Twitter Facebook RSS Feed Print
Daily Dose

School & Infectious Disease

1:30 to read

I received an email this week from a patient…subject line: “potential exposure to Herpangina”.  In the body of the email was the following:

Dear Parents,

We want  to inform you that a case of Herpangina disease has been reported for a child at ….. room #112.  This is a contagious disease that  is spread by direct contact with another person or contaminated objects.  Herpangina is an illness caused by a virus, characterized by small blister-like bumps or ulcers that appear in the mouth, usually in the back of throat or the roof of the mouth. The child often has a high fever with the illness. We have attached further information about this common childhood illness published by Children’s Hospital in Boston. Our teachers are carefully disinfecting their room to help prevent further spread of the disease.

The mother of the child that sent me the email was “freaked” out and “worried” about  sending her child back to pre-school.  

My question is this, when did it become a “rule” to notify parents in a pre-school or day care setting that there were viral illnesses circulating?  It certainly seems unnecessary to me to send notification of EVERY childhood illness that occurs and for most of my families only serves to cause anxiety.  Some of the schools in our area post a sign on the entry that says something to the effect:  “there are cases of diarrhea, RSV, hand foot and mouth and fevers being reported in children that attend this school.”  Really, is it that surprising or necessary? Seeing that many of the numerous viral illnesses that children get these days are spread via respiratory droplets and contact with surfaces, such as toys and tables that everyone touches (computers too), children are exposed to things all of the time.  Do you go to work and ask your co-workers in a conference room..have you had diarrhea, a cough or a sore throat in the last day?

I understand notifying parents of illnesses, such as meningitis, measles, mumps…even chickenpox that are infectious and may be serious or life threatening. Thankfully, there are very few cases of these illnesses to report, now that the MAJORITY of children receive vaccines to these diseases. 

By putting these emails, texts and notices out for every parent to become alarmed about…and then to come to the doctor out of concern that their child  “may get sick….even before they have a symptom”,  serves no purpose. Herpangina and Hand Foot and Mouth are very similar viral illnesses, and both are caused by enteroviruses. It is at times hard to distinguish one illness from the other. But, with that being said, the treatment is solely symptomatic. In other words, treat the fever, make your child comfortable and don’t let them go back to school until they are fever free for 24 hours.  

Lastly, your child is going to catch a lot of these viruses, no matter what you do when they go out to play, shop or go to school. Each time they catch a viral illness it actually helps them to build antibody in order that their immune system may get stronger and stronger. I think the better note is….as winter comes children will get more coughs, colds and viral infections…if you think you child is not feeling well or running a fever, please keep them home from school for the day.  It is just a normal part of childhood…we don’t need any more anxiety in this world.   

 

Your Child

Why Kids Should Learn Handwriting

1:45

I think it’s fair to say that handwriting is becoming a lost art. Computers, tablets and phone keyboards have made actual writing with a pen and paper almost obsolete.

What was once an integral part of a child’s daily school lessons, today, gets about one-fourth the instruction time. What is surprising is that in the not too far future, some kids may never learn penmanship at all.

If keyboards become the most popular form of communication, is there really a need for printing and cursive skills? Yes, according to some educators. Not only will children lose the personal touch of handwriting but will they also lose the benefits learning penmanship offers the developing brain.

Putting pen to paper stimulates brain circuits involved with memory, attention, motor skills, and language in a way punching a keyboard doesn't.

"There is this assumption that we live in the computer age, and we don't need handwriting anymore. That's wrong," says Virginia Berninger, PhD, a professor of educational psychology at the University of Washington.

Indiana University psychologist Karin James, PhD, recently published a study looking at brain scans of preschoolers before and after they learned to produce letters, either by printing or typing. Before the lesson, the children couldn't decipher between a random shape and a letter, and their brains responded similarly to each. After they learned to hand-draw a letter, brain regions needed for reading lit up at the sight of the letter like they do in a literate adult. Learning to type a letter yielded no such change.

Other studies have shown that preschoolers that practice handwriting read better in elementary school.

