Fatherly Stress, Hoverboards, Teen Drivers – PediaCast 400

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Show Notes

Description

• This week we explore more news parents can use! Topics include fatherly stress at the time of conception, safe infant sleep in the care of babysitters, hoverboard hazards, vaccine rates in those with autism, the effect of TV viewing at age two with health and wellness at age thirteen, and the impact of ADHD and conduct disorders on early teenage driving. We hope you can join us!

Topics

• Fatherly Stress
• Safe Baby Sleep
• Hoverboards
• Vaccines & Autism
• TV Time
• Teenage Drivers

Links

• Safe Baby Sleep & SIDS – PediaCast 302
• Room Sharing & Safe Baby Sleep – PediaCast 379
• Guidelines for Safe Baby Sleep (AAP)
• The Vaccine War – PediaCast 329
• Childhood Vaccines – Part 1 – PediaCast 351
• Childhood Vaccines – Part 2 – PediaCast 352
• How to Make a Family Media Use Plan (AAP)
• AAP Family Media Plan Tool Kit
• The Dad Experience Podcast

Transcription

Announcer 1: This is PediaCast.

[Music]

Announcer 2: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children's, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello everyone, and welcome once again to PediaCast. It's a pediatric podcast for moms and dads. This is Dr. Mike, coming to you from the campus of Nationwide Children's Hospital. 

It's Episode 400 for April 11th, 2018. We're calling this one "Fatherly Stress, Hoverboards and Teen Drivers". I want to welcome you to the program. 

We are back this week with more news parents can use and we have topic this time around that span all the age ranges in pediatrics, whether you're planning on starting a family or your youngest child is a teenage driver. Maybe you have kids somewhere between those two extremes, you probably do. 

0:01:11

Be assured that we have something for everyone this week. So stick around and I'll get to the entire line-up in a moment. Give you a sneak peek of all of our topics.
 
First though, I'd like to take a moment to dedicate this 400th episode of PediaCast to my mother, Mary Sue Potts. You know, I've not dedicated a particular episode to a specific person in the past. But reaching the 400th episode milestone is a pretty big deal in the podcasting world. I've been around since 2006, sort of right at the dawn of podcasting and still going strong. 

And my mother has always been a big fan of the program. She encouraged me to keep at it. She listened to it. She critiqued it, offered suggestions for PediaCast. And she shared the show proudly with just about everyone she came in to contact with, whether they had kids or not because she figured everyone at least knows someone with kids. So by sharing the show, the hope was that person with raised awareness with those who really needed to hear and know about these things.

0:02:16

And in her way, she really strengthened evidence-based medicine in the power of knowledge by supporting my efforts and supporting me in helping to get the word out. And really, a boy and a doctor and a podcaster couldn't really ask for more. 

And of course, she was another wise terrific mom on all possible levels, a wonderful mother-in-law, a loving grandparent, and a model human being who relentlessly put others before herself and to serve them tirelessly.

Now, you notice I'm using the past tense and that's because my mom passed away last month following a 13-year battle with ovarian cancer. As it turns out, she won that battle because in the end it was pneumonia and sepsis that took her away. 

But her legacy lives on in all the folks whose lives she touched, which as it turns out includes all of you, because if you're listening to this program, hopefully you're getting something tangible and useful and practical from our time together. And much of who I am, how I interpret the world and present topics and teach come from the lessons I learned from my mom. 

0:03:26

Parents are powerful people, that's one of the reasons you are here, right? You're seeking knowledge because you want to be a more impactful parent. And that's why I want to dedicate this episode to the life of the most impactful parent I know. So, Mary Sue Potts, this one's for you.

All right, so what exactly are we talking about today? You got a little hint in the show title. First up, we're going to consider fatherly stress. This is an interesting one because we're talking about the stress a father may experience before a child is born. In fact, emotional and physical stress at the time of conception can alter genetic expression in the sperm and ultimately had an impact on development and mental health even many years down the road.

