Faculty Bibliography

'The data definitely did surprise me,' said Dr. Joachim Hallmayer, the lead author of the study and an associate professor of psychiatry and behavioral sciences at Stanford University. Dr. Miodovnik points out that potentially toxic substances are ubiquitous and cannot be completely avoided, but suggests that prospective parents try to avoid pesticides, don't microwave plastics that may contain endocrine disruptors, and consider choosing fragrance-free personal products (phthalates are used in many fragrances)

In the 1950s, autism famously was blamed on bad parenting and emotionally remote 'refrigerator mothers.' As the research advanced, including early important twin studies, the inherited basis of the disorder became clear. In a 2010 article published in an American Psychiatric Association journal, autism spectrum disorder is described as 'among the most heritable of psychiatric disorders.' 'environment' is a tricky word. To many scientists studying autism, it means 'everything that's not the inherited DNA,' said Irva Hertz-Picciotto, a professor of epidemiology at the University of California, Davis, MIND Institute. An environmental influence might be a chemical the fetus is exposed to via the placenta, or it might refer to aspects of nutrition, maternal health, stress -- or perhaps exposure to a microbe. Phthalates, chemicals found in many consumer products, are so-called endocrine disruptors, hormonally active substances that can interfere with a variety of developmental processes, including brain development. Yet these data don't demonstrate cause and effect, Dr. [Amir Miodovnik] said, 'only that these substances are associated with symptoms found in autism.' Conversely, taking prenatal vitamins around the time of conception has been associated with a lower risk of autism in a recent study

The law varies state by state, but many, including New York, allow minors to consent by themselves to medical care involving such sensitive needs as contraception, pregnancy, sexually transmitted diseases and mental health. 'In the vast majority of cases when we're working with a student who has some sort of medical or mental health news, they want their parents involved and we are able to communicate freely,' said Dr. Sarah Van Orman, executive director of University Health Services at the University of Wisconsin, Madison, and vice president of the board of directors of the American College Health Association

Dr. Debra Lotstein, assistant professor of pediatrics at the University of California, Los Angeles, studies this transition in adolescents and young adults with chronic medical conditions -- problems which can range from asthma and diabetes to developmental conditions like autism to complex and rare syndromes. As they move out of the pediatrician's office, Dr. Lotstein and her colleagues have found, gaps in care occur for as many as two-thirds of these young adults. Even for young adults with insurance, the lines between pediatric care and adult care are growing blurrier. Pregnancy, for instance: get pregnant, and it used to be that you graduated to the women's clinic. Now a reproductive issue no longer marks the end of pediatric care. While some young women start seeing gynecologists during adolescence, many are getting that care from their pediatricians. Conversely, adult specialists are struggling to learn how to handle adults with a range of problems once limited to pediatric practices. When I was doing my residency during the 1980s, we took care of adolescents with cystic fibrosis, knowing that many were unlikely to live past their 20s -- it was a pediatric disease, and the experts were pediatricians. Not that long ago, there were relatively few grown-up survivors of complex congenital heart disease, for example, or childhood cancer, or congenital H.I.V. infection

Dr. Debra Lotstein, assistant professor of pediatrics at the University of California, Los Angeles, studies this transition in adolescents and young adults with chronic medical conditions -- problems which can range from asthma and diabetes to developmental conditions like autism to complex and rare syndromes

There are complex behavioral and neurological connections linking screens and attention, and many experts believe that these children do spend more time playing video games and watching television than their peers. The kind of concentration that children bring to video games and television is not the kind they need to thrive in school or elsewhere in real life, according to Dr. Christopher Lucas, associate professor of child psychiatry at New York University School of Medicine

Dr. [Jack L. Paradise] and his colleagues tried to provide an answer in a study, published in 1984, that looked at children with many well-documented episodes of throat infection (seven or more in the preceding year). Those who got tonsillectomies had fewer infections in the first couple of years after surgery than those who didn't, the researchers found. But the children who didn't have surgery also had fewer and fewer infections as they got older. Dr. Richard M. Rosenfeld, one of the authors of the new tonsillectomy guidelines and a professor of otolarygology at SUNY Downstate Medical Center in Brooklyn, suggests that back when most children had their tonsils out, it was perhaps less common to see these sleep problems -- what with all the tonsillectomies, there was 'nobody breathing with a golf ball in the mouth.' Still, for anything short of obstructive sleep apnea, 'the advice to parents is, if you're even the least bit unsure, don't do it -- it's an elective surgery, don't worry about it, you can always re-address it in six months,' Dr. Rosenfeld said. 'There's very little harm to some watchful waiting till things sort themselves out.'

Parents saw scarlet fever, named for its red, sandpapery rash, as a frightening and dangerous childhood illness; rheumatic fever, which sometimes followed strep, could seriously damage the heart

'We're not looking for a gene for handedness or a gene for schizophrenia,' he said. 'We're looking for subtle relationships.' The gene affects the ways that neurons communicate with one another, he said, but its mechanisms still need to be studied. 'Handedness has a genetic basis, but like other complex traits - height, weight - it is complex,' he said. 'It's not a single gene that leads to it. There's a strong environmental component, too. It's a very tricky problem.' 'I can hold the pencil properly in my left hand, but I don't have the co-ordination to write,' he told me. 'It looks like I'm holding the pencil properly, but I am unable to make any letters.'

'We're not looking for a gene for handedness or a gene for schizophrenia,' he said. 'We're looking for subtle relationships.' The gene affects the ways that neurons communicate with one another, he said, but its mechanisms still need to be studied. 'Handedness has a genetic basis, but like other complex traits - height, weight - it is complex,' he said. 'It's not a single gene that leads to it. There's a strong environmental component, too. It's a very tricky problem.' A colleague's husband, Anthony Gentile, told me that though he was always left-handed, he was taught to write with his right hand - though he can form the letters, he could never learn to hold the pencil correctly in that hand. 'I can hold the pencil properly in my left hand, but I don't have the co-ordination to write,' he told me. 'It looks like I'm holding the pencil properly, but I am unable to make any letters.'