lots of pesticides.

A better study would have urine samples over a long time period. Years. I'm sure someone is working the data right now. We will wait.

ADHD via parental report.
There were no professional diagnoses here but moms and dads and maybe even grammy answering questions over the telephone about children's behavior. It's not clear if any of these kids really exhibited ADHD or even if their "caregivers" thought they did.

On a side note of interest to over-medication theorists, although 119 kids met the criteria in the phone interview, another 30 took ADHD prescription meds though they failed to meet the diagnostic criteria.

In any event, the better study would include professional assessments, maybe some undergrad scouring medical records for independent verification of ADHD.

Need I even mention this is correlational evidence, hardly causal in nature? No, you are savvy readers.

Here's the silver lining. Many kids failed to demonstrate "detectable" levels of pesticides.  In other words, too little in the pee to be measured accurately (35% to 80% depending on the pesticide).  For the organophosphate that was linked to ADHD behavior, 63% of kids had detectable levels.

Very good journal article too - it's free if you wanna give it a go. I'm happy to report the authors don't plump up the conclusions and thankfully laid out their methods, calculations, and limitations in pretty clear details. Could have mentioned the little parental self-report problem as a weakness but they didn't declare pesticides the grand culprit in ADHD. Nor did they suggest you go out and buy only organic produce.

That's progress in my opinion. Reasonable, measured, backed by evidence. My goodness, sometimes researchers do restrain their ambitious conclusions.

It's even published in the premier journal, Pediatrics back in July....July of 2010. That's right.  Just read about it on a story online at MSNBC.com this week as if there weren't any more recent studies to startle parents.

The Bottom Line:
One more report linking pesticides and children's poor behavior/developmental outcomes.  Some meaningful limitations, especially the limited time frame and lack of verifiable ADHD diagnosis.

Taken in content with existing studies, I will try to better remember The Dirty Dozen next time I'm strolling between the berries and bananas.  But seeing as this is no smoking gun I very well may slip the pesticide-ridden grapes into my shopping cart.

Vaccines Get a Thumbs Up: Institute of Medicine Finds Vaccines Generally Safe

2011-08-31T10:06:00.000-07:00

Vaccines got the stamp of approval in a new report by the Institute of Medicine.

I know, not terribly exciting news, but it beats another earthquake or hurricane for those of us on the east coast.

A panel of experts pulled together by the IOM checked out over 1,000 published research articles and tada! found very little evidence of serious adverse effects.  Their conclusion? Vaccines are generally very safe. At least the 8 most common vaccinations in claims reported in the National Vaccine Compensation Injury Program, a national police blotter of sorts for vaccine side effects.

Did I say effects? Yes, well, you know what the panel (and I) meant - there is no evidence of vaccines causing anything out there. It's all correlational evidence or in this case, lack of correlational evidence as in not enough convincing evidence, really not enough information to make any conclusion, for the majority of adverse outcomes.

In fact, most of what the expert panel looked at weren't in fact epidemiological studies but accumulated summaries of case studies that compared to sorting through individual case studies holds some value. The only large-scale epidemiological research basically focused on the MMR and, you guessed it, autism.

Not that any of this invalidates the IOM's conclusion.  Under the circumstances they did the best they could. Why are there so few rigorous studies out there? Well the biggies that resolve so much tend towards the pricey and take forever and remember, the really serious adverse reactions rarely occur.  It's hard to investigate very rare events.

Rare events?  Looks like children with compromised immune systems were more likely to experience "side effects" such as brain inflammation, seizures, and anaphylaxsis.  Speaking of high-risk kids, they are one more reason to vaccinate. They're the ones who really need the herd to be immunized.  I know, if only we knew who they were before we stuck them with needles.

On a side note, the panel didn't look at the risk versus benefits, in fact, didn't so much as glance at the benefits. They only focused on reports of adverse effects so this report in no way balances risks with benefits.

If you wanna read more, these media reports didn't do a bad job:
New York Times
Time's Healthland
HuffPo

Anyhow, guess there's one stress to cross of the hypothetical list of parenting perils this fall thanks to the IOM. Now if I can only convince my daughter she loves the only sneakers left in her size in the tri-state region, I can rest easily until the start of the school year next week.

The Scientist in the Closet?: Americans Can't Name a Living Scientist

2011-08-16T21:18:00.000-07:00

Evil Dr. Doofenshmirtz: Thanks, Wikipedia

Many Americans can't name a scientist, not a scientist who still breathes.

47% can conjure up Albert Einstein who for better or worse died over 50 years and is perhaps best known for his hair. Seems 23% of us can't provide a single name, dead or alive.

Not one.  Obviously the hot guy from CSI does not count. Nor the evil Dr. Heinz Doofenshmirtz from Phineas and Ferb.

So I read the above miserable stats in a New York Times story about the dearth of real scientists talking science outside of arcane journals (you don't say?). Groups Call for Scientists to Engage the Body Politic.

Who was responsible for those stats? Seems back in 2009 the USA Today, yes the paper targeted to fifth graders, polled some people according to a piece I finally found on TechCrunch.  L'Oreal sponsored the survey according to a science blog I came across. Before you start to smear L'Oreal spokescelebrity Gwen Stefani or smirk your Colour Riche lips, L'Oreal apparently did so under the auspices of their Women in Science program so obviously they do care deeply about women and science, even women scientists.

The L'Oreal poll was sunny compared to this factoid. An astounding 63% of people couldn't name a single living scientist in a recent Maryland public opinion poll. Those wearing their thinking hats conjured up a diverse list including these well-known figures:

Stephen Hawking (10%)
James Watson (2%)
Francis Collins (1%)
Jane Goodall (1%)
Bill Nye (1%)

Okay, so we got:

A Brief History of Time Guy
The DNA Guy
The Human Genome Guy

Not so bad.

The Chimp Chick

Okay.

Then...

The Science Guy

Jane Goodall, though she's contributed much to our knowledge our chimpanzees, was never formally trained as a scientist.  Though I like the whole Bill Nye The Science Guy schtick and appreciate that someone is making science fun and obviously he's very smart but I must point out that the only doctorate, in fact graduate degree Mr. Bill Nye holds, is merely honorary. Pretty impressive but he's known for his science act not career. He's not exactly cracking cancer or theorizing about radiation and black holes.

So what we have is a roster of some superior science minds and some remarkable people who've contributed to science and at least one who doesn't actually do much science.

We could get all sad and soak up the last of the Sangria but I'm thankful anyone can name a single scientist besides Albert Einstein. Honestly, who's that guy or girl in the lab coat? Uh-huh. Took a minute, right?

Sure, the lab crowd has never been the sort to preen about the public stage. It's not like many physicists or geologists end up on the front of Huffington Post or TMZ though there's no shortage of ego or drama on their part (see Retraction Watch).

We're well aware here at MommaData of the poor communication between the scientists, the media, and the parenting public (i.e. the real world). But before we start crying in the frosted animal crackers (my bad, ooops!) let's take a quick survey...

Name a living scientist who you'd like to invite to your next block party.

HHhhhmmm.

Next week: The scientist you'd like to see star on The Bachelor. Now that I would watch.

The Bad Science Chronicles: Mistakes in Science, Retractions and My New Media Crush.

2011-08-11T07:17:00.000-07:00

Bad science is on the rise - at least if you count articles that have been yanked out of academic journals.

Seems we're witnessing a storm of bad science in the form of retracted articles. Like the infamous Wakefied study linking vaccines to autism, the one that got booted out of the Lancet this past year for doctored and flawed data. Blame it on pressure to publish in academia and thus rushed analyses, distorted data, and even doctored data. Maybe better detection. Maybe the outright onslaught of studies waiting to be published. Or maybe it's just the angst of academia - see Life as an Academic Can be Tough on Family.

But don't take my word for it, the Wall Street Journal has also noticed:

Since 2001, while the number of papers published in research journals has risen 44%, the number retracted has leapt more than 15-fold, data compiled for The Wall Street Journal by Thomson Reuters reveal...Just 22 retraction notices appeared in 2001, but 139 in 2006 and 339 last year. Through seven months of this year, there have been 210, according to Thomson Reuters Web of Science, an index of 11,600 peer-reviewed journals world-wide. Mistakes in Science Surging

Bad science popped up on the radar of the New York Times recently too. An op-ed piece chronicled why scientific mistakes rarely get "corrected" by replication or publication and for that matter, even addressed in public or the media. As I posted before, bad studies are like bratty kids who get the slurpy because their parents are too distracted or busy to take on the bad behavior.

Of course there's also the somewhat fishy studies that grab so much media attention people start to believe them and panic, pass laws, buy entirely new sets of baby bottles and pricey Swiss water bottles, etc - like the speculative data behind the whole bisphenol-a threat that's starting to look less menacing by the month.

The deluge of bad data is so bad it got it's own blog, my new media crush - Retraction Watch. It's part CSI with a serious dose of New Jersey Housewives. Those scandal queens don't got a thing on the nerds, save maybe a boob job or Botox injection.

Who says science is boring?

Is it me or is the WSJ trying to drive people from academia with tales of plagarism, fraud, ivory-tower backstabbing and forgotten spouses and children? Gee, why did I ever leave the ivory tower...

Bloggers More Trustworthy Than News Media?: Other Tidbits from BlogHer 2011

2011-08-10T08:56:00.000-07:00

BlogHer 2011, San Diego. LOVE that town.  As for the 3,600 women and the various media and sponsors, I caught up with some fascinating folks and gleaned a few nuggets from the whole affair:

So women trust bloggers more than the news media.   That's according to one of the BlogHer founders who announced the results of a recent survey (funded by BlogHer and iVillage - Social Media Matters) to a rousing round of applauds. Of course this finding made me more than slightly uncomfortable.

How often do you trust the information & advice you get from Blogs you are familiar with?

88% of active blog users report they always/frequently/sometimes trust what they read on blogs.

Geez. Really? Scares me a bit.

True, this still means they sometimes don't trust what they read on blogs and the "sometimes" probably greatly outweight the "frequentlies" (and of course we didn't see that data!).  I'm sure the stats are different for "non-active blog users" whatever that means. Also, the Nielsen survey focused heavily on consumer recommendations, you know, like what shampoo or baby stroller to buy. Apparently parents rely on bloggers for this kind of info and hey, maybe that's okay.

Personally I'd love to see a survey addressing which sources parents trust for getting news and information about children's health. A totally fascinating topic that was absent at BlogHer 2011. In fact, it was too easy to get the impression that no bloggers discuss the matter or really any parenting matter in serious technical detail.

So please, BlogHer 2012 let's give some attention to the science-minded or otherwise geeky chics in the blogosphere. As Liz Ditz, my fellow blogger and Skeptimommy, commented, we need some attention!  We're here, we're vocal, and hey, we're sometimes even entertaining though no spontaneous public dance guaranteed EVER. Maybe we can get the Fearless Formula Feeder on the task too? Who's in? BlogHer 2012 in my backyard, New York City. There's nothing like August in Manhattan...

So although I wasn't completely down with all my fellow women bloggers (especially those who loved the "flash dances" or "mob flash" or whatever the spontaneous dance is called) I did meet a few really cool women way up on science and kids health.  Like Robin Herman, the first female reporter to enter the male's locker room and now at the Harvard School of Public Health. And oh yeah, she wrote a book on cold fusion. Yes I said COLD FUSION! Also met Peg Willingham who works on the Global Vaccines Campaign at the United Nations Foundation.  Yes, women working to make a difference in the lives of women and children! Gotta love that.

Media Ignoring New Study on BPA?: Hello from BlogHer (Almost)

2011-08-03T08:29:00.000-07:00

So while I'm en route to BlogHer check out this new study on BPA, yes, the little toxin that emptied the baby aisles and I might add, many a parental wallet seeking "safer" alternatives. Of course I got rid of the BPA bottles and sippy cups years ago, but as usual I have been skeptical of the suspected carcinogenic effects.

So read and we'll discuss next week, Trevor Butterworth's take on the new study. Okay I just wanted to type that name one more time. Take it away, Trevor....

Majestically Scientific” Federal Study On BPA Has Stunning Findings: So Why Is The Media Ignoring It?

BTW, I LOVE California. You peeps out here are so lucky and don't try to mention the state debt, etc.

Wish me luck, Legoland here we come.....

Austism Twin Study: Searching for the Cause of Autism and the Perfect Sandal

2011-07-18T11:10:00.000-07:00

Does the environment plays a bigger role in triggering autism than we thought?

CORK SANDAL by Jessica Simpson

Yes says a new autism study looking at twins recently published online in the Archives of General Psychiatry. Fascinating event for several reasons, most notably for challenging the prevailing notion autism is largely a genetic disorder. Also, the study out of California is the biggest of its kind to date.

Could this study be a summer trend like those cork sandals from the 1970s.  In other words, a dramatic tease ultimately shoved to the back of the epidemiological closet?

Here's the low down:

Researchers (partially funded by Autism Speaks) gathered 192 sets of twins (identical and fraternal) in which at least one twin had been diagnosed with an autism spectrum disorder. Now because identical twins share 100% of the same genes (at least at the start) and fraternal, about 50% respectively (as do non-twin sibs), these kids offer a ready-made study of the relative contributions of genes versus the environment.

The greater the predicted role of genes, the more we'd expect higher concordance rates among identical twins (i.e. if one twin has autism, the percentage of cases in which the other twin does too). Hypothetically if genes were solely responsible than if one twin had autism, the other one would too, guaranteed - a concordance rate of 100%.  Non-twins sibs and fraternal twins would be roughly equal and considerably less that the identical rate as both groups share the same amount of DNA (roughly 50%).

