Over the course of the past week, the conversation in my household has been focused on the election of François Hollande and the departure of Nicolas Sarkozy. While it would be nice to say that my highly intellectual children initiated these conversations on their own accord, the reality is that I enticed them into talking about the French elections with a description of the swearing in ceremony at the Elysée Palace and images of Hollande’s parade up the picturesque Champs Elysée! Regardless of how I engaged them, the result was a politically charged conversation about the elections, the process, and the topical issues the French people are grappling with today. Our conversation weaved into more general concepts such as the incumbent versus the challenger, campaigns and how scheduling voting day on a Sunday can impact voter turnout. 

My motivation to have these politically charged conversations with my children is just one of many tactics I use to avoid raising children who will end up as entitled adults. I find that one of the biggest challenges parents today face is that we are raising the “me” generation – the generation that is pandered to to such an extent that when adulthood rolls around, they can’t help but have a sense of entitlement.

Last year, I exposed my children to the events leading up to the uprisings in north Africa and the subsequent results. Examples such as these provided a great opening to develop an appreciation and gratitude for the democratic process. It also dispelled the idea that ‘not everyone lives like we do’ and was yet another strike against the foothold of the ‘me generation’!

While our conversation may have been about France last week, it is so easy to find political conversations that are closer to home. Local politics are convenient topics to discuss because it is an accessible way to have a conversation that is relevant to a child and the impact of governance on a local community.  Furthermore, this being a federal election year in the United States provides the perfect platform to have an ongoing discussion throughout the campaign and party nomination process.

My hope is that these political conversations will engage my children to their community moving them from ‘me’ to ‘we’ and forcing them to think about the governance of the world around them on their own terms. I am also hopeful that during their thought process, whether consciously or not, they develop an appreciation for the democratic process and for civic duty.  And who knows, then maybe all of this political talk will foster a sense of leadership?

Golnar Khosrowshahi is the founder of GoGoNews, a website that publishes up to the minute, age appropriate current events for children. She has also written for The Huffington Post and been featured in many technology and parenting related columns. You can read featured guest blog posts by her here at Red-Hot Parenting the 2nd and 4th Tuesdays of every month.

Mom, child and globe via Shutterstock.com

Should parents be wary about posting pictures and information about their kids on Facebook? What’s the downside? Are there precautions that could/should be taken? 

Sharing information about your kids on social networks is something we’ve seen lots of parents doing. In some ways, it’s a fun way to connect friends and family with your kids’ lives as they grow up. But like we tell kids to “self-reflect before they self-reveal,” it’s equally as important for parents to follow that advice. Everything posted online creates what we call a “digital footprint” of your life. Once something is up, it can’t be taken down. And when parents start by sharing, for example, ultrasound images, they’re ensuring their kids have a digital footprint before they’ve even entered the world! And also, there can be a big difference between sharing moments of pride like your child’s first Little League home run, and sharing something more personal. My advice for families is to use your social networks’ ability to create small, closed networks inside the larger group (for example, Google+’s circles, or Facebook’s groups) that include only those people with whom you can share more private, intimate moments with – like grandparents, aunts, uncles. And then, still be very, very careful about what you share about other people, including your kids – partly because you don’t want to potentially embarrass your children, but also because anything you post online could eventually become public.

What about other public forums, like blogs? Any tips/concerns? Any reaction to things like the recent Time magazine breastfeeding cover?

The Time magazine cover is definitely something I think is sparking this conversation. A lot of people are saying, “How is that child going to feel about this picture when he’s 13?” Thanks to the permanence of the digital world, that photo will be both referenced and searchable for years to come. There is a huge possibility that this child will be upset that his mother used him to promote her own personal views on a topic he wasn’t old enough to understand or weigh in on. And that’s a lot of what this “oversharenting” comes down to: is it about YOU or is it about your kid? If you have any doubt about your motivations … hold out.

Should parents consider that they need to model behavior for their kids? Should they not only communicate the dangers of viral information to their kids but also set good examples with their own behavior?

