Tag Archives: AAP

Autism research: right here in Arizona

This article has moved to: http://www.raisingarizonakids.com/2012/04/autism-research-right-here-in-arizona/

Urinary tract infections: Can you tell by the smell?

This article has moved to: http://www.raisingarizonakids.com/2012/04/urinary-tract-infections-can-you-tell-by-the-smell/

Understanding pediatric sudden cardiac arrest (SCA)

Would you recognize the warning signs of pediatric sudden cardiac arrest (SCA)? If not treated in minutes, SCA can result in death.

In a new policy statement to be published online on Monday, March 26, the American Academy of Pediatrics (AAP) provides guidance for pediatricians on underlying cardiac conditions that may predispose children to SCA.

Although the risk for SCA increases when children with underlying cardiac disorders participate in athletics, SCA can occur at very young ages and also when a child is at rest.

Research supports the need for a SCA registry, says the AAP. A registry would help experts gain a better understanding of the nuances of the condition.

Plus, many cardiac disorders are known to be genetic, so the evaluation of family members, even if asymptomatic, could be a critical step in the overall diagnosis of disorders predisposing to pediatric and young adult SCA.

We asked Arizona Pediatric Cardiology Consultants (APCC), members of the Arizona Chapter of the American Academy of Pediatrics, to weigh in on what parents need to know about SCA.

How common is SCA?  

According to the Centers for Disease Control, each year 2,000 individuals less than 25 years of age will die suddenly with the majority of these having a cardiac etiology.

What causes SCA?

Pediatric sudden cardiac arrest and sudden cardiac death can occur with various types of cardiac causes, including conditions in the heart muscle (such as hypertrophic cardiomyopathy), unusual positioning of a coronary artery, or an electrical disturbance within the heart. (Long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia).

More on genetic cardiac conditions from the Sudden Arrhythmia Death Syndrome Foundation (SADS)

How are family members evaluated, and what symptoms may be indicators that a child is pre-disposed to this? 

Signs that may suggest an increased risk for SCD include fainting or seizure with exercise, excitement, or startle, significant dizziness with exertion, unusual and consistent shortness of breath or chest pain with exercise.

If a family member has died suddenly or unexpectedly at a young age, has unexplained seizure disorder, died at a young age from a heart problem, or has a history of fainting, then screening is appropriate.

How do doctors determine if a child is at risk? What tests are performed?

Evaluation by a pediatric cardiologist will include a thorough individual and family history, ECG, physical exam and perhaps an echocardiogram, an exercise stress test, and genetic testing if necessary.

Would automatic external defibrillators (AED) on playing fields and in schools help?

A great majority of these deaths relate to a life-threatening arrhythmia, ventricular fibrillation. CPR and use of an AED may be life saving.  AEDs are often found in airports, casinos, and government buildings.

However, there is no law in Arizona currently requiring AED within schools, recreational sports fields, or other private facilities.

Are efforts being made to increase the availability of AEDs?

The decision about whether to have an AED on location is left up to the individual organization.  APCC’s electrophysiologists are making an effort to educate schools, sports organizations, and families regarding the importance preparation to prevent SCD.

The role of an ECG in all sports physicals remains a debated topic within the United States.  It is, however, very important to ask specific questions (use the attached screening tool) for risk factors and then refer to a pediatric cardiologist for further assessment.

What should parents or caregivers do if they believe a child might be at risk?

Once an individual is identified as having any of the conditions listed above, it is very important for first degree relatives to also be evaluated by a pediatric cardiologist even if they are not experiencing symptoms.

Sudden Cardiac Death is devastating to not only the families of those affected but to the communities in which they live.  Educating  families, schools, sports leagues, and primary care providers about quick and effective screening for children at risk for SCD is a first step in prevention.

Increased community awareness and the availability of AEDs in schools and sporting venues will help avert a tragedy.

Karen S. Eynon, RN, MSN, CPNP, MATS,  compiled these answers with support from Mitchell Cohen, MD, Andrew Papez, MD, and Jennifer Shaffer, RN, MS, CPNP, all of Arizona Pediatric Cardiology Consultants along with information from SADS.org.  

Check with your child’s physician if you are concerned about risks for SCA.

More from Parent Heart Watch, a network of parents and partners dedicated to reducing the effects of SCA.

 

New findings on what may lead kids to binge drinking

A recent study published by the American Academy of Pediatrics found that that the more exposure teens had to alcohol use in movies, the more likely they were to binge drink.

