Category Archives: Teens

Screen time for adolescents: what is appropriate?

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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.

Good eating habits as a way of preventing obesity and eating disorders

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Back-to-school time involves changes in just about everything: schedules, homework, sports, family time—even eating. Being rushed in the mornings makes having a decent, healthy breakfast a challenge. Families have to decide if kids will take lunch or buy the school lunch. Then comes the evening meal with people going in different directions, and often little time to prepare or eat a meal together. It’s no wonder that healthy eating and family time often take a back seat to homework, sports, and other activities.

As we all know by now, obesity among children and teens in our country is a widespread problem, and eating disorders (EDs) are also more common than before.

An article published last week on the website of the American Academy of Pediatrics (AAP) discusses how the same attitudes and habits can lead to both obesity and EDs. According to one study, dieting can actually be a precursor to obesity and EDs. Dieting “was associated with a twofold increased risk of becoming overweight and a 1.5-fold increased risk of binge eating…  Another study found that normal weight girls who dieted in ninth grade were three times more likely to be overweight in 12th grade compared with non-dieters.”

In addition to dieting as a cause, “weight talk”—no matter how well-intentioned—and “weight teasing” can lead to EDs and obesity.  “Weight talk, or comments made by family members about their own weight or to the child to encourage weight loss, has been linked to both overweight and EDs. Teasing children about their weight also has been associated with the development of overweight, binge eating and extreme weight-control behaviors in girls and overweight status in boys. Body dissatisfaction is a known risk factor for both obesity and EDs.”

So, how does a parent help a child be satisfied with her or his body? How do you encourage your teen toward a healthy relationship with food? “Adolescents who are more satisfied with their bodies report parental and peer attitudes that encourage healthful eating and exercise to be fit, rather than dieting.”

The article contains recommendations for pediatricians, and that guidance also applies to parents:

  • “Discourage dieting, skipping of meals or use of diet pills to lose weight. The focus should be on a healthy lifestyle rather than on weight.
  • Encourage more frequent family meals, which provide an opportunity to model healthy food choices and provide time for teenagers and parents to interact.
  • Promote a positive body image among adolescents. Body dissatisfaction should not be used as a reason to lose weight.
  • Encourage families not to talk about weight but rather to talk about healthy eating and being active to stay healthy.
  • Carefully monitor weight loss in an adolescent who is obese or overweight to ensure the teen does not develop the medical complications of semi-starvation.”

Don’t forget family meals. Though your children and teens may roll their eyes, the time spent together around the table is a time to connect over healthy food and discussions about topics great and small. Turn off the television and cell phones (including yours!) and enjoy each other’s company. It will make all of you healthier.

© 2016, MBS Writing Services

Drugs and young brains

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According to the American Academy of Pediatrics (AAP), one in four young people (ages 12-17) who uses illicit drugs will also develop a dependency. This is a much higher rate than that for adults.

Why? No one is certain, but there are some known factors.

Heredity is one of those factors. Is there an addict or alcoholic (recovering or otherwise) in your family’s history? If so, be aware that this one factor can greatly increase your child’s chances of developing an addiction to drugs or alcohol. You should talk to your teen about this with the hoped-for effect that she will choose to be more careful.

Here are some other factors listed in an AAP web article:

  • “Untreated psychological conditions such as depression, anxiety, conduct disorder, oppositional defiant disorder and personality disorder. For these youngsters, as well as for those with untreated attention deficit hyperactivity disorder (ADHD) and other learning problems that interfere with academic and social success, taking illicit drugs may be their way of self-medicating.
  • Temperament: thrill-seeking behavior, inability to delay gratification and so forth.
  • An eating disorder.
  • Associating with known drug users.
  • Lack of parental supervision and setting of consistent limits.
  • Living in a family where substance abuse is accepted.
  • Living in a home scarred by recurrent conflicts, verbal abuse and physical abuse.”

Start the conversation about drugs and alcohol early on, in age-appropriate ways. And don’t assume that just because you’ve had this talk once, that’s good enough. Young people are confronted with opportunities on a regular basis, so make sure that you leave the door open to talking with you about it.

Not sure how to begin? Here’s another great AAP article entitled “Talking to Teens about Drugs and Alcohol.” It gives great advice about a conversation that is essential to your child’s health.

Educate yourself about drugs and alcohol. Have open conversation. Don’t abuse substances. Help your teen stay healthy and free from addiction.

© 2016, MBS Writing Services, all rights reserved

Talking to children after a tragedy

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The recent shooting in Orlando leaves every parent—and anyone who cares about children and teens—in the position of wondering what to say and how to say it. You are reeling from the news, and you want to protect the children you love from being hurt by it.

There is no perfect way to handle tragedy with youngsters, but here are a few basic guidelines. All of the quoted information below comes from an article you may want to read in its entirety, from the American Academy of Pediatrics (AAP).

  • “No matter what age or developmental stage the child is, parents can start by asking a child what they’ve already heard. Most children will have heard something, no matter how old they are. After you ask them what they’ve heard, ask what questions they have.”
  • “In general, it is best to share basic information with children, not graphic details, or unnecessary details about tragic circumstances. Children and adults alike want to be able to understand enough so they know what’s going on. Graphic information and images should be avoided.”
  • “Keep young children away from repetitive graphic images and sounds that may appear on television, radio, social media, computers, etc.”
  • “With older children, if you do want them to watch the news, record it ahead of time. That allows you to preview it and evaluate its contents before you sit down with them to watch it. Then, as you watch it with them, you can stop, pause, and have a discussion when you need to.”
  • “Today, most older children will have access to the news and graphic images through social media and other applications right from their cell phone. You need to be aware of what’s out there and take steps in advance to talk to children about what they might hear or see.”
  • “The reality is that even children as young as 4 years old will hear about major crisis events. It’s best that they hear about it from a parent or caregiver, as opposed to another child or in the media…

The underlying message for a parent to convey is, ‘It’s okay if these things bother you. We are here to support each other.’”

