Beyond Words: How Autistic Children Communicate

Trisha Van Berkel described her disorder in the following way: "Autism is about having a pure heart and being very sensitive....It is about finding a way to survive in an overwhelming, confusing world...It is about developing differently, in a different pace and with different leaps." This week, I hope to dwell further into the question of how music therapy helps autistic individuals make sense of the world. Although some researchers remain skeptical about the healing power of music, therapists are thoroughly convinced that music serves as a unique channel of communication for autistic children who lack the ability to express their emotions through words or actions. In my exploration of the blogosphere, I encountered a touching account of the success of music therapy in an article by Jean Hwang, a writer for the Miami Herald. The blog entry, titled “Music Gets Backing for Addressing Autism,” details the dramatic impact of this treatment on young patients' lives. As an avid proponent for the use of music therapy, I also decided to share about this topic on a prominent autism blog in response to an entry titled “Expressive Communication in Children with Severe Autism” in which Nestor L. Lopez-Duran discusses recent findings that children with severe autism respond best to simple verbal commands in a classroom. My comments could be viewed on the authors’ respective blogs as well as in the following paragraphs.

“Music Gets Backing for Addressing Autism”
Comment

Thank you for your insightful entry on the topic of music therapy for autistic children. In a recent post on my own blog, I explored the benefits of music on emotional health through the unique perspective of how music benefits autistic patients. After considering several scientific publications about the merits of this treatment, it is refreshing and convincing to read a real-life testimony about the impact of music therapy on patients' lives. I particularly enjoyed the narrative about how Janna’s mother succeeded in teaching basic survival skills to her autistic daughter by singing instructions. In your entry, you explained that “music gives structure and a predictable rhythm to verbal directions.” As a violinist myself, I often perceive music as a constantly changing and morphing set of sounds, but your idea helped me realize that music is made up of elementary building blocks in the same way that a logical story is written with hundreds of words. I am delighted that musical therapists recognized this structural property of music and applied it to non-music-related fields such as medicine.

In your description of a typical session of music therapy, I noticed two instances when students responded negatively to sound. In the first instance, a 16-year-old had to wear headphones because of his auditory sensitivities. Although you did not specify the reason for why the second student "seemed pained by the therapy session," I assume that he/she was also unable to tolerate music. According to John Foley, who has been working as a music therapist for over ten years, "the world is a chaotic place, full of overwhelming levels of sensory input [, for people with autism]." Hypersensitivity to sound is a very common symptom of Autism, therefore I wonder how many children are unable to benefit from music therapy for this reason. Since some children are only sensitive to certain types of sound (pictured right), personalized music therapy may be an option for them. Do you think educational institutions and child development centers should be responsible for providing individual sessions to children who do not benefit from group therapy? I worry that clients with more severe autism and hypersensitivity to sound fail to benefit from, and perhaps suffer unnecessarily as a result of participation in music therapy.

““Expressive Communication in Children with Severe Autism”
Comment

Thank you for drawing attention to the issue that “children with severe autism are underrepresented in today’s published research.” As I scoured the internet for information on music therapy and autism while writing a recent post on my own blog, I also noticed that most published research articles involve participants with mild or high functioning autism. I applaud your decision to present studies of low functioning autism on your blog. I especially enjoyed reading your summary of Hsu-Min Chiang’s naturalistic observation of expressive communication among kids with severe autism. I think your blog is powerful because it conveys the main ideas from scientific experiments in a way that does not intimidate the general population. In response to Chaing's findings, I was surprised that teachers’ physical prompts did not seem to be as effective as verbal prompts. His results contradicted an earlier study which indicated that autistic children prefer signing to speaking because they are able to reproduce movements accurately. The study explained that instructors often prefer to teach signs (pictured below) because "signs are promptable - they can be physically guided - whereas it is not really possible to force a child to speak even with sophisticated speech therapy." What are your thoughts about the discrepancy between the two research studies? Do you support Chiang's suggestion that speech, or verbal prompts, are more effective than physical prompts? Do you have a theory as to why physical prompts are not as effective? I think part of the answer is that autistic children may be oversensitive to touch and therefore they may discourage this form of communication by not responding to it. Alternatively, perhaps their hypersensitivity to touch simply prevents them from responding rationally to physical prompts.

