Sleep Machines, ADHD, Teen Suicide – PediaCast 283

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Join Dr Mike in the PediaCast Studio for more News Parents can Use. This week’s topics include infant sleep machines, breastfeeding & IQ, ADHD & obesity, Teen Suicide, Cyberbullying, gang membership, and the benefits of volunteer opportunities.

Topics

• Infant Sleep Machines

• Breastfeeding & IQ

• ADHD & Obesity

• Teen Suicide

• Cyberbullying

• Gang Membership

• Volunteer Opportunities

• Muscular Dystrophy

Links

• CONTACT DR MIKE – Ask Questions, Suggest Show Topics

• CONNECT NOW with a pediatric specialist from Nationwide Children’s – Referrals and Appointment

​

Transcription

Announcer 1: This is PediaCast.

[Music]

Announcer 2: Welcome to PediaCast 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 a pediatric podcast for moms and dads. This is Dr. Mike coming to you from the campus of Nationwide Children's Hospital. We're in Columbus, Ohio it is episode 283 for April 2, 2014. We're calling this one Sleep Machines, ADHD, and Teen Suicide. I want to welcome you to the program. We have a news parents can use edition of the show lined up for you this week with topics that span from early infancy all the way through late adolescents. 

0:01:03.1

Regardless of the age of the kids in your life we do have some great take home information for you this week. Before we get to the entire line up I do want to remind you, and you know I usually cover this at the end of the program but every few months and I actually haven't done it yet this calendar year. I like to stick this up here at the beginning of the show and not just a simple reminder that we really rely heavily on your word of mouth to let other moms and dads know about PediaCast. Think about how you found us, it might have been on iTunes, or on iHeart Radio, maybe it was on Facebook, or Google Plus, Twitter and Pinterest, or other possibilities. Maybe you saw us on a digital sign here at Nationwide Children's Hospital or a poster in your doctor's office, maybe you're the doctor and one of your patients let you know about the show. However you found us it's likely you heard about PediaCast because someone else helps spread the word. 

0:01:58.2

So my simple request is this, to please pay it forward and consider taking an active role in spreading the word about our podcast to those who will discover us in the future. That might be by liking our Facebook page, or sharing our posts, creating a Pinterest board with your favorite episodes. iTunes reviews are incredibly helpful as our re-tweets on Twitter. Be sure to let everyone in your social circles, those who have kids, or take care of kids, or teach kids, or doctors, or nurse practitioners, or nurses for kids let them know about the show. And finally whatever you have done or continue to do to help spread the word about PediaCast just please know that I am genuinely appreciative and I do thank you from the bottom of my heart. One more thing before we go to the line-up, we have a great blog here at Nationwide Children's. It's called 700 Children's and you may wonder how we got that name. From the 1800's on this hospital address has been 700 Children's Drive and so 700 Children's is something that folks around the hospital definitely recognize.

0:03:09.8

I know those of you who are in California, or Texas, or New York may not quite understand that but that's where we get the name 700 Children's and you can find our blog at 700childrens.org. We recently featured a fantastic post by Dr. Nicole Caldwell on the importance of reading to your child which fits in nicely with one of our new stories that I'm going to cover this week so you definitely want to check that one out. We also have stories on medical missions to Honduras, one thing almost all kids with cancer have in common, that's a post and there's one has more information for you on organic foods are they safer for our children? So be sure to visit our hospital blog, 700childrens.org. So what are we talking about this week? 

0:03:57.7

First up, infant sleep machines. White noise has help many baby fall asleep and stay asleep but are they safe? You may be asking what is he talking about. I mean how could it be the sleep machines would be harmful? Well as it turns out they can be too loud which might damage your child's hearing and result in speech, and hearing, and language problems down the road. Now does that mean sleep machines are bad all together and you should stop using them? Not necessarily, they have their merits so stay tuned and I'll share some safe strategies for using them. Then we'll have breast feeding and IQ points. Several studies have shown that breast fed babies tend to be smarter than bottle fed babies but is the difference really the breast milk? Or could it be that certain maternal behaviors that are more common among breast feeding mothers are really what's going on here? And if that's the case what are those behaviors of superior parents that lead to smarter kids? I'll have that answer coming your way. 

