Child Health and Safety (124)
School starts relatively early for most school-aged kids. This often results in poor sleep and often a child may not eat breakfast. This is not an optimal start to anyone’s day. For many children it’s just something to adjust to.
For some, though, such a morning is just the start of a long and stressful day. For children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD), a night of too little sleep followed by a morning dash out the door sets the stage for a bad day.
Sitting through multiple classes struggling to focus only adds to stress. And, once the school day is complete, it is no wonder that children and adolescents are found to be more impulsive, hyperactive, and irritable than their normal, baseline behavior.
What does this all mean to parents who want to help their children?
Stress affects each individual differently, so parents, teachers and health care professionals encounter a constellation of symptoms. Some children and adolescents turn inward, isolating themselves from their families. Others turn to impulsive, risk-taking behaviors such as substance abuse, truancy and refusing to follow house rules.
All of these symptoms or behaviors can be avoided or placated with some structure for the hours after school. That is when the pent up energy and stress is likely to manifest in undesirable behaviors.
Research indicates that participation in a structured activity such as a club, sport, or exercise regimen can increase “processing speed” (the ability to interpret and encode information) and decrease cortisol levels in the body. In simple terms, that means that structured activity will help children and adolescents with ADHD reduce impulsive behaviors and irritable moods.
A secondary gain from this is at a younger age, the child or adolescent my develop an interest and pursue it further as they grow older.
Parents also should seek therapy for children with ADHD to help uncover ways to cope with everyday stressors. By identifying the stressors and developing a personalized treatment plan, the person with ADHD can address immediate issues and work their way into more structured activities.
The average summer break for middle and high school students is around three months. During that time, adolescents have no trouble developing a routine to spend time with their friends and have fun. It is at the end of the summer when parents and their children run into problems transitioning back into the normal school routine. For adolescents diagnosed with attention deficit hyperactivity disorder (ADHD), this transition is even more challenging. We do well when things are predictable – predictability pacifies our emotions and lets people anticipate anxieties and function at an optimal level – but starting a new school year is anything but predictable.
Parents usually get their children ready for a new school year with stricter curfews and earlier bedtimes, starting a week or two before school begins. This may be effective for some children, but not for adolescents with ADHD. Transitioning from the summer routine, which is relatively loose and relaxed, to a more structured schedule, coupled with the responsibilities of schoolwork and other extracurricular activities, produces anxiety. Like most people, preparation for such change is often neglected. While there is no “best” solution, there are several options that can allow for a successful transition back to school.
Stricter curfews and earlier bedtimes can be effective, but it takes more time than most parents give the ADHD-afflicted teenager Gradual Changes are to truly shake the effects of staying up later and having sleepovers with friends. It takes a day or two for the child to get used to sleeping earlier, leaving only a few days for the new sleep pattern to take hold. Gradually reducing curfew and bed times by 30 minutes to one hour for four to five weeks prior to the start of school is a much more effective intervention. This allows for a longer adjustment period for adolescents and helps them to develop behavioral habits that are conducive to a successful transition.
Parents might consider getting their children involved in sports that require them to report to school for practice and training sessions prior to the start of the school year. This has a two-fold benefit: it brings structure back into their lives and promotes socializing with peers prior to the start of the school year. Far too often, structure and socialization are overlooked in favor of academic importance. Although important, academic performance is only one piece to the puzzle for successful middle and high school careers.
These two interventions are equally effective and reduce stress on both the parents and the child. Luckily, there is plenty of time left in the summer to prepare for this transition. When school starts, less stress will be placed on the change from summer to school year, and more attention can be given to other areas of the family.
Head lice are tiny insects that live on people’s scalp and crawl into their hair. Head lice feed on human blood by biting the scalp. The problem of head lice has been around for thousands of years. Even Egyptian mummies show signs of head lice. With the exception of the common cold, head lice affect more school-aged children than all other contagious illnesses combined.
