Lip and Cheek Stain

Lip and Cheek Stain

WebMD Feature

If you forget to reserve the liquid from cooking your beets, you can boil the skins that you peel from your beets.

Beets

Vodka

Cook beets as you normally would in a bit of water. Eat the beets, then reduce the leftover liquid in the pot until it thickens. Add a splash of vodka. Pour into a glass roll-on container.

(Courtesy of Béa Johnson, founder of the blog ZeroWasteHome.com)

Reviewed on November 27, 2012

© 2012 WebMD, LLC. All rights reserved.

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Herbal Vinegar Infusion

This slightly medicinal-scented herbal rinse helps to relieve an itchy scalp, remove flakes, and restore your hair’s pH balance. Try to use this blend daily until itching and flaking stops. Follow with a natural, leave-in conditioner or detangler if necessary.

2 cups distilled water

1/2 cup apple cider vinegar, raw or processed

2 tablespoons rosemary

2 tablespoons sage

1 tablespoon nettle

10 drops tea tree or rosemary (chemotype verbenon) essential oil

Recommended for: all hair types except very dry

Use: daily or as needed

Follow with: natural leave-in conditioner

Prep time: approximately 2 hours

Blending tools: strainer, spoon

Store in: plastic squeeze bottle

Yield: approximately 2.5 cups

In a small saucepan, bring the water and vinegar to just shy of boiling. Remove from heat. Add the herbs, cover, and steep for about 2 hours.

Strain, add the essential oil, stir to blend, and pour into a storage container.

No refrigeration is required if used within 2 weeks, or refrigerate for 4 weeks, then discard.

Application tips: Shampoo and condition hair or, if not shampooing, wet hair, condition, rinse, and squeeze out excess water. Shake the bottle vigorously to blend and apply approximately 1/4 cup to wet scalp and gently massage for 2 or 3 minutes. Rinse with cool water. Note: This rinse may stain light-colored towels.

(Excerpted from Organic Body Care Recipes © by Stephanie Tourles. Used with permission from Storey Publishing.)

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Sunscreen Safety: Ingredients, Labels, and More

Sunscreen Safety: What to Know

Sunscreen ingredients, labels, and more.

By Sonya Collins
WebMD Feature

Stocking up on sunscreen? We all know we’re supposed to wear it every day, rain or shine, to lower our risk of skin cancer and help prevent premature signs of aging.

But picking one can be confusing. There are different types and different ingredients, and sunscreen labels are changing.

As if that weren’t enough, you may have also heard warnings from some groups that some sunscreen ingredients are dangerous.

So what are you to make of all that? What about the risk of skin cancer? And what’s in the bottle, anyway? Here are answers.

Sunscreen Hazards

You may have heard that some sunscreens contain potentially dangerous ingredients, including the ones listed below — all of which are approved by the FDA and supported by the American Academy of Dermatology (AAD).

Retinyl Palmitate: Derived from vitamin A, retinyl palmitate is added to some sunscreens to help reduce the signs of aging. It is not a UV filter, so it’s not an essential sunscreen ingredient.

Some dermatologists feel that the research suggesting a connection between retinyl palmitate and skin cancer — in lab tests on mice — is worrisome.

“I would never use retinyl palmitate. When I give sunscreen suggestions, I always avoid the ones with retinyl palmitate,” says Debra Jaliman, MD, FAAD, assistant clinical professor of dermatology at Mount Sinai School of Medicine and the author of Skin Rules: Trade Secrets from a Top New York Dermatologist.

Some sunscreen makers are removing retinyl palmitate from their products. Only about a third of sunscreens contain it.

Other experts say the ingredient is safe.

“Those animals [in lab tests] are prone to develop skin cancer in the first place and the amount [of retinyl palmitate] they were exposed to is significantly higher than what a human would be exposed to,” says dermatologist Henry Lim, MD, former vice president of the AAD.

Vitamin A derivatives are used to treat skin cancer as well as acne. “It’s been in use for at least 30 years, and there has not been any signal to show that it would result in the development of skin cancer. Bottom line: It’s safe,” Lim says.

