Category Archives: preteens

Screen time for adolescents: what is appropriate?

If your family is like most, your teens have trouble putting down their screens at mealtime, bedtime, school, and just about anywhere! It’s a situation that is almost universal in our culture, but one that can lead to harmful long-term issues if they don’t develop some healthy habits. You can help.

According to the American Association of Childhood and Adolescent Psychiatry, screens can sometimes have negative consequences for a child’s or teenager’s physical, emotional, or psychological health. (Read the whole article here; it’s very helpful and informative.)

“Parents may not always know what their children are viewing, or how much time they are spending with screens. Children may be exposed to:

Violence and risk-taking behaviors
Videos of stunts or challenges that may inspire unsafe behavior
Sexual content
Negative stereotypes
Substance use
Cyberbullies and predators
Advertising aimed at your child
Misleading or inaccurate information

Too much screen time may lead to:

Sleep problems
Lower grades in school
Reading fewer books
Less time with family and friends
Not enough outdoor or physical activity
Weight problems
Mood problems
Poor self-image and body image issues
Fear of missing out
Less time learning other ways to relax and have fun”

You’ve likely seen or experienced some of these issues in your own family: your children upset because of being bullied on social media; negative stereotypes about looks and body image; a perceived need to answer every bling the phone makes or to constantly post pictures to Snapchat or Instagram. Being completely attached to a device is unhealthy, and there are some things you can do to help your teens strike a balance.

First, make sure you are modeling appropriate amounts of screen time. Do you seem to care more about a work email than about a moment with the family? Do you keep your phone with you every minute and read it constantly? Is the television on nonstop in your home?

This is a perfect subject for your teens to learn how to negotiate what’s important. Together in a family meeting (or a series of meetings) come up with a set of rules for everyone to follow. Rules might include: no devices during mealtimes; for every half hour on a device, spend a half hour in conversation or physical activity or a game; phones and devices are turned off 30 minutes before bedtime. Make sure your teens know that you have the right to monitor their activity on devices and social media, because you are keeping them safe even if they don’t like it.

Families that negotiate screen time can find that talking about it brings the family closer. Parents also probably need to focus more time on other family members instead of their screens. Modeling appropriate use of devices is a gift to them, and also to you. More time not watching a screen frees up time to do things together. And, while the things they experience and see on social media are fleeting, the time they spend with you is absolutely priceless for all of you.

Help your child want to wear a mask

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A year ago, no one could have guessed that a back-to-school list would include face masks, but that’s definitely where we are in 2020.

The school year is starting soon, with some huge changes. Many people are more than a little anxious about what the classroom will be like, and how students and their families, faculty, and staff will be able to navigate this new landscape of social distancing, extra hygiene, and mask-wearing.

A recent article from the American Academy of Pediatrics discusses the whys and hows of wearing masks.

Here are some guidelines.

Follow school rules. You always teach your child to respect the teachers and staff, and to obey school rules. Rules about mask wearing are no different. You may not agree with every rule, but it’s important that you support mask wearing if the school requires it.
Make sure the mask fits well. One that is too tight, too loose, or doesn’t cover both nose and mouth is not very effective.
Practice wearing at home. The whole family can wear masks for an hour, making everyone more comfortable with the sensation. Wear when you go into a store, and keep masks by the door so you don’t forget to take them when you go out.
Use age-appropriate talking points like, “Masks help us keep our germs to ourselves.” For teens, remind them that they are part of the solution for keeping themselves, their friends, and their families safe—they are being good citizens.
Avoid creating fear and anxiety. For young kids, here’s a great song video with Sesame Street characters about how we care for each other by wearing masks, washing hands, and keeping social distance.
Make mask-wearing fun. For younger children, put masks on their favorite stuffed animals. Give the child a gift of a mask you know they’ll enjoy.
Consider your budget and provide your child or teen with masks they’ll love showing off at school. Even though spending $10 or $15 for a mask sounds like a lot of money, think of it as an article of clothing. A purchase of two masks allows you to rotate them through the laundry each day. Buy masks that are washable, reusable, and that demonstrate individualism. From Amazon to Old Navy, there are masks that show support for your favorite team, are in a special color or design, or make you into a super hero. Your child or teen doesn’t like masks? Consider a neck gaiter instead; they also come in a variety of designs.
Find more ideas here from Norton Hospital in Louisville.

It takes all of us working together to keep our children, teens, and adults as safe as possible until a vaccine is widely available. We know you care about your family and your community, and we’re here to help you navigate this uncharted territory together. Call us if you have questions.

Is vaping a better option than smoking tobacco? The short answer: No.

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The use of e-cigarettes, or vaping, is growing nationwide and in our own community. While the purchase of e-cigarettes is limited to those who are 18+ years old, it’s not that hard to get your hands on e-cigarettes if you’re under legal age.