Handwriting also requires concentration and teaches brain circuits responsible for motor coordination, vision, and memory to work together. "If in the future we were to take away teaching handwriting altogether, I worry there could be real negative impacts on children's development," James says.

Timed right, cursive also comes with some unique advantages. Berninger's research suggests kids who link their letters via cursive get a better handle on what those words look like and end up being better spellers, she says. Cursive also allows them to compose their thoughts faster than in block handwriting or via typing (at least until about seventh grade, when their brains become mature enough to manage two-handed typing quickly).

Berninger says parents can offer their children extra guidance with learning handwriting even before their child begins school and through their early years. Some children may learn these skills quicker and some may need a little more practice. But on an average:

Preschoolers can strengthen motor skills by playing with clay, stringing beads, working through mazes, and connecting dots with arrows to form letters.

From kindergarten through second grade, children should master block letters.

Third to fourth grade is when kids can begin and master cursive.

By fifth grade, children should continue to write by hand while being introduced to typing by touch (not just hunt and peck.)

As I’ve become more accustomed to using my computer or phone to communicate with others, I’ve noticed that my own handwriting skills are beginning to suffer. Cursive isn’t as fluid and readable as when I handwrote more often and my eye, hand and pen coordination isn’t near as comfortable as it used to be. 

I hope future generations will not lose the art of handwriting, not only because of the developmental benefits it offers, but because each person’s handwriting is unique to them.

Story source: Lisa Marshall, http://www.webmd.com/parenting/features/handwriting-matters-kids#1

Play
3498 views in 1 year
Back to School

Back to School Stress

Your Child

Setting Up a Routine for Homework

2:00

If yours is like a lot of families, you’re just not quite ready to face the homework hurdle. But like it or not, after school assignments have arrived and helping your child get into a regular routine can actually make it easier for everyone.

Deborah Linebarger, PhD, associate professor of education at the University of Iowa, has come up with six tips to help families get back in the assignment swing of things.

Be prepared: Even if you’ve already picked up all the supplies your child needs at school, make sure the staples needed to complete assignments are also available at home. Items like pencils, erasers, folders, clips, rulers, computer paper & toner should have their own space and be ready to use if needed. This is also a good time let them set up a special place in the house where they can work undisturbed and with all the supplies they need. You may discover you have a budding interior designer with a knack for organization!

Set A Schedule: You child should do her homework at the same time every day. Many kids need a break after school for a snack and a little running around first. It's best to get homework done as early as possible -- when it drags on past dinner and toward bedtime, the work is likely to take longer and be sloppier.

Bedtime: Don’t leave homework till the last minute, make sure that it’s finished and checked at least a couple of hours before bedtime. Just like adults, children need plenty of good sleep to function well the next day. Preschoolers typically need 11-13 hours each night. Six to thirteen year olds need around 9-11 hours and teens need about 8 -10 hours a night. Make sleep a priority by having a cool, quiet and dark bedroom. Establish an appropriate bedtime for your child and stick to it. Cut off the access to computers, TVS, phones and any electronics at a minimum of an hour before it’s time for sleep. Quieting and slowing down before it’s actually time to nod off can help relax your child.

Break it down. Younger kids might get a week's worth of homework on Monday to turn in by Friday. Older children may have big responsibilities like term papers and science projects. Help them break large projects into smaller steps, and make sure they start early.

Keep up with your child’s assignments so that you’re not surprised by a last minute science project the night before it’s due!

Encourage "peer collaboration" -- to a point. It may be helpful for siblings close in age to do homework together. The older one may be proud and happy to offer help to the younger one. But if they bicker more than they cooperate, it's time for separate spaces.

What if you have a child with ADHD? As you probably already know, children with ADHD are more likely to face extra challenges with completing their homework.

He or she will need even more supervision and guidance, Linebarger says.

"Start by breaking up homework into really bite-sized amounts," she says. "For a younger child, that may be only about 10-minute increments. Expand them slowly as they show they're able to handle it." And expect that your child will need you to watch her homework efforts closely to make sure he or she stays on task.