Oxybenzone: Oxybenzone, a common UV filter, has been shown to interact with hormones when fed to animals in large amounts. Dermatologists say this is no reason to toss your sunscreen.

“If you covered your entire body with oxybenzone in the concentrations that are in sunscreens and used it every day, it would take over 30 years to get to the point of what these rats were fed in these studies,” says dermatologist Darrell Rigel, MD, FAAD, who is a clinical professor of dermatology at New York University Langone Medical Center.

Nanoparticles: Zinc oxide and titanium dioxide offer broad-spectrum protection in what’s called “mineral sunscreens.” People who find chemical sunscreens irritating may prefer these mineral forms.

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Beauty 411: Retin-A Vs. Retinol

WebMD the Magazine – Feature

Reviewed by Emmy M. Graber, MD

What’s the difference between Retin-A and retinol?

Both are retinoids. They’re both made from vitamin A and promote faster skin cell turnover. And they’re some of the most proven, effective, and powerful options for treating skin issues ranging from acne to signs of aging.

Retinoids come in prescription form and in a range of over-the-counter products. Prescription-level retinoids fall into these groups:

  • Tretinoin, including the brands Atralin, Retin-A, Retin-A Micro, and Renova
  • Tazarotene, such as the brand Tazorac
  •  Adapalene, such as the brand Differin

All three groups prevent the buildup of dead cells in the skin’s pores and follicles, and all three promote the growth of healthy cells. Common side effects include dryness, redness, irritation, and skin peeling as well as making skin more sensitive to the sun. 

Retinol is found in many products that don’t require a prescription.  Retinols are much weaker than prescription retinoids. Unless vitamin A is listed as one of the top five ingredients and the product is packaged in an airtight opaque bottle, what you’re getting might not be all that effective.  Neither retinoids nor retinols should be used by breastfeeding or pregnant women.

Find more articles, browse back issues, and read the current issue of “ WebMD the Magazine .” 

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Depression Takes a Toll on Parkinson’s Patients

daughter consoling depressed mother

Nov. 28, 2012 — For many people with Parkinson’s disease, depression affects quality of life more than the symptoms such as shaking, according to new research.

“At least 50% of people with Parkinson’s have depression,” says Michael S. Okun, MD, national medical director of the National Parkinson Foundation and professor of neurology at the Center for Movement Disorders at the University of Florida, Gainesville.

That was a main finding of the Parkinson’s Outcomes Project, a report released today by the National Parkinson Foundation.

“The big news is how large of a role depression plays in Parkinson’s disease, how under-diagnosed and under-treated it is,” says Joyce Oberdorf, CEO and president of the foundation.

The impact of depression on the health of people with Parkinson’s is nearly twice that of movement problems, the researchers found.

About 1 million people in the U.S. and more than 4 million worldwide have the disease. It is marked by tremors and difficulty with walking, movement, and coordination.

Tracking Parkinson’s Patients

Beginning in 2009, the researchers evaluated the care of more than 5,500 patients, ages 25 to 95. They went to 20 Centers of Excellence in the U.S., Canada, Israel, and the Netherlands.

About 9,000 clinic visits were included.

The researchers looked at information about medications, referrals to specialists, and rates of depression and anxiety, among other information. The study will be ongoing.

Based on the results, the researchers made some recommendations.

Depression & Parkinson’s Disease Details

Mood disorders are common among people with Parkinson’s, the researchers found. Besides widespread depression, anxiety is common.

“We have become more acutely aware over the last few years that these non-movement factors are impacting people’s quality of life,” Okun says.

Doctors should screen people with Parkinson’s for depression at least once a year, the foundation says. Patients are encouraged to report mood changes to their doctors. Family members are also encouraged to accompany them to doctor’s visits and to discuss any changes in patients’ mood.

Treatment with medications and talk therapy, as well as getting regular exercise, can help, according to the researchers. “People’s quality of life can significantly improve,” Oberdorf says.

It’s important to realize, Oberdorf says, that the depression is part of the disease, a chemical phenomenon. “It’s not, ‘Oh, I have Parkinson’s disease and I’m depressed,'” she says.

The depression, she and others say, is related to changes inherent in the disease, such as a decline in the brain chemical dopamine. It helps control the brain’s reward and pleasure centers.