0:04:10

So, we'll explore that topic. I promise it will stretch your mind a little bit. And then we're going to cover safe sleep. We've covered safe baby sleep many times on this program. We'll provide a reminder of the ABCs of safe infant sleep. 

But the spin this time around concerns those who watch your infant when you're not around including licensed childcare workers, babysitters, relatives, friends. Do they know the rules of safe infant sleep? How well do infants fare in their care? And as a parent, what can you do to keep your baby safe as he or she sleeps when you are not around? We'll talk about that.

And then we'll consider the hazards of hoverboards and some thoughts on keeping your kids safe if they have a hoverboard at home or access to one at a friend's house. 

We'll talk about vaccine and autism. Not so much in the sort of traditional sense because we've talked about the fact that vaccines are not associated with autism. We've talked about that many times on this program. And I'll direct you to some past episodes where we've clearly made that point. 

0:05:12

Instead today, we'll explore vaccine rates in kids with autism spectrum disorder and the younger siblings of those with autism. Turns out these kids often don't complete their vaccines even though the vaccines had nothing to do with their autism. And this puts them at risk of contracting and spreading vaccine preventable diseases. 

So, we'll look at the scope of the problem and hopefully provides some reassurance for parents who have kids with autism and are wondering about the safety of vaccine completion. 

And then we're going to consider TV time. This is another interesting study. It's a well-designed longitudinal project that compares TV viewing time at 2 years of age with the health and wellness at 13 years of age in the same cohort of kids. So a longitudinal study, those are very powerful as we consider scientific research.

I'm not going to give away too much now. But stick around, I think you'll find the results compelling and I'll do my best to put a practical spin on the information as we consider health and wellness at 13 years of age and how TV viewing back at the 2 years of age affected that.

0:06:17

And then we'll wrap up with the study on teenage drivers and the role ADHD and contact disorders play on driving skills and car crashes. And what you can do as a parent during those early driving years especially if your child is challenged in the areas of attention, hyperactivity, and impulsivity.

So lots coming your way this week. Don't forget, if there is a topic you'd like us to talk about, if you have a question for me or you want to point me in the direction of a news article or a journal article, it's easy to get in touch. Just head over to PediaCast.org and click on the contact link. I do read each and every one of those that come through. And if you contact me there, we'll try to get your suggestion, your topic, your question on the program. 

Also, I want to remind you, the information presented in every episode of PediaCast is for general, educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. So if you have a concern about your child's health, be sure to call your doctor and arrange a face-to-face interview and hands-on physical examination. 

0:07:17

Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement, which you can find at PediaCast.org. 

All right, let's take a quick break and then I will be back with lots more news parents can use. It's coming up right after this.

[Music]

0:08:03

Dr. Mike Patrick: As you can imagine a father's stress levels can have lots of impact on his children and family. But did you know the fatherly stress can be an issue even before his first son or daughter is born? This is according to research from the University of Maryland School of Medicine presented at the 2018 Annual Meeting of the American Association for the Advancement of Science, which recently took place in Austin, Texas.

Investigators studied mice and found that stress in a father-to-be mouse affected the brain development of his offspring. More specifically, stress appeared to change the father's sperm, which in turn alters the brain development of his child. Researchers say this finding provides better understanding of the key role that fathers play in the brain development of their offspring.

Scientists have known that a mother's environment during pregnancy, including factors such as poor diet, stress, infection, can negatively impact her offspring. This is not to be due in part to how environmental factors affect the expression of certain genes, a concept known as epigenetics.

0:09:09

Now, researchers led by Dr. Tracy Bale, a neuroscientist at the University of Maryland add to this evidence by demonstrating that a father's stress can also affect offspring development by altering important aspects of his sperm.

Dr. Bale had previously found that adult mice experiencing chronic periods of mild stress have offspring with an altered response to stress, including changes in stress reactivity that have been linked to some neuropsychiatric disorders such as depression and post traumatic stress disorder. 

