Interesting research into tantrums

[Fuschia]

http://m.npr.org/story/143062378?url=/blogs/health/2011/12/05/143062378/whats-behind-a-temper-tantrum-scientists-deconstruct-the-screams

[Belle]

That is interesting Fuschia...there was a story on the bbc the other day about behaviour being affected by breathing problems interrupting sleep (e.g. adenoids/snoring), and the conclusion was that that some children may be diagnosed with ADHD or other behavioural 'disorders' when in fact there is an underlying medical issue.

[cornelia]

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[Saffron]

Belle Wrote:

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> That is interesting Fuschia...there was a story on

> the bbc the other day about behaviour being

> affected by breathing problems interrupting sleep

> (e.g. adenoids/snoring), and the conclusion was

> that that some children may be diagnosed with ADHD

> or other behavioural 'disorders' when in fact

> there is an underlying medical issue.

That's true in adults as well. Doctors and psychologists have known this for years. Strange that it has taken so long for this to be widely accepted as true in children too.

[Saffron]

From the link:

But where one age-old theory of tantrums might suggest that meltdowns begin in anger (yells and screams) and end in sadness (cries and whimpers), Potegal found that the two emotions were more deeply intertwined.

"The impression that tantrums have two stages is incorrect," Potegal said. "In fact, the anger and the sadness are more or less simultaneous."

Green and Potegal found that sad sounds tended to occur throughout tantrums. Superimposed on them were sharp peaks of yelling and screaming: anger.

The trick in getting a tantrum to end as soon as possible, Potegal said, was to get the child past the peaks of anger. Once the child was past being angry, what was left was sadness, and sad children reach out for comfort. The quickest way past the anger, the scientists said, was to do nothing. Of course, that isn't easy for parents or caregivers to do.

"When I'm advising people about anger, I say, 'There's an anger trap,"' Potegal said.

Husband and I have a long-standing disagreement about this. I've always said to take the "do nothing" approach once the tantrum is unavoidalbe. Husband has always insisted that this is giving in to the child, and that I'm ruining/spoiling our daughter by doing this. Because my approach is to do nothing, and his is to intervene, I usually get overruled when we're together. No surprise then that Little Saff is now much more likely to have a tantrum if we're all together. Grrr.

[Saila]

>some children may be diagnosed with ADHD or other behavioural 'disorders' when in fact there is an underlying medical issue.

i heard a theory that adhd is 'possibly linked to poor sleep'. TVs in bedrooms, computer games, and/or just poor ability to sleep well for whatever reason. The resulting tired child was considered linked to adhd and that's why amphetamine (speed) analogues help so much with these behavioural problems.

So... all they're doing to these kids is waking them up

then they take sleeping tablets in the evening to help them sleep after taking speed. and the cycle continues.

just a theory and a wild one at that - but no one else seems to understand why amphetamines actually calm 'adhd' children down....

[Saffron]

Amphetamines and amphetamine-type compounds help children who truly have ADHD because in ADHD the areas of the brain that filter ambient distractions are underactive (yes, I'm oversimplifying it a bit for brevity, sorry). This underactivity interfers with concentration, reasoning, and behavioural control. Amphetamines and amphetamine-type compounds increase the activity in these underactive areas. Children who truly have ADHD and benefit from drug treatment do not also require sleep aids because the amount and type of amphetamine used should not interfere with sleep. This is well-known and documented in peer-reviewed journals.

I agree that diagnosis needs to include ruling out other factors like poor sleep whatever the cause, as this can mask whether or not someone truly has the disorder in question.

[Saila]

Sound much less scary than what I was told

Any ideas as to why it's on the up in US and other Western countries, or is that misdiagnosis?

[Saffron]

Better diagnosis of true cases? Misdiagnosis of some cases? Although there is evidence supporting altered brain function, the ultimate cause of ADD or ADHD is not known and is likely to be multifactorial, eg genes + environment.

There are also some hypotheses that ADD/ADHD is not a disorder, but rather that it is simply a different brain type (again, sorry, simplifying for brevity), which would have conferred a evolutionary advantage in some societies. A very crude analogy would be skin pigmentation. Very dark skinned people living near the equator have some natural protection from UV damamge. However, dark skinned people at higher latitudes would be more likely to suffer vitamin D deficiency because UV penetration of the skin is the main (non-dietary) source of vitamin D. But having darkly pigmented skin is certainly not a disorder of any sort.

ADD/ADHA are also difficult to study b/c they are not a single disorder (using the term disorder lightly here as per the above statement). They appear to be a cluster of disorders with similar symptoms, or sub-clusters of disorders under a similar umbrella.

Incidentally, this is true of many psychiatric disorders. It's also true that the type and number of psychiatric disorders can vary hughly amoung different societies. This doesn't necessarily mean that inclusion in certain societies causes disorders. It may mean that different societies identify and respond to disorders differently.

