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Your Child

ADHD: Behavioral Therapy First Before Drugs

1:30

Researchers have been studying the possible benefits of using behavioral therapy as a first choice in treatment for children with attention-deficit hyperactivity disorder (ADHD).

One paper found that children’s ADHD problems improve quicker when behavioral therapy is started initially instead of medications, the New York Times reported. . Another paper noted that this treatment progression is less expensive over time.

If the effectiveness of the behavior therapy-first approach is confirmed in larger studies, experts say it could change standard medical practice for children with ADHD, which currently favors medications as first-line treatments.

Medications were most effective when used as supplemental, second-line treatment for children with ADHD who required the drugs. In many cases, the drugs were effective at doses lower than normally prescribed, according to the findings in the Journal of Child & Adolescent Psychology.

"We showed that the sequence in which you give treatments makes a big difference in outcomes," study co-leader William Pelham Florida International University, told The Times.

"The children who started with behavioral modification were doing significantly better than those who began with medication by the end, no matter what treatment combination they ended up with," he said.

Some experts noted that the research focused on behaviors and not some of the other complications associated with ADHD such as attention and learning problems.

"I think this is a very important study, and the take-home is that low-cost behavioral treatment is very effective, but the irony is that that option is seldom available to parents," Mark Stein, a professor of psychiatry and pediatrics at the University of Washington, told The Times.

One resource for more information on finding a specialist in behavioral and cognitive therapies is, http://www.abct.org/Home. Click on the “Find a CBT Therapist” link.

Another online resource is, www.additudemag.com, which offers information on the program, COPE (Community Parent Education) and how to locate one in your community.

Story Source: WebMD News from HealthDay, http://www.webmd.com/add-adhd/childhood-adhd/news/20160218/behavioral-therapy-adhd

Daily Dose

Happy Thanksgiving!

1:30 to read

This is the week that really kicks off the holiday season and for me it often begins with reflection.  I am often guilty of not appreciating the many blessings that I have, and rather focus on just getting through one day at a time. But as I reflect, I realize that I have so much to be grateful for and much of that gratitude is for my family.

When you are in the throes of parenting, I think it is sometimes hard to appreciate many of the blessings that we have as families. As parents we are anxious for the next stage, whether that is having a baby sleep through the night or wanting your child to talk, start school, begin to read, or finish their college applications. Parenting is so often about looking ahead rather than living in the moment.

It is sometimes hard to take a breath and sit on the floor and play with your baby, or let your elementary school child read you a book at bedtime, or enjoy editing your high school student’s next paper (why was that always a Sunday night at 9 pm event?).  But, from someone who has been there, sit back, take a breath, put down your electronics and appreciate whatever stage your child is in right now!  For this too shall pass...

Why not take a minute during Thanksgiving and ask each one of your children what they are thankful for, and write their answers down on a note card to file away to read years from now. It is fun to see their answers and how their gratitude changes with age....some of their answers are funny, others are quite thought provoking.

As our family grows, now with a granddaughter and a new daughter in law, I find myself trying to take my own advice. We are fortunate to be gathering together for Thanksgiving and I am going to “re-start” the tradition with their comments on paper... No more trying to remember what they said and no videos either. Just a note card that each of us will write on and a box to keep the cards in.  One day our adult children and their children can read all of these comments...and be thankful for family. 

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Sportsmanship with Drew Pearson

Daily Dose

Play It Safe While Playing on the Slide

Do you remember the first time your child went down a sliding board? Or do you have a toddler who is about ready to make their first trip down the slide?

I remember watching my child climb the ladder up a sliding board, and then looking back and saying, “Mommy, you come with me.” So, up the ladder you go, putting your child in your lap for that first sliding board experience. Isn’t that the safest and easiest way to teach your child about a sliding board? What a sense of accomplishment, for both parent and child. Such a fun day at the park!! Well, I was reading a study by Dr. John Gaffney in an issue of the Journal of Pediatric Orthopedics. Dr. Gaffney noted that he was seeing fractures of the tibia (shin bone) in toddlers, many of whom had a history of being on a slide. I must admit, I haven’t ever seen a fractured tibia from a sliding board accident, but he looked at medical records for all tibia fractures he treated over an 11- month period. Of the 58 tibia fractures he studied, eight (13.8%) were sustained while playing on a playground slide. The age range of these patients was 14 – 32 months, and the average age of the eight patients in the study was 20.7 months. All of the tibia fractures associated with playing on a slide were sustained while going down the slide on the lap of an adult or an older sibling. None of the eight children studied had been on the slide alone. Dr. Gaffney states, “if a toddler is riding by himself and gets his leg stuck against the side of the slide, he can stop himself fairly easily, but with a parent’s weight added in you have greater velocity and momentum and it is harder to stop and the leg may get wedged and subsequently break.” He advises that if a child cannot use a sliding board independently, you should look for another age appropriate piece of playground equipment. I guess that would mean the sandbox. Thank goodness that I was lucky enough that all of my children made it safely down the slide with their parents, as I know both my husband and I were on the slide numerous times. I am sure I have pictures of that event, but I will be telling my patients about this interesting study. Like many things, there are risks involved, so find a smaller slide that your child can handle alone, or just wait until they are bigger. It ironic that something that we think will make our children safer might actually cause more injury. That’s your daily dose, we’ll chat again tomorrow. Send your question to Dr. Sue right now!