Additionally, she and her colleagues isolated the mechanism of this altered stress response by demonstrating the father's sperm showed changes in genetic material known as microRNA. MicroRNA is important because it plays a key role in which genes become active and form functional proteins. Furthermore, Dr. Bale's team has unraveled new details regarding changes in microRNA. 

0:10:03

In the male reproductive tract, the caput epididymis is a structure where sperm matures and tiny vesicles packed with microRNA fuse with the sperm changing the genetic cargo that is ultimately delivered to the egg. It turns out the caput epididymis responds to the father's stress by altering the genetic content of the microRNA containing vesicles.

This suggests that even mild environmental challenges can have a significant impact on the development and potentially the health of future offspring. Dr. Bale says that by learning more about links between father's exposure to stress and the risks of disease for his offspring, we can better understand, detect, and prevent these disorders.

So lots more work to be done as we try to understand the relationship between parental stress around the time of conception, the resulting brain development of our children, and then mental health disorders that ultimately arise in the context of our stress and their development. Lots more work to be done.

0:11:04

But in the meantime, one thing we can say about all these, it's important to take care of ourselves, and our family life and our jobs. We attempt to balance the two. It's important to manage our stress and improve our own mental health, whether you're currently engaging as a family member and parenting a child or you have soon-to-be plans to do so.

Babies who died during their sleep while being watched by someone other than their parents were often placed in unsafe sleeping positions, such as on their stomachs, or in unsafe locations such as a couch. This is according to researchers from the University of Virginia School Medicine and Children's Mercy Kansas City and published in the Journal of Pediatrics.

In response to these findings, investigators are urging parents to educate anyone who cares for their children about safe sleep practices and the risk of Sudden Infant Death Syndrome, also known as SIDS, which is the leading cause of death among babies between one month and one year of age. 

Dr. Rachel Moon, leader of the research team and pediatrician with the University of Virginia Children's Hospital says, "If someone else, a babysitter, relative, or a friend is taking care of your baby, please make sure they know to place your baby on his or her back, in a crib and without any bedding."

0:12:17

Researchers reviewed more than 10,000 infant deaths and found in about 14% of them occurred when a parent was not present. Among those cases, when someone else was caring for an infant when death occurred.

Babies were less likely to be placed on their back, the sleep position recommended by the American Academy of Pediatrics, compared to babies being cared for by a parent.

Babies were more likely to be placed in sleep environments with obstacles and objects that might prove hazardous. Remember, the American Academy of Pediatrics recommends that sleep spaces be free of toys and soft bedding, including pillows, blankets and sleep bumpers.

73% of licensed childcare providers placed babies in a crib or bassinet, as recommended. However, among babysitters, this number was only 49%, placing babies in a crib to sleep. Among relatives, the number was only 29%, and among friends 27%.

0:13:12

So, licensed childcare providers tend to know safe sleeping guidelines. Although, a quarter of them didn't. Babysitters, relatives and friends, however, they need lots more education regarding safe sleep. And it's really up to parents to provide this education.

And then what about placing babies to sleep on their back? 54% of licensed childcare providers placed infants in the recommended supine position or on their back. But that's only half of licensed providers. So, again we really need more safe sleep education. 

Among babysitters, relatives and friends only 38% of them correctly place babies on their backs.

Another important observation from the study, deaths while under the supervision of friends and relatives were most likely to occur while the babies were held or placed on an adult bed.

0:14:03

Dr. Jeffrey Colvin, one of the researchers from Children's Mercy Kansas City says, "A lot of relatives and friends may not be aware that babies are safest on their backs. They may have raised children before we knew that this was the safest."

Investigators do have some encouraging news to report of past studies found most licensed childcare providers placed infants on their stomachs to sleep. Researchers noted the same group was now the most likely non-parental supervisor to place babies in the recommended sleeping position on their back and in cribs. They suggest this may be a result of the educational efforts of the Safe Sleep national campaign and changes in state regulations.