When they gets distracted -- and they will -- encourage your boy or girl to do something physical to get back on track. "Let her jump up and run around for 5 minutes, or have him do 10 push-ups or 30 jumping jacks," Linebarger says. "Research shows that acute physical activity right before a challenging mental task helps to control behavior."

Children with ADHD often hear a lot of criticism, be sure and compliment them and encourage them when they’ve completed a difficult task.

When they manage to sit still for that 10 minutes of homework, or come home with their homework folder in order, give them lots of praise for making a great choice," Linebarger says.

It won’t be long till summer is a fond memory and the school year is just how things are. You can help your child adjust to this either new or familiar way of getting through Monday through Friday by using the tips above and finding out what adjustments may need to be made to work best for your family.

Source: Gina Shaw, http://www.webmd.com/parenting/features/back-school-homework-routine

 

Daily Dose

Back to School

1:30 to read

Schools around the country have opened their doors and some will be starting soon. This is the first week of school for most students in my area and parents have been busy in the last few days attending “back to school” and “meet the teacher” nights in preparation for a new school yea

So…every school has different rules, expectations and strategies for helping their students evolve into their “best” selves and as you get older the “rules” often change in hopes of making students more independent and responsible. I other words, getting ready for the “real world ‘ one day.

Catholic High School for Boys in Little Rock, Arkansas has recently been highlighted in the news and on social media for the sign that is posted on the entrance to the school. It reads “If you are dropping off your son’s forgotten lunch, books, homework, equipment etc, please TURN AROUND and exit the building”  Your son will learn to problem solve in your absence.”  The school posted the same message on their Facebook page as well.

According to the principal of the school, this has been a Catholic High rule for quite some time…it was also a rule at the high school my boys attended.  While some feel that this is unjust and that the students should be allowed to “phone home” if they have forgotten something, the school’s explanation is really fairly simple…allowing your child to have some “soft failures” and to learn both problem solving skills and responsibility will ultimately mold them into functioning members of society as they reach adulthood.  Sounds reasonable to me.

I know that as my boys went from elementary school, on to middle school and then high school their father and I had greater expectations that they needed to be responsible for getting their “stuff” to school.  We started off the school year with a game of sorts where you were given 3 “hall passes” for the year. I guess this started from something at school where they were given a hall pass to go to the bathroom or the office, and some teachers would hand out homework passes that allowed you to “skip” an assignment. So, each child ( this probably started in about 3rd or 4th grade) had 3 passes/year  where they could call and have us “rescue” them if they forgot something. Once you used up your “hall passes” you had to suffer the consequences of no lunch or turning in an assignment late.  Interestingly, each child was a bit different….one would use them up pretty quickly, another would “hoard” them for late in the year.  One wanted to know if they could be accrued? 

By the time they reached high school it was not a SHOCK when they were told the school rule that they could not call their parents.  It seems they figured out how to borrow money for lunch, or share with a friend, how to borrow a tie or jacket for an assembly and that turning in assignments a day late usually meant 10 points off. Not only did it help them become more organized and responsible, it also made me a working Mom “feel less guilt” that I really was not available to rescue them sometimes, even if I wanted to.  Do you think you would appreciate waiting in your pediatrician’s office (any longer than you may already) while they tried to run a homework assignment to school??  

You might try starting off the school year with a few hall passes and see if it works for your family!  

Your Child

Recess Is Important for Kids

1.45 to read

Add recess to reading, writing and arithmetic says a report from the American Academy of Pediatrics (AAP.)  The pediatricians believe that recess can be as important to a child’s overall development as standard classes and should never be denied, especially as a punishment.

"We consider it essentially the child's personal time and don't feel it should be taken away for academic or punitive reasons," said Dr. Robert Murray, who co-authored the new policy statement for the AAP.

According to the authors, recess is a “crucial and necessary component of a child’s development.”

Other reasons given for the importance of recess are that it helps students develop better communication skills, counteracts the time sitting in classrooms, and may foster skills such as cooperation and sharing - all good things.

