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Autism

The Truth About Autism

Daily Dose

Children & Thunderstorms

1:15 to read

It is not uncommon for young children to be afraid of thunder and lightening.We had big thunderstorms in our area last night. The skies were filled with lightening, huge claps of thunder, loud winds and torrential rain. While the storms only last for a short time it was enough to wake up the dog and I watched and listened as she ran for cover beneath our bed and curl up in the "dog" fetal position. She is really afraid of storms and didn't come out for hours.

This reminded me of the many times that our children would come running to our room during a thunderstorm and also curl up (great cuddle time) afraid of the lightening and thunder. It is not uncommon for young children to be afraid of thunder and lightening. It is usually loud and dark, two things that are both often scary to young kids. It often awakens them from sleep causing further disorientation. The blowing wind only makes it seem scarier as the tree limbs hit the roof and the rain seems like it will blow through the walls. Throw in a little hail and you have the makings for many scared children.

When your children are old enough, get some library books and read about thunderstorms. It is a great time to learn a little about the weather. They love understanding different types of clouds, why it hails and learning to count the time between the thunder and lightening. Having the knowledge of what is happening is empowering and often makes a thunderstorm less frightening. There are even storybooks for children in the toddler age, with characters that are afraid of storms too, which helps a child work through their own fears. Funny thing, as children get older they usually like the storms and want to watch the weather change. Before you know it they are teens and believe it or not, they sleep through anything.

That's your daily dose, we'll chat again tomorrow. 

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Daily Dose

Toddler Behavior

1.30 to read

Do you have a toddler? If so you are in the throes of some difficult, albeit sometimes funny, yet inappropriate behavior. It happens to every parent...suddenly their precious child turns into Dr. Jekyll and Mr. Hyde.  Somewhere around 15-18 months, you will most likely see this change in behavior. Although most books refer to the “terrible twos” I really think it is the “me no wanna” 18-30 month old. 

“Me no wanna” is the phrase we often used around our house, and it was coined when the boys were toddlers. It just seemed like the best line when our sweet toddler would rather have a tantrum than do the simple task that we wanted him to do. Example: please put your toy back in the box. “Me no wanna”, I would prefer to fall to the floor and scream.   

How is it that your typically sweet 20 month old child can be in middle of playing nicely and then suddenly seems possessed as they fling themselves to the floor kicking and screaming?  What is the matter?  Are they having a seizure? Or is it that “something” just didn’t seem right to them and they are angry and frustrated???  How can they change behavior so quickly.?   (hint, foreshadowing for those teen years). 

You never know with a toddler what kind of answer you will get when you say something as easy as “let’s get on your shoes to go outside”. Sometimes they happily run get the shoes, bring them to you, sit down and the shoes go on licitly split.  The next time they get the shoes, throw them across the room, lay on the floor and look at you like “me no wanna”. 

Trust me, you are not a “bad” parent, you are just living through some really challenging parenting. It is exhausting at times, but while this age is typically difficult it is some of your most important parenting. This is really the beginning of behavior modification.  Your brilliant toddler is testing you, this may be the first time you the parents understand why everyone talks about boundaries and consequences. 

Some children also express their “me no wanna” by acting out with hitting, biting and kicking. Again, very inappropriate behavior. Your job is to change that behavior by using time out, or taking away a toy or even putting the child to bed early.. There are so many ways to start letting your toddler know that there are consequences for misbehaving, and that tantrums don’t work. 

I am in throes of “me no wanna” again, only this time it is with a puppy! Seems very similar to me.

Daily Dose

The Homework Battle

1:15 to read

Homework is one of the least favorite exercises for both parent and child.

Homework is one of the least favorite exercises for both parent and child. I was reminded of this while helping my five and seven-year-old nephew and niece with their homework recently. It seems like yesterday since I was helping our own sons with homework, when in actuality it was many years ago. It is easy to forget the complaining, cajoling and pleading to get homework finished. But it is also an important exercise in helping your children get an organized workplace at home, to having family rules about computer and TV time before homework is finished and to teach independent study skills as a child matures.

So... trying to get my niece and nephew to settle down for homework with out getting up, trying to "sneak" back to the computer andto focus on the letter ‘N’, was a real test of forgotten parenting skills. I am not sure I was a total success. They did not want to do their homework, gave me 10 reasons it wasn’t necessary and told me "Aunt Sue you are the meanest aunt we have", which I am sure was not a compliment.