Absolutely – without question. Parents are the biggest role models kids have when it comes to using digital media safely and wisely. That goes for every part of digital media – from what we’re posting to how often we’re using it. For example, you can’t expect your kid to respect a no-devices-at-dinner rule if you as a parent can’t separate yourself from your BlackBerry. The same goes for your behavior on social networks. It’s part of parenting in a digital world to make sure your kid understands the tenets of safe and appropriate online behavior, and that means parents have homework to do. Stay involved, know what your kid is doing, and always set the best example you can.

To this end, I sought out the perspective of Dr. Wendy Sue Swanson. Dr. Swanson sees patients at The Everett Clinic in Mill Creek, Washington and is on the medical staff at Seattle Children’s. Dr. Swanson is also a Clinical Instructor in the Department of Pediatrics at the University of Washington. In addition, she writes the Seattle Mama Doc blog, which I turn to frequently (as a professional and parent) for concise and up-to-date information and guidance on many pediatric issues. Dr. Swanson was kind enough to answer a number of questions I posed to her about whooping cough which I am pleased to share here.

1) What is whooping cough?

Whooping cough (also known as pertussis) is a highly contagious respiratory illness that can spread from one person to another with a single cough or sneeze. In older children and adults, it starts as a typical cold but can advance to a more prolonged/protracted cough that is serious, uncomfortable and disruptive. The cough can get so bad that it makes it difficult to eat, drink or even breath. Sometimes the cough causes a characteristic “whoop” and often it causes vomiting. But most dangerous is whooping cough in infants. In infants it can cause feeding delays, severe respiratory distress, pauses in their breathing and/or death. Infants under 6 months of age are at high risk, and those under 2 months of age are at severe risk for complications.

2) How is it spread?

Via coughing, sneezing, or other ways in which droplets spread from one to another.

3) Are children of all ages vulnerable? 

Although infants are most vulnerable – particularly those under 2 months of age – all children are at higher risk. In Washington state during our epidemic, 80% of positive tests were in children under 18 years of age. That is primarily because it is more distressing to children and they are the ones who get treated. Most data supports the notion that during epidemics, only aboute 10% of those with whooping cough get tested.

4) Why do we see surges in it?

Whooping cough tends to cycle every 3-5 years with surges. Part of that has to do with immunity and the herd. Part of those surges have to do with the fact that we never develop lifelong immunity. After a whooping cough infection, our immunity to whooping cough wanes somewhere between 4-20 years and after the immunization it wanes somewhere between 4-12 years later. That is why it is recommended that all children over age 11 get a Tdap shot NOW. We also immunize infants with DTaP at 2,4, 6, 15 months and 4 years of age. It’s essential that pregnant women get the Tdap in their 3rd trimester (after 20 weeks gestation). All adults who will be around newborns should also get the Tdap. We know that newborns are most vulnerable to the serious complications from whooping cough so if we “cocoon” them with family and friends who are immunized we reduce the likelihood that they get an infection.

5) What symptoms should parents look for? What should they do when they observe these symptoms in their kids?

In infants, if your newborn or infant has a cold, difficulty feeding, vomiting with cough or coughing fits, see the pediatrician. In older children, if they have been exposed to whooping cough and present with a cold, or have a cough that lingers past 2 weeks, cough with vomiting, or a “whoop” sound, see the doctor immediately.

6) What should parents do to protect their kids and help prevent it?

The best way to protect against whooping cough is to get immunized (as detailed above). After you get immunized, ask that your family, your children’s daycare and school teachers, and all adults that come into your home get immunized, too. Grandparents of any age are recommended to get the Tdap shot, too!

If you would like to learn more, here are additional blog posts that Dr. Swanson has written on whooping cough:

Post on how to protect newborns:

http://seattlemamadoc.seattlechildrens.org/cocoon-a-newborn-only-an-email-away/

What is the Tdap shot? (YouTube video and post w/list of resources):

http://seattlemamadoc.seattlechildrens.org/what-is-the-tdap-shot-seattle-mama-doc-101/

All Grandparents need a Tdap shot:

http://seattlemamadoc.seattlechildrens.org/all-grandparents-need-a-tdap/

Woman sneezing via Shutterstock.com

Rather than identify “child psychopaths,” researchers have studied specific traits in childhood and adolescence that are considered to be early signs of risk of later psychopathy in adulthood. Primary amongst them are “callous-unemotional” traits. Here are some examples:

• glibness
• lack of guilt
• manipulation
• untruthfulness
• callousness
• failure to accept responsibility

Studying these characteristics as a trait means that it’s not just a “yes or no” approach. Any kid could show some of these traits at any point in time. The idea is to get a bigger picture (a total score) when you add up the levels of each of these traits. When this is done, the vast majority of kids show very low levels of callous-unemotional traits. An especially informative study tracked the trajectory of these traits in nearly 10,000 kids from age 7 to age 12. They found that about 4% could be considered to have very high levels of callous-unemotional traits along with documented conduct problems. This is a small subgroup of kids that would warrant intensive intervention.