Have you ever heard of music therapy for autistic children? As I mentioned earlier, I did some research on this topic and gathered strong evidence that supports the efficacy of this type of treatment. Music therapists often provide instructions to patients in the form of singing. Research suggests that music therapy may help children with autistic spectrum disorder improve their communicative skills. Do you think this type of communication is more potent than verbal prompts in the Chiang study? I think verbal instructions should be presented in musical forms to maximize response from autistic children. I admire your decision to disseminate the latest scientific findings related to autism spectrum disorders to parents, teachers, and clinicians through your blog. I would like to refer you to a recently published article that discusses the benefits of music for autistic patients as well as the general population. I hope you will consider sharing it with your blog readers.

A Whole New World: Music Therapy as an Intervention for Autism

Music therapist Dr. Deforia Lane once said, "Music has the power to move a person between different realities: from a broken body into a soaring spirit, from a broken heart into the connection of shared love, from death into the memory and movement of life." Since April is Autism Awareness Month, I decided to explore the positive effect of music on emotional health through the perspective of music therapy as an intervention for autistic patients who are incapable of effectively communicating and interacting with others. Finding ways to alleviate the symptoms of autism is a top priority among researchers because it is the fastest-growing developmental disability in the U.S., affecting one in 150 children; a child is diagnosed with this disorder every twenty minutes. Evidence shows that music serves as a unique channel of communication for autistic children who lack the ability to express their emotions through words or actions, but some patients must overcome special challenges when encountering music. According to Linda Brandenburg, the director of school autism services at Kennedy Krieger, "some students are sensitive to sirens and vacuums; some are sensitive to music, to specific instruments or the frequency of the instrument." Despite its limitations, this therapy has yielded positive results and educators across the nation are making music an integral part of programs for children with autism.

Richard Ashley, associate professor of music cognition, confirmed that “musicians demonstrate greater sensitivity to the nuances of emotion in speech.” Ashley’s latest study, which was published in the latest issue of the European Journal of Neuroscience, found that those with many years of musical experience are able to perceive and distinguish emotion in sounds after hearing them for only 50 milliseconds. Study participants were asked to watch a subtitled nature film that kept them distracted as they heard a 250-millisecond fragment of a distressed baby’s cry through earphones. Measurements indicated that musicians’ brains responded more quickly and accurately to sounds than those of non-musicians. Since the acoustic elements that musicians process more efficiently are the very same ones that children with language disorders, such as autism, have problems encoding, Strait (a doctoral student in the Henry and Leigh Bienen School of Music and a researcher in the Auditory Neuroscience Laboratory who worked with Ashley) suggested musical training as a method to enhance emotion perception in the autistic population. Strait's theory is important because an improved ability to feel and understand others' emotions ultimately leads to more effective communication between an autistic individual and the outside world.

Music therapy (pictured above) is defined as “the clinical and evidence-based use of music to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program." It may include listening or creating music, playing instruments, moving to melodies, or singing. Treatment is based on the understanding that everyone has an innate responsiveness to music that transcends the physical, cognitive or emotional limitations of those who experience difficulties with affective perception/expression and communication. The therapist uses instruments or voice to "converse" with patients. This intervention enriches emotional perception by using different music genres to elicit experience of a wide range of feelings and stimulates more meaningful communication between participants and therapists because music-making involves many of the fundamental elements of social interaction, most notably self-awareness and the concept of “self in relation to another”. Increased self-awareness/self-other awareness enables participants to initiate more open social interactions in settings inside as well as outside the classroom. In a review of its effects for individuals with autism spectrum disorder, Gold, Wigram and Elefant concluded that this therapy may help clients improve their interpersonal skills. For example, improvising offers a creative means of expressing thoughts and feelings. It is non-judgmental, easily approached, and requires no previous musical training. Professionals believe that "where words fail or emotions are too hard to express, music can fill the void." Controlled research studies such as those by Edgerton and Aldridge, Gustorff and Neugebauer, confirmed that improvisation can increase the communicative behavior of children with autism.

The power of music entails emotional arousal and functions as a powerful form of communication. We value this form of art because of its ability to move us, to induce feelings and moods, and to alter our states of mind. Oliver Sacks, a clinical professor of neurology at the Albert Einstein College of Medicine in New York wrote that "therapeutically, this power can be very striking in people with autism who may otherwise have little access to strong emotional states." Crucially, music therapy has the potential to alleviate autism symptoms by enhancing patients' emotive perception and subsequently widening their channel of communication with therapists, peers, and family members. It is hard to believe that a few touches on the piano or utterances from the mouth could have such a profound impact on one's well-being, but the efficacy of this intervention is supported by strong empirical evidence as well as personal accounts of its life-changing results. Simpson, mother of fifteen-year-old Janna who has a speech impairment, autism, and a seizure disorder, explains that ''latitude, longitude, looking through a microscope: Such skills are not important [... Janna] needs basic skills to live, such as brushing her teeth, taking a bath, the pragmatics of engaging with people. This is a difficult thing to teach.'' Fortunately, music therapy has served as a useful tool for many caring therapists and loving mother alike.