0:04:59.4

And then ADHD and obesity, lots of little kids with ADHD have decreased appetites when they start stimulant medication which can lead to delays in growth which of course matter to moms and dads. I mean lot of moms freak out about this. I mean now my kid's losing on their growth chart because of the stimulant medication that they started and yet we can't deal with their behavior and their school performance without it, what do we do? But what about the long run? Do these kids stay little, or do they have rebound growth and obesity in the teenage years and young adulthood? We're going to consider a couple of recent research studies that looks into this and we'll let you know what you can do to keep your kids with ADHD healthy. And then teen suicide, after a nice decline at the beginning of the millennium unfortunately teen suicide is on the rise again. We'll take a look at possible reasons for this including the increasingly common problem of cyber bullying plus we'll talk about how you the parent can spot suicidal behavior in your kids and intervene before it's too late. 

0:06:04.5

So that's coming up. And then we'll stick with some teenage topics and discuss the long term effects of gang membership as well as the benefits of getting your kids involve with volunteering in your community, so that's coming your way. Then at the end of the show for my final word I'll clue you in about an opportunity for families dealing with muscular dystrophy. We have a great educational opportunity coming your way here at Nationwide Children's for moms and dads, and kids with programming for those as young as age seven, I'll let you know the who, what, when, where, why, and how at the end of the show. Finally a couple of quick reminders don't forget if there's a topic that you would like us to talk about on PediaCast. If you have a question for me that you'd like answered, or you want to point me in the direction of a new story or journal article, or you have idea for a topic to do an interview show on, just let me know. It's easy to get in touch, just head to pediacast.org and click on the contact link. And then finally the information presented in every episode of this program is for general educational purposes only.

0:07:05.3

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. Also your use of this audio program is subject to the PediaCast terms of use agreement which you can find at pediacast.org. Let's take a quick break and I'll be back with News Parents Can Use right after this.

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Dr. Mike Patrick: We are back. Many parents use infant sleep machines to mask environmental noises in busy households, or to provide ambient noise to soothe an infant during sleep. But parents should be aware because sleep machines can also contribute to baby's hearing loss. That's according to the American Academy of Pediatrics and a study published this month in the journal Pediatrics. Researchers tested 14 different infant sleep machines at their maximum volume. The machines produce a total of 65 different sounds which investigators tested at three distances. 30 centimeters (to simulate placement on a crib rail), 100 centimeters (simulating placement near a crib), and 200 centimeters (to simulate placement across the room). All 14 machines exceeded 50 decibels which is the current recommended noise limit for infants in hospital nurseries. 

0:08:59.0

And here's the surprising part, all but one machine exceeded the recommended noise limit at across the room distances of 200 centimeters away from the baby. The study also determine that regular exposure to white noise through an infant sleep machine on a nightly basis can affect hearing, speech, and language development especially if the machine is too loud. Even though maximum volumes were measured in this study, the authors encourage parents to place infant sleep machines across the room and more than 200 centimeters from your baby and to lower the volume to protect your infants' hearing. Many studies over the years have shown that children who are breast fed score higher on IQ points and perform better in school but the reason has remained unclear. Is it the mother-baby bonding time, something in the milk itself or some unseen attribute of mothers who breastfeed their babies? Now a new study by sociologists at Brigham Young University pinpoints two parenting skills as a significant source of this cognitive boost: Responding to a child's emotional cues and reading to your child starting at 9 months of age. 