What happens to kids with high levels of these traits? Do they go on to be psychopaths in adulthood? Most do not. One report found that the majority of teens with high levels of callous-unemotional traits at age 13 would not be diagnosed with psychopathy at age 24. That said, there was some prediction available, particularly in the sense that those diagnosed with psychopathy at 24 were also likely to have had high levels of callous-unemotional traits at 13. So kids with this profile are at high risk for psychopathy – but clearly there is some malleability and other factors influence the extent to which they develop maladaptive behavior as adults.

Lots of studies have tried to examine the causes of callous-emotional traits. There is strong evidence that genetics plays a role, as indicated by informative twin studies. Some projects also suggest that genetic factors may underlie the linkage between callous-unemotional traits and aggressive behavior. But the role of the environment is not trivial, and a disruptive family environment is often involved as well. Bear in mind that this work is far from complete, and no genetic markers – or associations with brain architecture or functioning – have been established with certainty.

This brief sketch of the research provides something of a big picture on the development of psychopathy. Individual case studies always have their own nuance. The bottom line is that kids who show a troubled picture characterized by callous-emotional traits – especially when combined with early emerging problematic behavior – should receive intensive clinical evaluation and care. As pointed out in a thoughtful piece in the Huffington Post, though, specific tailored treatments have yet to be developed – suggesting the need for more clinically-based research.

Child brain via Shutterstock.com

As screen time increases for both parents and kids, we often talk about how to reduce it. But is this focus misplaced and unrealistic in today’s society? Today Golnar Khosrowshahi of GoGoNews offers her perspective on how the quality of screen time may be a more forward looking way of approaching the issue. 

The Louvre Museum in Paris recently unveiled Nintendo hand held consoles as their interactive device of choice for visitors to navigate the museum and learn more about selected works of art. While the innovation is fantastic and it delivers substantive nuggets of information to the museum goer, it also partially transforms what was previously an interactive experience with the art and other visitors into an interactive experience between man and machine. In support of the device however, I would argue that providing easier access to better information results in an enlightened individual and altogether, more productive time spent under Pei’s pyramid.

When I was growing up, the popular trend in helicopter parenting was to limit children’s exposure to television. Today’s generation has a more generic limitation in that many parents want to limit ‘screen time’. It is undeniable that children are consuming a variety of content be it video games, television shows or music videos through a variety of screens be it television, smartphones, tablets or computers. However, it cannot all be that bad with the wealth of educational content that is distributed through these very same screens. Should parents be counting and thus limiting those ‘good’ screen hours together with the ‘bad’ screen hours? Many parents’ aversion to long hours spent in front of the screen is prompted by the misconception that these have to be solitary hours. Why not turn this time spent together looking at interesting websites and using the content as a platform for further discussion?

I often question my personal indifference to my children’s time spent between their desktop and tablet computers. Instead of encouraging them to power down, I am exchanging notes with them on the latest and greatest Apps, getting into drawing competitions with them with interactive games such as Draw Something and when not in their company, gifting them books I think they would enjoy to their e-reader accounts. I know, however, that I would start limiting their screen time if all they were doing was watching mindless teeny bopper comedies. But because they are either reading, drawing, or even playing games that hone their fine motor skills, I not only have absolutely no problem with the screen time, in fact I actually encourage it.

I believe that we can all benefit from the ease and access that children have to information in today’s world. For my children, the additional exposure and cross platform access is making them read in great quantity across a variety of subjects. Experiences such as a visit to the museum are of a greater quality because children can learn and understand more than they would have otherwise – all from a screen. So perhaps, our job as parents is not so much to limit screen time, but to ensure screen quality time, and at the end of the day, channel all of these eye opening experiences into dinner table conversations.

