Tag Archives: Journal of Pediatrics

Kids who are bullied less likely to be physically active

Children who are bullied by their peers endure great emotional pain and suffering.

Staying active has emotional benefits, too. Courtesy YMCA of the East Bay, Oakland, CA

But a new study, to be published in the March 2012 issue of Pediatrics, found that children who are ostracized, even for brief periods, are significantly more likely to choose sedentary over physical activities.

Researchers asked children between the ages of 8 and 12 to play a virtual ball-toss game. They were told that they were playing the game online with other kids. In some of the sessions, the game was pre-programmed to exclude the child from receiving the ball for most of the game.

In the other sessions, the child received the ball one-third of the time. After the game, the kids were given a choice of any activity they liked. They were then monitored by a device that measured physical activity.

The researchers found the kids who were excluded were far more likely to choose an activity that did not require physical effort.  They concluded that being ostracized may reinforce behaviors that lead to obesity in children.

Even though this study seems small, it is important, says Dr. Farah Lokey, a member of the Arizona Chapter of the American Academy of Pediatrics.

Children who are prone to being bullied and then ostracized in school every day tend to spend more time at home and less time participating in activities with other children.

And that can damage self-esteem. “The key to getting these children active, and feeling good about themselves, says Lokey, who practices at Southwestern Pediatrics Gilbert, “is putting them into activities where they can shine on their own and meet like-minded individuals.”

Individual sports such as golf, swimming, and tennis can provide these opportunities, Lokey adds. “These sports not only allow them to become experts in the sports by learning these skills but definitely help their self- esteem and pride.”

Sports like Karate and other self-defense activities encourage treating others with respect. That keeps the concept top-of-mind for children.

When to worry

Younger school-age children typically begin their school years with a sense of excitant about learning and making new friends. But if a child seems suddenly less enthused and more fearful around school, or develops separation anxiety, that could be a red flag that bullying is going on, says Lokey.

Some children will show physical problems with no diagnosable cause, such as a tummy aches – but maybe only on the weekdays, not on weekends. Sleep problems or anxiety in social situations can also be indicators.

With older children, behavior can become more aggressive and defiant, says Lokey. Grades may suffer, and parents may notice a change in appearance as well as a tendancy to seclude themselves from others.

 What to do

If parents do see sudden changes, they should speak to school officials and enlist the help of school counselors. Lokey says that pediatricians can be a great resource when parents have questions about these behaviors.

A child’s physician can talk to their patient in confidence and offer to speak with school counselors if needed. “Bolstering confidence and self-esteem in the children we pediatricians treat,” says Lokey, “is one of our main goals.”


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



Fostering emotional and social well-being: here’s how

About 1 in 5 children need care for a mental health issue, says Robert W. Block, MD, FAAP, president of the American Academy of Pediatrics (AAP).

Courtesy AZAAP

Block says the AAP wants parents to have the knowledge and tools they need to recognize when their child may be struggling so they can get help, but also to foster their child’s emotional and social well-being.

Children’s mental health is an important part of their overall well-being.

So to help guide parents, the American Academy of Pediatrics (AAP) offers a collection of interviews with pediatricians about child behavior, emotions and other mental health topics.

Parents can listen first-hand as pediatricians answer common questions:

  • How do you instill good habits in your children?
  • What’s the best way to praise your child?
  • Is it normal for teenagers to be moody?
  • How can parents nurture their young child’s emotional development?
  • How is ADHD diagnosed in preschool-age children?
  • How can parents encourage open communication with their teenager?

Listen to Sound Advice on Mental Health

Parents can have a tremendous positive impact in helping their children learn how to manage stress, develop healthy relationships and form positive emotional habits, says the AAP.

The site also includes videos on these topics:
  • Fostering positive mental health in  children
  • Adolescent mental health and depression
  • Infant and toddler emotional development
  • Postpartum depression on children and families
  • New AAP guidelines on diagnosing and managing ADHD in children and adolescents
  • Advice on helping children cope with traumatic events.

Are your kids “sexting”? How to talk about it

Everybody has an opinion on teens and the use of digital communication and social media. Technology is truly changing the way kids interact with each other—and that can be challenging for parents in many ways.

It’s good, because it allows them to swiftly connect with their friends— or even their parents or other relatives. It’s not so good, because it swallows them up and prevents them from forging relationships the way we did it…in the way of past generations. It’s unfamiliar territory.

Courtesy State of Rhode Island, Office of the Attorney General

But on the topic of “sexting,” most parents agree: sending sexually explicit messages of themselves or others over cyberspace is a very bad idea.

In fact, depending on the type of material we’re talking about, and the location from where it was sent or received, participating in sexting can potentially violate child pornography laws.

