Get Rid of Cradle Cap the Gentle, Natural Way

Cradle cap is a rash that can develop on a baby’s scalp, usually between the ages of one-three months of age. The name “cradle cap” comes from the fact that it happens to very young babies, hence “cradle.” But also “cap” because cradle cap can look like a thick and waxy, sometimes yellow layer that covers the skin of the scalp like a cap. Cradle cap is not dangerous and it is not a sign that you’re doing something wrong. It is easy to get rid of cradle cap in a gentle, natural way.

Like the adult version of cradle cap that we know as “dandruff,” cradle cap is caused by seborrheic dermatitis. And like dandruff, cradle cap is unattractive. It can be embarrassing to show off your baby when he or she has cradle cap. Especially when well-meaning friends and relatives tell you, “My baby never had that,” or offer unwanted advice on how to cure the condition.

The experts are divided on what causes cradle cap. Some doctors believe that it comes from overactive oil glands due to excess hormones the baby gets from the mother during pregnancy and nursing. Others believe that cradle cap may be the result of an overgrowth of yeast named Malassezia that likes to feed on the stuff called sebum that comes out of oil glands. Both theories have to do with oil glands and both make a lot of sense. Cradle cap can be found not just on the scalp, but anywhere on the body where there are many oil glands, including the face, chest, and back.

Cradle Cap Isn’t Itchy

Cradle cap should not be confused with eczema. Eczema is uncomfortable for baby, and itchy.  Cradle cap, on the other hand, doesn’t seem to bother baby at all. It just doesn’t look very pretty.

Baby gets a shampoo
Shampooing regularly with a gentle baby shampoo will help your baby maintain a healthy scalp.

You don’t really have to do anything about cradle cap. It usually goes away by itself, with regular shampooing with a gentle shampoo made just for baby. Expect it to take 2 weeks to 3 months for cradle cap  to disappear on its own. For some babies, the condition lasts for one year or for as long as up to four years. But such cases are uncommon.

Some moms prefer to be more proactive and do what they can to remove the “cap.” It’s not difficult to treat and it can feel really nice to restore your baby’s scalp to its normal condition and appearance.

Cradle Cap Treatment

Here’s what you need to do to get rid of cradle cap:

  1. Shampoo with baby shampoo and dry baby’s hair gently, with a soft towel
  2. Apply a few drops of baby oil or mineral oil to the baby’s scalp
  3. Gently massage the oil into the cap
  4. Wait 30-60 minutes to allow the oil to soften the cradle cap
  5. Comb the scales out of baby’s hair with a baby comb
  6. Keep tissues handy to wipe the scales off the comb as you go
  7. If the baby’s scalp begins to redden, stop, and repeat the treatment a day or two later

Note that olive oil should not be used to treat cradle cap. It is believed that olive oil can strip the skin’s natural moisture barrier. This can make things worse. If you prefer to use a natural oil, use coconut or almond oil to get rid of cradle cap. These are gentle oils that will add moisture to your baby’s thirsty skin.

Sometimes, cradle cap comes with reddened skin and more than just the scalp is involved. The child may seem ill or have a fever. In this case, it’s time to check with your baby’s doctor. A case of cradle cap that gets this complicated or hangs around for too long, needs to be checked out by a medical professional. In severe cases, doctors may prescribe antifungal shampoo, or anti-inflammatory plus anti-yeast cream or oil to help control the condition.

Cradle cap shouldn’t be oozing or bleeding, or causing lots of discomfort or itching. There should be no swelling. These may be signs of eczema or even infection. See your doctor. In the rare case of infection, baby may need some oral antibiotics to clear things up.

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Banning Michael Jackson’s Music: As Parents it’s Time We Left Neverland

Leaving Neverland leaves parents with a quandary: should we ban Michael Jackson’s music from our children’s playlists? From our own? Is Jackson’s music now tainted due to public acceptance that the now dead performer was, in all probability, a pedophile?

Watching the public wrestle with what to do about their playlists in the wake of the documentary is a mystifying phenomenon to this parent. The fact is that Michael Jackson’s music was frowned upon in my home way before Leaving Neverland with its testimony from alleged child sexual abuse survivors.

Not that there was ever any doubt about MJ’s musical genius and fluid dance skills. The performer never failed to amaze us with his outstanding talent. But Jackson’s public crotch-grabbing, antisemitism, and baby-dangling all combined to kick my maternal instinct into high gear.

That instinct told me to protect my children from his influence.

#MeToo Zeitgeist

Leaving Neverland comes at a time when the public feels constrained to believe the testimony of victims of sexual abuse. But some of us didn’t need a #MeToo zeitgeist to guide us in what to do as parents. To parents like me, Jackson’s iconic and quite public crotch grabbing was always something obscene, even pornographic.

This was not something I wanted my kids to see. And I figured that the music of a person who grabs his crotch in public could not be a good influence. So I told my children there would be no Michael Jackson in the house and I told them why.

I knew that meant my children might still listen to his music and watch his videos out of the house or perhaps on the sly. But I wanted them to register and take in the nature of my disapproval. No matter how independent teens may seem, they do still care for their parents’ opinion. I wanted them to think twice before listening to or watching MJ. I wanted them to internalize the message that such graphic exhibitionism was not okay, and even worse than not okay, considering a large sector of Michael’s audience were young people.

“Jew Me, Sue Me”

In addition to explaining to my children why I thought it was inappropriate for Michael Jackson to grope his own crotch in public, on the stage, I brought up the issue of Michael Jackson’s lyrics in They Don’t Care About Us. The singer’s protests and apologies notwithstanding, the words “Jew me, Sue me,” smacked of antisemitic sentiment.

But the antisemitism went beyond lyrics that could be explained away when Michael Jackson called Jews “leeches.” Speaking of pornography, United States Supreme Court Justice Potter Stewart once said: “I know it when I see it.”

Paraphrasing the famous jurist, I told my kids that the same held true for antisemitism: “You know it when you hear it.”

Beyond the public crotch-grabbing and the lyrics that appeared to defame me, my family, and my people, there was the incident in which Jackson dangled his then infant son Blanket from a balcony four stories high. Michael seemed unaware that to do so threatened the baby’s life. To me, this said something about Jackson’s character that could not be glossed over, no matter how great his music.

Because of all these things: the crotch-grabbing, the antisemitism, and the way he endangered his infant son, Michael Jackson was off-limits in our home in every shape and form.

I knew about the allegations of pedophilia, of course. The whole world knew about them. But no one could prove the allegations and with the alleged victims denying abuse at that point, I figured that on that score at least, Michael Jackson, like everyone else, was innocent until proven guilty.

Not that it mattered. From my perspective, there was enough information about this man’s character and comportment to indict him without the added charges of child abuse and molestation. Which is why I watch on, bemused, as the world rushes to join the hasty chorus to ban MJ in all shapes and forms.

From The Guardian:

A number of radio stations, from Australia to Canada have stopped playing Jackson’s music after the documentary was aired, and the creators of The Simpsons also shelved one of the animated series’ classic episodes because it featured Jackson’s voice.

The French luxury brand Louis Vuitton dropped Jackson-themed clothing on Thursday from a collection it had shown at Paris fashion week in January, saying it found the “allegations in the documentary deeply troubling and disturbing”.

From ESPN, meanwhile, we learn that UCLA star gymnast Katelyn Ohashi is no longer using Michael Jackson music as the background to her perfect routines:

As proud as she is of the routine, she felt conflicted following the release of “Leaving Neverland,” the two-part HBO documentary about Michael Jackson and his alleged sexual abuse of children. She no longer felt comfortable using his music, or his moves, and made the deliberate decision to remove his influence entirely. She now boasts a routine set to artists that include Tina Turner, Beyonce and Janet Jackson.

If we want to measure parenting trends, we have only to look at the On Parenting section of the Washington Post.  When Leaving Neverland came out, On Parenting was full of to ban or not to ban. One op-ed went so far as to seek the expert opinion of two psychologists: was it okay for parents to nix the music. Spoiler alert: If it makes anyone feel uncomfortable, feel free to stop listening to Michael Jackson songs.

We could perhaps forgive the out-of-the-blue rash of awareness that Michael Jackson and his music might not be such a good influence. That is, were it not for the earlier stamp of approval the world had given the man. Until now, however, Michael Jackson was plugged as mentor to the world’s children.

From The Daily Mail:

The Prince’s Trust has cut ties with Michael Jackson musical Thriller Live following allegations the late singer abused young boys.

The show in London’s West End is based around Jackson’s music and hails his ability to ‘change the world’. . . Now The Prince’s Trust, the youth charity founded by Prince Charles, has ended a partnership with the musical.

Last September, Thriller Live, which has run at the Lyric Theatre on Shaftesbury Avenue for ten years, committed to offering ‘experiences and mentoring’ with the trust for a year.

Sign for Thriller, a London show, which has lost its backing since Leaving Neverland, the documentary
Sign for Thriller, a London show, which has lost its patron, Prince Charles, in the wake of Leaving Neverland, the documentary

Rolling Stone, meanwhile, tells us that several Michael Jackson items were removed from a display at an Indianapolis children’s museum. Because not only was Michael Jackson a “mentor” to children, but an actual icon:

“When we put together exhibitions, we look at the objects and their association with high-profile people. Obviously, we want to put stories in front of our visitors (showing) people of high character,” said museum Director Chris Carron.

“When you learn new stories or you look at something historical in a different way, then sometimes we re-evaluate whether that’s appropriate to be (on display).”

(photo credit: Abi Skipp from Michael Bush and Dennis Tompkins exhibition of Michael Jackson’s Wardrobe collection, October 12, 2012, illustration, only)

I have to ask: what about Michael Jackson was “appropriate” for display prior to the documentary? Why the change in public opinion now that a documentary has been aired? Wasn’t he grabbing his crotch before Leaving Neverland? Hadn’t he already referred to Jews as “leeches?” Dangled his baby four stories high?

Were these behaviors we wished our children to admire and emulate?

(Raise your hands if, as a parent, you too find it difficult to buy the sudden rush to disavow the man and his music.)

Too many parents and institutions rely on headlines instead of parental instincts and the headlines now tell us to omit Michael Jackson from our lives and the lives of our children. What we need to do instead is develop an inner voice to inform our behavior as parents. Because hearing the truth only now, makes all our parenting up to now, a sham.

We Knew Better

All along, we were exposing our children to a negative influence. And it simply isn’t true that we didn’t know better until the documentary.

