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Pediatrics, Research

The power of music: how music training in high school helps brain development

The power of music: how music training in high school helps brain development

3353349312_d6aa1254bc_zIt was my second year of high school and I was talking to a childhood friend. When I asked if she was taking any music classes she shrugged and told me, “They cut my choir this year.” I wish I could say I had never heard of such a thing, but I knew it was common in public schools.

When budgets are low, music programs are often some of the first things to get cut – and it might be because those classes don’t seem as important to the academic experience as other classes. But according to a recent study (subscription required) in the journal PNAS, they are.

In the study, researchers at Northwestern University showed that studying music promotes academic success and that brain development and language skills are especially strengthened. “Although learning to play music does not teach skills that seem directly relevant to most careers, the results suggest that music may engender what educators refer to as ‘learning to learn,’” Nina Kraus, PhD, senior author of the study, said in a Northwestern release.

The researchers observed two groups of high schoolers: those enrolled in band classes, which involved music and instrumental instruction, and those enrolled in Reserve Officers’ Training Corps, which focused on physical fitness. After three years in the same schools, the students in the music classes showed a stronger neural response to sound in comparison to the students in Reserve Officers’ Training Corps. In addition, the music students were also more sensitive to auditory details than their peers.

It appears that cutting music classes from schools might leave students at a disadvantage. At the very least, it denies students the opportunity to increase their brain development and language skills. “Our results support the notion that the adolescent brain remains receptive to training, underscoring the importance of enrichment during the teenage years,” the researchers said.

Alex Giacomini is an English literature major at UC Berkeley and a writing and social media intern in the medical school’s Office of Communication and Public Affairs. 

Previously: Excessive homework for high-performing high schoolers could be harmful, study findsMusic in the brain: A report on rare auditory hallucinations and Stanford researchers gain new insights into how auditory neurons develop in animal study
Photo by Monica Liu

Health Policy, In the News, Medicine and Society, Pediatrics, Stanford News

Stanford researchers analyze California’s new vaccine law

Stanford researchers analyze California's new vaccine law

CA vaccine photoWhat do California, West Virginia and Mississippi have in common? Stumped?

Thanks to a recent law signed by California Gov. Jerry Brown, these three states now have strict vaccine policies that require children to be vaccinated before entering school, unless they have a medical exemption. The new requirements eliminate religious and philosophical exemptions.

Stanford’s Michelle Mello, JD, PhD, and David Studdert, LLB, ScD, (along with co-author Wendy Parmet, JD) heralded the change in a New England Journal of Medicine commentary published this week. From a Stanford News release:

“The move represents a stunning victory for public health that affects not only California schoolchildren, but the prospects for strengthening vaccination requirements nationwide,” they wrote.

The new laws come in the wake of a measles outbreak that started at Disneyland last year. It fueled a nationwide debate about the merits of vaccines, and of the large number of children unvaccinated due to parental objections.

The new California law requires all children enrolled in private and public schools and day-care facilities to be vaccinated against measles, whooping cough and several other diseases.

Yet the law is sure to face challenges, particularly from opponents who say it violates their religious rights. In addition, a lack of enforcement may weaken the law’s ability to ensure widespread protection.

Nonetheless, California’s new law is worth celebrating, they say:

“Although California politics may be distinctive, its experience with SB277 teaches us that even strong opposition can be overcome with the right combination of astute public education, political strategy and legislative fortitude,” they wrote. “Fewer vaccination exemptions and vaccine-preventable illnesses would be accomplishments that other states would find difficult to ignore.”

Previously: A discussion of vaccines, “the single most life-saving innovation ever in the history of medicine”, Science Friday-style podcast explains work toward a universal flu vaccine and Side effects of childhood vaccines are extremely rare, new study finds
Image by Niyazz

Autism, Behavioral Science, Neuroscience, Pediatrics, Research, Stanford News

A new insight into the brain chemistry of autism

A new insight into the brain chemistry of autism

TrueHugFor several years now, scientists have been testing the hypothesis that one particular hormone, oxytocin, plays a role in autism. It seems logical: After all, this molecule nicknamed the “love hormone” promotes bonding between romantic partners and is one of the main signals involved in childbirth, breastfeeding and helping new mothers form strong bonds with their babies. And social-interaction difficulties are a known characteristic of autism, a developmental disorder that affects one in every 68 kids.