Dr. Moon sums up the findings with this, "It's always best to discuss where and how your baby should sleep. You can't make assumptions that the person with whom your baby is staying will know what is safest."

So, let's review for parents everywhere. And parents, please review this with anyone taking care of your baby, whether they are licensed child care provider. As we see, many of them are not going with the tenets of safe sleep. Or if it's a babysitter, a relative, a friend, whoever it is, make sure you let them know the ABCs of safe baby sleep because they may not hear it if you're not the one to let them know.

0:15:18 

And ABCs of safe baby sleep, what are they? A, baby should sleep Alone. B, they should sleep on their Back. And C, they should sleep in a Crib. 

So what do we mean by Alone? Well, it means no pillow, stuff animals, blankets, bumpers. Just dressed in appropriate clothing and on top of nothing more than a flat-fitted sheet. 

On their backs, so that's the B, means just that, put them down on their back.

And in a crib refers to a safe space design for baby sleep such as a crib or bassinet. So not a car seat or a swing, any of those sort of things. Now, you know, if it's a quick nap and you're right there, that's a little bit different. But if they're going to have unsupervised sleep for any extended period of time, you definitely want them to be in a crib or bassinet.

0:16:10

You can learn more about SIDS and safe baby sleep by tuning in to PediaCast Episode 302, also 379. Also there are safe infant sleep guidelines from the American Academy of Pediatrics. And I'll put links to all of these resources in the Show Notes for this episode, 400, over at PediaCast.org. So you can find them easily and share them with the childcare providers, babysitters, relatives, and friends who maybe taking care of your baby.

New research shows that nearly 27,000 children and teenagers were treated in US emergency departments for injuries they received while riding hoverboards, also called self-balancing scooters during the product's first two years on the market. This is according to an article in the April 2018 edition of the journal Pediatrics called Pediatric Hoverboard and Skateboard Injuries.

Researchers analyzed data from the National Electronic Injury Surveillance System for the years 2015 and 2016 and found the highest number of hoverboard injuries occurred among 12-year-old boys.

0:17:10

The body parts most frequently injured were the wrist (19%), forearm (14%) and head (14%). And the most common injury types were fractures (40%), contusions at 17%, and strains and sprains at 13%. Head injuries accounted for 14% of all hospital admissions. 

Although, hoverboards were known for spontaneously catching fire before they were required to undergo safety inspection, only three burns were reported in the study and none of these burns were from the toy's malfunctioning batteries. 

Two other burns resulted from patients being scalded while riding a hoverboard in the kitchen and colliding with a pot of boiling water. Yes, that happened twice. Maybe don't hoverboard in the kitchen or inside. And the other was a friction burn that developed after a hoverboard ran over a child's finger.

0:18:02

The study also found over 120,000 skateboard injuries among patients under 18 years of age who were treated in US emergency departments during the study period. While the majority of hoverboard injuries occurred at home, they found most skateboard injuries occurred on the street.

The study authors say their findings highlights the importance of injury prevention measures such as wearing helmets, wrist guards, and knee pads while riding hoverboards and skateboards. 

So you know, we think about helmets when riding bicycles, which is great, and we think about wrist guards and knee pads when rolling skating and rollerblading. But keep in mind, hoverboarding and skateboarding, these also have the potential to cause serious injury which can be reduced in frequency and severity, although not entirely eliminated, with the use of protection equipment in the form of helmets, wrist guards, and knee pads.

[Music] 

0:19:22

Dr. Mike Patrick: Children with autism and their younger siblings are significantly less likely to be fully vaccinated than the general population. This according to a new study from Kaiser Permanente and reported in the journal, JAMA Pediatrics.