The Jewish mother in me wants to respond with sarcasm: “What? This was a mentor, an icon? You wanted your child should maybe grab his crotch in public?”

I think not.

Time We Left Neverland

Here is the truth: we knew enough about Michael Jackson to ban his music all along. None of us needed a documentary, or headlines, or even allegations of pedophilia. We knew that he was neither mentor nor an icon for children. We just pushed our concerns aside.

It was easier that way.

Going forward, we may need to reexamine how we feel about other famous people and their influence on our children. Let us see the aftermath of Leaving Neverland as the watershed moment that signals a need for all parents everywhere to examine their hearts. We need to be parents first, consumers of music and entertainment second. We need to listen to our “inner parent,” our own voices, rather than let the media tell us what to think.

Because it’s time we left Neverland for good.

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Using My Daughter’s Life (And My Own) to Find New Purpose

March means many things: it’s Cerebral Palsy Awareness Month; it comes in like a lamb and out like a lion (or vice-versa); there’s March Madness; and let’s not forget the Ides of March. But for me it means another thing. The anniversary of my daughter’s death, or as some of her friends ask me “are we celebrating her birthday or her death day?”

Eliza Sheckley
Eliza Sheckley

She was only six when she passed.

This year March is also the celebration of the first year that the elementary school we opened to honor her legacy will be open. The journey from grief to positive action has not been an easy one, definitely not a straight path, but one that looks more like scribble marks across a page, both in the business journey and the emotional one. Let me share my journey and some ideas on how to use events in life to live with greater purpose and, hopefully, happiness.

When my daughter passed, my entire being changed. I had literally lost a piece of myself: a part of myself had died. My brain changed: I couldn’t remember things, I had no motivation. My physical body changed: I couldn’t exercise; old injuries became inflamed; I was physically and mentally broken. I now liken the experience of losing a child to a brain injury: part of me was injured and changed that day and will never be the same.

I wanted to cover my head, hide in my bed, and eat brownies for breakfast. Which I did some days, but those actions didn’t make me feel better; they weren’t productive to anyone around me and felt selfish. These things weren’t helping me to heal; they weren’t healing activities or healing foods. I couldn’t just “move on;” I wasn’t going to “get over it,” and nothing would ever be normal again. But in grief, we really have only two choices: let it consume us and stay in bed eating brownies all day, or do something positive.

The first thing we did as a family was to really look at what Eliza’s life meant to us. My daughter taught us so many things but we boiled these down to three main lessons: be kind, be strong, and always do your best.

Eliza Sheckley with classmates
Eliza with her classmates. She taught others to always do their best.

Eliza had cerebral palsy. That meant that kindness and gentleness were necessary from everyone to help her succeed and be her best. She was the strongest kid I’ve ever met. She wouldn’t give up. She struggled, she kept trying, and she would succeed. She was strong mentally as she was building her physical strength. She always tried her best: she would be in therapy, exhausted, and give her all for one more rep. She would work with her project groups at school and calmly settle disagreements. She would work hard to do the things that were difficult for her.

In looking back at those you’ve lost, it’s important to understand how your life has been impacted, what would be different if you had never met. Take those traits, lessons, and understanding, and make them the values for your journey going forward.

Find a way to honor that life

We had already begun the process of establishing the school when Eliza passed. Deciding to move forward with opening it was a pretty quick decision. But for most people, deciding to open a business when losing a loved one is too much. It might be a thought, or even a plan for the future, but not something to embark on immediately.

There are many ways to honor a life. You might, for instance, raise money for a charity, or serve as a volunteer doing work your loved one believed in. Or you might take it a step further and look for an organization that holds the same values your loved one taught, and work on their behalf. Find activities or organizations that align with the values and lessons you’ve identified, then commit to continuing in this work. Doing something positive will honor your lost loved one and will add purpose to your life.

Eliza Sheckley with best friend Natalie
Eliza with best friend Natalie

Be gentle with yourself

Most importantly, give yourself time, space, and patience. Our organization was founded in 2015, but when my daughter passed in 2016, I took a full year off to put myself back together again. I couldn’t function, I couldn’t concentrate. I wasn’t motivated, I couldn’t work. I was lucky to feed my family each night.

It took me a year and I still have days where I can’t work and can’t find motivation. Tonight, for instance, my family had snacks for dinner. I couldn’t find the motivation to prepare a meal.

The Sheckley Family.
The Sheckley Family today. Some days are better than others.

I remind myself that it’s not me. I’m not lazy, and it’s okay to not be okay some days.

For me, grief looks like lack of motivation and feels like my head is swimming in cotton. For others, grief may be angry outbursts; random or not so random crying; an inability to pay attention and connect to others; or so many other things. What’s important is that the feelings are recognized, blame is not placed, but instead feelings are understood and given the space and the time they need to heal. Each person is different and each will heal to their own extent in their own time.

Identifying values, honoring life, and finding a purpose has helped me to accept the grief I live with. As time goes by, the days of deeper grief are farther apart, but still present. Especially in March.

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Toothpaste: Is Your Child Getting Too Much?

Toothpaste can seem very attractive to small children. Maybe that’s why parents are putting too much toothpaste on their children’s toothbrushes. So says a new study from the Centers for Disease Control and Prevention.

Brushing teeth can seem like an unpleasant chore to children. But toothpaste makes that task more desirable. First of all, toothpaste has that sweet taste that kids crave. Not to mention, toothpaste tubes are decorated with brightly colored cartoon characters that have kids begging their parents to, “Buy this one, Mommy. Please???”

Twins brush their teeth

So maybe all of this is the reason that parents are overdoing it when it comes to loading up that toothbrush. But whatever the reason, the fact is that close to 40 percent of children ages 3-6 are using too much toothpaste, which means they’re getting too much fluoride.

Maybe that’s because kids actually need so little toothpaste to do the job that parents way overestimate the correct amount?

How Much Toothpaste?

It could be. After all, kids aged 3-6 are only supposed to have a pea-sized amount of toothpaste on their toothbrushes. And kids younger than that are meant to have an amount of toothpaste the size of a single grain of rice—in other words, a smear.

So now you know how much toothpaste kids are supposed to have. You also know that kids are getting too much toothpaste: up to twice the recommended amounts. What’s the problem with that, exactly?

smiling blond girl brushes teeth

Kids are swallowing the stuff. They almost can’t help it. Especially when you don’t stand over them and keep reminding them not to swallow. And that means children are taking in too much fluoride, which can lead to fluorosis.

Too Much Toothpaste=Fluorosis

Now when mild, fluorosis is not such a big deal. It may cause some white discoloration on the teeth. But when fluorosis is severe, it can cause pitting of the teeth, with the rotten spots stained brown to devastate a child’s smile. This is permanent damage we’re talking. Your child will carry that rotten brown smile into adulthood, though the stains can be masked somewhat with (expensive) cosmetic treatment.

The crazy thing is that only children are at risk for fluorosis. Adults don’t have to worry about getting too much fluoride. That’s because, as the American Dental Association (ADA) explains, “The chance of development of fluorosis exists through approximate age eight when the teeth are still forming under the gums.”

What’s the good/not so good news in this story?

Father and daughter brush teeth

Brush That First Tooth

It seems that the same CDC report that found parents are putting too much toothpaste on kids’ toothbrushes, found that kids aren’t brushing early enough or often enough. As many as 80 percent of children aged 3-15 didn’t begin brushing their teeth until after their first birthday. That’s way too late, says the ADA. Parents are supposed to begin brushing their children’s teeth the minute a tooth can be seen.Mother brushes babys teeth while looking into mirror

Children, moreover, are brushing once a day, when twice a day is recommended.

What’s good about any of this? Kids are actually taking in less fluoride than they might have if they’d been brushing from an earlier age or enough times a day. Still, it’s less about that than using the wrong amount of toothpaste (and not standing over kids as they brush, reminding them not to swallow.)

Younger Kids Swallow More

The swallowing issue may be why the CDC recommends that children under age 2 use non-fluoridated toothpaste. You could remind a 1 year-old not to swallow until you’re blue in the face, and it won’t make a difference. They’re going to swallow. And in fact, a Brazilian study found that the amount of toothpaste a child swallows is linked to age. The younger a child is, the more toothpaste he or she is likely to swallow.

At any rate the American Academy of Pediatrics (AAP), American Academy of Pediatric Dentistry (AAPD), and American Dental Association (ADA) disagree with the CDC on the issue of what kind of toothpaste to use with younger children. They say that as long as you use only a smear of fluoride-containing toothpaste, equal to the size of a grain of rice, your baby’s future smile is safe. Even if he swallows.

mother brushes baby's teeth

Meantime, older kids (3-6) should be getting no more than 0.25 grams of fluoridated toothpaste, the size of a pea. But fully 38 percent of children in this age group are using too much. Of the 38 percent, 17.8 percent are squeezing out a line of toothpaste to load the full length of the brush. Even those who use half that amount squirting out half a line of paste, 20.6 percent, are way over the safe limit for fluoride ingestion.

Toothpaste Takeaways

So, what are the takeaway points from all this?

  • Brush beginning with baby’s first tooth.
  • Use the right amount of fluoridated toothpaste: grain-of-rice-sized smear for kids under 3, a pea-sized amount for kids ages 3-6.
  • Make sure your child brushes twice a day.
  • Watch to make sure your child spits and rinses after brushing.
  • Keep all toothpaste and fluoride rinses and mouthwashes safely out of reach of children.

Smiling pigtailed girl holds up toothbrush

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Mister Rogers on Distracted Daycare: What He Would Say

Mister Rogers probably would have had plenty to say about distracted daycare.  We know that, because in 1983, a 30-minute special entitled “Mister Rogers Talks with Parents about Daycare,” was broadcast on U.S. national television. Hosted by none other than Fred Rogers of Mister Rogers’ Neighborhood fame, the program advised parents on topics germane to the placement of children in daycare, including

1) managing separation anxiety,

2) transitioning from home life to the daycare environment, and

3) choosing a daycare that works best for parents and child.

Unfortunately, Mister Rogers’ daycare special was filmed prior to the advent of mobile internet technology. So, it did not broach the subject of distracted caregiving and its dangerous consequences for child wellbeing.

If the show were aired today, it would need to address the risks of entrusting the health and safety of children to daycare workers who regularly check their portable internet-enabled devices to the point of distraction.

