Kevin Leehey M.D. Child, Adolescent, and Adult Psychiatry Board Certified

1. Kevin Leehey M.D.Child, Adolescent, and Adult PsychiatryBoard Certified 296-4280 leeheymd.com

2. Salpointe Catholic High SchoolCommunity of Concern What’s Brain Got To Do With It ? leeheymd.com

3. Nature vs. Nurture • Nature means biology, inheritance, genetics. • Nurture means environment, experiences. • Color perception is almost purely genetic. • Ability to learn language is genetic. But what language we learn is purely environmental. • Neither controls how we turn out in life. It’s both, the interaction of nature and nurture.

4. The brain develops at a different rate than the rest of the body. • Brain development allows physical, intellectual, emotional, moral, and spiritual development to occur. • The brain (biology, nature, genetics, inheritance) must interact with and be shaped by environment (experiences, nurture, parenting) to develop normally. • Understanding the process of brain (and body) development clarifies the need for parenting.

5. Brain Development • If a child is not played with, interacted with, nurtured, exposed to stimuli, or is rarely touched he/she will develop a 25% smaller brain. • Experiences shape and reshape the structure of the brain.

6. By the time a child is 6, his or her brain is 90 to 95 % of adult size. • Between age 6 and 12 neurons grow bushier by each neuron adding dozens of connections based on what is reinforced by learning and experience. • This is why such things as learning a second language, riding a bike, swimming, learning to play a piano, or to throw a ball are easier when young and can last a lifetime.

7. Neuron connections peak at 11 in girls and 12 to 13 in boys. • Unused connections are further pruned out in the teen years at the same time the white matter protective coating around neurons called Myelin Sheath cells increase. • The brain is becoming more efficient but also losing its raw potential for learning and ability to recover from trauma, drugs, alcohol, or injury.

8. Synapses that are used often are kept and reinforced. • Those that are not used are lost. • How you spend your time and the experiences you have or don’t have are critical.

9. The part of the brain that makes teens responsible is still under construction. • Brain development proceeds from back to front and bottom to top. • The Frontal Lobe, which controls impulses, motivation, and judgement is the last to develop. • Teen’s inconsistent Melatonin production contributes to irregular sleep patterns.

10. Phineas Gage On 9/3/1848 at age 26, a 13 lb 3.5 feet long tamping iron blasted through his left ventromedial prefrontal lobe. He lived 12 more years but “Gage was no longer Gage”

11. A Neural Signature for DyslexiaUnderactivation of Neural Systems in the Back of the Brain Source: Shaywitz – Overcoming Dyslexia

15. Thus you must parent. • You are the most powerful and important environmental (“nurture”) force. • Remember it’s the interaction between nature (biology) and nurture (environment) that determines the outcome.

16. Parenting is the structure, limits, direction, supervision, encouragement, rewards, praise, and consequences you do to optimally develop your youth’s brain. • Parenting is your provision of the needed external controls and experiences to develop your child/teen’s character. • Parenting is “hands on” thru 11-13, “hands around” thru 17-19, “hands under” thru 18-25, then “hands off”. • Parenting is based on developmental needs. • Parenting is thus the building of character, instilling values and self discipline, and teaching independent living skills.

17. The teen brain is more vulnerable to the stimulating, damaging, and addicting effects of nicotine, alcohol, and other drugs. • One in three teens who start smoking as a teen will die of a tobacco related disease. • 90% of adult smokers began as teens. • Almost 45% of kids who start drinking alcohol by 13 will become alcoholic, while only 10% of those who wait till 21 will. • Substance use in youth thus becomes hard wired in as a tendency for life. This is in addition to any genetic predisposition.

18. Healthy Subject watching video of using Substance abuser in remission watching video of using

19. Bad things can happen to Good kids • Typically people don’t say, “I think I’ll get a DUI and ruin lots of lives today.” • No one says or thinks, “Gee, today I’m gonna drink, smoke, or use a drug so I can become an alcoholic or addict.”

20. Causes of death ages 15-24 : • Accidents -primarily motor vehicle, many are substance impaired. • Suicide • Homicide These 3 account for 75% of all deaths in our kids. Suicide and homicide are mostly by guns and many are substance impaired.