Your Child

Harsh Parenting May Hurt a Child’s Physical Health

2:00

While it is generally known that harsh parenting often leaves psychological scars on children, a new study suggests it may also impact their physical health with problems like obesity.

Researchers also note that having at least one kind and caring parent doesn’t necessarily counteract the effects of the harsh parent.

"Harshness, as we measured it, is always bad for kids. But it is particularly bad if the adolescent perceives high levels of warmth and support from the other parent," said study lead author Thomas Schofield.

The researchers defined "harsh" parenting as angry, hostile and antisocial.

Schofield and his colleagues assessed the results of a study of 451 children.

All were seventh-grade students in eight Iowa counties in 1989.

The researchers studied their families, even videotaping how they interacted in their homes. Then, the investigators followed the children's health through age 20. All of the families lived in small towns or on farms. All were white and spoke English.

The study authors also asked kids questions about their health and whether their parents showed warmth to them by expressing caring or appreciation.

The findings showed evidence that harsh parenting appears to have a measurable impact on the health of kids. When parents were "hostile, angry, and antisocial towards their adolescent," Schofield said, the kids were more likely to report declines in their physical health and to gain extra weight.

Meanwhile, "warmth from the second parent did not consistently buffer or protect the adolescent from the harshness from the first parent," he said.

When the researchers looked at body mass index (BMI) -- a ratio of weight to height -- they found that the harmful effects of the harsh parent on BMI increased even as the warmth of the other parent went up.

The study showed an association between the harsh parenting and childhood health problems, but did not prove cause and effect.

The study didn't reveal possible reasons why a harsh parent might cause lasting physical harm. But, Schofield said, stress in childhood does hurt people's health over their lives.

Michael MacKenzie is an associate professor of social work and pediatrics at Rutgers University in New Jersey. He said stress may indeed be the cause of health issues in kids with harsh parents. The reason: there's evidence that stress disrupts the functioning of the immune system and growth hormones, he said.

Schofield said the new study findings should help show parents that their behavior matters. "Parents reacting emotionally to life stress or parenting stress is natural, and can require concerted effort to master," he added.

Schofield said parents should consider their actions with their kids and think about whether they'd act differently in public when people are watching.

"If we're behaving one way at home and another way in public, some part of us knows we're doing something we feel the need to hide," he said. "And if a child ever begins to behave as though they're on edge, afraid, or timid around the parent, that's a sign that something needs to shift."

Schofield says that there are ways parents can change their own behaviors and self-help books as well as therapy may offer new options for them.

"All of these options require parents to admit 'We may have in the past done things that hurt our children,' and 'We can improve [our] parenting behaviors,' " he said. "Acknowledging those two truths is very hard, but it is probably the first step, and it is universally true because none of us are perfect parents."

The study was published recently in the journal Social Science & Medicine.

Story source: Randy Dotinga, http://www.webmd.com/parenting/news/20160506/harsh-parenting-may-harm-a-childs-physical-health

Daily Dose

Breast Feeding Woes

1:30 to read

I recently read an editorial in The New York Times entitled “Overselling Breast Feeding”. It was written by Courtney Jung who is a professor of political science at the University of Toronto.  It was quite interesting to me as she stated “the moral fervor surrounding breast feeding continues unabated, with a steady stream of advocacy and education campaigns”.  The WHO (World Health Organization) developed “ten steps to successful breast feeding” in hopes of increasing breast feeding initiation and duration around the world. Hospitals have been designated “Baby-Friendly”  (aren’t they all supposed to be?)  if they adhere to these steps as well. But the United States has done well with breast feeding rates as 79% of mothers initiate breast feeding.

