Ask Dr. Shapiro

Screen Teens for Mental Health Problems Will Save Lives

2011-01-22T12:31:00.001-05:00

The American Academy of Pediatrics is advocating that teens receive a simple mental health screening once a year. The screening can be administered in schools, at annual physical exams, or other health care problems. The TeenScreen national Center for Mental Health Check Ups at Columbia University has designed a five to ten minute questionnaire for 11 to 19 year olds using a brief questionnaire,. With 11 percent of the nations youth suffering from a diagnosable mental disorder , only 20 percent receive mental health services. The screening is designed to identify mental health disorders that might otherwise go undetected in teens, including anxiety, depression, and addictions.

Click here to download a brochure describing the TeenScreen program: http://www.teenscreen.org

Protect Your Child From the Choking Game

2010-03-09T09:36:00.000-05:00

Q: I just read about the Choking Game, and I’m wondering if my 14 year old son, who has ADHD, is more likely to play this game. What should I do to prevent this?

You are right to be concerned about your son. He is right in the target age of children who play the Choking Game which is early adolescence, 11-15. Although there are no studies to suggest that ADHD kids are more likely to play this game, it is common for ADHD kids to have poor judgment and to be more influenced by peers who are engaging in this potentially harmful activity. All kinds of kids play the Choking Game, but ADHD kids may be more at risk.

Of course the Choking Game is not really a game at all. Also called Roulette, Rising Sun, Space Monkey, the Tingling Game, and the Pass Out Game, young teens try this activity to get a high by cutting off oxygen to the brain, and then experiencing a rush as the blood begins to flow again. Teens may literally choke each other with their hands, push each other’s chests to expel air and hyperventilate , or use a belt or a rope to restrict their airways.

The Choking Game is most often played in groups, but it is most dangerous when kids try to play when they are alone, often tying a rope to a bed post or closet rod, and unintentionally strangling themselves. It only takes 3 or 4 minutes of oxygen deprivation to start killing brain cells, and death occurs in as little as four or five minutes.

There are some obvious signs that kids are playing the Choking Game, including red marks around the neck, bloodshot eyes, frequent headaches, and belts or ropes tied to a bedpost or closet rod. But most kids are good at hiding secrets from their parents, so don’t think that a lack of obvious signs means that your child is not in danger.

Ironically, many teens think that the Choking Game is a “natural” high, safer than drugs or alcohol. But in reality, it can be even more dangerous. An estimated 250 to 1,000 children die each year from playing the Choking Game, but many more children get concussions from falling down or have seizures when their brains have been deprived of oxygen.

So what can you do to prevent your child from experimenting with the Choking Game?
There are four simple steps:

1. Eat dinner with your children. Statistics tell us that teens who eat dinner with families at least three times a week, are much less likely to engage in all kind of high risk behaviors.

2. Talk to your child about the Choking Game. Don’t be an inquisitor, but rather begin the conversation saying something like: “I just heard about the Choking Game on TV. It sounds like a lot of kids do this. Have you heard about any kids trying it?” Whatever your child’s answers, calmly explain how serious this activity can be, and how you hope that your child will never take this kind of foolish risk.

3. Teach kids how to be assertive if they are pressured into playing the Choking Game or any dangerous activity. Ask your child if she has ever been pressured to do something she didn’t want to do, and then role-play how she would respond. Also teach your child to be assertive in telling other kids not to engage in this dangerous activity and talking to an adult if they are concerned about a friend or even an acquaintance.

4. Make sure that your school has a prevention program which includes teaching kids about the Choking Game. School prevention programs work! Make sure that your school has a trained teacher or counselor regularly talking to kids about all the problems that affect kids and teens.

How to Recognize Computer Addiction & What To Do

2010-03-06T12:42:00.002-05:00

According to the Media Research Lab at Iowa State University, about 8.5 percent of 8-to-18-year-old children can be considered addicted to video games. And nearly 1 in 4 children, (more boys than girls) admit they've felt like their video game playing was out of control.