Read more on Arizona’s “sexting” law, Senate Bill 1266, which took affect in July 2010, from the University of Arizona’s Frances McClelland Institute for Children, Youth and Families.

A new study to be published in the January 2012 issue of Pediatrics (online today) found that 2.5 percent of the youth surveyed participated in some form of sexting in the past year.

The subjects in the survey included 1,560 Internet users ages 10 through 17.  They were surveyed about their experiences with appearing in, creating, or receiving sexual images or videos.

Only one percent of those surveyed participated in sharing images that could potentially violate child pornography laws.

Most kids who participated in sexting said they did it as a prank, or while they were in a relationship. A significant number said that drug and alcohol abuse was a factor that influenced the behavior.

Why do kids “sext”? Read a fact sheet with information from the State of Rhode Island Attorney General’s office.

The National Campaign to Prevent Teen and Unplanned Pregnancy reports that one in five teens say they have sent electronically or posted online nude or semi-nude photos or video of themselves.

Both the American Academy of Pediatrics and the National Campaign say that young people must be educated on the possible consequences of sexting.

How should parents talk to their kids?

Remind them to think of anything they post on social media as a “cyber tattoo,” a searchable something that will be around as they or their friends apply for college, jobs and navigate through life.

It’s a challenge for today’s kids, who are just beginning to develop impulse control, to stop for a moment and think. That’s why it’s crucial for parents to talk to their kids.

Once a user hits “send” –be it from a phone or a computer or other digital device– it effectively is up for grabs. Ask your child to think before hitting “send:” would I want my grandma, my teacher, my baby sister, to see this?

Read more recommendations from the American Academy of Pediatrics on how parents can talk to kids about sexting and their digital footprint, no matter how savvy parents are themselves are about today’s technology.

The State of Rhode Island also provides these useful tips on how to talk to kids about “sexting.”

Find general internet safety information for parents from the Arizona Attorney General’s office.

If dad is depressed…the kids are affected

When parents are depressed, the children who live with them are affected.

Those were the recent findings from a new study to be published in the December issue of Pediatrics (online November 7).

Researchers looked at a sample of 22,000 children living in two-parent homes.  They found that the risk of a child having emotional or behavioral problems were greater if the mother, rather than the father, showed depressive symptoms.

But having two parents with depressive symptoms was associated with a dramatically increased rate – 25 percent – of children with emotional or behavioral problems, as compared to 6 percent of children who had neither a mother nor a father with depressive symptoms.

Maternal depression has well-documented effects on the mental and physical well-being of children. More research is needed on the effect that depressed fathers may have on their children.

It is estimated that one in four men in the United States suffer from depression. Most never receive treatment.

How do you know if dad is depressed?

Depression has many signs and symptoms. In men, three of the three of the most common signs are pain, risk taking, and anger. Find out more.

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.

Want organized, attentive kids? Limit the cartoons.

A new study finds more evidence that a diet of fast-paced cartoons may affect brain development in young children.

Courtesy yipDog Studios

We all want our kids to be organized. We want them to be able to plan, problem solve, pay attention to important details (when was the homework due?) and develop the discipline to forego those video games in order to study for that test.

Developing these critical mental tasks —  or “executive function” – is essential for kids to ultimately achieve those goals so they can take responsibility for handing in homework, studying for tests, keep a dentist appointment, or even meet a college deadline…and do it with minimal intervention from mom or dad.

Executive function, says child development expert Adele M. Brodkin, PhD., is what gets us down to business even when we’d rather just hang out.

A new study to be published in the October, 2011 issue of the journal Pediatrics, found that some fast-paced cartoons may affect the development of executive function in young children.

The study, “The Immediate Impact of Different Types of Television on Young Children’s Executive Function,” published online Sept. 12, tested 4-year-old children’s attention, problem-solving, self-regulation and other executive function abilities after they watched one of two cartoons for nine minutes.

The first group of children watched a fast-paced cartoon featuring an animated kitchen sponge. The second group of children watched a slower-paced, realistic Public Broadcasting Service cartoon about a typical preschool boy.

Researchers also gave a control group of children crayons and markers for free drawing for a pre-determined time period.

The children who had watched the fast-paced cartoon performed significantly worse on post-testing than did the group of children who were assigned to the drawing group.

But there was no difference in performance between the drawing group and the group that watched the slower-paced, realistic show about the preschool boy.

Study authors stated they cannot tell which features of the TV show created the effects, though they speculate the combination of fantastical events and fast pacing are responsible. 

They conclude that parents should be aware that watching similar television shows may affect development of executive function.

The American Academy of Pediatrics (AAP) recommends limited television for children – and discourages it altogether for children under age 2.