The age, affluence and rebelliousness of the teens did not seem to matter. And this pattern was observed across cultures in countries with different norms regarding teen and adult alcohol use and drinking culture.

What can parents do to make sure kids don’t pick up the cues from the many movies out these days that show alcohol use? And what are some ways that parents can prevent a child from binge drinking?

Dr. Dale Guthrie, a pediatrician in practice at Gilbert Pediatrics, says communication is the key.

Guthrie, who serves as vice president of the Arizona Chapter of the AAP, encourages parents to stay involved — and to make sure to meet and know their children’s friends, from the early days of pre-school right on through high school.

More tips from Dr. Guthrie on how to help prevent your child from using alcohol and other drugs:

  • Know where your teen is at all times.  Teens may act as if they don’t like it but teens are actually more secure knowing their parents care enough to know where they are and what they’re doing.
  • Consciously and genuinely praise your teen for something good he does every day.
  •  Make sure she knows she can talk to you about anything, at any time, if it is important to her and that she won’t be interrupted judgmentally with a lecture.
  •  Remember you are his parent, (not his best friend, afraid to step on his toes) and offer advice when requested and at opportune teaching moments in short phrases, not long lectures which are tuned out anyway.
  •  Better yet, ask inspired questions of your teen—the kind which help her arrive at the correct solution.
  •  Attend movies with your teen and then ask open-ended questions about what he thought about it.
  •  At a nonthreatening time, (not right as your teen is headed out to a movie), sit down as a family and discuss what are your family goals and standards.  As part of that, set family standards for what types of movies you will view and which are beneath your family standards.
  •  When your teen returns from being out with friends, it is helpful to have a “check-in” with parents.  If the tradition has been set that he will give parents a hug (or even a kiss) no matter what time he returns, parents will know more about what he’s been doing  just by being close to him, listening and observation.

Parents of younger children might not be thinking about the teenage years, but is there anything they can do to lower the risk that their child will abuse alcohol down the road?

Will your six-year-old become a teen drinker?

One very simple way is for parents to make sure they truly listen to their child right from the start.

Guthrie says that children need to feel that what they say is of prime importance to their parents. “Then when she has something really serious to discuss, he adds, “she will feel comfortable coming to you.”

Modeling healthy behaviors themselves, and engaging kids in conversation at opportune moments (short snippets in lieu of lengthy lectures) are other ways parents can make a difference, says Guthrie.

RAK Archives: Talking to teens about alcohol poisoning

More on talking to kids about drugs and alcohol, and upcoming Parent Workshops from the Partnership for a Drug-Free America, Arizona Affiliate

Getting breastfeeding off to a good start

Where you choose to deliver your baby may have a tremendous impact on reaching breastfeeding goals, says pediatrician and lactation consultant Laurie Jones, MD, IBCLC.

Laurie Jones, MD, and Tanya Belcheff, CNM, examine day-old Judel Alia

That’s because a key predictor of long-term success for breastfeeding rests on what happens between a mother and her newborn in those precious hours after birth.

Doctors, nurses, hospital policies, and family member interaction- even well-meaning visitors—can “make or break” the early breastfeeding relationship. “Babies and mothers are programmed with instincts to breastfeed, says Jones, who practices at St. Joseph’s Hospital and Medical Center, “but modern hospitals and health care providers mostly get in the way or interrupt those instincts.”

Jones, a member of the Arizona Chapter of the American Academy of Pediatricians says the Arizona Baby Steps program, launched by the Arizona Department of Health Services (AZDHS), has worked wonders at hospitals across the state to train nurses, doctors, and administrators in the best ways to support breastfeeding mothers after delivery.

More on how Arizona is helping moms to meet breastfeeding goals

The program promotes the implementation of five evidence-based maternity care practices that help a new mom to meet her breastfeeding goals.

Funded in part by the Centers for Disease Control and Prevention (CDC), the voluntary program was offered to hospitals in Arizona by the AZDHS, and implemented beginning in early summer, 2010.

The most important thing a mother can do to get breastfeeding off to a good start, says Jones, is to have unrestricted and uninterrupted time “skin-to-skin” in the first days following birth.

That first hour immediately after birth, says certified nurse-midwife Tanya Belcheff, MSN, CNM, should be considered the “golden hour.”  Belcheff, who also practices at St. Joseph’s, says it’s a time to cuddle, to bond- and can even predict the duration of the breastfeeding relationship.

