“Families need to recognize what will be a fairly substantial presence in all areas of media,” said Dr. Steven Krug, chair of the American Academy of Pediatrics’ Disaster Preparedness Advisory Council. “This will occur in the workplace and schools. You can begin to develop a plan to address these issues. Even the youngest children may hear a discussion they misunderstand in school.”

Given that many adults will themselves be upset by the remembrances about 9/11(and that children are perceptive, and will pick up on their parents’ distress) it’s important for parents to have these conversations with their children. This 9/11 anniversary offers “an opportunity to talk to children about loss and grief,” said Dr. Krug.

Children may also wonder “‘Could this happen to me?’”, added Dr. Krug. He recommended that parents ask, “‘What do you hear about this?’”

If your child’s school is planning some kind of observance for 9/11, don’t hesitate to contact the teacher or principal to find out exactly what will happen in school, so that you’re able to “fill in the gaps and offer a consistent message,” said Dr. Krug.
Children crave reassurance, he added, so anything parents can do to demonstrate that children are safe would be a good approach to reduce any anxiety related to 9/11 observance. Dr. Krug also recommended that families watch 9/11 anniversary events together, to be able to “talk to kids about what’s happening.”

September is National Preparedness Month, which offers another opportunity to discuss the events of 9/11 with your family from a different perspective. Some strategies include practicing fire drills with your children and updating your family’s personal disaster kit and disaster plan, to give your children a “degree of empowerment,” said Dr. Krug.

For a Printable Check List Click HERE

Backpack Safety

A national consortium of chiropractors and other health care providers have banded together to form Backpack Safety America, which has endorsed steps to safe backpack use. Those steps include:

• Choose the right SIZE backpack. It should be large enough to contain all the school essentials, but not so large that it overwhelms your student.
• Carefully PACK the backpack. The maximum weight of the backpack should not be more than 15% of your student’s body weight — so pack only what is needed.

LEARN MORE AT: http://www.backpacksafe.com

Sun Protection

Minimizing exposure to the sun’s ultraviolet rays — while walking to school, during physical education classes, and at recess — can help prevent skin cancer later in life. The tools you should use regularly are:

• Hats
• Sunglasses
• Sunscreen

LEARN MORE AT: www.peggyswalk.com

Healthy Food Choices

Eating healthy meals, especially breakfast, is a no-brainer. Did you know that the U.S. Department of Agriculture recently issued new guidelines for how to eat healthily that replaces the Food Pyramid? The new model is called MyPlate, which is much simpler. It uses an image of a plate, with four sections:

• Proteins
• Fruit
• Vegetables
• Grains

LEARN MORE AT: www.choosemyplate.gov

Bus Safety

With school as with so many things in life, getting there safely and securely is half the battle! Whether your child takes a city bus or a school bus, there are common-sense principles that can help them be safe:

• Stay seated anytime the bus is moving.
• Never stick arms or heads out of bus windows.
• Once you exit the bus, watch for the bus driver to tell you when it is safe to cross the street — and double-check, looking both ways before crossing.

LEARN MORE AT: http://www.ehow.com

Immunization Updates

The state of New Jersey requires that certain students receive vaccines to protect themselves and others from common childhood diseases. Among them are:

• Students entering daycare or preschool
• Students entering New Jersey public schools for the first time
• Students entering 6th grade

LEARN MORE AT: http://nj.gov

Seat Belt Safety for Carpoolers

State laws now require all passengers, including back seat riders and adults over 18, to buckle up. If your young carpoolers protest wearing seat belts, this resource is chock full of surprising statistics on safety. For example, did you know:

• A seat belt increases your chances of surviving a crash by 75%
• Only 37% of kids ages 8-18 buckle up in the back seat
• Good news: Front-seat seat belt use is at an all-time high of 93.73% in New Jersey!

LEARN MORE AT: www.njbackseatbullets.com

Safe Walking

Pedestrian injury is the #2 leading cause of unintentional injury death for children ages 5-14. If your children walk to and from school, or around the community, this resource contains tips about safely walking everywhere, like:

• Cross streets at corners, and in crosswalks wherever available
• If there are no sidewalks where you are walking, walk facing traffic as far to the left as possible
• Look left, right, and left again — and keep looking! — as you cross the street

LEARN MORE AT: www.safekidsnewjersey.com

Adequate Sleep

Getting the right amount of sleep each night can mean a world of difference to your student. And setting the stage for a productive night of ZZZs is easy:

• Remove distractions, such as televisions, from the bedroom
• Keep the room as dark as possible — perhaps just a night light, if necessary
• Keep the temperature cool to optimize a solid night’s sleep

LEARN MORE AT: http://www.healthychildren.org

Can We Help? Cooper In Schools, a program of Children’s Regional Hospital at Cooper, offers FREE information and continuing education sessions for parent-teacher organizations, school district staff inservices, coach and trainer clinics, and community groups. Please contact Maureen Donnelly, Cooper In Schools Intake Coordinator, at cooperinschools@cooperhealth.edu to learn more.

