Focusing on a child’s strengths can transform assessments – and help them thrive after an ADHD or autism diagnosis
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When parents are concerned about their child’s development, they often seek an assessment to address concerns and identify any conditions, such as autism, attention-deficit hyperactivity disorder (ADHD), or learning disorders.
Common worries include difficulties making friends, focusing on tasks, or meeting educational goals.
It might seem counter-intuitive but assessments are starting to focus on a child’s strengths during this process. This can create powerful opportunities to improve child and family outcomes, particularly when too much of the focus is on challenges in the family home, school and play settings.
There is, however, a lack of evidence about how to do such assessments and how certain strengths can be used in assessment.
In a new research paper, we have developed a strengths checklist for parents, carers and clinicians to more easily identify children’s skills, talents and positive qualities – and understand the type of support they need at home, school or socially.
The aim was to provide an easy way for parents and clinicians to identify strengths in children, and to provide a method for studying the role of strengths in development. This assessment can be used alongside more established assessments of challenges.
Why highlight a child’s strengths?
Focusing on a child’s strengths can have a powerful impact on children and parents. It can boost a child’s motivation, self-esteem, cognitive skills, language development, problem-solving abilities and build stronger relationships.
For parents and caregivers, it can increase their own feelings of self-worth and improve the quality of their relationship with their own children.
When parents and caregivers believe in their child’s abilities and encourage their strengths, children and families thrive.
However, there are many gaps in research about how to apply a strengths-based approach in the context of a neurodevelopmental assessment.
Currently, while the basic principle of incorporating strengths is clear, clinicians need to rely on intuition and creativity to guide their practices.
We have long needed better evidence-based methods to guide this.
This is where our research comes in
Our new study used the Sydney Child Neurodevelopment Research Registry, which aims to improve the neurodevelopmental assessment processes and the evidence for what works for families and clinicians. We asked caregivers to identify their child’s strengths on their first assessment visit.
Nearly 700 caregivers reported an average of 2.8 strengths about their children. Using these themes, we developed a child strengths checklist to use for clinical assessments.
We showed caregivers identified six categories of child strengths: cognitive and intellectual, social and interpersonal, hobbies and passions, character and personality, physical, and resilient behaviours.
Some caregivers might report that while their child had difficulty with peer interactions, they were also kind, affectionate, honest and caring.
Other caregivers described concerns about cognitive delays, but they also described how children persevered and persisted with tasks.
Analysing the data qualitatively – where we read caregiver transcripts and extracted themes – we captured the richness and detail of unique strengths. In total, we identified 61 unique strengths.
With community representatives and clinicians, we used this to develop a strengths-based checklist we’re calling the Child Autism and Neurodevelopment Strengths Checklist, or the CANS checklist.
This type of research will provide the evidence needed to be able to implement national guidelines and to develop better evidence about how strengths can be used to improve outcomes. We want to develop best practices for combining concerns and strengths into feedback, support plans and intervention strategies.
What can caregivers and clinicians do now?
Support schemes including the National Disability Insurance Scheme (NDIS) often require families to highlight what children can’t do. Still, there are some practical ways caregivers and clinicians can ensure a child’s strengths are kept front and centre.
For caregivers, along with discussing concerns, reflect on and talk with your clinicians about your child’s strengths. Make sure clinicians keep these in mind when devising supports.
For both caregivers and clinicians, it can be helpful to think about characteristics often seen as challenges – such as a strong need for routine – as also potential strengths. It may lead to new ways of supporting children. With the right environment and support, these traits can be valuable assets in a child’s development.
For clinicians, consider how a child’s strengths can inform your assessment and intervention strategies. Make sure you don’t only focus on what children can’t do or need support with.
Communicate clearly about the child’s strengths and consider how these strengths can:
- support the child’s long-term development and goals. If the child thrives on routine and pays close attention to details, showing them how to embrace these strengths can teach them how to use them to reach their own goals and to be more independent
- be the target of an intervention. Everyone needs to experience success. Designing activities around strengths can make intervention more enjoyable and engaging, and the effects are more likely to be long-lasting
- be used to support the wellbeing of families. Helping families focus on each other’s strengths and improve the way family members talk about and support one another creates a positive environment where they can all feel valued, respected and cared for.
By focusing on strengths, we want to create more effective and personalised support for children with neurodevelopmental conditions to reach their full potential.
Building a strong, evidence-based approach will help ensure children’s strengths are consistently considered in assessments and intervention planning.