The authors noted that previous research has found that children are able to pay closer attention and perform tasks better after a recess break.  A year ago, 14 studies were reviewed and researchers found that kids who get more exercise do better in school. Recess and sports related activities offer children the opportunity to exercise and burn off excess energy.  They also get a chance to recharge their brains and bodies.

Other organizations have recommended that children need recess as well. The American Heart Association and U.S. Centers for Disease Control and Prevention (CPSC) both call for schools to offer recess to kids.  You might think that recess in schools is a given, but in a 2011 survey of 1,800 elementary schools, researchers discovered that a third of the schools did not offer recess to their third-graders.  However, most schools do offer recess of between 15 and 30 minutes once or twice a day.

Is there a particular time of day that helps kids most?  Before lunch seems to be the consensus from government agencies, CPSC and the U.S. Department of Agriculture. Previous studies have found that children waste less food and behave better for the rest of the day when their recess is before their scheduled lunch, the pediatricians' statement notes.

They also agree that PE should not be substituted for recess. "Those are completely different things and they offer completely different outcomes," said Murray. "(Physical education teachers are) trying to teach motor skills and the ability of those children to use those skills in a bunch of different scenarios. Recess is a child's free time."

Free time means no structured activities by adults such as games. "I think it becomes structured to the point where you lose some of those developmental and social emotion benefits of free play," said Murray.

"This is a very important and overlooked time of day for the child and we should not lose sight of the fact that it has very important benefits," he added.

I remember recess fondly.  A group of friends would gather and run from one end of the schoolyard to the other at full gallop. The first one back would win the honor of becoming the “lead horse.” Yes, in our recess fantasy we were a heard of horses – whinnying and throwing our heads around (showing off our glorious manes.)

It was fun and exhilarating as we trotted around strutting our stuff.

Recess isn’t only important because it breaks up the monotony of sitting, studying and listening, it can also spark the imagination!

Source: http://news.yahoo.com/pediatricians-kids-recess-during-school-0547374

Daily Dose

More Updates on the Swine Flu Vaccine

This week the U.S. Department of Health and Human Services announced that the first doses of H1N1 vaccine will not be available until mid-October and there will be far fewer doses initially than expected.I know everyone is still concerned about H1N1 (swine flu) and I want to keep updating the information as it is available. This week the U.S. Department of Health and Human Services announced that the first doses of H1N1 vaccine will not be available until mid-October and there will be far fewer doses initially than expected. Only about 45 million doses will be available at that time, with another 20 million doses produced weekly, until the 195 million doses that were ordered are completed.

As discussed previously, making a new vaccine is a difficult process, and despite the fact that “swine flu” is easily spreading within communities, it has been more difficult to grow enough “lab virus” for vaccine production. It is due to this that vaccine production is about 50 percent of what was initially expected. I continue to get questions as to how the vaccine will be distributed, how many doses will be needed etc. Most of this information is not yet available and should be forthcoming in the next several weeks as the preliminary trials on vaccine efficacy are completed. It does appear that the “swine flu” vaccine will probably require two shots that are separated by at least three weeks. It also takes several weeks post vaccination to produce antibodies to prevent infection. Unfortunately, you are not immune the minute the needle is inserted! The logistics of providing the immunizations have not been worked out, and different communities may provide vaccine in different ways. Some state and local health departments may provide school based vaccine clinics, but again that decision may vary. With school just around the corner the concern is that the vaccine may be too late to halt outbreaks as “swine flu” has continued to be diagnosed throughout the summer months and will probably become more prevalent within weeks of school resuming. The concern is that school aged children seem to be the most vulnerable, with the median age for infection being 12 – 17 years. The symptoms of “swine flu” resemble those of seasonal influenza and one type of flu does not prevent the other. In other words, this could be a very long flu season with successive illnesses with different influenza viruses. For now the best advice is to get your seasonal (regular) influenza vaccine, which is already available in both injectable and intranasal formulations. This is not a good year to “miss” your seasonal flu vaccine as it is still the best protection there is for “regular flu”. This vaccine is recommended for ALL children between the ages of six months and 18 years. (See previous links for more details about recommendations for others). Remember the seasonal flu vaccine does not prevent H1N1 (swine flu) and vice a versa. This is going to be a long and complicated flu season, so stay tuned for more information. That’s your daily dose, we’ll chat again soon!