0:10:11.3

Lead author of the study Dr. Ben Gibbs says, "Breastfeeding mothers tend to do both of these things." He adds, "It's really the parenting that makes the difference. Of course breast feeding matters in others ways, but finding this behavioral associations boosts our confidence about interventions that promotes school readiness." According to the analysis which was published in The Journal of Pediatrics, improvements in sensitivity to emotional cues and time reading to children could yield two to three months' worth of brain development by age 4 as measured by math and reading readiness assessments. Dr. Gibbs says, "Because these are four-year-olds, a month or two represents a non-trivial chunk of time. And if a child is on the edge of needing special education, even a small boost across some eligibility line could shape a child's educational trajectory….

0:11:00.3

The BYU scholars utilized a national data set that followed 7,500 mothers and their children from birth to five years of age. The data set is rich with information on the home environment, including how early and how often parents read to their kids. Additionally, each of the mothers in the study also participated in video-taped activities with their children. As the child tried to complete a challenging task, the mother's supportiveness and sensitivity to their child's emotional cues were measured. The study gained editorial praise from child development expert Dr. Sandra Jacobson at Wayne State University School of Medicine. She noted that children in the study who were breastfed for 6 months or longer performed the best on reading assessments because they also "experienced the most optimal parenting practices. She says, "This study found that reading to an infant every day as early as age 9 months and sensitivity to the child's cues during social interactions, rather than breastfeeding per se, were the significant predictors of reading readiness at four years of age."

0:12:02.6

The BYU researchers note that the most at-risk children are also the least likely to receive the optimal parenting in early childhood. Single moms in the labor force, for example, don't have the same luxuries when it comes to breastfeeding and quality time with their children. Also parents with less education are less likely to hear about research-based parenting practices. Co-author of the study Dr. Renata Forste says, "This is the luxury of the advantaged, it makes it harder to think about how we promote environments for disadvantaged homes. These things can be learned and they really matter. And being sensitive to kids and reading to kids doesn't have to be done just by the mother…. So three take home points today for parents of babies, 1. Move those sleep machines across the room and turn the volume down, 2. Respond to your baby's emotional q's, in other words interact with them. Interact in a way that's appropriate and is in response to their emotions, it's an important thing.

0:13:02.2

3. And start reading to your baby on a regular basis by nine months of age. A study out of the United Kingdom shows children with attention deficit hyper activity disorder or ADHD are more likely to become obese and physically inactive teenagers. That's according to research from Imperial College London and reported in the Journal of the American Academy of Child and Adolescent Psychiatry. Previous studies have suggested a link between ADHD and obesity, but whether one leads to the other is unclear. One way to better understand the link is to follow children through to adolescence. The new study, which followed almost 7000 children in Finland, found that those who had ADHD symptoms at age eight had significantly higher odds of being obese at age 16. Children who had ADHD symptoms were also less physically active as teenagers. ADHD affects two to five per cent of school-aged children and young people in the United Kingdom and is related to poor school performance.

0:14:01.9

The main symptoms are inattentiveness, hyperactivity and impulsivity. ADHD is complex to diagnose, but screening questionnaires can give an indication of a probable diagnosis, based on a child's behavior. Conduct disorder, a condition related to ADHD and linked to tendencies towards delinquency, rule breaking and violence, was also found to increase risk of obesity and physical inactivity among teens. The 9% of children in the study who had positive results on an ADHD screener at age eight were at higher risk of obesity at age 16. Senior author of the study Dr. Alina Rodriguez from the School of Public Health at Imperial College London says, "Obesity is a growing problem that we need to watch out for in all children and young people, but these findings suggest that it's particularly important for children with ADHD. It appears that lack of physical activity might be a key factor. We think encouraging children with ADHD to be more physically active could improve their behavior problems as well as helping them to stay a healthy weight, and studies should be carried out to test this theory….

0:15:08.2

Furthermore, children who were less inclined to take part in physically active play as 8 year-olds were more likely to have inattention as teenagers. Binge eating, which was also investigated as a possible factor that could contribute to the link with obesity, was not more prevalent in children with ADHD. According to Public Health England around 28% of children aged 2 to 15 are overweight or obese. Obesity in childhood and adolescence is linked to a wide variety of short- and long-term health risks, including type two diabetes, heart and circulatory issues, and mental health conditions. The study used questionnaires completed by parents and teachers to assess 6934 children for ADHD and conduct disorder symptoms at ages eight and 16. Body mass index was calculated based on parents' reports of their children's height and weight at age seven. At age 16, the participants had health examinations that recorded their height, weight, waist and hip measurements.