In our practice we’re very concerned about how e-cigarette ads target teens, and we’re seeing an increase in usage. The “juice” that is used in e-cigarettes comes in child and teen-friendly flavors. This juice is heated by a coil in the device, delivering a high dose of nicotine.

E-cigarettes and other vaping devices may look like traditional cigarettes or cigars, or they may be designed to look like pens, flash drives, or any number of items. These ENDS (electronic nicotine delivery systems) might seem cool, or even a way to quit smoking tobacco, but the nicotine is highly addictive and dangerous.

According to an article by the American Academy of Pediatrics (AAP), here are some important points to know about vaping:

“Kids might use different words to talk about e-cigarettes and vaping. For example, “Juuling” is a popular word among the patients of Susanne E. Tanski, M.D., a tobacco prevention expert from the AAP, to describe using a brand of e-cigarette. About one in four kids who use e-cigarettes also tries “dripping.” Instead of using a mouthpiece to vape, they drip the liquid directly onto a heat coil. This makes the vapor thicker and stronger.
Kids can order “e-juice” on the Internet. The legal age to buy e-cigarettes is 18 years, but online stores don’t always ask for proof of age.
E-cigarette juices are sold in flavors like fruit, candy, coffee and chocolate. Most have the addictive ingredient nicotine. The more kids vape, the more hooked they become. “This is potent stuff,” Dr. Tanski said.
Kids who vape just once are more likely to try other types of tobacco. Their developing brains make it easier for them to get hooked, according to a recent study.
E-cigarettes may not help people quit using tobacco. Some adults use e-cigarettes when they want to stop smoking tobacco cigarettes. While a recent report found e-cigarettes are “less toxic” than cigarettes, most people who use e-cigarettes do not quit using cigarettes.”

The link above also contains a 30-second video about vaping. If your child or teen is vaping, you should be concerned. We can provide a consultation with your child to help them understand the dangers of nicotine addiction. Call for an appointment.

Bullying is a serious matter

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October is National Bullying Prevention Awareness Month. That means now is a good time for us to talk about this important subject.

Bullying can occur at school or on the bus, in the neighborhood, on the playground— anywhere. Cyber bullying is also on the rise, where people use the internet or phone apps to harm others.

At the very least, bullying lowers self-esteem. But as we know, continual bullying can cause children and teens to withdraw socially, may create depression or other mental health issues, and can even result in physical harm.

Parental awareness is essential. It’s almost certain that your child will, at some point, either be on the receiving end of bullying behavior, or will bully someone else, or both. An article on the American Academy of Pediatrics (AAP) website references a study from 1999, in which four out of five teens admitted to participating in bullying behavior at least once a month. Those who have been bullied often go on to mistreat others.

Conversations about appropriate behavior and language need to begin early between parent and child. Don’t hesitate to correct your child or teen when you hear name-calling or witness unkind behavior, even between siblings. They can learn early the boundaries between acceptable and unacceptable behavior. Teach them how to express themselves, especially when hurt or angry, by using language that doesn’t cross the line into disrespect. Don’t tolerate violent acts against people or animals.

Of course, your kids are not always near you, and you won’t be aware of everything that happens to them or everything they do. Continue the conversation about bullying; remind them to walk away from confrontations and to inform a responsible adult if they experience or witness bullying. Talk about kindness; role-play sticky situations. Monitor their internet and cell phone activity and discuss what you find there.

Teach your kids some nonviolent and non-confrontational ways to handle conflict. There are excellent resources for this in the article mentioned above, also here and here.

Remember that school counselors and other therapists can be really helpful if your child or teen is a victim or perpetrator of bullying, and our office can always make a referral.

As children get older, remind them that they help create a safe environment for others. They can be a positive force by refusing to contribute to an atmosphere of hatred.

As the school year continues, things can get very hectic. Don’t forget to pay attention to what’s going on with your youngsters. Ask questions, be supportive, get help when needed. Let’s keep our schools and community safe for everyone’s children.

Artwork by Shawna

Breast development in boys?

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As odd as it may sound, about three quarters of boys will develop some breast tissue early in their puberty. This is a normal physical reaction to the increase of hormones, including estrogen, in the male body as it matures.

Gynecomastia, as it’s called, is a source of concern for many boys because they are unprepared for it and think something may be wrong with their bodies. And, of course, it comes at a time in their lives when they may already feel insecure about their physical and sexual development, when they may already be uncomfortable in the locker room at school

Gynecomastia can start as tenderness or soreness around the nipple and can manifest in one or both breasts. Most of the time, the tissue will only grow a half inch or so, and often will be just around the nipple. It can take a couple of years to go away, but normally it will go away.

You should also know that certain medications, both prescription meds and illegal drugs, can cause gynecomastia. In particular, anabolic steroids, marijuana or heroin can lead to gynecomastia, as can insulin and other prescription drugs.