Petsmart: Health Benefits of Pet Ownership

When Marjorie Smith (pictured left) walked into the Idaho Humane Society in Boise several years ago, the 72-year-old was struggling with the recent loss of her son and the 9-11 tragedy. Today, Smith is a firm believer in the power of pet companionship and claims that "[Gus, her adopted dog,] has changed [her life] completely. [She is] sure he has added years to [her] life. [She has] found that adopting a pet can help a person after a death of a loved one.” Kelly Connolly, issues specialist for companion animals in the Humane Society of the United States, suggested that animals’ unconditional love and commitment to their owners is almost like free therapy. Could pet therapy be the solution to one of America's most imminent problems? As I argued in my previous post, America’s health care system simply cannot afford to provide full-time care for an increasing number of senior citizen (aging baby boomers) with age-related mental health problem. This week, I presented medical evidence for pets’ positive impact on their owners’ mental well-being to support my affirmative answer to the rhetorical question posted in the title of Alicia Spark’s blog by Psych Central blog: “Could A Dog Benefit Your Mental Health?”. Furthermore, I discussed the physical benefits of pet ownership in response to a blog entry titled "Pets Good for Mental, Physical Health" by Barb Berggoetz, a writer for the Detroit Free Press. My goal for commenting on the above posts is to familiarize individuals with the benefits of with pet companionship. Given that 3-4 million cats and dogs are euthanized by shelters each year due to lack of adopters, I urge everyone to consider the advantages of adopting a pet from a local animal shelter. My comments are posted below for convenience.

“Could A Dog Benefit Your Mental Health?”
Comment

I commend you for composing a coherent and insightful blog entry that supplicates readers to think carefully before adopting a pet. I am an avid proponent for animal adoption, but I agree with you that “animals aren’t toys, and if you can’t dedicate a significant amount of time to taking care of a pooch, you shouldn’t get one.” As an experienced dog owner, I could easily relate to your joys and miseries that accompanied the experience of raising your dog. Although I was very young when my parents brought home a puppy, I believe my parents experienced some concern (which you cleverly termed “canine postpartum depression) after seeing a big hole in the wall created by our new puppy. Thank you for your precaution to potential animal adopters. As I mentioned in my most recent blog entry, many animal shelters are struggling to cope with the 6-8 million cats and dogs that are abandoned each year. It is certainly important to encourage pet adoption by increasing awareness about the advantages of pet ownership, but adopted pets will only end up back in shelters if their adopters are not financially, psychologically, and physically prepared to care for their new companions.

In the remainder of this comment, I hope to provide your readers with a brief synopsis of mental health benefits associated with caring for companion animals. Your link to dog rescuer and trainer Silvia Jay’s blog post titled “Dog Ownership and Mental Illness” is crucial for dispelling the false belief that people with mental illness cannot be good pet owners. Jay’s story about her mentally disable friend who “belongs in the top 1% of amazingly caring and responsible dog owners” is a powerful testament to the competency of pet owners who suffer from mental illnesses such as depression. Further research into this subject brought me to the conclusion that animals make an equally significant contribution to the lives of their mentally ill caretakers. According to Dr. Aaron Katcher of the University of Pennsylvania and Dr. Patricia Gosner of the University of Southern Alabama, animals offer social and emotional benefits to those with mental illnesses. In fact, the Americans With Disabilities Act provides guidelines for training service dogs to mitigate certain mental impairments such as Panic Disorder, Post Traumatic Stress Syndrome (PTSD), and depression. For example, service dogs use their bodies to maintain distance between masters with panic disorder and anyone who may wish to approach them. Since panic disorder patients often react strongly when another person comes too close to them in crowded areas, they cannot accomplish tasks such as shopping on their own or riding on public transportation without the help of their canine companions. Studies on the mental benefits of pet companionship can also be generalized to “normal” individuals who suffer from negative emotions such as stress or anxiety. Researchers have known for a long time that attachment to a pet could combat depression among older persons in situations of personal stress (such as death of a spouse). As another example, a news article by Barry Serafin from ABC News described the role of specially trained therapy dogs as “counselors who never [said] a word” to those who lost loved ones in the 9-11 tragedy. From examining past and present scientific documentation as well as personal testimonies, it is clear that a pet could offer many mental benefits to its loving and responsible owner.

