Rx For Parenting Today

Infants with Special Needs

Several years ago I was asked to see a newborn with muscle weakness. The baby was still in the hospital nursery and in reviewing the baby's chart, I was concerned to see that no referral had been made to the California state CCS program. This was important because I knew the young parents were going to  have to struggle to pay the hospital bill that was increasing daily. Fortunately, the hospital had a good social worker and together we were able to get CCS to take over the hospital payments. Whenever a child has a special problem, CCS  or whatever the state's program is called should be notified because they can help financially and in other ways.  Sadly, I find that a lot of physicians either don't know to do this or don't want to bother filing out the needed forms. 

Most states have regular clinics where they see children with special needs. Usually a pediatrician,orthopedist P.T., O.T. or other medical specialists attend these clinics. Some are good and some are not the best. However, usually any needed equipment can be provided. If social workers are present they can usually be very helpful. 

You may be able to find your state's program on the Internet and I also give a list of each state program's telephone number and address in my book, Raising a Handicapped Child.

 

Learning Disabilities and Accompanying Problems

Parents, grandparents, and teachers can be helpful in identifying learning disabilities if they notice unusual or abnormal problems that occur in a child's behavior. I had one child who developed a tic in his face that the parents thought was related to his favorite grandparent's death. I referred the boy to an excellent child psychologist and in testing she found quite a severe  learning disability. Another child started refusing to go to school and he, too, was found to have a significant learning disability. 

Children with autism or some other disability, as spina bifida or Duchenne muscular dystrophy, can have an accompanying learning disability. It is important to note that a teacher may ask that a child  be tested by a school psychologist because of his or  her concern about the child's learning ability.  Unfortunately, some schools use individuals for testing who are not qualified educational psychologists. I can remember arguing with a school principal about a child who I was sure had a learning disability. When I used grant money to  have the child tested by an excellent child psychologist, the learning disability was identified and we were able to get the child some special help. Some principals don't want to use  school funds for adequate testing and also some parents do not want a child identified as having  a learning disability. Brilliant people who have achieved remarkable things have had some difficultly with reading or writing. However with special help they can learn to handle their problems and achieve great things. I have a friend who is the world's expert in her particular field, but she said she didn't know she was smart until a special teacher helped her and she got needed help. Each of us has areas in which we  excel and others in which we don't. Parents and teachers can change a child's life if they detect a learning disability that can be helped with the a learning specialist. 

More Thoughts about Adoptions

If you are going to try to have a private adoption, it is important to have a lawyer help you  who is knowledgeable about adoptions. I remember a couple, when I was in pediatric practice, who did all the right things including hiring an attorney, but the child they adopted was so destructive they returned him to the adopting agency. Fortunately, the lawyer had planned that this could happen, so it was all done legally.

If you are planning an overseas adoption a lawyer is also important. A divorced, older, professional women adopted a child from eastern Europe and had on-gong problems. The boy did not speak any English and the woman did not speak the language of his country. She tried very hard to give the child as much love as possible, but the long-term outlook did not look good.

Any child who is adopted should  be carefully examined by a pediatrician and have a complete blood count, urinalysis, and tuberculin test. All the immunizations should also be up to date and as much family history obtained as possible. 

There are some websites that can be helpful. One is  the  National Adoption Clearing House at: adoption/adopt/national-adoption-clearing-house and the other is www.aask.org for Adopt a Special Kid. The child who is adopted should know he or she is adopted, as soon as possible and if they are from another country learning about the culture of that country is important. 

Things to Consider When Adopting

I admire parents who want to adopt and give a child or teen a warm, loving home. In caring for many adopted children, as a pediatrician, I am surprised about some of the things that are overlooked.