But in the flurry of interest around oxytocin, a related signaling molecule has been largely overlooked. Called vasopressin, it’s structurally very similar to oxytocin. Both are small proteins made of nine amino acids each, and the amino-acid sequence is identical at seven of the nine spots in the two hormones. Vasopressin is best known for its role in regulating blood pressure, but it also has social roles, which have mostly been studied in rodents.

Noting the dearth of autism-vasopressin research, a Stanford team decided to study vasopressin levels and social behavior in children diagnosed with autism and controls who had not been diagnosed with autism. Our press release about their study, which was published today in PLOS ONE, explains:

The research team found a correlation between low levels of vasopressin, a hormone involved in social behavior, and the inability of autistic children to understand that other people’s thoughts and motivations can differ from their own. …

“Autistic children who had the lowest vasopressin levels in their blood also had the greatest social impairment,” said the study’s senior author, Karen Parker, PhD, associate professor of psychiatry and behavioral sciences.

Parker and her colleagues examined “theory of mind,” the ability to deduce that others have a mind of their own – and that they may perceive the world differently than you do. It’s an important underpinning to forming empathetic relationships with other people. In kids with autism, the lower their vasopressin levels, the worse their scores on a test of theory of mind, the study found. Children without autism did not show this link; they all had pretty good theory of mind scores, whether their vasopressin levels were low or high.

It’s worth adding that low vasopressin level did not diagnose whether a child had autism; the hormone’s levels ranged from low to high in both groups of children. So autism is not simply a state of vasopressin deficiency. However, the researchers are interested in whether giving vasopressin might help relieve autism symptoms and are now carrying out a clinical trial to test its effects.

The work also provides an interesting complement to oxytocin findings published by the same team last year. In the oxytocin study, the scientists found that children with autism could have low, medium or high oxytocin levels, just like other children. However, oxytocin levels were linked to social ability in all children, not just those with autism.

Based on the new findings, it’s possible, Parker told me, that vasopressin is uniquely important for children with autism. She’s eager to expand her work in this overlooked corner of brain-chemistry research.

Previously: Stanford research clarifies biology of oxytocin in autism, “Love hormone” may mediate wider range of relationships than previously thought and Volunteers sought for autism drug study
Artwork by Dimka

Health Disparities, Mental Health, Pediatrics, Public Health

Stanford study of mental illness in incarcerated teens raises policy questions

Stanford study of mental illness in incarcerated teens raises policy questions

depressionMental illness is an even bigger problem for jailed teenagers than experts previously realized.

That’s the take-away message from a Stanford study, publishing today in the Journal of Adolescent Health, which compared 15 years’ worth of hospital stays for adolescents in California’s juvenile justice system with hospitalizations of other California kids and teens. Experts already knew that juvenile inmates are more likely than other young people to have mental health problems, but the new study gives fresh perspective on the scope of the issue.

The research team, led by Arash Anoshiravani, MD, an adolescent medicine specialist at Lucile Packard Children’s Hospital Stanford, looked at 15 years of hospital-stay data for California’s 11- to 18-year-olds. From a total of almost 2 million hospitalizations, about 11,000 were for incarcerated youth.

Of these 11,000 hospital stays, 63 percent were due to mental-health diagnoses. In contrast, just under 20 percent of the hospital stays by adolescents from the general population were prompted by mental illness. Hospital stays were also longer for the incarcerated teens, suggesting more severe illness.

However, the kinds of diagnoses were pretty similar between the two groups, with depression and substance abuse the most common. From our press release about the new study:

The types of diagnoses suggest that many incarcerated teens’ mental health problems developed in response to stressful and traumatic childhood experiences, such as being abused or witnessing violence, Anoshiravani said.