Dr. Ousseny Zerbo, lead investigator of the project and a post-doctoral fellow with the Kaiser Permanente Northern California Division of Research says, "In this large and comprehensive study, we found that after children received an autism diagnosis, the rates of vaccination were significantly lower when compared with children of the same age who did not have an autism." 

The retrospective matched cohort study entitled Vaccination Patterns in Children After Autism Spectrum Disorder Diagnosis and in Their Younger Siblings included more than 3,700 children with autism spectrum disorders diagnosed by 5 years of age, and nearly 500,000 children without an autism spectrum disorder born between 1995 and 2010 and their respective younger siblings, born between 1997 and 2014.

0:20:24

The researchers reviewed whether the children received vaccines recommended by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices. The data were drawn from six sites participating in the CDC's Vaccine Safety Datalink including Kaiser Permanente locations in California, Colorado, Oregon, and Washington, and Marshfield Clinic in Wisconsin.

Dr. Nicola Klein, senior author of the report and director of the Kaiser Permanente Vaccine Study Center says there was large differences in vaccination rates between children with and without autism spectrum disorders, as well as between their siblings and across all age groups and after adjusting for important confounding factors.

For example, among children aged 7 years or older, 94% of those without an autism spectrum disorder received all their vaccines recommended between 4 and 6 years of age, compared with 82% of those with an autism diagnosis. And specifically for the measles, mumps, rubella or MMR vaccine, 96% of those without autism were vaccinated compared with only 84% of those with autism.

0:21:31

In addition, the proportion of children who were fully vaccinated with the recommended vaccines was lower among younger siblings of children with autism, compared with younger siblings of children without that diagnosis. For vaccines recommended between 1 and 11 months of age, 85% of younger siblings of children without autism were fully vaccinated, compared with only 73% of younger siblings who had an older brother or sister with the disorder.

Dr. Frank DeStefano, co-author of the study and Immunization Safety Officer for the Centers for Disease Control and Prevention says, "Numerous scientific studies have reported no association between childhood vaccination and the incidence of autism spectrum disorders. Nonetheless, this new study suggests that many children with autism and their younger siblings are not being fully vaccinated. We need to better understand how to improve vaccination rates in children with autism spectrum disorder and their siblings, so they can be fully protected against vaccine-preventable diseases."

0:22:31

So, you know we've covered vaccines and autism many times on this program. And one that I really would consider a must-listen is Episode 329 called The Vaccine War. We interviewed New York Times best-selling author and investigation journalist, Seth Mnookin. And we took a deep dive into the background of how autism and vaccines became falsely connected. It's an interesting and important story for all parents to hear. 

And then we did a two-episode primer on vaccines including safety considerations and we talked about autism there, too. Childhood Vaccines Part I and Childhood Vaccine Part II with Dr. Michael Brady, an infectious disease specialist and associate editor of The Red Book which contains updated information from the AAP's Committee on Infectious Diseases. 

0:23:22

So, terrific resources all around if you're interested in learning more about vaccines including safety considerations and autism. And I'll put links to all three of those episodes in the Show Notes for this particular episode, 400, over at Pediacast.org. 

Bottom-line here, folks, when taken as a whole, the collective body of scientific evidence refutes any association between vaccines and autism. And when we parents refused vaccines for our kids with autism and the younger siblings of our kids with autism, we're increasing the risk that these kids will catch and potentially die from a vaccine preventable disease.

And we're placing the vulnerable among us, so those with a chronic illnesses and weakened immune systems, at an increased risk by reducing the effectiveness of community immunity.

Watching too much television at the age of two can translate into poor eating habits in adolescence and poor performance in school. This according to researchers at University of Montreal's School of Psychoeducation and published in the journal Preventive Medicine.

0:24:28

Dr. Linda Pagani and graduate student Isabelle Simonato looked at the cohort of nearly 2,000 boys and girls in Quebec born between spring 1997 and 1998.