The first time your child is infested, you probably won’t know right away that something is wrong. The body’s immune system takes 4-6 weeks to develop sensitivity to the bites. During that time, a female louse can lay 6-10 nits a day. Nits take about two weeks to hatch, mature, and begin laying more eggs. By the time you find an infestation, several generations of lice may be living in your child’s hair.
You might suspect that your child has head lice if he or she:
• Complains about a tickling feeling or something moving in the hair.
• Feels itching caused by reaction to the bites.
• Is irritable.
• Has sores on the head caused by scratching.
Scratch marks on the scalp, especially behind the ears or on the nape of the neck, are a telltale sign that your child has head lice.
How Do I Get Rid of Head Lice?
Treatment is recommended if even one nit is found. Two approaches get rid of lice – removing the nits by hand with a comb and using a special shampoo. A combination of both is most effective. Ask your pharmacist, health care provider, or school nurse to show you how to comb out nits and how to treat your child’s belongings and your home.
Two types of shampoo are available without a prescription. One type uses a pesticide to kill the nits. The other uses a pesticide-free cosmetic cleanser to eliminate lice and help dissolve the glue that attaches the nit to the hair shaft. If you are not sure what treatment to choose or how to use it, ask your pharmacist or health care provider. When using any lice-removal product, always follow the directions.
Can I Keep Head Lice
From Coming Back?
Reinfestation is always possible. If the source of the original infestation is not corrected (for example, a classroom with many infested children), reinfestation is probable.
Remember that each day is a new day for the risk of a new infestation. Inspect all family members daily for at least two weeks after treatment. Notify your child’s school, camp, and child care provider if you find head lice on your child. Ask about their “nit policy” and when your child can return to the classroom. Tell other parents in your neighborhood. Although reporting an infestation may be embarrassing, it is the best way to make sure that the problem is solved at its source.
Tell your child not to share or borrow personal items such as combs, headbands, hair ribbons, scarves, hats, headphones, sports helmets, towels, blankets, and stuffed toys. Teach your child to avoid head-to-head contact with other children. Don’t store clothing (such as hats, hooded jackets, and scarves) and personal items (such as pillows, bedding, combs, brushes, and stuffed toys) where they can touch and ask that your child’s school or day care do the same. Children should not share cubbies or lockers at school.
Many times when I recommended that a child receive treatment under general anesthesia in a hospital setting, parents were puzzled and confused. When they hear the words “hospital dentistry” mentioned, some parents feel quite compelled to quickly reject the notion.
Recent reports from the American Academy of Pediatric Dentistry have indicated that over the past few years, more parents have become more comfortable and appreciative of hospital dental surgical procedures. The purpose of this article is to help parents understand hospital dentistry.
What is hospital dentistry?
It is a service that some pediatric dentists would offer their selected patients to be treated under general anesthesia in a hospital setting. This is a one-time outpatient dental surgical procedure that ranges from thirty minutes up to three hours of sedation time, depending on the severity of the child’s dental needs.
Patients who cannot be treated successfully in a dental office may benefit from or require treatment in a hospital by a pediatric dentist working in conjunction with a medical anesthesiologist. Patients that require hospital dentistry are often those children with significant medical and dental conditions.
Patients falling into these categories are young infants and children with early childhood caries (aka, nursing bottle caries), severe congenital enamel or dentin malformations (soft teeth), or children and adolescents with physical and mental health conditions. Hospital dentistry may also be offered to children who were overly apprehensive and extremely uncooperative for other reasons.
Is general anesthesia safe?
Like any other surgical procedure, there is some risk associated with general anesthesia. However, it can be used safely and effectively when administered by appropriately trained medical professionals in an appropriately equipped facility. In a hospital operating room, anesthesiologists and nurse anesthetists are trained to manage complications and will monitor your child closely.