In the present article I define the problem of distracted daycare, explain its ramifications for child welfare and imagine a similar contemporary television show, “Mister Rogers Talks with Parents about Distracted Daycare.” In this fictional show, Mister Rogers would offer advice to parents concerning how to protect their children against the threat posed by distracted daycare workers.

What Is Distracted Daycare?

‘Distracted daycare’ indicates those distracted caregiving behaviors displayed by workers in modern daycare businesses, behaviors that potentially endanger the health and safety of the same children these workers are paid to educate, care for and protect. It can also indicate a daycare business where distracted behaviors are rampant among the caregiving staff.

Distracted daycare and distracted parenting are manifestations of a more general phenomenon: distracted caregiving. So, let’s start by defining that term.

Distracted caregiving is a form of escapism. With the aid of a smartphone, tablet or other internet-enabled device, caregivers flee to social media sites in order to escape the daily grind of household chores and the banal duties of child rearing. The receipt of push-notices (or pings) immediately draws the caregiver’s attention away from the child’s needs and towards a virtual world of titillating adult experience.

Surge In Distracted Caregiving

The past ten years have witnessed a surge in distracted caregiving and studies documenting the phenomenon:

  • In a Boston Medical Center study,caregivers were observed interacting with children while dining at restaurants. Of 55 caregivers, 40 were distracted by their portable devices to such an extent that, according to the researchers, their “primary engagement was with the device rather than the child.”
  • Another study found that regular distraction undermines a caregiver’s ability to properly monitor children’s activities, provide educational instruction or prevent accidents that lead to physical injury.
  • A third study links unintended physical injury to children with poor caregiver supervision or caregivers with high-risk personality traits.

Maximizing Profit

In today’s predominantly private daycare ecosystem, the problem of distracted caregiving is magnified. In order to maximize profit, childcare businesses employ low-paid, contingent workers from the most “wired” generations. These daycare employees, often called “teachers” or “teacher’s assistants,” typically feel:

1) Resentful towards daycare owners and clients for their low wages;

2) Entitled to use internet-enabled devices during work hours even if there is a policy against it;

3) Blameless for any accidents that could have been prevented had they not been distracted; and

4) Convinced that they should protect and be protected by fellow daycare workers when accused of distracted caregiving, even if the coverup involves lying or other forms of deceit (what I call “distracted daycare workers’ omerta”).

How Does Distracted Caregiving Harm The Child?

Distracted caregiving in private daycares is a pressing child welfare issue. The harms children suffer as a result of distracted caregiving are very real. They can be divided into three categories: physical, cognitive and emotional.

Physical Injury

The most obvious harm children suffer as a result of distracted caregiving is physical injury. Between 2000 and 2007, the U.S. Consumer Product Safety Commission compiled statistical data that support the claim that caregiver inattention causes physical harm to children:

1) Playground injuries involving children less than 5 years old spiked 17%

2) Nursery accidents went up 31%

3) Swimming pool injuries jumped 36%

However, in specific cases, it proves difficult to assign blame for these injuries. Distracted caregivers will typically minimize or deny the distraction, refusing to acknowledge that the child’s injury could have been prevented if but for the distracted behavior.

According to Wally Ghurabi, the director of the Nethercutt Emergency Center, “Folks are not going to admit the fact that—look I was doing this [e.g. texting or posting on social media], and that’s why … [the] kid fell off [the playground equipment] and broke his arm.”

Cognitive Damage

Distracted caregiving can also undermine children’s cognitive development, resulting in postponed speech acquisition, social-emotional delays and, in extreme cases, the onset of psychopathological disorders. 90% of brain development occurs in a child’s first three years of life. Neglecting to interact with the child during these formative years can cause lasting cognitive damage. Children can, as a result, develop an array of pathologies that survive into adulthood, including an aversion to healthy relationships, anti-social behavior, and several psychopathological disorders, such as oppositional defiant disorder and conduct disorder.

Emotional Harm

A third harm distracted caregivers inflict upon children is emotional trauma. In the Boston Medical Center study of caregivers dining with children, researchers observed regularities in the caregivers’ distracted behavior and the child’s emotional reactions. When the child attempted to gain the caregiver’s attention, the most common caregiver reaction was to reject the child’s intervention and express irritation.

These negative and insensitive interactions between caregivers and children can produce deleterious long-term effects on a child’s emotional well-being. One study finds that a lack of attentive care in the first three years of a child’s life makes the child more prone to emotional disorders, especially depression, in their adolescent years. Distracted caregiving can effectively stunt a child’s capacity to develop healthy emotional relationships with others.

Despite the overwhelming evidence that distracted caregiving endangers children physically, cognitively and emotionally, distracted daycare is nevertheless an under-reported child welfare issue. Many childcare businesses seek to deny, obfuscate and cover up incidents involving harm to children in their care. Likewise, due to under-reporting, most state and county agencies tasked to regulate private daycares have yet to realize the full magnitude of the problem.

Mister Rogers Talks With Parents About Distracted Daycare

Mr. Rogers on distracted daycare
What would Mr. Rogers have said about distracted daycare?

Imagine a contemporary television special entitled “Mister Rogers Talks with Parents about Distracted Daycare.” What advice might Mister Rogers offer parents concerned about the dangers of distracted daycare?

Selecting A Daycare

While no daycare is perfect, parents should select a childcare facility that minimizes the dangers distracted daycare workers pose to their children’s safety. In Mister Rogers’ special, he took a tour of several daycares, speaking to owners, directors and workers.

Four things that parents should look for are (1) an open-door policy, (2) a no-internet-enabled-devices-during-work-hours policy, (3) a camera surveillance network in all rooms and areas (including the playground) where children stay (not including restrooms) and (4) public complaints and notices.

Open-Door Policy

  • Open-door policy. The daycare that parents eventually select should have an open-door policy. With such a policy, parents can show up to the daycare at any time unannounced to observe daycare activities and worker behaviors (for an example see Toddler Town Chicago’s Open Door Parental Policy). Parent coach and author of The Nanny Whisperer, Tammy Gold, also recommends intensive parental monitoring of “babysitters, daycare workers or nannies [who] are on their smartphones, texting, emailing and otherwise distracted.” However, not all daycare businesses will open the doors for parents to make surprise inspections, citing the parent’s presence as a disruption to the flow of student activities.

No Internet-Enabled Devices

  • No-internet-enabled-devices-during-work-hours policy. The daycare should also have human resources policy forbidding the use of internet-enabled devices by workers during operating hours (for an example, see Kinder House Day Care Technology Policy). While some daycares have a no-portable-device-in-the-classrooms policy, others adopt a more laissez-faire approach, only banning recordings of children that daycare workers might post to social media sites. The daycare owner and/or director should be able to produce the no-internet-enabled-devices-during-work-hours policy on demand, explain how it is enforced and report how many violations of the policy have occurred in the past year.

Camera Surveillance

  • Camera surveillance network. Ideally, the daycare should have cameras recording all activities in the child areas during working hours. However, most daycare businesses still do not accommodate the request for camera recordings on the grounds of employee privacy. The reason for this is that direct surveillance of daycare businesses makes it difficult for these businesses to attract and retain low-paid daycare workers. Such workers may see the easy access to their portable devices as a trade-off for low wages. Even where there is camera surveillance, many employees know the blind spots of these cameras, the places where they can check internet-enabled devices without fear of detection.

Public Complaints And Notices

4) Public complaints and notices. At the very least, parents should contact the public agency (usually state or county) that regulates private daycares and ask how many complaints and notices the daycare has received in the previous 12 months. If there are many, or if they are serious, give that daycare a miss.

Demanding Accountability

Parents should hold daycare workers, directors and owners to account for any harms to their children that they believe resulted from daycare workers’ distracted behavior. A significant obstacle to making these allegations stick is the inability of parents to easily gather evidence that the worker’s distracted behavior contributed to the harm or that the harm could have been prevented if the worker were not distracted.

In most U.S. states, daycare businesses must complete an incident report and inform the parents when a child is physically harmed on daycare premises. Claims that repeated injuries were self-inflicted is a possible warning sign that the harms were the result of daycare workers’ distracted behavior.

If the child is pre-verbal (can’t yet speak), it is difficult to determine the truth of these claims. Parents should interview the director and the worker to determine the exact circumstances under which the injuries occurred. Lodging a complaint against the daycare with the state or county agency that regulates private daycare businesses is always an option.

Communication is also essential. Parents should talk to other parents about the problem. Sharing incident reports allows them to detect patterns of distracted behavior among specific daycare workers. Parents need not be ashamed to withdraw the child from the daycare if they suspect that it is a site where distracted behaviour is rife among the caregiving staff.

Last Resort – Suing The Daycare

Although no parent plans to sue their child’s daycare, in cases where a worker’s distracted behavior causes severe injury to a child, filing a lawsuit is a perfectly reasonable response. It can also be employed as a last resort, in case satisfaction cannot be had through less formal channels.

Following the example of Mister Rogers, it helps to consult experts on technical matters.The Injury Claim Coach is a good resource. Here, legal experts explain that most daycares require parents to sign waivers of legal liability. The waivers, however, are not an adequate defense in a court of law. Indeed, they are commonly struck down by courts as contrary to public policy.

Distracted Daycare: A Story

Injury Claim Coach offers an example of a child injured by a daycare worker because of “lack of supervision” and distracted behavior (cell phone use). In the example, 12 three-year-olds were left alone as the caregiver spoke on her cellphone. While the caregiver was distracted by her phone conversation, one of her charges repeatedly bit a second child on his back:

Later that evening, when the child’s mother was bathing him, she noticed several deep bite marks on his back. The mother applied an antibiotic to the wounds and bandaged them. The next morning, the child had a high fever. The emergency room physician diagnosed the child with a staph infection likely caused by the bite marks.

The parent alleged in court that the daycare was negligent and breached its duty of care to protect her child. The court agreed and ruled the daycare center was negligent. The court said the teacher breached her duty by leaving the children alone. “But for” the teacher’s actions, the child might not have the infection.

Satisfying Legal Standards

The standard legal elements that must be satisfied for a distracted daycare injury claim (civil suit for negligence) to be successful include:

1) The daycare center shoulders a duty of care (obligation) to prevent the child from suffering undue harm

2) The daycare center breached (violated) its duty of care

3) The child’s injuries were directly and proximately caused by the breach;

4) The daycare staff or management could foresee the injury

5) The nature and value of the child’s injuries must be proven.