Thanksgiving is a time to give thanks, express gratitude, and enjoy a holiday meal with family and friends. It’s also when there is almost three times the daily average number of cooking fires. In fact, cooking fires are the number one cause of home fires and injuries in the United States.

Turkey, stuffing, pumpkin pie and all of the trimmings call for a lot of preparation and cooking. But, when family, friends, and especially children gather in the kitchen, it’s very easy to get distracted and forget about what’s on the stove. Unattended cooking is the leading cause of kitchen fires. Each year, there are approximately 102,408 emergency room visits due to a fire/burn-related injury for children ages 0-14. Contact with a hot surface or flame causes the greatest number of burns in children.

Safe Kids Southern NJ, part of the Children’s Regional Hospital at Cooper, offers these safety tips to help you prevent a fire and keep the Thanksgiving holiday a memorable tradition.

Prevent Cooking Fires

• Never leave hot food or appliances unattended while cooking. If you are frying, grilling or broiling food, stay in the kitchen. If you are baking, boiling, or simmering food, check food frequently.
• Always be alert when you are cooking. If you are under the influence of medication or alcohol, avoid using the stove or stovetop.
• Keep anything that can catch on fire at least three feet from the stove, toaster oven, or other heat source.
• Keep the stovetop, burners, and oven clean.
• Do not wear loose fitting clothes when you are cooking as they may catch fire from the stovetop.

Prevent burns and scalds

• To prevent hot food or liquid spills, use the stove’s back burner and/or turn pot handles away from the stove’s edge.
• Keep appliance cords coiled, away from the counter edges and out of children’s reach, especially if the appliances contain hot foods or liquids.
• Use oven mitts or potholders when carrying hot food.
• Open hot containers from the microwave slowly and away from your face.
• Never use a wet oven mitt, as it presents a scald danger if the moisture in the mitt is heated.

Keep Your Kids Safe

• Create a three-foot Kid Free Zone around the stove. Young children should be more than three feet from any place where there is hot food, drinks, pans or trays.
• Never hold a child while cooking, carrying or drinking hot foods or liquids.
• Hot foods and items should be kept from the edge of counters and tables.
• Do not use a tablecloth or placemat if very young children are in the home.
• When children are old enough, teach them to cook safely and always with help from an adult.

Safe Kids Southern NJ works to prevent accidental childhood injury, the leading killer of children ages 1 to 14. Safe Kids Southern NJ is a member of Safe Kids USA, a national network of organizations dedicated to preventing accidental injury. Safe Kids Southern NJ was founded in 2002 and is led by Children’s Regional Hospital at Cooper.

Related Links:

• Children’s Regional Hospital at Cooper
• Safe Kids Southern NJ

School-struggling can be very debilitating for a family. Tensions rise as the patterns of avoidance and non-compliance emerge as the school year progresses. Parents can feel hopeless and directionless relative to the mounting school problems.

The Matthews family came in to consult about their child, Elijah, age 14. Speaking eloquently and passionately about their family challenges, Mr. Matthews stated, “Every night it’s the same thing. We live under constant stress around school and homework issues. If it were not for my wife providing Elijah with daily support, he would be sinking like a stone. We’re just depleted and exhausted.”

As a child psychologist, I have seen many children who have shut down because of their unresolved school issues. The signs of a shut-down learner typically start to emerge in the upper elementary Grades, and become much more pronounced by high school. They include:

• A sense that the child is increasingly disconnected, discouraged and unmotivated.
• Fundamental skill weaknesses with reading, writing and spelling, leading to diminished self-esteem.
• Increased avoidance of school tasks such as homework.
• A dislike of reading.
• A hatred of writing.
• Little or no gratification from school.
• Increasing anger toward school.