One day a professional man  asked me when was the best time to tell a child he or she was adopted. The parents had two boys and I did not know that one of the youths, a teenager, was adopted. The couple had one child of their own and then adopted the other when he was a baby. I replied that I think the sooner you let a child know of the adoption the better it is. How awful as a teenager to find out you were adopted, but your brother was not. Children  need and want to feel they belong and every adopted child  should learn  right away they were specially chosen. One woman told me she knew right away she was adopted by an older loving couple. It was not until she was an adult and did research into her birth mother, after  the parents who raised her were dead, that she had a shock Her birth mother was no longer living, but she discovered she had a sister and a niece. The mother had had one child, then when the woman was born, she put her up for adoption,  but later had another child. The woman said she has fought a feeling of abandonment all her adult life. She married a special man and they had many good years together, but she never had children. She did have considerable counseling, but the pain, she said is still there. Why was she put up for adoption? She will never know. 

I will do another post tomorrow  about the many other things that need to be considered about overseas adoptions and medical care. 

Babies with Special Needs

All parents hope for a healthy child, but this sadly is not always what happens. However, there are some special groups, agencies, and parents who will be helpful. If a baby has a so-called "birth defect",  your state's agency for children with a disability should be notified while the infant is still in the hospital. That way monetary and other aid may be available. Most states will cover the hospital bill if they are notified. 

There are support groups for almost all disabilities. Some are helpful and unfortunately some are not and may give poor advice. If it is possible to find a parent who has a child with a similar problem, he or she can often tell you which groups are the best. You should be able to find specific agencies on the Internet. Also my book, Raising a Handicapped Child lists most of the agencies in the appendix. 

The National Organization for Rare Disease or NORD  can be extremely helpful. They can be found on the Internet or at 1-800-999-NORD. Hospital or agency social workers usually have a wealth of information, so I would contact one in the hospital where the baby is born.

One of the most important things for parents to do is to grieve and take care of themselves. This is a very difficult time to go through and spending long hours in the hospital may lead to illness or depression. Taking care of yourself allows you to do the best for your child. 

Parenting in 2020

As a parent and pediatrician, I believe there are basic things children need and want from their parents. I worry with all the craziness in the world today, parents can get so caught up in just making it from day to day that their children may not be receiving important things. All children need to feel safe, to know they are loved and valued for who they are (not who their parents want them to be.) Yes, they need to be fed and clothed and receive good educations and health care, but above all they have to know they are treasured and even though they may make mistakes that their parents still love them.

I have cared for children of very wealthy parents, children of poor parents, and children with disabilities. I have also cared for children who disappointed their parents and children who had such a severe disability that their parents could hardly be in the same room with them. One mother of a spina bifida child said in the examining room, sitting next to her very sweet, but disabled child  "The day she was born was the worst day of my life!" 

Because the suicide rate is increasing among children and teens, something is very wrong. Are parents not telling their children how much they love and value them or are they expecting so much of the children, that the kids feel life is not worth living?

Children want and need lots of time with their parents, not just one parent, but both parents. Being a single parent is tough, but in many ways a single parent has an advantage because  he or she can parent the way they know is best without any problems with a partner. Family traditions and continuity are both extremely important. 

I have cared for children of some wonderful parents and I still hear from many of them. Their children are a true credit to the way they parented. I have long-term follow-ups of children  with parents who spent little time with them or pushed them to do things they were not capable of doing. Their lives have been tough and yes, some suicides have happened. 

So as parents starting the new year, please think about how you parent and let your children know often how much they mean to you. Happy New Year!

Toys for Children with Special Needs

With the frenzy of buying gifts for children, it is often hard to find toys for children with special needs. A list of ideas was given in a December issue of a pediatric newsletter. Their suggestions were to be sure and chose a toy for the child's developmental age, not real age. Watch always for any child to be sure there are no small parts that can come off or break off and be swallowed. Choking can easily occur. 

Staying away from electronic, difficult to handle toys is a good idea. Physical and occupational therapists may have some good ideas about appropriate toys, as can parents of older children who have a child with a disability. 

Books that parents can read to or with children are always good. There are so many beautiful children's books now that a book gift can long be treasured. My favorite cousin, Jean Bothwell, wrote 61 children's books and I still enjoy reading some of them. 

