Tag Archives: teens

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.

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.

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

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.

Back in School, Part 2: Homework

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If it seems that with the new school year your kids’ amount of homework has increased, that’s likely true. Each year a new grade brings with it increasing amounts of responsibility, including homework. Some homework can be started during the school day, but often it needs to be finished after hours.

Homework can sometimes seem overwhelming, both for your child and for the whole family. Here are a few helpful tips.

Attitude. If you treat homework as positively as possible, that will help your young student. Doing schoolwork at home has many up sides, including letting you in on how things are going at school. You’ll learn what your child is studying and how easy or difficult a particular subject is for him.
Assistance. You shouldn’t do your child’s homework, but there are many things you can help her with. Memorization is one of the biggest. Make practicing for spelling and arithmetic tests fun. Make flash cards together out of scrap paper cut into squares. Use free online websites to get ideas or even create games around specific words or subjects. Prepping for a social studies test about Mexico? Make sure you understand what topics are being covered, and look at some web videos that show art, culture and travel.
Time. This is the biggie, isn’t it? You’ve been thrown from sleeping in and days by the pool, to waiting for the bus and trying to decide what to have for supper and how you’ll get everyone where they need to be when they need to be there. Every day is crunch time. How to schedule in homework?
- These first few weeks are important in figuring out which subjects and days of the week will require more time.
- Negotiate with the students in your house. They may need a little down time to play a game and have a snack when they first get home, or they may prefer to get homework out of the way.
- Do a back-off timetable from bedtime. Figure out when they need to be in bed, about how much time homework will take, and work out with the students when and how they’ll get the work done.
- If the time is overwhelming and your child is spending far too much time with homework, talk to the teacher. This is important information for any teacher to know.
Space. Find the right space where you can keep an eye on computer screens while also limiting distractions.
Support. The Scott County Library has online help from 2 p.m. until midnight, a great local resource. Many teachers and classrooms have their own website where homework assignments may be posted. For middle and high school, get familiar with the Infinite Campus site, where you can follow grades and attendance. There’s even an app in the Apple Store.
Involvement. If you see problems developing, don’t wait. Talk to your child’s teacher right away. Usually they’ll have good ideas for helping your youngster’s academic progress at home. If you worry that there may be a medical problem or learning disability, contact our office for an appointment.

Homework is an essential tool in learning, both now and in developing the right skills for a lifetime. With your help and encouragement, the students in your family can do well.

Manners? Yes, please.

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Summertime is easy—so they say. It can also be an easier time to remind children and teens about good manners. Hopefully, you will have more times of relaxed conversation when you aren’t trying to juggle homework, school and extracurricular schedules all at once.

Manners are important because they remind us of the value of every human being. Saying please and thank you is respectful, whether those words are spoken to someone in the family, a teacher or coach, or a complete stranger. Being helpful ingrains kindness in the helper and encourages it in the recipient and observer.

What are age appropriate manners?

Ages 2—5. Teach children to say please and thank you at the right times. Children at this age usually love to help people, so encourage that tendency. At the playground, they can help a younger child, with supervision. At home, they can learn to pass the potatoes. When meeting someone, they can shake hands and learn to answer questions that are asked.
Ages 5—7. As the child develops physically and emotionally, so should their moral growth be progressing. Teach good phone manners by practicing in a game. Have a “manners night” once a week at the supper table, where everyone has to speak politely and initiate good conversation. Give a small reward at the end of the meal for the person who showed the best manners.
Older children. Learning to smile and maintain eye contact during a conversation is important as children grow. They can learn to ask people about themselves, and to distinguish between appropriate and inappropriate questions. Your suppertime conversations can engage their imaginations and teach them how to talk to other people.
Teens. When our children mature into teens, they often become less receptive to their parents’ helpful instructions on manners, but that doesn’t mean you can let them off the hook. By now they should know your standards, and you should be able to witness them using their manners at home and elsewhere. Teens who are mannerly, you may tell them, will likely advance at school and work because others respond positively to our good behavior.

Perhaps the main thing to remember about teaching manners to your children is this: be an example. Use please and thank you when you remind them about their chores. Treat your spouse and other adults and youngsters with respect.