Understanding the formula of shut-down learners

Shut-down learners are children who become academically discouraged and disconnected from school over time. A simple formula helps to explain how kids become shut-down learners:

Cracks in the foundation + Time +Lack of Understanding + Strained Family Communication = Shut-Down Learner.

Understanding this formula will help parents be in a better position to take appropriate action.

Cracks in the foundation. Cracks in a child’s learning can usually be identified as early as preschool- and Kindergarten-age. Indicators during this period are easily identified. Does your child have trouble learning letter names and their sounds, for example. By First Grade, is your child taking steps toward blending sounds? In middle to upper elementary school, is writing a laborious, often agonizing process for your son or daughter? If the answer is yes to these questions, it does not necessarily follow that your child will become a shut-down learner. However, like cracks in your house that expand if unaddressed, it is important to act to prevent academic cracks from widening. Otherwise, they will contribute to discouragement over time and a child ultimately shutting down.

Lack of understanding. In my evaluation of shut-down learners, I have found that many receive work on a daily basis that they simply cannot handle, causing them unnecessary frustration. Too often, parents and teachers do not understand the skill deficits that are causing a child difficulty. For example, I recently tested a Fourth Grader who struggled to read certain words presented in a text. Since most Fourth Graders read silently to themselves, her teacher and parents mistakenly believed that the student had a comprehension problem, when she was actually experiencing difficulties with word-reading and decoding. Additionally, many children who struggle in school simply do not have problems deemed to be ‘severe enough’ to warrant special education. For those children, parents will need to seek outside remedial help in the form of tutoring, where available.

Strained family communication. The beginning of homework time often marks an increase in the household temperature, as screaming and arguing become part of the landscape. Strained communication around homework can be overwhelming for families and can contribute to a child becoming a shut-down learner.

Addressing (or preventing) shut-down learners

1. Trust your gut. If you believe your child is experiencing difficulties at school, listen to yourself. Don’t wait, or fall for such oft-used statements as, “You know how boys are” or, “She’ll grow out of it.” Act on your feelings even if your child has been deemed ineligible for school services. Consult a trustworthy, competent person outside of school whom you feel comfortable with to assess your child.

2. Know what you are targeting. If your child’s assessment has identified issues of concern, chances are an area in your child’s reading needs addressing. There are essentially two types of reading problems. In the first, the child has trouble decoding words and reading fluently. In the second, the child can read fluently, but experiences great difficulty understanding what they have read. Get clear on the exact issues that you hope to resolve. Don’t scattershot remediation.

3. Take the heat out of the interaction. Try to step back a little bit and turn down the heat within the house. The daily ritual of yelling, pecking or nagging never leads to positive change. When was the last time your child said, “Thanks for yelling, mom, I see your point. I’ll get down to business”? Right. Never. Why persist? Your kids are probably feeling overwhelmed by homework that they can barely handle. In raising the heat, you’re simply adding stress to their lives. Turn down the temperature. Kids need emotional fuel to tackle their school difficulties, especially those kids who derive little gratification from their efforts. Look for the small things that your child is doing well. Statements like, “Wow, I like the way you took out your work tonight without my asking,” can really mean a lot to a child, especially one who might be a bit discouraged.

4. Find someone to connect with and mentor your child in school. The shut-down learners I know do not feel very good about themselves and they do not see their true strengths. If your child is of junior high school age or older, (those preteen and teenage years when the development of a sense of self is critical), it is particularly important for them to have at least one person in school who really values them and will rally on your child’s behalf – even if they aren’t succeeding academically.

5. Support your child. Academic discouragement is debilitating to children and families. Connecting with your child’s natural strengths and letting them know that you are both on the same ‘team’ can make an enormous difference in preventing your child from becoming a shut-down learner.

6. Is your child over their head? Too often children are asked to manage work that is too hard for them. If your child has struggled with reading, for example, often the text material is overwhelming. To test out whether the material is too difficult, ask your child to read from a random place in the textbook. Is the reading smooth? Are they making many errors and stumbling over the words or substituting ones that are nonsensical. If so, then the work is probably at the child’s frustration (difficulty level) and is inappropriate. A similar screening can be done with the vocabulary demands of the text. Pick a few of the words your child has to read. Does your child have any idea what the words mean? While occasional frustration level work will not result in your child shutting down, asking the child to manage work that is too difficult will lead to discouragement and a pervasive sense of frustration. Politely speak to your child’s teacher about the issue.