“Studies show that the number of minutes you can have your baby skin-to-skin immediately after delivery, says Belcheff, “directly correlates with the number of months that you are successful at breastfeeding.”

It’s a new-old concept, she adds,  which helps regulate a newborn’s temperature, glucose levels, and breathing rate.

Also known as “metabolic stabilization,” Jones says that a baby will warm faster on a mother’s chest –or a father’s chest, or a partner’s chest, for that matter — rather than the traditional warmer used in hospitals. No matter what the feeding method is — breast or formula – this early contact is best for a new baby.

If moms come in asking for skin-to-skin contact during labor, and the nurses understand the importance, they are more likely to get it, says Belcheff, so it is important for labor/delivery professionals to educate their patients during pre-natal care.

Dr. Jones with Dr. Plimpton, who delivered Judel

Dr. Steven Plimpton, MD, an OB-GYN in private practice in Phoenix, says that that skin-to-skin contact is often offered as routine by labor and delivery nurses who understand and appreciate the benefits. “The mom will do it right away, assuming that it is the best thing for the baby.” This early contact helps bring in the breast milk, too.

A first bottle during the very early hours, says Plimpton, can interfere with the process. “The baby sucks it down like it’s the best thing in the word, and then the mom thinks she’s inadequate because the baby doesn’t suck on her like that, or cries when she tries to put her to the breast. The more you promote it right at the beginning, I think the more successful it’s likely to be.”

AAP new updated policy clearly says that all procedures should be delayed until after the first feeding, says Jones. But expanding that policy beyond the pediatric literature takes time.

Preparing for breastfeeding: what to ask your pediatrician

Getting everyone on board – obstetricians, midwives, family practice doctors, nurses –who helps participate in the birthing experience — is the best way to get baby off to a good start.

That’s why policies like Arizona Baby Steps are needed, so that nothing is left to chance. As long as the baby has a healthy Apgar score, which can be taken while the baby is on mom’s chest, says Jones, other routine procedures, like weighing and giving medicines – can wait.

Expectant moms should make a birth plan, says Belcheff, and discuss their wishes with their care provider. Jones says that a mother can reach her breastfeeding goals with a strong belief that she can do it and by making choices that support her goal. “Don’t overthink things in the first few days — human mothers have been doing this with no other option for 267 million years. And you can, too!”

 Jones offers the following tips on what expectant moms should know in order to get breastfeeding off to a good start:

  • Choose a hospital that has inpatient lactation consultants (designated as IBCLC) seven days a week and trains nurses and other providers in basic breastfeeding support.
  • There are still many hospitals that keep babies in a separate unit to get routine phototherapy or routine antibiotics which is very disruptive and always detrimental to the early establishment of a mother’s milk supply.
  •  Discuss a birth plan with your birth provider that includes immediate skin-to-skin after delivery and keeping mother and baby together at all times during the hospital stay with minimal interruptions.
  •  Let the nurses and doctors know that you do not want any formula, bottles, or pacifiers given to your baby.
  • Ask friends and family to visit during a limited window of time so that you have as much uninterrupted time with your baby as possible to be free to learn your baby’s hunger cues and needs.
  • Avoid any hormonal contraception until breastfeeding is well-established at the earliest around 6 weeks post-partum.

Arizona Baby Steps to Breastfeeding participating hospitals and medical centers

Greater Phoenix Area:

Banner Baywood Medical Center

Banner Del E. Webb Medical Center

Banner Desert Medical Center

Banner Estrella Medical Center

Banner Gateway Medical Center

Banner Good Samaritan Medical Center

Banner Thunderbird Medical Center

Chandler Regional Medical Center

Maricopa Integrated Health System

Mercy Gilbert Medical Center

Mountain Vista Medical Center

Phoenix Indian Medical Center

St. Joseph’s Hospital and Medical Center

Other participating Baby Steps hospitals in Arizona:

Carondelet Holy Cross Hospital, Nogales

Carondelet St. Joseph’s Hospital, Tucson

Casa Grande Regional Hospital

Flagstaff Medical Center

Kingman Regional Medical Center

Northwest Medical Center, Tucson

Sierra Vista Regional Health Center

Summit Healthcare Regional, Show Low

Tucson Medical Center

The University of Arizona Medical Center, Tucson

Yavapai Regional Medical Center

Yuma Regional Medical Center

Source: Anne Whitmire, Breastfeeding Program Manager

Arizona Department of Health Services

What to ask a pediatrician about breastfeeding

Exclusive breastfeeding for about the first six months of a baby’s life is best for baby, says the American Academy of Pediatrics, in a statement that reaffirms AAP policy.