I hope small children will not be given smartphones or i phones. I think old fashion toys will mean a lot more in the long run. I still have my daughter's favorite stuffed animal that she dragged around when she was little and I have my grown granddaughter's big panda. A single stuffed animal may be a long-lasting friend. Happy gift buying!

Holiday Safety for Children

Holidays can be special and leave lasting memories. They can also be dangerous for children if a few safety precautions are not taken. Because entertaining happens more often at the holidays parents can get very stressed and not be as aware as usual of problems that can occur with the children. Holiday decorations can be a problem if holly and mistletoe are used, because both are dangerous for children. Lighted candles and toys that contain detachable pieces or magnets that can be swallowed  may also be a cause of harm.

Children with autism love to escape and can easily slip out a door as guests are arriving. Hiring a teenager to watch an autistic child during a party is a good idea and can even save a life. Guests may carry medicine in their purses, so these should be put up high if there are little children.  If glasses with alcohol are not cleared up after a party, a child may decide to  take a drink. I have cared for little children who were essentially drunk after a parents' party. Cigarettes should also be carefully disposed of because nicotine poisoning can occur. Kids will ingest almost anything when they are small. 

Why are Youth Suicides increasing?

A good article in the 12/3/19 New York Times stressed the importance of doing something about the marked increase in youth suicides. It stressed that from 2000 to 2007 the suicide rate of youths from ten years to twenty-four increased by 56 percent. That is startling. It is the second leading cause of death in this age group next to car accidents.  It also stated that "since 2011, there's been nearly a 400 percent increase nationally in suicide attempts by self-poisoning." 

What is going on? Are parents getting so busy that they are not recognizing a child in trouble? Perhaps they are in denial or just not paying attention to their children. School, too, are to blame when individuals in trouble are expelled rather than identified and helped. I've seen several articles about schools that send troubled kids to charter schools so their graduation rate stays high, rather than helping the students in trouble.  The charter schools don't seem to be helping these students either because many students do their school work online and no one pays much attention to them. 

Social media is terrible for the many students who spend a great deal of time online and their smartphones are their connection with the outside world. I would not allow any child of mine to constantly be on a smartphone. What about talking to your children, having family dinners, what about chores or doing things together? Has parenting turned into just feeding and clothing children? When I was in private pediatric practice, many kids would pretend to be ill just so they could come and talk to me. I still hear from patients I took care of many years ago. They are desperate for real communication and knowing an adult who cares. One of the reasons I sold my practice was I was either going to open a group home for the many lost kids I saw almost daily, adopt a bunch of them, or find an answer to their loneliness. 

Medical Care for College Students

Many parents have real concerns about letting their child or children go away to college. One of their fears is if the student becomes ill who will look after them. This is a very real concern, but there are ways to ensure your child will be safe. One way is to find an outside physician in the local community.The other is to teach your child what is acceptable and what is not acceptable in college medical care. When my daughter went to University of Colorado, I checked on the credentials of the health service doctors. I also found an outside internist she could see. She needed some medical advice, so made an appointment with the one doctor I  thought was the best. When she went for her appointment, she was told she would see a nurse practitioner. "No", Jennifer said, "My parents are both doctors and they researched Dr,. X. That is the doctor I want to see." Yes, she was taken to see Dr. X. 

One thing that is important to do when a child goes away to college is to check if he or she will be covered by your insurance. Some colleges require you have insurance under their specific health insurance. 

The child of a local doctor called me one day in San Francisco and told his daughter was very ill in Berkeley. She had seen someone at the local student health service who diagnosed tonsillitis and gave the girl antibiotics. She was alone in her dorm on a Friday night and was having a hard time swallowing. I got in my car and drove to the dorm in Berkeley. The girl had enormous tonsils and signs of infectious mononucleosis. I called an ambulance and arranged for her to be admitted to the local hospital. My diagnosis was correct and with good medical care the girl survived the night. Her big tonsils could have created a serious problem.

If a student has a chronic problem, such as asthma or diabetes, the health service should be  notified of this. An outside specialist would be particularly important  in this situation.