The curious part is explaining different concordance rates between the groups when environmental triggers appear on the scene (as they surely do with autism) especially during the prenatal period.  Because twins share the womb, we'd expect the concordance rates to be closer together for identical and fraternal twins if in fact there are prenatal environmental triggers. Hypothetically if there were no genetic component, we'd expect the rates to look similar for identical and fraternal twins.

But back to reality...

The researchers found when one identical male twin had autism, the other did too in 77% of the pairs. The "concordance" among identical girls was 50%.  As for the fraternal twins, if one twin had autism, 36% of girls and 31% of boys did too.

Okay, nothing so unusual thus far. Those figures are somewhat in line with rates in recent studies though some have calculated it around 90% for identical and 10% for fraternal.  If anything the fraternal rate was considerably higher than past estimates as some studies put it at about zero though many have doubted it was really that low.

But it was what the research team did next that raised some eyebrows. Using high-powered new statistical techniques that confuse most people they estimated the portions of autism triggered by both environmental factors and genetic ones (i.e. the latter, the "heritability).

Drum roll please...the results revealed:

About 40% could be blamed on genetics!

About 60% could be blamed on environment!

In other words, a complete, um, flip-flop of common wisdom and other recent research.  But don't take it from me, here are some other autistic experts who can't keep from wondering what happened in the numerical mumbo jumbo that is modern-day statistical modeling (i.e. elusive to most people except statisticians):

I think they're really on shaky ground to say that," said Dr. Paul Law, director of the Interactive Autism Network at the Kennedy Krieger Institute in Baltimore. (Autism Study Downplays Role of Genetics, LA Times)

"Their data is so similar to everybody else's, and yet they come up with another conclusion," said Robert Plomin, a behavioral geneticist at King's College London. "I don't know how this happened.(Autism Study Downplays Role of Genetics, LA Times)

“When somebody gets a totally different answer from what anyone else has seen, you need to see it a few more times before you believe it,” says Susan Folstein, a child psychiatrist at the University of Miami in Florida and autism researcher. (Environment Blamed For Autism, Science News)

So first and foremost, we have the issue of a freakish finding. In other words, we need to await replication to validate these figures, especially the heritability and concordance among fraternal twins.

If only we could tell the classics from the mere trend. Of course it's possible the results will be replicated, but there is some reason not to buy this just yet.

It's worth noting how many twins from the solicited sample ended up "participating" in the study. Not many. Originally researchers gathered 1,156 eligible pairs but ended up with only 192. Less than 20% of the original sample and that's worrisome especially if you're trying to look at a complex issue riddled with numerous variables. It's not just my opinion either.

“That is too low of a response rate to marketing survey research, much less an epidemiological study,” says Edwin Cook, a child psychiatrist at the University of Illinois at Chicago. (Environment Blamed For Autism, Science News)

Why? For one the families who participated could differ in substantial ways from those who passed on the study. Maybe in the participating families both twins were more likely to have autism thus making them more motivated to say yes. That would explain the higher heritability rates too. Also, studies with low participation are simply more prone to error, you know, the freak factor.

It's clear the old ENVIRONMENT v GENES is a tired dichotomy much like the stale choice of either flats or four-inch heels choice in the women's shoe aisle. I think it's time to seek some middle ground in both epidemiology and ladies' footwear. The roots of autism, just like women's feet, clearly cannot be comfortably squashed into the present either/or options. Our kids and our feet deserve more nuance.

In fact, our notions of environment and genes need an overhaul. Environment is not just about toxic cleaning supplies and bad plastic. Let's let Heather Turgeon over at Babble's Science of Kids explain it:

When we think environment, we tend to imagine toxins, diet, or unhealthy family conditions swooping in and altering a child’s biology or behavior. But it’s much more intricate and subtle than that. Anything that affects the expression of our underlying genetic code is considered the environment. It’s a loose term that encompasses even the most subtle (and less sexy, news-making) molecular signals in the womb that alter the expression of our genes. During all fetal development – healthy or otherwise – chemical switches are constantly turning off and on certain pieces of DNA. (Is Autism Linked to the Environment?, Babble)

Heather also reminded us that a recent review of autism research in Pediatrics identified 16 factors linked to autism. The suspects include multiple births, low birth weight, parental age, fetal distress, umbilical cord complications - many overtly "environmental" in nature, some that suggest genetic contributions too, like perhaps parental age (i.e. faulty DNA?) thus blurring the line between the two.

Speaking of which, genetics doesn't just boil down to DNA. The burgeoning field of epigenetics suggests what your grandma ate just might influence whether or not your child's DNA will be destiny or merely a suggested route even though she or he got grandma's same DNA. Clearly genes are not what they used to be.

So just as I've stayed clear of flip flops, ballet flats and heels (shorts and heels, really? cannot pull that off even living in Jersey), I'm also throwing out the clunky genes v. environment. It's time to clean out our epidemiological closets.

Now if someone would refer me to the perfect 2-inch summer sandal that I can wear all day and won't make me sentimental for my days working as the sole straight woman at an all-natural women's clothing catalog, I will love you forever or until the rubber soles disintegrate.

By the way, I wonder what heels Heather Turgeon at Babble is wearing these days? Maybe she will reveal her footwear preferences? She writes with clarity about complex matters in such a calm and reassuring voice I bet she is also a terrific therapist with a good pair of shoes.

All thoughts on autism or sandals kindly accepted...

Foreskin Conclusions: The Pros, Cons and Inflated Claims of Male Circumcision

2011-07-12T11:32:00.000-07:00

Intactivist Mom: Photo from the New York Times

Now that Weinergate has died down, let's turn to another pressing drama involving male anatomy recently arousing considerable ado.

Circumcision.

Come November San Francisco voters will decide whether the age-old practice of snipping foreskins should be banned.  For a good review of the two sides of the parental bugaboo, see the recent LA Times article (Pro / Con: The debate over circumcising baby boys). FYI, the title is misleading.

It's more like Not Recommending Ban versus Con.

Most doctors aren't exactly pushing parents to snip-snip.  Health authorities have been walking a fine line. While most fall back on the "not medically necessary" they do cite some small health benefits, especially for the transmission of sexual diseases.  Ones that worry the World Health Organization that isn't exactly pleased by the declining circumcision rates as the practice is tied to lower rates of HIV infection.

Personally I can't decide which side has done more disservice by exaggerating the data. My vote probably goes to the "intactivists" - those behind the ban (why do the extremists always get the best names?).  It's not like they're just sitting in their offices forming panels to issue policy recommendations.  They're out gathering signatures.

Take Matthew Hest, the San Diego-based intactivist behind the new ballot measure.  He not only wrote the measure but writes an online comic book, “Foreskin Man” that I kid you not, features the evil “Monster Mohel" (see a recent article in the New York Times).

Speaking of comics, there is plenty of comedic relief from both sides here. Take grass-roots intactivist Jena Troutman who has wandered the beach preaching her anti-snipping sermon:

“I am just a mom trying to save the little babies,” Ms. Troutman said. “I’d rather be on the beach, but nobody is talking about this, so I have to.” (The New York Times, Efforts to Ban Circumcision Gain Traction in California).

As if Ms. Troutman, a former lactation educator and doula - big surprise - could just slather her young boys with sunscreen and forget about all the other little penises in the surf.

You wanna do the snip-snip to your son, go for it. You think it's genital mutilation, obviously you won't.

Either way I hope you do so with a fully informed conscience. Easier said than done given the river of drivel on this one. Some of it spouted by health authorities - like the health benefits.

Are there benefits to circumcising male infants?

Absolutely. If your son may at some point have unprotected sex in Sub-Saharan Africa or is otherwise at risk for HIV infection (by a woman, not another male).

Or if there's a chance he'll wind up without access to running water.

You know, should he turn into a nomad wandering a drought-plagued wilderness, an Into the Wild wannabe minus the flowing streams and excellent sound track. Forget the starvation, the psychological effects of isolation, the random grizzly attack. No, this is a mother's worst nightmare: How will my child keep his penis clean? Maybe that's what drove the poor young man to despair up in Alaska. He just didn't feel fresh.

But freshness and for that matter hygiene may not be as important to the penis owner as the penis cleaner according to the LA Times article:

...And in a study of nurses in a U.S. geriatric unit, about 90% were strongly in favor of circumcision because it was difficult to bathe uncircumcised men in their 90s. When we look at a baby and we think about circumcision, we have to think not just about that baby but that he's going to turn into a man and, eventually, an old man. (Daniel Halperin, lecturer in international health at the Harvard School of Public Health).

Not only do circumcised men curry favor with geriatric nurses but possibly also sexual partners. Our health expert above, Daniel Halperin, reported circumcised men "enjoy a wider range of sexual activities." Though I cannot even begin to fathom an explanation for those results a few rather graphic images come to mind. Presumably evidence the circumcised male still enjoys an active and diverse sex life.

Seriously, circumcised men as sexual adventurers? Ninety year-old penises? Really?

Ladies and gentlemen, the debate now has left the realm of serious scientific inquiry.

On both sides.

Witness the allegations from the anti-snip side:

Some men even say that they have post-traumatic stress disorder that they associate with their circumcision as infants. I think we would have no trouble believing that from a woman, but we write off men's trauma and recollection as being whining and unmanly. (Georganne Chapin, founding executive director of Intact America in the LA Times article)

Actually Georganne, I do have great difficulty believing any adult, male or female, could experience post-traumatic stress related to memories from a minor procedure during the first weeks of life. If this were the case, who could ever get over being pushed/pulled/cut out of the womb? Circumcision is a walk in the park compared to being born. So, at the risk of being contradicted by freakish future evidence of negative psychiatric long-term side effects of memories produced in infancy - RUBBISH!

Some men may resent having been circumcised. Some may have suffered a rare physical injury (most are very mild). Some may even have been led to believe by suspect therapists they suffer from circumcision-induced PTSD and that is unfortunate.

But it is ridiculous to suggest circumcision contributes to or even sets off post-traumatic stress, a disorder associated not with merely emotionally or physically painful episodes but severe, unspeakable trauma the likes of war, hurricanes, plane crashes, rape.

Or being held down as a 10-year old by your relatives while your Nana cuts off your labia and clitoris with a sharp piece of glass putting you at risk of significant blood loss, severe infection, chronic sexual and reproductive impairments and oh yeah, death.

To equate male circumcision with the horrific practice of female genital mutilation is an assault on our rationality.  End of discussion.

Let's admit it, the risks of male circumcision are quite small and limited to those associated with minor medical procedures and basically zilch in childhood and adulthood. Just as there seems little harm, the benefits are few and overblown.  And by the way, it's on the wane anyhow. Just like so many other parenting issues, there is no black and white here, no right, no wrong.  No one size fits all.

As for the countless perfectly legal means by which parents imperil their children's future health and well-being, removing the foreskin seems rather tepid in comparison.

Second-hand smoke.
Harsh parenting devoid of affection.
Too much sugar, fat, empty calories (e.g.  editorial in JAMA arguing some obese kids should be taken into protective custody).
Not enough sugar, fat, empty calories (hello, bulimia and anorexia).
Not teaching kids how to avoid pregnancy and sexually-transmitted diseases.

I will spare you a rant...certainly you like me have compiled a mental list of the more insidious parenting practices, a "pet peeves" of bad parenting if you will (e.g., soda in the baby bottle, rewarding bratty behavior because it's easier).

More worrisome - what's next, a ban on infant formula here in the US? If only it were a joke.

Bad Studies That Won't Go Away: How Bad Science is like the Bratty Kid with the Slushy

2011-06-29T07:13:00.000-07:00

I have no idea why this slurpy is sideways!

What happens to crappy studies?

Unless they ignite international brouhahas (e.g.. thousands of parents choosing not to vaccinate), not much according to an op-ed in the New York Times. It's Science, But Not Necessarily Right.

(Title in paper: Why Science Struggles To Correct Its Mistakes).

Turns out bad science is like the bratty kid with the push-over parents who keeps getting away with less than acceptable behavior.

Bad science gets rewarded in the short-term (i.e. published) then is ignored and thus ultimately excused much like the bad behavior of the kid in Target whose temper tantrum earns him a slushy. Mom or dad are too busy, too distracted, too unmotivated, too fill-in-the-blank to address the dreadful performance and thus it gets a pass and remains a regular feature of the kid's behavioral repertoire.

Just as the other shoppers (in addition to neighbors, family members, Facebook friends) will dissect any incidents of poor parenting, academics are only too happy to trash bad studies at department meetings, conferences, maybe the blogosphere but they're not gonna often lift a hand or research dollar to correct it.

They know it's ridiculous, why bother proving it? If it's a study of little merit, who's gonna want to replicate it except for some beleaguered grad student who's searching for a dissertation project.

Researchers are too busy with their own research gigs (for good reason), not to mention visions of tenure, to waste precious time and grant money trying to take down the competition even if the work appears deeply flawed. It's no fun doing what's right and dragging your child out of the mall mid-tantrum to make a point and there's little glamour let well enough alone prestige in replicating already-published results.

Top journals want significant and original results. So do tenure committees.

Add to this dilemma the media's eagerness to publicize studies with dramatic or entertainment value regardless of scientific merit and no wonder people don't trust experts or anything they read or hear in the parenting sphere.

Now it's not always clear that the results are flawed right away, especially if they are highly speculative and doctored (ahem, Andrew Wakefield's MMR-autism results).

Sometimes the results are just freak findings - the 1 in 100 chance of finding "statistically significant" results that truly are not significant. Like the now debunked Mozart Effect based on the study showing a few minutes of classical music improves cognitive performance, work that launched the Baby Einstein empire but has ultimately not been successfully replicated despite many attempts.

More often small or limited results get blown out of proportion, especially in areas without much research. Like the incidence of fatal analphylatic reactions attributed to food. Meredith Broussard blew the lid off that small, shoddy, greatly stretched set of data a few years back (see my earlier post).

