Ask the Experts: Neurofeedback, Discussing Your Child's Weight and Indoor Allergies

Written by Various

Our experts answer your health and wellness quesions.

Dr. Stephen A. Ferrari, Ph.D., is the director of Alta Neuro-Imaging Neurofeedback in Placentia and specializes in learning disorders. www.ocbiofeedback.com.

Michael Uram, LMFT, is a therapist based in Costa Mesa, CA and a member of the California Association of Marriage and Family Therapists (CAMFT). www.CounselingCalifornia.com.

Dr. Marc J. Meth attended Georgetown University and received his medical degree from the UCLA School of Medicine.  He is a pediatric allergist at Century City Allergy. www.centurycityallergy.com.

School Struggles? Is ADHD to Blame?

Q (Grade School): My son has struggled with his grades and with his behavior all year long. It is difficult for him to focus and he doesn't seem to think before he acts or says things. We've tried tutoring and counseling but nothing seems to have gotten better. The school is talking about holding him back or putting him in a special class. Should we just write this school year off and hope for better next year or is there still something we can do?

A: Let me begin by saying how much I sympathize with the situation. This, unfortunately, is a question I hear all too often this time of year. When a parent has struggled all year to overcome constant problems and tried everything they can think of (and usually endured lots of family and parent-teacher conflict) only to be told it has been a losing battle and nothing can be done, can be very discouraging.     

There are two parts to your question. For the first part, no, it is not too late to get help for this school year. It is at the end of the school year that the evaluations and decisions are made as to what is best for the child in the coming year and we are not at that point yet. I have worked with many teachers, school psychologists and principals and I am consistently told that if they see significant improvement in academics and/or behavior before the end of the year, it can affect their decisions.

A parent's attitude toward this issue is also critically important for their child. Your decision to accept these problems as unavoidable and/or to give up on this school year, as opposed to continuing to work to find the solution, makes an indelible impression on how he sees himself and his attitude toward solving the problems that he will encounter in life. If you take this option, things will probably get worse. For one thing, your own efforts will probably ease off some. Secondly, children tend to take much of their attitude toward life from their parents. If you choose to give up, the behavior problems will probably worsen.

If you choose the alternative option and find the right solution to your son's difficulties, things will most likely improve at school and at home and you will have a good chance to avoid the measures the school is considering. You will also be giving your son an invaluable life-long gift. He will learn that his true value as a person is not represented by whatever problems he is having at a given time and that no matter what a problem may be, he is worth the effort that is necessary for him to express his true potential. Also, more to the problems currently at hand, he will learn that these difficulties do not represent his true abilities and that, with the stumbling blocks removed, he can succeed and feel good about himself. This will not only help minimize any resistance from him, it will also be giving him a true picture of who he is and what to expect of himself. As his self-esteem and effort climbs, combined with finding the right solutions, so do your chances of success for the school year.

Now, as for finding the right solutions, the second part of your question really regards whether or the not the proper underlying cause of the problem is being addressed. I want to commend you for not giving up. There are many things that can cause children to struggle in school. While tutoring and counseling definitely have their place, the convergence of problems your son is having with focusing and not thinking before he acts or says things, suggest that his difficulties may be stemming from Attention Deficit Hyperactivity Disorder (ADHD).

There are three sub-types of this disorder. They are Primarily Inattentive, Hyperactive-Impulsive and Combined Form (this is a combination of the first two types). It sounds to me that your son may be suffering from the combined form of ADHD. This is a disorder that many parents reject testing for and, if present, treating, because they fear the use of medication with its undesirable side effects. There is, however, a preferable alternative to this scenario, which allows the majority of children (and adults) to alleviate the condition without the problems that may be caused by medication.
Neurofeedback is an effective procedure - drug and side effect free - in which the individual learns to retrain the attention and/or impulse control mechanisms of the brain, alleviating the condition. There is the further benefit that with this method of treatment the individual, through their own effort, solves the problem. When it is possible for someone to correct a problem they are having themselves, as is the case with neurofeedback, as opposed to having to rely on a substance (medication) to perform better or be accepted, that person is strengthened as a result of finding that they (with help) were capable of solving their own difficulty. This is a much healthier lesson to learn - especially for children - than having to rely on a substance to solve problems. - Dr. Stephen Ferrari

Approaching 'Heavy' Issues

Q (Pre-teen): My pre-teen daughter is very overweight and I want to help her get down to a healthy size. How do I approach the subject of diet and exercise without hurting her feelings?

A: Discussing weight can be a very difficult conversation. From high cholesterol and diabetes to social isolation and depression, childhood obesity is a growing concern that can have serious physical, social and emotional consequences.
Before having the first discussion with her about weight, check in with her pediatrician to rule out any medical concerns. I would then consult with a registered Dietitian/Nutritionist. After accumulating knowledge about how she needs to change, you will be able to address her concerns in a realistic manner.

She is likely looking for a chance to develop a method to adapt to a healthier lifestyle as well. Open up a dialogue with her about health. Today's preteens already are likely worried about what others think. When speaking to her about her weight, the less that she feels judgment in the tone of your voice, the higher of a chance you have of her listening. Have her develop a plan that she is in control of to address her concerns with plenty of your support. The more she owns the change, the higher chance she has of sticking with the plan.

