Is Vision Impacting Behavior Concerns for Your Child?

It is estimated that 80% of a child’s learning in the first 12 years of life is learned visually. Indeed, toddlers may learn social cues by visually observing adults around them. Symptoms of a vision challenge may be subtle, or may mirror symptoms of other concerns, such as ADHD. Often, behavioral challenges, such as outbursts, tantrums, or avoidant behavior may be linked to vision impairments in children.

Dr. Eileen Gable recommends having your child’s vision checked for any of the following reasons:

  • Loses interest in activity quickly
  • Turns head or looks with a ’tilt’ when looking at an item
  • Changes in behavior at play or school (acting out, tantrums, avoiding certain tasks)

As Cortical Vision Impairment (CVI) is the current leading cause of visual impairment among children, and behaviors may often mimic those of other conditions, a full evaluation should be considered for children who display the following behaviors. A “full evaluation” may include an MRI, pediatric neurologist, and/or a pediatric ophthalmologist, as the child may appear to have a typical eye examination.

As noted on the “Blind Babies Fact Sheet” symptoms may include:

  • Using side (or peripheral) vision to look at items, rather than directly looking
  • Light avoidance or light gazing behaviors
  • Poor depth perception (difficulty reaching for objects)
  • Vision may appear better while the child is moving (or the object is moving)
  • Short visual attention span (possibly due to overstimulation)
  • Turning away, while reaching for an object

Any concerns should be discussed with an eye care professional who has experience with evaluating children for CVI and a child’s pediatrician, particularly in discussing a possible ADHD diagnosis.

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Leveled Reader Review (& a Freebie)

I recently received a pleasant surprise at my front door via FedEx… A packet of leveled readers from Newbridge & Sundance Publishing. As negative behaviors in school are often highly correlated with academic struggles, particularly in reading, I felt a review of this product was appropriate. (Even if it isn’t within the typical scope of Behavior Rescue).

It is important to note that these items were not delivered as a requested review, but instead through a program to provide samples, which means that you can order your very own sample here.

A set of 2 Laugh-Out-Loud chapter books and 1 Weird, Wild, and Wonderful science non-fiction book on Frogs were provided.

The text on frogs provided a large amount of information about frogs and amphibians, as well as interesting and vivid photos to capture student attention. Information was provided in short snippets, to avoid overwhelming students. A graphic organizer and lesson plan were provided for teachers to use, and the variety of information provided in the text lends itself to multiple days of instruction. On the downside, images are very vivid and because text is not presented in a linear fashion, it may require some practice for students to follow the information on each page. Assessments are simplistic, but could be modified to review more information that is presented in the text. Overall, the text was interesting and engaging for students, but might have been a little distracting due to format.

The Laugh-Out-Loud Chapter Books; however, were wonderful! Both books provided clear text and vocabulary, while still providing some openings to discuss inferences. William Wild was a fun read, even as an adult, involving imaginative play. Follow-up questions were provided, in the book, as a check for understanding and the About the Author & Illustrator information was engaging to read. The characters and setting are described clearly, with illustrations at the beginning of the text, aiding understanding. The Heebie Jeebies was a second book included and involved nighttime monster (who were pretty friendly), as well as sibling themes. A glossary was included in both texts, with illustrations for each term. Each book provided a lesson plan guide and comprehension worksheets, as well as tips for English Language Learners. The books are labeled for grades 2-6, and although they may appear a bit juvenile for the 6th grade, look comparable to The Magic Treehouse or Pee Wee Scouts series, making them appropriate for struggling readers.

Overall, I would rate the chapter books as entertaining, although the high quality of both sets of books is clear. Unfortunately, in order to access the teacher’s guides it looks as though a “classroom pack” has to be purchased at $336 for Loud-Out-Loud Chapter books and $969 for the Weird, Wild, and Wonderful books, based on the price sheet included in the set. As far as cost of leveled readers, this doesn’t seem excessive by any means, but it is still pricey.

As I noted before, a sampler pack is available for free here.

Please share your thoughts, if you review a sample set.

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Social Understanding is Present in Toddlers

The Daily Mail Online reports that toddlers may have more social awareness than previously recognized. A study was conducted with 2 and 3 year old children to determine what they understood of group norms and expectations. Children observed an adult refer to an action as “daxing” and then, later, saw a puppet say that she would “dax.” When the puppet’s action did not match the adult’s, the children objecting by saying things like, “It doesn’t work like that” and, “You have to do it like this.” These types of comments reference the earlier exposure to the made-up activity. It suggests that toddlers understand what is done correctly and when samples do not match the original example.

Other Interesting Findings

  • Toddlers only applied expectations to those of a group, primarily that looked or sounded the same.
  • Toddlers only apply expectations to those they perceive as being in “their” social group (i.e., other people who are similar to them).
  • Children can learn about social norms by observing adults who “expect things to work a certain way.”
  • Children can apply social norms to appropriate groups and settings, at a very early age (by the age of 3 years old).

Access to the original studies can be requested here.