Your child’s pediatric dentist will discuss the reasons for recommending hospital dentistry for your child and the risks and benefits of general anesthesia. As a reminder, to prevent early childhood caries that may put your child in a hospital setting for dental treatment, the American Academy of Pediatric Dentistry recommends that a child’s first dental visit should be soon after the first tooth eruption or no later than one year of age.
Kids are usually more interested in eating an item (even a healthy item) if it’s something that they’ve made themselves. Here are some tips to get your family started in the kitchen:
1. Work together to make their favorite restaurant meals from scratch. Cooking experiences make food more memorable, even if the meal is not cooked perfectly.
2. Let kids decide. Make personal pizzas on whole-wheat dough with your own homemade red sauce, and let kids choose their own toppings. Sauces are a wonderful way to use “stealth” to make sure the healthy veggies are incorporated into a diet. Carrots, red peppers, onions, and even spinach have been known to make it into pizza sauce at our house.
3. Get silly with food. Make polka dot mashed potatoes (peas mixed in with mashed potatoes) or use skewers, shape cutters and fancy toothpicks to present a visually appealing meal.
4. Think outside the box. Put the forks away for a night and eat finger foods instead. Or, bring out the chopsticks to tackle spaghetti for a night. Tired of long noodles? Try a different pasta shape with a new sauce.
5. Try a polite bite. Kids may not like everything that is served, but the rule in our house has been that they have to try a bite of everything. Try it, and they might like it. If not, there’s always yogurt in the fridge. But turning up one’s nose at what is offered for dinner is not an excuse to avoid eating a nutritious meal. Good nutrition is not negotiable.
5. Ramp up your culinary fare. Parents often make the mistake of thinking that kids have unsophisticated palates, but this is far from true. Kids like diversity and can appreciate a wide selection of foods – but only if they are offered. Parents should be prepared to vary their own diets as well, since kids often imitate what they see their parents do.
6. Don’t get discouraged. An occasional thumbs-down from the kids does not rule out a dish for life. Try again a few months later. Kids’ palates and appreciation for different foods evolve over time and change as they grow.
Is there an increase of ADHD and processing problems?
Is there an increase, at an alarming rate, of autism?
Is it ADHD or is it a trendy name: “Sensory Integration Disorder”?
Are more professionals feeling panicked and concerned about a possible epidemic?
Are parents feeling hopeless and overwhelmed?
Where is this coming from? Is it environmental or genetic or a combination of both? It is our lifestyles? Is it genetically modified foods?
More and more professionals are currently asking themselves about this ever increasing alarming societal problem noted in our children’s abilities/disabilities. Many different opinions about this matter are evolving. Many children with special learning difficulties are presenting themselves with self-regulation issues, or in layman terms, issues in regards to poor arousal, and poor attention; ranging from hyperactivity to lethargy.
Why and how is it that our children are exhibiting such a range of difficulties in a world where we can fly to the moon?
In this day and age, parental love and support is not any less than the old days. That is one thing that is constant. Our great need to better our children and their lives is so strong and obvious in our great gains in this county today.
But why isn’t our children’s development not also gaining in strength and momentum?
These are all difficult questions to answer. Treatment techniques use a combination of sensory integration and neurodevelopment theory. Sensory processing affects a child’s overall development, and a problem or difficulties with sensory integration can negatively impact a child’s development.
Sensory integration has been shown to be very beneficial and astonishing changes can be made in a child’s processing and behaviors.
Connecting the body and brain mechanisms may be one of the most important answers in our fast paced, sedentary lives in helping children and families counteract and resolve (without drugs) this seemingly out of control crisis and epidemic in the United States.
Sensory Integration Theory and Treatment, as well as Sensory Processing Disorders, are not new to the area of pediatric occupational therapy, and not new in the literature from famous and reputable neuroscientists. However, it is very new to our society in general, and to the medical community as a viable option of treatment and treatment rationale for its application to the treatment of learning and processing disorders (and possibly for ADHD as well). If interested in learning more about sensory integration disorders please go to www.sensory_processing_disorder.com.
