National Childhood Obesity Awareness Month

September has been designated as National Childhood Obesity Awareness Month. According to the Center for Disease Control and Prevention (CDC), childhood obesity has more than tripled in the past 30 years. These rates are very alarming considering both the short- and long-term effects on a child’s health status. According to the Institute of Medicine, children and adolescents ages 2 to 18 years with a BMI of > 30 or > 95th percentile for age and gender—whichever is smaller—are considered obese.  Additionally, it has been recommended that children and adolescents with a BMI > 85th percentile but < 95th percentile or a BMI of 30—whichever is smaller—be considered overweight.

What are the consequences of childhood obesity?

According to research, studies have found that compared to healthy children and adolescents, children and adolescents who are obese have significant impairments in health related quality of life (HRQOL) in all domains, including physical and psychosocial functioning (e.g., emotional, social, and school). The CDC notes that some immediate health effects include: higher risk of cardiovascular disease, high cholesterol or high blood pressure, diabetes, bone and joint problems, and sleep apnea. Furthermore, long-term consequences of obesity may include type 2 diabetes, cancer (e.g., colon, breast, or prostate), osteoarthritis, or stroke.

Interventions and treatment of childhood obesity:

As a parent or caregiver, you can play a major role in improving childhood obesity. First Lady Michelle Obama has worked with organizations across the United States with her Let’s Move! initiative to expand access to nutritious foods and promote physical activity among children. To access more information about the Let’s Move! Campaign and how you can deal with the issue of childhood obesity, visit www.letsmove.gov

In my work as a psychologist and researcher, I have collaborated with others to examine the impact of obesity on children. We have found that psychologists can be a great resource to assist with changing healthy lifestyles and decreasing childhood obesity. The use of behavioral modification and behavior therapy can significantly improve health eating and physical activity. Limbers, Turner, and Varni (2008) discuss how behavior modification programs and motivational interviewing can target eating, exercise, and diet behaviors to result in significant improvements in weight status, increasing physical fitness, and psychosocial improvements for children who are obese children. 

General resources to improve healthy eating and increase physical activity:

• Strategies for parents and communities
• Basic prevention tips
• Resources & Facts from the American Psychological Association

Note: Please contact Dr. Erlanger Turner for references.

© Copyright 2012 Erlanger A. Turner 

ADHD in young children: One of the most common difficulties of childhood

Working as a licensed clinical psychologist I am often faced with parents coming to me for help with their young child. These families may seek help with managing a number of concerns such as anger, excessive worrying, or attention problems. Now that summer vacation for children has ended and the school year is here, many parents and teachers will be confronted with over-active children. Some of these concerns may be due to limited opportunities to go outside and play, while others may have difficulties resulting from a more complex issue such as a diagnosable disruptive behavior disorder.

During early childhood children often have difficulty sitting still, paying attention, or controlling their impulses. This is part of the normal developmental process. However, for a small number of these children the problem is more persistent and impacts their daily lives at home and at school. Children with pervasive over-activity levels and inattention may have Attention-Deficit Hyperactivity Disorder also known as ADHD.  ADHD is a neurobiological disorder characterized by developmentally inappropriate impulsivity, inattention, and in some cases, hyperactivity. There are several types of ADHD that can be diagnosed and children may present with different symptoms. About 9.5 percent of children ages 4 to 17 in the United States have been diagnosed with ADHD, according to the Centers for Disease Control and Prevention. People with ADHD can be very successful in life. But without appropriate identification and treatment, ADHD can have serious consequences such as difficulties with school work, poor social skills, and conduct problems. Early identification and treatment are extremely important so if you notice concerns please consult with a psychologist.

The best outcomes for children with ADHD are associated with the use behavior therapy and medication management. According to Pediatrics, it is recommended that young children with ADHD receive behavioral interventions first, such as parent training in behavior management techniques. These treatments can be followed-up with medication if behavioral interventions are not successful.  In my practice, I typically recommend that parents attempt to implement behavior treatments. If the difficulties associated with ADHD are moderate or severe I will recommend consultation with a pediatrician or psychiatrist for medication management considerations. There is some evidence showing benefits of medication for treating ADHD in young children, however it is unclear how medication affects the child’s brain.