If you are often cross with them, they will reflect that attitude back to you and to others. But if you treat them and others kindly, they will learn to mimic that behavior, both consciously and unconsciously.

Expect good manners from your children and that is likely what you will get.

Video games—pay attention to what your kids are playing

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As technology increases at home and school, video games have increased in number. Each year they become more realistic-looking and exciting. But they are also often violent, and may contain language and themes inappropriate for your youngster.

Playing video games has benefits, to be certain. They help young people learn eye-hand coordination and computer skills, things they will need to keep up in the modern world.

But there are down sides, too. Big ones. Questions and concerns about content top the list, but you should also be aware that many online games require the sharing of personal information and location.

First, content. The debate continues regarding whether or not violent video games encourage violent behavior. Opinions abound, but the bottom line is that you should monitor and decide what your child or teen can or cannot play. In addition to violence, language and themes may often be too adult.

Understand ratings. The ESRB (Entertainment Software Rating Board) rates virtually all video games in terms of content, age-appropriateness, and interactive elements (including whether or not location and other information is shared). All three of these areas are important.
Content and age-appropriateness. The ESRB website has a great video and also written language to help you understand ratings and how they define words such as “animated blood” and “adult humor.” The basic content and age ratings are:
- Early Childhood;
- Everyone;
- Teen (13 and up);
- Mature (17 and up);
- Adults only.
- Pay attention! Games rated “Mature” have truly adult themes (sex, violence, language) and are simply NOT appropriate for younger ages. Even those with a rating of “Teen” may surprise you with their level of violence and tasteless language.
- PREVIEW. Learn about games before you buy. This website at Common Sense Media is a great source of information. If your youngster is asking for a particular game, look for the title here to see some screen shots and other details.
- Interactive elements. If you are concerned about private information being shared, or worry your child or teen might be connecting (accidentally or purposefully) with people you don’t know, READ THIS.

One important note about violence. Whether or not your teen or child plays violent video games, you should pay attention if he exhibits violent behavior. If she is violent with you or other family members, with schoolmates or with animals, talk to your pediatrician about finding a counselor.

Bottom line: know what your child is doing, watching, playing. Video games are fun, but you need to be aware of content and privacy.

My head hurts!

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A headache is a common complaint for some children and teens, and nearly all kids will get one every now and then. Causes are numerous. Usually, a headache is nothing to worry about, though there are times when you should go to the ER or call your doctor immediately (see below).

Headaches can be caused by things like strong smells, stress and anxiety, a cold or the flu, allergies, even changes in the weather. Other common causes include:

Hormonal changes. Puberty is often a time when headaches begin or worsen.
Diet. Nitrates and caffeine, in particular, can cause headaches at any age. Does your child or teen get a headache several hours after drinking a caffeinated beverage? Or eating a hotdog?
Lack of enough sleep. Make sure your child gets an age-appropriate amount of sleep every night.

Some children have migraines, which can (but don’t always) run in families. The pain can be strong and on one side of the front of the head or the other. Your child may express a need to lie still in a dark room, and other symptoms may include nausea.

If your child’s headaches are not severe, pay attention to patterns before coming to the see the doctor. Keep a diary of food and beverage intake (paying special attention to caffeine and nitrates), amount of sleep, allergy attacks, even weather conditions.

There’s an app for that. Here are a couple of phone apps that can help you keep a headache diary to determine what some of your triggers (causes) might be.

An Apple app by drug company Novartis.
An Android app by Froggyware.

If headaches are bad and persistent, see your pediatrician.

Keep in mind there are times when you should seek medical help immediately.

If your child has suffered a blow to the head in an activity, fall, or accident and has a headache. This could be a sign of concussion.
If the headache is severe and other symptoms include high fever.
If the pain is sudden and severe.
If the headache awakens the child at night.
If the headache is accompanied by dizziness, weakness, or other neurological symptoms.

By paying attention, you may be able to help your child or teen reduce their number of headaches, and if they are severe, to get help immediately.

Georgetown Pediatrics

Caring for your children.

Tag Archives: teens

Screen time for adolescents: what is appropriate?

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

Drugs and young brains

Diabetes overview, type 1

Back in School, Part 2: Homework

My head hurts!