The children were followed longitudinally beginning at five months of age as part of the Quebec Longitudinal Study of Child Development. When they reached two years of age, their parents reported on their daily television viewing habits. And then, at age 13, the youth reported on their own dietary habits and behavior in school.

Dr. Pagani says, "Not much is known about how excessive screen exposure in early childhood relates to lifestyle choices in adolescence. However, this birth cohort is ideal because the children were born before smart phones and tablets and before any pediatric viewing guidelines were publicized for parents to follow. They were raising their children with TV and it seemed harmless. This makes our study very naturalistic, with no outside guidelines or interference, all a huge advantage."

0:25:27

Isabelle Simonato adds, "Watching TV is mentally and physically sedentary behavior because it does not require sustained effort. We hypothesized that when toddlers watch too much TV, it encourages them to be sedentary. And if they learn to prefer effortless leisure activities at a very young age, they likely won't think much of non-leisure ones, like school, when they're older."

Researchers found that every hourly increase in toddlers' TV viewing forecasted bad eating habits down the road, with an increase of 8% at age 13 for every hourly increase of TV viewing at age 2. 

So, what exactly was increasing by 8% with each extra hour of TV viewing? 

Well, in questionnaires, the 13-year-olds who watch more TV at age 2 also reported eating more french fries, prepared meats and cold cuts, white bread, soft drinks, fruit-flavored beverages, sports drinks, energy drinks, salty or sweet snacks, and desserts.

0:26:24

Early TV viewing also translated into less breakfast eating on school days by 10% and led to more overall screen time at age 13. Every hour increase of TV viewing also predicted a higher body mass index, a 10% increase and less effortful behavior at school in the first year of secondary school, ultimately affecting performance and ambition.

Dr. Pagani says, "This study tells us that overindulgent lifestyle habits begin in early childhood and seem to persist throughout the course of life. An effortless existence creates health risks. For our society, that means a bigger health care burden associated with obesity and lack of cardiovascular fitness."

The researchers also measured their results against revised screen time guidelines by the American Academy of Pediatrics, which reduced the amount of daily viewing from two hours a day to one hour a day for children between ages two and five. 

0:27:17

Compared to two-year-olds who viewed less than one hour a day, those who viewed more than one hour a day reported at age 13 had less healthy dietary habits, skipping breakfast on weekdays, had a higher BMI, engage in more intense screen time, and became less engaged as students.

Isabelle Simonato says, "Because we had a lot of information on each child and family, we were able to eliminate other psychological and socio-demographic factors that could have explained the results, which is a really ideal situation. We even removed any influence of screen time habits at age 13 to really isolate long-term associations with toddler viewing."

Dr. Pagani adds, "In preschool, parents use screen time as a reward and as a distraction. They establish quiet 'idling' at a teachable moment when children could actually be learning self-control. Using distraction as a reward to help children behave in situations where they should be learning self-control sets them on a trajectory where they will seek out distraction when faced with demands for thinking and effort."

0:28:22

"Rewarding distraction and low mental effort via entertainment will later influence a young person's commitment to school and perseverance in their studies. So we believe the AAP guidelines of not more than one hour of TV viewing for young children is correct, to ensure healthy developmental trajectories in adolescence."

So, this study looked at two-year-olds, their TV viewing habits and the effect early TV viewing appears to have at age 13. Now, you may be saying to yourself, all right, but I have a five-year-old or a 15-year-old. Is it too late to intervene? Can I change that the trajectory? How do I know what amount of TV viewing is right for my kids and my family? 

And what about other forms of screen time and things like computers and tablets and smart phones? Especially if you're using those things for school, where do they fit in? 

0:29:10

Well, to help answer these questions and come up with the family media plan of your own, the American Academy of Pediatrics has some terrific resources on creating and customizing a family media use plan for your kids and family. And I'll include links to that in the Show Notes of this episode 400 over at PediaCast.org to help you get started.