"Pets Good for Mental, Physical Health"
Comment

Your narrative about Gwen Dubay’s experience with her dogs (pictured below) effectively captivates the reader's attention and brought up some interesting questions in my mind. Do the physical benefits associated with dog ownership exist even for owners who do not have time for a five-mile walk with their dogs everyday? In your blog entry, you wrote “studies have shown that pet owners have lower blood pressure, cholesterol and triglyceride levels, less stress, fewer minor health problems, better psychological well-being, better longevity after heart attacks and less depression and loneliness.” Which ones of these benefits are directly correlated to caring for pets rather than increased motivation to walk (with pets) regularly? Since only dogs need to be walked, do you think dogs benefit their owners more than cats from a health perspective? Your examples of how different individuals have physically profitted from relationships with their pets provide readers with a clear understanding about the topic of your entry. Although you briefly mentioned findings from previous research, I believe you can increase the credibility of your entry by incorporating more detailed descriptions of the actual experiments done by researchers. In the following paragraph, I hope to share about a study suggesting that pet therapy lowers blood pressure naturally.

As you stated, several studies have shown the relationship between physical health (such as lower blood pressure) and pet ownership. One experiment randomly assigned forty-eight New York stock brokers with hypertension to one of two treatments: ACE inhibitor therapy and pet therapy with either a cat or dog. During periods of high stress, those who acquired pets had significantly lower blood pressure than participants assigned to receive ACE inhibitor therapy. Researchers attributed the positive results of pet therapy to social support offered by the cat or dog. I think this study provides convincing evidence for your blog entry because it differentiated between standard hypertension treatments and pet therapy. While the costs of both treatments may cost the same in the end (considering the price of pet care supplies and hypertension medicine), pet therapy seems to be more beneficial not only because it keeps blood pressure low during periods of high stress, but also because owning a pet has so many other physical and mental benefits. I hope this comment could help you realize the importance of critically analyzing experimental findings and using them to support your arguments. Thank you for your post and I look forward to hearing from you soon.

Get Smart: Fitness Improves Spatial Memory

Do brilliant scientists such as Albert Einstein have a bigger brain than the average human being? Conversely, do students who perform poorly on intelligence tests have a smaller brain than those with remarkably high scores? Neuroscientists suggest that individuals with bigger brains are not necessarily smarter, but several studies have indicated the size of the hippocampus (the part of the brain responsible for memory formation) as a robust predictor of memory performance. In other words, having a bigger hippocampus (pictured below) is indeed better. Previous experiments have identified memorizing geographical information and studying for finals as examples of activities that increase hippocampus size, but these findings have limited applications to the real world. Although memory loss and other natural aging processes are largely unavoidable, evidence from recent developments in health care research signify physical exercise’s crucial role in enlarging the hippocampus and thereby counteracting cognitive decline that is detrimental to elderly individuals' independent lifestyles.

The scientific community has generated several ideas about how to enhance memory formation, but many of these suggestions lack practicality and applicability. For example, a study found that London taxi drivers have bigger hippocampi than control subjects because their profession involves memorizing the locations of major streets in London. Despite this confirmation of the hippocampus’ role in spatial memory, or the storage of information regarding the location of physical objects in space, most individuals do not have the time or motivation to memorize maps of London or other major cities solely for the purpose of improving spatial memory or enlarging their hippocampi. This gap between scientific research and reality was also manifested in findings that German medical students' hippocampi increased in size as they studied for final exams. Gray matter in the posterior hippocampus increased consistently during and even three months after the learning period. Since I was unable to retrieve the original publication of this study, I could not ascertain the primary factor underlying this change in the hippocampus. However, I did come up with several possible explanations for this phenomenon. Perhaps hippocampal size increases when extra mental effort is required for a task such as studying. Alternately, hippocampal size increase may be dependent on the type of information studied (medicine in this case). Even though the investigation provided evidence for the benefits of testing procedures (finals) in the education system, it is irrelevant to individuals who are no longer in school, most notably the elderly population. Like the taxi driver study, it did not offer any viable solutions for resisting age-related memory decline in the elderly population.