The AAP wants parents to think of breastfeeding as not just a lifestyle choice, but as an investment in the short- and long-term health of their newborn.

Part of the pediatrician’s job is to encourage and support breastfeeding — as well as convey the health risks of choosing not to breastfeed.

Laurie Jones, MD, IBCLC, with her son and daughter

Laurie Jones, MD, IBCLC, one of the few pediatricians who is also a board certified lactation consultant, and a member of the Arizona Chapter of the AAP, developed a strong interest in breastfeeding after her daughter, now three, was born.

Things didn’t start out so well, says Jones, who says she almost quit on day 11. “I was a mess from exhaustion and pain and feeling like a failure. Nothing feels worse than not being able to feed your baby.”

But Jones was lucky — she found help from a skilled lactation consultant who she says “changed everything.  My husband and my mother also gave me encouragement and support in those tough first weeks.”

Getting that breastfeeding relationship on track, says Jones, “changed my life and my career forever. I took steps to become a lactation consultant in the year and a half following her birth.”

In her pediatrics practice, Jones fills a gap that she thinks has been lacking—an understanding of the critical interaction between mother and infant as part of the physician’s complete care of the patient. “Watching the baby get on the breast and observing a feed is critical to assessing a newborn or infant. I don’t feel that I have completely examined an infant until I see the baby nursing.”

Jones says that the subject of breastfeeding has been lacking in medical education. She’s out to change that. One tool she uses is a new AAP breastfeeding curriculum. She teaches medical students and residents about breastfeeding techniques, and works with the St. Joseph’s Pediatrics Breastfeeding Clinic.

In her practice, Jones provides extra-long appointments for new moms who need help. Her practice encourages mothers to nurse in the waiting room and also during painful procedures such as vaccinations.

Jones says she discusses the nursing relationship at every well visit until the child or mother chooses to wean, and supports extended breastfeeding as recommended by the AAP, the Centers for Disease Control, and the World Health Organization.

“I love helping mothers get past breastfeeding hurdles, and seeing them reach their goals, says Jones. “Nothing makes me happier than to see a mother leave my office with her breastfeeding problem solved. I can relate to so many of the issues they are dealing with because of my own experience with my two kids.  I feel like I am in the trenches with them!”

Jones says that parents should select a pediatrician who understands and supports breastfeeding and does not routinely supplement infants with formula.  Ask in advance for a clear explanation of any medical reasons for giving formula.

What should an expectant mom ask a prospective pediatrician about breastfeeding? Tips from Laurie Jones, MD, IBCLC:

  • How long do you recommend a child be breastfed?
  • Do you routinely supplement breastfed babies?
  • Do you have an IBCLC in your office?
  • Do you have a resource list for breastfeeding help if I need it?
  • Is anyone on your staff specially trained to help breastfeeding mothers?
  • Do you encourage mothers to nurse in your waiting room?
  • Do you have handouts or other support materials for breastfeeding mothers?
  • Do you encourage mothers to nurse if they desire while the baby has shots or other procedures?
  • When do you recommend solids be introduced?
  • When do you recommend a child be weaned from breast milk?
  • Do many of your patients reach the recommended 12 month mark for breast feeding?
  • Do you use the 2010 CDC growth charts based on breastfed infants?
  • Do you offer formula bags to your breastfeeding patients?
  • Does the office display formula brochures or formula bags in the front office area or exam rooms?
  • How do you feel about extended nursing and child-led weaning?
  • What resources do you use to check if a drug is safe in breast milk?

How to talk to your pre-teen about the HPV vaccine

The American Academy of Pediatrics now recommends that boys ages 11 or 12 receive the HPV vaccine in a three-dose series, which can be started as early as 9 years old.

Courtesy MCN Healthcare

How do you explain what the HPV vaccine is to a nine-year-old boy?

Well, that’s up to parents to decide.

So you will have your facts straight, however, we asked  Michelle Huddleston, M.D.  a member of the Arizona Chapter of the American Academy of Pediatrics, to explain why the HPV vaccine is on the schedule for pre-teen girls, and now boys, too.