7. Don’t forget the fun. Do something fun and enjoyable with your child. Play a board game or do an arts and crafts project together. Go out for an ice cream treat. Most kids would enjoy doing an activity like that with you. Try not to let school problems set the tone for the entire household and all of your interactions.

Dr. Richard Selznick is a child psychologist and the Director of the Cooper Learning Center, Department of Pediatrics. He is the author of The Shut-Down Learner: Helping Your Academically Discouraged Child.

This article originally appeared in the September-October issue of Calgary Child Magazine.

The type of seat your child needs depends on several things, including your child’s height, weight and the type of vehicle you are driving.

“Nine out of ten car-safety seats are installed incorrectly,” said Maureen Donnelly, RN, MSN, NPC, Coordinator, Safe Kids Southern New Jersey, led by the Children’s Regional Hospital at Cooper. “Children are either too big for the child restraint that they are using or have been moved to the next seat prematurely.”

Here are a few guidelines you can follow based on your child’s age to determine which product is right for them:

• Infants. Use infant seats or rear-facing convertible seats until the infant reaches the highest weight or height allowed by their car-safety seat’s manufacturer. At a minimum, children should ride rear-facing until they have reached at least one year of age and weigh at least 20 pounds.
• Convertible Seats. When they have outgrown the rear-facing seat, toddlers/preschoolers should use forward-facing convertible seats with a full harness that attaches at the shoulders, hips, and between the legs.
• Booster. When a child outgrows their convertible seat, booster seats are designed to raise the child up so that the lap and shoulder seat belts in the car fit properly. Children should stay in a booster seat until a regular belt fits correctly (between 8 and 12 years of age).
• Seat Belt. Once children have outgrown their booster seats, they should ride in the back seat of the car until 13 years of age and use the car’s lap and shoulder seat belts.

Safe Kids Program at Cooper

Safe Kids Southern New Jersey is a local branch of Safe Kids USA, an organization dedicated to unintentional-injury prevention in children 14 and under. Safe Kids Southern New Jersey is led by the Children’s Regional Hospital at Cooper, and performs car-seat inspections to determine if children are properly restrained in the car.

For more information, contact Maureen Donnelly at 856.968.8687.

Related Links

• Safe Kids Southern New Jersey
• Upcoming Car Seat Classes & Inspections

Throughout preschool and her early elementary grades, Emma was sunny, confident, and engaged in school. Now 12 and in Grade 6, her teacher’s comments paint a different picture:

Emma enters class pleasantly and she seems to get along nicely with the other kids. During class, however, Emma never participates and it seems that her mind is elsewhere. Emma’s work reflects a general lack of effort. It’s almost as if she doesn’t care.

What happened to the sunny, confident and engaged Emma?

Jacob, age 9, loves playing with Lego and other hands-on materials. Building elaborate cities and complex scenes, he is confident and very capable. In class, though, Jacob is unenthusiastic. An observer watching Jacob’s lack of connection and energy in class would probably think his “light bulb” was dim. Often, Jacob actually looks pained in class – particularly during open-ended writing assignments.

A recent sample of Jacob’s writing about a school experience offers insight into Jacob’s in-class struggles:

One day in scool it started as and ordenary day but at resec we hade a safty meet and I got my posit (post) I got to raes the flag It was cool because every morning I hade to come to scool erly to raseis the flag and tack down the flag I was cool because I was incharg of the flag that is one thing that happond to me.

While both of these children are quite different in style and personality, both manifest the signs of a shut-down learner. The signs of a shut-down learner typically start to emerge in the upper elementary grades, and become much more pronounced by high school.

They include:

• A sense that the child is increasingly disconnected, discouraged, and unmotivated
• Fundamental skill weaknesses with reading, writing, and spelling, leading to diminished self-esteem
• Increased avoidance of school tasks such as homework
• Dislike of reading
• Hatred of writing
• Little or no gratification from school
• Increasing anger toward school

Understanding the formula of shut-down learners

Shut-down learners are children who become academically discouraged and disconnected from school over time. A simple formula helps to explain how kids become shutdown learners:

Cracks in the foundation + Time + Lack of Understanding + Strained Family Communication = Shut-Down Learner

Understanding this formula will help parents of children like Emma and Jacob to be in a better position to take appropriate action.

Cracks in the Foundation: Cracks in a child’s learning can usually be identified as early as preschool and kindergarten age. Indicators during this period are easily identified. Does your child have trouble learning letter names and their sounds, for example? By first grade, is your child taking steps toward blending sounds? In middle to upper elementary school, is writing a laborious, often agonizing process for your son or daughter?

