Articles
Beyond Distraction: Helping Your Child Overcome Attention Challenges
Welcome back to another Kid's Corner. I'm Doctor Jennie, and today we're going to be talking about a topic that's becoming increasingly more common in children - poor attention and ADHD (or attention deficit hyperactivity disorder). ADHD is a chronic disorder of the brain that makes it difficult to control impulses. If you have ever noticed that your child has difficulty focusing or finishing tasks, then it's a good idea to talk about it more with your doctor. Let's talk about some of the signs and symptoms of ADHD. There are three main categories we see in ADHD. The first is inattention. This can look like frequent moments of daydreaming where a child's attention drifts off. They might have trouble following directions or have difficulty staying focused on a task, or they may just seem overly forgetful or frequently lose things. Due to the inattention, they can also show problems learning or might struggle to finish their school work. With frequently missed details, this can lead to problems in comprehension and school performance. The second feature of ADHD is hyperactivity. Some children may fidget or cannot sit still and have lots of energy. I mean, what young child doesn't have a lot of energy. But in ADHD, this will be pronounced and frequent. You may also notice a child who's hyperactive that moves around quickly or knocks into objects often. The third feature we see in ADHD is impulsivity. Children with impulsivity sometimes act without thinking as if they're being run by a motor. They might have trouble taking turns. They may often interrupt, push, or even grab things that aren't theirs, and you might even notice more risk-taking behaviors. It's important to note that boys are more than twice as likely as girls to be diagnosed with ADHD, and ADHD is more common in children with other language and learning problems as well. So, what causes ADHD? The exact cause is not clear, although it does seem to have a genetic basis. There may also be some prenatal exposure factors at play. ADHD is not caused by eating too much sugar, or by food additives, allergies, or immunizations. And listen carefully: ADHD is not caused by poor parenting. If you do have concerns your child may have ADHD or attention problems, what should you do? First, talk to your child's teachers and caretakers to see if they have noticed any issues. ADHD is a diagnosis that's made based on the presence of symptoms both in a home and a school setting. Then, make an appointment with your child's pediatrician as well as their school to discuss your concerns. Both the school and your doctor can provide further assistance, evaluation, resources, and referrals as needed. If you do have concerns, I encourage you to speak to your doctor sooner than later. If your child does have ADHD, it is chronic and usually won't go away on its own. Unfortunately, untreated ADHD over time can become more pronounced and can lead to problems in forming social relationships, poor school performance, and eventually can negatively impact one's mental health and self-esteem. But don't worry. Once diagnosed, there are excellent proven treatments available for ADHD depending on your child's age. This usually involves therapy and sometimes medication. As an example, I once saw a patient who simply could not sit still in the room. He was constantly moving around, touching everything in the room, and having difficulty following directions because he just couldn't pay attention. His mother had brought him in because of failing grades, and she was worried that he had an undiagnosed intellectual disability or a low IQ. But when I talked to her more, it was clear that the content of the material wasn't the problem. His problem was finishing his classroom assignments. And he was often not even turning in his homework because he was completely missing the teacher's explanation of what the homework assignment was. We had him evaluated for ADHD more formally through the school district, and testing showed that he did in fact meet the criteria for ADHD. He was started on an ADHD treatment program, which included behavioral therapy. And within one year, his grades had all improved to A's and B's. So please, if you have any concerns about your child's attention, talk to your child's pediatrician to find out more. While you are awaiting further information, there are some basic things that you can do at home to help your child focus better. Praise and reward your child for any positive behavior, and give your child plenty of attention and affection. Try to follow a routine for meals, naps, and bedtime. Some children with ADHD have a hard time with change, and knowing what comes next in the schedule can be very helpful. Avoid skipping meals and make sure your child gets plenty of sleep. Give instructions to your child clearly. Give one instruction at a time and break down large tasks into smaller steps. You may need to repeat the instructions more than once and make sure you make eye contact from giving directions. Also, try to avoid distractions in the background like TV. If your child is working on homework or larger tasks, build in frequent small breaks. Try to be patient and calm around your child. Your child may unintentionally act without thinking so try not to get angry too easily. Look for extracurricular activities like art, sports, music, or dance that your child likes and can do well. This can help boost your child's self-esteem. At school, ask your child's teacher if your child needs any extra help and encourage your child to ask questions whenever they are confused about anything. Help your child organize his or her schoolwork. Teach them how to use checklists to keep on track. And finally, communicate often with your child's teachers and caretakers. Communication is very important. I know that attention concerns can be challenging for a parent. I've treated many children with attention and with the right care, they have been able to achieve as much in school and life as any other child. Thanks for watching another edition of Kid's Corner. I'm Doctor Jennie. I'll see you next time.