Vaccines are designed to prevent diseases, says Dr. Huddleston, who practices at Phoenix Children’s Hospital. This vaccine is no different.

The HPV vaccine provides protection from certain subtypes of the HPV virus long before boys and young men (and young women) become engaged in any type of sexual activity. 

HPV transmission can happen with any kind of genital contact and intercourse isn’t necessary, adds Dr. Huddleston, who says that many people who have HPV infection are without signs or symptoms and unknowingly pass the virus to their partner.

The HPV vaccine is most effective in the pre-teen age group producing higher antibody levels than in older patients. So, that’s why the vaccine is on the schedule for pre-teen boys and girls.

Talking about the purpose of the vaccine might be a conversation starter for a talk about sex. Dr. Huddleston says that although feeling nervous about broaching the subject with kids is fairly common, she suggests  that as parents,  we should try to consider sexuality a normal topic of conversation.

“Certainly by the time your child starts to exhibit the physical changes of puberty, questions will start to arise,” says Dr. Huddleston. “Be certain to listen, answer honestly and by approachable. You may start the conversation by asking, ‘What do you know about sexuality?’ and see where the conversation leads.

Dr. Huddleston recommends  www.youngwomenshealth.org as a good resource for parents as they prepare to talk to kids about sex.

Another update on the vaccine schedule is the age at which the meningococcal vaccine can be given.

Children as young as 9 months can get the vaccine if they are residents or travelers to countries with epidemic disease or at increased risk of developing meningococcal disease, says the AAP.

Routine immunization with the meningococcal vaccine should begin at 11 through 12 years with a booster dose administered at 16 years of age.

So who is at greatest risk for developing meningococcal disease? And what is it, exactly?

Children who do not have a spleen, have an abnormally functioning spleen or certain immune disorders are at increased risk of developing meningococcal disease, says Dr. Huddleston.

Teenagers are at increased risk of developing meningococcal disease by being in crowded places, living in close quarters, sharing drinking and or eating utensils or having a run-down immune system.

Meningococcal meningitis and septicemia can present with flu-like symptoms and patients can die within 24 hours. 

And, speaking of flu, there’s one more update on the vaccine schedule. 

For children aged 6 months through 8 years, the influenza vaccine should be administered in two doses for those who did not receive at least one dose of the vaccine in 2010-11, says the AAP.

Children who received one dose last season require one dose for the 2011-12 influenza season.

Questions about vaccines or this most recent schedule revision? We list resources below, but any parent who is unsure of what a vaccine is for or when it should be given to a child should check with the child’s health care provider.

More resources on vaccines:

Centers for Disease Control and Prevention 

Center for Young Women’s Health

The Arizona Partnership for Immunizations 

American Academy of Pediatrics Healthy Children website

 

 


Why carpooling parents skip booster seats

Plenty of parents drive children other than their own in carpools, but according to new study findings published in the February issue of Pediatrics, they don’t consistently use booster seats for these “guest passengers.”

In this particular study, about three-quarters of the 4- to 8-year-olds using a seat

Courtesy U.S. Dept. of Transportation

belt were doing so in accordance with the laws in their state. But state laws don’t always comply with the national recommendations.

National recommendations encourage the use of booster seats until a child reaches 57 inches, the average height of an 11-year-old.

State booster seat laws were associated with higher safety seat use, regardless of the carpooling factor, even though half of parents admit to not knowing the age cited in their state booster seat law. Another 20 percent guessed incorrectly.

So, take a guess. What’s the law for booster seats in Arizona?

Arizona is one of only 3 states that currently does not have a law requiring children to be restrained in a booster seat, says Sara Bode, M.D., a pediatrician and Arizona AAP member who practices at Phoenix Children’s Hospital. Current law only requires car seats for children 5 years or younger.

Part of the lower incidence of use may be due to a lack of state booster seat laws, says Bode. There is a current house bill this legislative session that has passed initial committee hearings. House Bill 2452 would mandate booster seats for children up to age 8 or until they are 4 feet 9 inches tall.

Booster seats are just as important as infant and toddler seats, says Bode. They allow correct positioning of the seat belt across the chest and hips.

Kids can easily slip out of a seat belt during a crash or can suffer serious or fatal injuries to the neck and abdomen. In her work at Phoenix Children’s, Bode has seen many children who have experienced trauma from a motor vehicle injury.