Is your child or a child you know spending too much playing video games? Check off any of the statements below that pertain to your child.
1. Most of the child's "free time" is spent on the computer or playing video games.
2. The child is always tired, sometimes falling asleep in school.
3. The child is not keeping up with homework assignments and projects.
4. The child has worsening grades.
5. The child is lying about computer or video game use so privileges aren't taken away.
6. The child is choosing the computer or playing video games rather than spending time with friends or family.
7. The child is dropping out of activities such as social groups, clubs or sports.
8. The child is irritable, cranky or agitated, when not playing a video game or on the computer.

If you check even one of these statements, your child is spending too time playing video games, and you need to do something right away.

Here are some things you can do:
1. Talk to your child about the affects of playing too many video games, including: irritability and mood changes, weight gain, and loss of friends.
2. Decide on a reasonable amount of time he or she can play (most experts feel that children should not be in front of a "screen" (including TVs, computers, and video games) for more than 1.5 hours a day. Software is available to help you limit time on the computer.
3. Provide many alternative activities, preferably ones that involve active play and exercise.
4. Avoid leaving the child alone for long periods of time in his room or other unsupervised places. 5. Reward activities like reading, spending time in the library, or community service with lots of praise and attention.

Is your child popular? Do you want him to be?

2010-03-05T11:24:00.000-05:00

Parents often assign a negative connotation to the concept of popularity. After all, popular culture often portrays “popular kids” as vacuous jocks and cheerleaders, without much character or moral fiber. But our psychological definition of popularity is both simple and straightforward, and makes it clear that all parents should want their children to be popular. Popular children are liked by many and disliked by few. You do not need to be the captain of the football team or the class president to be popular. You don’t need to be the handsomest or the prettiest among your peers. You must only be well liked.

Do know if your child is well-liked? I usually assume that the more time children spend with their peers and the more varied their activities, the more popular they are. Check off the following statements if they apply to your child, age six or older. The more statements checked the better.

___My child talks to other children on the phone usually on a daily basis.
___My child spends time every weekend with other children of the same age.
___My child talks about his or her “best friend.”
___My child belongs to a sports team, or participates in other sports activities at least once a week.
___My child belongs to nonathletic groups of children outside of school (Cub Scouts, church youth groups, special interest clubs, etc.).
___My child is regularly invited to parties and other social functions.
___My child corresponds with others using email or letters.
___My child (eight or older) is frequently invited to go over the house of other children for extended periods of time (four hours or more).
___My child (eight or older) sometimes sleeps over at another child’s house or has a child sleep over at our home.
___My child (eight and older) spends time in academically oriented activities with other children, such as science projects, study groups, or helping each other with homework.

Each one of the statements in the checklist refers to an important milestone in a child’s social development. If your youngster has not achieved these social milestones, there are many simple things that you can do to help her become more socially adept. Look for these ideas in my daily parenting tips.

What do I do when my child doesn’t listen?

2009-04-03T13:43:00.006-04:00

Use the “Repeat Technique.”

A lot of parents have a hard time getting kids to follow simple requests and directions. They ask their children to get ready for bed, or pick up their toys, or get dressed for school, but their kids just don’t do what they are asked. Then parents may scream, threaten, or just give up. When this happens, it causes lots of bad feelings in the home, and can be the start of serious behavioral problems.When children don’t listen I often tell parents about the “Repeat Technique.” It is simple to do, and almost always works right away.

Instead of asking children to do something (“Will you pick up the toys?”), tell them what you want them to do in a clear, firm, simple sentence, saying something like:“Pick up the toys, please.” No matter what your children respond back—and they may bargain, whine, plead, give excuses and over and over again. Do not raise your voice or change your expression.Keep your emotions in check. Just keep repeating the same simple directive, and within a few moments your child will see that you mean business and will do what you want.

Although this technique may seem awkward at first, if you do it correctly, most children will do what you want after you have stated your directive five or six times. If you use this technique whenever your kids resist your directions, they will soon learn that you mean business when it comes to being in charge of the household, and the negotiating, whining, and challenges will stop. Soon you’ll find there is nothing quite like a peaceful household where kids are kind, considerate, and attentive to others’ needs.