Feeding the Fussy: Tips for Dealing with Picky Eaters
Oh, hi. I'm Doctor Jennie, and welcome to Kid's Corner. Do you have a picky eater? At age two or three, children already start to like certain foods and dislike other foods. There may be a lot of variation in how hungry they are for different meals each day or even in the amount of food they intake from one day to the next. Don't expect your child to eat the same amount of food at every meal and snack each day. With toddlers, you can trust them to eat the right amount of each meal as long as you're providing them with a healthy plate. As the parent, you decide what, when, and where your child eats, and your child decides how much to eat. As you introduce your child to a variety of new foods, it helps encourage an acceptance of different textures and flavors. This exploration of food helps lead to a well-balanced and varied diet. So, how can you help improve your child's picky eating? First, encourage healthy choices. Offer plenty of vegetables and fruits every day. Aim for five different servings of fruits and vegetables daily, or try to keep half of their child-sized plate filled with fruits and vegetables each time they eat. Buy healthy snacks that your child likes and keep them within an easy reach. Remember, snacks can also be fruits or vegetables. If your child only likes a couple types of fruits or vegetables, that's okay. It's okay to offer the same vegetables or fruits every day while you work on continuing to expose them to new options. I often have parents come into my office telling me that their child won't touch a single vegetable, but when I actually ask their child directly if they like any vegetables, they usually can name at least one or two that they like. Usually, it's corn or cucumbers. So I tell the parent, start with that one vegetable they know they like on a daily basis, and continue to build from there. Be a good role model. Let your child see you eat the same healthy foods that you want your child to eat. To do this, I encourage you to eat together as a family whenever it's possible. Try to get in at least one meal a day together. And keep your family meals pleasant and positive. Children are much more likely to try a new food if they just see you eating it yourself. And this method is a lot more effective than verbally asking your child to try something new. You also want to try to make a healthy routine for your child. Start by making a regular snack and meal schedule. Most children do well with three meals and about two snacks a day. Find at least one healthy food from each group of food that your child likes, and try to make sure that food is available most of the time. Another good tip is to have at least one safe food that you know your child likes a lot, one okay or they only eat at some time food on the plate, and occasionally have a small portion of a new food or something they're less comfortable with on the plate. Be sure your child eats a healthy breakfast every day. If you're in a hurry, try wheat toast with peanut butter or avocado, low-sugar yogurt with fruit, or oatmeal. It's also important to encourage your child to drink water. Avoid fast food in your routine. If you have to eat out sometimes, that's okay. But try your best to find quick options that include whole grains, vegetables, and lean or grilled proteins instead of fried foods. Next, try to prevent problems with eating. Be patient when you're offering a new food to your child. As pediatricians, we know it can take multiple exposures to the same exact food before a child will even try it or eventually like it. So just because your child didn't even touch the broccoli on the plate last week doesn't mean you shouldn't offer it again the next week if you're already cooking it. For young toddlers, even just touching or tasting the food should be counted as a win in your book. Praise your child for trying new foods. Try different ways of serving the food. Some children may prefer the same vegetable raw, steamed, or grilled. Some kids even enjoy dips on the side. Have fun. Use funny or silly names for foods. For younger children, you can call broccoli little trees. Or I like to use cookie cutters to cut foods into more appealing shapes that you know your child will like. Try not to be too forceful with your child. Avoid making comments like clean your plate or just take one more bite. This can actually set up an unhealthy relationship with food and teaches children to ignore their fullness cues. Along the same mind, don't use a dessert as a reward for finishing their plate. While it's best to limit sweets in general, if you're going to occasionally offer them, it's actually better to serve a small portion with their meal. This helps prevent dessert being placed way up on a pedestal. Likewise, don't use food as a reward for good behavior. Instead for rewards, you can use stickers, small prizes, toys, or other activity incentives, like letting your child choose what game to play or which park they want to go to. Finally, let's talk about why it's so important for kids to have a balanced diet. A balanced diet provides nutrients to fuel your child's body. They give your child the energy it needs to keep their brain active and their muscles working. And they also help to build and strengthen bones, muscles, and other body tissues. For a balanced diet, offer your child a variety of foods every day. Let's talk about some of the main food groups you want to include. Grains. Try to choose whole