Golnar Khosrowshahi is the founder of GoGoNews, a website that publishes up to the minute, age appropriate current events for children. She has also written for The Huffington Post and been featured in many technology and parenting related columns. You can read featured guest blog posts by her here at Red-Hot Parenting the 2nd and 4th Tuesdays of every month.

What’s especially sobering is that this study was very well conducted. It used the most highly supported medication regimen for the early stages of type 2 diabetes along with psychological intervention designed to change lifestyles. The research protocol attempted to secure adherence to the interventions. The youth were carefully studied and monitored over time. Yet despite all this, in only half of the cases did the medication regimen achieve “glycemic control” – and that the psychological component did not produce additional benefit. Again – it bears repeating – the net result is that half of these kids will likely need insulin therapy in just a few years.

While it’s clear that researchers will continue to try to come up with more effective treatments for the early stages of type 2 diabetes in obese youth, this study provides yet another reason for parents to take prevention seriously in childhood. There are no magic bullets here – we all need to struggle with a number of environmental trends and pressures that promote the development of obesity in youth. So here are the logical places to start:

• Become familiar with the guidelines for how kids should eat. Have you seen the MyPlate representation of how to structure a kid’s meal? Click here to read about it.
• Become familiar with some of the thinking on how kids should exercise. I like this description of the types of exercise that all kids should get. Since many factors promote sedentary behavior in kids these days, try hard to find ways to be sure you kid is active everyday.
• Become familiar with sleep guidelines. Part of the obesity epidemic is tied to sleep issues (lack of appropriate amounts of sleep can have a direct effect on metabolic processes that are risk factors for type 2 diabetes). Convince yourself how important it is for a kid to get sufficient sleep. If you can’t find a good routine that works for your kid consider visiting a sleep clinic.

None of this is easy. It’s really not. Especially given the day to day challenges we all face as parents. But trying to be vigilant about your child’s nutrition, exercise, and sleep is the best pathway to trying to prevent obesity and the onset of type 2 diabetes.

Definition of insulin via Shutterstock.com

• New Libraries: Target will remodel 32 school libraries across the country in 2012. The remodeled libraries will feature 2,000 new books, furniture, carpet and shelves, and a complete technology upgrade including new iPads. Each school will also have the option to receive a Target Meals for Minds school based food pantry. Click here to view a video: http://shuttle.imre.com/a98899f1.wmv
• $15,000 Reading Grants: Target will show its continued support of the program’s previous library makeover recipients by donating $15,000 reading grants to more than 100 schools for a total of $1.5 million.
• Literacy Pilot Program: Target will partner with the Los Angeles Unified School District and D.C. School District to launch a literacy pilot in 12 schools. The goal of the pilot program in each school will be to improve third grade reading proficiency.

Could you briefly give a description of what you examined in your research?

Our research specifically studied child exposure to maltreatment (the large majority, though not all, at the hands of the mother) and domestic violence against the mother. These kinds of trauma exposures may require additional considerations compared to other types of traumas that do not involve the parent (for example, being involved in a serious car accident, death of a non-parental family member). For example, when the caregiver is the perpetrator of the trauma, the child may need to be removed from the caregiver’s custody and some of the answers below may not be as applicable.

Do we know yet what the mechanism might be that affects cognitive/brain development? How does trauma affect the developing brain especially early in life?

There are many ways that trauma may affect the developing brain. Certain types of trauma, such as physical abuse or neglect, may cause direct injury to the brain, for example through injury to the head or malnutrition. We also know that when humans face a stressor, especially an extreme stressor like a trauma, the body prepares to react to the stressor. Chronic or severe stressors can cause changes in how the body secretes and processes a number of hormones that affect how the brain functions. These effects may be particularly strong in early life when the brain is developing so rapidly. Any changes to the brain during this critical time may affect how the brain is organized, and therefore have lifelong consequences. Also, infants and young children have fewer coping resources to manage stress, given their immaturity and dependence on their caregivers. We know that caregivers have a critical role in fostering children’s cognitive development. Sensitive, warm, consistent, empathic caregiving is key. Finally, for many children, trauma exposure can lead to emotional difficulties, like depression and posttraumatic stress disorder (PTSD). This is true even for very young children. These difficulties can interfere with learning new skills. For example, a child with PTSD may be preoccupied by disturbing memories of the trauma and have difficulty sitting still and paying attention. This can make it difficult to pick up new cognitive skills.