For example, historically, it has been noted that compared to Western societies, the incidence of dissociative identity disorder (DID or "multiple personalities") in tribal societies is lower. In a small community, everyone is needed and valued. The community can't have too many people not working because it needs their input for the society to run. So a person afflicted with DID would not be excluded. He/she would be found a task, no matter how small, to which he/she could be made useful, eg very simple labour or domestic chores. This act of including the person, rather than excluding is hypothesised to help manage the symptoms of the disease so that it doesn't manifest at clinical levels. The disorder may exist, but it's just not seen as a problem. (It was some time ago that I heard this hypothesis discussed, so I don't know if new data has since changed this idea. Nevertheless, it's interesting.)

I would hazzard a guess that the rate of tantrums varies differently among different societies or social groups too. Would love to know more about this!

[esme]

Belle Wrote:

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> That is interesting Fuschia...there was a story on

> the bbc the other day about behaviour being

> affected by breathing problems interrupting sleep

> (e.g. adenoids/snoring), and the conclusion was

> that that some children may be diagnosed with ADHD

> or other behavioural 'disorders' when in fact

> there is an underlying medical issue.

I have watched something similar, although there appear to be little remedies and my son (2 yrs) has now been diagnosed with sleep apnea. Until now he has been full of beans but well behaved and understands boundaries. However, the last few weeks (when we have noticed a massive change in his sleep patterns - far worse snoring, almost choking sounds at times, constant movement around the bed, and his breathing so loud it has kept us awake concerned most of the night) he has started showing signs of being more tired in the mornings or when woken after his nap, and is more difficult to wake up. I had my adenoids and tonsils removed when I was younger for similar reasons (tho they diagnosed "narrow nasal passages" rather than sleep apnea) so sadly I think he has inherited my problems, tho slightly worse.

If anyone has any hints or tips they might share - we have tried nose drops (saline and now have some with steroids that I really want to avoid using for obvious reasons and plus they're short term solution), air purifier, vicks and olbas oil / sweet thyme drops in his room in bowl of hot water to add moisture, windows open / closed... At wits end, none of us getting proper sleep and I want to avoid him having an operation(s) at this young age, especially as your adenoids apparently disappear when you are 7-8 years old.

There are adult face masks you can buy but nothing seems to be suitable for toddlers - as with many problems like this I guess...

Advice much appreciated from anyone who has experienced something similar. Saffron you seem to have a wealth of knowledge - so nice of you to share it with everyone, I for one find it incredibly useful :)

[GCOakley]

my friend had this problem with her 2 year old daughter and it did clear up when she was about 5. might be a long shot, but she used to use raw onion - sliced and put in rings on the child's neck and also on the bedside table. she found this helped with minor attacks. for serious ones she used to take the child to the hospital but there was nothing they could really do except keep an eye on her.

[Saffron]

esme Wrote:

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> If anyone has any hints or tips they might share -

> we have tried nose drops (saline and now have some

> with steroids that I really want to avoid using

> for obvious reasons and plus they're short term

> solution), air purifier, vicks and olbas oil /

> sweet thyme drops in his room in bowl of hot water

> to add moisture, windows open / closed... At wits

> end, none of us getting proper sleep and I want to

> avoid him having an operation(s) at this young

> age, especially as your adenoids apparently

> disappear when you are 7-8 years old.

>

Hi- Sorry I don't have any personal experience of sleep apnea in children. I have read that children often outgrow apnea, possibly due to physical changes as they develop. I agree surgery should probably be the very last resort unless there is confirmed to be a profound physical abnormality of the upper airways.

Why do you say that you don't want to use steroids "for obvious reasons"? Were you prescribed steroids? If so, do you think you were mis-prescribed? That is, do you think there is not an inflammatory condition present, or do you think you've been given the wrong dose/type of steroid?

Steroids are a much misunderstood and much maligned group of drugs. Generally, steroids (corticosteroids) are given to reduce excessive inflammation or to suppress inappropriate immune responses. In many cases, steroids will not treat the root cause of an illness, but are appropriate and necessary in order to sufficiently control symptoms so that the body may heal itself.

Perhaps you need to push for a more certain, or more detailed, diagnosis of what may be causing the apnea. It's not just adenoids that can cause apnea. Nasal polyps or deviated septum could be possible causes, though likely rare in toddlers.

Have you tried to raise the head of your child's bed a little? Sometimes the obstruction that results in apnea is worsened when the child is sleeping flat. I've also read that Breathe Right makes a child-sized nasal strip, but maybe your LO is a bit young for this (strip will be too big)?

[Saffron]

If you're not able to significantly improve the apnea, and/or decide to wait and see if your child will outgrow it, think about asking for a referral for some kind of age-appropriate behavioural therapy to manage the daytime sypmtoms of sleepless nights. If your child is not sleeping well b/c of apnea, and this is resulting in daytime behavioural disturbances, these need to be handled with care and sensitivity under the guidance of a behavioural expert. School/childminders/etc need to be aware of the situation and informed how to appropriately handle it. For example, your LO may need more one-on-one adult attention, or additional quiet time during the day compare to peer group.