grain products like oatmeal, brown rice, or wheat pasta, for at least half of your child's grain servings, instead of white flour grains, like white rice or flour tortilla. Be sure to include a wide variety of colors from dark green vegetables broccoli and spinach to orange vegetables like carrots and sweet potatoes. You can talk to your child about how eating all the colors of the rainbow will help their body grow big and strong and make their brains super smart. Fruits. Again, try to offer a variety of colors or when possible choose in-season fruits. Dairy products like yogurt, milk, and eggs. And proteins like chicken, fish, lean meat, beans, nuts, or nut butters. I know it can be hard to change eating habits. Oftentimes, making your child's diet healthier might also mean making improvements to your higher household's eating habits, but try not to feel too overwhelmed. Wait until it's a good time for you and your family and then start by making small changes one at a time and gradually. If you do decide to make a change, that's great. Your doctor can give you plenty of more information to help support you. So try some of these tips at home so that you know your child can have a more balanced, healthy diet. Thanks for watching Kid's Corner. I'm Doctor Jennie, and I'll see you next time.
The Screen Time Dilemma: Impact and Management for Kids
I'm Doctor Jennie, and welcome to another edition of Kid's Corner. There's a mental health topic parents ask about today that wasn't an issue ten years ago. Can you guess what it is? That's right. It's screen time. While technology has offered many advances, it has also created new challenges for parents and caregivers. Many families enjoy watching a favorite show or playing a video game together, and this can be a good bonding time. And both parents and teams like texting or using social media and other apps. There can certainly be many social benefits to screens. However, too much time in front of a screen can actually have negative impacts on children's health and development. And this is regardless of whether it's a television, computer, tablet, smartphone, or video game. For very young children, increased screen time has been shown to be associated with speech delays. And for older children, it can affect reading, doing school work, and socializing with family and friends. It has also been linked with behavioral issues like increased aggression or inattention. For all ages, too much screen time can disrupt good sleep. And the more screen time that kids have, the more likely they are to eat unhealthy foods or overeat. Children see and are influenced by thousands of ads each year. And many are for sugary cereals, snacks, and soda. It also cuts down on time for physical activity such as sports or other active play. Prolonged screen time can even have effects on vision and excessive headphone use can be damaging to your child's hearing as well. At its worst, too much screen time can even impact children's mood and self-esteem. Excessive screen time has been linked with aggression and behavioral problems. Aggressive behavior is especially linked to poor quality content, shows or videos that display physical violence or unkind language. Maybe you've already been thinking about limiting screen time but you're not sure how to begin. You also may not feel sure that your family is ready for this change. I get it. Cutting out the screens can be hard, and now may not be the best time for your family. That's okay. You can wait until you're ready. If you're not ready to limit the screen time yet, at least try to monitor the ratings for movies and the type of content your child is watching or interacting with. When possible, look for age-based restrictions or children's profiles on your child's apps, tablet, or TV. Give your child choices of programs to watch that are more educational, interactive, and age-appropriate. If you are ready to start thinking about changing your child's screen time, that's great. Let's go ahead and discuss some helpful ways to start. First of all, know that cutting back on screen time does not mean no screens at all. It means being mindful about what your child is watching and how much time your child spends looking at a screen. I know that making this kind of change can be hard and it takes time. But you do not have to make this change all at once. Even cutting back on some screen time can be helpful. As a general rule of thumb, as pediatricians, We recommend no more than two hours per day of screen time. Remember, this includes all screens like phone, TV, tablet, and video games. And these two hours do not include school work that's done with the computer. You can start by making one or two changes and see how it works. For example, for one week, cut back by just thirty minutes a day the amount of time your child spends in front of a screen. Or try co-viewing for some of your children's screen time to help engage in conversation and enhance their mental stimulation and learning. Remember that you can control how fast you make any changes. Making small gradual changes to how you and your family spend time using devices will help you maintain those changes. As an example, I once had a parent bring in their child for a visit, concerned that their speech was significantly behind. This two year old child was only saying a couple words. When I asked the parent more, I found out that the child was watching over eight hours of screen time a day. So I had that parent cut their screen time