  • What if you have an older child or teen? “After asking your child what they have heard and if they have questions about what occurred during a school shooting, community bombing, natural disaster, or even a disaster in an international country, a parent can say something such as: ‘Yes. In [Orlando, Florida]’ (and here you might need to give some context, depending on whether it’s nearby or far away, for example, ‘That’s a city/state that’s pretty far from/close to here’), there was disaster and many people were hurt. The police and the government are doing their jobs so they can try to make sure that it doesn’t happen again.’”

If your child seems to be overwhelmed with anxiety after a tragedy, and that feeling doesn’t get better with time, talk to your pediatrician. You may also request our office to refer you to a counselor who specializes in working with children or teens. Signs that they are having trouble coping include problems with sleeping or eating (too much or too little); physical symptoms such as tiredness, headaches, digestive issues; or behavioral changes.

It is only natural to be upset when a tragedy occurs. Every adult feels that way, and so do children and youth. If you haven’t had a conversation with them about it, today is a good time for that discussion.

© 2016, MBS Writing Services, all rights reserved

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.

© MBS Writing Services, 2015, all rights reserved

Artwork by Shawna

Artwork by Shawna

Sports physicals – it’s time

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Your kids are on the move – literally, and all the time! If they are involved in a fall sport at school, then it’s time for their sports physical. Don’t forget that there is tremendous benefit to getting these physicals at your child’s pediatric office, rather than at a clinic or a school-sponsored physical day. The pediatrician has all your records including vaccinations, allergies, and your individualized and family medical history. He or she can discuss important sports information with you, including nutrition. And, of course, follow-up is always readily available, whether one week or six months from now. We are delighted to be working, with you as our partner, to make a medical home for your family here with us. If your child has a physical at a clinic or the school, that physical is not a part of our records, and we end up with an incomplete picture of his or her development and needs. Read our previous blog post for more reasons on why it’s wise to bring your child to the pediatrician when it’s time for a physical.

© MBS Writing Services, 2015, all rights reserved

Diabetes overview, type 1

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Diabetes is a disease that can hit at any time of life from childhood to old age.  It can be a scary diagnosis, and it’s certainly not one a parent wants to hear.  Even so, new medical advances are constantly being made that can limit the bad effects of diabetes, and early diagnosis and treatment are always important.

Diabetes is not uncommon among children and teens.  According to the National Institutes of Health (and the National Diabetes Education Program—NDEP) article from which we have drawn much of the information for today’s blog, “About 208,000 young people in the US under age 20 had diabetes in 2012.”  Those numbers are growing.

The disease is classified into two categories, called type 1 and type 2.  Both types mean there is an elevated glucose (sugar) level in the blood, which is caused by problems with insulin production in the pancreas, and/or how that insulin acts on the body.

Type 1 diabetes, though only 5% of all diabetes cases, accounts for nearly all diagnoses in children under age 10.  It’s actually an autoimmune disease, in which the child’s own immune system destroys the beta cells of the pancreas that produce insulin.  (Insulin is the hormone that regulates the metabolism of carbohydrates, including sugars, and fats.)

Usually, symptoms of type 1 diabetes don’t appear until the disease has destroyed most of the beta cells.  According to the same article cited above, “Early symptoms, which are mainly due to hyperglycemia, include increased thirst and urination, constant hunger, weight loss, and blurred vision. Children also may feel very tired.”  If you are suspicious that your child has type 1 diabetes, seek medical attention immediately.

So far, there is no cure, but type 1 diabetes is managed through careful monitoring of blood sugar levels, and insulin administration by pump or injection.  The amount and timing of insulin doses is determined by taking into account food and beverage intake, physical activity, and the presence of any illness.  This management must be under the care of a physician who understands diabetes.

There are many ongoing studies into type 1 diabetes.  Perhaps in the not-too-distant future there will be a cure, or at least a way of pre-determining who is at risk and finding ways to treat the disease before it has destroyed the body’s ability to produce its own insulin.  The future is promising.

© MBS Writing Services, 2015, all rights reserved

Younger children—don’t just focus on one sport

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Summertime is just around the corner, and it’s time for kids to be outside enjoying themselves.  Organized sports are often a part of that.  Whether you have big dreams for your child’s sports future (college scholarship, pro career) or she has dreams for herself, it’s important not to push too hard too soon.  Doing so can cause injury and, perhaps more importantly, can decrease the all-important fun factor.

Most children love to play with a ball even before they can walk.  As their bodies mature, they’ll enjoy learning to swim, running short distances, playing physical games like tag in the backyard.  Activities like these are great for children’s physical health and for helping them grow into well-rounded people.  Staying active prevents obesity, gives a boost to the immune system, improves mental outlook, and fosters the development of social skills (learning to play fair, settling disputes, taking turns, sharing).

Parents should be cautious by not encouraging a child to play one sport to the exclusion of others.  Focusing on one sport, whether it’s swimming, soccer, baseball, gymnastics or something else, can lead to specific injuries.  Swimmers may develop shoulder problems; gymnasts can damage joints; runners might get shin splints.  Keeping a variety of physical activities in a young child’s life enables the whole body to develop, get stronger and more flexible, and decrease the risk for injury.

Eventually your child may decide to specialize in one sport, but doing so too early goes against the recommendations of the American Academy of Pediatrics (AAP) Council on Sports Medicine and Fitness.  There’s a great article on the subject here.  It’s best for your child’s physical, mental and social development to generalize, try a lot of different sports and activities, and to simply have fun.

 

© MBS Writing Services, 2015.  All rights reserved.