Helping Homeless Children

2009-03-26T11:51:00.005-04:00

A recent article on “tent-cities” for the homeless sprouting up across the nation made me think about how we can help homeless children in America. According to a new report issued by the National Center on Family Homelessness, one out of every 50 American children experiences homelessness in their lifetime and according to data analyzed from 2005 and 2006, 1.5 million children experience being homeless in America each year. We can only assume with the current recession that this statistic is significantly higher and growing in 2009.

The report also looked at how individual states deal with this problem, ranking performance in four areas: child homelessness per capita, child well-being, risk for child homelessness, and state policy and planning. The top five states were Connecticut, New Hampshire, Hawaii, Rhode Island and North Dakota. At the bottom were Texas, Georgia, Arkansas, New Mexico and Louisiana.

According to the report, most states have inadequate plans to address this worsening and often-overlooked problem. One can only imagine the suffering that a child experiences after having to leave his home, and then live in a homeless shelter or even on the street. The report said homeless children are far more likely than other children to experience hunger, suffer chronic health problems, repeat a grade in school and drop out of high school. As President Obama said in his press conference earlier in the week, the wealthiest nation on earth cannot tolerate having children living without homes.

The report offered 19 recommendations for government action, including beefed-up federal spending on low-income housing, assistance to struggling renters and homeowners, and investment in childcare for homeless children. It urged states to place homeless families directly into permanent housing rather than into motels. It recommended that we set the goal of ending homelessness for all U.S. children within a decade.

In the meantime, those of us who are educators and counselors need to think about how we can help homeless children today. The only way I know is by helping children develop their resiliency (emotional intelligence) skills, which is why I wrote the book When Can We Go Home? The free e-book contains 13 activities that help children deal with the loss of their home, feeling safe no matter where they are, meeting new people, self-calming tips, problem-solving ideas, and remaining positive about themselves and their families. Please click the book cover on the right to download it to your computer. You are welcome to print out as many copies as you like.

What Can Kids Do For Homeless Kids?
Over the years I have recommended many websites that encourage helping and caring in children. One of my favorites, kidscare.org, promotes Kids Care Clubs. Kids Care Clubs are groups of young people who work together to help others in their communities and around the world. Below are some ideas on how kids can help homeless kids.
· Collect canned food for shelters.
· Clean a closet and give old clothes, toys, and games in good-condition to shelters.
· Raise money or give part of your allowance to a shelter.
· Teens can volunteer directly at a shelter. They can babysit, read stories, provide homework help or just play with the kids. Being homeless is one of the worst things that can happen to a child. If you can think of ways to help these children, I hope that you will.

Free Download: Understanding How Emotions Affect Your Body

2009-03-19T09:55:00.002-04:00

Every week in my newsletter, EQ Kids, I offer a free activity you can download which can help you teach children emotional, social, and behavioral skills that can last a lifetime. Increasing a child’s emotional intelligence will make him happier, healthier, and more successful in everything he does. Studies also suggest that teaching kids EQ skills will make them more resilient, and better able to cope with both common and uncommon emotional problems.
This week’s download is an activity which teaches children how emotions can affect their bodies, and how learning to relax can help calm stress, anger, and anxiety.

Click the image of the couch to your right to download the image. You can also sign up for my weekly newsletter by clicking the link to your right.

Do Kids Outgrow ADHD?

2009-03-18T11:43:00.001-04:00

Q: My 8-year just went on medication for ADHD. My pediatrician says that this will help him in school, and that he may outgrow the problem in a few years. Is this true? Do kids really outgrow ADHD and if so, when?

A: Your pediatrician is correct, about 75% of children outgrow their ADHD symptoms by early adulthood. A study by scientists at the National Institute of Mental Health and McGill University compared brain scans from two groups of children, one with attention deficit disorder and one without (reported in the NY Times http://www.nytimes.com/2007/11/13/health/13kids.html?_r=1&hp&oref=slogin). In the group of children with ADHD, the pruning process of the cerebral cortex, sometimes called the thinking part of the brain, began about 3 years later than kids without ADHD. The greatest delays in brain maturation were found in those areas most involved with attention and motor delay. The authors of the study concluded that most children with ADHD develop normally, just more slowly in some areas of the brain. Of course statistical studies do not necessarily apply to individual children. While this study suggests that your child is likely to grow out of his ADHD by the time he is in college, there is still a 25% chance that this won't happen. Six month follow-ups with your pediatrician are recommended to evaluate his medication protocol, and at least an annual review of his school performance. Most physicians also recommend "medication vacations" so that a child's behavior can be evaluated without the influence of drugs.

