It's time to check for back-to-school illness, and that means a trip to your pediatrician is in order. Even if your children feel perfectly healthy, let the doc make that decision before you send them back on the bus.
ADHD and ADD
Dr. Denise Lippitt, a pediatrician at Medical Center Pediatrics in West Bloomfield, Michigan, recommends a physical every fall, as some behavioral disorders can go undetected for years. "If we're seeing the kid yearly, we usually know the family the best: the siblings, the parent interaction, the family history. If you've seen them all along and there's a difference, you're going to notice it," Dr. Lippitt says.
Since many children are bursting with energy, be careful not to write off attention deficit disorder or attention deficit hyperactivity disorder as bad behavior. According to Lyndsay Ori, a board-certified behavior analyst at North Shore Pediatric Therapy in Chicago, kids with ADD and ADHD are often easily distracted and struggle with hyperactivity, lack of impulse control and organizational tasks, such as problem solving and planning.
Lyndsay says ADHD is easier to catch and is especially noticeable in schools—students with ADHD often have difficulty sitting still and paying attention for long stretches. "These students may talk out in class, and their desks are typically a mess. They will have difficulty completing work and turning in homework. ... They may even engage in physical interactions due to their inability to control impulsivity," Lyndsay says.
As for social interaction, kids with ADHD may lack the ability to filter their thoughts and can therefore make unintentionally hurtful comments to their peers. However, don't let such obstacles write off a child's potential for academic and creative success. Many kids with ADHD are able to overcome their struggles with distractions when engaged in reading and art, Lyndsay says.
While children with ADHD face fundamentally similar struggles to those with ADD, they may not display the rambunctious behaviors associated with ADD. Take notice if children need constant reminders to brush their teeth, get dressed or clean their room. "Children with ADD may fall through the cracks because they don't stand out as much as their hyperactive counterparts," Lyndsay says.
If a teacher or pediatrician notices signs of ADD or ADHD, Dr. Lippitt says they often refer the patient to a psychiatrist who can take a closer look. She says almost all medications are going to be Adderall or Ritalin variants. Don't panic if the medication doesn't initially trigger behavioral changes. "Sometimes it's trial and error for what drug works best for each child," Dr. Lippitt says.
Symptoms that seem like ADD and ADHD may actually be unrelated. If a child seems exhausted, Dr. Lippitt says he may just need to have his tonsils or adenoids removed, which can trigger sleep apnea if overlooked. "Sleep apnea causes you to pause during the night in your breathing and then do catchup breathing so you're having these little mini-wake-ups during the night," she says. In addition to looking tired, a child struggling with this inconsistent sleep cycle may either be wound up or staring into space, both of which are classic symptons of ADD and ADHD.
Many children who suffer from Asperger's syndrome may also go undiagnosed or misdiagnosed—often as having ADHD—until late into their childhood. "These children are usually able to function in the lower grades and then fall apart when they reach junior high," Lyndsay says.
Thumb-suckers, beware—Lyndsay says that sucking and chewing on hands and clothes are often markers of anxiety, a disorder from which children of all shapes and sizes suffer. Such tendencies may have been passed on by you—anxiety is, in fact, a genetic medical disorder.
To combat anxiety in your children, Lyndsay suggests desensitization. Take birthday parties, for example. Lyndsay says that you can start by having your child go inside, say happy birthday to the host, give them their present and leave the party. At the next birthday party, however, your child may have to stay for three minutes before leaving. As you push them to overcome their anxiety, positive reinforcement can be a very powerful tool.
Don't panic! Although the symptoms are those of typical influenza, the swine flu is actually relatively mild, Dr. Lippitt says. "You're going to see fairly sudden onset of high fever, headache and sore throat, followed by congestion and a cough," she says.
In reality, it was the rapid spread of the swine flu—and the media's intensive reporting—that brought hype to the illness. Dr. Lippitt says there are 36,000 influenza-related deaths in the United States each year, a number the swine flu won't likely come close to matching.
There is no formal recommendation for vaccinating the swine flu. It has been rumored in the medical world that the vaccine will contain two doses separated by a month and will probably make its pediatric debut in late fall.
The regular flu vaccine will be available as early as August. Dr. Lippitt says the vaccine is recommended for all children under 18, but especially those who are high-risk candidates—children 5 years and younger, diabetics, asthmatics and those with other chronic illnesses.
The vaccine will first be released in the form of flu mist in August or September, but if you have a newborn, you're going to have to wait on this one. "It's only available for kids 2 years old and older," Dr. Lippitt says. "It's a live virus vaccine, so there are restrictions, such as [those in] pregnancy and undergoing chemotherapy."
If you're more inclined to use the vaccine injection, it should be available in September or October. However, you might want to consider the mist-style vaccine. "The flu mist has a quicker onset for protection and maybe even more protection," Dr. Lippitt says. "But it's been out for a shorter time than the flu shot."
While most vaccinations are available year-round, the beginning of the school year is the perfect time for a physician check-in to make sure your family's immunizations are up-to-date.
While there's no hard and fast rule, Dr. Lippitt says children should be caught up on vaccines. Ask your pediatrician when—and how many times—you should have your kids receive immunizations for the following illnesses:
If your kids ever complain about getting dizzy during exercise, asthma may be the reason. Dr. Lippitt asks her patients if they ever feel faint or have rapid heartbeats after running around, especially kids older than 5.
If your child struggles with asthma, you should make sure he has an emergency inhaler at school. Many schools don't allow children to keep their medications on hand, but regardless, the kids should discuss with their physician the rules and regulations of an inhaler. "They should know what the signs are and how many times a day is appropriate to take their rescue inhaler before seeking medical attention, especially if kids are treating themselves," Dr. Lippitt says.
Dr. Lippitt and her colleagues also do a vision screening every year, starting when children are toddlers. "It's kind of like an EEG of the brain that shows your kids' vision pathways until they're old enough to use the eye chart," she says.
If she does suspect there's a problem, she will always refer the patient to an ophthalmologist for a second opinion.
Dr. Lippitt says the most important thing about combating lice is staying calm. "People go crazy over lice, but it's a childhood problem. It doesn't mean anyone's dirty," she says. "It's more annoying than an actual medical problem."
If your child becomes infected with lice, Dr. Lippitt suggests combing through his hair to remove as many of nits as you can before using an over-the-counter treatment to kill the lice. Then, repeat the process for the next 10 to 13 days. "[The treatment] will kill the lice, not the nits or eggs," she says. "They're more easily killed once hatched."
She finds that what people forget about lice is that they have to have a human host. If the lice are left on a hair band, hat or even furniture and don't touch human hair for several hours, they die. You may want to try furniture sprays on tough-to-clean spots in your home, but in terms of fabrics, Dr. Lippitt says that hot water—a normal wash cycle of 140 degrees—and a hot dryer should do the trick. "All those ideas about smothering your things with mayonnaise and olive oil," she says, "They haven't really been proven affective."