After much stalling, begging and promising "we" finished one worksheet for first grade and a Pre-K sheet glued with picture of ‘N’ words cut from catalogs (while he searched for Christmas presents for me to buy him). It was organized chaos to say the least, but it was finished! The short story is, have a set time for homework and a place for your young children to work, where they are within your sight, but also without a lot of distraction.

Try to get homework done earlier than later; it’s always harder when both parents and children are tired. Make their homework their responsibility, even from early elementary years, as it sets the stage for the rest of their years of homework. Lastly, don't ask Aunt Sue the pediatrician to help; she has "way too many rules".

That's your daily dose, we'll chat tomorrow.

Daily Dose

Marketing Healthy Foods to Kids

1:15 to read

The marketing of foods to children continues to be a hot topic.  As any parent knows…by the time your child is 3, 4 or 5 years old…they can often point to the box of sugary cereal with their favorite cartoon character on it, or identify a sign (McDonalds, Chic-Fil-A, Pizza) although they are not yet reading.  Companies are very clever when it comes to marketing…especially to children who drive a lot of consumer choices.

But, a recent article in Pediatrics shows how marketing may also drive healthy food choices. The study entitled, “Marketing Vegetable in Elementary School Cafeterias to Increase Uptake”, looked at the number of students who chose fresh vegetables from the salad bar at 10 elementary school cafeterias in a large school district over a six-week period.

The study included four different groups. In the first group the schools displayed vinyl banners with branded cartoon vegetable characters. These banners were then wrapped around the salad bar bases. The characters displayed “super human” strength related to eating vegetables (the Popeye of my generation - with his spinach).  The second group of schools showed short television segments which had vegetable characters delivering healthy nutritional advice. In the third group of schools both the salad bar banners and TV segments were used to promote healthy nutrition and food choices.  The fourth group was the control group and received no intervention.  The intervention schools also had decals with the vegetable characters placed on the floor which directed the children to the salad bars.

The results?  Nearly twice as many students ate vegetables from the salad bar when they were exposed to the banners.  More than 3 times as many students who were exposed to both banners and TV segments went to the salad bar (more girls than boys ). Interestingly, the marketing campaign also increased the number of students who chose a vegetable serving in the regular lunch line as well. 

So, it seems that branded marketing strategies may be used in a positive way to promote healthier food choices among young children.  Now we just have to get the advertisers to change some of their branded messaging aimed at young children from the “junk” to the healthy foods, as we have data to show that kids will choose good foods…especially if their super heroes like it too!

Daily Dose

Breaking Bad Habits

1:15 to read

Do any of your children bite their nails or suck their thumbs? If so, are you always saying, “take your fingers out of your mouth, they are dirty”, or “if you keep biting your nails you will get sick due to all of those germs on your fingers”!  I was guilty of saying those very things to my own children, and I also remember being a nail biter and my mother saying the same thing to me.

Well, who would have thought that a study just released today in the journal Pediatrics might make us parents eat our own words (it wouldn’t be the first time).  The study, “Thumb-Sucking, Nail-Biting and Atopic Sensitization, Asthma and Hay Fever” suggests that “childhood exposure to microbial organisms reduces the risk of developing allergies”.  Who knew that there might be something so positive coming from a “bad habit”.  

This study was done in New Zealand and followed over 1,000 children born between 1972-1973 (dark ages) whose parents reported that they either bit their nails or sucked their thumbs at 5,7,9 and 11 years old. The participants were then checked at ages 13 and again at 32 years old to look for an allergic reaction ( by skin prick testing) against at least one common allergen.  And guess what…at 13 years of age the prevalence of an allergic reaction was lower among those children who HAD sucked their thumbs or bitten their nails.  Incredibly the the findings persisted almost 20 years later!  This study even looked at cofounding factors including sex, parental history of allergies, pet ownership, breast feeding and parental smoking… none of which played a role. 

So, while not advocating for children to suck their thumbs or bite their nails (which unfortunately I did until high school when I decided to have nails to polish) there may be a silver lining….a protective effect against allergies that persists into adulthood. 

Lemonade out of lemons!!!

