Posts Tagged ‘ Kids Health ’

“1 in 68″: The New Data On Autism Spectrum Disorder

Friday, March 28th, 2014

It is now estimated that 1 in 68 children are diagnosed with Autism Spectrum Disorder (ASD), based on a report issued by the Centers for Disease Control and Prevention. This detailed CDC report deserves a close look as there are a number of important findings on the prevalence of ASD and factors that influence evaluation and diagnosis.

THE RATE KEEPS INCREASING: As described by the CDC, the new estimate is 30% higher than the prior estimate made just 2 years ago (1 in 88). The estimated prevalence of ASD has gone up tremendously in the last decade, and it is assumed that improved recognition and diagnosis is the primary factor. The implication here is that we have underestimated the true rate of ASD and as such the new data suggest an urgency in mobilizing resources to understand the causes and accelerate the delivery of interventions (see, for example, the reaction from Autism Speaks to the new estimate).

SEX OF CHILD MATTERS: ASD has always been more prevalent in boys. The new data continue to support that, as 1 in 42 boys in the study received a diagnosis, as compared to 1 in 189 girls. The reasons for this sex difference are still not well understood. But it’s clear that boys in particular are especially likely to be diagnosed with ASD – 1 in 42 is a very high prevalence for any disorder. So anticipate increased efforts at screening for ASD by pediatricians, especially for boys. And it is noted¬† that ASD should be screened for in girls with more intensity as well, as 1 in 189 is a high prevalence for a disorder.

ETHNICITY MATTERS: While the rates of ASD continue to go up, it is diagnosed more frequently in white, non-Hispanic children. Non-Hispanic white children are 30 times more likely to receive a diagnosis as compared to non-Hispanic black children, and nearly 50% more likely to be diagnosed than Hispanic children. Evaluative and diagnostic efforts need to increase for children in these ethnic groups.

ALL LEVELS OF COGNITIVE FUNCTIONING ARE AFFECTED: Nearly half (46%) of the diagnosed cases in the study had cognitive abilities in the average or above average range. This is potentially one factor that has increased the estimated prevalence over time, as there is more recognition of symptoms of ASD without cognitive/intellectual impairment. Level of cognitive functioning is important clinically in terms of managing other potential conditions and planning interventions – but it’s clear that ASD is being diagnosed across all levels of functioning.

ASD IS STILL DIAGNOSED LATER THAN IT COULD BE: Although recognition of ASD has certainly increased over the last decade, the evaluative and diagnostic efforts are still being done later rather than sooner. The CDC suggests that less than 50% of the diagnosed cases were evaluated before age 3, and that the majority of diagnoses were made after age 4. Reliable screenings of ASD can be made by 2 years of age, and it is imperative that early detection is encouraged, as there are interventions that can begin at these earlier ages. So while detection of ASD has improved over time, we need to see evaluations done at younger ages to ensure that children with ASD receive interventions as early as possible.

WILL THE RATES CONTINUE TO RISE?: This question is raised because of the change in diagnostic criteria offered by the DSM-5, which was introduced in May 2013. Note that the current study collected data in 2010, using the prior version of the DSM (the DSM IV-R). There has been much speculation that the prevalence of ASD will decline given the new criteria. However, we are years away from getting the answer to that question, given the amount of time that it takes to mobilize these intensive data collection efforts. But it’s something to keep in mind for the future.

WHAT ARE THE MOST IMPORTANT IMPLICATIONS OF THE “1 in 68″ STUDY?: Clearly, the need for earlier detection is key – we can’t confuse the increasing recognition with early detection. More vigilant efforts need to be applied to evaluate children in every ethnic group. And while the rate of ASD in girls is much less than that for boys, keep in mind that “1 in 189″ is still a very high prevalence, so efforts to detect ASD in girls should also be intensified. For parents, the most important point is to be aware of early signs of ASD, and to work collaboratively with your pediatrician to monitor your child’s early development and seek out further evaluation if necessary as young as possible.

Awareness Ribbon via Shutterstock.com

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Hands Off, Eyes On: Letting Kids Take Risks They Can Handle

Friday, March 21st, 2014

There is a consensus brewing that we are depriving this current generation of young kids a chance to do what they are not only equipped to do, but need to do – take some risks. And we’re not talking about trivial ones, either. Chrisanne Grise raises the issue that kids may need to learn how to handle “dangerous” things like power tools, make fires, and derive the benefits that occur from “playing with knives.” These kinds of opportunities used to be a part of growing up, but some worry that kids are being sheltered from these key learning experiences – done of course with adult supervision – because of excessive and inappropriate fear.