The major roadblock for parents alleging that the children’s injuries were caused by a daycare worker’s distracted behavior is satisfying the threshold of proof required by a court of law (usually preponderance of evidence). Evidence that distraction contributed to the harm — in other words, “but for” the distraction the harm would not have ensued — is often difficult for parents to gather and easy for daycare owners, directors, and workers to hide.

Surveillance Cameras

Since parents wish to avoid sending their children to distracted daycares, naming and shaming these private businesses is a valid option. Another option is petitioning state and local governments to actively police distracted behavior in private daycares by, for instance, requiring surveillance cameras.

Keeping daycare workers, directors, and owners accountable for distracted behaviors and the harms they cause to children is of utmost importance to society at large. Harming children physically, cognitively and emotionally has terrible long-term social costs, from delinquency to addiction to incarceration.

Communities ought to honestly address the problem of distracted daycare, not minimize, deny, and cover it up. Parents, lawmakers and child welfare professionals should regularly broach the issue with the daycare business community. In the end, as Mister Rogers would remind us, open discussion of the problem and cooperative efforts to resolve it will make us all better neighbors!

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The Myopia Epidemic: Protecting Your Child

Myopia, or nearsightedness, has reached epidemic proportions in parts of Asia. The National Eye Institute warns that by 2020, 39 million Americans will be nearsighted, and that the figure will grow to 44.5 million by 2050. The myopia epidemic begins with children and teenagers, so that some call it the childhood myopia epidemic. Mild to moderate cases of childhood myopia tend not to have any serious long-term effects on health or vision. Progressive myopia, on the other hand, comes with a higher risk of serious complications including detached retina and glaucoma.

In myopia, the eyeball is either too long from front to back, or the cornea, the clear covering of the front of the eye, has a steep curve. This changes the way light rays land on the eye. When all works as it should, light rays find their way to the retina. The retina is light-sensitive tissue at the back of the eye.

In myopia, the different shape of the eye changes its slope, causing light rays to fall just in front of, instead of directly on the retina. The result is a change in vision.  Myopia means that objects that are close up are seen clearly, while faraway objects are blurry.

Myopia is nearsightedness. Hyperopia is farsightedness.

For most people, nearsightedness gets worse over time. Glasses and contact lenses are used to restore normal vision. For those looking for a more permanent solution, surgery may be a good option.

The Myopia Epidemic

The extent of the myopia epidemic in Asia is striking. Back in the 1950’s just 10-20 percent of the population in China had myopia. Now, as many as 90 percent of teenagers and young adults are nearsighted. It’s not just China, either. In Seoul, 96.5 percent of 19-year-old men are nearsighted.

Students in Chinese classroom illustrate effects of myopia epidemic
JIANGXI CHINA-April 19, 2018: April 19, 2018: junior high school students in Jiangxi, China, affected by myopia epidemic, wear spectacles for nearsightedness in class. The prevalence of myopia in China ranks first in the world.

Asia may have seen the worst of the myopia epidemic, but nearsightedness is also affecting the West. Half of all young adults in the United States and Europe are nearsighted. That’s double what it was 50 years ago. Some experts think that as many as one-third of the entire world population, 2.5 billion people, may have myopia by 2020. And it’s mostly happening to our young people.

Myopia Risk Factors for Children

Myopia is, in part, something a child inherits from his parents. But myopia can also develop from pollution in the environment or from stress on the eyes. Spending long hours reading, doing close work like embroidery, or working at a computer screen, are examples of activities that stress the eyes, and may cause or worsen nearsightedness. Spending 2 hours a day outside, on the other hand, can stop myopia from getting worse.

Here is a list of risk factors for myopia and myopia progression from the American Academy of Ophthalmology:

  • Near work or visual activity that forces the eyes to keep near objects in focus
  • High level of education
  • Low levels of outdoor activity
  • Diet
  • Television
  • Computer games
  • Electronic devices
  • Pollution
  • Female gender
  • Season of birth/daylight hours
  • Parents are nearsighted
  • Use of a night light
  • Younger age at diagnosis
  • High IQ score

Myopia And Free Radicals

There is evidence that oxidative stress inside the eye causes eye problems, including nearsightedness. This type of stress can increase the amount of something called reactive oxygen species (ROS) in the eye and in the retina, in particular. ROS is a type of unstable molecule or free radical, that interacts with other molecules and contains oxygen. Too much ROS can cause damage to DNA, RNA, and proteins, and may even cause cell death. The retina has continuous exposure to light, and this causes a buildup of ROS.

Antioxidants are known to fight eye problems caused by oxidative stress. Eating a diet rich in antioxidants can help stop the progression of myopia. For this reason, kids should eat foods containing vitamins A, C, and E; beta carotene; and zinc/copper.

Zinc is of particular importance to the retina. Not getting enough zinc can damage eye tissues and other structures important to the eyes. Too much zinc can cause a copper deficiency, so you want your child to eat foods that contain both copper and zinc. Foods containing copper and zinc include seafood, beef, beans, and seeds.

Foods rich in zinc
Foods rich in zinc can help protect your child from the myopia epidemic

Myopia: Genes Or Lifestyle?

Experts used to believe that developing myopia was all in the genes. A study from 1963, for instance, found that nearsightedness is more common in identical twins than in non-identical twins. This would suggest that DNA plays a big role in who develops myopia. Since that time, scientists have found over 100 regions of DNA that can be linked to myopia.

It was obvious, on the other hand, that myopia was caused by more than genes. A 1969 study of Inuit people in Alaska showed that lifestyle changes may be causing myopia. Of the 131 adults in the community, just two were nearsighted. But over half of the children and grandchildren of this community were found to be nearsighted. It was clear they weren’t inheriting the condition from their parents and grandparents. Something else was going on.

Researchers figured the difference might have to do with reading. It’s not a new idea. Moms have always told children not to read in dark rooms and to give the eyes a break  every once in awhile. And in fact, over 400 years ago, Johannes Kepler, a German astronomer and optics experts, said he’d become nearsighted because of all his studying and book-learning. Leading ophthalmologists of the 1800s recommended that students use headrests to create a distance between the eyes and a book’s text. This was meant to prevent reading too close, which was thought to strain the eyes.

Myopia And Reading

The myopia epidemic does seem to be connected to reading, but it’s not so much about reading books. Today, kids are spending most of their time reading from computer and smartphone screens. That’s also true in East Asia, but kids there aren’t just chatting and going on social media: they’re using computers and smartphones to study, too.

Just how much are the kids in Asia studying? A report from 2014 by Organisation for Economic Co-operation and Development (OECD) found that the average 15-year-old in Shanghai spent 14 hours a week on homework, compared with 6 hours in the United States, and just 5 hours in the United Kingdom.

Anywhere that there is a focus on education, you’re going to see lots of myopia. In the 1990s in Israel, for example, teenage boys who studied in yeshiva seminaries had higher rates of myopia than their peers. In seminaries, the boys spend the entire day, every day, studying religious texts. Taken on the face of things, it did seem to researchers as though reading up close for long periods over time may change the shape of the eye and the way light hits (or doesn’t hit) the retina.

Yeshiva students are affected by the myopia epidemic
Yeshiva students spend long hours studying religious texts

But the idea was myth-busted when, during the early 2000s, researchers tried to find a link between myopia and the number of books read each week or hours spent using computers. These factors, as it turned out, didn’t seem to be the main contributor to a young person becoming nearsighted. In 2007, however, the light went on, so to speak. That’s when researchers figured out that kids in California who became nearsighted had stopped spending time out of doors. A year later, a much larger study done in Australia of 4,000 Sydney children over three years’ time, found that the kids who spent less time outside had a higher risk for developing nearsightedness.

Myopia And Natural Light

Why is it so important for kids to spend time out of doors? It has to do with getting enough natural daylight. It seems that indoor light is always going to be less bright than outdoor light. The natural light outside is brighter than the most brightly lit indoor room, even on the cloudiest days. Light bulbs just can’t compete with Mother Nature.

In the winter, kids may be less inclined to play outside. It’s also true that the days are shorter during the colder months. That may be the reason that more kids become myopic in winter than in summer. There’s just less exposure to natural light at that time.

It’s not just the natural light that helps preserve eyesight and prevent nearsightedness. Being out of doors means being in wide open spaces. That means that the eyes have more room to focus. That’s better for vision than being in an indoor room that forces the eyes to focus at shorter distances.

Kids at risk for myopia should try to spend 14 hours a week out of doors. That’s about two hours a day. And of course, if they can spend more time out of doors, they absolutely should.

girl walks dog in park
Walking the dog is a great way to avoid becoming a statistic in the myopia epidemic

Here are some recommended outdoor activities:

  • Sports (baseball, basketball, tennis, and etc.)
  • Walking the family dog
  • Hanging out in parks
  • Hiking
  • Riding a bike

Balancing Study Periods With Rest

Kids can’t be outside all day and they do have to study. That’s why it’s important to limit the amount of time spent doing close work. Kids should also take a break from close work every half an hour. During these breaks, if they can’t go outside, kids should at least look out the window to give their eyes a rest. When kids are reading, watching television, or using computer and phone screens, they should have good light and not sit too close to books and screens.

Natural sunlight seems to be the simplest solution to avoiding childhood myopia, or prevent it from worsening. But researchers have been working on other means to stop childhood myopia from getting worse. There are corrective lenses that reshape the eyes. There’s also research to suggest that using atropine eye drops at night may help to get myopia progression in children under control. The problem is that researchers don’t yet know why these drops help. What they do know: atropine is known to block neurotransmitters.

The upshot of all this research on childhood myopia? Balance study time with time spent resting the eyes. Have children go outside as much as possible, at least two hours a day. When children are studying, make sure there’s good light and that they don’t sit too close to their work

Childhood Myopia And Eye Exams

Beyond all that, make sure your child has an eye exam once a year, so the doctor can see if or how your child’s eyes are changing. That should be on a parent’s to-do list whether or not a child complains about his vision. Kids generally don’t complain about being nearsighted. They just figure out how to make do.

Child having eye exam

Do you think your child may be at risk for becoming nearsighted? Bring your child to an eye doctor as soon as possible. Finding and treating myopia is still the best way to keep your child from becoming a statistic in the childhood myopia epidemic.