When Do Teens Start To Have Sex?

2009-03-16T09:40:00.001-04:00

Q: My 15-year old daughter is very mature, and has started dating older boys. I’ve talked to her about sex, and told her that I want her to wait until she is older to have intercourse. She asked me “how much older,” and I didn’t really have a good answer. How old do you think a teen should be before having sex?

A: The age that teens have sexual intercourse varies according to cultural standards, and of course in many religious countries, sex outside of marriage is strictly forbidden. We do have some ideas about norms for the U.S., thanks to a review of the research done by the Kaiser Family Foundation in January 2005. According to this report, there has been a decline in the number of high school students (9th to 12th grade) who reported having sexual intercourse, from 53% in 1993 to 47% in 2003. The percentage of high school students predictably increases with each grade from 33% in 9th grade to 62% in the 12th grade. The median age for first sexual intercourse is 16.9 years for boys and 17.4 years for girls. Education about safe sex seems to be working. According to this report, 98% of teens reported that they had used birth control, although not all of the time. Nearly 17% of sexually active females and 9% of sexually active males said that they did not use contraception the last time they had sex. Having sex at an older age, and an increase in birth control has reduced the rate of teen pregnancies, but the rate of sexually transmitted diseases remains high. One in four sexually active teens contracts an STD every year. You can read the report for yourself at: http://www.kff.org/youthhivstds/upload/U-S-Teen-Sexual-Activity-Fact-Sheet.pdf

If you want your teen to be abstinent, or at least wait until he or she is out of high school to have intercourse, there are some things you can do:
1. Discourage drugs and alcohol. Over ½ of teenage girls say they might participate in sexual activities they really did not want to when drinking or using drugs.
2. Have frequent family meals. Many studies correlate the number of family meals with a decrease in the use of drugs and other risky behaviors.
3. Teach your children values from an early age. Values are learned from early in childhood, and remember that children pay more attention to what you do than what you say.
4. Teach your children and teens about the influence of the media and social networking sites. Teens are barraged with overt and subtle messages that promote early sexuality, particularly on sites like MySpace and Facebook.
5. Set limits from an early age. Teens complain about limits, such as early curfews, but studies suggest that this is an important factor in teaching responsibility. Teens who have had clear limits set since childhood will be less likely to rebel as they get older.

Pictures Can Help Fight Stress For The Whole Family

2009-03-10T11:39:00.001-04:00

In spite of our love affair with technology and electronics, humans have a natural affinity towards nature and natural scenes. Scientists call our need to look at and be in nature biophilia. Although nothing beats a stroll on the beach or a walk in the woods, as we continue to cope with cold winter days just looking at nature scenes may have a calming effect on your psyche. Researchers speculate that our need to see nature, even when we can’t be in it, explains why so many people have mountain or beach scenes as screen savers, or photos of nature decorating their wallw. You can try this at home with your kids, or in your office. Print out images of nature and put them around the house. Use scenes of nature as a background on for your computer/ Make a little indoor garden or put a group of house plants in a place where you spend a lot of time. Make sure that your plants or pictures are in a place where you will see them often. Even a little bit of nature goes along way. Some researchers say that when patients in a hospital can view natural scenes from their windows, they heal quicker.

Music Can Help Get Kids To Listen & Learn

2009-03-06T14:54:00.001-05:00

You have undoubtedly heard the expression “music tames the savage beast.” But did you know that it also can tame a pretty wild child? Research studies have shown that music is one of the quickest ways to influence human behavior. Whether we like it or not. our brains are significantly influenced by music almost as soon as we hear it, and parents can use music in the home to influence the mood and behavior of their children. Here are a few ideas you might want to try:

· Do you want kids to get ready quicker in the morning? Play music with an upbeat tempo. The faster the beat, the quicker kids will move.
· Do you want kids to calm down before bedtime? Play slow soothing music. Quiet music lowers the heart rate and blood pressure.
· Do you have kids who are anxious or can’t concentrate? Music played at the rhythm of the human heart beat is said to calm kids down and help them focus.
· Do you want to calm the temper of angry kids or teens? Limit loud music with a “hard beat.” It raises the irritability/anger threshold.