0:16:06.1

A little closer to home but along these same lines a recent study from researchers at Johns Hopkins Bloomberg School of Public Health found that children treated with stimulants for attention deficit hyperactivity disorder or ADHD initially experienced slower growth than their undiagnosed or untreated peers, followed by a rapid rebound of growth that exceeded that of children with no history of ADHD or stimulant use and this rapid rebound of growth could lead to obesity. The study published on the journal Pediatrics and thought to be one of the most comprehensive analysis of ADHD and stimulant use in children to date, found that the earlier the medication began, and the longer the medication was taken, the slower the growth in early childhood but the more rapid the rebound in later adolescence, typically after discontinuation of the medication.

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Researchers concluded that stimulant use, and not a diagnosis of ADHD, was associated with higher growth and obesity. Dr. Brian Schwartz lea author of the study and the Professor of Environmental Health Sciences, Epidemiology, and Medicine at the Bloomberg School of Public Health says, "Our findings should motivate greater attention to the possibility that longer-term stimulant use plays a role in the development of obesity in children. Given the dramatic rise in ADHD diagnosis and stimulant treatment in recent decades, this is an interesting avenue of research regarding the childhood obesity epidemic, because the rise in ADHD and stimulant use, and the rise in childhood obesity roughly parallel one another…. Previous research has found substantial evidence that stimulant use to treat ADHD is associated with growth deficits, and some evidence of growth delays. However, the reported associations of ADHD with obesity in both childhood and young adulthood was paradoxical and somewhat unexpected. The results of this study suggest it is likely due to the strong influence that stimulants have on growth, with delays in early childhood and a strong rebound in late adolescence.

0:18:09.9

The study also found longitudinal evidence that un-medicated ADHD is also associated with a higher body mass index, but these effects were small. ADHD is one of the most common pediatric disorders, with a 9% prevalence among children in the United States, and ADHD medication is the second most commonly prescribed treatment among children. Over the past 30 years, treatment for ADHD with stimulants has increased rapidly. From 2007 to 2010, 4.2% of children under the age 18 had been prescribed stimulants in the past 30 days, more than five times the amount prescribed to the same-aged children between 1984 and 1988. The study analysed the electronic health records of 163,820 children, ages 3 to 18, in central and north eastern Pennsylvania. 

0:19:00.5

The researchers compared the BMI trajectories of a controlled group comprised of those who had never had a diagnosis of ADHD or a stimulant prescription with three different experimental groups. 1. Those with an ADHD diagnosis but no stimulant prescription; 2. Those with a stimulant prescription without an ADHD diagnosis and 3. Those with both an ADHD diagnosis and a stimulant prescription. Not sure which non-ADHD kids are getting stimulants. Those with an ADHD diagnosis and a stimulant prescription had slower rates of BMI growth in early childhood, but went on to have rapid rates of growth during adolescence that eventually exceeded those of the control group. Those with a diagnosis of ADHD but no stimulant prescription had more rapid BMI growth after age 10 compared to the controls, but the effects were small. Dr. Schwartz says, "Stimulant use was strongly implicated, the earlier stimulants were started and the longer they were used, the stronger was their influence on the degree of both delayed growth in early childhood and rebound growth in late adolescence. This is an important unintended consequence of stimulant use in childhood….

0:20:10.3

So a few take home points here for listeners, 1. Early in the article the researchers mentioned that we see this rebound particularly when the stimulant medicine is stopped. And so this really isn't too much of a surprise, we do know that stimulants are an appetite suppressant and parents know this when you have kids which start on one of these medicines for ADHD, their appetite decreases, they don't need as much, they don't gain weight as fast as they had been previously and so it makes sense that in adolescence if you stop the medicine then their appetite comes back and it seems that the longer they've been on the medicine and the earlier they started the medicine, the greater the degree of their rebound growth when they're taking off of it. They only mentioned this association with being taking off of it the one time.

