children’s health

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Child Psych: How Not To Lose It On The Umpteenth Snow Day

Jim D/flickr

Jim D/flickr

By Steve Schlozman, MD

Yes, it’s still snowing. More. And more.

Even writing the word “snow” now makes me cranky at this point. I never thought I would actually long for the morning commute.

But, I did in fact sign up to be available for my kids, and this is actually a bigger problem right now than any of us expected. The weather in Boston has of course been unprecedented, and while it would be foolish and infantile to act like it is anything other than a royal pain in the backside, we’d also be committing a big fat empathic failure if we didn’t acknowledge just how stir crazy we’re going.

I have developed new sympathy for my daughter’s hamster; she see’s the same cage, the same scene, the same everything, day in and day out.

But, alas, my kid’s hamster cannot work scissors, or a remote control for the television, or engage in any sort of higher order thinking, such as hitting her big sister in the back of the head with a pillow.

In the interest of the city not losing it’s collective mind, and in the interest of genuine public health, may we offer some suggestions. You’ve gotta mix it up right now. If there was a Super Bowl of day-killing, we’d be having a major parade by now. Sundown is still a long ways off. Here are ten tips to pass the day with minimal damage

Screen Time
I wouldn’t fret too much about TV or computer time. Limit the screen time in a way that makes sense to you, and limit what they watch. My family had to put the kabash on Dance Moms, for example It just got a bit too toxic. But use entertainment, in a family way if possible, and set the boundaries around what is watched as well as for how long. For example — say something like: at noon, you can watch/play (fill in the blank with appropriate program) for one hour. Then you can watch/play (fill in the blank with appropriate show) at 4 pm again.

Jigsaw puzzles

I know. “Boring,” your kids will sing. But puzzles have a unique appeal around a living room table. That burst of satisfaction when two pieces fit together has got to be neurobiologically driven. It just feels so good. Thirty minutes or more with a good jigsaw puzzle, even one you’ve done before, is both calming and rewarding.

Food

Speaking of calming and rewarding, don’t forget to feed ‘em, and don’t indulge in excess either. Remember that for most kids, there is structure during the day in the form of lunchtime and recess and activity time. I’m a big believer in free and unstructured time, but in recent days we’ve been closing in on Lord of the Flies territory. Feed ‘em at the table and then let them move onto other things. The meal should take around 20 minutes. You might get more time out of it if you bake something. (That’s the length of the average meal at school)

Go Outside Continue reading

Frostbite, Hypothermia And Other Fun Facts To Remember On Blizzard Day

It’s going to be a long, long day. If you’re like us, you’ve already cooked some kind of elaborate breakfast, chosen the morning movie lineup, and set up the “Let’s Dance” Wii. And it’s not even 8 a.m.

When you’re ready to venture outside and “play,” remember it’s freezing, with ferocious winds. No doubt you’re familiar with this kind of extreme weather, but there are a few health tips worth repeating. Here’s the Boston Public Health Commission with a cute video reminder:

Pets As ‘Social Lubricant,’ Helping Kids With Autism Develop Assertiveness

(Onesharp/Flickr via Compfight)

(Onesharp/Flickr via Compfight)

If you’ve never considered your dog or cat part of your social network, maybe it’s time to start.

A new study from the University of Missouri-Columbia finds that pets of any kind in the home may help autistic children develop crucial social skills.

Gretchen Carlisle, research fellow at the Research Center for Human-Animal Interaction in the M-U College of Veterinary Medicine, found that pets serve as a “social lubricant,” making kids more likely to engage in behaviors such as introducing themselves, responding to other people’s questions or asking for more information.

While researchers have already found that dogs provide great assistance to children with autism, Carlisle explains that her study looks at the possible benefit of all types of pets. These pets also help the greater public interact with autistic kids in social settings. “When children with disabilities take their service dogs out in public,” adds Carlisle, “other kids stop and engage. Kids with autism don’t always readily engage with others, but if there’s a pet in the home that the child is bonded with and a visitor starts asking about the pet, the child may be more likely to respond.” Continue reading

Lose The Spoon: Study Finds Milliliters Best For Measuring Kids' Meds

Spoon with liquid medication (Wikimedia Commons)

Spoon with liquid medication (Wikimedia Commons)

Veronica Thomas
CommonHealth Intern

You wake up to your 8-year-old son crying in the middle of the night. He’s had a sore throat for a few days, which the pediatrician is treating with liquid Tylenol. As you grab the bottle and kitchen spoon from the medicine cabinet, you wrack your brain trying to remember the doctor’s instructions. Was it two teaspoons or two tablespoons? But wait, the pharmacist had said to measure it in milliliters.