Below are a few suggestions for managing difficulties associated with ADHD:

• Provide positive attention to the child
• Target performance goals and monitoring behavior by tracking progress
• Implement individualized home and school reinforcement programs
• Utilize non-physical punishment procedures such as time-out or response cost systems

It should be noted that some of these recommendations may be implemented at home without a professional. However, if the child’s difficulties are persistent and long-standing you will benefit from contacting a psychologist in your area who can help tailor treatment to you and your child. Additionally, teachers and parents may consult with a school psychologist at their local school who can assist with interventions in the classroom settings and developing appropriate educational accommodations.

Additional suggestions for parents:

Driven To Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood Through Adulthood By: Edward M. Hallowell and John J. Ratey

Taking Charge of ADHD: The Complete, Authoritative Guide for Parents  By: Russell A. Barkley PhD




© Copyright 2012 Erlanger A. Turner 

References:

http://www.chadd.org/ http://www.apa.org/monitor/2012/03/adhd-guidelines.aspx
http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/complete-index.shtml
http://www.cdc.gov/ncbddd/adhd/
http://kidshealth.org/teen/school_jobs/school/adhd.html#

Mental Health Services Use in Ethnic Minorities

Given July is designated as Minority Mental Health month; I decided to write a post on disparities in mental health. One of the reasons I pursued a Ph.D. in clinical psychology was because as an undergraduate student I felt that the research on mental health concerns in children was limited, specifically as it related to service utilization for ethnic minorities.

According to the Center for Disease Control (CDC) Office of Minority Health and Health Disparities₁, less than ½ of adults and 1/3 of children receive the needed mental health treatment. This is alarming given that over time these problems may become worse resulting in poor daily functioning and having a negative impact on relationships. Additionally, mental health difficulties can also impact health outcomes such as chronic diseases.

According to the research ethnic minority populations (e.g., African American, Hispanic American, and Asian American) are less likely to seek help from a mental health professional such as a psychologist. My own research_2,3 on child mental health services focuses on examining what are some contributing factors to preventing parents from seeking treatment. The US Surgeons General₄ has reported that for ethnic minority groups some of these barriers include financial considerations, racism, and discrimination. Other_{1, 2} report barriers such as stigma, attitudes, income, mistrust, and lack of health care providers. In my own research, I have found that attitudes toward mental health and mental health stigma are highly important to the lack of service use by ethnic minorities.

Given these disparities in mental health, what can be done to meet the needs of ethnic minorities? Personally, I believe there needs to be increased education about the benefits of psychological treatment. The American Psychological Association, Division 42 (Psychologist in Independent Practice) has developed a video that promotes seeking treatment. See below:

Additional ways to help decrease the stigma around mental health services include:

·         Ensuring that mental health and behavioral health services are covered by insurance

·         Training psychologist to provide culturally sensitive treatments

·         Applying a community based approach to treatment

·         Talk to a doctor about mental health (to increase the referral process)

Note: If you feel the need to seek treatment, you can access the following sites to locate a provider in your area.  

American Psychological Association

APA Division 42, Psychologist in Independent Practice

National Register Health Service Providers in Psychology

© Copyright 2012 Erlanger A. Turner 

Sources:

1. Fact Sheet on Mental Health Disparities (http://www.cdc.gov/omhd/amh/factsheets/mental.htm)

2. Turner, E.A., Heffer, R., & Jensen-Doss, A. (August, 2010). Disparities in Child Mental Health Services: The Role of Ethnicity, Attitudes, and Stigma. Presentation at the American Psychological Association Convention, San Diego, CA.

3.  Turner, E.A., & Liew, J. (2010). Children’s Adjustment and Child Mental Health Service Use: The Role of Parents’ Attitudes and Personal Service Use in an Upper Middle Class Sample. Community Mental Health Journal, 46,3, 231-240.

4. American Psychiatric Association, Minority Mental Health (http://www.psychiatry.org/mental-illness/people/minority-mental-health)

5. National Council of Community Behavioral Health (http://www.thenationalcouncil.org/cs/about_us/mental_health_stats_infographic)