After reading the op-ed in the NY Times about shyness a couple days ago I searched high and low for updated figures on the percentage of introverts in the population. ( see Shyness: Evolutionary Tactic?). Not much out there. For years the accepted figure was 10 - 20% of the population. Why? According to Susan Cain who wrote the op-ed and also a book on the topic, the estimate came from the creator of the Myers-Brigg personality test - and it was just a guess so not based on actual research.

Cain cites Jonathan Cheek's figure (50% of adults) but in a quick check of his work (and a quick check in Google Scholar) I can't find the relevant study nor any other estimates of introversion. So who knows the origin of that number. If you know, please let me know because now I'm intrigued and slightly irritated - if only expert sources would provide a full reference then my life would be complete.

So have any good or pressing examples of bad science on your mind? The journals might not care but I do...rant away.

The Breast Milk Cure.... or Curse? It's the Water Not the Formula

2011-06-27T07:41:00.000-07:00

Breast milk, the miracle cure for child malnutrition and global poverty?

Nicholas B. Kristof, The New York Times, The Breast Milk Cure

That's what New York Times foreign affairs columnist (i.e. not a trained science writer) proposed in his latest compassionate yet flawed, okay, botched attempt at public health advocacy - The Breast Milk Cure:

What if nutritionists came up with a miracle cure for childhood malnutrition? A protein-rich substance that doesn’t require refrigeration? One that is free and is available even in remote towns like this one in Niger where babies routinely die of hunger-related causes?

Impossible, you say? Actually, this miracle cure already exists. It’s breast milk.

Why is it such a good cure? It's natural, readily available and oh yeah - doesn't include contaminated water.

Oh that minor issue - the water. The filthy water used to make infant formula.

Citing research showing a link between breastfeeding and lower mortality rates (hello, confounding factors!! correlational results!!), Kristof eagerly argues breastfeeding can save lives as do the experts he digs up:

“As far as nutritional interventions that have been studied, we have crushing evidence of breast-feeding’s efficacy in reducing child mortality,” said Shawn Baker, a nutrition specialist with Helen Keller International, an aid organization that works on these issues.

Crushing evidence for sure but evidence of the curative powers of breast milk? No, not exactly. Maybe evidence of the Curse of Breast Milk - health authorities the world over ignoring what the data really say in order to glorify the almight powers of breastfeeding.

The curative powers of breastfeeding have little to do with breast milk and plenty to do with the fact babies who get the boob don't have to suffer the dirty water.

Gee, do you think the moms who nurse could be more informed say, about children's health? Might they differ in any number of substantial ways from those who didn't opt for the breast? Hmmm.

Why oh why can't public-health minded peeps be honest and accurate about the benefits and limitations of breastfeeding?

No child has ever died due to insufficient breast milk. Despite that crazy Harvard study shouting about 900 annual baby deaths - there is no evidence whatsoever that not breastfeeding kills infants. In Niger where Kristof focused his editorial insights, children die because of the unsafe water and a host of poverty-related factors that have nothing to do with sub-optimal levels of breast milk.

Should more women in Niger breastfeed? Absolutely.

Only 9% breastfeed exclusively for 6 months (compared to 13% in the US) according to Mr. Kristof who opines on the reasons women in Africa breastfeed in such low numbers.

That's when the you-know-what really starts flowing:

It’s not clear why a human instinct to nurse went awry. Just like the instincts to kill our competitors, our babies and run like hell when we hear a loud noise? Speaking of going awry...Does it have something to do with the sexualization of breasts? In Africa? Has he seen the movie Babies in which it becomes clear even to my 8-year old that breasts are just another limb and not a cash cow for the fashion and cosmetic-surgery industries. Or with infant formula manufacturers, who irresponsibly peddled their products in the past but are more restrained now? Maybe formula should be outlawed? Along with high fructose corn syrup, trans fats and white bread, I mean honestly, aren't those parents in Africa worried about their children's health? I know there's a horrific famine and all but honestly, stooping to formula? Or is it just that moms worry that their babies need water on hot days? Nobody really knows. Mainly because no one has bothered to figure it out because it's so much more productive churning out flawed studies showing links between breastfeeding and health benefits.

Then there's the fact that it's not easy charging up a double breast pump in the middle of the Sahara desert. It's not like women can run over to the nearest village and find breast milk storage bags either to say nothing of the perfect nursing bra or nipple cream.

Hey, honey, on your way to the military coup, could you pick up another Boppie cover?

So, please, Mr. Kristof, get the story straight. Doesn't take a genius to poke holes in your plaintive plea. You've won the Pulitzer, you are a genius and by the way, you have a huge stage. You the man, don't abuse it.

The Future of Mental Health...Official Mental Health that Gets an Insurance Code

2011-06-09T10:07:00.000-07:00

Narcissism out. Asperger's out. Pervasive Developmental Disorder out. The Autistic Spectrum collapsed.

The new Diagnostic and Statistical Manual, aka "the bible" of the mental health field, likely will include these revisions and more come 2013. The American Psychiatric Association hasn't overhauled it since 1994 when we still thought of autism as a rare disorder marked by extreme deficits and impairments. Back then ADHD was king and autism was the guy in Rain Man.

A recent article in the LA Times (paper has a great Health section) hits on some of the more fascinating quandaries facing the psychiatrists and psychologists trying to figure out what determines a so-called mental disorder, not so easy these days given advances in neurological imaging and molecular biology that blur the line between mental and physical health.

For instance, Alzheimer's is recognized as a medical condition and yet it features impaired cognitive function, a typical "mental" component and as such might qualify some individuals for one of the new mild cognitive conditions in the next DSM.

But despite all the fancy new research that costs a fortune there still are no definitive biological or physiological markers of autism, ADHD, depression or any other mental disorder. We can't take a picture of the brain and make a diagnosis. We still (and hopefully always will) look to behavior for deciding what's problematic.

Bringing me to the next issue.  How bad off do people have to be to get a diagnosis?

Should someone be diagnosed even if they appear to be functioning okay at work, school, in marriages, friendships, etc?  We all know people like this, right?

But it gets even harder to define okay when it comes to kids who are notoriously irregular in their development and who have more help navigating the world. Their social limitations may not be obvious as they have more limited social demands than adults.

How about when we have, say, a young child with communication delays and mild other behavioral symptoms. Should we go ahead and use Pervasive Developmental Disorder- Not Other Specified (on the autistic spectrum now but to be collapsed into autism in the new DSM)? There's an argument that kids who could benefit from early intervention should be labeled and get the treatment. It can be difficult to figure out to what degree a child is not "functioning" in part because kids develop at different rates. It's not clear where the line should be drawn between diagnosis and (irregular) child development.

Remember the study out last summer finding children who start kindergarten at an earlier age are more likely to be diagnosed with ADHD? Hard to argue the diagnosis isn't in some part socially-constructed and thus has more to do with brain development than brain "dysfunction":

The researchers figured that children born just a few days apart should have the same underlying risk of having ADHD. So finding a significant difference in diagnosis rates between children born only a few days apart is strong evidence of medically inappropriate diagnosis.

(Researcher) Morrill explains that the study shows that children born just after the kindergarten cutoff date were 25 percent less likely to be diagnosed as having ADHD than children born just before the cutoff date. “This indicates that there are children who are diagnosed (or not) because of something other than underlying biological or medical reasons.

“We believe that younger children may be mistakenly diagnosed as having ADHD, when in fact they are simply less mature,” Morrill says.

So basically we have diagnoses based to some degree on when a child starts school. Uggh. It's enough to give a parent mucho stress trying to figure out whether to send a "late birthday" child to kindergarten or hold them back, yet another swirling controversy. I know, dealt with it personally, two times.

Check out the revisions if you have time - including the addition of Premenstrual Dysphoric Disorder and Hyper-Sexual Disorder (Arnold, Tiger, Elliot Spitzer...).

By the way, The American Psychiatric Association wants to know what you think about the DSM proposed changes. You can add your two cents officially until June 15.

Of course I will take all comments indefinitely.

Gender Neutral Nonsense? Lessons from Professor Money

2011-05-31T10:53:00.000-07:00

The two Canadian parents raising the gender-neutral child. Surely you've read the story about Storm and the swirling controversy as it's even reached my bachelor brother.

Now that there's been time to digest both the seeming lunacy of keeping secret the sex of a young child and all the subsequent media coverage this decision inspired, I still can't forget the deeply tragic and obviously flawed theory of John Money, the gender guru who preached children could transcend their chromosomal destiny. Boys could be girls and girls, boys.

From his professorial perch at Johns Hopkins the sexpert oversaw his most famous case, a baby boy who after a botched circumcision would be "sexually reassigned" - living life as a girl. The parents agreed to rename him "Brenda," dress him in pink and oh yeah, cut off his testes.

So I remember this case vividly from my undergraduate psych courses, an example of the fluidity of gender and sexual identity. Of couse real life in the 1970s was much bleaker for David Reimer, the victim of Money's theories and supposed perverse inclinations. He wasn't exactly identifying with Marsha or Cindy Brady. According to a piece in Slate by John Colapinto, "Brenda" and her family weren't exactly the Brady Bunch:

The reality was far more complicated. At age 2, Brenda angrily tore off her dresses. She refused to play with dolls and would beat up her brother and seize his toy cars and guns. In school, she was relentlessly teased for her masculine gait, tastes, and behaviors. She complained to her parents and teachers that she felt like a boy; the adults—on Dr. Money's strict orders of secrecy—insisted that she was only going through a phase. Meanwhile, Brenda's guilt-ridden mother attempted suicide; her father lapsed into mute alcoholism; the neglected Brian eventually descended into drug use, pretty crime, and clinical depression. John Colapinto, from Slate Magazine.

So the true nature of David's despair didn't come out until much later:

As for Reimer, when he finally reached the age to make his own medical decisions, he was so distressed by Money's demand for further surgery to complete his "female" genitals that his parents decided to reveal his medical history to him. He immediately re-transitioned to a male gender role and later underwent genital reassignment surgery again, in order to complete his male gender identity with male genitalia. He underwent four rounds of reconstructive surgery to facilitate his reappropriation of the male sex. Towards the end of his life he lost his job, was separated from his wife, fell victim to an unscrupulous financial investment, and mourned the death of his twin brother Brian, who died in a drug overdose. He committed suicide on May 5, 2004. John Colapinto, who publicised Reimer's story in a Rolling Stone article...and the book As Nature Made Him...speculated that Reimer never psychologically recovered from his childhood trauma...

Reimer said Money sexually abused him and his brother during superfluous photo shoots. This added stress was harmful to Reimer and instilled in him a fear of Money and his medical "expertise." A 20/20 interview (A Different Sex, April 19, 2002) contains this primary source. Thank you, Wikipedia.

His medical expertise! That's one name for it, the FBI might call it something else. By the way, Money had no children of his own. Thank goodness or he might have experimented further. The pathetic part in all of this medical misinformation and mayhem, though, is that as David Reimer struggled through his short life the textbooks and one would imagine the professional community regarded him as a successful example of the mutability of gender identity.

Would I like my children to transcend the barriers of their gender? Absolutely. I spent my prime childbearing years in The Social Perception Lab where we couldn't stop talking and writing about the pernicious effects of discrimination and stereotypes based on gender and race and sexual orientation and every other category we could quantify.

But that Canadian couple is forcing the non-existent category of "no gender" on a young child in a male/female/ transgendered world. Even in an unschooling, co-sleeping, nomadic existence, it might be unnerving to be singled out to such a degree. The kid's brothers have been free to explore their gender orientations without any secrets. At some point this secret will come out as the kid's sex and gender become clear but the freak factor may never end. Not a chance.

By the way, I remember a study a few years back finding that young kids who really get into gender roles (i.e. girls dressing as princesses, boys wielding pirate swords) actually end up engaging in less stereotypical behavior later on. Can't dredge it up from the research files but it stuck in mind at a time soon after my own girls clamored over plastic heels and bright pink - and it suggests learning how to be really, really girlie or boyish may have its advantages. Anyone know this study?

So, it's only a matter of time before the two gender-bending crusaders up north sign a book deal or worse yet, start taping their own reality show.

FYI: Nova featured the Reimer story back in 2001. It's still a fascinating discussion ten years later. The interview featured David Reimer's mother and Milton Diamond, the biologist who questioned the success of the sex change. You can read the transcript.

The Kumon Condition: Preschool Math and Reading Prep

2011-05-17T09:02:00.000-07:00

Fostering a love of learning? Photo from The New York Times.

Math and reading tutors for two year-olds.

It's called Kumon and is coming to a strip mall near you.

Some see this academic prep program as scholastic progress.  The three year-old girl in the photo at right may be learning her letters but I suspect she's also learning that learning can be a real bore.

So who reaps the benefits of these for-profit educational centers?

Clearly this kind of extracirriculur enrichment isn't geared to kids with poor small-motor control, speech delays, learning disabilities or other diagnosable deficits meriting occupational or other therapeutic intervention.  Nor is it directed towards the Head Start crowd who might benefit from an extra dose of the ABCs. Nor is this the tutoring of yore for students struggling in their classes - as if it were possible for preschoolers to "struggle" with the academic cirriculum, like letter formation and number identification.  Not that writing letters isn't hard for the under-five set, of course it's hard, they're barely out of diapers.

This is, however, the program for kids who request pesto on their pizza (read the article below).

So yesterday's Fast-Tracking to Kindergarten in the New York Times about Kumon fascinated me.  Here's the deal. After shelling out several hundred dollars a month and somehow schlepping their preschoolers to twice weekly one-hour sessions these supposedly savvy parents then must bribe the kids to sit down for homework each day:

Children are then expected to do 20 minutes of homework on each subject (math and reading) every day, with their parents guiding and grading them.