Undoubtedly, there is a large proportion of seniors who live independently despite the inconvenience caused by reduced memory capacities and other cognitive problems. So why should researchers help this population maintain mental competency by proposing new ways to improve memory? According to a researcher who published a paper in the most current issue of the journal Hippocampus, impairment of spatial memory "is one of a number of reasons why older people end up losing their independence." Furthermore, statistics from the American Psychiatric Association show that fifteen to twenty-five percent of elderly people in the United States suffer from significant symptoms of mental illness. If this pattern persists, our health care system must prepare to provide support for at least 18 million of the 72 million American baby boomers who are expected to turn 65 over the next two decades. Since our health care system is already struggling with the number of elderly patients with cognitive degeneration, it is imperative for researchers and physicians to educate the aging population about ways to protect themselves. America's health care system cannot cope with a dramatic increase in the number of elderly patients who require long-term, full time care as a result of severe or even moderate mental decline.

Until recently, most people believed that the intrinsic properties of our brains remain unalterable after birth; we can accumulate knowledge, but we cannot improve our intelligence or our performance on IQ tests no matter how hard we try. Contrary to conventional wisdom, new evidence suggests that physical exercise can alter specific brain region, thus leading to radical improvements in cognitive function. For example, a 2006 study in the Journal of Aging and Physical Activity found that strength training (pictured above) increased participants' working memory span. The higher the level of resistance, the bigger the improvement in short-term memory. At McGill University in Montreal, scholars concluded that participants, ages 62 to 90, who danced two hours twice a week for 10 weeks improved in balance, posture and motor coordination, as well as cognition. Recent experimental data proposed exercise as the most effective way to increase hippocampus size and subsequently improve spatial memory. Researchers discovered that elderly individuals who are physically fit retain key regions of their brain involved in learning and memory. Even though natural aging processes are largely unavoidable, physical exercise is the best way to counteract physical and cognitive decline due to brain volume shrinkage (which begins at a rate of 1% every year after age 65). It also has many physical health benefits as discussed in my previous posts. Crucially, this activity could be accomplished without expensive equipment and could be done virtually anywhere at anytime.

Individuals with impaired cognitive abilities simply cannot live independently and consequently rely on health care professionals for their daily needs. According to the American Geriatrics Society, "mental illnesses, including depression, paranoia, and dementias, such as Alzheimer's disease, are clearly among the most physically, emotionally, and economically devastating illnesses that commonly affect elderly persons. By some accounts, over $15 billion a year are spent on the care of victims of dementias alone." Even though President Obama promises to lower health care costs and make health insurance affordable and accessible to all, his plan does not involve increasing the number of health care providers. As mentioned above, the United States government would have to provide for 18 million baby boomers with significant symptoms of mental illness (within the next two decades) if the current trend continues. Logically, the only way to cater to the increased needs of dependent patients is to sacrifice quality of health care available to each patient. In closing, I strongly urge the government and physicians to promote consistent participation in physical activities because exercise effectively prevents or delays the onset of multiple age-related physical and mental disorders.

Just Keep Walking: Health Benefits of Cardiovascular Exercise

In my previous post, I evaluated the feasibility of using the Wii as a substitute for more traditional forms of exercise. Statistics from the scientific literature clearly indicate that playing authentic sports burns significantly more calories than playing Wii sports. Furthermore, research suggests that participation in actual sports offers more long-term health benefits such as cardiovascular endurance, which is preventative against diseases including diabetes and stroke. This week, I wish to address the issue of cardiovascular health by critically examining and commenting on two fitness-related blog posts: "Take the Stairs" by Women's Health magazine and "Cardio-Why You Should Trash the Treadmill" on That’s Fit.com. The first post effectively alerts readers about a simple way to improve their fitness without sacrificing too much time, which is an increasingly valuable commodity in today’s industrialized society. Although the author's claim about the health benefits of climbing stairs is unquestionably true, I questioned her choice of evidence and suggested additional references that could strengthen her claim. I also had the opportunity to comment on the significance of this post in relation to the rising prevalence of type II diabetes worldwide.In contrast to the first post, the second post contained a more opiniated discussion about the possibility of using weight training as a substitute for cardiovascular exercise. I was impressed with the level of interaction between the author of this blog (a professional fitness trainer) and visitors to the blog. My response to the post callenged some of the author's statements and addressed some of the comments posted by other bloggers. Given the accessibility of the World Wide Web, especially in industrialized countries, individuals who previously avoided exercise due to their dislike for cardiovascular activities can now learn about alternative exercise routines that they could consider. I commend both bloggers for sharing new ideas about how to maximize health benefits by making wise decisions about our lifestyles. Their advice is a valuable resource in today's world where more and more individuals are struggling with lack of exercising time and consequently becoming unfortunate victims of life-threatening and life-altering cardiovascular diseases. My responses to both posts can be found below and at the respective sites.