If a baby/toddler is exposed, what can be done with respect to intervention? What could a parent or caretaker do to minimize the effects?

Caregivers are absolutely essential to children’s recovery after a trauma. First, caregivers need to make sure that they are taking proper care of themselves so that they can be most helpful to their child. Sometimes, a caregiver and child suffer the same trauma (for example, being in a car accident together). Just knowing that your child has suffered a trauma can be very upsetting to the caregiver. This may cause feelings of guilt, helplessness, depression, and anxiety and difficulties with sleep, appetite, and concentration. Caregivers should seek out help for themselves if they feel that they are having symptoms that are getting in the way of their ability to function or care for their child. They may talk to their primary care physician or seek out a counselor.  They should make sure to get enough sleep and eat right and exercise if possible.

The other really important step caregivers can take is to help the child to feel safe again. Maintaining routines, such as the same bedtime rituals every night, is very important. Keep in mind that the child’s behaviors may change—for example, the child may become more clingy, have difficulty separating from the caregiver, have nightmares or resist going to bed, or not want to eat or want to eat a lot. The caregiver should do her best to be patient and remember that these are normal reactions. The child is not trying to manipulate anyone.  If possible, the caregiver should try to minimize separations, at least temporarily. If a separation is necessary, the child should be left with someone she knows and trusts. A familiar object to keep while the caregiver is gone, like a photograph of the caregiver, may help. The child may need extra hugs and lap time to feel reassured. If the caregiver feels the need to talk about the trauma with someone, she should make sure that the child cannot overhear the conversation. However, if the child wants to talk about the trauma, she should be allowed to do so. She may need to talk through what happened and get reassurances that she is now safe. If the caregiver has concerns about the child, she should talk with the child’s pediatrician. There are counselors who treat traumatized children, even very young children. These counselors can be very helpful in giving caregivers advice about ways to help their child. For example, we treat traumatized children and their families in the Psychosocial Treatment Clinic in the Outpatient Psychiatry Service at Children’s Hospital Boston.

Any suggestions to help parents in a compromising situation seek out help to prevent exposing their baby to trauma?

If parents are feeling stressed, they should seek out help for themselves, for example by calling a parenting helpline or by talking with their primary care physician or a counselor or friends and family. Physicians and counselors should be able to help parents find resources if needed to get out of a domestic violence situation or to get help if there is child abuse or neglect. The National Child Traumatic Stress Network has helpful information regarding child trauma, including information for parents and caregivers. Their website is www.nctsnet.org<http://www.nctsnet.org>.

Image depicting overcoming trauma via therapy courtesy of Shutterstock.com

If your child has been diagnosed with Autism Spectrum Disorder (ASD), there is a good chance that you will be considering – or evaluating – Applied Behavioral Analysis, or ABA. This is the third of three question and answer sessions with Lauren - who was featured here last December - who offers us the combined perspective of  a mother of a child with ASD and a professional who works with children with ASD. Click here to see the first post that describes ABA; click here to see the second post which gives an example of ABA.

Does it help all kids or just some?

ABA can be used with anyone with or without disabilities at any age. It is often used for kids diagnosed with ASD (see http://www.autismspeaks.org/what-autism/treatment/applied-behavior-analysis-aba). No other method I’ve researched has been shown to have the same ability to develop someone’s true potential as ABA.  Goals vary from person to person and depend on age, interests, and ability.  It’s important to keep your goals simple, measurable, realistic and easy to follow.  In a perfect world, ABA for children with ASD needs to be practiced 40 hours a week with a therapist and continued with family and friends 24/7.  Discrete trials are used primarily for students in the beginning to learn new concepts within a controlled setting.  After they master the goals, then the other ABA techniques are used to generalize the new concepts in different environments and with different people.