“They’re regular kids who have had really, really horrible childhoods,” he said, adding that he hopes the new data will motivate social change around the problem.

“We are arresting kids who have mental health problems probably related to their experiences as children,” he said. “Is that the way we should be dealing with this, or should we be getting them into treatment earlier, before they start getting caught up in the justice system?”

Previously: Online health records could help high-risk teens, study finds, Lucile Packard Children’s Hospital partners with high schools on student mental health programs and Increasing awareness and advocacy of emotional disorders with mental health first-aid programs
Photo by ryan melaugh

In the News, Pediatrics, Public Health, Stanford News, Technology

Water-conscious hospital will debut in 2017 with expansion of Lucile Packard Children’s Hospital

Water-conscious hospital will debut in 2017 with expansion of Lucile Packard Children’s Hospital

hospital-expansion-exterior-stanford-childrensPlaces where people live and work tend to use a lot of water, and hospitals are no exception. According to the U.S. Environmental Protection Agency’s 2012 report on water use in public buildings, hospitals rank third in water use just behind senior care facilities and hotels.

Now, the Lucile Packard Children’s Hospital Stanford is working to buck this trend with a new expansion that will use the latest water and energy-saving techniques and tools. This 521,000 square foot addition, which will open in 2017, is predicted to use about 38 percent less water than a comparable hospital.

This sustainable approach to building design began long before the current drought situation in California made water conservation a top priority. “In 2008, when we started planning, we knew there was not enough rainfall to sustain even the most efficient hospital’s needs,” said Robin Guenther, lead designer of the expansion project, in a recent post on the Healthier, Happy Lives blog.

In the piece, Guenther and her team discuss some of the expansion’s energy saving features, including shade structures that reduce the building’s heat gain from the sun and moving the hospital’s data center to the roof where it can be cooled by a wind-powered ventilation system instead of by air conditioning. According to Guenther, these modifications will make the building’s thermal energy consumption about 60 percent less than the average hospital in Northern California.

“Sustainability is a guiding principle in everything we do,” Christopher G. Dawes, president and chief executive officer of the hospital, commented. “Everyone on our team shares in this commitment. It’s part of being a good neighbor and a member of the larger community, and ensuring we’re doing the best thing possible when it comes to preserving all of our environmental resources.”

Previously: Green roofs are not just good for the environment, they boost productivity, study shows and From the Stanford Medicine archives: A Q&A with actor Matt Damon on water and health
Image courtesy of Lucile Packard Children’s Hospital Stanford

Dermatology, Evolution, Pediatrics, Research, Science, Stanford News, Surgery

To boldly go into a scar-free future: Stanford researchers tackle wound healing

To boldly go into a scar-free future: Stanford researchers tackle wound healing

scarshipAs I’ve written about here before, Stanford scientists Michael Longaker, MD, and Irving Weissman, MD, are eager to find a way to minimize the scarring that arises after surgery or skin trauma. I profiled the work again in the latest issue of Stanford Medicine magazine, which focuses on all aspects of skin health.

My story, called “Scarship Enterprise,” discusses how scarring may have evolved to fulfill early humans’ need for speed in a cutthroat world:

“We are the only species that heals with a pathological scar, called a keloid, which can overgrow the site of the original wound,” says Longaker. “Humans are a tight-skinned species, and scarring is a late evolutionary event that probably arose in response to a need, as hunter-gatherers, to heal quickly to avoid infection or detection by predators. We’ve evolved for speedy repair.”

Check out the piece if you’re interested in reading more about this or learning how scarring happens, or why, prior to the third trimester, fetuses heal flawlessly after surgery. (Surprisingly, at least to me, many animals also heal without scarring!)