Teenage drivers ages 16 to 19 are three times more likely to have a fatal car accident compared to older drivers. Also in this age group of 16- to 19-year-olds, around 20% in the United States have been affected by a mental health disorders, including 9% with the history of attention deficit hyperactivity disorder or ADHD.

So what are the relationships between these observations? That was the question before researchers at the University of Pennsylvania, Utah State University and the Center for Injury Research and Prevention at the Children's Hospital of Philadelphia. 

0:30:09

Lead investigator Dr. Catherine McDonald and her team set out to study what distracts these newest drivers by analyzing data from 60 teens who completed a simulated driving assessment and several questionnaires and linked their mistakes behind the wheel with self-reported symptoms of ADHD and other mental health disorders. The team's finding were reported in the journal Nursing Research. 

Dr. McDonald explains, "Previous studies have shown an increase in crash risk related to an ADHD diagnosis. We wanted to tease apart the nuances behind this observation. Is it about risk-taking, skill, or performance deficits? Is it about decision-making? By using a simulator and considering self-reported behaviors, we wanted to see if our data could get at the why of teenage car crashes."

The research team began by recruiting 16- and 17-year-olds in Pennsylvania who had their driver's licenses no more than 90 days. At the beginning, participants rated how closely numerous statements aligned with their thoughts and feelings. For example, one question assessing symptoms of ADHD asked if the teenager had trouble paying attention to conversation with others. Another, accessing conduct disorder, asked if the teenager bullied or threatened others.

0:31:24

Participants also completed a questionnaire about depression symptoms and another regarding their driving behaviors on the road, such as tendency to speed, use of cell phones, and the number of passengers they carried. In addition, parents assessed their child for ADHD symptoms and other mental-health problems.

Dr. McDonald says, "We know that about 5% of older teens meet the criteria for ADHD, so we weren't expecting too many in our sample to meet the threshold for diagnosis. For that reason, we looked at symptom measures instead. That gives us an idea of the severity of symptoms, even if they are not high enough to meet the criteria for a full diagnosis."

Next step, participants completed an assessment in the driving simulator where they were exposed to different crash scenarios, a rear-end collision, a hidden hazard, and other situations that we're voidable with safe driving skill. By the end of the simulated assessment, each teen had been presented with 21 potential crash situations. 
Researchers analyzed the simulator data on a variety of the participants' actions, including how they behaved at stimulated stop signs, in which lane they drove, where they looked on the road, and how they applied the brakes in potentially dangerous circumstances.

0:32:35

Investigators noticed the clear link, the more problems with attention reported by the student, the more mistakes that driver made in the simulator. Dr. McDonald says knowing this association offers a clear opening for healthcare providers.

She adds, "Inattention was associated with more errors in the simulator, and self-reported symptoms of hyperactivity and conduct disorder were related to more self-reported risky driving behaviors. This presents an opportunity to help intervene with patients and their families, to talk about the child's whole health and mental well-being and how it might relate to driving behaviors."

The researchers acknowledged several limitations to the work. For one, the study cohort was predominantly white and thus not representative of the young driver population overall. 

Second, investigators didn't seek out participants already diagnosed with disorders such as ADHD, but rather assessed for symptoms once an adolescent agreed to participate. 

Finally, they could not measure all contributors to risky driving and performance errors. Dr. McDonald says she hopes to mitigate some of these limitations in future research.

She says, "We would like to learn more about the relationship of mental health symptoms in driving behavior in a sample with higher rates and severity of ADHD so we can examine the impact of inattention, hyperactivity, and impulsivity with teenage driving."

That next step could move the research toward its ultimate goal, tailoring interventions for teens drivers who are at risk in different ways.

So regardless of the limitations of the study, it sure makes sense that teenagers with ADHD, whether they're having problems with attention or hyperactivity or impulsivity, it sure makes sense that these symptoms could affect their driving, especially during the early years of driving where there is a critical lack of experience. So the investigators may want to tighten their methods and have further research before making specific recommendations. 