"Take the Stairs"
Comment

Your brief entry effectively conveys the multiple health benefits associated with taking the stairs. I am curious about your reference to the study in the European Heart Journal. Although the sample of sixty-nine hospital employees seems appropriate to the scope of this study, is it fair to generalize the results from this study to your blog readers who may work in an entirely different setting? In addiiton, I hope that you could consider posting a link to the article for those of us who wish to read it in more details. As an avid participant in fitness training with an educational background in the sciences, I hope to suggest additional sources that could provide your blog readers with a more comprehensive understanding of the health benefits of walking or taking the stairs.

My research on this topic resulted in the realization that climbing downstairs have different health benefits than climbing upstairs. Dr. Heinz Drexel of the Academic Teaching Hospital of Feldkirch, Austria, researched the effects of uphill and downhill hiking on forty-five health individuals who normally exercised very little. For the study, the participants took three to five hour-long hikes each week. For two months they hiked uphill and rode the ski lift down. The next two months they took the lift up and hiked down. While uphill hiking increased the proportion of "good cholesterol" or HDL, downhill hiking removed blood sugars and improved glucose tolerance. Dr. Gerald Fletcher, a cardiologist at the Mayo Clinic, commented that downhill hiking may be a very suitable form of exercise for diabetics since it lowers blood sugar levels and demands less exertion than many other types of aerobic exercises. Moreover, downhill hiking helps reduce the risk for developing type 2 diabetes. These findings could readily be applied to real life settings such as offices with stairs; those who are incapable of climbing up the stairs could still benefit by taking the elevator up and then climbing down the stairs. Additional benefits associated with stair climbing includes a lower risk of mortality from cardiovascular disease, weight loss, higher bone density in post-menopausal women, and increased leg power (which may reduce the risk of injury from falls in the elderly population). However, climbing stairs also increases the risk of injury from falls and may not be suitable for all individuals. Therefore, you might consider ending your post with a precaution about possible health risks associated with climbing stairs. I commend you for reminding your readers about the benefits of climbing stairs and sincerely hope that the additional information provided above will further motivate your blog's visitors, especially diabetics, to live healthier lives.

"Cardio-Why You Should Trash the Treadmill"
Comment

Thank you for your thought-provoking post about the option of substituting cardio workouts with weight training. I support your choice to continue doing cardio workouts because I am skeptical about the generalizability of Nicholas’ results from exclusive weight training. Could females who weigh as much as Nicholas burn the same amount of calories by following his weight training routine? Does this method yield favorable results for everyone? You cited the statistic that “For every pound of lean muscle mass your body has, your calories burned per day increases by about 50.” According to my research, women typically burn less calories than men when performing equivalent exercise since men tend to have more muscle mass. Furthermore, people who weigh more can burn calories at a higher rate than those who weigh less. For instance, if a person weighing 200 pounds swims freestyle at moderate speed for 30 minutes, he or she will burn about 330 calories. Whereas, if a person weighing 140 pounds does the same exercise, he or she will burn only about 230 calories. Thus, it seems dangerous to presume that everyone can achieve Nick’s results by exclusive weight training. In addition, I think it is wise to remind your female blog readers that weight training will result in additional gain of lean muscle, which may balance out the weight loss from additional calorie burned as a result of weight training.
I also appreciate your reasoning for not “ditching [your] cardio workouts." The mental benefits of cardio are often overlooked as we concentrate on finding the fastest way to lose weight. Aerobic exercise produces endorphins, which are brain chemicals that essentially make us “happier” and help us cope with stressful situations and pain. Moreover, aerobic exercise increases blood flow to the rest of the body, thus increasing mental acuity, cognitive ability, and stamina. In addition, several comments to your post alluded to the cardiovascular benefits that are more strongly associated with cardio than weight training. Continuous cardio for an extended period of time is more conducive to strengthening the heart muscle. Lastly, cardio seems more conducive to weight loss, which is a potent motivator for individuals to exercise regularly. Apart from aesthetic reasons, moderate weight loss is also beneficial because it decreases the risks of heart disease, high blood pressure, stroke, diabetes, and some forms of cancer. Since both types of exercise appeal to me for different reasons, I agree with the comments to your post that pose a simple solution to this dilemma by asking the question “Why can’t we simply do both?”