back to less than two hours a day. The very same patient came back three months later and they were saying close to fifty words in just a matter of three months. So you can see how important this truly is. You can help your child spend less time on media devices by using some of the following suggestions, or you might have other ideas about how to do this for your child and your family. As you do start making plans, think of possible problems ahead that will make it difficult to succeed. Having options for these problems will improve your chances for success. What can you do to help your child? First, have a discussion about screen time as a family. Talk to your child about the new changes in screen time or limits that you're going to place and discuss the reasons why you want to reduce their screen time. Next, come up with a substitute plan for alternative activities they can do, like going outside to play, listening to music, reading, drawing, writing, homework, cleaning, playing board games, helping with cooking, talking to friends or family, the list goes on and on. Once you do have a plan in place, try some of these physical blocks to help stick to your plan for less screen time. Move the screens out of reach to help ensure that your plan will be successful. Take the TV computer, tablet, smartphone, video games, and move them out of your child's bedroom. Keep the dining table a screen-free zone, and that applies for adults too. Use phone timers for apps to help shut them off when the limit is used, or you can even try an alarm clock for screen time. Set specific times for when screen time is allowed. For example, screen time should always come after homework time. You can try setting up a bin or a basket in a public room where devices can be charged overnight. Keeping devices out of the bedrooms and having a screen-free time for at least one hour before bedtime will help improve your child's sleep too. If possible, delay getting your child a cell phone until middle or high school. If you do give them a cell phone at a younger age, try to avoid using smartphones and social media. Hopefully, some of these changes will even help you reduce your own screen time. Remember that we are our children's greatest role models, so try to be mindful of how often you're checking your phone. One possible, try to set your own screen-free times where your cell phone is put away and you're focused on connecting directly with your child without interruptions. We are learning more and more about this topic every day. So look for more videos from me on screen time in the near future. I'm Doctor Jennie. See you on the next Kid's Corner.
Navigating Mental Health in Children: Signs, Support, and Solutions
Hi. I'm Doctor Jennie. Welcome back to Kid's Corner. Mental health is a topic that carries a lot of stigma and judgment for many people. But mental health issues are actually quite common in children. The good news is they are treatable. Since the COVID-19 pandemic, mental health issues have skyrocketed for many children and teens. Getting help from your child's doctor can make a big difference. As a pediatrician, I have seen firsthand the widespread impact that poor mental health can have on a young person's life. It can impact learning, development, and even physical health. A mental health condition can also make it harder for your child to manage their feelings and behaviors. They may struggle with things like doing school work, making friends, or getting along with their siblings. This can be very stressful for a child and for a parent. So how do you know if it's just normal childhood development, teenage angst, or a true medical problem? Let's review some of the symptoms of two of the most common mental health conditions. The first is depression. Signs of depression may include changes in mood, like feeling more grouchy or sad, losing interest in one's usual activities, a decline in grades, not wanting to spend time with friends or family, changes in appetite, which can mean eating more or less than usual or changes in sleep, which may be sleeping more or less than usual. Depression can run in families and it can also be triggered by stressful life events. If you do have concerns for depression, talk to your child's doctor right away to have them screened. Fortunately, we have many different treatment options available that can help. Usually, treatment will involve counseling, and sometimes medication. Remember, depression is a medical condition. It is neither your nor your child's fault. But we do know that treating depression is incredibly important. If your child ever exhibits severe symptoms of depression or make statements about suicide, please take them to the nearest or call 911. Another common mental health condition seen in children and teens today is anxiety. Of course, everyone feels anxious or worried sometimes. All children may worry when it comes time to give a big presentation or when they have a test. But when that fear or worry becomes frequent enough to cause interferences in your child's day-to-day life, that could be due to a medical condition called generalized anxiety disorder. Some of the ways that anxiety can present in kids can include avoiding social settings, being overly clingy, difficulty sleeping, or frequent nightmares, a frequent fear about the safety or even the safety of their family members, refusing to go to school, lack of self-confidence or low self-esteem, or even physical complaints, like frequent stomachaches