Adam Guastella, Professor and Clinical Psychologist, Michael Crouch Chair in Child and Youth Mental Health, University of Sydney; Kelsie Boulton, Senior Research Fellow in Child Neurodevelopment, Brain and Mind Centre, University of Sydney, and Natalie Silove, Neurodevelopmental Paediatrician and Associate Professor, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Why Rheumatoid Arthritis Often Defies Drugs (& What Else you Can Try)
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Arthritis is the umbrella term for a cluster of joint diseases involving inflammation of the joints, hence “arthr-” (joint) “-itis” (suffix used to denote inflammation). These are mostly, but not all, autoimmune diseases, in which the body’s immune system mistakenly attacks our own joints.
Rheumatoid arthritis is one of those. Indeed, it’s the common of the autoimmune forms of arthritis. Some quick facts:
- Approximately one third of people stop work within two years of its onset, and this increases thereafter.
- It affects a little under 1% of the global population, but the older we get, the more likely it becomes
- Early onset of rheumatoid arthritis is most likely to show up around the age of 50 (but it can show up at any age)
- However, incidence (not onset) of rheumatoid arthritis peaks in the 70s age bracket
- It is 2–4 times more common in women than in men
When meds don’t work (and why)
There are three main kinds:
- Pain relief (always hit-and-miss, unless going for literal anaesthetic)
- Anti-inflammatory (can rarely go too far wrong, although some can give different problems)
- Arthritis-specific, which are usually also anti-inflammatory in their own way, but deserve a special mention
For example, a lot of arthritis medications act via the interleukin-17 pathways.
However, researchers (Dr. Martina Zoccheddu et al.) found that in rheumatoid arthritis, the immune cells that normally make IL-17 gradually stop producing it, which explains why IL-17-targeted drugs lose effectiveness as the disease progresses.
Even worse, once these cells stop making IL-17, they turn into aggressive forms that can still sustain joint inflammation independently of IL-17, meaning that the meds can end up doing more harm than good in the long-run!
To quote Dr. Joyce So when asked about this,
❝This important new insight contributes to shifting the paradigm of how we understand rheumatoid arthritis progression and why IL-17 treatments haven’t worked as well as expected. Only with a precise understanding of the biological mechanisms of disease can effective, precision therapies be developed.
In the meantime, clinicians can help patients in early or presymptomatic stages make the most of treatments that may lose effectiveness over time.❞
You can find the paper itself, here: TH17 cells converted into exTH17 cells sustain rheumatoid-like IL-17–independent inflammatory arthritis
About those early or presymptomatic stages…
Another team of researchers (Dr. Marla Glass et al.) recently found that rheumatoid arthritis begins long before pain, with people who carry a particular kind of antibodies showing body-wide inflammation, malfunctioning immune cells, and gene-regulation changes for at least seven years before symptoms show up.
In other words, the immune system is behaving as though rheumatoid arthritis is already active, and so, in a way, arguably it is already active.
This is all going on in ways that you wouldn’t see without doing blood tests, though.
For example (we will quote these key points directly):
- Widespread inflammation: The researchers observed that people at risk for RA already showed signs of systemic inflammation throughout the body. This inflammation was not limited to the joints. Instead, it resembled the body-wide inflammatory pattern commonly seen in individuals with active RA.
- Immune cell dysfunction: Multiple immune cell types showed unusual behavior.
- B cells, which normally create protective antibodies, were found in a heightened pro-inflammatory state.
- T helper cells, especially those similar to Tfh17 cells, had expanded far beyond typical levels. These cells help coordinate immune responses, including the creation of autoantibodies (antibodies that attack the body’s own tissues). Their expansion helps explain why the immune system begins targeting healthy tissue.
- Cellular reprogramming: One of the most striking discoveries was that even “naive” T cells, which have not yet encountered pathogens, showed epigenetic changes. Although their DNA sequence remained intact, the regulation of their genes had shifted. This altered gene activity suggests these cells were being reprogrammed before encountering any threats.
- Joint-like inflammation detected in blood: The team also found that monocytes (a type of white blood cell) circulating in the bloodstream were producing high amounts of inflammatory molecules. Remarkably, these cells closely resembled the macrophages typically found in the inflamed joints of RA patients, indicating that the immune system was already setting the stage for joint inflammation.
You can find this paper itself, here: Progression to rheumatoid arthritis in at-risk individuals is defined by systemic inflammation and by T and B cell dysregulation
What that means in practical terms
If you get a rheumatoid arthritis diagnosis, even if it feels like you got it quickly, chances are you’ve technically had it for a long time already.
So, if you don’t have such a diagnosis, it is good to behave as though you did (aside from the pain relief component, of course, if you have no pain), because honestly, the advice for managing arthritis is very good advice anyway, since it tends to target improving joint health and reducing chronic inflammation.