Confusion about medication measurement like this is surprisingly common among parents, often resulting in serious dosing errors that contribute to more than 10,000 calls to poison centers each year and 70,000 ER visits.

Parents who used teaspoons or tablespoons were twice as likely to make a mistake.

A new study in the journal Pediatrics found that around 39 percent of parents incorrectly measured the dose they intended and about 41 percent made an error in measuring what their doctor had prescribed. The researchers found that parents who used teaspoon or tablespoon units for medications were twice as likely to make a mistake in measuring the dose compared to parents who only measured medications in milliliters.

This increased error may partly be due to the fact that parents measuring in teaspoons or tablespoons are more likely to use a kitchen spoon to measure the medication, rather than a standardized instrument like an oral syringe or cup. However, even parents using standardized instruments were more likely to make a dosing mistake if they used teaspoon or tablespoon units. The link between tablespoon or teaspoon use and measurement error was even stronger among parents with low health literacy or limited English proficiency.

To minimize this confusion and reduce medication errors among parents, the study investigators suggest adopting a milliliter-only unit of measurement. But while a standardized unit of measure seems like the logical fix, it probably won’t be a quick one, according to Dr. Shonna Yin, the lead investigator of the study.

She sees growing support for a move towards a standard milliliter system from groups like the American Academy of Pediatrics, the American Academy of Family Physicians and the American Association of Poison Control Centers, but says concerns remain that this transition would cause greater confusion, since parents are familiar with teaspoon and tablespoon terms.

I asked Dr. Yin, from the New York University School of Medicine and Bellevue Hospital Center, to provide additional insight on the study’s implications, including what parents can do to reduce dosing errors. Our conversation, edited:
Continue reading

Understanding Aster: How Singing And Dancing Help Heal A Child’s Trauma

For the past four years, I’ve been involved with a local nonprofit, the North Cambridge Family Opera, which stages original productions featuring cast members age 7 to grandma, and with a range of abilities. In 2011, I wrote about how performing in the group’s opera helped children with autism. This year, I was struck by the story of how music helps heal the past trauma of one young cast member, 8-year-old Aster, adopted from Ethiopia after her birth parents died. I asked Aster’s mother to write a bit about their experience. Here’s her post:

By Marina Vyrros
Guest contributor

In the mid 1990s, I worked as a refugee aide in the Guatemalan rainforest.

Many people in that community — having fled horrific atrocities, like their villages being razed or worse — were suffering from post-traumatic stress.

Atrocities notwithstanding, a contingent of ranchero musicians somehow managed to lug homemade, oversized guitars to the camps and play music each night, often in the 100-degree heat.

While the NGO’s provided a valuable service — helping the people rebuild their external structures — the service that the ranchers provided, though perhaps less tangible, was invaluable. Their nightly gatherings, singing songs about their plight, helped the community to rebuild and heal internally.

Four years ago, when I adopted an almost 4-year old child from Ethiopia (who continues to recover from the trauma of having lost both birth parents during her formative, early childhood years) the lesson of the power of music was not lost on me.

Claudia M. Gold, a pediatrician, blogger and author of “Keeping Your Child in Mind: Overcoming Defiance, Tantrums, and Other Everyday Behavior Problems by Seeing the World Through Your Child’s Eyes,” explains what may be going on in my daughter’s brain:

“Severe meltdowns are common in children who have experienced early trauma, at the time when the higher cortical centers of the brain were not yet fully developed. Stress of a seemingly minor nature can lead the rational brain to in a sense go ‘off-line.’ The child will have access only to the lower brain centers that function more instinctively.”

Especially during her first few years in Cambridge, Aster’s meltdowns were epic, but music and dance have consistently provided the most important vehicle to help her regulate her emotions.

Before, she might bang on the walls, now, to relieve her frustration, she pounds on a djembe, an African drum, in an afterschool program; instead of crying over seemingly inconsequential things, now, to release her emotions she invents and belts out Whitney Houston-y type songs, tears streaming down her face. To release her energy — which is abundant — she dances around. Everywhere. It all helps.

Recently, over the past five months, Aster’s been singing, dancing and even acting with the North Cambridge Family Opera based in Cambridge. In this year’s production, “Rain Dance,” she and the other animals living on the South African savannah elect a Machiavellian lion in a desperate attempt to end the local drought. Trouble ensues.