"Wii"view: Health Benefits of Playing Wii

A Google search for the term “Wii breaks TV” yields over two million results, including numerous videos of Wii controllers flying into large, expensive plasma TV screens. The Wii, a video game system released by Nintendo in the fall of 2006, became the first gaming console to ever reach the ten million mark in a single year. Its popularity is primarily due to cutting-edge technologies such as infrared output and motion sensors that enable gamers to manipulate Wii characters with actual physical movements. Many Wii enthusiasts claim that this breakthrough in technology, combined with the game Wii Sport or the newly released Wii Fit, allows gamers to become physically “fit” in the comforts of their own homes. Is the Wii truly a viable substitute for engaging in actual athletic activities? Does playing tennis on Wii have the same health benefits as playing tennis on an actual tennis court? More crucially, do the potential health benefits of playing Wii justify taking the risk of getting a gigantic, irreparable hole in one's new 52’’ plasma television? Please join me as I attempt to objectively answer these questions by consulting several research studies on this topic.

A study by a team of exercise scientists at the University of Wisconsin aimed to test the potential health benefits of playing Wii Sports, a game that simulates five different sports (bowling, tennis, boxing, baseball, and golf). Sixteen volunteers-eight men, eight women-were taught to play all five sports on the Wii and instructed to “simulate the body movements used in each actual sport” as opposed to using minimal body movements, which is a technique that Wii gamers often employ. During actual testing, participants played all five sports in random order while researchers recorded their heart rate and oxygen consumption at one-minute intervals. Primary results revealed that participants increased their oxygen consumption, which corresponds to the amount of calories burned, at least two to three times above their normal resting values. In order to compare the average calorie burn of playing Wii Sports to that of participating in actual sports, researchers referenced values described in McArdle, Katch and Katch’s Exercise Physiology, a standard text for caloric expenditure information (see below for comparison).

Tennis:
The real sport: 8.1 calories per minute Wii Sports: 5.3 calories per minute

Boxing:
The real sport: 10.2 calories per minute Wii Sports: 7.2 calories per minute

Golf:
The real sport: 3.9 calories per minute Wii Sports: 3.1 calories per minute

Bowling:
The real sport: 7.2 calories per minute Wii Sports: 3.5 calories per minute

Baseball:
The real sport: 7.3 calories per minute Wii Sports: 4.5 calories per minute

Analysis of results from the above study, which have been replicated in a similar study with children participants, shows that Wii Sports does not burn as many calories as playing actual sports. However, it offers more health benefits than playing more traditional hand-held video games and serves as an excellent alternative for those who do not have access to exercise facilities or those who live in environments where outdoor exercise is severely restricted by adverse weather conditions. Furthermore, the competitive nature of Wii Sports may motivate players to exercise more often and to exert more energy in pursuit of victory. For instance, playing 30 minutes of Wii Boxing burns 216 calories, which is 51 calories more than 30 minutes of brisk walking. In fact, Wii Sports’ potential weight-loss benefit is so widely accepted that it has been discussed as a feasible solution to the growing problem of child obesity. According to a MSNBC news article, the number of overweight children worldwide will increase significantly by the end of the decade. The article also predicted that nearly half of the children in North and South America will be overweight by 2010. Fortunately, encouraging findings from a report published by the Mayo Clinic suggests that children burn three times as many calories playing “active” video games rather than sedentary video games. Therefore, the Wii’s unprecedented interactivity with gamers may help decrease rates of childhood obesity and prevent obesity-induced heart disease and stroke from overwhelming the public health care system of the near future.

On further investigation, the Wii may play a significantly greater role in health-related issues than its creators originally intended. In addition to its potential to alleviate obesity problems, games such as Wii Fit may help improve balance of older people. Dr. Alison Stewart, the head of a study conducted by the University of Aberdeen, Scotland and the United Kingdom's National Health Service (NHS), expressed her concern that “'falls are the most common cause of accidental injury in older people and the most common cause of accidental deaths in 75-year-olds and over”. Since current medical fitness devices that improve balance are quite expensive and unavailable outside of the clinical setting, only a small percentage of the elderly population has access to this means of improving balance. The Wii’s comparably low cost, wide availability and high entertainment value could provide a larger percentage of the elderly population with the opportunity and motivation to improve balance and therefore decrease their risk of falling. Furthermore, compliance rates with rehabilitation programs in clinical settings may increase if therapists utilize the competitive and entertaining nature of the Wii to motivate their patients. For example, a 86-year-old Wii gamer told CNN that “[he[ always loved sports, particularly football […], but [he] had a stroke six months ago and [is] now in a wheelchair. Since the Wii [he] really feel movement in [his] right arm has improved.”