As for any free-time in between the study sessions, there's the recommended "reading lists that start in preschool with Goodnight Moon and Each Peach Pear Plum."

Two hundred dollars!

Speaking of money, take the tutoring company's CFO, a man apparently gifted with numbers (profit margins?) who might need some tutoring in child psychology:

“Age 3 is the sweet spot,” said Joseph Nativo, chief financial officer for Kumon North America. “But if they’re out of a diaper and can sit still with a Kumon instructor for 15 minutes, we will take them.”

We will take them. If we must. We'd rather not but if you insist...

Anyhow, at least one psychologist, a well-respected researcher and author of The Scientist in the Crib, doesn't think this early-academics approach is so sweet:

“The best you can say is that they’re useless,” said Alison Gopnik, a professor of psychology at the University of California, Berkeley.

“Yes, your child might know more of his letters than the child who spent Saturday in the sandbox,” she said. “But the people who are team players, who are creative innovators, they are the ones who are going to invent the next iPad. The kids who are just memorizing are going to be outsourced to the kids in India who have memorized the same stuff.”

So at the worst an early focus on academics can undermine the development of valuable life skills like sharing and creativity. For individual children it might not seem to matter whether they do math worksheets but when parents demand more academic preschool curriculums, there consequences do add up. Like less time for social interaction and free play.

Ah parents. We're a tortured bunch. I'm as conflicted about "The Race to Nowhere" as anyone else. My kids do a lot of homework. I get that Kumon might be useful for older students. Some schools (like my kids') prefer to teach fifty ways to solve equations rather than relying on memorization. My daughter could spew out 10 ways to compute 10 plus 10 but had to take a minute to answer 5 + 8. After all that creative problem-solving I had to convince her she simply had to memorize the multiplication table.

But I think there's cause for concern when some parents are so focused on early academics (i.e. memorizing) and their childrens' futures in the global marketplace that they can't help but sign toddlers up then sit and watch them (doing worksheets) through a window in the waiting room - an arrangement designed by Kumon to limit any separation anxiety because who on earth would want to mess with the emotional health of young children.

Autism Underestimated? Autism Rates Twice as High in South Korea

2011-05-11T07:20:00.000-07:00

A new study out of South Korea finds a surprising 2.6% of children have autism. This 1 in 38 autism rate is more than twice the 1 in 110 estimate for US children. The researchers looked at symptomatology among not only kids already diagnosed with autism (as is more typical) but those in the general school population. So what do researchers and thus the media conclude from this unexpectedly high estimate?

Basically there are more children with autism than we think even in the United States - the true rate of autism is likely higher than previously thought with many children on the autistic spectrum flying under the radar, undetected in their schools and homes. If we'd only look for them more closely they would reveal their disabilities and deficits to us:

From the get-go we had the feeling that we would find a higher prevalence than other studies because we were looking at an understudied population: children in regular schools,” said the lead researcher, Dr. Young-Shin Kim, a child psychiatrist and epidemiologist at the Yale Child Study Center. Study in Korea Puts Autism’s Prevalence at 2.6%, Surprising Experts, New York Times

"If researchers went into the grade schools in their communities and looked there, we think they would come up with numbers similar to those we are reporting," (lead researcher Bennett L. Leventhal, MD, of the NYU Child Study Center) said at the news conference. "This means there are uncounted children who are not in the services system." Study: Autism May Be More Common Than Thought, WebMD

You didn't think Autism Speaks, the advocacy group that partially funded the research was gonna pass up this opportunity?

"These findings suggest that ASD is under-diagnosed and under-reported and that rigorous screening and comprehensive population studies may be necessary to produce accurate ASD prevalence estimates," stated Autism Speaks Chief Science Officer Geraldine Dawson, Ph.D. " New study reveals autism prevalence in South Korea estimated to be 2.6 percent or 1 in 38 children, Eureka Alerts

Just how many under-diagnosed and under-reported cases of autism are we talking?

Plenty.

Lots of autism cases popped up in the heretofore undiagnosed kiddies, meaning they weren't diagnosed prior to the researchers poking around their business.

It would seem a portion of these students were functioning well enough in daily life to prevent any psychiatric labels. Surely some were not doing well and for whatever reason (parental lack of awareness, stressful home life, overcrowded schools, social stigma etc.) were never hauled into the school psychologist. Apparently there is lower awareness and more stigma associated with autism in South Korea.

Now here's the amazing part.

MOST cases of autism went undiagnosed!   Most cases!  Two-thirds.

Two-thirds of the children classified in the study as autistic were not diagnosed before the researchers started asking questions and assessing their behaviors. Thus the mental health professionals working with the researchers decided they were autistic.

It's hard to understand how so many children would go undetected - especially here in the US. Maybe in some areas far from a bevy of health professionals and autism awareness bumper stickers in school car lines but here in my suburban existence it seems unlikely most or even many kids with autism go unrecognized. It's even odder to think about autistic behavior in older kids going unnoticed. Maybe a kindergartener even first grader but a 12-year old seems unusual.

True, I have little idea what life in South Korea is like for a kid struggling with the demands of social interaction. The typical school day lasts for 12 hours. The schools stress academics and rote learning over the more social aspects of development. The researchers studying the autism rate have suggested the more socially-impaired students "passed" as they weren't forced to communicate or interact in a less-structured manner with their peers while in the classroom, unlike say their more touchy-feely American counter parts practicing anti-bullying role playing and writing letters to congresspersons advocating more fruits and vegetables in the cafeteria.

So are we to assume undiagnosed kids with autism don't stick out on the tether ball court or the birthday party? As a psychologist I am always on the lookout so I'm not a good judge. What about teachers? My parents, grandparents, several aunts and uncles - all teachers - have a sixth sense for spotting the students who can't fit in or need extra attention.  Of course teachers can suggest parents seek an asessment but they can't force one.

So we have an autism rate in South Korea more than double the one here. Certainly there are students in our classrooms here that probably would get placed on the spectrum if assessed but probably not enough to double the current estimates.

We are left with a mystery. Is the Korean estimate an accurate reflection?  Or is it biased by some factor related to the Korean socio-cultural experience, the particular sample selected, research bias (i.e. lower threshold for identifying autism) or is it a fluke, a result that will never be replicated. Is the autism rate here underestimated? Are there true differences in symptoms across the globe?

Love to hear your opinions. How many of you think we have a significant portion of children on the spectrum who are not already diagnosed?

You can read the online copy of the study for free right now.

Prevalence of Autism Spectrum Disorders in a Total Population Sample, American Journal of Psychiatry, May 9, 2011 (online edition).
doi: 10.1176/appi.ajp.2011.10101532

Hitting the BPA-free Bottle: Home Decor, Hype and Toxins

2011-05-09T16:35:00.000-07:00

What does toxicology have in common with interior design?

Nothing.

Almost nothing.

Save journalist Dominique Browning. The latest "science" writer taking on BPA. She's also the former editor-in-chief of House and Garden whose op-ed Hitting the Bottle appeared in today's New York Times.

After perusing the baby aisles for gifts, Ms. Browning laments all the BPA-free sippy cups and baby bottles. In her words - "it breaks my heart." She worries the alternatives may be more dangerous than BPA, the much suspected endocrine disrupter.

Can't say I disagree with the one-time doyenne of decor who also wishes substances were more fully tested for safety before showing up on store shelves. Who doesn't? Though of course no one's about to actually test worrisome substances on babies and small children.

Can you imagine the informed consent form?

We're pretty sure Goo X is safe and almost entirely without permanent side effects. Please sign on the dotted line to participate. After your participation is complete you will receive $150 dollars for your time and effort (and possible medical bills).

While I get Dominique's suspicion over the new substances replacing BPA in baby products, I can't completely applaud here. Like so many media outcries over BPA and it's chemical cousin, phthalates, however, Ms. Browning's plea lacks nuance or in design speak, the fine attention to detail that transforms a space:

There is growing evidence in animal studies that exposure during fetal growth affects the development of reproductive systems and, in offspring, can lead to neurological problems. BPA has also been linked to prostate and breast cancer.

Never mind a raft of experts who've repeatedly cautioned human harm cannot be inferred from rat studies. Never mind many of those furry creatures received injections far surpassing normal human intake. Never mind the lack of evidence of disrupted reproductive systems in humans. Never mind that links to cancer and heart disease might be better explained by other factors besides BPA. Never mind that even tiny newborns rather quickly rid their bodies of BPA.

Such details make all the difference. Her suggestion the government is sitting silent while toxins permeate baby products doesn't quite get at the full picture:

Because the federal government has taken no action to ban or even limit BPA, some states have taken matters into their own hands.

More accurately, the FDA has not "taken no action." The agency has not ignored the issue. It has revisited BPA several times over the last decade and decided as of January 2010 there was not enough evidence to ban it though it's recommending people (and parents) reduce exposure. In other words, they don't think it's terribly hazardous though they're not completely confident but awaiting further evidence.

Doesn't take a scientifically untrained journalist to brush over these fine details. But I have to question why the New York Times, one of the most highly respected media organizations, published a sciency piece written by a woman though highly articulate and successful still remains unqualified in the realm of science despite her recent attention to environmental concerns.

A quick review of Ms. Browning's web page, though wildly impressive by anyone's standards, reveals no sign of advanced training or experience in research methods, toxicology, chemistry, biology, medicine, health care or any other field touching on scientific methods.  A major in Philosophy, Literature and History might have prevented a course in quantitative research methods.  Although she now writes a blog at the Environmental Defense Fund, this hardly qualifies her as a BPA expert.

Maybe it's just me. Maybe I shouldn't expect the experts amongst us to write the op-eds that often annoy me anyhow for their inaccuracy even when authored by recognized authorities. In fact op-eds remind me of the 5-paragraph essays I had to write in high school. Pick a thesis then find your three main arguments and supporting evidence and boom, you're done.  I can't forget the girl who argued Hamlet was like a light bulb. Amusing and well-written but ultimately not so reasonable.

So it's hard to know how much trust to place in science/health journalists when they're not adept at picking apart the research, even when their opinions and arguments seem valid.

Should we expect more from the NY Times? If a respected editor transitions from lifestyle to health/science do we still treat her like an authority?

An interior design specialist wouldn't be my first choice for guidance in assessing possible toxins.  Next time the FDA selects a panel to review BPA I doubt they'd make inquiries at Elle Decor.  Not even the high-minded Architectural Digest.

The Reverend Doctor Andrew Wakefield: Autism Guru, Savior and Conspiracy Freak?

2011-05-02T10:47:00.000-07:00

Shaun Curry/Agence France-Presse — Getty Images
Mister Wakefield with Wife and Faithful Followers

The Denunciation of Dr. Wakefield by Susan Dominus. An article in the April 24th New York Times (The Crash and Burn of an Autism Guru - the online title). So it's Mister Wakefield now. Better yet Reverend Wakefield given his devoted flock disseminating his debunked vaccine-gut-autism doctrine. The New York Times reported him preaching his gut-gospel in a house of worship:

As people streamed into Graceview Baptist Church in Tomball, Tex., early one Saturday morning in January, two armed guards stood prominently just inside the doorway of the sanctuary. Baptist no less...no wishy-washy, agnostic, maybe-we buy-it Unitarian rationality. We'll ignore the hired muscle packing heat for the moment.

He's not just a preacher but a hero and savior:

“To our community, Andrew Wakefield is Nelson Mandela and Jesus Christ rolled up into one,” says J. B. Handley, co-founder of Generation Rescue, a group that disputes vaccine safety. “He’s a symbol of how all of us feel.” And we are feeling terrified right now, hence the men with guns. We hate to think what all the reasonable parents out there who respect good science and never fell for his magical thinking would do if they got a hold of him.

The religious undertones continued. Dominus "sounded impatient but righteous." The righteous shall live by faith.

Who needs evidence when you have faith. No surprise, Wakefield's still a firm believer in his own theories. Fair enough but now I say with delight mixed with a smidgen of pity, he might have stepped off the edge of rationality altogether:

He said he believes that “they” — public-health officials, pharmaceutical companies — pay bloggers to plant vicious comments about him on the Web. No payment necessary, honestly. “Because it’s always the same,” he says. “Discredited doctor Andrew Wakefield, discredited doctor Andrew Wakefield.” He also “wouldn’t be surprised” if public-health officials were inflating the number of measles mortalities, just as he thinks they inflate the risks of the flu to increase uptake of that vaccine.

Not a doctor now, never a real researcher, never a follower of research principles or medical ethics.

Would anyone have paid him any attention if he didn't look like the slightly rumpled, older half-brother of Brad Pitt and Brendan Fraser?

The comparison is not without merit.

Apparently he is great on stage with plenty of "charisma" and "rhetorical flair."

...he spoke with great rhetorical flair. He took off his glasses (i.e.cue the worry,concern,deep thinking) and put them back on like a gifted actor maximizing a prop. “What happens to me doesn’t matter,” he said at one point. “What happens to these children does matter.”

Ah, the children. Blessed be the little lambs. Sacrificial lambs. In other words, party guests AND available and cheap research control subjects. Guy joked at a conference presentation about drawing blood samples from kids at his child's birthday party. You can watch it on You Tube. Here's the details according to Dominus:

“Two children fainted,” he said. “Another threw up over his mother.” For their service, they were rewarded with £5. “People said to me, ‘Andrew, you know you can’t do this to people; children won’t come back,’ ” he recounted. “I said, ‘You’re wrong — listen, we live in a free-market economy; next year, they’ll want £10.’ ”

One helluva birthday party. Don't pass up an invite to the Wakefield!. These remarkable details, the fainting, the boasting in public, too crazy to make up. Then we learn he's also an armchair economist and visionary - planning a community for autistic adults even. All due to his devotion to the children, the ones (poked and prodded in the name of science) who will someday grow up and still require his kind services. His selflessness.