The information for this blog was gleaned from an article on the website for the American Academy of Pediatrics, an article which contains much more information about male puberty and what changes a boy may expect in his body.

If your son has gynecomastia, make sure he knows the condition is common and will resolve itself with time. Show him this article. Encourage him to talk to his physician who can assure him that nothing is wrong with his body or his development.

Back in School, Part 4: Friends

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While you are worrying about your child’s academic year, he is probably more concerned about friends. Honestly, he has a point. While academic skills are an important part to future success and happiness, so are the social skills that help us make and keep friends.

Children at a very young age are usually too self-centered to have friends. This isn’t their fault; it is just a normal developmental stage. If you watch a couple of toddlers on a play date, they will usually engage in what is called “parallel play,” meaning they play side-by-side, but not really together. Even so, you can start to teach them to share, not to grab toys away, etc.

By school age, most children want friends, whether it is just one or many. Good social skills are learned from parents, teachers and peers. Here are some behaviors you can teach your kids that will serve them in school and throughout their lives.

Kindness. Use kind words and tones around the house. Don’t allow your children to be unkind to their siblings, to pets or to adults. Everyone responds positively to kindness, and no one likes a bully.
Politeness. (See our post on manners.)
Assertiveness. You don’t want your child to be aggressive toward others, but you want her to be able to assert her opinions and express her feelings without being overbearing. This takes practice, and it can be something you encourage through conversation, questions, and even role playing. For example, “What will you say if your friend wants to play kickball and you’d rather swing?” They can learn from you the give-and-take of good relationships.
Meeting and greeting. Teach your youngster to introduce himself and to ask questions about another person. They can learn to shake hands, make eye contact, smile.
Listening. Hearing what another person has to say is as important as expressing your opinion.

Here’s a really nice FREE online resource entitled 101 Ways to Teach Social Skills to Children. While the games and activities are designed for groups, many of them can be adapted for use within the family—a fun way to learn appropriate ways of behaving in different settings.

Every school in Scott County has a counselor who can observe behavioral issues both in and out of the classroom, and who can meet with your child and/or other students if needed.

A final word: pay attention to the friendships your child/teen is forming. Get to know his friends and their parents. Make sure their behavior isn’t out of line with what you expect from your own kids.

The friendships we form in childhood and adolescence may or may not last a lifetime. But they teach us skills and behaviors that are timeless.

Back in School, Part 3: Teachers

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Every morning when you send your child to school, you are putting her into the educational, social, emotional and physical care of other adults. This can be intimidating at times, but it doesn’t have to be.

The vast majority of teachers are in classrooms because they want to be, because they care about the students and love the material they teach, and because they want to make a difference. They spend time in the classroom trying to instill in youngsters the love of learning. And they spend time outside the classroom preparing lessons, grading work, and keeping the mountains of records and paperwork required by the school system.

Most of all, they want every child—your child—to be successful. That success is far less likely without your support.

Speak positively about your child’s teachers. If you hear complaints from your young student, listen with an objective mind.
Establish a relationship with a teacher. If you can volunteer at the school, wonderful. Your schedule may not allow that, so find other ways to be in touch.
- Stay connected. Most teachers and classrooms have a website. Send the teacher an e-mail when you appreciate something he’s done for your child or if you have a question. If there’s ever a problem, you will have built a positive base for your relationship, and the problem will be easier to deal with.
- Attend parent-teacher conferences. These are important for everyone concerned: student, teacher, family. You will learn things about the classroom and how your child interacts with adults and classmates, and will come away with a much more rounded picture of the education process in that particular class.
- Make appointments. Don’t wait for a conference if you have questions or concerns. Face-to-face meetings are helpful and teachers want to be available to you. They will want to hear from you sooner rather than later.
- Reinforce at home what’s happening in the classroom. From spelling tests to chemistry homework, from learning how to talk out problems with fellow students to deciding what to eat for lunch, the teacher and you are on the same team.
- Of course, if there is ever concern about inappropriate or illegal activity by a teacher or any other adult, notify the authorities immediately.

Teachers are on the front lines of helping your child develop in age-appropriate ways. Support them, connect with them, and thank them.

Back in School, Part 1: Staying Healthy

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Now that your child is back in school, the sometimes easy-breezy days of summer have turned hectic with schedules, deadlines, homework, complex relationships. For the next few weeks we’ll be running a series about things to keep in mind during the school year ahead.

Today we start with how best to insure a healthy year at school.

You already know the best way to stay healthy, but it bears repeating: prevention is always the best medicine. Here are some pointers.