Most, if not all of the new mothers I make rounds on are proponents of breast feeding. They have read the books, gone to classes and are determined to be successful at breast feeding. But, in my experience over the last several years, I have actually seen more and more new mothers becoming over-wrought and wary of breast feeding fueled by the “rules” that they are being required to follow. With that being said, having someone “tell you that you must breast feed your baby in the first hour after birth”, and that “your baby must remain in your room 24 hours a day“, and that they “may not have a pacifier”, “and should “breast feed on demand” is actually anxiety promoting and leaves many a new mother exhausted and tearful within a day or two of having a baby. 

While breast feeding is “natural” it also requires some practice and the only practice is really “on the job” training.  Some babies just latch on quickly and are pros immediately, but not all babies will become proficient at breast feeding in the first day or two. The mothers are told to “let the baby nurse on demand” and some mothers have had their babies at the breast for hours on end and are exhausted, with sore and bleeding nipples. I have walked in to too many hospital rooms with a mother in tears and a fretful baby, and a “helpless” new father.  Some feel as if “they are failures” as mothers before they even are discharged, and at the same time are having serious doubts about continuing to breast feed.  They are sure that their baby will catch serious illnesses and have a lower IQ if they don’t breast feed, but how can they maintain this constant breast feeding and no sleep and never put a pacifier in their baby’s mouth??? Is there only one way to be successful at breast feeding?

I loved breast feeding but it was a long time ago and we were instructed by caring nurses “to just go home and put the baby to the breast every 2-3 hours”. While that may not have been the best education has the pendulum swung too far?  Will giving the baby one bottle when a mother is having postpartum anxiety and sleeplessness really harm the baby?  Should a mother have to sign an order allowing her baby to have a pacifier??   While guidelines for breast feeding are helpful should they be so rigid that a mother “gives up” on breast-feeding because she can’t follow 10 steps in the first 24-48 hours?   

The New York Times article was quite interesting and I had to agree with many of the author’s  points. Supporting a woman’s choice to breast feed is admirable and “policy changes promoting maternity leave, and flexibility” are definitely needed to encourage women to continue to breast feed. But as she states “is all of this breast feeding advocacy crossing the line?”   A mother should choose to breast feed because she wants to, and that does not mean if her baby does not breast feed in the first hour that she will never bond with her baby or be successful at breast feeding.  Some woman are unable to breast feed for a multitude of reasons and that decision should not label her as a “bad mother”.  Again, breast feeding, like a woman’s breast, is not “one size fits all”. 

 

Your Toddler

12 Tips to Make a Home Safer for the Grandkids

2:00

Grandparents and grandkids are two-way blessings. Grandchildren benefit from having a close relationship with their grandparents. They have an extra pair of eyes to watch over them and a lot of hugging and spoiling.

Grandparents get the joy of being around their grandchildren, watching them grow and develop and yes- spoiling them.

Many younger families depend on grandparents to supplement with childcare. Some grandparents are the preferred choice for day care. And of course, sometimes it’s just a family visit.

Not all grandparents think about making their home safer for the grandkids because they aren’t always around them. They may not be aware of what to look for or what to do to make their home safer for little ones. It may have been a long time since a grandparent has had to think about having a child in the house. A lot more information is quickly available regarding child safety than in years past.

The American Association for Retired Persons (AARP) recently published an article with tips for making a home safe for grandchildren. Reading it reminded me of when my child was little and the visits our family used to have with my husband’s parents and mine. I never thought about having a list of suggestions to help them safeguard their home for our child. Most of the time there wasn’t a problem, but occasionally there were big safety issues that they just hadn’t thought about.

If you’ve been thinking about how to talk with yours or your spouse’s parents about making their home more kid-proof – here’s some excellent tips from “ Grandparent Central”, AARP:

1. Keep meds out of reach. About 38 percent of child-poisoning cases involve grandparents' medications, so clear all drugs from countertops, tables and drawers. Put a childproof lock on the medicine cabinet. Make sure your purse is not within reach of your grandchild.

2. Get rid of crib-clutter. Not long ago, cribs were filled with such things as stuffed toys, little pillows, bumper pads and blankets. Nowadays, more people are aware that these items can present a suffocation hazard and are best left out of the crib

3. Baby should sleep on back. Make sure that baby is sleeping on his or her back and not face down or on their side in the crib.

4. Lock up detergent pods. These colorful packets of liquid laundry or dishwasher soap look like candy. They can pose "a serious poisoning risk to young children," says a study in the journal Pediatrics. If you use these products, make sure they are locked in a cabinet and cannot be accessed by curious little hands.