If the answer is “yes” to these questions, it does not necessarily follow that your child will become a shut-down learner. However, like cracks in your house that expand if unaddressed, it is important to act to prevent academic cracks from widening. Otherwise, they will contribute to discouragement over time and a child ultimately shutting down.

Lack of Understanding: In my evaluation of shut-down learners, I have found that many receive work on a daily basis that they simply cannot handle, causing them unnecessary frustration. Too often, parents and teachers do not understand the skill deficits that are causing a child difficulty. For example, I recently tested a fourth-grader who struggled to read certain words presented in a text, including “porcupine,” “passage” and “amazement”. Since most fourth-graders read silently to themselves, her teacher and parents mistakenly believed that the student had a comprehension problem, when she was actually experiencing difficulties with word-reading and decoding.

Additionally, many children who struggle in school simply do not have problems deemed to be “severe enough” to warrant special education. For those children, parents will need to seek outside remedial help in the form of tutoring, where available.

Strained Family Communication: The beginning of homework time often marks an increase in the household temperature, as screaming and arguing become part of the landscape. Strained communication around homework can be overwhelming for families and can contribute to a child’s becoming a shut-down learner.

Addressing (or preventing) shut-down learners

1) Trust your gut: If you believe your child is experiencing difficulties at school, listen to yourself. Don’t wait, or fall for such oft-used statements as, “You know how boys are,” or “She’ll grow out of it.” Act on your feelings even if your child has been deemed ineligible for school services. Consult a trustworthy, competent person outside of school whom you feel comfortable with, to assess your child.

2) Know what you are targeting: If your child’s assessment has identified issues of concern, chances are an area in your child’s reading needs addressing. There are essentially two types of reading problems: in the first, the child has trouble decoding words and reading fluently.

In the second, the child can read fluently, but experiences great difficulty understanding what he or she has read. Get clear on the exact issues that you hope to resolve. Don’t scattershot remediation.

3) Take the heat out of the interaction: Try to step back a little bit and turn down the heat within the house. The daily ritual of yelling, pecking or nagging never leads to positive change. When was the last time your child said, “Thanks for yelling, Mom, I see your point. I’ll get down to business”? Right. Never. Why persist? Your kids are probably feeling overwhelmed by homework that they can barely handle. In raising the heat, you’re simply adding stress to their lives.

Turn down the temperature. Kids need emotional fuel to tackle their school difficulties, especially those kids who derive little gratification from their efforts. Look for the small things that your child is doing well. Statements, like, ”Wow, I like the way you took out your work tonight without my asking,” can really mean a lot to a child, especially one who might be a bit discouraged.

4) Find someone to connect with and mentor your child in school: The shut-down learners I know do not feel very good about themselves and they do not see their true strengths. If your child is of middle-school age or older (those preteen and teenage years when the development of a sense of self is critical), it is particularly important for him or her to have at least one person in school who really values him or her and will rally on your child’s behalf – even if he or she isn’t succeeding academically.

5) Maintain a sense of equilibrium: Do something fun and enjoyable with your child. Play a board game or do an arts and crafts project together. Most kids would enjoy doing an activity like that with you. Try not to let school problems set the tone for the entire household and all of your interactions.

6) Support your child: Academic discouragement is debilitating to children and families. Connecting with your child’s natural strengths and letting him or her know that you are both on the same “team” can make an enormous difference in preventing your child from becoming a shut-down learner.

About Dr. Selznick

Dr. Richard Selznick is a child psychologist and the director of the Cooper Learning Center, Department of Pediatrics, Cooper University Hospital in New Jersey. He is the author of The Shut-Down Learner: Helping Your Academically Discouraged Child (www.shutdownlearner.com).

Reprinted with permission from Exceptional Family, Canada’s Resource Magazine for Parents of Exceptional Children. To subscribe to Exceptional Family, visit www.exceptionalfamily.ca.

Related Links

• The Cooper Learning Center
• The Shut-Down Learner: Helping Your Academically Discouraged Child
• Richard Selznick, Ph.D.

Here are some tips from the Children’s Regional Hospital at Cooper, where we have pediatric gastroenterologists ready to help children who may have this health issue.