Daily Dose

Omega-3 Fatty Acids

1:30 to read

Many of the patients that I see who have problems with attention and focus as well as other behavioral and learning issues have been started on all sorts of different medications. For some children their medications seem to be “working well”. But, for some children it has been difficult to find the “right” medication to alleviate all of their symptoms.  Studies have shown that anywhere from 10%- 30% of children with ADHD do not respond favorably to stimulant medications. Therefore,  it is not uncommon for their parents to inquire about the use of alternative or complementary medications. In several cases their parents have already started “dietary supplements”, which at times they are reluctant to admit to, or ask for my opinion.  

Interestingly, there is recent data regarding dietary supplements that parents and pediatricians should be paying attention to…and open to discussing.  A study that was presented last fall at the American Academy of Child and Adolescent Psychiatry showed that omega-3’s “could augment the response in children aged 7-14 years who were receiving psychotherapy for depression and bipolar disorders”. There have been  studies as well that have shown “significant improvements with Omega-3’s relative to placebo for problems including aggression as well as depression and anxiety symptoms”.  There are also numerous studies looking at ADHD symptom improvement in those using Omega-3’s, and again the results have been mixed, made even more difficult by the fact that ADHD is a subjective diagnosis.  

Another issue that requires more study is how these fatty acids actually work within the body and brain. Omega-3’s are an important building block of the brain and it is present in the brain's cell membranes, where it is thought to facilitate the transmission of neural signals.  Current thought is that these fatty acids may change the cell membrane fluidity and may also have anti-inflammatory effects….but a lot of research continues on the issue of mechanism of action. 

Several of the studies looked at dosage of the Omega 3 fatty acid supplements and “it seemed that there were more positive trials related to higher daily doses of  certain omega 3 fatty acids including eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA).  There need to be further studies to address the amount and ratio of these Omega-3’s as they are used for supplements. 

So while the research continues as to the effectiveness of Omega 3’s on focus, mood, behavior and learning it is important for all children to consume enough Omega-3 fatty acids in their diet. Eating fatty fish a few times a week would be beneficial for the health of all children - and the decision to supplement beyond that may be a topic for discussion with your own physician. 

 

Daily Dose

More Teens Testing Positive for STD

1.15 to read

I was thumbing through one of my many journals and came upon a recent study which had some surprising data regarding teens, sex and STDs. This study was from Emory University released in the journal Pediatrics. The researchers looked at the rates of 3 sexually transmitted infections which can be detected in urine, and found that more than 10% of teens who had said they were abstinent tested positive for a sexually transmitted disease. This is the second study, the first being released in 2005, which also showed that there were not significant differences in STD rates between teens who had pledged to be virgins until marriage and those who had not. In other words either teens are not being truthful about their sexual history (are you shocked?) or they had “forgotten” that they had had intercourse in the last 12 months. In either case the results of this latest study might indicate the need to perform routine urine STD screening tests on all teens, rather than only those teens who admit to having sexual activity. In the latest study, 14,000 youth agreed to provide a urine specimen to check for 3 common STDs:  Chlamydia, gonorrhea and trichomniasis.  More than 11,000 of the teens in the study said that they had had sexual intercourse in the last 12 months, while 3,000 teens reported no sexual intercourse during that time. Of these urine samples, there were 964 that tested positive for a STD, 118 of these were from teens who denied having intercourse in the last 12 months, and 60 of those said they had never had sexual intercourse in their lives.  Really?? This was quite an interesting study to me as I routinely ask my teenage patients about sexual activity, and while I think many of my patients are honest with me (as I tell them it is important to be honest so that I may treat them appropriately). I am also not naïve enough to think that they are all completely open and truthful. In this study 10% of those found to have an STD claimed to have been abstinent for 12 months and 6% claimed that they had never had penile/vaginal contact. Maybe there is a question of semantics?   It may be that we need to have even more specific questioning surrounding the “definition of abstinent”.  I often have teens ask me about a specific incident that they were involved in and they say “Does that count as sexual activity?”  This study speaks to that issue, differ people have different definitions of abstinence. The most important message from this study is that we doctors may need to be testing all teens for STDs on routine urine specimens.  The sexually transmitted diseases in this study need to be treated with appropriate antibiotics, not only in the patient but also their partners. As both a doctor and a parent, I know that the reality is that teens, for many different reasons, are not always truthful.  A simple urine specimen may be the best way to make sure that we don’t miss potentially serious infections. That’s your daily dose for today.  We’ll chat again tomorrow. Your thoughts? Let me know! I would love to hear from you.

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