All kinds of research suggests that music can minimize the symptoms of post traumatic stress and other types of trauma. A 2011 study found that guitar-playing can help veterans with PTSD drown out the traumatic memories of bombs blasting; and in 2008 researchers found some reduction of post-traumatic stress symptoms following drumming, in particular “an increased sense of openness, togetherness, belonging, sharing, closeness, connectedness and intimacy, as well as achieving a non-intimidating access to traumatic memories, facilitating an outlet for rage and regaining a sense of self-control.”

Dr. Ross Greene, author of “The Explosive Child” writes that “children with behavioral issues don’t lack the will, they lack the skills.” Continue reading

Why To Exercise Today, Moms: For The Kids, Of Course

mikebaird/flickr

mikebaird/flickr

My 11-year-old daughter recently asked if she could take a hot yoga class with me. My first reaction was negative: it’s too hot, it’s not “fun” and it’s one of the few things I do that’s truly mine — 90 minutes in which I don’t have to worry about anyone else’s needs.

Of course, I said yes. And I’m glad I did. She made it through class, and was totally into it (though she wished there’d been more “tricks” and less pose-holding).

“That was great, Mom,” she said afterwards. “When’s the next class?” And whether she becomes a yoga fan or not, I consider those 90 minutes to be a small gift: another way for me to show her how strong and able a body can be, and how good it feels. It doesn’t much matter if it’s yoga or running or swimming or playing ultimate frisbee — our kids are clearly taking their physical activity cues from us.

A new study out of the U.K. confirms this: researchers report that physical activity levels in mothers and their pre-school kids are directly associated. The study, published in the journal Pediatrics, suggests that interventions to promote more physical activity among mothers (who, understandably, are often exhausted, harried and not great at fitting exercise into busy, kid-filled days) might also benefit their young children.

Here’s some of NPR’s report on the study of 554 mothers and their kids:

Mothers’ increased physical activity boosted children’s moderate and vigorous activity overall…

It’s not entirely clear whether it’s the mother’s activity that influences her child’s, or if mothers are more active because they’re busy keeping up with a playful child, says Esther van Sluijs, a behavioral epidemiologist at the University of Cambridge and the study’s lead author.

But busy mothers don’t have to drop all other priorities to play with their children all day. Van Sluijs says just small changes – walking to the park instead of driving or playing a good game of tag instead of a board game – can make a difference. Continue reading

Doll Dangers: Girls Imagine Fewer Career Options After Playing With Barbies

Charles (dollstuff.net)/flickr

Charles (dollstuff.net)/flickr

I grew up in the era of Marlo Thomas’ Free To Be You And Me, with gender-liberated lyrics like this: “Some mommies are ranchers or poetry makers, or doctors or teachers or cleaners or bakers, some mommies drive taxis or sing on TV, yeah, mommies can be almost anything they want to be.”

Indeed, Barbie dolls — with their overly sexualized, crazy-making-body-image implications — had no place in our little Brooklyn apartment.

Apparently, that was a smart move.

A small, but novel new study exploring gender roles and how kids imagine their future careers found something disturbing: little girls who were asked about 10 different jobs told researchers that boys could take on “significantly more occupations” than they could themselves. What’s more, according to the study, girls who played with Barbie dolls before being interviewed indicated fewer career options compared to boys, while girls who played with the far less sexy Mrs. Potato Head reported a smaller difference between future job options as compared to boys. The jobs mentioned to the kids were: teacher, librarian, day care worker, flight attendant, nurse, construction worker, firefighter, pilot, doctor, and police officer

allieosmar/flickr

allieosmar/flickr

The study (which I’m now calling “Mrs. Potato Head Rules” but is actually titled “Boys Can Be Anything”: Effect of Barbie Play on Girls’ Career Cognitions,”) involved 37 girls, ages 4-7. The research, led by Aurora M. Sherman, an associate professor in the School of Psychological Science Oregon State University with Sherman and Eileen L. Zurbriggen of the University of California, Santa Cruz, was published in the journal Sex Roles.

I asked Sherman via email how the project originated. She said that while there have been studies on what girls thought about fashion dolls like Barbie, there’d been “no actual experiments that could test whether playing with one kind of doll or another kind caused a difference in kids’ thinking.”

Sherman continued:

“I thought it would be interesting to test ideas girls have about careers as the outcome because there is a lot of emphasis on the 130+ careers Barbie has been dressed for, so it was logical to ask whether a Barbie costumed as a career professional (Dr. Barbie) would give girls a “boost” in their ideas about careers. However, that boost did not appear in my study…The lack of difference between Dr. Barbie and Fashion Barbie surprised me the most; it seems from our data that just a professional title and costume isn’t enough to expand the career horizons of girls when they play with Barbie.”