0:21:01.1

And the study did not taken to account in other words the experimental group, there wasn't a specific group where we look to see if the stimulant was stopped and then we measure their growth. The experimental group were just kids who had been on a stimulant. It makes sense that it would be when they stop the stimulant that that's when the growth happens but truth be told the study didn't really look at that specifically. The study just showed the earlier that you started it and the longer you're on it, the more the rebound growth in adolescence whether you stop taking it or not. A few take home points here, I think this is an important to realize we're going to assume that it's not just when you stop taking it that that's when the rebound happens. That even when you're still taking it you can have this rebound of growth which is what the study showed. So if you look at these reports in isolation you may be tempted to think stimulants are bad, they delay a child's growth early on and then they contribute to obesity. 

0:22:06.5

But remember we have other studies that demonstrate the results of untreated ADHD which includes poor school performance, difficult family dynamics, increase likelihood of addiction, divorce and incarceration as an adult. So parents are left wondering which is worse, using a stimulant or not using them? So how about his for a take home message, if you and your doctor agree that the benefit of using a stimulant will outweigh the risk, then anticipate the risks and do what you can to minimize their effect. Now what do I mean about this? Well early on expect your child to have some growth delay and as long as they are otherwise healthy don't get too upset about this because long term studies show they'll compensate later on, in fact they're at risk for over compensation and obesity. So start some healthy habits as early as possible. Teach your kids to only eat when they're hungry, don't push them to eat more because you're worried about their growth delay, that's only going to set you up with more problems down the road. 

0:23:02.4 

So establish healthy eating habits and encourage lots of physical activity early on, and keep encouraging these things and modeling these behaviors straight to childhood and adolescence. Stimulant medications can make a big difference in the lives of many kids but parents do need to be armed with further knowledge. Expect some growth delay and don't get too upset about it because a rebound of growth is likely to come in a few years and anticipation of that rebound start those healthy eating habits and encourage lots of physical activity right from the gecko. That's the take home I get from this information, how about you? A new study from Saint Michael's Hospital found that after four years of declining the rates of teenagers coming in to Ontario, Canada emergency department with suicide-related behaviors stopped dropping between 2006 and 2010. Suicide-related behaviors are incidents of self-inflicted injuries or self-poisonings.

0:24:01.8

Using data from the Institute for Clinical Evaluative Sciences, the researchers found that from 2002 to 2006, the rates of teenagers coming into Ontario emergency departments with suicide-related behaviors declined by 30%. However, from 2006 until the end of the study in 2010, rates did not continue to drop and about one-third more of these events resulted in a hospital admission, suggesting an increase in severity. Dr. Anne Rhodes, lead author and research scientist in St. Michael's Hospital's Suicide Studies Research Unit says, "Coming into the hospital with a self-inflicted injury or poisoning is a strong risk factor for suicide. Within a year of coming into a hospital with suicide-related behavior, 16% will repeat their behavior and about 2% will die by suicide…. Previous research from Dr. Rhodes has shown that more than 80% of youth who die by suicide had some form of contact with the health care system in the year before their death. 

0:25:01.8

Compared to population-based peers, youth who have gone to an emergency department with suicide-related behaviors had three to four times higher risk of death. The study recently published in The Canadian Journal of Psychiatry, outlines potential factors contributing to the declines between 2002 and 2006… including the increased efforts made by some groups to reduce stigma about mental illness and seeking help, also reductions in alcohol consumption and misuse among youth. While unable to specifically account for the change in suicide rates after 2006, researchers suggest that the economic recession and FDA regulatory warnings against prescribing antidepressants may have halted further declines in the rates of suicide-related behavior and led to the increase of hospital admissions. The findings show that increases in suicide rates were not explained by shifts in the population age, community size or income structures.