THE OVERPROTECTED KID

Hanna Rosin focuses on some of the misguided reasons we are raising “The Overprotected Kid” in the Atlantic. She details our preoccupation with kids’ safety that goes beyond the actual risks. For example, while many parents don’t want their kids to wander in their neighborhoods alone because of fear of abduction, a review of the statistics suggests that abduction by a stranger is a very rare occurrence, and that the rate has not increased over the years. What’s changed is simply the perception. The same goes for injury. She describes a new kind of playground that is filled with all kinds of potential “dangerous” objects and opportunities for calculated risks – in some ways, one that looks more like a junkyard than a playground. It’s been suggested, by Rosin and others, that we need more of this for our kids, because our playgrounds have become designed to prevent injury rather than promote appropriate risk taking – assuming that kids even go there because of overriding safety concerns.

In principle, I agree with this emerging perspective. For many kids growing up today, there are fewer and fewer opportunities to practice risk taking. Risk taking is an important skill – every kid needs to learn how to stretch themselves, how to do something that they are a little scared of doing because they haven’t done it before. Part of the reason for “overprotection” is certainly the parental gravitation to fear. This is certainly evident in terms of the physical environment as discussed by Rosin, Grise, and others. The solution is somewhat straightforward – providing what I describe as “Hands Off, Eyes On” opportunities for kids. While you might not want to send your kid to a camp or playground that champions fire making, the broader idea is certainly a good one. We want to know they are in an environment where they can take a supervised risk, and we want to let them have a chance to fall and risk getting hurt.

FEAR OF INJURY – OR NEED FOR ACHIEVEMENT?

I contend, however, that much of the parental mindset that inhibits risk taking isn’t driven by fear of injury – it’s more about concern with success. While many kids aren’t wandering around playgrounds and playing in junkyards, they are doing structured physical activities that carry plenty of risk of injury. Think about the current concern about concussions in football. Have a look at the risk for serious injury that comes with being a cheerleader. We’re quick to dismiss these risks because we see the link with potential for achievement. We don’t see the same connection for unstructured play. “Play” may be in fact less dangerous than our structured sports – yet we focus more on the risk because we don’t see the benefit. This is the case even though the physical, social, and cognitive virtues of exploration have been well articulated many times in both the academic and popular press. It’s just harder to see the immediate deliverables of that experience as compared to watching a kid hit a home run. And this broader concern with success is not limited to the playground or sports field. “Overprotection” certainly happens in the social and academic realms as well, as phrases like “helicopter parent” have become not only mainstream but cliches. There is plenty of social and academic risk taking that can also be inhibited because of the perception of risk (e.g., a bad grade) as opposed to the benefit of pushing oneself in a new direction (e.g., a child taking a class in a new area of study that will eventually lead them to doing something with that experience even if they don’t get an “A”).

MANAGEABLE AND MEANINGFUL RISKS

So where do we take all this? Gail O’Connor suggests that we all – parents and kids alike – benefit if parents become less “hands-on.” It’s a healthy perspective and one worth considering. We can, of course, be “eyes on” though, to make sure we are exposing kids to risks that they can handle. For some, this may mean letting them walk around their neighborhood. For others, that may not be the case. Parents can define for themselves what life skills they want their kids to have and how to let them begin to acquire them. What’s important is that we embrace the idea that risk taking is a part of childhood, and it’s more about the process of learning how to take meaningful risks – rather than the immediate payoff – that will serve kids best in the long run.

Kid in Snow via Shutterstock.com

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Pertussis: Celebrities Talk About The Vaccine For Parents

Thursday, March 13th, 2014

Pertussis (Whooping Cough) continues to be a serious health issue for babies, one that can lead to death. One the primary ways to reduce the risk for babies is for adults to get the vaccine. Not just parents – but any adult who has regular contact with the baby.

Sarah Michelle Gellar, the current Sounds of Pertussis campaign ambassador, offers clear and heartfelt advice for parents and other adults in a babies life in a current goodyblog post that I encourage you to read.

In addition, I include here a video interview with Jeff Gordon, who has also championed the mission of the Sounds of Pertussis campaign. Please note that this interview also includes the heartbreaking story of one brave mom who has shared her own tragedy to help others.

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Baby Sports Stars: Can A Toddler Be A Sports Prodigy?

Thursday, March 13th, 2014

How early can you see extraordinary sports ability? Well, consider that, in Europe, toddlers are being signed to professional contracts as footballers (soccer players). For example, last fall a 20-month-old was scooped up after his father had posted a YouTube video showing his ball handling and kicking skills.

While sports signings have gotten younger and younger over the years, this story is intriguing to say the last because, well, it’s really hard to tell what toddlers are going to be like when they grow up. We could dig up examples of many athletes who showed promise at an early age, or advanced abilities. You can watch a clip of a toddler named Tiger Woods hitting a golf ball on national television when he was not yet three years old. And of course, the discussion doesn’t have to be limited to sports – similar stories could be found about musical prodigies.