With that in mind, do check out:
And for a very deep dive into excellent exercise vs arthritis, see:
Yoga Therapy for Arthritis – by Dr. Steffany Moonaz & Erin Byron
…which is a particularly good book, much better than most of its kind, because:
- One of the problems with arthritis and exercise is that arthritis can often impede exercise.
- Another of the problems with arthritis and exercise is that some kinds of exercise can exacerbate arthritis.
This book deals with both of those issues, by providing yoga specifically tailored to living with arthritis. Indeed, the first-listed author’s PhD in public health was the result of 8 years of study developing an evidence-based yoga program for people with arthritis, including osteoarthritis and rheumatoid arthritis.
The authors take the view that arthritis is a whole-person disease (i.e. it affects all parts of you), and so addressing it requires a whole-person approach, which is what this book delivers, and so that’s why we highly recommend it.
And if you do have the pain component already…
We’ve written quite a bit about pain management, including:
- Before You Reach For That Tylenol…
- How To Stop Pain Spreading
- How To Dial Down Your Pain
- Managing Chronic Pain (Realistically!)
- Get The Right Help For Your Pain
- The 7 Approaches To Pain Management
- Science-Based Alternative Pain Relief (When Painkillers Aren’t Helping, These Things Might)
Take care!
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What Really Works For Anti-Aging? Science-Backed Skincare Ingredients
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Dr. Andrea Suarez, dermatologist, goes beyond her pet hate skincare myths (e.g. sunscreen causes cancer, tanning is healthy), and talks about how actually one of her biggest frustrations is people wasting money on ineffective skincare products.
She also details what works, according to the evidence:
Science vs hype
Dr. Suarez explains that the root causes of skin aging are sun exposure, lifestyle habits, and menopause-related hormone decline (as applicable). However, skin aging is not the same for everyone, as for example paler skin tends to show more wrinkling and yellowing while richly melanated skin resists wrinkling but develops more pigmentation and texture issues.
With this in mind, here are the products that she ranks as…
Best:
- Sunscreen is the most effective anti-aging product with strong evidence for reversing and preventing damage in all skin tones.
- Topical retinoids like tretinoin and adapalene improve collagen, reduce wrinkles, and even skin tone.
- Alpha hydroxy acids such as glycolic acid and ammonium lactate exfoliate and hydrate, improving texture and skin thickness.
- Niacinamide is a marvelously multitasking antioxidant that improves moisture, dark spots, redness, and sallowness.
- Vitamin C works best in the form of stable ascorbic acid combined with vitamin E and ferulic acid.
Questionable:
- Topical peptides may hydrate and reduce water loss but lack strong evidence for significant anti-aging effects.
- Topical estrogen may boost collagen in menopausal skin but may also cause pigmentation and vascular changes.
Worthless:
- Growth factors are unlikely to be effective at all and probably act only as moisturisers
- Exosomes and PDRN lack clinical evidence and are mostly marketing hype
In short: an effective anti-aging skincare routine includes cleansing, moisturising, daily sunscreen, and possibly a retinoid. Also important are lifestyle factors like healthy diet, stress reduction, and avoiding smoking and alcohol. Thus, she bids us skip trendy products and stick with simple, proven ingredients used consistently.
For more on all of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also enjoy:
The Evidence-Based Skincare That Beats Product-Specific Hype ← in case you’d like a second opinion from another dermatologist
Take care!
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Bamboo Shoots vs Zucchini – Which is Healthier?
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Our Verdict
When comparing bamboo shoots to zucchini, we picked the bamboo.
Why?
Both have their merits! But…
In terms of macros, bamboo has more than 2x the fiber for slightly more carbs and more than 2x the protein, scoring an easy first round win.
In the category of vitamins, bamboo has more of vitamins B1, B3, B6, and E, while zucchini has more of vitamins B2, B5, B9, and C, tying 4:4 here.
Looking at minerals, bamboo has more copper, iron, manganese, phosphorus, potassium, selenium, and zinc, while zucchini has more calcium and iron, netting bamboo a 7:2 victory in this round.
Adding up the sections makes for an overall win for bamboo, but by all means enjoy either or both, as diversity is good!
Want to learn more?
You might like:
Don’t Be Bamboozled By Bamboo! ← for how to prepare it, plus some of the special properties of bamboo’s fiber content
Enjoy!
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Securely Attached –
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A lot of books on attachment theory are quite difficult to read. They’re often either too clinical with too much jargon that can feel like incomprehensible psychobabble, or else too wishy-washy and it starts to sound like a horoscope for psychology enthusiasts.
This one does it better.