Bless his heart.

Do you think he's writing his memoirs now? It's clear who should play him in the movie but I'm afraid it's destined to Lifetime or maybe Oprah's network.

C-Sections and Induced Labor: Don't Kick Out the Anesthesiologist

2011-04-26T10:49:00.000-07:00

Full make-up? Did this woman about to give birth
just perform Swan Lake? Maybe she's planning
on a dinner and a movie afterwards? Good luck.
Her OB-Gyn looks like she might need bi-focals.

Hold the scalpel and the Pitocin, but don't dismiss the anesthesiologist quite yet.

Caesarean sections and induced labor don't much matter to a newborn's condition according to a new study out of upstate New York featured in the New York Times Science section (Childbirth: More Labor Interventions, Same Outcomes) and published in this month's Journal of Maternal-Fetal and Neonatal Medicine.  Rates of labor induction and primary cesarean delivery do not correlate with rates of adverse neonatal outcome in level I hospitals. I know, you were gonna read it after the kids go to sleep. So forgive me for spoiling this cliff hanger.

So Dr. J. Christopher Glantz, a professor of obstetrics at the University of Rochester checked out over 30,000 birth records from 10 upstate hospitals (without neonatal intensive care units). He found that although rates of c-sections and inductions varied from institution to institution there were no differences in newborn condition in hospitals performing lots of these procedures versus few.  No differences appeared in terms of Apgar scores or need for ventilation assistance or intensive care.

Sounds so convincing.   But of what? Interesting question.

Now some might be tempted to argue these results are proof induction and c-sections are preformed all too often. If babies born via modern methods were as well off as others born the good old fashion way then it will be concluded the new fangled techniques didn't make a difference. Some may go so far in proclaiming they were unnecessary in the first place. If these procedures really improved a child's health (apparently mom's is not important here) - then we should see differences.

This study didn't compare babies born via c-section (or induction) to those born otherwise. No, it compared whether health outcomes were linked to hospitals' induction/c-section rates. Not the way I would have addressed the issue, but an easy method, rather simple once you have all the data.

But let's say that information is available and you have a lab full of motivated pre-med students.

It's a good question whether induced or c-section babies should be better off or worse than their counterparts born otherwise.

If the scalpel and Pitocin improve health and are medically necessary, then the babies should be better off - at least better off than the babies in similar conditions prior to birth. Maybe as good as those who were good before going down the birth canal on their own.

If the procedures are ineffective, do nothing, then the babies should be no different.

If they are potentially harmful, then worse.

If the medical procedures are medically unnecessary and non-harmful, there should be no differences.

If the procedures are medically unnecessary and harmful, then they should be...

You can see how terribly important it is to gather and account for the conditions of mom and baby before the birth. It's complicated for sure, but necessary to draw any worthwhile conclusions. Makes the routine practice of expectant moms being knocked out for the actual birth seem rather quaint, no?

Might we be too quick in pulling out some babies?

Perhaps but this pile of data is far from conclusive evidence a quick exit (or entrance) is worthless. It's difficult to argue anything here without a good accounting of critical factors related to birth, like why mom or doc decided to induce. I'm frustrated and I don't have to write up a birth plan.

According to the NY Times even the study's author, Dr. J. (Julius? Jebediah? Jethrow?), "acknowledged that the study...was retrospective and could not control for all confounding factors."

Ya think?

Another day, another lazy data dump here without many answers but plenty of loop holes.

doi/abs/10.3109/14767058.2010.514629

Bye Bye Parent Dish: Me, Arianna and The Serious Journalists

2011-04-21T17:05:00.000-07:00

Me and Parent Dish are over.

Arianna Huffington kicked me and Naked Data to the social media curb.

Not personally, mind you, but in an official email from one of her hench-persons sent in the middle of the night to no doubt many hundreds of freelancers on the AOL payroll. Apparently it's part of an effort to build a more professional, serious stable of full-time journalists who won't be tempted to freelance elsewhere.

Not sure how that includes the 6,000-plus unpaid (i.e. not professional) bloggers hanging at Huffington Post.

Speaking of HuffPo...

How does that new dedication to journalistic rigor square with the heavy influx of celebrity gossip?

On today's "front page" - I've been treated to such compelling news as this - Sharon Stone, age 52, still looks good in a bikini, Emma Watson left Brown (who?), and Johnathan Franzen keeps pot in his fridge (big suprise). Terribly crucial news. That said, two-thirds of the page is crammed with every which kind of national and international political seriousness including the killing of an American journalist in Libya.

I'd like Huffpo a lot better if Arianna didn't sacrifice scientific savvy in deference to the alternative-medicine (not that it's bad, just untested), high quack-quotient contingent - like Deepak Choprah's wellness empire and David Kirby's high-profile mission to link autism to vaccines.

True, some great pieces come from the site, especially the more socio-political ones. So while everyone goes around praising the journalism going on there I'm left wondering why politics equal serious journalism and scientific-based information gets kicked to the curb? It's not just HuffPo's bias, it's pretty much everywhere.

So please, Arianna, if you do care about accuracy and honesty, show us your evidence! If she's really serious she'd hire some more editors and writers trained in the hard and soft sciences.

As for hard-core health science writers, the Huffpo has an interview with Gary Taubes, yeah, Toxic Sugar Guy, a journalist and trained scientist who's written plenty about ironically, what we don't know (i.e. exercise causes weight loss) and the trouble with bad science. Conveniently enough, he's landed a story in last Sunday's New York Times magazine (Is Sugar Toxic?) and a Q and A today on HuffPo - just in time for his new book - Why We Get Fat: And What To Do About It. Hint: stop eyeing that donut.

Gary Taubes and The New York Times: Toxic Temptation or Simple Pleasure?

Haven't read the book or the entire NY Times sugar saga yet - but gonna have to pay attention as Mr. Taubes hasn't been particularly scared or convinced of anything, in fact, pretty much told us we didn't know enough about anything. He bashed low-fat diets years back, so the man is not fazed by the prospect of controversy.

In any event I'm still stuffing the plastic eggs with plenty of chocolate and jelly beans that will mostly be left untouched. As many of you know, it's the thrill of the hunt, not the consumption of the sugary spoils. Witness the left over Halloween and Valentine's candy 3 days after said holiday. The chocolate eggs will melt and re-congeal before they're eaten this weekend. We'll even find a few in the bushes come summer.

I've already gotten wind of a group email gone amok telling folks to read the sugar story - all in the name of promoting good health.

Terrific timing for the arrival of our furry friend this Sunday. Happy Easter to those who "celebrate" or otherwise condone sacrificing our children's future health and well-being for some short-lived pleasure. Don't even think about having more than a glass of wine.

Early Childhood, IQ, Mutism and Political Intrigue: All in a Day's Conference

2011-04-13T15:06:00.000-07:00

Who says professional conferences are a snooze?

Round up some academics, some therapists and throw in a public health or education official - and there's bound to be some drama, in this case, some indirect political intrigue of the big-city kind incidentally involving thousands of school children.

So the keynote speaker blew off the 8th Annual Young Child Expo and Conference last week.

Yeah, a real bummer for those of us in the audience waiting for inspirational fodder from some well-regarded public figure. Okay so it was in New York City and the official speaker was Dennis Walcott, the Deputy Mayor for Education under Mayor Michael Bloomberg. And it was early Friday, April 8th, the same morning Mayor Bloomberg announced Mr. Walcott as the new schools chancellor. Or should I clarify, announced his second choice following on the heels of the public relations mess over his first choice, Cathleen Black.

(FYI: I attended the conference thanks to Wellsphere, the health website that provided me with a press pass. Just in case you're imagining me living high on the hog in NYC - there were no goodie bags, no celebrity photo ops or lavish meals, only coffee and the city's finest, H2O).

After initiating a carefully constructed child care plan, I arrived at the Hotel Pennsylvania in Manhattan eager to learn who the conference organizers had convinced last minute to address the crowd of early childhood enthusiasts.

One Sophia Pappas, the Executive Director in the Childhood division of the NYC Department of Education. In other words, a young woman stalking better early education, a noble aim by anyone's standards. Taught preschool in Newark, NJ, can you imagine? Did another stint at Teach for America. A master's from Harvard's Kennedy School.  Wrote a memoir of her early teaching days. No slouch.  Her "keynote" was more casual chat over coffee rather than the typical lecture/sermon/speech.

The attendees spanned The Childhood Professional Spectrum.  The usual suspects. The special-ed teachers, the learning-disability tutors, occupational therapists, speech therapists, school psychologists and perhaps some parents.  Mostly women, but that pretty much goes without saying.

Plenty of sponsors showed too from the high-faultin' and like Fordham University, New York University's Child Study Center, the Children's Hospital at Hackensack University Medical Center, and the Brooklyn Children's Museum to smaller companies and who can forget the special interest non-profits such as my personal pet peeve, Autism Speaks. Rest assured, I did not pick up any of their propaganda or tchotchkes, or any other ones at the conference save a flimsy "Young Child Expo" bag filled with the conference program and assorted flyers.

So other than the keynote drama, what struck my fancy?

Some biggie topics, like parental involvement in education, changing definitions of autism (both which I missed) to smaller but still fascinating ones like teaching natural science, picky eating, oh and selective mutism - a disorder in which children but sometimes adults cannot or do not speak in certain environments (i.e. school, in front of adults).

The reigning theory links it to social anxiety and shyness. Even a decade ago many psychologists thought it the result of an oppositional personality or post-traumatic stress. But now some good studies have basically ruled that a bunch of bunk. Some of you may recognize the symptoms in the guy from The Big Bang Theory who can't talk to women unless he's good and sloshed. Lots of characters from books and film - like Charles from A Wrinkle in Time. As someone who remembers being very uneasy speaking to adults and strangers as a kid, I can relate to this so-called social anxiety disorder. Frankly, I'm still not crazy about making small talk with people I don't know, especially in large gatherings (i.e. the school fundraiser, weddings, etc.).

The roster also featured clinical assessment, the art and science of figuring out just what's going on and not going on with a child. Their weaknesses and strengths from the physical to the socio-emotional, cognitive and intra-uterine environment.

Got a kick out of hearing Dr. Vincent Alfonso, Professor and Associate Dean in the Graduate School of Education at Fordham speak about assessing young kids, especially those who fall through the cracks (i.e. those from non-English speaking homes, those low on the socioeconomic ladder). Guy energized what could have been a very boring, at times technical talk. Save the distraction of the women loudly filing her nails behind me Alfonso kept me right with him.
Here are some of my favorite nuggets from the child assessment expert, many that relate to child research:

We've only been formally assessing youngsters since 1975, the year the first legislation addressed the need.   Before that there was very little recognition kids needed any special interventions, behaviorally or psychologically speaking. Head Start began just in 1964 - the idea that kids benefited from early education. So the whole "special needs" thing was at least a decade away. Amazing since we have loads of researching showing early interventions do work for both the "special needs" and the disadvantaged crowd. So when we talk about rates of this and that, keep in mind that we haven't been tracking many disorders for so long, nor particularly well in the past when we did.

Cognitive abilities have gotten dissed of late. It's easy to forget they do matter when we tend to hate IQ tests. Hate SATS. Think they're rubbish (my words).  Alfonso reiterated intellectual skills serve a protective function, they help make kids more resilient in the face of multiple challenges. The lack thereof, it's a real challenge. A difference between an IQ of 70 and 90, is enormous. At these same time we despair of measuring intelligence we get too fixated on the upper end, breastfeeding so as to optimize tiny neural circuits.

By the way, we now speak of "intellectual disability" and not mental retardation or mental handicaps.

Don't forget parental stress. There's the stress of parenting itself then the additional non-child related stress. Children can be affected by it in any number of ways. Addressing and managing anxiety is key, one of the most important tasks a parent can do for their kids. Note to self: schedule girls night out, nix travel-team soccer.

Then there's the assessment tools, the scales and surveys. You have to consider what they ask, how they ask it and also score it. That's something that all researchers have to remember too. And those who interpret their results. Lots of similarities between doing assessments and doing research. The benefits of gathering lots of data over multiple times and settings. Using the best scales and measures. Making sure they're not too old (i.e. within last decade for assessment).

Speaking of which - Alfonso told of a child whose assessments just didn't match. The professional report didn't jive with the survey the parent completed. The parental answers just seemed off. Then he realized the parent couldn't read. That's right, she'd randomly completed the questionnaire. Unusual circumstance but as someone who's conducted assessments in let's just say "dysfunctional" families, I am not surprised. Extending circumstances always seemed to be the case. Of course these were children who'd passed through the court systems. Dysfunction on all fronts was the rule.

Early childhood specialists should like kids.

Seems necessary - but is it? Certainly someone who has extended contact or interaction like a teacher or therapist but what about the psychologist called in to do a one-off assessment. It's clear they should not dislike kids but should they just love little kids? They should understand, empathize, yes, and that probably goes along with liking but I've never though about it. I appreciate my pediatric dentist's (and hygienist's) seemingly natural affinity for kids. I often do wonder why the children's librarian at my local library seems to dislike children but do all pediatric professionals need to really like kids? How about pediatric cardiac surgeons?

Just for the record, I do like little kids. And babies. Though I don't wish to parent any more of either.

What about everyone else? Fess up.

Selling Self-Control with Sugar: Charlie Sheen, Donuts, and Preschool Self-Regulation

2011-04-05T11:27:00.000-07:00

Self-control at age 3 predicts life success.
Got it. Self-control begets success according to a new study out of New Zealand.

Makes sense. All those years learning patience allows kiddies to grow up and get to work on time every day and stay off the police blotter.