When talking to her about her weight, cover all areas of possible weight gain. Prioritize her emotional response to eating and her self-image. Sometimes healthy self-esteem is more important than a healthy waistline, which may come after she improves her self-image. Be sure to respect her feelings. A great plan is worthless unless everyone is on board. If you need to break the ice on the topic, discuss your own concerns about how weight management has played a role in your life. Let her know that it is a common concern and that she is not alone. If your family continues to struggle with the issue, it may be time to consult with a therapist. - Michael Uram

Combating Indoor Allergies

Q (All ages): My son has been having trouble sleeping at night because he gets allergy symptoms like a runny nose and itchy eyes. What can I do to mitigate indoor allergies for my son and ultimately help him to sleep at night?

A: Indoor allergies are an extremely common and under-recognized cause of allergic symptoms. They differ from outdoor allergies in that they are able to induce symptoms year-round. The most common indoor allergens include dust mites, pet dander, cockroaches and molds. Outdoor allergens include trees, grass and weed pollen. While they occur in different places, they are both able to elicit the same nasal, eye and lung symptoms including congestion, itching and wheezing.

Indoor allergies occur as a result of an over-active immunological reaction to specific allergens like dust mites. When an allergic person is exposed, specific antibodies bind to allergens that cause the release of multiple inflammatory chemicals like histamines. The result of this process is allergic symptoms including sneezing, tearing and difficulty breathing.
These allergies can disturb a child's ability to get a good night's sleep through symptoms ranging from nasal congestion, sneezing and a runny nose to even wheezing and difficulty breathing. Many people may not even realize that allergies may be the principal cause of their or their child's poor sleep patterns. This can ultimately influence children's daytime alertness and/or behavior.

The best methods for parents to mitigate indoor allergies and improve their child's sleep include reducing allergen exposure and providing medications when necessary to alleviate symptoms. In terms of reducing exposure, avoidance measures can range from encasing mattresses, pillows and box springs in dust-mite proof covers to limiting pet access of bedrooms. Common medications important in the management of indoor allergies include topical nasal steroids and anti-histamines. In more severe cases, children may even benefit from allergen immunotherapy or hyposensitization, otherwise known as allergy shots.

Also consider these simple tips:

• Put your mattress and pillows into casings to reduce contact between the sleep surfaces where dust mites thrive on dead skin cells and your skin.
• Wash sheets at least once a week in 140-degree water to kill dust mites. Replace pillows regularly and plan to invest in a new mattress every eight years.
• Remove bedroom carpeting to severely limit exposure to dust mites and pet dander. Can't afford new hardwood? Make sure to vacuum the carpet at least once a week, ideally with a HEPA filter vacuum.
• Make sure bathrooms are well ventilated to reduce the growth of mold spores and treat any visible mold patches with bleach.
• Keep windows closed in the spring and summer to keep outdoor allergens from further polluting the air inside your home.

Visiting an allergist is the best way to both appropriately diagnose and treat indoor allergies. They undergo extensive training learning how to combine both a medical history with skin and/or blood testing to accurately diagnosis the existence of allergies. They are also armed with the latest medical therapeutic tools to treat and alleviate allergic and/or asthmatic symptoms. - Dr. Marc Meth

TIPS FOR EARTHQUAKE SAFETY

1. Most everyone who simply "ducks and covers" when building collapse are crushed to death. People who get under objects, like desks or cars, are crushed.
2. Cats, dogs and babies often naturally curl up in the fetal position. You should too in an earthquake. It is a natural safety/survival instinct. You can survive in a smaller void. Get next to an object, next to a sofa, next to a bed, next to a large bulky object that will compress slightly but leave a void next to it.
3. Wooden buildings are the safest type of construction to be in during an earthquake. Wood is flexible and moves with the force of the earthquake. If the wooden building does collapse, large survival voids are created. Also, the wooden building has less concentrated, crushing weight. Brick buildings will break into individual bricks. Bricks will cause many injuries but less squashed bodies than concrete slabs.
4. If you are in bed during the night and an earthquake occurs, simply roll off the bed. A safe void will exist around the bed. Hotels can achieve a much greater survival rate in earthquakes, simply by posting a sign on the back of the door of every room telling occupants to lie down on the floor, next to the bottom of the bed during an earthquake.
5. If an earthquake happens and you cannot easily escape by getting out the door or window, then lie down and curl up in the fetal position next to a sofa or large chair.
6. Most everyone who gets under a doorway when buildings collapse is killed. How? If you stand under a doorway and the doorjamb falls forward or backward you will be crushed by the ceiling above. If the door jam falls sideways you will be cut in half by the doorway.
7. Never go to the stairs. The stairs have a different "moment of frequency" (they swing separately from the main part of the building). The stairs and remainder of the building continuously bump into each other until structural failure of the stairs takes place. The people who get on stairs before they fail are chopped up by the stair treads - horribly mutilated. Even if the building doesn’t collapse, stay away from the stairs. The stairs are a likely part of the building to be damaged. Even if the stairs are not collapsed by the earthquake, they may collapse later when overloaded by fleeing people. They should always be checked for safety, even when the rest of the building is not damaged.

Source: Doug Copp, Disaster Manager of the American Rescue Team International.