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Early Signs of ADHD Released by Kennedy Kreiger Institute

Based on current Centers for Disease Control (CDC) statistics, 1 in 11 school-aged children is diagnosed with ADHD (Attention Deficit Hyperactivity Disorder), but ADHD is currently the most commonly diagnosed mental health disorder among preschool-age children as well.

A Biological Basis

As ADHD involves differences in brain development, there is a biological component to the condition. Information from the Kennedy Kreiger Institute suggests that differences in behavior are noticeable at a young age, primarily by parent report. Noting ADHD symptoms early provides more time for intervention- crucial as an earlier onset may be related to higher risk for academic concerns. Recent studies using neurological imaging of the brain suggest that children with ADHD have a smaller caudate nucleus than their same-age peers. This part of the brain is associated with motor control, as well as cognitive control.

Symptoms to Watch For

Dr. Mahone, of the Kennedy Kreiger Institute, suggests that parents look for the following symptoms in preschool children (ages 3-4 years old).

  • Avoids activities that need attention for longer then 1-2 minutes
  • Loses interest rapidly (or cycles between activities quickly)
  • Talks more, or makes more noise, than other same-age peers
  • Climbs things when told not to
  • Cannot hop on 1 foot by the age of 4 years old
  • Consistently restless
  • Fearless and ends up in dangerous situations
  • Warms up too quickly to strangers (no “stranger danger”Smilie: ;)
  • Aggressive with peers (or has been removed from preschool due to aggression)
  • Has been injured because of running or moving too fast (requiring a hospital visit for stitches or more)

Recommendations

Parents should monitor a child’s behavior and if they have concerns should speak to their pediatrician regarding their child’s development. If they would like additional information, speaking with a behavioral health provider or professional may be helpful. Recommendations can be obtained through their pediatrician, or health care professional. Parents should monitor their child carefully, so that supports can be put in place while the child is young and negative impacts on academics can be limited. It is important to not immediately assume the child has ADHD due to several of the symptoms listed above; however. Treatment should be discussed and considered carefully, as some parents prefer more natural or behavioral interventions, as many stimulants (medications often used to treat ADHD) have not been evaluated for long-term risk in children as young as 3 or 4 years old.

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Tooth Fillings & Behavior- Why Correlation is NOT Causation

There has been a recent release of a large quantity of articles suggesting a connection between children who have teeth filled with composite fillings (the white kind) and negative behaviors. Most are citing BPA (Bisphenol A) as the chemical responsible for altering children’s emotional and behavioral output.

But there’s a CORRELATION…

This is one of those moments where I thank my lucky stars that every single professor I had felt compelled to remind us that correlation is not the same as causation. At the risk of sounding overly academic, just because two things share something in common, does not mean they are related. If most names in the obituaries contains the letter ‘a,’ there is a correlation. Those individuals are (one would assume) not deceased due to any particular letter in their name; however, so there is not a causal relationship. The letter ‘a’ did not lead to their deaths, but it would show up as a statistical similarity. The missing information is that the letter ‘a’ is prevalent in all names, so it will then be included in a high percentage of names of people who are deceased as well.

This Study

Researchers found that children with multiple composite teeth fillings scored consistently worse on a behavior measure than children with no fillings. Approximately 500 children were evaluated after being assigned to different treatment groups based on type of fillings. BPA has been linked to other health concerns in the past, making it appear to be related in this case. The current study suggests that fillings break down over time due to chewing and release bisGMA, which contains BPA.Changes in behavior reported, by parents, were small and no initial behavior evaluation occurred. As more than half of all American children will have a filling by the time they are in second grade, parents are left wondering what the safest dental fillings are for their children. The basic summary of recommendations is to avoid cavities by teaching children to practice good dental hygiene.

So, What’s this Mean?

Here’s the “Scooby Doo” (or “short version”- if you aren’t in the second grade and don’t know what that means). You can make your own decisions by reviewing the study abstract here. An association was found between exposure to white fillings and psychological ‘impairment’ are defined in the study by scores on the Child Behavior Check List (CBCL). The CBCL is a tool often used to identify behavioral and mental health concerns. However, one study alone cannot identify the why of this association. So, we’re back to the example of ‘death-by-letter-a.’ It is entirely possible that children who are sensitive to sugar have more irritable temperaments (‘sugar crash’ anyone?). What else is connected to sugar consumption? Cavities. What are most cavities filled with? White filling, as it matches the teeth. There’s no evidence to support my (non-dental-trained) hypothesis, but there’s also no evidence to show that the BPA is truly causing the behavioral concerns.

Other randomly generated explanations:

  • Fussy children are more likely to be bribed with candy making them more susceptible to cavities.
  • Children who are stressed (due to temperament) are more likely to grind their teeth, resulting in increased wear-and-tear on teeth, more cavities, and more released filling matter.
  • Children (in general) are likely to tantrum to avoid non-preferred tasks (thus, making them stand out on the CBCL AND avoid tooth-brushing).

Overall, with only 1 study, there may well be an association between fillings and behavior. It may be something to worry about, but it may also simply be a commonality, not a cause. As the researchers of the study suggest, more information and data-driven research is needed to evaluate their findings.

In the meantime, get behavioral support if you need it, and teach your child to brush and floss!

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