Don’t make these five tragic car seat mistakes!

“I personally have taken care of a family who suffered from a motor vehicle crash,” says Bode. “Their 5 year-old wasn’t properly restrained. As a result, she suffered a serious abdominal injury requiring surgery and a prolonged hospital stay.”

Kids who are seated in a booster seat in the rear of the car are 45% less likely to be injured in a crash as compared to those using a seat belt alone, according to data gathered by SafeKidsUSA, a nationwide network of organizations working to prevent unintentional childhood injury.

Study authors conclude that social norms may play a big role in booster seat use, too. As far as carpools go, there are inherent difficulties with the transfer of car seats between parents and carpool drivers, says Bode. It’s just one more thing for parents to do during a busy time of the day.

How do we change the social norm?  Bode suggests that daycares and schools could play a large role in educating parents on the importance of use as well as providing  expectations for proper restraint, and a designated area to store booster seats during the school day.

Plenty of community resources are available to help parents use booster seats properly. Check out our RAK Car Seat Safety Local Resource Page here.

Shopping for toys? How to make sure they are safe

Put safety at the top of the list when choosing toys for young children, says the Arizona Chapter of the American Academy of Pediatrics.

Most parents are aware of the “age-appropriate” factor when they shop, says Sue Braga, AZAAP executive director.

But Braga adds that some may not realize that the high-tech toys that top the list for some kids can come with built-in risks to safety.

Look for a toy that is sturdy, made with non-toxic materials, isn’t too loud, and if it is an electric toy, that it is UL approved, says the AAP.

Ten tips from HealthyChildren.org on how to make sure toys are safe.

The Consumer Product Safety Commission highlights these five hazards that have caused injury or death in recent years:

  • Toys with small magnets, which can be swallowed and lead to serious medical problems if two or more magnets are swallowed.
  •  Toys with lithium button batteries that can be easily removed without a screwdriver and can be a hazard if swallowed.

Read more on what happens when a child swallows a button battery–and about the symptoms -in our RAK archives.

  •  Lead paint on recalled toys.
  •  Metals in children’s jewelry, which can include lead, cadmium and other toxic metals. Some manufacturers, now barred from using lead in children’s toys, began substituting cadmium, another dangerous metal.
  •  Any shooting toys or toys that have pieces that shoot or fly off. Reminder: BB guns and air guns are not actually “toys.” More on BB gun safety.

December has been designated National Safe Toys and Gifts Month. Do your homework, says the AZAAP—don’t assume that all toys on your child’s list are one hundred percent safe.

Other sites that can help parents choose safe toys:

Kids Health.org

SafeKids.org

Recalls from the U.S. Consumer Product Safety Commission

Just shy? Or social phobia disorder?

How do you know whether your child is shy…or if it is something more?

A new study to appear in the November issue of Pediatrics found that twelve percent of youth who identify themselves as shy may in fact have a form of social

Shyness is a universal human trait. Click on the photo for tips for helping shy kids from Australia's KidsSpot

phobia. Study authors questioned whether or not there was an overlap between shyness and social phobia, how often social phobia is diagnosed, and the degree to which shyness and social phobia differ.

They also took a look at the differences in prescribed medication use among youth with shyness and/or social phobia.

Researchers conducted a face-to-face national survey of more than 10,000 teens ages 13 to 18, as well as more than 6,000 of their parents, on a series of mental disorders including social phobia.

While 62.4 percent of parents stated that their adolescent was shy, only 46.7 percent of the youth reported themselves as such.

The children with social phobia displayed significantly greater social impairment. They were more likely to experience a multitude of psychiatric disorders, including anxiety, mood and behavior disorders as well as substance abuse.

But the kids with social phobia were not any more likely than their same-age counterparts to be taking prescribed medication.

Researchers concluded that social phobia is an impairing psychiatric disorder, beyond the range of normal, and that medication may be necessary and helpful in easing symptoms.

Yet debate has recently surfaced over whether the diagnostic term social phobia “medicalizes” normal human shyness, resulting in unnecessary treatment, especially in youth. So how do you know?

One approach to understanding anxiety disorders is to use functional brain imaging (fMRI) to explore how the brain responds to different types of social signals.

Parents should share concerns about a child who seems painfully shy with a primary care provider. Children’s Hospital Boston offers a simple Q & A that can help detect social anxiety disorders. Read more here.