Should You Reward Kids For Good Work With Treats And Prizes?

2009-03-05T10:41:00.001-05:00

According to a recent NY Times article, the debate as to whether or not you should reward kids for doing homework, chores, or other expected behavior, continues to rage. Some psychologists think that it is the quickest way to get kids to do what you want. But there is also research that suggests that when kids just work for rewards, they don’t learn to value the task, and when the rewards are removed they stop doing what is expected.
In my opinion, this debate misses three essential points. First, we have to remember that kids are different. Some kids need very little to motivate them and others need a lot. If a child is willful and oppositional, we can assume that he or she needs more motivation to behave appropriately. In that case, a tangible reward system, such as a point system with a chart and a “rewards menu” is appropriate. If a child is already easy-going and eager to please, then there is no need to add an extra incentive.
Secondly, we have to make sure that rewards are given in a systematic way. Often parents and even teachers are inconsistent in the way that they give rewards, which can confuses kids can even make a behavioral problem worse.
Finally, we have to think of reward systems as short-term. If children are learning a new behavioral habit (for example making their beds or doing homework without supervision), then they often need extrinsic, concrete rewards. But once the habit is learned, there is no need to continue the rewards. Generally, it takes about 21 days to learn a new behavioral habit and that is when most reward systems can be phased out or eliminated.

Depression Is The “Common Cold” Of Psychiatric Problems

2009-03-04T09:00:00.001-05:00

For more than 20 years, researchers have been trying to find ways to prevent depression in children and teens. Although childhood depression doesn’t get nearly as much attention as ADHD or disorders on the Autistic Spectrum, depression is often called the “common cold” of psychiatric disorders, and an estimated 1 out of 3 people will have a serious depression at sometime in their lives.
Teens, of course, have a high risk for depression, which is often associated with other problems that get more attention, like drinking, eating disorders, or poor school performance. Suicide remains the third leading cause of deaths between the ages of 15 and 25.
Whether or not your child shows symptoms of sadness or depression, it is likely that she will experience this problem at sometime in her life, and there are things you can do to make sure that this mood disorder does not become a lifetime battle. To begin, you need to help your child be a “problem-solver.” When she comes to you with problems, particularly ones that involve other children, hold back on your suggestions. Instead ask her to “brainstorm” possible solutions, coming up with as many strategies as possible. Then show her how to evaluate each possibility, and decide on which one might lead to the best outcome. Encourage her to try the solution, and if it doesn’t work, go back to the original list and try again. This simple procedure fosters self-reliance and self-worth, the opposite of the feelings that underlie depression.

Music Can Help Get Kids To Listen & Learn

2009-03-03T15:07:00.000-05:00

You’ve undoubtedly heard the expression “music tames the savage beast.” But did you know that it also can tame a pretty wild child? Research studies have shown that music is one of the quickest ways to influence human behavior. Whether we like it or not. our brains are significantly influenced by music almost as soon as we hear it, and parents can use music in the home to influence the mood and behavior of their children. Here are a few ideas you might want to try:
· Do you want kids to get ready quicker in the morning? Play music with an upbeat tempo. The faster the beat, the quicker kids will move.
· Do you want kids to calm down before bedtime? Play slow soothing music. Quiet music lowers the heart rate and blood pressure.
· Do you have kids who are anxious or can’t concentrate? Music played at the rhythm of the human heart beat is said to calm kids down and help them focus.
· Do you want to calm the temper of angry kids or teens? Limit loud music with a “hard beat.” It raises the irritability/anger threshold.

Children Worried About Death

2009-02-27T10:17:00.000-05:00

Q: My 9-year-old is terrified of dying. She doesn’t know anyone who has died, but in the last few months she seems to think about death more and more. Even though she is normally a bright and “spirited” child, about twice a week she breaks into tears saying that she is worried that someone in the family will die. What can I do to help her?