or headache. Just be careful not to write off more serious physical complaints like chest pain or severe pain as anxiety. Always take your child to the for any severe physical symptoms. If you're concerned about any of these features in your child, I encourage you to speak with their doctor to have them screened for anxiety or other mental health conditions. Remember, we have plenty of treatment options to help your child. All you have to do is reach out to your doctor to ask for help. You might be wondering what types of treatment there are. Usually, most mental health conditions will respond best to therapy and sometimes to a combination of therapy and medication. These treatments are typically directed by a psychologist, and or a psychiatrist, but your child's doctor will be able to give you more detailed personalized information. If you are waiting to meet with your doctor for more help, or if you just want to improve your child's mental well-being, there are many things you can do at home to help. First, talk to your child often. Encourage open judgment-free communication. Listen closely and validate your child's emotions. Let them know you are there to help and that you love them. Validating your child's emotions can help your child feel understood and valued. It can also teach your child to accept their emotions and to work through them. Try to respond calmly when your child is upset. If you're feeling emotional, it's okay to take time to yourself. Be understanding of the challenges that your child faces and try not to minimize how they feel. Remember that your child's problems are as real to them as yours are to you. Something that seems so small to you might be a very big thing to your child. For example, I once thought it was so silly that my daughter had a big tantrum over losing a sequence she found on the ground. But then I thought, "How would I feel if I lost a piece of jewelry that was important to me?" I can relate to feeling frustrated, upset, and sad. So, try to relate to your children's emotions and try not to say things like "you're fine" or "stop crying." For teens, acceptance and belonging are big themes. So, try not to diminish any feelings they have about feeling left out or not fitting in. Next, make sure your child is getting good self-care. This can include getting enough sleep, eating a healthy and well balanced diet, not skipping meals, limiting screen time, and getting enough physical activity. It is also important that they have opportunities to socialize with family and friends. Some children may even benefit from creative outlets like doing art, writing in a journal, or playing music. You can also teach your child healthy ways to manage their stress, such as with deep breathing or meditation. You can also communicate with your child's teachers and counselors to get more insight into how your child is doing. Kids spend so much time at school. And sometimes teachers might have better insight into their social interactions than parents do at home. Next, talk to your child's doctor about any symptoms or changes in your child's mood or behavior that you're concerned about. Finally, find a counselor or therapist for your child. You can ask your child's doctor for a referral, contact their school to see if a counselor is available, or you can even call your health insurance plan to ask for a referral directly. Remember, mental health problems are common and you should not feel like a bad parent. Just the fact that you're here listening and learning, shows that you are a committed good parent. Thanks for watching another Kid's Corner. I'm Doctor Jennie. I'll see you next time.
Understanding and Resolving Challenging Child Behaviors
Hi. I'm Doctor Jennie Gary, and welcome to Kid’s Corner where I discuss the top childhood development issues facing parents. Today, I'll be discussing a real challenge for many parents out there, and that's overcoming difficult behavior in young children. Does your child act out? Have tantrums? Not listen? Don't worry. This doesn't mean you're a bad parent. All parents have to address challenging behaviors in their children at times. Sometimes those little bodies can produce some big feelings. It's important to know that these difficult behaviors are actually a part of normal child development. Children can have many strong emotions. They don't always fully understand their emotions or know yet how to control them. So they don't always listen to you or behave in the best ways. Children need guidance, clear limits, and patient parents to help them get through their struggles with behavior and emotions. But has your child ever acted out in ways that surprise you or concern you? That's okay. I have spoken with countless parents who feel the same way. Fortunately, there are things that you can do to help your child learn to navigate their big feelings. Before we talk about ways to help teach children to manage their feelings, it's always a good idea to consider if any underlying factors might be contributing to poor behaviors. Is your child tired? Hungry? In need of attention? Sometimes poor behavior can be a sign that a child isn't getting enough sleep, has inadequate nutrition, feels uncomfortable or out of their routine or is just craving your attention. Try to address any of these underlying issues like poor sleep or poor eating habits before tackling any behavior problems that your child may have. Let's review some of the ways we can help our children learn to manage their big