Spit Happens

Gastroesophageal reflux (GER) is common in infants, and most babies outgrow it by the age of one. GER occurs during or after a meal when stomach contents go back into the tube that connects the mouth to the stomach. GER occurs often in normal infants. Most infants with GER are happy and healthy even though they spit up or vomit. Spitting up tends to peak at four months and most infants stop spitting up by 12 months of age.

If your baby is spitting up without discomfort and is making appropriate weight gains, then he or she is probably a normal spitter. Here are several recommendations which might help:

• Avoid overfeeding. Don’t feed the baby again after he or she spits up — wait until the next feeding.
• Consult your doctor to see if the baby is taking appropriately sized bottles or nursing the appropriate amount of time.
• For formula-fed infants, your pediatrician may recommend a special anti-reflux formula or that feedings be thickened with a small amount of infant rice cereal.
• For formula-fed infants, your pediatrician may advise you to try a formula created to be non-allergenic (hypoallergenic) for two weeks.
• Keep your infant upright for at least 30 minutes after meals.
• Only put your baby in a car seat when driving in the car.
• Avoid tight diapers and elastic waistbands.
• Avoid exposure to tobacco smoke.

Treating GERD

If your child is diagnosed with GERD, your doctor may recommend a few simple but important strategies, including:

• Time the evening meal so your child has an hour or two of quiet relaxation but nothing more to eat or drink before bedtime.
• For older children: After mealtime, have your child sit upright in a chair, reading, doing homework, or some other calm activity to give the digestive process time to work.
• Lying down soon after eating encourages the reflux of stomach contents into the esophagus. Your child may sleep more comfortably if you raise the head of her bed. Sleeping with the upper part of the body elevated uses gravity to discourage reflux.
• If your child is troubled by indigestion or other symptoms related to GERD, your pediatrician may also prescribe a medication to help her stomach contents move through the digestive tract more easily.

Youngsters and teenagers can also be bothered by GERD. The best advice is to talk to your pediatrician. If you are referred to a pediatric gastroenterologist, please call our board certified specialists at Cooper: Alan Baldridge, M.D., Division Head, or Sabeena Farhath, M.D.

Office Locations

Camden
Three Cooper Plaza, Suite 200
Camden, NJ 08103
Appointments: 856.342.2001

Voorhees
6400 Main Street
Voorhees, NJ 08043
Appointments: 856.751.9339

Related Links

• Pediatric Gastroenterology and Nutrition

The Children’s Regional Hospital, with the American Academy of Pediatrics, is happy to provide you with this list that will give you some age-appropriate ideas to discuss your children.

Preschoolers

• I will clean up my toys.
• I will brush my teeth twice a day, and wash my hands after going to the bathroom and before eating.
• I won’t tease dogs – even friendly ones. I will avoid being bitten by keeping my fingers and face away from their mouths.

Kids 5- to 12-years-old

• I will drink milk and water, and limit soda and fruit drinks.
• I will apply sunscreen before I go outdoors.  I will try to stay in the shade whenever possible and wear a hat and sunglasses, especially when I’m playing sports.
• I will try to find a sport (like basketball or soccer) or an activity (like playing tag, jumping rope, dancing or riding my bike) that I like and do it at least three times a week!
• I will always wear a helmet when bicycling.
• I will wear my seat belt every time I get in a car.  I’ll sit in the back seat and use a booster seat until I am tall enough to use a lap/shoulder seat belt.
• I’ll be nice to other kids. I’ll be friendly to kids who need friends – like someone who is shy, or is new to my school
• I’ll never give out personal information such as my name, home address, school name or telephone number on the Internet.  Also, I’ll never send a picture of myself to someone I chat with on the computer without my parent’s permission.

Kids 13-years-old and up

• I will eat at least one fruit and one vegetable every day, and I will limit the amount of soda I drink.
• I will take care of my body through physical activity and nutrition.
• I will choose non-violent television shows and video games, and I will spend only one to two hours each day – at the most – on these activities.
• I will help out in my community – through volunteering, working with community groups or by joining a group that helps people in need.
• I will wipe negative “self talk” (i.e. “I can’t do it” or “I’m so dumb”) out of my vocabulary,
• When I feel angry or stressed out, I will take a break and find constructive ways to deal with the stress, such as exercising, reading, writing in a journal or discussing my problem with a parent or friend.
• When faced with a difficult decision, I will talk with an adult about my choices.
• When I notice my friends are struggling or engaging in risky behaviors, I will talk with a trusted adult and attempt to find a way that I can help them.
• I will be careful about whom I choose to date, and always treat the other person with respect and without coercion or violence.
• I will resist peer pressure to try drugs and alcohol.
• I agree not to use a cell phone or text message while driving and to always use a seat belt.