Previously: This summer’s Stanford Medicine magazine shows some skinWill scars become a thing of the past? Stanford scientists identify cellular culprit, New medicine? A look at advances in wound healing and Stanford-developed device shown to reduce the size of existing scars in clinical trial
Illustration by Matt Bandsuch

Chronic Disease, Patient Care, Pediatrics

On growing up with chronic illness: “I’ve never felt like I had ownership over my body”

We’ve partnered with Inspire, a company that builds and manages online support communities for patients and caregivers, to launch a patient-focused series here on Scope. Once a month, patients affected by serious and often rare diseases share their unique stories; this month’s column comes from a patient with Crohn’s disease.

woman-body-144220_1280

As a child who was diagnosed with Crohn’s disease at the age of nine, I learned to give my power over to my doctors and parents. I never questioned the constant prodding, the pain that I had to endure from different tests and exams, the dozen pills that I swallowed down each day, because after all, I was to trust doctors and adults. They knew what was best for me. They knew what was best for my body. And of course, this is true – but only to an extent. Please hear me out.

In no way am I undermining the miraculous work that medical professionals do each and every day. I am beyond grateful for the way that my disease was handled, I was given a fairly normal childhood because of the way my medical team was able to manage my disease. And on top of that, I have the most incredible parents who handled my disease beautifully; they allowed me to feel supported, loved and taken care of. Honestly, I just had to show up for doctor appointments, swallow pills, and be a kid. I left the details up to the adults.

But then I started growing up. High school, boys, and school dances became my new normal. I lost my power at the age of 17 when I was date raped. Although I attempted to say “no” and stick up for myself, I ultimately didn’t know how to confidently do this. I didn’t know how to command respect because I was so used to never being asked to say “yes.” Unfortunately, this situation snowballed into another date rape and ultimately a suicide attempt. I truly felt detached from my body. It wasn’t mine. I didn’t know how to handle it. I despised it. It was the source of so much pain. And so, I wanted to leave it.

I never connected my inability to stick up for myself with being a child of chronic disease until the last couple of years. As I reflect back, the correlation is so clear. I never was taught to question what my doctors did to my body. I cannot recall being asked if it was “okay” to be examined or to be touched. If I was in a doctor’s office, it was just assumed and expected. To be clear: There was absolutely never anything inappropriate that happened to me in my doctors’ care. I think the only reason that the perceived lack of power on my side affected me is because I was a child, and I didn’t have the capability to differentiate the way I handled my body in the care of a doctor versus the hands of a teenage boy.

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Autoimmune Disease, In the News, Mental Health, Pediatrics, Research, Stanford News

Stanford doctors unraveling mysterious childhood psychiatric disease

Stanford doctors unraveling mysterious childhood psychiatric disease

BrainModel2A story in Sunday’s Wall Street Journal highlights Stanford’s leadership in treating a mystifying disease in which a child suddenly develops intense psychiatric problems, often after an infection. The disease, called pediatric acute-onset neuropsychiatric syndrome, can be terribly disabling, altering kids’ personalities, interfering with their school work and making it hard for families to function.

As the story (subscription required) explains, some physicians question whether PANS is actually a separate disease from the psychiatric diagnoses it resembles, which include obsessive-compulsive disorder and anorexia nervosa. But doctors at Lucile Packard Children’s Hospital Stanford suspect something else is truly going on, likely an autoimmune attack on the brain. The team, led by Jennifer Frankovich, MD, and Kiki Chang, MD, is working to learn more about the disease:

In an effort to establish the science of PANS, the Stanford clinic is collecting extensive data on the patients. Doctors try to piece together what is driving symptoms from pediatric records, parent reports, even teacher interviews. They are analyzing DNA samples from each patient and looking for clues in their immune systems. If they find strep, they bank the strain for further research. “It is easier to study something that is established,” Dr. Frankovich said. “To build something new is really hard.”

The team’s insights from 47 of their patients were published earlier this year in a special PANS-focused issue of the Journal of Child and Adolescent Psychopharmacology, and the researchers are currently working to expand the capacity of their PANS clinic, the first of its kind in the country. More information about PANS and its effect on children and families is also available in a Stanford Medicine magazine story I wrote last year about Frankovich and Chang’s work.