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Flame Retardant Chemicals in House Dust, Sofas

hand of person dusting table

Nov. 28, 2012 — Many people may be breathing in chemical flame retardants that are seeping from their upholstered furniture, electronics, and other common household items, a new study suggests.

Researchers from the environmental research group Silent Spring Institute found potentially unsafe levels of several flame retardants in the dust from a large percentage of the homes they examined.

House Dust Has Flame Retardants

Among the chemicals found in the highest levels in household dust were those banned from children’s pajamas in the late 1970s, largely as a result of research by University of California chemist Arlene Blum, PhD.

In a separate study, Blum and colleagues from UC Berkley and Duke University found that 85% of the sofas they tested were treated with flame retardants and the most common one was the chemical Blum identified as a carcinogen decades ago, known as chlorinated Tris.

Both studies were published today in the journal Environmental Science & Technology.

“Hard to believe, 35 years after our research contributed to removing Tris from children’s sleepwear, our current study suggests that more than a third of Americans’ couches contain the same toxic flame retardant,” she says.

Flame Retardants: Pajamas to Couches

Blum, who is 67, has had a fascinating dual career as a mountaineer and an environmental health scientist.

She was the first American woman to attempt to climb Mount Everest, and she led the first women’s climbing team up Annapurna I.

She says her battle to remove chemical flame retardants from home furnishings has been a different kind of challenge.

Three decades after chlorinated Tris was removed from children’s pajamas, Blum learned that the chemical had become one of the most widely used flame retardants in foam upholstery.

In her new study, Blum and colleagues from UC Berkley and Duke University tested 102 couches for flame retardant chemicals.

They found that 85% of the couches were treated with chemical flame retardants that had either been identified as toxic or lacked health data.

Many of the tested chemicals were linked to cancer, hormone disruption, and learning problems in earlier animal and human studies, Blum says.

In the other newly reported study, led by Silent Spring research scientist Robin E. Dodson, ScD, researchers found that dust from most of the California homes they tested in 2006 and again in 2011 had levels of at least one flame retardant chemical that exceeded federal health guidelines.

The researchers tested household dust from 16 California homes for flame retardants used in products that included home insulation, upholstered furniture, carpeting and carpet padding, children’s and baby items, and electronics.

Babies and toddlers are thought to be particularly vulnerable to toxins in household dust, Dodson says, because they crawl on floors and furniture and frequently have their hands in their mouths.

Decreased levels were found in three homes where homeowners reported remodeling, installing new flooring, or buying new furniture after 2005. The researchers note that this is most likely due to bans of some of these chemicals.

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Primary Care Physicians May Be Hard To Find By Newly Insured Patients

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Primary Care / General Practice;  Health Insurance / Medical Insurance
Article Date: 28 Nov 2012 – 1:00 PST

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Implementation of the Affordable Care Act – now assured by the re-election of President Obama – is expected to result in up to 50 million currently uninsured Americans acquiring some type of health insurance coverage. But a study by researchers at the Mongan Institute for Health Policy at Massachusetts General Hospital (MGH) finds that a significant percentage of the primary care physicians most likely to care for newly insured patients may be not be accepting new patients. The investigators note that strategies designed to increase and support these “safety-net” physicians could help ensure that newly covered patients have access to primary care.

“This study raises very serious concerns about the willingness and ability of primary care providers to cope with the increased demand for services that will result from the ACA,” says Eric G. Campbell, PhD, of the Mongan Institute, senior author of the report to be published in the American Journal of Medical Quality. “Even with insurance, it appears that many patients may find it challenging to find a physician to provide them with primary care services.”

In 2000 the Institute of Medicine published a report on the health care “safety net” – physicians and organizations caring for a significant proportion of uninsured or Medicaid-covered patients – that noted a lack of enough safety-net providers and the chronic underfunding of Medicaid. The Affordable Care Act was designed to ensure almost universal health insurance coverage, including expanding the number of individuals eligible for Medicaid. The authors of the current study note that many newly covered patients are likely to turn to physicians in the already-stressed health care safety net and that areas where such patients are likely to live often have limited primary care services. In addition, studies have suggested that physicians caring for disadvantaged groups of patients may provide lower-quality care.