How then to explain Charlie Sheen?  Not only the highest paid television actor but the one who's exhibited precious little inhibition of late.

Either he had mucho control that he lost along with his self-respect and humility or maybe self-control is not as highly valued or even necessary in tv land.  Possibly self-discipline pales in comparison to good looks, talent and a daddy in the biz?

Still, I'm a big fan of self-control. Not the sugar-is-evil, no-tv, abstinence, not so much as a Kleenex box on the kitchen counter type but the more restrained kind that allows a person to focus, find friends, accomplish some goals while enjoying life including the waffle cone crammed with peanut butter fudge ice cream.

Wrote about self-control on Parent Dish if you want to check it out - Put Down the Bluetooth: Patience and Focus Can Mean More Money, Better Health - I dish on the Kiwi study, a pretty good one spanning several decades.

Anyhow, picked up We Have Met the Enemy: Self-Control in an Age of Excess, a new book by Daniel Akst.  Who doesn't enjoy a good read about self-control?

But honestly, I couldn't resist the big chocolate-frosted donut with sprinkles on the cover.

Not fair. Honestly, if you're pushing a book about societal's critical loss of self-control in an increasingly complicated consumeristic, super-sized, instant everything culture - is it fair to distract me with that mouth-watering treat in my already overscheduled day?  Is it ethical to sell an anti-temptation treatise by temptation?

Maybe it was a test of sorts. If you can pass up this bright orange book with the donut then you don't need to read it.  Despite its potential marketing genius, I've yet to see a diet book with a cupcake on the cover.

To Eat or Not to Eat: The Puzzle of Peanuts and Allergies

2011-03-24T11:44:00.000-07:00

200 people die a year from food allergies.
11 people die a year from food allergies.

Big difference. So which is it?

Meredith Broussard, a journalist hot on the trail of the peanut puzzle since her controversial Harper's article a couple years back, thinks the actual annual number of food allergy deaths is considerably smaller than the oft-quoted 150 to 200. Back in 2008 in a Huffington Post piece she reported the CDC listed only 11 deaths related to food-induced anaphylaxis in 2005. There were 12 in 2004 according to a 2008 New York Times article.

Why the larger estimate? Here's Broussard's answer:

The 150-200 death estimate comes from the media resource kit of the Food Allergy and Anaphylaxis Network, a lobbying and educational group headed by a former marketing executive at Dey Pharmaceuticals, the maker of the EpiPen adrenaline injector (which is prescribed to millions of food-allergic patients).

From The Food Allergy and Analphylaxis Network.   OF COURSE. An organization devoted to spreading the word about food allergies, that yes, can be life-threatening but that rarely kill anyone despite the considerable hype.  They help a lot of families but I see no reason why they shouldn't try to get the numbers correct. Unless of course they enjoy freaking out parents and children - come on, ANAPHYLAXIS in the title, really?

Fearmongering aside, where did FAAN get the numbers?

From one measly 1999 study from Olmstead county in Minnesota. A retrospective study tracking anaphylaxis - of all sorts, not just food-related - among its citizenry. How many people died? One. One death that wasn't related to food.  A man's throat swelled up while exercising.  Not eating.

The authors concluded "the incidence of anaphylaxis is less than 1%, and death rarely occurs." Less than 1%. DUH. The rate for food-induced death? Way lower than 1%.

Yes it's just one study, it could be larger. But it's ONE study. ONE tiny study does not yield a solid estimate.

So if extrapolated to the larger population it would still be less than 1%. So how that became like 200 annual deaths is entirely unclear. If the CDC is correct,the actual number is really too small to even quantify in a meaningful way. That said, it's still possible the rate is higher. But surely the symptoms of food-induced analphylactic death are difficult to miss or confuse with another condition.

Why pick on peanut allergies?

Some very smart professionals like noted Harvard Ph.D. and M.D. Nicholas Christakis worry that we're getting carried away with peanut-free environments to some not inconsequential consequences, like perhaps, more allergies. Oh yeah, there's some intriguing and troubling new evidence that early avoidance (no nuts during pregnancy, breast-feeding, or first three years of life) might not only be ineffective but harmful. Actually promoting more allergies. Even the American Academy of Pediatrics revised it's no-nuts recommendation recently.

If you're interested in the evolution of the new evidence and the no-nuts recommendation, check out my recent scoop on Parent Dish - Peanut Allergies: Snack with a Side of Drama. It's a drama alright.

Great article about it in the New Yorker too (The Peanut Puzzle:Could the conventional wisdom on children and allergies be wrong?).  Yes the New Yorker. Not kidding. It's rather pathetic parents have to track down a hard copy of a literary magazine to find out what's really going on.  If you have a subscription to it already what are you doing slumming it here? Although I might need a subscription too if they continue to cover these kinds of health/parenting stories.

Is there a Food Allergy Curse? Kind of like the King Tut curse that afflicts those who touch the royal tomb.  Just realized the red licorice I'd been nibbling on from Whole Foods (an infrequent treat, the shop not candy) - has "natural strawberry flavoring." Uggh. I'm allergic to strawberries - it's near the bottom ingredients so I shouldn't be wheezing as I've already dosed up for the day. Who flavors licorice with strawberry? Isn't red suppose to be cherry???? Last time I wrote about food allergies my son's face swelled up. Time before, I got a rash.   I'm not superstitious but....

Disentangling Attachment and Attachment Parenting

2011-02-28T08:42:00.000-08:00

Last week two diligent readers alerted me to the same article ostensibly about Attachment Parenting, a blog post by a mommy blogger on The Stir over at Cafemom.com who'd written about a recent study in the news. We'll get to it in a moment but first I've been wanting to feature all of your catches in the media. So now every Monday I'm going to post your finds, yes, the exaggerations, biased articles, and other assorted inaccuracies from the world of pedia media.

So what sent two readers into action last week? First Jen then Lori, so moved she even emailed the author of research to request a copy of the study! You go, girlfriend. Apparently the author, Jessica Salvatore, had been wondering how the information was being "disseminated" to the public.

Hmmm. Let's see...

Thank goodness the LA Times did a good job sussing out the substance of the study.

Your mother may be to blame for your relationship woes (though choosing a better mate could improve matters):

"The strength of the bond you formed with Mom during the first two years of life strongly affects how efficiently you and your partner will move beyond a fight and join forces to accomplish mutual goals, a new study finds."

Well done. But somehow between the LA Times and The Stir the study got misconstrued.

How? Well the study was about attachment (i.e. infant-mother bonding) but not Attachment Parenting. Most people hear "attachment" and think of Attachment Parenting and the whole Dr. Sears/co-sleeping/baby-wearing crowd. As did the mommy blogger above, an attachment parenting devotee.

But psych majors think of infant bonding and Ainsworth's Attachment Styles, a scheme outlining 3 different relationship styles infants exhibit when interacting with their caregivers (secure, resistant, avoidant). Ainsworth's scheme has been around since the 70s and still pops up in recent studies like the one that prompted the above impassioned blog post.

Here's the actual study published in Psychological Science:

Recovering From Conflict in Romantic Relationships : A Developmental Perspective

Basically, researcher Jessica Salvatore and her team trolled data from a big longitudinal study that tracked children from birth into adulthood, the Minnesota Longitudinal Study of Risk and Adaptation. The current study showed babies who were "securely attached" to their mothers fared better with their romantic partners some twenty-years later. It's a bit more complicated than that, but that's the basic gist.

It had nothing to do with Dr. Sears or the families attached at the hip or breast despite whatever claims the attachment doc may make about the bond between momma and baby and their future health and psyches.

The Best Parenting Books of 2010: Books for Parents Who Dig Evidence and Science

2011-02-23T17:19:00.000-08:00

Read any worthwhile parenting books this year?  Any besides those by Tiger moms or celebrity moms or baby whisperers. It goes without saying how delightful and entertaining those reads can be.... cough, cough, guffaw.

Wish I'd read more but did manage to find a few that rose above the usual pile of how-tos/what-to-expect/i'm-such-a-lousy-but totally hip-mom tomes.  Are they the most popular? No.  Most practical? Probably not.  Most well-written? Who knows. They won't tell you how to potty train, get your tween to talk to you or make your marriage hot. But if you care about the evidence behind the onslaught of expert advice and recommendations, these are like manna from heaven:

1.) Wrong: Why Experts Keep Failing Us - And How to Know When Not to Trust Them (David H. Friedman)

Hands down one of my favorite books of the year (number one: Keith Richard's Life).  David Freedman, a science and business journalist, gives us the low-down on expertise or more specifically - how and why it goes wrong - from scientists and health officials to less informal experts like journalists and the pediatrician who instructed you to breastfeed/circumcise/not circumcise/co-sleep/throw out the tv or whatever.  Freedman highlights the biases in the research process, the publication process, and the media.

How biased? Two-thirds of studies are inaccurate and/or get refuted.

Now that might be an exaggeration but the point is clear. Lots of studies just don't quite get it right.  Freedman also tells how to avoid falling for the flawed discoveries and advice although it's not much different from what we've been discussing here at Momma Data (e.g., be wary of freak findings, ground-breaking findings, blanket advice/findings without qualifications/limitations).  In fact he lists 11 handy rules for figuring out if you can believe a piece of expert advice.  He even has the sense to warn that he too may be wrong!

LOVE this book. Could kiss this man.

2.) Mind in the Making: The Seven Essential Life Skills Every Child Needs (Ellen Galinsky)

If you're wondering what kids really need to become thoughtful, independent, productive and well-adjusted adults (i.e. living on their own), look no further:

Self-Control and Focus
Perspective Taking Skills (empathy)
Communication Skills
Ability to Connect Ideas (creativity)
Critical Thinking skills
Willingness to Take on Challenges (motivation/perseverance)
Self-directed, Engaged Learning (curiosity)

You'll note there was nothing in the list about how to feed, immunize or otherwise maintain the physical health and safety of your child. It's comforting to know someone out there is tending to children's overall well-being and let's face it, real-life abilities and competencies.

All too often they get overlooked until Henry or Mary Grace ends up in the school guidance office. No lie, these more subtle qualities aren't as easy to achieve as stocking the pantry with whole grains, getting your daughter to practice the piano or driving to occupational twice a week. No, these take lots of attention and patience to foster over time. They don't arrive on the doorstep the next day like the lastest in your queue from Netflix.

Galinsky, the cofounder and president of The Families and Work Institute, has been studying children for many decades.  She knows her stuff.

Each chapter takes on one of the "essential skills." Galinsky gives plenty of examples how you can "teach" them in daily life, for instance through simple games, activities, or even more subtle behaviors. She also incorporates personal narratives from other people to illustrate their own experiences. I'm not a huge fan of these stories, probably because I'm always wondering whether they're the figment of the imagination of some twenty-year old intern. Most important to us here, the author, a longtime psychologist and researcher, backs it all up with studies. I bet a lot of it is familiar to you, in fact, things you already have done or still do (ask your child a lot of questions; have your preschooler count; talk, talk, talk to your child) and some you might not connect to prime child development (managing your own stress).

My only regret is that this isn't exactly a perky best-seller with wide crowd appeal, it's no Belly Laughs for sure. It's not chock full of technical speak, it's more an interesting seminar on Child Development with helpful hints, maybe a bit too academic for most tastes (anyone read it???).  Too bad, because it's valuable info. The reviews seemed to indicate the general parenting crowd would love this book but I'm not so sure. If only the respected author would have yucked it up a bit.

As can also be said for the last book...

3.) Is Breast Best? (Joan B. Wolf)

Where was this book ten years ago when I painfully proceeded into parenthood? Come to think of it, why hasn't it been all over the media? It's a controversial take on a timely issue we can't seem to stop discussing. Wolf, a political scientist in the Woman and Gender Studies department (yes, a feminist!) down in Texas A&M wrote this book after looking into the breastfeeding literature and being suprised by the lack of convincing evidence for all the hoopla. She'd been wondering how it had come to be that so many women who'd fought for their rights, their careers, and their bodies could accept the medical establishment's call to breastfeed, an act that takes considerable time and effort, without seriously questioning the evidence.

Ah, the evidence. She devotes a chapter to the scientific evidence but sprinkles references to it through out the entire book. More than a simple overview of the science, Wolf places our cultural craze for breast milk in socio-historical perspective.

Our obession with breast milk is a component of Total Motherhood, basically our contemporary approach to childrearing as a 24/7 endeavor to protect kids from every conceivable risk, including the perils of formula.

Remarkably, this book has been virtually ignored by mainstream media though thoroughly bashed in the blogosphere. Even the Booklist reviewer front and center on Amazon couldn't hide her contempt:

This heavily footnoted defense of formula feeding will undoubtedly fan the fire between those who believe “breast is best” versus those who think manufactured food is just fine, thank you. Wolf, a political scientist, is on strongest ground when she discusses the history of this emotionally charged topic. Unfortunately, she seems out of her element when describing perceived flaws in medical studies of breast milk and talking about financial issues. Inexplicably, she fails to discuss the price of formula, which can easily run $1,000 to $2,000 a year. Instead, she talks about what she sees as the “exorbitant” costs of breastfeeding. (Presumably, she is referring to how it’s tricky for poor women to hold down a job and nurse their babies.) An expansion of a 2007 article Wolf wrote for the Journal of Health Politics, Policy and Law, this pro-formula book treatise would have benefited from a more nuanced argument. For a better book, see Dr. Naomi Baumslag’s Milk, Money, and Madness (1995). --Karen Springen

Wolf's book is not a "pro-formula treatise" - she doesn't argue the case for formula but seriously examines our adoration of breastfeeding - and it is quite nuanced, in fact, as nuanced (in detail and scope) as anything else on the topic and a lot more than many articles you will likely read, including journal articles. Did you catch how Karen Springen, the reviewer, referred to the actual flaws in the science as "perceived flaws." And of course that's where Wolf is "out of her element". Big surprise. By the way, the book the reviewer perceives as more nuanced? Milk, Money and Madness. You guessed it, a rather aggressive pro-breastfeeding "treatise". Did Amazon expect an objective review?