It always seems to happen at 6 p.m. You left your happy, healthy baby at the daycare center this morning, and now you have a cranky baby with a runny nose, cough, and fever. Since your pediatrician’s office is closed for the day, you know you can either wait until morning to make an appointment or take your child to the nearest emergency room or urgent care center. But, are you overreacting?
First and foremost, it is never wrong to take your child to the emergency room or an urgent care center – that is what they are there for. Trust your parental instincts because you know in your gut when something is wrong with your kid.
Emergency rooms and urgent care facilities will provide your child with a full work-up and ease your worry about their illness.
If you decide to not immediately go to an urgent care facility and your child has a fever, rest assured that a relatively high fever in a small child is usually not harmful because raising the body’s temperature is its method of fighting off infections.
In fact, in some countries doctors do not advise using ibuprofen or acetaminophen because they want to let the fever take its course.
In the United States, most physicians advise taking antipyretics (i.e., Children’s Tylenol or Children’s Motrin), which knock down the fever. When determining the proper dose of Children’s Tylenol or Children’s Motrin for children over six months, be sure to administer the proper amount based on your child’s weight – not their age. Even a small amount under the required dosage based on weight will render the entire dose ineffective.
Here are some rules of thumb for administering Motrin:
- If your child is 22 pounds, give them 1 teaspoon.
- If your child is 33 pounds, give them 1 and 1/2 teaspoon.
- If your child is 44 pounds, give 2 teaspoons, (10 mls).
It is important to note that children under six months should not be given Motrin at home. Treatment should be discussed with your pediatrician, emergency room physician, or urgent care physician.
Asthma is the most prevalent chronic disease in children and is the number one cause of frequent school absences. As we approach the winter season, many of these children will need to visit their healthcare provider or the emergency room with an asthma flair up.
For the most part, we don’t know what causes asthma. It is a disease that can be controlled but not cured. Therefore, education is the cornerstone of successful asthma management.
Asthma is a disease that affects the airways. It has two major components. The first component is the bronchospasm that occurs when exposed to an allergen or a triggering factor. The smaller airways are lined with smooth muscles and when exposed to an allergen, these muscles contract causing narrowing of airways. This is a quick process that is usually noted by the parents as an acute onset of wheezing, coughing or shortness of breath.
The second component of asthma is the silent process caused by inflammation of airways. This is usually an ongoing process resulting in the swelling and clogging of the airways and excessive mucus production. When this process is not adequately addressed, it can lead to poorly controlled asthma and frequent exacerbation.
If your child has asthma, there are three major elements you should have a good understanding of: symptoms, triggers, and management.
Although many parents view asthma symptoms as mainly wheezing or the whistling noise heard when the child is breathing, the reality is most children possess a cough that persists for days or weeks. A majority of these children are thought to have “mild cases” of asthma and actually learn to adapt to their symptoms. These are the children who take frequent breaks during activities.
Depending on the severity, other symptoms of asthma can include shortness of breath, chest tightness, waking up with breathing problems or trouble with exercising. A quick and easy assessment of whether a child is in acute respiratory distress is to evaluate if they can talk to you in complete sentences. A child in acute respiratory distress will only speak in one or two words.
The second element is to have a good understanding of your child’s asthma triggers in order to prevent asthma attacks. There are several triggers of asthma, such as change in weather, colds and flu, seasonal allergies, exercise and chemical exposure such as smoke. As a preventative measure, all children with asthma should receive the yearly influenza vaccine.
The third component is medical management. Most parents are familiar with the management of the acute onset of the bronchospasm, which is controlled by bronchodialators or rescue medications, commonly Albuterol and Xopenex.
Children who have persistent asthma are also managed with anti-inflammatory medication to treat the quiet part of asthma. You will not see immediate changes with anti-inflammatory medication, because it takes time for the airway swelling and excessive fluid to clear up. These medications protect against the damaging effects of asthma symptoms caused by inflammation.