The authors set out to better understand the physicians in the primary care safety net, to determine their willingness to accept new Medicaid patients and to assess their attitudes about and interest in quality improvement activities. As part of a 2009 survey of medical professionalism, physicians were asked to indicate the approximate percentage of their patients who were covered by Medicaid or were uninsured and unable to pay. They also were asked whether they were accepting new Medicaid or uninsured patients, along with several questions regarding services they provided to vulnerable populations and their attitudes towards and participation in quality improvement activities. Because of their focus on the primary care safety net, the investigators restricted their analysis to responses from internists, pediatricians and family practitioners.

Of 840 primary care physicians responding to the survey, 53 percent were safety-net providers, defined as having patient panels with more than 20 percent uninsured or Medicaid patients. Half of all responding primary care physicians indicated they were accepting new patients who either were covered by Medicaid or had no means of paying for their care. But safety-net physicians were considerably more likely to accept both patient groups, with 72 percent taking new Medicaid patients and 61 percent taking new patients with no medical coverage. There were no significant differences between the physician groups in reported attitudes about or participation in quality improvement efforts, and safety-net physicians reported greater awareness of and efforts to address disparities in health care than did non-safety-net physicians.

The authors note that the concentration of care for Medicaid and uninsured patients among a limited number of safety-net physicians and the fact that 28 and 39 percent, respectively, of those physicians are not accepting new Medicaid and uninsured patients indicate that the current health care safety net may have reached its capacity. In addition, they note, safety-net physicians’ interest in quality improvement and attention to health care disparities suggests that reported differences in the quality of care they provide probably reflect limited resources available to their practices or barriers to care within the local communities.

“We found the attitudes of safety-net primary care physicians are consistent with providing equitable, universal care, and they were almost twice as likely to look out for possible racial and ethnic disparities within their practices,” says Lenny López, MD, MPH, MDiv, of the Mongan Institute, corresponding author of the report. “We’re already aware of the need for more primary care physicians, and these results make it apparent that the need for safety-net PCPs is even more critical. We also found that safety-net physicians were more likely to be women, under-represented minorities or foreign medical graduates, so efforts to bring more such physicians into primary care, along with efforts to close the income gap between safety-net and non-safety-net PCPs, could help expand the safety net.”

López is an assistant professor and Campbell an associate professor of Medicine at Harvard Medical School. Additional co-authors of the study, which was support by the Institute on Medicine as a Profession, are Christine Vogeli, PhD, and Lisa Iezzoni, MD, Mongan Institute of Health Policy at MGH; Catherine DesRoches, PhD, Mathematica Policy Research, Princeton, N.J.; and Richard Grant, MD, Kaiser Permanente Northern California.
Massachusetts General Hospital
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Terminating Medicare Consults Linked To A Rise In Total Spending

Editor’s Choice
Main Category: Medicare / Medicaid / SCHIP
Also Included In: Health Insurance / Medical Insurance
Article Date: 27 Nov 2012 – 10:00 PST

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Terminating Medicare Consults Linked To A Rise In Total Spending

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Getting rid of payments for Medicare consultations frequently billed by specialists was seen to be connected with a new increase in spending during visits to specialists as well as primary care doctors, suggests a new study examining medicare data published in Archives of Internal Medicine.

Preceding 2010, Medicare costs for consultations were significantly greater than for office visits that were almost identical in terms of difficulty, and were frequently charged by primary care physicians (PCPs). In January of 2010, Medicare got rid of consultation payments from the Part B Physician Fee Schedule and simultaneously increased costs for office visits.

Regarding the budget, these changes would leave it unaffected since it would reduce payments to specialists but increase payments to PCPs.

A research team led by Zirui Song, Ph.D., of Harvard Medical School, Boston, analyzed the relationship of this policy with spending, capacity and coding for office visits during the initial year of the plan going into effect. Zirui and his colleagues investigated outpatient claims from 2007 to 2010 for over 2.2 million Medicare beneficiaries with Medicare Supplemental coverage via sizable employers.