The author gives us a clear overview and outline of attachment theory, with minimal jargon and/but clearly defined terms, and—which is a boon for anyone struggling to remember which general attachment pattern is which—color-codes everything consistently along the way. This is one reason that we recommend getting a print copy of the book, not the e-book.
The other reason to invest in the print copy rather than the e-book is the option to use parts of it as a workbook directly—though if preferred, one can simply take the prompts and use them, without writing in the book, of course.
It’s hard to say what the greatest value of this book is because there are two very strong candidates:
- Super-clear and easy explanation of Attachment Theory, in a way that actually makes sense and will stick
- Excellent actually helpful advice on improving how we use the knowledge that we now have of our own attachment patterns and those of others
Bottom line: if you’d like to better understand Attachment Theory and apply it to your life, but have been put off by other presentations of it, this is the most user-friendly, no-BS version that this reviewer has seen.
Click here to check out Securely Attached, and upgrade your relationship(s)!
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Nicotine Benefits (That We Don’t Recommend)!
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Does nicotine have any benefits at all? I know it’s incredibly addictive but if you exclude the addiction, does it do anything?❞
Good news: yes, nicotine is a stimulant and can be considered a performance enhancer, for example:
❝Compared with the placebo group, the nicotine group exhibited enhanced motor reaction times, grooved pegboard test (GPT) results on cognitive function, and baseball-hitting performance, and small effect sizes were noted (d = 0.47, 0.46 and 0.41, respectively).❞
Read in full: Acute Effects of Nicotine on Physiological Responses and Sport Performance in Healthy Baseball Players
However, another study found that its use as a cognitive enhancer was only of benefit when there was already a cognitive impairment:
❝Studies of the effects of nicotinic systems and/or nicotinic receptor stimulation in pathological disease states such as Alzheimer’s disease, Parkinson’s disease, attention deficit/hyperactivity disorder and schizophrenia show the potential for therapeutic utility of nicotinic drugs.
In contrast to studies in pathological states, studies of nicotine in normal-non-smokers tend to show deleterious effects.
This contradiction can be resolved by consideration of cognitive and biological baseline dependency differences between study populations in terms of the relationship of optimal cognitive performance to nicotinic receptor activity.
Although normal individuals are unlikely to show cognitive benefits after nicotinic stimulation except under extreme task conditions, individuals with a variety of disease states can benefit from nicotinic drugs❞
Read in full: Effects of nicotinic stimulation on cognitive performance
Bad news: its addictive qualities wipe out those benefits due to tolerance and thus normalization in short order. So you may get those benefits briefly, but then you’re addicted and also lose the benefits, as well as also ruining your health—making it a lose/lose/lose situation quite quickly.
As an aside, while nicotine is poisonous per se, in the quantities taken by most users, the nicotine itself is not usually what kills. It’s mostly the other stuff that comes with it (smoking is by far and away the worst of all; vaping is relatively less bad, but that’s not a strong statement in this case) that causes problems.
See also: Vaping: A Lot Of Hot Air?
However, this is still not an argument for, say, getting nicotine gum and thinking “no harmful effects” because then you’ll be get a brief performance boost yes before it runs out and being addicted to it and now being in a position whereby if you stop, your performance will be lower than before you started (since you now got used to it, and it became your new normal), before eventually recovering:
In summary
We recommend against using nicotine in the first place, and for those who are addicted, we recommend quitting immediately if not contraindicated (check with your doctor if unsure; there are some situations where it is inadvisable to take away something your body is dependent on, until you correct some other thing first).
For more on quitting in general, see:
Addiction Myths That Are Hard To Quit
Take care!
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How to Change – by Katy Milkman
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Sometimes it seems that we know everything we should be doing… We have systems and goals and principles, we know about the importance of habits, and we do our best to live them. Yet, somehow, life has other plans for us and things don’t quite come together they way they did in our genius masterplan.
So, what happened? And more importantly, what are we supposed to do about this? Katy Milkman has answers, right from the start.
Sometimes, it can be as simple as when we try to implement a change. It’s not that there’s a “wrong time” for a good change, so much that there are times that are much more likely to succeed than others… and those times can be identified and used.
Sometimes we’re falling prey to vices—which she explains how to overcome—such as:
- Impulsivity
- Procrastination
- Forgetfulness
- Laziness
We also learn some counterintuitive truths about what can boost or sabotage our confidence along the way!
Milkman writes in a compelling, almost narrative style, that makes for very easy reading. The key ideas, built up to by little (ostensibly true) stories and then revealed, become both clear and memorable. Most importantly, applicable.
Bottom line: this is a great troubleshooting guide for when you know how everything should be working, but somehow, it just doesn’t—and you’d like to fix that.
Click here to check out “How To Change” on Amazon, and get those changes rolling!
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