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Untreated ADHD May Reduce Life Expectancy

ADHD can make young people impulsive, and increases the risk for dangerous behavior. According to a new study, this translates to shorter lives for young people and adults with ADHD who forgo treatment. Treatment, on the other hand, can increase the lifespan of those with ADHD by an average of 9-13 years.

This new research on untreated ADHD is the brainchild of Russell A. Barkley, Ph.D., who investigated the connection between ADHD and 14 important health factors, among them nutrition, exercise, and tobacco and alcohol use. Dr. Barkley spoke about his findings during his keynote address at the 2018 Annual International Conference on ADHD in St. Louis, Missouri, where he was presented with the CHADD Lifetime Achievement Award.

“Our research shows that ADHD is much more than a neurodevelopmental disorder, it’s a significant public health issue,” says Dr. Barkley. “In evaluating the health consequences of ADHD over time, we found that ADHD adversely affects every aspect of quality of life and longevity. This is due to the inherent deficiencies in self-regulation associated with ADHD that lead to poor self-care and impulsive, high-risk behavior. The findings are sobering, but also encouraging, as ADHD is the most treatable mental health disorder in psychiatry.”

Russell A. Barkley, Ph.D., is an internationally recognized authority on attention-deficit/hyperactivity disorder (ADHD) in children and adults. Dr. Barkley serves as a Clinical Professor of Psychiatry at the Virginia Treatment Center for Children and Virginia Commonwealth University Medical Center in Richmond, Virginia.

Long-Held Suspicions

Dr. Barkley and his team culled data from a Milwaukee, Wisconsin study, that followed patients, mostly male and with ADHD, from childhood into adulthood. The researchers analyzed the data with an actuarial-based life expectancy calculator. The calculator was developed by the Goldenson Center for Actuarial Research at the University of Connecticut. “Dr. Barkley’s research confirms what we’ve suspected for some time,” says CHADD Resident Expert L. Eugene Arnold, MD, M.Ed., Professor Emeritus of Psychiatry and Behavioral Sciences, Nisonger Center Clinical Trials Program, Ohio State University.

Dr. Barkley compared the risk of shortened life expectancy from untreated ADHD to other major health risks. “If you look at the four biggest health risks in the U.S.—poor diet, insufficient exercise, obesity, and smoking—ADHD presents a greater risk than all four of these concerns combined,” said Dr. Barkley.

The study in question wasn’t large, by any standards. The data looked at was gathered from just 131 participants with ADHD, plus a control group of 71 participants. The researchers, on the other hand, followed the participants until age 32, a much longer period than for most longitudinal studies on children with ADHD.

Impulsive Behavior

What is it that cuts the lifespans of those with untreated ADHD? According to the data in this research trial, it’s mostly about suicide and accidental injury. Suicidal thoughts can come to anyone who’s feeling down. But if you have untreated ADHD and you’re impulsive, you might just act on those thoughts without further ado. Not to mention, if you’ve got ADHD, you have trouble organizing yourself to do things as you should, so it’s easy to get hurt doing everyday things like cooking.

While limited in size, the study does go beyond the obvious to look at lifestyle issues that may be exacerbated by having ADHD. Things like not getting regular exercise, not eating right, or getting enough sleep. There’s also the fact that people with untreated ADHD may not attain adequate education, which puts them in a riskier demographic. And of course, the risks of obesity and substance abuse are both increased in those with ADHD.

Dr. Arnold suggests that ADHD has yet to be seen by the powers that be as an important health risk. “ADHD is a major health problem that has not been evaluated in that light by policymakers,” said Dr. Arnold. “It needs to be taken much more seriously.”

Policymakers Don’t See ADHD

If you were to examine the factors that contribute to risky lifestyle behaviors, ADHD would crop up again and again. According to Dr. Barkley, if you want to reduce these behaviors, you have to treat the underlying causes. In many cases, that means treating the symptoms of ADHD. But, says Dr. Barkley, those experts who can influence us in those spheres, for example our primary care physicians, pediatricians, cardiologists, and other healthcare professionals—don’t often turn to ADHD as the possible reason for a patients’ inability to follow medical advice to make positive lifestyle changes.

“Healthcare professionals need to look behind the curtain for ADHD,” says Dr. Barkley. “Patients who struggle to follow their physicians’ advice to manage weight, stop smoking, or reduce sugar intake, among other concerns, should be screened for ADHD and treated accordingly. We need to educate our colleagues about the symptoms of ADHD, the substantial impact this disorder can have, and how to screen for it. The good news is, with accurate diagnosis and the continued use of evidence-based treatments including cognitive therapy, educational support, skills training, and medications, people with ADHD may add years back to their lives. And collectively, we can make a significant impact on some of the biggest health concerns we face as a nation.”

Dysgraphia: The Learning Disorder That Makes it Hard to Write

Dysgraphia is a learning disability that makes it difficult to write. The word comes from the Greek dys (difficulty) and graphia (making letter forms). A person with dysgraphia knows what to write and how to write, but copying and turning thoughts into words is a challenge.

Dysgraphia, like other learning difficulties, has nothing to do with intelligence or motivation but with how the brain processes the information it receives. It’s a condition that never goes away, though there are methods and tools to improve writing. A child may have other learning difficulties along with dysgraphia, for instance, dyslexia, dyspraxia, language disorders, or ADHD.

Children with dysgraphia may find it difficult to hold a pen or pencil. They may find it hard to line up letters as they should, even with the help of lined paper. They may also have trouble spelling words or taking the thoughts in their heads and putting them down in writing.

For some children it’s an organization, storage, and memory problem. A child may have learned everything he needs to know about writing. Finding, sorting it all out, and using that information is another thing.

Girl with dysgraphia thinking letters

Writing is complicated. Think about your hand picking up a pencil and placing it in the writing position. Watch your hand move this way and that as you write the different letters and punctuation. There is a lot going on there with your fine motor skills as your brain tells your hand how to make all those many, small graceful movements.

At the same time as you’re using all those many fine motor skills, you’re also using language processing skills. Your brain must think how to take all the thoughts and words in your head and turn them into written words and thoughts on paper. You need good hand-to-eye coordination to get pencil to paper, get letters and words to be approximately the same size, and to line them up, nice and straight on the page. You have to know where it makes sense to put a space between letters, words, and paragraphs, (and where it does not).

All of these many brain-based activities must be working just so for writing to come out right, for letters and words to be neat and readable. But in dysgraphia, something, somewhere along the line, goes wrong. It could be any number of things. The result is that the child finds it difficult to write, and we find her writing difficult to read.

The brain is a lot like a circuit board. The connections from one part of the brain to another are called synapses. Synapses are like thin threads or wires and there are lots of them in the brain. Just like the wires in a circuit board, synapses can get kinked up or twisted. They can get crossed or connect to the wrong place.

Colorful tangled wires

Now think how many brain processes are used for writing. That means lots of opportunity for things going wrong. You may never know why your child has dysgraphia, since the exact cause could be so many different things and even many different things at once. It’s actually miraculous that any of us can write smoothly and well, since writing is such a complicated process. For the child with dysgraphia, writing is a long, slow, sometimes even painful process, and the results may still be quite difficult to read.

Dysgraphia Defined

The word “dysgraphia” doesn’t appear in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). Instead, the DSM-5 calls dysgraphia “an impairment in written expression.” Because of this, most experts refer to dysgraphia this way. For most people however, “dysgraphia” is easier to say and use.

A child with dysgraphia should qualify for special education services under the Individuals with Disabilities Education Act (IDEA). To qualify for help, a child must have a condition that is named or described under IDEA. Like the DSM-5, IDEA doesn’t actually use the word “dysgraphia.” But IDEA does specify that children with specific learning disabilities are entitled to help. The DSM-5 classifies “an impairment in written expression” (dysgraphia) under the category: “specific learning disability.” IDEA defines a specific learning disability as something that makes it hard to understand or use language, either spoken or written, so it’s difficult to “listen, think, speak, read, write, spell, or to do mathematical calculations.”

Lots of children have messy handwriting when they are first learning to write. For some children, however, poor handwriting continues over a period of years, even with lots of practice and help. That’s when it’s time to look into whether the child might have dysgraphia.

Experts think that memory plays an important role in dysgraphia. The brain pulls in information through our five senses and stores it for later use. Think about the way you automatically raise your cup of coffee when going over a bump when riding in a car or airplane. You don’t think about it, it’s information you absorbed. You don’t know why you do it. You just know that if you don’t, your coffee will spill.

Arm holding up coffee cup

There are all kinds of information like this that you have absorbed through your senses and stored in your brain. These bits of information help you do your daily tasks, including writing. The information could be something as small as how to grasp a pencil, or how to turn that pencil with your fingers and hand to make a circle, a curve, or a loop. It could be about how to cross a t or dot an i. When a person gets ready to write, he has to find and use all these bits of information that are stored in his short-term or long-term memory. Then he must think how he wants to use all this information and in what order to use it so that his writing makes sense on the page.

In someone with dysgraphia, something goes wrong with this process. It may be about how the bits of writing information are organized and stored in the memory. Or it may be about getting the words out and onto paper or a computer screen. The result is writing that is full of mistakes and difficult to read. What we see may not even be what the child meant to write.

Girl writing on chalkboard

Sometimes dysgraphia is about the working memory. The child may not be able to remember how a new word is supposed to look and be written. He can’t write the word or type it, because he can’t remember how it goes. When a child can’t remember how words look in written form, he is said to have a problem with orthographic coding.

Dysgraphia may be genetic, which means that dysgraphia may run in families. If a child is behind the class into his writing and has some symptoms of dysgraphia, he should be evaluated for the condition.

Dysgraphia Symptoms

Dysgraphia symptoms fit into six groups:

Visual-spatial: Has trouble telling shapes apart, and leaving the right amount of space between letters and words. Finds it difficult to write words in one direction, for instance left to right. Has difficulty writing on the line or inside a margin. Finds it hard to read maps, and to draw or copy a shape. Is slow to copy text. Letters may be written in all different directions, with letters and words running together.

Fine motor: Finds it difficult to hold a pencil the right way. Other things that are hard to do: tracing, tying shoelaces, cutting up food, doing puzzles, typing, coloring inside the lines, using a scissors. Holds arm, wrist, body, or paper in an awkward manner when writing.

Language processing: Needs more time than others to get his thoughts typed out or written on paper. Finds it difficult to follow directions or understand game rules. Forgets what he was going to write in the middle of writing or loses his train of thought.