Researchers all over the world are conducting additional studies on the health benefits of Wii Sports and Wii Fit. For example, researchers in Australia believe that the Wii could offer Parkinson’s patients a safe and enjoyable way to boost their activity levels without leaving their home, or even their chair. In addition, the Wii is actually being implemented in various areas of health care. Occupational therapists are trying to use Wii Fit as a way to improve timing, coordination, and balance for sufferers of Parkinson’s disease. Rehabilitation therapists have created a therapy called “Wiihabilitation”(see left) to work on range of motion, coordination, strengthening, and stretching. Whereas Wii Sport focuses on cardio and weight loss, Wii Fit focuses on improving muscle tone and balance. Both games are valuable resources that could literally change the lives of individuals who previously lacked motivation or suitable means to exercise.

It is amazing that a video game system could offer entertainment and health benefits to gamers, solutions to health-related problems such as high obesity rates, and improvements to current methods of rehabilitation. However, one must also consider the negative health effects of playing Wii as well as health benefits that are exclusive to participation in authentic sports. From a cardiovascular health standpoint, Wii boxing is the only sport tested that would be considered intense enough to maintain or improve cardio respiratory endurance as defined by the American College of Sports Medicine. In other words, exercising with the Wii does not provide long-lasting health benefits such as cardiovascular endurance, which protect against conditions such as diabetes, stroke, osteoporosis, and certain types of cancer. Another health concern is that long hours of playing video games such as Wii Sports may result in vision problems.

Playing Wii Sports or Wii Fit (with full body movements) certainly offers more health benefits than playing sedentary video games, but participating in authentic sports is most conducive to maximizing physical fitness. Playing Wii seems to be a viable alternative to, but not a complete replacement for playing authentic sports. Nevertheless, the Wii makes exercising possible for elderly people or patients with limited mobility and accessibility to exercising facilities. The entertainment value of the Wii is a feature that distinguishes “Wiihabilitation” from more traditional physical rehabilitation programs, which are prone to low compliance rates resulting from lack of motivation. The creators of Wii definitely deserve recognition for creating an entertaining video game system that has so much potential for revolutionizing rehabilitation treatments and tackling current health-related issues such as rising obesity rates. As to the question of whether the potential health benefits of playing Wii justify taking the risk of getting a gigantic, irreparable hole in one's new 52’’ plasma television, I will leave it up to my visitors to decide.

Mental Workout: An Exercise in Locating Valuable Resources

As a novice in the blogosphere, I intend to create a dynamic blog that encourages free exchange of ideas concerning relevant and current issues in sports medicine. As shown in the cartoon to the right, not all internet sources are accurate and credible. Therefore, I hope to establish a basis for meaningful and academically driven discourse with my blog visitors by providing a list of useful and reliable resources that could stimulate fruitful discussions. My findings, as listed in the "linkroll," consist of websites and blogs that present health care news, discuss recent developments in sports medicine, and contribute information about sports psychology. The Librarians’ Internet Index directory, Google and Cuil search engines, and World News Network were most instrumental in my search for websites that will offer support for arguments that I make in future posts. The Librarians' Internet Index directory helped me locate websites of major organizations such as the U.S. Department of Health and Human Services and the National Association of Health and Fitness. Alternatively, Google and Cuil search engines enabled me to find online periodicals that provide me with peer-reviewed, scholarly research articles on sports medicine and sports psychology. Furthermore, the World News Network linked me to other news sources such as Medline Plus. Using the Webby Awards criteria, I identified websites that have thorough content, consistent structure, easy navigation, appropriate and engaging visual design, and excellent interactivity. In addition to websites, my exploration of the World Wide Web also resulted in the discovery of several high-quality blogs relating to health care. Blog engines and meta-engines, specifically Healthcare 100 and Dogpile, were particularly constructive to my quest for authoratative blogs that adhere to the IMSA criteria. All of the blogs in my linkroll are well-established and frequently updated by influential bloggers. Furthermore, they contain insightful content with substantive comments from visitors. In my opinion, medical professionals write the most insightful blogs because they incorporate their professional experience into their commentaries on selected health care issues. For example, Dr. Patrick Cohn discusses latest issues, techniques and developments in sports psychology in his blog titled Sports Psychology for Athletes, Coaches, and Parents. Other examples include KevinMD.com Medical Weblog and the Health Care Blog. According to a Chinese proverb, "learning is like rowing upstream; not to advance is to drop back." As we embark on this rowing adventure, I hope that the resources in my linkroll will empower visitors to critically evaluate and respond to my subsequent posts so that we may all advance our knowledge about sports medicine and sports psychology.