The authors explained:

“Medicare’s elimination of consultations was associated with a 6.5 percent increase in overall spending for outpatient encounters in 2012. This increased spending was explained by higher fees paid for office visits and by increased intensity of coding. Our results suggest that the policy did not achieve its goal of budget neutrality in the first year. However, it did appear to narrow the gap in Medicare payments for office encounters between PCPs and specialists.”

The researchers found that an average of $10.20 extra was spent per beneficiary per quarter on physician meetings after the policy was enacted, however, the total volume of physician visits was unchanged. The rise in spending was accounted for by higher office-visit fees from the policy and a shift in the direction of higher-difficulty visits to trouble PCPs and specialists.

The authors conclude that their examination of Medicare’s termination of consultations bring about possible lessons for policymakers. Volume effects connected with fee decreases depend on the type of service.

The researchers said:

“Finally, the inherent flexibility and subjectivity of code definitions could lead to potentially undesirable coding behavior in response to fee-based policies, as numerous areas in the physician fee schedule feature a gradient of service intensities captured by a set of closely related codes.”

Written by Kelly Fitzgerald
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our medicare / medicaid / schip section for the latest news on this subject.
“Unintended Consequences of Eliminating Medicare Payments for Consultations”
Zirui Song, PhD; John Z. Ayanian, MD, MPP; Jacob Wallace, BA; Yulei He, PhD, MS; Teresa B. Gibson, PhD; Michael E. Chernew, PhD
Archives of Internal Medicine, November 2012, doi:10.1001/jamainternmed.2013.1125.
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28 Nov. 2012. <http://www.medicalnewstoday.com/articles/253263.php>


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Lower Impact Sports Better For Knees

Main Category: Arthritis / Rheumatology
Also Included In: Bones / Orthopedics
Article Date: 27 Nov 2012 – 0:00 PST

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Both very high and very low levels of physical activity can accelerate the degeneration of knee cartilage in middle-aged adults, according to a new study presented at the annual meeting of the Radiological Society of North America (RSNA).
Nearly one in every two people in the U.S. may develop knee osteoarthritis by age 85, according to the Centers for Disease Control and Prevention. By 2030, an estimated 67 million Americans over the age of 18 are projected to have physician-diagnosed arthritis.
Researchers at the University of California in San Francisco (UCSF) previously had found an association between physical activity and cartilage degeneration. But that study focused on one point in time.
For the new study, the UCSF researchers looked at changes in knee cartilage among a group of middle-aged adults over a four-year period. They used magnetic resonance imaging (MRI)-based T2 relaxation times to track the evolution of early degenerative cartilage changes in the knee.
“T2 relaxation times generated from MR images allow for analysis of the biochemical and molecular composition of cartilage,” said Wilson Lin, B.S., research fellow and medical student at UCSF. “There is increased water mobility in damaged cartilage, and increased water mobility results in increased T2 relaxation time.”
The researchers analyzed 205 patients, age 45 to 60, from the UCSF-based Osteoarthritis Initiative, a nationwide study funded by the National Institutes of Health on the prevention and treatment of knee osteoarthritis. Participants used a questionnaire to record their physical activity. The researchers measured T2 values of cartilage at the patella, femur and tibia of the right knee joint at baseline and at two- and four-year visits.
According to the results of the study, participating frequently in high-impact activities, such as running, appears associated with more degenerated cartilage and potentially a higher risk for development of osteoarthritis.
“When we compared the scores among groups, we found an accelerated progression of T2 relaxation times in those who were the most physically active,” said Thomas M. Link, M.D., professor of radiology and chief of musculoskeletal imaging at UCSF. “Those who had very low levels of activity also had accelerated progression of T2 values. This suggests that there may be an optimal level of physical activity to preserve the cartilage.”
The results open up numerous areas for future inquiry, including analysis of the impact of specific types of physical activity on knee cartilage health. For instance, some of the participants in the Osteoarthritis Initiative wore an accelerometer, a device with a motion sensor to record physical activity.

“In this study, we used the subjective measure of a questionnaire,” Lin said. “The accelerometers provide a more objective way to measure physical activity.”

Along with the findings on changes in knee cartilage, the study also highlighted the potential of T2 relaxation times as an early indicator of cartilage degeneration.