What steps can parents take to keep their teens and pre-teens healthy?

“The most important steps parents can take are to keep the lines of communication open, and to empower teenagers through responsible decision-making and the establishment of trust,” said pediatric specialist Lori B. Feldman-Winter, M.D., M.P.H., Head of the Division of Adolescent Medicine at Cooper University Hospital.

By way of good example, and by encouraging rapport in the home, parents can provide their children with the skills they need to handle the physical, emotional and psychological changes they face during adolescence.

“Maintaining healthy habits shifts from parental control to adolescent control, and parents can model healthy habits by engaging in regular physical activity and establishing healthy eating habits,” Dr. Feldman-Winter said. “The most prevalent health problem affecting adolescents is obesity, followed by trauma due to accidental or intentional injuries, as well as other health concerns that arise from high-risk behaviors.”

For both teens and pre-teens, obesity can trigger health problems, such as diabetes. For pre-teens, emotional issues related to the onset of puberty can occur, particularly among those who go through puberty earlier than their peers. Older teens are at risk for injuries from playing sports and from high-risk behaviors, such as alcohol and/or substance abuse. The late-teen years also are the most common period for mood disorders to become apparent, including anxiety and depression. For adolescent females, problems with menstruation and hormonal imbalances can occur.

“The most important consideration when thinking about the medical needs of adolescents and the way to keep them healthy is their psycho-social history,” Dr. Feldman-Winter said. “Most serious health problems in the adolescent arise from behaviors that lead to accidents and injury. Other risk behaviors may increase the likelihood that the adolescent will become infected, such as with sexually transmitted infections. Since behavior is at the root of many health problems encountered by adolescents, we in Cooper’s Division of Adolescent Medicine spend a lot of time taking detailed history while respecting the autonomy and privacy of our adolescent patients,” Dr. Feldman-Winter said.

With adolescence being a time of substantial physical and behavioral change, parents can be assured that physicians specializing in adolescent medicine can provide insights on, as well early diagnosis and treatment of, health and wellness issues specific to teens and pre-teens.

Related Links

• Health eTalk Web Chat: Keeping Your Adolescent Healthy
• Adolescent Medicine at Cooper

Most people with 2009 H1N1 have had mild illness and have not needed medical care and the same is true of seasonal flu. However, the flu can be serious, especially for young children (risk is highest in children younger than 2 years) and children of any age who have certain chronic medical conditions. These conditions include asthma or other lung problems, diabetes, weakened immune systems, kidney disease, heart problems and neurological and neuromuscular disorders. Children with these conditions can have more severe illness from any flu, including from the 2009 H1N1 flu virus.

If your child is 5 years or older and otherwise healthy and gets flu-like symptoms, including a fever and/or cough, consult your doctor as needed. Make sure your child gets plenty of rest and drinks enough fluids.

If your child is younger than 5 (and especially younger than 2), or you have a  child of any age with a medical condition like asthma, diabetes, or a neurologic problem, and develops flu-like symptoms, ask a doctor if your child should be examined. This is because younger children (especially children younger than 2), and children who have chronic medical conditions, may be at higher risk of serious complications from flu infection, including 2009 H1N1 flu. Talk to your doctor early if you are worried about your child’s illness.

Call the doctor or take your child to a doctor right away if your child seems very sick with any of these symptoms:

• Fast breathing or trouble breathing.
• Bluish or gray skin color.
• Not drinking enough fluids.
• Severe or persistent vomiting.
• Not waking up or not interacting.
• Being so irritable that the child does not want to be held.
• Flu-like symptoms improve but then return with fever and worse cough.
• Has other conditions (like heart or lung disease, diabetes, or asthma) and develops flu symptoms, including a fever and/or cough.

Remember that the flu spreads through sneezes and coughs of someone with the flu, or if you touch an object with the flu viruses on it and then touch your mouth or eyes. Using good hygiene can help you and your child to stay healthy.

If you would like further information about protecting your child from H1N1, please click here to view the CDC’s Seasonal and 2009 H1N1 Flu: A Guide for Parents.

Related Links

• Children’s Regional Hospital at Cooper
• H1N1 Influenza Immunization Schedules and Information
• Seasonal and 2009 H1N1 Flu: A Guide for Parents