0:26:00.4

Dr. Rhodes and her team also reported on gender differences between suicide and suicide-related behaviors and confirmed that girls are more likely to exhibit suicide-related behaviors, particularly in youth, whereas boys are more likely to die by suicide. Dr. Rhodes says, "Because girls are more likely to come to emergency departments with suicide-related behaviors compared to boys, they may actually reduce their suicide risk by interacting with the healthcare system more frequently…. For both boys and girls self-poisoning was the most common method of suicide-related behavior with cutting and piercing injuries a distant second. In Canada, suicide is the second-leading cause of death in youth – nearly one quarter of all deaths for those aged 15-19 years. This study purposes the recession and FDA warnings about the use of anti-depressants as possible causes of the increase in suicide-related behavior. Those FDA warnings by the way were the anti-depressant use may lead to suicidal behaviors.

0:27:02.3

Of course we also know suicidal behaviors are associated with untreated depression, so depression that's not treated with anti-depressant medications sort of a catch 22 there. Here's another possibility for the rise in teenage suicide related behavior, cyber bullying. Bullying is a risk factor for suicidal thought and suicidal attempts by children and adolescents and as it turns out cyber bullying appears to be more strongly related to suicidal thought than traditional bullying. That's according to researchers at Leiden University in the Netherlands and published in JAMA Pediatrics. Prior research suggests that bullying (also known as peer victimization) is an important risk factor for adolescent suicide. Overall, suicide is one of the most frequent causes of adolescent death worldwide, and 5-8% of teenagers in the United States attempt suicide each year. The authors reviewed the available medical literature (known as a meta-analysis) and identified 34 studies that focused on the relationship between bullying and suicidal thoughts and nine studies that focused on the relationship between bullying and suicide attempts. 

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In all over 35,000 teenagers were included in these studies. So what did they find? The research confirms that bullying was related to both suicidal thoughts and suicide attempts among children and adolescents. Cyber bullying also appeared to be more strongly related to suicidal thoughts than traditional bullying, however the authors were in caution when interpreting these results because the meta-analysis only included three studies for cyber bullying. The author says, "This meta-analysis establishes that peer victimization is a risk factor for suicidal thoughts and suicide attempts. An efforts should continue to identify and help victims of bullying, as well as to create bullying prevention and intervention programs that work…. 

0:28:58.4

So boiling it down to the take home here for moms and dads, teenage suicide both thoughts and attempts are on the rise and in the US 5-8% of teens will attempt suicide each year and bullying and cyber bullying increase this possibility. Parents, the question is, is your child at risk? And the best way to know is really to be involved in their lives. Have those frank conversations, know what their stresses and their concerns are, make it your business to know the character of their relationships and monitor their online activity. And if concerns arise, find the help they need fast. Best place to start is a call to your teenager's doctor. Imagine two children both with the exact same risk factors for joining a gang. As teenagers one joins a gang, the other doesn't. Even though the first teen eventually leaves the gang, years later he or she is likely to be significantly at a higher risk for being incarcerated and receiving illegal income, but they're also less likely to have finished high school and more likely to be in poor health, receiving government assistance and struggling with drug abuse.

0:30:10.8

University of Washington researchers have found that joining a gang in adolescence has significant consequences in adulthood beyond criminal behavior, even after a person leaves the gang. This research is published in the American Journal of Public Health. Dr. Karl Hill, study co-author and research associate professor in the School of Social Work at the University of Washington says, "It turns out that, like violence, gang membership is as much a public health problem as a criminal justice problem. And joining a gang in the teen years has enduring consequences on health and well-being…. The Seattle Social Development Project, which was founded by study co-author J. David Hawkins, followed 808 fifth-grade students from 18 elementary schools serving high-crime neighborhoods in Seattle, beginning in 1985. More than half of the students came from low-income families. Participants were interviewed every year until the age of 18, then every three years until the age of 33.