21. Suicide Rate for Age Group 15-19 by Year AACAP NEWS

22. 2010 - 11 Update • Teen use of methamphetamine, alcohol, ecstasy, cocaine, cigarettes are slightly down • Teen cigarette use is dropping below 25% toward adult rate of 20%; 365 colleges banned cigs totally • Abuse of prescription meds are increasing • Teens #1 alcohol, #2 marijuana, #3 cigarettes, “pills”= opiates, benzos, stimulants, DXM, Soma • College – alcohol, “weed”, cigs, Adderall, “pills” • Approval of marijuana is increasing – sign of use going up. “Medical marijuana” and decriminalization

23. Safer cars; more opiates abuse Drug related death rate doubled in 10 years. 8 states 2004; 12 in ‘05; 16 in ’06; ? now Opiates (Vicodin, Oxycontin, oxy and hydrocodone, methadone, heroin), Cocaine MA, NH, RI, CT, NY, NJ, MD, PA, OH, MI, IL, CO, NV,OR, UT, WA Drugs now kill more people than cars do in 16 states.

24. Actual Causes of Preventable Deaths

25. Opiates and more… • Vicodin, Percodan, Percocet, methadone, oxycontin • Oxycontin 50 cents to $1/ mg • HEROIN - smoked, foil, $40/gram, IV • Benzos – Xanax “bars”, Klonopin, Ativan, Valium • Sleeping pills - Ambien • “Triple C’s”, “DXM”, Robitussin, dextromethorphan • Spice, K-2, Salvia, Head and Smoke shops; fake urine • ADHD medicine abuse, stimulants like Adderall • Meth, Crystal, methamphetamine • Soma, muscle relaxers • Ecstasy, “club drugs”, hallucinogens, PCP, Inhalants • Hookah, Shisha do contain nicotine • energy drinks – caffeine, guarana, taurine, Four Loco

26. Tobacco kills more than all drugs and alcohol together. • Youth drink to get drunk - binge on as much as possible as fast as possible. Drinking games. • 60% HS seniors have had intercourse. • >50% HS seniors drink regularly. • 25% HS seniors smoke cigarettes. • 33% HS seniors use other drugs • 60% teens will try other drugs by end of HS

27. Parenting Tips • Don’t leave town and leave your teen home alone. Don’t rent hotel rooms, etc for kids. • Cell phones make “flash” parties possible. • Don’t trust sleepovers and campouts. • Call other parents. • If you’re the host check what’s up. • Have your teen wake you up when they come home. Talk to them, get close. • Seat belts, air bags, slower speeds, less passengers, home before midnight, and safer cars save lives.

28. Parenting Tips II : • Teen’s main source for alcohol and prescription medicines to abuse is your and their friends’ homes. • 2% of us over age 40 smoke marijuana daily. • Teens know homes where parents allow or give alcohol, “weed”, other drugs, or sex to your kids. • If you want your kids to come out of their rooms keep the electronics out. • Internet and gaming are best monitored out of their bedrooms.

29. Parenting Tips III • Social networking (Facebook, MySpace, Twitter, YouTube, etc) is here to stay. Check, know passwords, teach what’s OK, not OK, why. • High schools now require internet, word processing. College requires even more. Ensure they learn now – with supervision. • Offer a phone, computer, gaming with features that fit the age and developmental level of your child or teen. Increase with age and trust. Agree on a plan of you checking for appropriate use. • You can control calling, texting, internet use, hours, phone numbers allowed and banned – all of it. All cell companies have these controls – use them.

30. Parenting Tips IV • YOU are your child’s + teen’s #1 influence ! • If they see you drunk/impaired/partying they are 33% more likely to drink or use. • If you say, imply, or even think it’s OK or inevitable that they’ll drink or use, then they are 10X more likely to do so. • If you repeatedly (not nag) tell them not to, then they are 10X less likely to drink or use. • Say “No”, Don’t try to be the “Cool” parents, and don’t try to be your kids’ “Best Friends” ! • Read the C of C booklet - it’s very useful !

31. Thank you and good luck… Kevin Leehey M.D. leeheymd.com 296-4280