And while Sherman says she was interested in Barbie dolls as a child, “my parents didn’t allow them in my house. I didn’t have very many dolls of any kind as a kid, actually — my parents were more into providing games and books.” Continue reading

Study: Bullying Toll May Linger For Years, Leading To ‘Substantially’ Worse Health

(trix0r/flickr)

(trix0r/flickr)

Researchers at Children’s Hospital Boston report that children who have been bullied suffer not only the immediate blow of humiliation or worse, but that the toll of such childhood insults may linger for years — particularly if the bullying re-occurs — and lead to dramatically worse mental and physical health.

The negative impacts of chronic bullying may accumulate and snowball, researchers report, with ongoing bullying associated with greater depression symptoms in kids and lower self-worth over time.

From the study, “Peer Victimization in Fifth Grade and Health in Tenth Grade,” published in the journal Pediatrics:

We analyzed data from 4297 children surveyed at 3 time points (fifth, seventh, and tenth grades) in 3 cities. We used multivariable regressions to test longitudinal associations of bullying with mental and physical health by comparing youth who experienced bullying in both the past and present, experienced bullying in the present only, experienced bullying in the past only, or did not experience bullying.

RESULTS: Bullying was associated with worse mental and physical health, greater depression symptoms, and lower self-worth over time. Continue reading

Parents, Rejoice: Study Finds Messy Kids May Be Better Learners

B Kitty/flickr

B Kitty/flickr

Anyone with kids may recall those wild toddler “meals” in which the food went flying, ending up all over the floor, the furniture, you, your child’s face and body. The ratio of food offered to food actually ingested was grim.

It turns out there may be an unexpected upside to those epic messes (other than making fabulous holiday cards): new research suggests the messier infants and toddlers are at mealtime, the more they are learning.

Specifically, researchers suggest, learning vocabulary for new things is enhanced when toddlers are playing in a particularly happy place to be messy: the high-chair. A new study, led by Larissa Samuelson and her colleagues at the University of Iowa, shows that context matters for learning.

When 16-month-old infants sitting in a high-chair were presented with novel non-solid objects (such as, say, glue, oatmeal, or jelly), they were much better at then identifying something made of the same material compared to 16 month-olds sitting at a lab table. This was measured both in terms of their recalling names of the new objects (some example words were “dax” and “kiv”) and in distinguishing them from objects made of a different material but in a similar shape.

How could toddlers tell the difference between a jar of glue and a glass of milk? Well, not by just looking. The infants showed the best recognition of the objects they played with the most using their hands and mouths; gentle, non-messy touching didn’t help.

But perhaps the most significant finding is that the infants’ skills at identifying and naming these new objects was dependent on how messy the kids were outside the lab Continue reading

The Surprising Risk Of Swaddling Your Baby: Hip Troubles

Who knew swaddling your baby could be so risky? I loved swaddling my daughters, and they seemed to calm instantly as I tucked them up in soft flannel cloth, feeling (I imagined) safe, contained and protected.

But, like so many aspects of child-rearing, one wrong move can produce a major screwup. In this case, according to new research published in the journal Archives of Disease In Childhood, improper swaddling can lead to hip dysplasia. (The key to safe swaddling, experts say, is to allow the baby’s legs to bend, rather than wrapping them up with their legs tightly extended and pressed together.)

Infant swaddling has, historically, been a near-universal practice, researchers report, and in recent years it’s enjoyed a popular “resurgence.” Why? Because it genuinely appears to calm kids down with “its perceived palliative effect on excessive crying, colic and promoting sleep,” researchers write. “Approximately 90% of infants in North America are swaddled in the first few months of life.”

StarMama/flickr

StarMama/flickr

While the report found that swaddling did, indeed calm infants, it didn’t help much with colic.

WBUR and NPR’s Here & Now explored the topic today, quoting the study’s lead author — Nicholas Clarke, a consultant orthopaedic surgeon at the Southampton University hospital in the U.K. — on how best to swaddle a baby:

‘Safe swaddling’ with appropriate devices should be promoted because it is recognised that traditional swaddling is a risk factor for DDH [developmental dysplasia of the hip]. In order to allow for healthy hip development, legs should be able to bend up and out at the hips. This position allows for natural development of the hip joints. The babies’ legs should not be tightly wrapped in extension and pressed together. Commercial products for swaddling should have a loose pouch or sack for the babies’ legs and feet, allowing plenty of hip movement and hip flexion and abduction.