5. Make furniture tip-proof. Flat-screen TVs and modern furniture are particularly prone to tipping if little ones try to pull themselves up. Attach anti-tip brackets or straps to safely secure these items. And don't forget outlet covers, drawer locks, stairway gates, and edge and corner guards for furniture.

6. Walkers and wheelchairs. These items may look like toys to a young child. Make sure they are either out of sight or that someone keeps an eye on the child if they seem a little too intrigued by them.

7. Keep guns under lock and key. One of the most important tips! If you're among the 1 in 3 Americans with a gun, always keep it unloaded in a locked cabinet, with the ammunition stored separately.

8. Be present when your grandchild is with your pet. According to the Centers for Disease Control and Prevention (CDC), more than 77,000 children under age 10 are treated each year in emergency rooms for dog bites.

9. Guard pools and drains.  Always keep your cell phone with you when your grandchild is in the pool in case you need to call 911. If you've got a backyard pool or hot tub, you likely know to prevent access with a childproof gate. But you may not be aware of the danger of drains: Suction forces can be powerful enough to trap small children underwater.

10. Watch all water. Since toddlers' heads are heavy in proportion to bodies, they can easily be pulled down. That's why even an inch of standing water is dangerous. Put a childproof lock on the toilet and drain bathwater immediately.

11. Stove safety. When kids are around, use back burners and always keep handles of pots and pans turned in.

12. Beware of choking hazards. 5 of the most overlooked choking hazards for young children are mini-batteries, jewelry, refrigerator magnets, pen caps and loose change. Five items you may not typically think about.

These 12 tips are obviously good for every family household but may be particularly helpful when someone is not used to having children at their house for extended periods of time.

Grandparents and grandchildren often share a special bond that can grow even more secure and stronger when the home safe during their visit.

Story source: Bulletin staff, http://www.aarp.org/home-family/your-home/info-2016/home-safety-tips-grandkids.html

Daily Dose

Happy Mother's Day!

1.00 to read

So, what if you were given a second chance as a mom? I know this is supposed to be a short blog, but I may need several pages to get this all out. 

As a mom, I know I have made many mistakes over the years while raising our three sons. They are adults now, but will always be “my baby boys”.

If I could re-play anything, I would advise moms to enjoy and embrace every stage of parenting as it all goes by too quickly. I always remember looking at other families and thinking, “when will I get to that stage?” as it always looked like the next milestone would be easier or more rewarding or more anything. But in reality, every single stage of parenting has its ups and downs and you can only realize that in retrospect. I was guilty of looking ahead too much rather than enjoying whatever present situation we were in. The old adage of “live in the moment” is never so true as while you are a parent. I say enjoy playing blocks with your baby, reading to your children every night, playing games in the yard, trips to the pool or long chats with your teens about their friends and making good choices. For each of these things goes by so quickly and cannot be replayed except as special memories in your mind. I would also remind you to take more pictures, and videos, as these are the things that will jog your memory later in life.

All of the memories that are hidden away in some remote spot in a mom's aging brain become clearer when you see a picture of an event. This was evident when I was trying to pull together our family pictures for our oldest son’s wedding. Why is it that I took pictures of everything when our oldest son was little, and by the third child, the pictures are fewer and farther between? He was no less important for sure, but the time issue just didn’t seem to allow it to happen. I should have made the time!! How long could it have taken to take a picture of kids playing together in the yard, or eating dinner at the table together or doing homework? Those are the memories I long to have, the “normal” family times. Most family pictures are of “events”, which is fine, but documenting the simple things too, for they are the most special memories.

Lastly, I asked “my boys” about a re-do, and they all said, “You should have let us wrestle more!” How funny is that! Seems like such a simple thing, but I was always breaking up those boys for fear of them hurting one another. The louder it got, the more I was sure it would only lead to trouble, so I was the “girl” in the middle pulling them off of one another. My advice to young parents, enjoy the ride and try to live in the moment that you are given. You never know what lies ahead, and some of the hardest times in parenting may actually help you appreciate the wonderful times even more. I am continuing to give myself that advice as I am learning about parenting grown sons and now a grandmother! Thankfully, parenting never ends! 

Your Child

Getting Into the Swing of Summer Safety

2:00

As we wave goodbye to another school year, we say hello to summer.

Today marks the first official day of summer with a special event that hasn’t occurred for nearly 70 years. Tonight there will be a rare summer solstice full moon.

What a unique opportunity to round up the kids and do a little stargazing and moon watching this evening!

Getting into the swing of summer often includes fun activities like swimming, boating, biking, camping and other outdoor activities, but it also requires more attentiveness from parents and caregivers.