Spelling and Handwriting: Spelling rules are difficult to understand, for instance: i before e, except after c. Finds it hard to tell if a word is spelled wrong. May have perfect spelling when spelling aloud, but makes spelling mistakes when writing. May misspell the same words a number of different ways. Spell check is more confusing than helpful—he looks at the spelling suggestions and can’t figure out which is the right word to choose. Doesn’t know when to use upper or lowercase letters—his writing is a jumble of both. May mix printing and cursive in the same word or sentence. May not be able to read back to you what he’s written in his own handwriting. Tries to get out of writing. His hand gets tired and cramps up and aches as he writes. Goes through many erasers.

Grammar: Can’t figure out punctuation—may use the wrong punctuation, not enough punctuation, or too much punctuation (for example, too many commas, or run-on sentences that lack period or full stop punctuation marks, so that they never seem to end). May use different verb tenses in the same sentence or paragraph, for example, “When running, Sally ran to the beach.” Forgets to begin sentences with capital letters. Sentences may look unfinished, or be written in list format.

Language organization: Finds it difficult to tell stories, and may begin in the middle. May leave out important ideas, thinking you already know what he’s talking about. He might add many extra unimportant details, because he doesn’t know which facts are or aren’t important to a story. Uses vague language to describe things, so you don’t know what he’s talking about. A story he tells may seem to have no point, or the point is repeated many times over. Two or more sentences may get mixed up, so they’re impossible to understand. He’s better at telling you something than writing it out for you.

Dysgraphia

Dysgraphia Symptoms by Age

Symptoms of dysgraphia are different at different ages. You might not know a child has dysgraphia until the child begins learning how to write.

In preschool children, you might suspect dysgraphia in the child who hates to color and tries to get out of writing and drawing.

Children already in elementary school may mix up print and cursive in the same word or sentence. They can’t seem to stay on the lines and their letters aren’t even in size or height. School children with dysgraphia may need to sound out words as they write them. They may find it hard to get their thoughts out in written form.

High school students with dysgraphia may keep their sentences very simple. They make many grammar mistakes compared to their classmates.

Impact of Dysgraphia

In some children, dysgraphia is mild, in others, the symptoms are severe. That means that the impact of dysgraphia is different for each person. Here are some of the more common areas of difficulty for children (and adults) with dysgraphia:

Life: Children with dysgraphia may have trouble with their fine motor skills. It can be hard for them to tie their shoes or button a shirt. Scrambling an egg may be hard to do. Since writing and typing is difficult, it’s hard for them to make grocery or to-do lists.

School: Students with dysgraphia may push off or avoid writing assignments. It takes longer for them to write and their writing may be full of mistakes. It’s hard for them to take notes and it’s hard for them to read them. They may not complete their assignments on time. These issues can cause children to fall behind their classmates.

Social and Emotional: The challenges of dysgraphia can affect a child’s self-esteem and make it hard to develop friendships. Children with dysgraphia feel different than the other children they know. They have trouble expressing their thoughts. They feel frustrated at how hard it is for them to do their schoolwork. The thought of going to school or doing schoolwork, is a source of stress. When a child has not been identified as having dysgraphia, her teachers may not understand that the student has a real condition. A teacher may tell a child that she’s not working hard enough or that her writing is “messy” or “careless.” These labels can be hurtful, especially when the child is trying hard, and still failing. When children with dysgraphia fall behind in school, they may feel discouraged. They may even decide to drop out of school.

Diagnosing Dysgraphia

Signs of dysgraphia can be seen in preschool and elementary school children. Often, however, the condition is not diagnosed until middle school or high school. As with all learning difficulties, the earlier a child is diagnosed, the sooner the child can get help.

Dysgraphia is diagnosed by psychologists who specialize in learning disorders. Your child will need to be evaluated. During the evaluation, the tester will assess the child’s fine motor skills and writing ability. The evaluator will also want to see how your child expresses himself in writing.

Your child will also be asked to copy text and write sentences. The evaluator will watch your child as he writes to see how he writes, his posture, the way he holds the pencil, and whether it looks like the child’s hand is cramping as he writes. He will look at the child’s handwriting and measure the child’s fine motor speed as he taps his fingers, or flexes his wrists.

Other professionals, for instance school psychologists or special education teachers, may look at how the child’s difficulties affect his social life, his school work, or his emotions and self-esteem.

Getting Help

Once a child is diagnosed with dysgraphia, he should qualify for special education services. A team of teachers and experts will work with you to create an Individualized Education Program (IEP). Your child may receive tutoring in handwriting, and receive accommodations and modifications to address his specific issues. If your child isn’t found to be eligible for an IEP, request a written 504 plan that lays out how the school will work with your child to accommodate his needs.

Some schools use the response to intervention (RTI) approach. This helps identify any learning difficulties and offers extra group help to students who are behind in class. If group instruction doesn’t seem to help your child, the school may move to private, one-on-one tutoring.

Types of Dysgraphia Help

There are three kinds of help your child can receive for dysgraphia: accommodations, modifications, and remediation:

Accommodations change the way your child learns. Examples of accommodations include letting a child type on a keyboard instead of writing by hand; using voice-to-text software for note-taking and written assignments; or taking tests orally, instead of in writing.

Modifications change the content of what your child learns. Your child may be able to write shorter written reports, or receive fewer or different test questions than the other students in the class.

Remediation is extra work in the skills your child needs. Your child may spend more time doing tasks like copying letters and drawing inside raised lines. A child with dysgraphia may receive occupational therapy such as hand exercises to improve strength, agility, and hand-to-eye coordination.

Some children also find that medication for ADHD can ease the symptoms of dysgraphia.

Dysgraphia Home Help

At home, here are some of the many things parents can do to help children with dysgraphia:

Keep a notebook: Watch your child and write down what you observe about your child’s writing issues. How is your child sitting? What time of day is writing more difficult? Does stress make things worse? What makes things better or easier? Your notebook will be a big help when you discuss your child’s progress with teachers and other experts and educators.

Do hand exercises before and during homework: Have your child stretch the fingers of his hands several times, shake his hands out, or rub his hands together before doing written work. You may want to have your child take several breaks in his homework to repeat these exercises. The purpose of these exercises is to warm up the muscles and relieve built-up muscle tension, too.

Find fun ways to improve motor skills and increase strength: Have your child crumple a piece of paper, squeeze a wet sponge, squirt a water gun, or work with modeling clay.

child crumpling paper into a ball

Always watch your child to see how she’s handling these activities. Try not to overwhelm the child. Offer lots of praise for real accomplishments. It may not be easy—it never is—but with your help and support, your child will learn to cope with dysgraphia and succeed in school and in life.

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Developmental Coordination Disorder (DCD): Why is My Child so Clumsy?

Developmental coordination disorder (DCD) is a condition that lasts a lifetime, and can make children appear to be clumsy. Children with DCD have trouble learning motor skills and coordinating the way they move. They might have trouble tying their shoes and buttoning buttons. In school, they may have trouble with writing, drawing, and sports. DCD is also known as dyspraxia and sensory-based motor disorder (SBMD).

Children with DCD may be late with developmental milestones such as crawling, walking, feeding themselves, and getting dressed without help. At first, a parent or a pediatrician may not see these delays as a sign of a condition. DCD may not be diagnosed until a child is five years old, or older.

While DCD affects both boys and girls, it is 3-4 times more common in boys. The condition seems to run in families. Experts think that at least 5 percent of children have DCD. The main treatment for DCD is occupational therapy (OT). If you think your child may have DCD, you should speak to your child’s doctor.

A child with DCD will not outgrow the condition, since it is a lifelong condition. Once diagnosed, however, a child with DCD can learn how to cope with the condition. Children can also do a great deal to improve their motor skills.

Is DCD a Learning Disability?

DCD isn’t thought of as a specific learning disability like dyslexia or dyscalculia. Experts think of it as a neurodevelopmental disorder, like ADHD. DCD often comes with or is comorbid with other issues or disabilities. Since the symptoms of various conditions can look the same or overlap, DCD may be confused with something else or misdiagnosed.

A child with DCD will not outgrow the condition, since it is a lifelong condition. Once diagnosed, however, a child can learn how to cope with the condition. A great deal can also be done to improve motor skills.

DCD Signs and Symptoms

DCD makes life a struggle both inside and outside of the classroom. In school, children with the condition may have trouble organizing their books, notebooks, pens, pencils, and erasers. They can have trouble taking notes or copying from the blackboard.

Outside the classroom, children may have trouble tying their shoes, pouring a bowl or cereal, or brushing their teeth. As DCD affects their balance, they may find it hard to sit on chair without constantly squirming. This can make eating difficult and messy.

DCD means that the skills that we call on to help us move, don’t work right. These movement skills include:

  • Fine motor skills
  • Gross motor skills
  • Motor planning
  • Coordinating movement (coordination)

When motor skills don’t work as they should, there may be problems with everyday life. Your child may find it hard to:

  • Keep his/her balance
  • Quickly change the way he or she is moving to avoid bumping into things or getting hurt
  • Get his/her body to move the right way
  • Learn new ways to move
  • Predict what will happen when s/he moves this way or that
  • Figure out and solve motor tasks (like buttoning a button)

Just Clumsy?

Most of us learn from experience. A child with DCD may not learn the right way to move from past mistakes. All of us have clumsy moments. We may misjudge how close a hand is to a glass a milk and knock it over. But after we clean up the mess and pour a fresh glass of milk, there are no more accidents. A child with DCD, on the other hand, may knock that glass of milk over again and again.

Children with DCD have trouble figuring out the order of how they must move to do a task. This is called sequencing. Trouble with sequencing can make it difficult to put one foot in front of the other when walking, for instance. That means that children with DCD may bump into other people, fall a lot, or drop things they are holding as they walk.

Kids don’t all learn to crawl, walk, and get dressed at exactly the same time. Some do these things earlier, and some later. That makes it hard to spot a problem like DCD. A parent or a pediatrician may think these delays are just normal for the child. They may think a child will outgrow being clumsy.

Once a child is in preschool, and the issues persist, it may become easier to see there is a real problem. That means that it is usually not until preschool that a child with DCD is diagnosed and given treatment. At that point, parents can look back and realize they were seeing the signs and symptoms of a real condition in their child, all along.