0:34:25

The practical take-home for parents is this, young drivers need lots of supervised experience . And those with mental health conditions including ADHD and conduct disorders may very well benefit from a longer and more intense period of training and supervision. And ultimately, as parents, it's up to us to keep our teens safe by getting them connected with the driver training, supervision, and experience that they need.

[Music] 

0:35:22

Dr. Mike Patrick: We are back with just enough time to say thanks to all of you for taking time out of your day and making PediaCast a part of it. Really do appreciate that. 
 
Don't forget, you can find us in all sorts of places. We are in iTunes, Google Play, iHeart Radio, Spotify, and most mobile podcast apps for iOS and Android.

And then, don't forget about our landing site over at PediaCast.org. We have our entire archive of past episodes, 400 of them now. Also, all of our Show Notes, our transcripts, Terms of Use Agreement, and our contact page so you can suggest the topic or ask your own question. 

We're also a part of the Parents On Demand Network at parentsondemand.com. It's a collection of podcasts for moms and dads. The collection includes PediaCast along with many others. There's a Parents On Demand Network mobile app which you can find in the app store, in Google Play. That way, you can find all the shows and listen to them all in one place. 

0:36:15

Speaking of all the shows in the Parents on Demand Network, one you might want to check out is the Dad Experience with Adam and Mike. Adam is a high school band teacher with a toddler at home. Mike has two slightly older kids and he works with the program for students with special needs. 

And as you know, many general parenting podcasts target moms, which of course is great and helpful and supportive, but it's also nice to hear about parenting and family and life from the father's perspective. And this is true for other dads, as well as for moms, to hear about the dad perspective. 

So be sure to check out that highly informative and entertaining Dad Experience podcast. They have a terrific line-up of shows. Some recent episodes include teaching our kids to be informed, being born abroad in another country, parenting and work, acknowledging fear, raising a family with no support system, finding time to be an adult, balancing a full house. So lots of great useful content and I'll put a link to the Dad Experience podcast in the Show Notes for this episode, 400, over at PediaCast.org so you can find it easily and check them out. 

0:37:22

Also, don't forget iTunes and other places, reviews are helpful. So wherever you find PediaCast, wherever you regularly listen, they likely have a method to leave a review and let others know about the show. Whether that's iTunes or Google Play, please consider writing a review for PediaCast. 

Those reviews are important. When I'm looking for something new, whether it be a restaurant, something that I'm going to buy at Amazon, wherever, whatever it is, you always check out the reviews to see what it's all about before you give it a try. And the podcasts are no different, and so it is very helpful if you do leave a review for us in iTunes or whatever other place you get your podcast.

And then, of course, don't forget us on social media. We are on Facebook, Twitter, Google+, even Pinterest. And we always appreciate it when you share our content with your own online audience. 

0:38:14

And then those face-to-face referrals are really, really important. Please do tell your family, your friends, your neighbors, coworkers, babysitters, grandparents, anyone who has kids or takes care of kids. That way they can find out about safe baby sleep, right? 

A lot of people don't know about that, unless you've been told by a pediatrician because you're a parent and you're taking the kid in. But folks who might be watching your child at home may not have that information. And this is one of the places where they can get that and it can reinforce what you tell them.

Also, let your child's teacher know about PediaCast and of course, his or her pediatric medical provider. That's really important. We do have a program for them, too. PediaCast CME, it's similar to this program. We turn up the science a couple of notches and we offer free Category 1 Continuing Medical Education Credit for those who listen and participate. Shows and details are available at the landing site for that program, PediaCastCME.org.

0:39:11

That show's also on iTunes, Google Play, iHeart Radio, Spotify, and most mobile podcast apps. Simply search for PediaCast CME. 

All right, thanks again for stopping by and until next time, this is Dr. Mike saying stay safe, stay healthy, and stay involved with your kids. So long, everyone. 

[Music] 

Announcer 2: This program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast. on PediaCast.