The more laissez-faire days give kids a chance to relax from school routines, but can also put them at a higher risk for accidents and injuries. It’s always a good idea to brush up on your summer safety tips.

Summer means high temperatures. In certain parts of the country, temperatures can be well over a hundred degrees. That’s not likely to keep kids indoors all day, and they really shouldn’t be if they are generally healthy.

Outdoor play is good for kids, but you may need to get them out in the mornings and later in the evening when temps aren’t quite so high. Before sending kids out to play, make sure they always wear shoes to protect feet from cuts, scrapes and splinters, and wear sunscreen to protect from sunburns and harmful ultra-violet rays.

While playing poolside may be a blast, Safe Kids Worldwide reports that drowning is the leading cause of injury-related death for children ages 1 to 4 and it is the third leading cause of injury-related death among children 19 and under. Prevent accidents and injuries with these tips to ensure your family’s safety:

Pool Safety:

•       Teach children to never swim alone or go near water without an adult present.

•       Always jump in feet first to check the depth before diving into any body of water.

•       Never dive in the shallow end of the pool or into above ground pools.

•       Never leave a child unattended in or near water.

•       Make sure your child knows how to swim, starting at a young age.

•       Teach children to stay away from drains.

•       Make sure any pool or spa you’re child gets in has a safety compliant drain cover. Powerful suction from a pool or spa drain can even trap an adult.

•       Know how to perform CPR on a child and an adult. Often, bystanders are the first to aid a drowning victim, so learning CPR can help save a life.  CPR classes are available through many hospitals, community centers, or by contacting the American Red Cross.

•       Keep a cell phone nearby in case of an emergency, but don’t let it distract you from overseeing the children.

•       Know your child’s limits. Watch out for the "too's" — too tired, too cold, too far from safety, too much sun, too much hard activity.

•       Watch for kids diving above other kids. Make sure the area is clear when a child dives from a diving board.

•       Keep an eye on the weather. Make sure kids are out of the pool or lake if bad weather approaches. Take the fun inside till it’s clear.

•       Make sure that the water is clean – polluted water can make a child very sick.

Boating and water skiing safety:

Boating and water skiing can be great fun, but requires a lot of supervision.

According to the U.S. Coast Guard, nearly 71 percent of all boating fatalities are caused from drowning, 85 percent of which are a result of not wearing a life jacket. Here is what you can do to enjoy the water safely:

•       Always have children wear a Coast Guard-approved, properly fitted life jacket while on a boat, around an open body of water or when participating in water sports.

•       Educate yourself. According to the U.S. Coast Guard, 86 percent of boating accident deaths involve boaters who have not completed a safety course.

•       Always check water conditions and forecasts before going out on the water.

•       Never consume alcohol when out on the waters with your child. Impaired judgment is often the cause of the most critical accidents and injuries.

Lawn Mower safety:

While not considered a typical summer “fun” activity, many severe accidents occur to small children riding on lawn mowers with a parent or grandparent.

According to the American Academy of Orthopaedic Surgeons, lawn mower injuries account for a large percentage of accidental amputations. The Academy cautions that the speed of a typical lawn mower blade can send dirt and bacteria deep into a wound, creating a high risk for severe infection. To avoid accidents involving lawn mowers, keep these tips in mind:

•       Teach children to never play on or around a lawn mower, even when it is not in use. They should never be permitted to walk beside, in front of or behind a moving mower.

•       Children under 6 years of age should be kept inside the home while mowing.

•       Children should be at least 12 years of age before operating a push lawn mower and at least 16 years of age before operating a riding lawn mower.

Fire and fireworks safety:

Summer often involves grilling, campfires and fireworks. All of these activities are standard fair for a lot of families. A few simple safety tips can help prevent injuries.

•       Teach kids to never play with matches, gasoline, lighter fluid or lighters. Make a habit of placing these items up and away from young children.

•       Do not leave children unattended near grills, campfires, fire pits or bonfires. Always have a bucket of water or fire extinguisher nearby whenever there is a burning fire.

•       Take your child to a doctor or hospital immediately if he or she is injured in a fire or by fireworks.

•       Never let children ignite fireworks or play alone with them. Fireworks that are often thought to be safe, such as sparklers, can reach temperatures above 1000 degrees Fahrenheit, and can burn users and bystanders.

•       Attend community fireworks displays run by professionals rather than using fireworks at home.

These tips cover a few of the most common summer activities. We’ll continue with more summer safety tips in future articles. Welcome to summer fun and don’t forget to catch that awesome full moon tonight!

Story sources: http://dbqkidsguide.com/get-into-the-swing-of-summer-safety/

http://aap.org

 

 

 

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