feelings. Teach your child healthy ways to express their anger. For example, tell your child they can take a deep breath or use their words to express their anger or frustration. Let your child know that it's okay to feel angry, but it's never okay to hurt other bodies. Praise your child when they use words instead of hitting, biting, or throwing. Try to relate to your child. Try saying something like, “You seem like you feel upset. That's okay. I feel angry too sometimes.” Just remember that sometimes these teaching moments are best done once your child has already calmed down. Starting at age three or four years old, play board games with your child to help them learn how to play with others, take turns, and be patient. Be consistent with your rules and boundaries. Setting limits helps a child know what to expect and helps them feel safe and secure. Once you've made the rules and boundaries clear to your child, try to follow them as much as possible. The less that you give in to bending these boundaries, the more quickly your child will learn to follow the rules. Likewise, try to be true to your word when it comes to consequences. If you don't follow through with any of your warnings, then your child might slowly learn not to take them seriously. Use logical and natural consequences. For example, If your child draws with crayon all over their wall, have them help you clean it up, then put the crayons away for the rest of the day. Monitor what your child is watching. Try to avoid shows or videos that show verbal or physical aggression. And co-viewing is recommended whenever possible so that you can talk about any bad behavior of bad words if they ever come up. Model the good behavior you want your child to have. Children learn best by modeling. So display healthy and calm ways of managing your anger, the best that you can. Try not to yell, threaten, or display physical signs of anger. And don't worry. No parent is perfect. If you ever lose your cool or yell at your child, it's best to later apologize and discuss that with them. You can say things like, "Mommy was feeling really frustrated earlier, and I made a mistake in yelling at you. Next time when I'm frustrated, I will try to remember to take a deep breath and speak to you calmly instead." Build your child's self-esteem. Make it clear that it's their behavior that you don't like, not them. Try not to use phrases like "bad boy" or "bad girl" and help your child know that they are still a good boy or girl. They just made a bad mistake or had a bad behavior. Let them know that everyone makes mistakes sometimes and that you will love them even if they make a mistake. Use positive reinforcement. When your child is behaving well or managing their anger in appropriate ways, tell them that they're doing a good job, reward good behavior. Rewards can be simple, like hugs, praise, or stickers. If you've already tried many of these methods and you still find that your child's behavior is overly disruptive or aggressive, then please make an appointment with your child's doctor to talk about it more. Sometimes excessively difficult behavior may be a sign of an underlying developmental issue. So always talk to your doctor about any concerns you may have. Finally, let's talk about time out. This is an older method of behavior management that most pediatricians no longer routinely recommend. It can make children feel isolated or teach them that their behavior is too much for the parent to handle or deal with. Time out should be very rarely and only for violent behaviors. If you are going to give a time out, it should happen immediately after the behavior. And it's preferred that the parents sit with the child during this time out and that it be instead used as a break time to allow space and time to cool off. For this break time, keep it short and use it only for children aged three years old and up. The number of their break time should be equal to their age in years. So for a four year old, it should be four minutes old, a five year old, five minutes old, and so on. Make it clear to your child that you're using this break time to allow time for their body to calm down and to prevent hurting others. Similarly, physical punishment like spanking is never advised. It inadvertently teaches a child to solve problems with violence or physicality, and extensive evidence and studies show that while it may work in the short term, it makes no long term impact on stopping the undesired behavior. Additionally, this type of physical or corporal punishment can humiliate your child and lead them to distrust you. Instead, focus on positive reinforcement and good discipline. You may be wondering why using good discipline is so important. That's because effective discipline can help teach your child responsibility. It also builds your child's self-esteem and strengthens your relationship with your child. With discipline, no single technique works for all situations. It is best to try a variety of approaches that we have discussed today to see what fits best for your family. Whatever you do, try your best to be patient and be consistent about the limits that you set. I'm Doctor Jennie. Thanks for watching, and I'll see you next time.
Taming Tantrums: A Guide to Tackling Toddler Meltdowns
One of the most common and challenging aspects of parenting is dealing with tantrums. Tantrums are a common occurrence in the lives of children, especially toddlers, but they can be overwhelming for parents, especially new parents.