A: It is not unusual for 9-year-olds to suddenly be worried about death. A child’s understanding of death changes as she grows. Young children typically think of death as a long trip from which you can return, but between 8 and 12 children begin to get a sense of the permanency of death, a terrible and sometimes overwhelming thought. Many children go through periods when they worry about death, and, like your child, they get upset on a regular basis. The mind can work in mysterious ways, and just because you don’t see any triggers for her worries, this doesn’t mean that they don’t exist. Perhaps it is the news reports of the war in Iraq, or a book she is reading, or a television show or movie that she has watched. Maybe she has a friend who has experienced a death in her life. Often these kinds of anxieties are “contagious.”Whatever is triggering her fears, you must ask yourself if her worry about death is a symptom of a more serious anxiety disorder. There are several tests which can help you distinguish normal anxiety from clinical anxiety, including the Multidimensional Anxiety Scale for Children (MHS, Inc. 1997), and the Revised Children’s Manifest Anxiety Scale (Western Psychological Services1985). A school psychologist should have access to these or similar standardized ways to measure anxiety. Obviously if an anxiety disorder is discovered, treatment should follow as soon as possible.The most important part of your question is what should you do to help alleviate your child’s worries. Whenever I encounter a psychological or developmental problem in children, I ask myself: “What does this child need to solve the problem herself.” The answer to this question is always a specific emotional intelligence skill.In the case of your daughter, I would say that the two most important skills she needs are to “self-calm” and to be able to communicate her feelings to people who can give her a sense of support and belonging. Every emotional intelligence skill is related to a specific part of the brain’s emotional chemistry. Learning to self-calm (through deep breathing, meditation, guided imagery, and so on) reduces stress biochemicals, including cortisol, adrenaline, and norepinephrine. Practicing using self-calming techniques will train your child’s brain to be able to deal with all kinds of stress and worry. Talking about her feelings to others produces serotonin in the brain, a biochemical that is a mood modulator. These feelings may be about her anxiety, but talking about any concern at all will help her feel a sense of belonging and being cared about. When people say that they “feel better” after talking to a counselor, a family member, or a friend, this feeling actually comes from the increased serotonin in the brain.Although I don’t really think that talking about death will help your daughter, and may temporarily increase her anxiety, there are several books available to help parents open a discussion about this difficult subject. One of my favorite books for children is When Dinosaurs Die by Laurie Krasny Brown and Marc Brown. This illustrated book has a comic book feel, and seems to intrigue children without talking down to them. You may want to read this book yourself to get a better feeling of how a child your daughter’s age thinks about death and what might be appropriate answers to her questions and concerns. Then show the book to your child and suggest that she may want to look at it herself. Let her choose whether this is something she wants to do.

How Old Should Kids Be Before They Play Video Games?

2009-02-26T12:37:00.002-05:00

Q: My 3-year old has been watching his 9 and 11 year old brothers play video games, and wants to start playing games too. I know that there are games out there for kids his age, but is 3 too young for him to start?

A: There are many video games available for three years olds, including one by Fisher Price that has tots pedal a miniature stationary bike to work the game. But I would advise delaying having your son play video games for at least another year. The American Academy of Pediatrics suggests that children under three shouldn’t spend any time in front of the “screen” (TV or video games), although that may be a bit unrealistic. A recent survey from the Kaiser Family Foundation found that half of all four to six year olds play video games, and about 25% play several times a week.As with all children, the real question is: How much time playing video and computer games are we talking about? Beginning at four, children might find some some video games entertaining and educational, but they should really be spending their time in more active and imaginative play. Time spent playing video games becomes much more of a problem beginning at five or six, when there is a significant push to get kids on Internet sites like WebKinz, and many more commercial games are available for the various video consoles. And things don’t get better. In the ‘tween years, many kids add Instant Messaging and social networking sites to their repertoire of time-consuming sedentary interests.
Clearly, being outside on a bike or skiing or playing tennis in the fresh air, with real people, is preferable than doing these activities in a virtual world.As with so many issues in child-rearing, the best answer involves appropriate use of the “L” word. No, I'm not talking about love, the “L” word I’m referring to is limits. Parents need to determine a limit for their children to be in front of the screen (TV, video games, computers) for each child, and don’t exceed it. My recommendations would be: one-half hour or less a day for children ages 3-5, one hour a day or less for children ages 6-12, two hours a day for teens (which hopefully would include using the computer for educational purposes). Of course setting limits is one thing, and getting kids to do things like chores, reading, or sports is another. Responsible parents need to work at both limiting questionable habits and supporting habits which lead to physical and mental health. When it comes to video games other gadgets and gizmos, the sooner you teach good technology habits, the better.