Joan, many thanks. You rock.

Read a piece by Joan on Babble, essentially a mini-version of Is Breast Best?

Okay, peeps, keep me up-to-date on your own not-to-missed reads.

Formula, Food, and Fat: Put Down That Enfamil, Lady!

2011-02-08T16:54:00.000-08:00

Girl, 3, attributes slimness to eating well (i.e. breastmilk)

Formula-fed babies get fat if they eat food before 4 months according to the latest entry in the breastfeeding-is-god literature, a study just published in Pediatrics no less.

The babies lucky enough to get the real deal, the liquid gold, the boob?

The Chosen Few (i.e. breastfed for at least 4 months) could nosh on cereal and other delectably mushy meals before the recommended 6 months without becoming obese at age 3. But their formula-fed friends (i.e. not breastfed for 4 months or formula-fed from birth*) paid the price for the "early introduction" of solid foods. Almost 6 times as likely to be pudgy preschoolers.

That formula goes straight from the lips to the hips, don't ya know?

These "early food" findings come to us by way of Project Viva, a name better suited to paper products and pharmaceuticals than infant health:

Project Viva is a ground breaking longitudinal research study of women and children. The goal of Project Viva is to find ways to improve the health of mothers and their children by looking at the effects of mother's diet and other factors during pregnancy on her health and the health of her child. The information we collect enables us to investigate, for example, the effects of diet on child development and obesity, how diet and the environment influence the development of asthma in children, and how a woman's pregnancy is affected (by - certainly not "has affected") lifetime experiences of racism or violence. From the Project Viva website.

Borrrriiiinnngggg. Nobody ever corrected the typo above because nobody but me (and maybe you) has ever read it. Before you swallow this one....

I bet the researchers probably didn't bother with what mommy fed the little darling after the boob or the bottle. At least the media reports didn't mention it nor the Viva website and because I didn't want to spend the money reading the actual article I can only guess.  Betcha two Tootsie Rolls they didn't ask how often their toddlers dined at McDonald's or drank, eek, soda.

So it's perfectly reasonable to ask if the parents who didn't follow the official breastfeeding procedures (i.e. give birth, pull out breast, attach mouth, repeat, repeat, repeat) also gave the finger to the organic-complex carbohydrates-5-fruits-and-veggies- food guidelines.

Hhhhmmm. What do you think?

I don't know how you do a longitudinal study on diet and obesity without asking about food. It's as if  humans magically stop eating after infancy.

But since I like solving mysteries please allow me to speculate.

Viva (Las Vegas!!) started out "looking at the effects of mother's diet and other factors during pregnancy on her health and the health of her child." So the researchers didn't think about those questions because they were so focused on the womb and the breasts (as in breast milk).

Can you imagine if they had asked about what the kids actually ate?

How would you describe the foods your child consumes in a typical meal:
a. Very Healthy
b. Healthy
c. Unhealthy
d. No comment

I serve my child a green vegetable:
a. Every day
b. Once a week
c. Once a month
d. Once a decade

The snacks I usually serve my child are:
a. Apples and carrots
b. Yogurt and pretzels
c. From the vending machine
d. Okay, got me, I'm a bad, bad parent

Did I mention the research team hailed from Harvard. Why of course!! The very belly (or butt) of breastfeeding research as witnessed by recent studies.  (See last post)

For a good take on the "breastfed babies don't get fat" phenomenon go read Rebecca Goldin over at STATS. Can breastfeeding halt obesity - or is the media misreading the research?

The last two breastfeeding studies I've felt the urge to debunk came straight from Cambridge from two different groups of Harvard researchers. How is it our best and brightest have been so blinded by the breast?

Peeps, if this is the best our best has to offer then I'm going to brush up on Mandarin. Assuming our Chinese friends haven't declared a war on obesity, here's the first lesson:

要薯片吗？(want fries with that?)

* Try telling the mommies who stuck it out for 3.75 months they didn't really qualify for The Breastfeeding Merit Badge.

Surgeon General Botches Breastfeeding Call to Action: A Suboptimal Study in the National Spotlight

2011-02-03T09:24:00.000-08:00

Surgeon General Regina Benjamin (courtesy AP)

“I believe that we as a nation are beginning to see a shift in how we think and talk about breastfeeding,” said Dr. Benjamin. “With this ‘Call to Action,’ I am urging everyone to help make breastfeeding easier.”

A shift! Amen! It's about time we change our talk about breastfeeding.

Bless dear Dr. Benjamin, the Surgeon General, Her Health Excellency who declared breastfeeding a national priority in a press release last week.

Yes, let's please talk it out, Dr. Bennie.

We can agree breast milk is the best choice for building tiny brains and bodies, even the formula makers admit it. I breastfed all three of my babies and would do it again in that hypothetical younger-me universe where I spend a couple years in Paris eating baguettes and painting large canvases.

However, the top doc and I would disagree over the degree of these health bennies, especially those loose links involving the health outcomes years if not decades past the actual "laying on of the lips" so to speak.

I can forgive a lapse or two here and there but Dr. Bennie highlights a particularly poor piece of what I can only describe as propaganda "research" in her press release, uses it as evidence of the high health care costs attached to not breastfeeding enough.

In fact, it's the only study she cites in the press release (The Burden of Suboptimal Breastfeeding in the United States):

A study published last year in the journal Pediatrics estimated that the nation would save $13 billion per year in health care and other costs if 90 percent of U.S. babies were exclusively breastfed for six months. Dr. Benjamin added that, by providing accommodations for nursing mothers, employers can reduce their company’s health care costs and lower their absenteeism and turnover rates.

Now I don't know if Dr. Bennie's read the actual journal article but if she had she'd find this:

The authors, Bartick and Reinhold, relied on a 2007 government report reviewing research on the health benefits. We can debate the accuracy of the review - it was based on data from the 80s and 90s - but let's excuse that for now. We'll ignore the accuracy of the findings linking 10 health conditions to (not!) breastfeeding. While we're in a forgiving mood we'll also ignore the authors' ridiculous assumption that 90% of mothers can and want to breastfeed exclusively for 6 months.

Bartick and Reinhold then computed the health care costs for treating these conditions ranging from the minor and fleeting like ear infections and stomach upset (the strongest links) to the more serious like childhood obesity, Type 1 diabetes even SIDS. We'll not quibble too much there, we got a bigger battle ahead. Fine. We'll accept all those estimates. Whatever you say, Bart and Reiny!

Here's the rub, the ruse really.  It's the 900 dead babies.

If you remember the headlines this study captured you'll recall the dead babies. The authors concluded over 900 baby deaths a year could be prevented if their mommas complied with the breastfeeding recommendations.

900 dead babies!!!  Really?

Do we know breastfeeding actually prevents "premature death?" Good question. The answer is pretty much no, no we don't know if babies actually die from "suboptimal breastfeeding".

Nor is there much in the way of empirical numbers to help us figure that out. But that didn't stop the researchers. Somehow they computed how many babies die each year due to a variety of conditions, in fact, this was the first study to do so - in a peer-reviewed journal, the premiere Pediatrics journal - and reported "premature deaths" for a variety of conditions. So it was an important study not only because it was the first large-scale analysis of the health costs associated with not breastfeeding - but also because it estimated baby deaths.

Despite setting a precedent for future research - not to mention future government Calls to Action, the authors never revealed how they calculated the annual baby deaths. This is a very large hole. Huge.

This omission makes me very suspicious and very irritated.  The journal editors and reviewers should have demanded to see these calculations and it's anyone's guess why they didn't insist on them in the actual text.  Me suspects the estimates are jerry-rigged.  In other words highly speculative and thus inaccurate.  It's not only aggravating and sloppy but disingenuous.

And that's not the worst of it.

The authors took those 900 annual deaths and estimated the cost of their premature deaths. Basically how much those dead babies would have earned over their lifetimes, roughly $10 million each. That's 9 billion a year.  Then Bartick and Reinhold rolled that 9 billion into their big fat estimate of how much not breastfeeding costs us each year.

The whopping $13 billion in the headlines last spring and the Surgeon General's press release - over 70% of it isn't even a health care cost. Most of it involves the lifetime earnings of all those dead babies Bartick and Reinhold somehow calculated die each year from not enough breast milk.

Forgive me for thinking we were talking about the medical costs of not breastfeeding. When most of us hear about health care costs we imagine doctor bills, prescription medication, etc. Not forgone earnings.

Bartick and Reinhold seriously inflated the numbers and did so in a very deceptive manner. Not only did they not reveal how they computed the actual number of annual dead babies but they vaguely refer to the costs of premature death that I naively assumed meant the colossal end-of-life bills.  They include a line or two of economic mumbo-jumbo that I only realized meant lost lifetime earnings after I'd read the paper they cited. Now that's pretty darned ballsy. You claim 13 billion and hundreds of dead babies but somehow never spell out how you got that many deaths or that you've included not only true health costs but lost earnings of the deceased. Remarkable.

I'm not sure I've read anything this disappointing in years - at least not in a prominent journal from researchers at a prominent institution (Harvard).

I expect a little braggadocio, the speculations in the conclusions, the exaggerations. I know researchers have to make a good argument for their data, they gotta have a good "story" and stretch the results from time to time. We all know they sometimes poke around in the data for those significant results. I get it, been there, done that.

But this study, "The Burden of Suboptimal Breastfeeding" is not only suboptimal but sneaky, deceptive, disingenuous and it's got the weight of Harvard and the US Surgeon General behind it.

When I first read it a few months back I worried it would become the bench mark for health authorities. So much so I named it one of the year's worst pieces of research in my column Naked Data at Parent Dish. Voila, now the suboptimal study officially entered into the public health canon and will haunt me for years to come. It's there, folks, taken as matter of scientific fact.

With no questions asked. Amazing.

Sweet Jesus, just when I thought I could finally stop writing and thinking about breast milk.

Was Dr. Bennie aware of these lifetime wages snuck into that 13 billion? In her press release she refers to the $13 billion as "health care costs and other costs" - so if she did know, how sneaky of the Surgeon General. If she didn't, why the hell isn't our top doc doing her homework?
So yes, Dr. Bennie, a shift is needed.  Let's start talking honestly about breastfeeding for a change.

Autism and Traffic: Where's the Data?

2011-01-26T06:39:00.000-08:00

Did you hear the one linking autism to freeways?

Forgive me if it sounds like a joke. Just finished watching a documentary about Joan Rivers. Her comedy's just okay but it made my snow-bound day (week? winter?) to see a woman still going strong at 75 with in-your-face remarks - catch it while you still can - Joan Rivers: A Piece of Work.

Woman says she'll wear a diaper, doesn't care, will do anything to work. Kind of a lost sentiment today. Almost want to show it to my kids, except for the vulgar, vulgar moments not to be missed!

Anyhow, we could use some comedic schtick, some Joan Rivers, in the parenting sphere. The message boards could use some lightness and humor.

Would love to hear Ms. River's response to this study out of California that I wrote about on Parent Dish:

Pregnant women living near freeways were almost twice as likely to have a child later diagnosed with autism, the neurodevelopmental disorder characterized by deficits in social interaction and communication.

The freeway hypothesis sounds reasonable: Pollution bad and fetuses fragile, alas, autism.

Read on at Naked Data over at The Dish...On Ramp to Autism: Do Freeways Trigger Autism?

The comments about the Freeway Hypothesis? Not so crazy, applauds, though one reader blames autism on ultrasounds. Anyone? Not sure there's any research out there to settle this one. But go ahead, see if you can dispute it. I dare you! First one to show me the data wins a free ultrasound.*

*Prize contingent on me, like the supposed celebrity mentioned by a reader, buying my own ultrasound machine. Don't you think it would complement the calf massager and busted puppet theater languishing in my basement?

Studies Gone Wild: How We Come to Wrong Scientific Conclusions

2011-01-24T06:28:00.000-08:00

If you've ever wondered why the experts can't get it right, head over to a good read at Newsweek - Why Almost Everything You Hear about Medicine Is Wrong. Basically a quick reminder of how studies get misinterpreted, the results flawed and/or exaggerated, the problem of the preponderance of positive or freak findings to the exclusion of negative ones. The rising star of the flawed medical science, Dr. John P.A. Ioannidis is a former child math prodigy who hunts down bad results, a medicine "mythbuster":

As the new chief of Stanford University’s Prevention Research Center, Ioannidis is cementing his role as one of medicine’s top mythbusters. “People are being hurt and even dying” because of false medical claims, he says: not quackery, but errors in medical research.

How wrong? Most says the grown-up digits guru.

I've heard him say as much as two-thirds in other articles. Now that might be an overstatement according to some, but still he has a ledge to stand on. He often points to the problem of negative results, rather, the fact that they don't get aired in public as in published. Get sweeped right under the proverbial lab rug.

What we know for sure, at least according to Newsweek (until they try to tell us differently next week):

Smoking kills, being morbidly obese or severely underweight makes you more likely to die before your time, processed meat raises the risk of some cancers, and controlling blood pressure reduces the risk of stroke. The upshot for consumers: medical wisdom that has stood the test of time—and large, randomized, controlled trials—is more likely to be right than the latest news flash about a single food or drug.

I would add a few more from the wacky world of child research:

Childhood obesity is rising
Sleeping reduces the incidence of SIDS (though it is not the "cause")
Breastfeeding has some slight benefits for mom and child
Vaccines do not cause autism

What else?

I wonder if Doctor Data is friends with Gary Taubes, the science writer who basically says we know next to nothing about anything, especially health and nutrition.