“Standard MRI shows cartilage defects that are irreversible,” Dr. Link said. “The exciting thing about the new cartilage T2 measurements is that they give us information on a biochemical level, thus potentially detecting changes at an earlier stage when they may still be reversible.”

Dr. Link noted that people who have a higher risk for osteoarthritis (such as family history of total joint replacement, obesity, history of knee injury or surgery) can reduce their risk for cartilage degeneration by maintaining a healthy weight and avoiding risky activities and strenuous, high-impact exercise.

“Lower impact sports, such as walking or swimming, are likely more beneficial than higher impact sports, such as running or tennis, in individuals at risk for osteoarthritis,” he said.

Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.
Visit our arthritis / rheumatology section for the latest news on this subject.
Coauthors are Waraporn Srikhum, M.D., Charles E. McCulloch, Ph.D., Michael Neitt, Ph.D., John Lynch, Ph.D., Gabby B. Joseph, Ph.D., and Hamza Alizai, M.D.Radiological Society of North America
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n.p. (2012, November 27). “Lower Impact Sports Better For Knees.” . Retrieved fromhttp://www.medicalnewstoday.com/releases/253186.php.

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Are Children With ADHD Gifted?

Kids with ADHD have “gifts” — and by helping them develop these gifts, parents give their children more control of problem behaviors, a child psychologist argues in her popular book.

In The Gift of ADHD, child psychologist Lara Honos-Webb, PhD, tells parents not to focus on the disturbing words “deficit” and “disorder” in their children’s ADHD diagnosis.

“I tell parents it is a brain difference, not a brain disorder,” Honos-Webb says. “Children’s sense of identity is not yet formed at the time of ADHD diagnosis. Reframing the disorder as a gift helps them define themselves by what is working, not by what isn’t working.”

What isn’t working for ADHD kids usually becomes apparent in school. Kids with ADHD have trouble sitting still. They have trouble focusing their attention on a single task. They’re given to outbursts of emotion.

Despite their challenges, Honos-Webb says, these children tend to be gifted in specific areas: creativity, exuberance, emotional expressiveness, interpersonal intuition, a special relationship with nature, and leadership.

It’s more than just a way of looking at ADHD, she says. It’s a treatment strategy that motivates ADHD kids and improves their self-esteem.

“Just by finding and focusing on gifts, people change in positive, noticeable ways,” Honos-Webb says. “You build on strengths and motivation; you give them the confidence to try harder. And the more they try, the more they can change their brains.”

Gifted or Not, Children With ADHD Suffer

Is ADHD a gift? Emory University psychologist Ann Abramowitz, PhD, doesn’t see it that way. Abramowitz, an ADHD and special education expert, directed Emory’s Center for Learning and Attention Deficit Disorders from 1989 to 2001.

“ADHD is not a gift,” she says. “If a child has ADHD symptoms but is not impaired, we don’t diagnose ADHD. So by definition, there is suffering going on.”

Abramowitz and Honos-Webb agree that ADHD too often is carelessly diagnosed, often by a child’s primary care provider under pressure from frustrated teachers and distraught parents. Since there’s no definitive test for ADHD, proper evaluation takes time, expertise, and judgment to rule out other factors that might affect a child’s behavior, such as a disruptive family situation or an unmet medical need.

Abramowitz doesn’t agree that ADHD kids are specially gifted, or that being told they have ADHD necessarily harms their self-esteem. But she does agree that it’s important to build on whatever special strengths a child with ADHD may have.

That approach makes sense to Elza Vasconcellos, MD, a pediatric neurologist at Miami Children’s Hospital. Vasconcellos treats children with ADHD — and is the mother of a child who has ADHD.

“ADHD kids have a lot of gifts and a lot of good things about them,” she says. “Many are very artistic with music, with art. They are talkative, able to multitask, and social. When I talk to parents, I try to encourage those gifts.”

On the other hand, Vasconcellos says, ADHD often makes it hard for children to use their gifts.

“With drawing, for example, some of these children cannot even focus long enough to draw a straight line,” she says. “And while they may tend to be more social, some are so impulsive other kids have trouble being around them.”

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