We will have to wait more than a decade to find out how these toddlers fare as professional athletes. They may in fact turn out to become professionals and maybe even excel. But before we see a surge of YouTube videos of kids demonstrating their sports skills, let’s keep a few things in mind.

First, it’s really hard to figure out who’s going to be great even when athletes are turning professional at the normative ages. Think about the extraordinary time, effort and expertise that goes into drafting professional football players. Think about the careful decision making that results in a player being selected as a first round draft pick. The assumption would be that they all become stars. In fact, over the last decade or so, only about 30% of all the first round draft picks have been selected as Pro Bowl players.

Check out the list of Heisman Trophy winners (“the most prestigious award in college football”) and see how many have become stars. Think about who’s not on that list, players like Tom Brady. Consider his career trajectory. He was a backup quarterback for his first 2 years in college, and was drafted in the 6th round with the 199th pick. Yes, 198 players were drafted before the player who is frequently called the best football player ever. Have a look at the 6 quarterbacks drafted before Brady and see how their careers compare to his.

The point is that it’s hard for decision makers to look into that crystal ball even when athletes are of age and have gone through all the requisite training before turning professional. There are certainly objective benchmarks that are measured as they do in the NFL scouting combine. Interviewing is done to assess character and motivation. There is no shortage of performance data and video. Yet it’s still a probabilistic process at best.

All of this is offered because many of us want to put our children in a position to excel at earlier and earlier ages. There’s nothing inherently wrong with that. But the problem becomes when the stakes get raised when kids should just be growing up and learning to love the things that they are doing. Excessive pressure to achieve is not to be confused with support and encouragement to do their best. There’s no need to document this pressure. You can see it at any age. Certainly not all parents, not even the majority of parents. But that feeling is palpable. Kids aren’t just playing a game. They are performing with a lot riding on it, well before an age where that should be a relevant concern. And that fact is kids are most likely to succeed when they invest their time in something that they like and learn to love.

Some “prodigies” do in fact go on to experience great success as professionals. Many don’t. We often hear about the “numerator” in that fraction – the number who achieve that level of success. We don’t typically hear as much about the “denominator” – those individuals plus all those who don’t reach that ultimate level of greatness.

So when you hear about prodigies, or see other kids who look like they are going to be stars, don’t up the pressure on your kid. Make sure they are getting the most out of their experiences – their successes and their failures. Encourage their effort and enthusiasm and determination and their growth. Let them find their passions over time, even if it takes some time. And in that process they will define their own success.

Also check out the following blog posts on “success”:

Success and Character

Authentic Success

The Triple Package

What career will your child have? Take our quiz to find out!

Hoop It Up Cake
Hoop It Up Cake
Hoop It Up Cake

Boy Kicking Ball in Field via Shutterstock.com

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Success and Character and Parenting

Monday, March 10th, 2014

In recent years, the word “success” has been batted around in parenting culture. This series of blog posts considers a number of views of what “success” might mean – and how that influences how we parent.¬†

In prior blog posts, I’ve discussed typical benchmarks of success that we may (or may not) prioritize for our children, including academic, professional, and financial achievement. I’ve also highlighted alternate perspectives that argue for more balance in our goals, in order to make sure our kids are also happy and lead psychological fulfilling lives.

What’s interesting is that these two orientations are not mutually exclusive and the idea of “balance” in fact supports success in the long run. It’s worth revisiting the premise of Paul Tough’s How Children Succeed: Grit, Curiosity, and the Hidden Power of Character. The book suggests that, if we take a long-term view on child development, character traits are often critically important factors for fueling the pursuit of achievement across developmental stages. So if we want to nurture “success,” we can’t just focus on skill development, but also the development of character.

There is a good deal of research on the importance of resilience, optimism, and the like in development. We could add to the list the downside of stress and depression and anxiety. From the perspective of parenting, pushing kids relentlessly to pursue success (e.g., extreme pressure to get good grades or achieve in a sport) can backfire. But this doesn’t mean you just let kids be and hope for the best. Focusing on fostering psychological investment in the process of working hard, having goals, and handling setbacks positions kids better for evolving the many skills they will need to chase after “success.”

What career is your child destined for? Take our quiz and find out.

Manners & Responsibility:  3 Manners Toddlers Should Know
Manners & Responsibility:  3 Manners Toddlers Should Know
Manners & Responsibility: 3 Manners Toddlers Should Know

Also in this series:

The Triple Package

Authentic Success

Little Girl in Roller Skates Getting Back Up via Shutterstock.com

 

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