New Guidelines on Children’s Weight

2009-02-25T12:10:00.001-05:00

Q: My 5-year old is pretty chubby, but I looked this way too when I was young. Then, when I was a teenager I dieted and remained thin. Should I be worrying about her weight? How old should a child be before going on a diet?

A: With every passing year an overweight child increases the probability that she will have a lifelong struggle with weight. There is a window of opportunity, between 8 and 12, which is the critical developmental period to make a difference in a child’s future weight. This is a time when children are cognitively ready to understand the relationship of good nutrition and exercise to their health, and yet they are still highly influenced by their parents’ rules and values. As they enter their teen years, children eat more meals away from home and they are more susceptible to influences from the media and the barrage of commercials for soda and junk foods. This is also a time that children often cut down on their physical activity (with the exception of children who are in organized sports who tend to remain active through high school).While the tween years are an important time for parents to help their children develop a healthy and permanent lifestyle, we also know that good eating habits must begin in infancy and concern about nutrition and exercise is a concern at every age.A panel convened by government health agencies and the American Medical Association called for improved guidelines for monitoring weight in children including: weight checks at least yearly, counseling about weight even if children aren't overweight, and a four-stage treatment plan that could end in medication or surgery for the most persistently obese children.The study also noted that children need an hour of physical activity a day, along with limits on sweetened beverages, computer and TV time, as well as fast-food meals. Doctors are advised to get a family history of obesity, diabetes and heart disease. Doctors also are advised to check cholesterol levels of overweight children.For overweight kids (85th to 94th percentile) and the obese (95th percentile and above), diet and exercise guidelines are more specific and follow-up times are shorter.Despite concerns about soaring childhood obesity—roughly 17% of American children are considered obese-- diagnosis still lags, with studies showing only half of overweight kids are diagnosed as such by their doctors. While being overweight is a concern for any age child, “dieting” is never recommended for children under 12. Children need good nutrition and should never be put on a diet that restricts any major food group. Less soda and junk food and more exercise is the prescription for most children, but if children are seriously overweight, you should certainly consult your pediatrician or a nutritionist. Dietary guidelines for infants and children can be found at the web site of the American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=4575.
Overweight teens may benefit from dieting, but given the risk factors for depression and eating disorders in teens, dieting should always be done with caution and supervision. I strongly recommend a new book based on the highly acclaimed Sierra School (the only high-school in the U.S. specifically designed as a weight loss program): http://www.parentchild411.com/s.nl/it.A/id.803/.f

Kids need to get dirty. Organisms in dirt improve a child’s immune system.

2009-02-24T16:15:00.000-05:00

According to a recent article by Jane Brody in the NY Times, researchers are saying that kids need to spend time more in the dirt and that the millions of bacteria, viruses, and especially worms that enter the body along with “dirt” spur the development of a healthy immune system. The studies suggest that our obsession with keeping kids clean may in part explain why immune system disorders like asthma and allergies and even multiple sclerosis and Type 1 diabetes, have risen significantly. This trend is happening in developing countries as well as the U.S. Some doctors believe that the current emphasis on antibacterial products convey a false sense of security for parents and may foster the development of disease-causing bacteria. Plain soap and water are all that kids need to be clean. Psychologists and sociologists also suggest that kids should play more outdoors. Richard Louv, author of “Last Child in the Woods,” claims that spending too much time in front of a screen, and not enough time outdoors, is resulting in more behavioral problems in children. So now that the cold weather is moderating . . get those kids outside!