By using your child’s asthma medications as prescribed by your healthcare provider and routinely following up, your child can achieve an active healthy life.
Most kids love to move. All children should be encouraged to move, especially those children who are timid or uncomfortable with maneuvering their bodies. Movement classes like gymnastics can boost the skills and confidence of all ages of kids while they are having fun. In gymnastics class I often hear joyful shouts of “I can do it” as kids swing or roll or walk on the balance beam.
During my 16 years of teaching gymnastics to children I have observed many positive effects of exercise. A recent New York Times article by Gretchen Reynolds entitled Phys Ed: Can exercise make kids smarter? reports on several studies that have tracked the effects of aerobic exercise on brain development. A recent experiment at University of Illinois offers sound scientific evidence that exercise helps brain development.
All the studies discussed in the New York Times article found that physical fitness was a catalyst for brain development. In the Illinois experiment, aerobic exercise was found to increase the size of the basal ganglia area of the brain. This area aids in maintaining attention and “executive function,” both of which are of paramount importance in academic learning abilities. Difficulty with executive function is typical in children with ADHD and a host of other learning and developmental challenges. Another study of complex memory with 9 and 10 year old children showed that the more physically fit the child, the larger the hippocampus area of their brains. One study, yet to be published, showed that test scores increased following 20 minutes of running on a treadmill. However, test scores did not increase for the children in the study that played sports-style video games for an equal time and intensity.
These findings leap off the page at me in their significance. Recess and physical education programs are being cut in favor of more “academic” time or in many areas of the country, because of budget cuts. With TV, computers, and video games vying for their attention, children are increasingly sedentary. Learning issues and developmental delays are increasing in young children. This research provides scientific proof that aerobic play and physical activity are great ways to boost children’s academic achievement potential. This is great news because physical activity can be accessible and inexpensive. A walk or run in the neighborhood, riding a bike, playing at the playground: all these are kid friendly ways to boost brain power. These findings suggest that after school sports could make homework easier and keeping the body healthy can help the brain function.
Yes, respiratory season is here. Typically the transition from late summer viruses to fall and winter respiratory illnesses occurs just when the kids are back in school and the germs start circulating.
Head colds, or upper respiratory illnesses (URIs) are just that. Symptoms include bothersome sneezing/congestion, cough from postnasal drip, a scratchy throat, and maybe a low-grade fever. But typically URIs are self-limited viral infections, gone within a few days. They are usually not associated with bacterial complications like sinus infection, strep, or pneumonia and therefore do not need antibiotic coverage
The flu, or influenza, on the other hand is a serious viral infection affecting the lower respiratory tract. It has a high incidence of pneumonia and secondary serious bacterial infections are very common, and sometimes need hospitalization, or in some cases, even lead to death. These complications are primarily the reason to vaccinate against influenza.
Every season the influenza virus changes just a little bit, or we have a totally new strain like the 2009 swine flu (H1N1), so we have to vaccinate every year to protect against that season’s strain.
There are very few reasons NOT to vaccinate, one being severely allergic to eggs (not just “I don’t like eggs”), or if you are sick with a fever. Your doctor or provider will be able to tell you which flu vaccine is better for you, the shot (killed/inactivated version) or the nose spray flumist (live-attenuated).
This year both the seasonal H3N2 and the H1N1 (swine flu) vaccines are included in one vaccine. All children less than nine years of age who have never had either the seasonal influenza vaccine or last year’s H1N1 influenza vaccine should have two doses, given one month apart, in order to boost their immune response.
First defense measures to protect against respiratory illnesses are important. They include washing hands frequently, limiting contact with sick persons, and avoiding large crowds during the peak of respiratory season. Anti-infective gels and wipes are a must if you are on the go, and many public places offer hand sanitizers now too.
So, ask questions, call for advice, get informed and make the right choices when it comes to your child’s health. Don’t hesitate; vaccinate.