0:31:07.1

Amanda Gilman, lead author of the project and doctoral candidate in the School of Social Work says, "Joining a gang serves as a turning point, creating consequences that cascade into other areas of life for many years. Very few of those studied reported still being in a gang at age 27. In fact the vast majority had left a long time ago, but the consequences stuck with them long-term,… Researchers used 23 risk factors to calculate a child's propensity for joining a gang, and then compared 170 youth who had joined a gang with 173 who did not but showed a similar propensity for doing so. In this way the only difference between the two groups was gang membership. The average age of joining a gang was just under 15 years. And No one in this study period joined a gang after the age of 19, the majority (60 percent) were in the gang for three years or less.

0:31:59.5

The 23 variables used to match the groups included individual factors such as antisocial beliefs, alcohol and marijuana use, violent behavior and hyperactivity; family factors such as poverty, family structure, sibling behavior and parent pro-violent attitudes; school factors such as academic aspiration and achievement; neighborhood factors such as the availability of marijuana and neighborhood kids in trouble; and whether the child associated with friends who engaged in problem behaviors. Researchers measured three areas of adult functioning at age 33: illegal behavior, education and occupational attainment, and physical and mental health. Those who joined a gang in adolescence were nearly three times more likely between ages 27 and 33 to report committing a crime, more than three times more likely to receive income from illegal sources, and more than twice as likely to have been incarcerated in the previous year. Former gang members also were nearly three times more likely to have drug-abuse issues, were almost twice as likely to say they were in poor health, and twice as likely to be receiving public assistance. They were also half as likely to graduate from high school.

0:33:10.0

Dr. Gilman hopes the study will motivate schools and communities to develop and implement research-based strategies to prevent children from joining gangs, in the hopes of not only reducing crime, but increasing graduation rates and reducing physical and mental health costs. Dr. Hill says, "Everyone can be involved in gang prevention in their own way, by reducing the 23 variables shown to be risk factors. If you're a parent, manage your family well. If you're a community member, be involved in kids' lives. If you're a teacher, engage your kids and recognize good work. We can't solve all of the risks kids are exposed to alone, but we can if we work together…. One of the things you can do as a parent is get your teenagers involved in volunteer work. Pro-social behaviors or actions intended to help others remain an important area of focus for researchers interested in factors that reduce violence and other behavioral problems in youths. 

0:34:05.4

However little as known regarding the connection between pro-social and anti-social behaviors. A new study by University of Missouri Human Development Expert found that pro-social behaviors can prevent youth from associating with deviant peers, thereby making the youth less likely to exhibit antisocial or problem behaviors, such as aggression and delinquency. Dr. Gustavo Carlo, the Millsap Professor of Diversity in the Missouri University Department of Human Development and Family Studies says, "Our research reaffirms suspicions that youth who engage in some forms of pro-social behaviors, such as helping, volunteering and comforting others, are less likely to engage in antisocial behaviors such as aggression and affiliating with deviant peers. Dr. Carlo and his colleagues surveyed more than 650 adolescent children in Valencia, Spain, about their pro-social behaviors, affiliations with deviant peers, and delinquent and aggressive tendencies.

0:35:06.3

Of the six forms of pro-social behaviors measured, Dr. Carlo found that only two forms, altruism and compliancy significantly reduced the chances of adolescents' displaying problem behaviors. Compliant pro-social behaviors are actions that often require some level of social conformity and respect for authority, while altruistic behaviors are actions done without concern for self-reward. Dr. Carlo says, "Identifying which forms of pro-social behaviors are related to antisocial behaviors has important implications for intervention programs designed to reduce problem behaviors and promote more constructive pro-social behaviors in adolescents." He adds, "Developers of intervention programs could use these findings to create programs that teach youth the benefits of engaging in pro-social behaviors."