Previously: What happens when the immune system attacks the brain? Stanford doctors investigate and My descent into madness — a conversation with author Susannah Cahalan
Photo by GreenFlames09

Health Policy, Mental Health, Patient Care, Pediatrics, Stanford News

Stanford expert on new treatment guidelines for teens’ eating disorders

Stanford expert on new treatment guidelines for teens' eating disorders

eatingdisorder-plateEating disorders often begin in the teenage years, but, surprisingly, the medical community long lacked a teen-specific set of guidelines for treating these serious illnesses.

That changed in May with the publication of a set of practice parameters co-authored by Stanford eating disorder expert James Lock, MD, PhD, who also directs the Comprehensive Eating Disorders Program at Lucile Packard Children’s Hospital Stanford. The parameters were based on an extensive review of the current scientific evidence around eating-disorder treatment, including recent studies by Lock and his colleagues that show that teens’ parents can play an active role in helping their children recover from anorexia nervosa. That’s a big shift from traditional thinking about eating disorders, which held that young patients’ families should be shut out of treatment.

In a new Q&A, I talked with Lock about why the parameters were needed. He told me:

There have never been practice parameters that address eating disorders in children and adolescents, and expertise in treating these disorders has been sort of sequestered. Yet eating disorders are so prevalent and are such a severe problem: Lifetime prevalence in adolescent girls is around 1 percent, and the disorders have among the highest fatality rates of all mental illnesses.

Teens need treatment approaches that account for their level of physical and emotional development, the fact that their parents generally want and need to be involved in their recovery, and the fact that they have not usually had eating disorders for as long as adult patients with the same diagnoses.

Lock also discusses how he hopes the new guidelines will improve training of psychiatrists, how recent changes to eating disorder diagnostic criteria are making it easier for doctors to get their patients the help they need, and why outpatient treatment is the new front line for young people with eating disorders.

Previously: Patient tells how social media helped her overcome the “shame” of her eating disorder, Incorporating family into helping teens overcome eating disorders and Story highlights need to change the way we view and diagnose eating disorders in men
Photo by Darren Tunnicliff

Pediatrics, Public Health, Public Safety, Sleep, Stanford News

Rolling through campus and talking sleep with famed researcher William Dement

Rolling through campus and talking sleep with famed researcher William Dement

Dement in shuttle2 (RS) - croppedRenowned sleep researcher William Dement, MD, PhD, is maneuvering his way in his “Sleep and Dreams Mobile” through the Stanford University campus, en route to the Jerry House, site of some of the early, landmark studies in sleep. The house, a sprawling Mediterranean-style dormitory, housed Stanford’s Summer Sleep Camp in the 70s and 80s, where Dement and his colleagues planted the seed for some of the most important findings in the field of sleep among adults and teens.

Three years ago, the house was immortalized with a plaque and a party in which Jeff Chimenti of Grateful Dead fame performed for a crowd of 60 celebrants (the building is named after the Grateful Dead’s Jerry Garcia). Dement, now 85, says he often passed the house on his way to his ever-popular Sleep and Dreams class and thought it was important to mark the spot.

“I’d go by this house and think, ‘What happened here is the biggest thing in sleep disorders.’ So I thought something should be done to create a memorial,” he says, leaning on the banister in the living room of the house.

I’ve asked him to give me a tour of the house as background for a story on teen sleep that I’m writing for the next issue of Stanford Medicine magazine. He points to the backyard of the house, now a barren Lake Lagunita, where young volunteers played volleyball, all the while carrying a nest of wires on their heads to monitor their brain waves. Inside, researchers would monitor the youngsters’ brain activity 24 hours a day to better understand their patterns of sleep.

“The electrodes would stay on their heads because it was too difficult to take them off,” Dement explains. When the volunteers would trudge off to Tresidder Union to go bowling or do other activities, he says, “People would say, ‘Here come the trodes.’”

Dement and his colleagues followed the youngsters for ten successive summers, observing patterns in how their sleep changed as they matured.

A major goal of the study was to confirm the popular belief that as teens get older, they need less sleep. To the researchers’ surprise, they found that as the youngsters aged, the number of hours they slept stayed the same – roughly 9 hours.

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