Wouldn't this be a fascinating reality show? Medical Mythbusters. Of course it's really going to need a hip host. Any ideas? There's got to be a disgruntled post-doc out there somewhere yearning for a media career? By the way, if this show already exists, please let me know because I need to add it to my Tivo lineup.

Breastfeeding Bubble Burst?

2011-01-15T16:36:00.000-08:00

Pediatricians challenging exclusive breastfeeding.

What next? Gisele Bundchen turning to formula. Gwyneth Paltrow forgoing her kids' daily dose of lemon-flavored flax oil (yes, read about her hectic day at HuffPo).

A group of British pediatricians bring to the table some evidence exclusive breastfeeding for 6 months (i.e. not introducing solids or any formula or other liquids such as soymilk, cow's milks, etc. until 6 months) may have, eek, several downsides - like higher risks of allergies, iron deficiency anemia, and celiac disease. They speculate further about possible limited food preferences and nutritional deficiencies.

Remarkable article in the British Medical Journal. Refreshing, someone has done their homework. I particularly appreciate their reasonable tone.

Not only do the docs question exclusive breastfeeding, and thus the American Academy of Pediatrics and the behemoth breastfeeding-is-best lobby but also provide a glimpse at the faulty foundation beneath the exclusive breastfeeding recommendations set down by the World Health Organization in 2001. According to these daring docs out of University College London, "the evidence base supporting a major, population-wide change in public health policy underwent surprisingly little scrutiny."

Hmm. How faulty was the evidence?

The WHO edict rested largely on one published review of international studies authored by Kramer and Kakuma, the former who published one of the most methodologically-messed up pseudo scientific hatchet jobs (on breast-feeding and IQ!) I've laid eyes on outside of undergraduate pysch courses. Here's how the London baby doctors see it:

The review included 16 eligible studies, seven of which were from developing countries. Apart from two randomised trials in Honduras, the studies were observational, precluding proof of causation for the outcomes examined, since residual or unidentified confounding may remain even after adjusting for potential confounders. The study’s conclusions (box 1) included evidence for the efficacy of six months’ exclusive breast feeding (notably reduced infection rate) but also potential risk (iron deficiency anaemia, with its associated adverse neurodevelopmental outcomes).

Okay, so what about the "developed" countries, you know, like the US? There must have been lots of evidence, right?

"One study from Belarus showing a lower risk of gastroenteritis. "

In other words, stomach flu. The WHO seemed to ignore another large review of 33 studies that basically concluded there was no basis for the 6 months-clause.

So there you have it. By the way, the British peds are very much pro breast-feeding and would readily agree to exclusive breast-feeding for 4 not 6 months. The evidence for 4 months is slightly less suspect.

Spacing-Out Siblings and Autism: Another Spacey Study Gets Its Fifteen Minutes

2011-01-13T07:06:00.000-08:00

So siblings conceived less than a year apart raises the risk of autism for the younger child?

Yeah, I know, yet another spacey study (i.e. one with a slight finding) thrust into the national spotlight. Searching for the study online I happened upon The Biology Files, a blog written by Emily Willingham, aka The Biolotrix, who I believe is also the mother of an autistic child. She's already tackled the spaced-out autism study, so thoroughly and clearly I highly recommend reading her post. She even goes after the media for dramatic headlines. Maybe we're long lost second cousins?? Anyhow, always a pleasure to come across another blogger debunking the latest scientific evidence in the media.

An added bonus - in an earlier post, Willingham calls out the two other authors of the infamously retracted Lancet autism article - the two that refused to pull their authorship, that is, sided with the now defrocked Andrew Wakefield. Love it.

Sloppy Science Meets Slimy Science: Andrew Wakefield and the Dangers of Junk Science

2011-01-11T08:03:00.000-08:00

The esteemed British Medical Journal took up the strange and sordid case of Andrew Wakefield, the discredited autism quack whose 1998 study launched the vaccine-autism debacle. Read the piece if you can stomach it. Wakefield’s article linking MMR vaccine and autism was fraudulent

The BMJ editorial accuses the former doc of fraud - arguing Wakefield elaborately and thus knowingly constructed the crappy case against the MMR vaccine.  Much of the leg-work in deconstructing the fraud came not from the scientific community but a persistent and perhaps pissed off journalist, Brian Deer. True, researchers were too busy doing real studies investigating the vaccine-autism link. In fact, 14 large-scale studies from 3 continents finding no differences in autism rates between vaccinated and unvaccinated children. Enough said.   The BMJ felt compelled to weigh in but seemed to miss an important aspect of the spectacle.

Yes the former doc committed fraudulent, unethical acts upon vulnerable children and families, not to mention the hundreds of kids sickened by measles and whooping cough outbreaks, the thousands of unvaccinated children, and of course we parents who had to weather this spectacle.

His study was always sloppy science. Pseudoscience. Junk Science.

The unethical behavior aside, Wakefield produced a sloppy study that should never have been published, never should have been unleashed on the scientific community or the general public.

Paul Offit, the vaccine expert, reminded me of that crucial fact in an editorial in the Wall Street Journal that minces no words. Title says it alone. Junk Science Isn't a Victimless Crime: Vaccines don't cause autism—and there was never any proof that they do. Too bad kids had to die while we figured that out.

Even if you believe Dr. Offit is the devil's spawn, you must trust that he's right here. Even if you believe Andrew Wakefield a scapegoat, a savior, you must admit the study suffers many limitations. There's no room for argument.  Wakefield's work was flawed every which way until Sunday. In fact, the editor of the Lancet published it despite it being outright rejected by 4 out of 6 of its peer reviewers. It was descriptive, hardly rigorous, only 8 kids!! It doesn't take an expert to realize how truly speculative and unscientific the results from a study of 8 kids.  Amazing.  Really.  Not even close to good science. Wouldn't have passed any graduate-level course.

Should it have been published because of its critical topic? Should we give a pass to really loose hypotheses on the chance they might be right? Look at the damage. There was virtually no other evidence to suggest he was on the right track. Wasn't then nor is there today. In fact, plenty refuting the whole "gut" theory. He could have done a real study, a larger one, a better one, but he didn't. He took the easy route.

It was a crappy study. Poorly constructed, obvious from day one. He was not serious about testing his hypothesis. Yes, about finding his results, constructing his case, but not testing anything. No excuse for that. None.

Experts didn't go out of their way to remind parents of this startling clear fact amist the growing vaccine controversy. Did any of you read about those 8 kiddies back several years? You wouldn't find it anywhere in the national media. Nowhere. Not unless you happened to read the original research.

Breastfeeding as Proxy for SAT Scores: Does Breastfeeding Spell Less Sleep and Better School Performance?

2011-01-03T08:35:00.000-08:00

Howdy, my sleep-deprived friends and fellow parents. Got to hold a little itty bitty baby this New Year's Eve.  How I  miss those teeny tiny hands and feet! But not the tiny stomachs and the tiny bouts of sleep. Speaking of sub-optimal rest, some of you might have you heard that breastfed babies sleep less and thus deprive their moms of sleep. Had to write about a new study out of West Virginia questioning that mommy myth.

Did breastfeeding spell less sleep?   No. Nada.  In other words, new moms you now have one less reason not to breastfeed according to those who can't help telling new moms what to do. And of course I couldn't help but take the study on in my Naked Data column over at ParentDish (A Good Night's Breast: Does Breast-Feeding Mean Less Sleep?).

I was happy to see that some mothers, including those who had breastfed, didn't buy into the breastmilk-is-god hype and took the time to let me know. Thanks, ladies, your parenting savvy warms my heart. Yes there are all kinds of things we do to nurture our children.  How and what we feed them in the first year of life is but a relatively small contribution.

And of course the usual suspects showed up in the comments.  Those who bemoaned my poor children being breastfed for a measly three months. (So deprived, if only I'd let them suck along for another year, maybe our lives would be utter bliss.) Of course some mommas asserted breast milk made their children smarter, healthier, and happier.

Geez, maybe college admissions applications should include this information as a short cut for a young person's achievement and abilities, their over-all well-being and potential.  Folks seem unhappy with SAT scores, they're so objective and uncaring, who wants to be summed up in a three-digit score anyhow. So maybe we should use breast-feeding as a proxy. It conjures up warm fuzzy images of the applicant at his or her most vulnerable.

Please describe your breastfeeding experience below. Did your mother breastfeed you? If so, how long? If not, please indicate why not and how you have been impacted.

Three months gets you a second look.
Six months, the acceptance letter.
One year? Maybe a scholarship.

Not at all - are you kidding, how in the earth did you end of in our admissions pool.  You drank formula and accumulated these fine set of accomplishments?  True genius. Maybe not being breastfed should be considered a deficit. Maybe those kids should merit more time on the standardized tests, an extra look in the admissions process, their own scholarships.

I know, it's a stretch. It's crazy. But so is this breastfeeding beatification.

Witness the new study out of Australia published online last month in Pediatrics suggesting breastfed kids excel academically in middle school.

I can barely stomach the speculative conclusion that comes without the proper adjustment for momma's intelligence not to mention dadda's. Let me make it clear - educational attainment and income are not the same thing as intelligence. But the researchers believe they are good enough to make their case.

There's another very large red flag - the breastfeeding benefit emerged for boys and not girls. Oh boy. Not a good sign. There's little reason to believe the brain boost only works for boys. Oh sure the authors have to speculate about neuro-development differences and the mother-son bond but we've never heard tell of those gender differences before which should make you very suspicious.

Makes me wonder about how the moms who breastfeed for 6 months may be different. Maternal behavior that attributed to the breastfeeding and their son's but apparently not their daughter's better educational outcomes.  What about you? Also makes me think the "effects" might disappear if the researchers had controlled for maternal IQ.

If this study were a graduate thesis, the committee reviewing it would have had reason to reject it. I'm just saying, not a good one here. But it's a beloved topic so it gets not only a free pass, but prime spot in Pediatrics.  Proving even the best journals fall prey to bias. You can read this clunker for free if you find yourself stuck on a snowy tarmac or waiting in the returns line.

Oh yeah, Happy New Year! My wish? Better studies, better media reports, and of course, more sleep for everyone.

Violence and Video Games: Is Lego Wii the Gateway to Grand Theft Auto?

2010-12-20T08:58:00.000-08:00

My five-year old son became besotted with Indiana Jones Lego on the Wii in like two weeks.

My fault entirely since I gave it to him for his birthday recently after several recommendations and online reviews. When the Lego Indiana Jones cracks his whip the bad block guys "crumble," falling apart. Had to rein it in as I was amazed by how quickly the game grabbed hold of my little guy's imagination. He is obsessed with getting to the next level. The temptation of unlocking the next whatever holds quite an attraction for little minds. It's like kiddie crack. That's worse than the whip and all in many ways if only because it becomes a constant battle. When can I play Wii? Can I play? Basketball, no thanks. Drawing, no thanks. Real-life Legos, nope. Real life has lost some of its appeal.

Do I think playing Lego Wii will lead to chronic aggression? Not really. Nor do I believe Lego Wii is the gateway to Grand Theft Auto.

But I don't like it and am already worried about rumors of excessively violent video games as part of the middle school social experience - and all the peer pressure that entails. I'm well aware of the many correlational findings surrounding violent media fare and aggressive behavior. Watched this literature for a while now. It's a tangle of results made messier by methodological limitations. Like the whole chicken and egg problem. What came first, the real-life aggression or the fictional exposure via games, tv, and video games? Probably some of both is my guess.

A new study published in the Journal of Youth and Adolescence found media violence had no effect on future criminally violent behavior (e.g., pushing, stealing). Researchers looked at over 300 mostly Hispanic youths aged 10 to 14 as part of a larger study on violent behavior. Meaning, they got all kinds of aggression-related data. Interviewed the kids at the start of the study and the end and also assessed their behavior and media fare at these two times. Here's what they found:

One year later, 7 percent reported engaging in at least one criminally violent act during the previous 12 months, the most common being physical assaults on other students or using physical force to take an object or money from another person. Nineteen percent reported engaging in at least one nonviolent crime during the same period, with shoplifting and thefts on school property at the top of the list. In addition, (the researcher) found that depressive symptoms were a strong predictor for youth aggression and rule breaking, and their influence was particularly severe for those who had preexisting antisocial personality traits. However, neither exposure to violence from video games or television at the start of the study predicted aggressive behavior in young people or rule-breaking at 12 months. From Science Daily.

Depression strikes again! The strongest predictor of later aggression. One more reason why children's mental health should be given an extra dose of attention.   Children's mental health should matter as much as their physical health. And still we wonder why kids grow into violent adults.

Let me also point out another obvious point:

Plenty of teens and tweens play video games and don't get suspended or locked up.

How many? A lot.  According to this study 75% of kids played video games in the past month, 40% of the crowd played violent ones. Boys more than girls, by the way.  And only 7% reported a serious act of aggression. Yes, it was self-report. I know, not great. Would love some collaboration, independent verification.

Nonetheless the testosterone-packed games don't make every kid more violent.  There are some kids who may seek them out, like those dealing with depression or other stressors and yes, might in turn be more influenced by the body blows and such. I should also caution that violent exposure might cause more immediate less intense reactions. This study didn't assess behavior immediately following each viewing or gaming session. There's quite a pile of experimental results showing immediate aggressive behavior following exposure.  But no, it doesn't generally measure mental health, as in depression.

Still, I don't enjoy seeing Indy cracking his whip at block figures nor the power the Lego land holds over my young son.  I still let him play it but not as much. Gotta channel that physical energy elsewhere.

So Santa, please, no more video games with the pushing and punching! I've had almost all I can take regardless of the scientific evidence.  Whether of not violent media content begets more violence I don't appreciate it.