Signs and Symptoms by Age

Here are some signs of DCD in children, according to age:

Preschoolers

  • Finds it hard to hold and use spoons and forks
  • Finds it hard to throw a ball
  • Doesn’t realize he or she is playing too roughly
  • Is always bumping into other kids
  • Squirms in his/her seat
  • Can’t seem to sit upright
  • Falls off of chairs

Kindergarten through Second Grade:

  • Finds it hard to hold and use crayons, pencils, and scissors
  • Can’t write letters the right way
  • Can’t seem to get the spacing right between letters
  • Going up and down the stairs is difficult
  • Always bumping into people
  • Still finds it hard to get dressed or brush his/her teeth

Third through Seventh Grade:

  • Needs more time to write than the other kids
  • It’s hard to cut up his/her food
  • Still finds it hard to tie shoes or button buttons, so getting dressed is hard
  • Math is difficult because s/he finds it difficult to line up the columns of numbers the right way

Eighth through Twelfth Grade:

  • Finds it hard to type and text
  • Has trouble with visual spatial tasks, for instance understanding how to work with shapes in geometry class.
  • Finds it a daily challenge to open the latch on his/her school locker
  • It’s hard to learn how to drive

DCD or something else?

It’s usual for children with DCD to also have learning disabilities or attention difficulties. The most common problem seen together with DCD is ADHD. Experts think that half of all children with DCD have ADHD, too.

Sometimes DCD seems to be something different. Kids with the condition have trouble sitting still or sitting up straight. They may squirm in their seats in an effort to keep their balance. Even a teacher with lots of experience may see the squirming and decide the child has ADHD. Or the child may have both DCD and ADHD, but the squirming and clumsiness can make the experts miss the DCD part of the problem.

To confuse things further, other issues can make children fidget or squirm. Sensory processing issues can cause these behaviors. A label inside a shirt collar can drive a kid with sensory processing problems to squirm and fidget every bit as much as a child with DCD, trying to sit still in his/her chair.

But DCD can just look like other issues. For example, because of balance problems, these kids often have trouble sitting upright or sitting still. They may move around a lot to keep their bodies up.

Conditions with similar symptoms

There are many issues that can come with DCD or be confused with the condition, including:

Because DCD may be confused with or come along with other conditions, it’s important for a child to have a full evaluation. That way, if a child has other issues, these too will be diagnosed and treated.

DCD Risk Factors

We don’t know what causes DCD. We do know some of the risk factors, including:

  • Male gender
  • Small for size at birth
  • Born early, before the 37th week
  • Low birth weight
  • Family history of DCD
  • Maternal alcohol or drug use during pregnancy

Evaluating your child

If you suspect your child may have DCD, see your child’s doctor. Your child’s pediatrician may be able to diagnose the condition. Or the pediatrician may work with other experts, for instance, a developmental behavioral pediatrician, a pediatric neurologist or a child psychologist, to evaluate and diagnose the problem.

The most common ages to evaluate for DCD are 5 and 6. Evaluators will look at motor and cognitive skills. They’ll ask questions about other factors that could be having an impact, too, in school and home life. They’ll also want to know whether your child has hit certain milestones in development and when symptoms began.

Evaluating children for DCD calls for assessing how your child moves. Here are some of the movement skills that evaluators will seek to assess:

  • Balance
  • Coordination
  • Fine motor control
  • Motor planning
  • Range of motion
  • Strength

The evaluators will want to see how well your child moves by having him do things like cut out paper shapes with a scissors, or string beads. Your child may be asked to draw different shapes or color a picture, to see how well s/he stays within the lines. These tasks show a child’s visual perception skills.

Therapy for DCD

The main treatment for DCD is occupational therapy (OT). An occupational therapist will work with your child to improve movement and motor skills. In order to improve handwriting skills, for instance, the occupational therapist may have your child practice tracing letters. A child who struggles with tying shoelaces, can practice on a lacing board.

Children with DCD who have an IEP or a 504 plan, may be able to receive OT for free in school. You may be able to get OT covered through your insurance plan. You can also hire a private occupational therapist.

Some children with DCD also need to work with a physical therapist. Physical therapy can help improve balance and strengthen muscle tone.

In school, children with DCD may need accommodations to manage their schoolwork. They may need extra time for tests or written work, because writing is difficult. Assistive technology for instance speech-to-text tools that can take dictation, can also be a big help in getting a child with DCD through school. The teacher may be willing to let your child use these accommodations in the classroom. Otherwise, your child can receive formal accommodations with an IEP or 504 plan.

Love and Support

The most important thing you can do for your child with DCD is to offer support and understanding for the challenges your child will confront every day. Advocating for your child is part of that. You may have to explain that your child didn’t mean to bump into his friend yet again, or that your child has trouble sitting still, because he has DCD. When you mention DCD, you can expect to be met with blank stares—sometimes even from your child’s teachers. (You can always tell people that Harry Potter actor Daniel Radcliffe also has DCD—to Google it!)

Daniel Radcliffe
Actor Daniel Radcliffe has DCD, photo credit: Joella Marano [CC BY-SA 2.0 (https://creativecommons.org/licenses/by-sa/2.0)]
Children with DCD, like children with any other disorder or condition, can suffer from self-esteem issues. Your support and understanding go a long way toward helping your child overcome these feelings of not being good enough. Work on building up your child with sincere praise for real efforts. Notice any improvement in your child’s motor skills and let him/her know you noticed! Give your child opportunities to practice motor skills at home.

Help your child break down difficult tasks into smaller parts and offer lots of practice on a regular basis. Find ways to change tasks so they become easier. You might, for instance, use special grips for pencils and pens that make them easier to hold. With occupational therapy, physical therapy, help at home, and accommodations in and out of the classroom, your child is bound to improve his or her motor skills to some degree.

David Branson, Daniel Radcliffe, and photographer David Bailey all have DCD
Left to right: David Branson, Daniel Radcliffe, David Bailey (photo credits: Joella Marano, David Shankbone, Ben Broomfield, via Wikimedia Commons)

Be patient and always remember that it’s not easy to live with DCD. Encourage your child however you can and always be ready with your sympathy and understanding. Remind your child that many great and successful people have DCD. (In addition to actor Daniel Radcliffe, there’s entrepreneur Richard Branson and photographer David Bailey—imagine having to hold that camera still!) Most of all, let your child know your love is there to be counted on, no matter what happens today or any other day, in or out of the classroom.

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Dyscalculia: Does Your Child Have Trouble With Numbers?

Dyscalculia is what we call it when a child has trouble understanding, learning, and using numbers. Children with dyscalculia may have trouble reading and writing numbers, or using them to make sums. They may also find it hard to remember strings of numbers, for instance, a telephone number. As a learning difficulty, dyscalculia is a lot like dyslexia, but with numbers instead of letters, words, reading, and writing.

Many children think of math as their least favorite subject. They may struggle with assignments. In dyscalculia, however, a child’s troubles with math go beyond simple frustration. When a child has a serious, long-lasting problem with even basic math, it may be a sign of dyscalculia.

Dyscalculia is not very common. While there are no exact statistics available, experts think that anywhere from 5 to 7 percent of all elementary school children have dyscalculia. Both boys and girls can have dyscalculia in equal numbers.

Is Dyscalculia a Disability?

Dyscalculia is a learning disability or disorder. But some people prefer to call dyscalculia a learning “difference” or “difficulty.” These words don’t feel as much like a negative or hurtful label.

It’s important to know that dyscalculia is not the only learning difficulty that causes problems with math. Other learning problems that can make math a challenge include ADHD, dyslexia, and visual or auditory processing disorders. Then again, a child can have more than one learning difficulty. A child may, for example, have both dyscalculia and ADHD, or dyslexia and a visual processing disorder.

Trouble with math may lead to testing for dyscalculia. But math is just one challenge for people with the learning difficulty. Dyscalculia affects everyday life and it doesn’t go away. A person with dyscalculia may, for instance, always find it hard to follow a recipe, remember a phone number, or read a map. It’s good to know there are strategies to help children develop the skills they need to live a normal, happy life.

Math frustration boy with dyscalculia

 

Children with dyscalculia may struggle with math in many different ways. A child with dyscalculia may not understand amounts or the difference between largest and smallest. The child may not see the numeral 3 is the same as the word three. The plus sign may not mean anything to the child or may not seem different than the multiplication sign. Some call these skills number sense.

It makes sense that children with poor number sense skills will also have trouble with math. The child with dyscalculia may understand the logic behind a math problem. He may, for example, understand that he is to take an apple and put it next to another apple and that this is called “adding.” But he doesn’t see one apple and think “one,” so he cannot tell you that one plus one equals two. He may also find it difficult to understand that two apples are more than one apple.

Children with dyscalculia have trouble with their working memory. The working memory is the part of your memory that keeps items you need in the short term for the work you are doing. A child with dyscalculia may not be able to work through a math problem with multiple steps. It can be hard to hold the numbers in mind as the child completes each step.

Girl Struggles with Math Dyscalculia

 

Dyscalculia can cause different problems in different children. That means the symptoms of one child with dyscalculia may be different from those of another child with the learning difference. It’s a good idea to write down what you see as you observe your child. Sharing your notes with the child’s doctor or teacher can help them find the best way to work with or get help for your child.

Signs of dyscalculia can be seen in a preschooler, but may be difficult to spot. After all, lots of children have a difficult time learning basic concepts like numbers and math. As the child becomes older, however, it becomes clear that there is a real problem that isn’t going away with time.

Common Signs of Dyscalculia

Here are some common signs of dyscalculia, according to age:

Preschool

  • Learning to count is hard. The child skips numbers or says them out of order, long after friends are able to say their numbers in the proper order.
  • Has trouble organizing toys according to size or pointing to the largest or smallest item in a storybook, when asked to do so.
  • Find it difficult to understand the connection between written numbers and what they mean. (Doesn’t understand that “3” means three.)
  • Doesn’t really understand what it means to count. If you ask her for 3 blocks, she will give you an armload instead of counting them out.

Grade School

  • Learning and remembering basic math is difficult, for instance 2+3=5.
  • Can’t remember the names of basic math symbols and finds it a challenge to remember how to use them, too.
  • Counts on fingers, instead of remembering basic math like 2+2=4.
  • Finds it a challenge to understand ideas like greater than and less than.
  • Finds even a visual-spatial representation of numbers, for instance number lines, hard to understand.

Middle School

  • Has trouble understanding place value.
  • Finds it difficult to write numbers clearly.
  • Has trouble lining up or placing numbers in the right column.
  • Struggles with fractions.
  • Measuring ingredients for even a simple recipe is a challenge.
  • Keeping score during sports games is tough.