0:35:58.3

"Such preventative efforts may be most effective in preventing youth from affiliating with deviant peers and from engaging in subsequent aggressive and delinquent behavior…. OK so let's boil this one down. The bottom line here, it does matter who your kids hang out with. If they hang out with deviant peers then they're more likely to learn and exhibit anti-social and aggressive behaviors. But is they hang out with those who put a premium on helping others and volunteering their time, then those pro-social behaviors are more likely to rub off in your kids. So down with gangs and up with volunteer activities. Now I do realize that those likely to join gangs aren't necessarily the ones being presented with volunteer opportunities. Moms and dads, community leaders, school officials, shouldn't we try changing that? That does wrap up our news parents can use edition of the program this week. Let's go ahead and take a quick break and I will be back with a final word right after this.

0:37:03.7

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Dr. Mike Patrick: Alright we're back. The third annual Wellstone Center Muscular Dystrophy Parent-Patient Conference presented by the Wellstone Center at Nationwide Children's Hospital will be held Saturday, April 12, 2014 at Nationwide Children's Education Center located at 575 south 18th street Columbus, Ohio from 8:00 am until 5:00 pm. 

0:37:58.5

The conference is designed to educate patients with muscular dystrophy and their families and caregivers about advances in research and future therapies and treatments, as well as independent, healthy living. Conference topics include x on skipping and gene therapy, genetic modifiers of disease severity in Duchene muscular dystrophy, maximizing independence, dietary needs, school advocacy, recreation, adaptive equipment, succeeding in college, driving, bone health, cardiac care, service dogs and Wellstone tours. The conference features break-out sessions geared to patients under 7 years of age. Those ages 7-12 and teenagers 13 years and older. The Wellstone Center is a Muscular Dystrophy Cooperative Research Center and as part of the Research Institute at Nationwide Children's Hospital. Muscular Dystrophy Cooperative Research Centers was established by the MD Care Act and are overseen by the National Institutes of Health. These centers are parts of university and hospital research institutions across the country and strengthen the muscular dystrophy community by conducting basic translational and clinical research. 

0:39:05.0

The program at Nationwide Children's is committed to finding a treatment for muscular dystrophy. Child care will be available at the conference for toilet trained children ages 3-6 years and parking is free. You can register online for the conference at nationwidechildrens.org/edu. For additional information call 614-355-0662 or email community education@nationwideshildrens.org. So it's only a few days away but you can still register, if your family is affected by muscular dystrophy, then you are a reasonably close to central Ohio be sure to join us for the third annual Wellstone Center Muscular Dystrophy Parent-Patient conference presented by the Wellstone Center at Nationwide Children's Hospital. Again the conference will be held Saturday, April 12, 2014 at the Nationwide Children's Education Center from 8:00 am until 5:00 pm. And that's my final word. 

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I want to thank all of you for taking time out to your day for making PediaCast a part of it. I really appreciate your support. That does wrap up out time together. PediaCast is a production of Nationwide Children's Hospital. Don't forget that PediaCast and our single topic short format program PediaBytes are both available on iHeart Radio Talk which you'll find on the web at iheart.com and the iHeart Radio app for mobile devices. Our show archive which includes over 250 programs as well as our show notes, transcriptions, terms of use, and contact page are available at our landing site which is pediacast.org. We're also on iTunes under the kids and family section of their podcast directory. And you'll find PediaCast on Stitcher, TuneIn, Downcast, iCatcher, Podbay and most other podcasting apps for iPhone and android. We're also on Facebook, Twitter, Google Plus, and Pinterest. And of course we really appreciate you connecting with us there and as I mentioned at the beginning of the program, sharing us, re-tweeting, re-penning or post is really important to us and in that way you can tell your own online audience about our show.

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We also appreciate you talking us up with your family, friends, neighbors, and co-workers, anyone with kids, or anyone who takes care of children. And as always be sure to tell your child's doctor about the program. Posters are available under the resources tab at pediacast.org. Until next time this is Dr. Mike saying stay safe, stay healthy, and stay involve with your kids. So long everybody.

[Music]

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

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With your kids.  So long everybody.

[Music]

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

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