I believe ABA principles such as positive reinforcement should be practiced all the time.  I always reinforce the positive and redirect the negative behaviors with my children or my students. It’s important to remain even toned and only show lots of emotion when a positive behavior is exhibited – try not to yell or get upset at a negative behavior.  This could incite the child and even make them want you to do it again.  Negative attention is still providing attention and for a child wanting attention.  Also, what could be acquired quickly by one student may take a long time with another student.  Always think what’s best for the child’s ability.

Is it hard to do?

The ABA Therapist should make the objectives very clear and manageable. If you don’t follow the directions exactly as written, then the student or teacher may not understand the target behavior. If you are using ABA to change behavior in a more natural setting, it’s important to remain consistent with the therapist’s directions.  In that sense it is very demanding and frustrating since a behavior that you are trying to change may being reinforced by another family member.  Also, be aware of the student’s likes and  interests.   They are constantly changing. So, using a reinforcer that works with one person won’t always work on another.

Are there other approaches to consider?

When my son was first diagnosed, I thought he should be put with lots of typical children so he could learn by imitating appropriate behavior.   However, children with ASD are lacking prerequisite skills to know how to learn.  If you can place a child with ASD in a typical classroom with an aide, you cannot teach the child the skills needed to sit, attend, and understand his environment.  If you place them in an individualized program where the ABA therapist teaches appropriate behaviors prior to age of 5, the student will hopefully have developed the prerequisite skills to be able to join a typical classroom one day. Sure, there are lots of other approaches out there, but ABA is a scientifically proven method that works with kids diagnosed with ASD and can have a substantial impact on their development.

Symbol of autism awareness via Shutterstock.com

If your child has been diagnosed with Autism Spectrum Disorder (ASD), there is a good chance that you will be considering – or evaluating – Applied Behavioral Analysis, or ABA. This is the second of three question and answer sessions with Lauren - who was featured here last December - who offers us the combined perspective of  a mother of a child with ASD and a professional who works with children with ASD. Click here to read Lauren’s explanation of what ABA is and how it works. 

Can you give a brief example of some of the behaviors that you can change using ABA?

Here is an example that doesn’t use discrete trial teachings, instead it utilizes a social story, visual countdown, schedule, positive reinforcement, and functional communication training.  Jane,  4 years old, loves to play with her sister Alexa, 6 years old, but Alexa has homework to do at her desk. Jane starts crying because she wants to play with her sister. Alexa tells her to stop crying but Jane doesn’t, instead she cries louder.  Alexa stops doing her homework and plays with Jane. This is a behavior.  Behaviors can be changed!

To figure out the behavior as in the example above, one needs to:

1. Describe what the behavior looks like – in ABA this is done using the concepts of antecedent, behavior, and consequence. The antecedent is – Alexa sits down to do homework at the desk, Jane says play with me, Alexa says she has homework to do. The  behavior is – crying. The consequence is – Alexa stops her homework and goes to play with Jane.

2. Determine what is the function of the behavior (crying). In this case, it is to get attention.

3. Explore what did Alexa do before and after and what should she have done differently? Alexa did not give Jane enough notice that homework comes first, then playtime.  Jane didn’t want to wait.

An ABA therapist would use the definition of the behavior – crying – and track how many times that behavior is being seen and all the different contexts in which it can be observed.

An example using ABA to provide an appropriate replacement for Jane’s “crying” due to wanting attention would be to write a quick social story, using the Berenstain Bears as a prototype.  In the story, there will be an explanation that sometimes old sister Alexa has homework to do.  While Alexa does her homework, list some activities that Jane can do to keep herself entertained.  These activities need to be motivating and something she can do alone.  Also, in the story, it’s important to mention how to replace the crying. For example, if during playtime, she has a hard time waiting she can use her words and say,”waiting is hard” or “how much longer”?   Also, Jane can have a visual schedule written  - 1. homework  2.  play with Alexa – with a visual countdown that Jane can cross out as the time goes by.  The schedule provides Jane a sense of control and understanding that there is an end to the waiting. Throughout the countdown, a smaller positive reinforcer such as a sticker can be given to Jane to maintain her appropriate behavior. In addition, verbal reinforcers like “I like how you are waiting for me, 4 more minutes, then I will play with you” can be used as well.

By  providing more appropriate proactive strategies for Jane, with practice and patience, the behavior will change!

Symbol of autism awareness via Shutterstock.com