High School

  • Has trouble using math concepts with money, for example, estimating the total cost of items he wants to purchase, counting out exact change, or calculating the waiter’s tip in a restaurant.
  • Finds it hard to understand graphs, charts, and maps.
  • Struggles with using a measuring cup or measuring spoons.
  • Can’t see another way to do a math problem. For instance, 6-1 is the same as 2+3.

Dyscalculia isn’t just about the problems it causes in school. Having a numbers difficulty also affects everyday life. Getting to an appointment on time is difficult because time is based on numbers. You might accidentally schedule overlapping events, and have to miss out on a promised lunch with a friend.

Dyscalculia gets in the way of figuring out how much time you need to set aside for tasks. This, in turn, can affect your approach to setting up work projects. If you miscalculate how much time you need to complete a project, you end up missing deadlines. In the home, dyscalculia can make it a chore just figuring out how to time dinner so that all the food is ready and on the table at the same time, at the right temperature.

Dyscalculia Comes with Other Issues

Learning difficulties like dyscalculia often come with other such issues. When someone has more than one learning difficulty, the issues are said to be comorbid. Dyscalculia is often comorbid with dyslexia and/or ADHD. Some 43-65 percent of children with math issues also have reading issues. ADHD can make it difficult to pay attention when doing math and may play a part in a child’s math errors.

A child with dyscalculia may be weak in executive function skills, which have to do with working memory, flexible thinking, impulse control, planning, and organization. It is also common for children with dyscalculia to have math anxiety. Math anxiety makes children so afraid of poor results on a math test that their nervousness leads to exactly the poor performance they fear.

Some learning difficulties have symptoms that are similar to the symptoms of dyscalculia. This can make diagnosis difficult. It might look like a child only has dyscalculia, when the child actually has more than one learning disability or difficulty. Or, the child’s dyscalculia may be altogether missed or misdiagnosed as something else.

Girl with math anxiety dyscalculia

If you suspect your child may have dyscalculia, it’s best to have a full evaluation. A full evaluation can reveal whether your child has more than one learning issue. A proper diagnosis will help you know what type of support and therapies your child needs. Most schools will test your child for free.

 

If your child has ADHD, for example, it may be suggested that your child have her math skills reevaluated after getting the symptoms of ADHD under control. The treatment for ADHD may be all your child needs to fix her math issues. This may suggest the problem was never dyscalculia in the first place. It was all about an attention difficulty, and paying attention to detail.

If your child is tested at school, and found to have dyscalculia, it should be possible for the school to get her the help she needs. She may need tutoring or special classes in math. The school may give your child accommodations to make learning easier. An accommodation may be to have your child answer math questions orally instead of having to write them out. Or your child may be allowed to use a calculator in the classroom or do fewer math homework problems.

Causes of Dyscalculia

Sometimes dyscalculia is the result of a genetic disorder. Genetic disorders that may cause dyscalculia include fragile X syndrome, Gerstmann’s syndrome, and Turner’s syndrome. For other children, poor math skills just seem to run in the family.

Sometimes outside, environmental factors can cause dyscalculia. Fetal alcohol syndrome, for example, can lead to dyscalculia. Premature babies and low birth weight babies may later turn out to have dyscalculia.

Helping Children with Dyscalculia

Here are some strategies that can be used in the classroom and at home to help strengthen numbers and math skills:

  • Use real objects to help your child connect numbers to items. You can have your child use an abacus. Or have your child sort buttons by size or color. Once the buttons are in piles, you can have the child tell you which piles are larger and which are smaller. This kind of practice can help to improve your child’s number sense.
  • Give numbers a form by having your child draw pictures of items, or move objects around to show addition and subtraction.
  • Have your child use graph paper for working with numbers and math. This helps keep numbers neat and easier to read.
  • When working on a math problem, cover the rest of the math sheet with a piece of paper. This helps your child focus on the problem at hand.
  • Play board games that build number and math skills
  • Talk up your child’s abilities, to combat low self-esteem caused by poor math skills

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Can Children Get Type 2 Diabetes?

Diabetes is a condition that affects the body’s blood glucose levels. There are two main types of diabetes that are diagnosed in children and adults: type 1 and type 2. In type 1 diabetes, the pancreas can’t make enough insulin, which is a hormone that helps spread glucose (sugar) into the body’s cells to produce energy. Those diagnosed with type 1 diabetes are most often born with the condition.

Type 2 diabetes is diagnosed when the pancreas creates enough insulin, but the body won’t use it. This is referred to as insulin resistance. Diabetes affects the way the body makes and uses insulin. That means rising levels of blood glucose and, ironically, a body starved for energy.

In the United States, over 30 million Americans suffer from diabetes. In 2017, 18,000 children below the age of 20 were diagnosed with type 1 diabetes, and over 5,000 children were found to have type 2 diabetes. November is Diabetes Awareness Month–the perfect time to learn about a disease that affects so many people of all ages every day. If you believe your child is at risk of being diagnosed with diabetes here is what you need to know.

Child Risk Factors for Type 2 Diabetes

Once referred to as adult-onset diabetes, type 2 diabetes has become a more common diagnosis in children. This is because of rising levels of childhood obesity over the past twenty years. Most cases of childhood diabetes are diagnosed in puberty, though children can get it as young as 8 years old. There has also been an increase in mothers who are diagnosed with gestational diabetes during pregnancy. Gestational diabetes increases the risk for developing diabetes later in life in both the mother and her baby.

Children, most often girls, are also at an increased risk for developing type 2 diabetes if they have a family history for either diabetes or obesity. If your child is of African American, Hispanic, Asian American, Pacific Islander, or Native American descent, he/she also has a higher chance of developing type 2 diabetes as a child.

Obesity is linked with insulin resistance, the leading cause of type 2 diabetes. Childhood obesity affects around 12.7 million children and teenagers in the United States. As the childhood obesity epidemic grows, so do the number of children who become insulin resistant and go on to be diagnosed with type 2 diabetes.

Can Diabetes Type 2 Be Prevented?

Children with prediabetes are at risk for developing type 2 diabetes. In prediabetes, blood glucose rises to levels approaching type 2 diabetes. If your child has prediabetes, the doctor may make recommendations to help lower your child’s blood glucose levels. Following the doctor’s recommendations may prevent your child from developing type 2 diabetes.

Encouraging children to eat healthier foods can help prevent the development of diabetes. Eating a diet low in carbohydrates with adequate protein and healthy fats, can reduce the risk of excess weight gain. Such a diet should also result in weight loss in children who have gained too much weight. Obesity is a major cause of type 2 diabetes development.

Another common type 2 diabetes prevention tactic is getting regular exercise sessions of around 30 minutes each, five days a week. Participating in physical activities can prevent not only diabetes, but many other serious health complications and diseases like, for instance, cancer. Limiting TV and video game time and encouraging children to be active reduces their risk for being diagnosed with type 2 diabetes.

Healthy Activities Prevent Type 2 Diabetes

Here are some fun activities that can help prevent diabetes type 2 in children:

  • School sports like baseball, lacrosse, and soccer
  • Walking the family dog
  • Physical chores like shoveling snow and raking leaves
  • Walking or bike-riding to school
  • Physical family activities like hiking or sledding
  • Daily runs or walks
  • Dance or gymnastics class
  • Karate

Signs & Symptoms of Type 2 Diabetes

In the beginning stages of type 2 diabetes, signs and symptoms of the disease are uncommon. Only as time passes do the symptoms begin to appear. Some of the most common symptoms include:

  • Extreme Thirst
  • Frequent Hunger
  • Unexplained Weight Loss
  • Dry Mouth
  • Frequent Urination
  • Itchy Skin
  • Blurred Vision
  • Numbness or Tingling in Hands or Feet
  • Heavy Breathing
  • Slow Healing of Sores and Cuts
  • Darkened Skin in Armpits and Neck

Complications of Type 2 Diabetes

A diagnosis of type 2 diabetes can lead to complications that come on faster in children than in adults. Diabetes is the leading cause of vision loss and blindness from a group of eye conditions called diabetic eye disease. These conditions include diabetic retinopathy, diabetic macular edema, glaucoma, and cataracts, and affect most major portions of the eye. Other complications of diabetes can include coronary artery disease, stroke, heart attack, kidney failure, and sudden death.

Children at risk or already diagnosed with type 2 diabetes should receive an annual flu shot. The flu can increase the risk of diabetes-related complications. Any illness at all, in fact, can make diabetes more difficult to manage.

Children who are at risk for developing type 2 diabetes are also at risk for diabetes complications. For this reason, at-risk children should be screened for the disease on a regular basis. Early diagnosis means a chance to begin treatment as soon as possible. Early treatment of diabetes helps to prevent later complications from the disease.

Complications of Diabetes Treatment

Insulin therapy is often necessary to control type 2 diabetes. But as diabetic children and teens grow into young adults, the doctor may add further medication to their treatment plans. Some of these prescription drugs are known to have side effects far worse than the symptoms they are used to treat.

One such class of drugs is SGLT2 inhibitors. SGLT2 inhibitor medications regulate blood sugar levels by keeping the body from absorbing glucose back into the blood. Invokana is an example of an SGLT2 inhibitor. This drug has come under fire for increasing the risk of rare genital infections, lower-limb amputations, and ketoacidosis in adults over the age of 18 who use this medication.

Diabetes medications are often prescribed as part of an overall treatment plan. Ask your doctor about the possible side effects and complication of the various prescription drugs for diabetes. Having this information can help you decide see which medication is right for the child approaching adulthood.

What Can Parents Do?

A diagnosis of type 2 diabetes sounds scary. After all, diabetes, whether type 1 or type 2, cannot be cured. In spite of this fact, with proper management, most people with diabetes live a happy, healthy life. If your child or teen has been diagnosed with type 2 diabetes, you can help manage the disease by encouraging your child to engage in physical activity and eat healthy meals.

If you believe your child is at risk for type 2 diabetes, there’s so much you can do to avoid that dreaded diagnosis. You can help your child fit in more exercise and other healthy activities. You can make sure your child eats right and loses weight. Most of all, if you notice any possible symptoms of diabetes in your child, you’ll want to speak to your child’s pediatrician right away. Early diagnosis and treatment are the best way to keep your child’s life as normal and as healthy as possible

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