Checkups. Has your child had her annual well child checkup? If not, now is the time to schedule it. The doctor will look at health history, height and weight, and will discuss age-appropriate health topics with you and your child. If you have a specific concern (social behaviors, learning difficulties, chronic ear infections, etc.) to discuss, you’ll want to let the office know when you call for the appointment to make sure they schedule a longer visit for you.
Immunizations. Yes, we harp on this a lot, but it’s for good reason. Immunizations protect children, families, and even whole communities from dangerous diseases. The state requires that you keep certain ones up to date; we have others we recommend. Check with our office (or on the patient portal) for your records.
Exercise. Sitting all day at school, then coming home and sitting in front of the TV or at the computer and homework desk is not good for your kid. He needs to get moving. Don’t expect physical education classes to provide all the exercise he needs. Unstructured play is good for all children, and organized sports are a great way to learn things like discipline, teamwork and a sense of accomplishment.
Germs. Let’s be honest. There’s no way to avoid germs at school. Uncovered coughs and sneezes, shared desks and close quarters give viruses all sorts of opportunities to infect students. Some exposure is good to develop immunity, but keeping hands clean is a great way to stave off colds and flu. Send hand sanitizer to school in your children’s backpack, and remind them to clean their hands before eating and after they use the restroom. Every time. Don’t share drinks or eating utensils. And, while we’re at it, remind them not to share combs, brushes or hats, which is the most common way to spread head lice.
Sleep. A good night’s sleep is an essential ingredient in the learning process. Sleep also helps mood and strengthens the immune system. Set a regular bedtime and stick with it, making sure your child or teen has an age-appropriate amount of sleep.
Balanced diet. Eating right feeds both body and brain. This webpage at the American Academy of Pediatrics site lists several of their articles regarding diet. Don’t forget we have a dietician on staff who can help you come up with an action plan for your young athlete, picky eater, diabetic, or can help you plan easy lunches and snacks to pack for school.

Keep these things in mind throughout the school year and they will help your child have a successful and healthy school year.

Talking to your kids about alcohol and drugs

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Every parent worries about their child’s health, including whether or not that child will use drugs or alcohol.

It’s a valid concern. According to the Centers for Disease Control and Prevention, several studies in 2011 showed that:

“among high school students, during the past 30 days

39% drank some amount of alcohol.
22% binge drank.
8% drove after drinking alcohol.
24% rode with a driver who had been drinking alcohol.”

In addition, 40% of high school students have used marijuana at least once, and 25% have been offered, sold or given illegal drugs on school property.

What can parents do to prevent drug and alcohol use and abuse with their own children?

There is no single answer, and some children and teens will use or abuse substances no matter how hard parents try to keep them safe, but here are some things that may help.

Start young. Teach them how to say “no” when they don’t want something. Show them how to be strong in the face of peer pressure. Make sure they know the dangers and consequences of drugs and alcohol use.
Educate yourself. Don’t hide from statistics, but learn from them.
Be firm. Set rules and stick to them.
Be an example. Don’t abuse alcohol or consume illegal substances. If you drink, be responsible and don’t EVER drive intoxicated. Keep alcohol and prescription drugs inaccessible to your youngster. Never offer alcohol to an underage person.

If you think your child or teen is drinking or taking drugs, talk to your pediatrician or school counselor. They can find you the right kind of help.

When testicle pain can be a surgical emergency

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Sudden, severe testicular pain should always be taken seriously. It can be a sign of testicular torsion, a dangerous condition that requires immediate surgery.

Testicular torsion occurs when the spermatic cord inside one testicle becomes twisted, which cuts off blood supply to the testicle. If surgery isn’t performed within 6 to 12 hours, then the testicle might have to be removed. There is even the danger of permanent infertility.

While testicular torsion can occur at any age, it is most common between the ages of 12 and 20. Rapid growth of the testicles during puberty can cause torsion, as can exercise or an injury. However, torsion can occur during inactivity, even while asleep.

If your son complains of extreme testicular pain, even if it goes away, report this to your pediatrician. According to the American Academy of Pediatrics (AAP), up to 50 percent of patients with testicular torsion have had scrotum pain before.

Other symptoms: the scrotum can become enlarged, red, and very painful; abdominal pain may accompany torsion, along with nausea and vomiting.

The AAP article also tells how the condition is diagnosed:

“Physical examination by a urologist;
Urinalysis, to detect presence of white blood cells;
A radionuclide scan or scrotal doppler ultrasound, to assess blood flow to the testicles;
Some urologists will take a patient with typical symptoms of torsion directly to the operating room.”

The bottom line: take testicular pain very seriously. It could be an emergency.

Georgetown Pediatrics

Caring for your children.

Category Archives: preteens

Screen time for adolescents: what is appropriate?

Is vaping a better option than smoking tobacco? The short answer: No.

Breast development in boys?

Back in School, Part 3: Teachers

Back in School, Part 1: Staying Healthy

Talking to your kids about alcohol and drugs

When testicle pain can be a surgical emergency