Daily Dose

Home From School

1:30 to watch

I continue to talk about it being  the “sick season” and thankfully it is now February!  Parents are all tired of having sick children and I can now at least assure them that we are halfway to the end of upper respiratory and flu season.

 

But, with that being said that means I am still seeing children with RSV, Flu and every other virus I can think of. Remember, the majority of the illness I see every day in my office is VIRAL.  It really doesn’t matter if you can put a name to the virus, as the treatment is the same. Rest, fluids, fever control and watch for any respiratory distress or symptoms of dehydration. As I told one young mother who said that her other child had been tested for RSV (by another doctor), testing the child I was now seeing will not make any difference in how we treat the illness. So, why make the child uncomfortable when doing the swab and also drive up health care costs, for no change in treatment recommendations.  I think people are confused about what the test actually does….it does not change how a child is treated, and it also causes a lot of “alarm” as the mother of one patient goes home to tell her friends that her child has RSV and then the school starts sending out emails and parents become more anxious and alarmed that they may have been exposed….as they are every day all over our city.

 

So…when do you know it is time to keep your child home from day care or school as we all know these viruses are spread at home, school and work as well.  

 

If your child has a fever over 100.5 degrees (by any method of taking their temperature) they should not go to day care or school for at least 24 hours after becoming fever free (without fever lowering medication).

 

If your child is vomiting, 2 or more times in the last 24 hours, they should stay home. Some young children may vomit after coughing as well, but if infrequent they may attend school. 

 

Diarrhea as defined by two or more loose, watery stools that are “out of the ordinary stool pattern” for your child. Any child having diarrhea that does not stay contained within a diaper should stay home. A child who has blood in their stool should not attend day care or school (and should see the doctor).

 

Children with strep throat may return to school after 24 hours if they are fever free and have received the appropriate antibiotic therapy.  (Newer article suggests 12 hours if they are feeling well).

 

Your child does not need to stay home due to a cold, cough, runny nose (of any color) or scratchy throat if they do not appear ill and do not have a fever. Look at how your child is behaving…some times a day of rest may be needed (even when you get sick, right?) 

 

Most importantly, it is not necessary to name the virus that your child might have, but to follow the guidelines for keeping them home (as well as out of stores, church, and after school activities) until they are feeling better. Wash hands, cover coughs and yes….still get the flu vaccine. It is not too late…the ground hog even said we still have a lot of winter left.

 

 

 

Your Teen

Pediatricians Take on Bullies

The American Academy of Pediatrics (AAP) wants doctors to take an active role in preventing bullying in schools and violence among dating teenagers. An updated policy, published in the July 2009 issue of Pediatrics, gives pediatricians tips for doing that. Doctors should tell parents to talk to their children about bullying, teach children how to resolve conflicts and promote respectful relationships in dating, the policy says. It also suggests doctors volunteer to talk about the topics at schools, churches and youth organizations.

This is the first time the AAP has addressed the issue in detail. "Violence is a public health problem that needs to be dealt with in the context of health care," said Dr. Joseph Wright of Children's National Medical Center in Washington. Wright heads the academy's violence prevention committee and helped write the recommendations. Studies suggest children's early home life, if stimulating and emotionally supportive, can protect them from being victims of bullying later in life, Wright said. "Having meals with your child, watching television with your child" are among ideas that doctors can share with parents at "every single visit between birth and age 21," Wright said. The policy also says a European program that emphasizes the role of bystanders in preventing bullying in schools could be a good model for prevention efforts in the U.S. Dr. Robert Sege of Boston Medical Center, who also helped write the policy update, said the Olweus Bullying Prevention Program teaches children that bullies are kids with problems and bystanders can protect victims. Schools that use the program teach children "we take care of our own," Sege said. Kids learn "even if you have freckles or wear glasses, it's our job to include you in the social environment."

Tags: 

Pages

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

DR SUE'S DAILY DOSE

The best ways to cope with seperation anxiety.

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.