Rx For Parenting Today

Drastic Special Education Cuts are In Trump's New Budget

When a child needs special education help in school, he or she should also be eligible for services other than from an educational specialist. These services can include physical and occupational therapy, speech therapy, executive function coaching and an aide. Sometimes other services are also needed. However, with Trump's new terrible budget the only people who are going to be helped are the extremely rich top 1%. Four billion dollars are to be cut from special education. This means that many children will struggle even harder just to get a basic education. We are certainly turning into a have and have not nation. Marie Antoinette was reported as saying about the poor before the French revolution, " Just let them eat cake." No wonder the French celebrate Bastille day on July 14th. How anyone can be so insensitive is beyond understanding.

If  a child needs special education services, there are some agencies and organizations who can give parents the names of lawyers who can help. A parent or parents may have to decide whether it costs more to hire an attorney or pay for the services themselves if they can afford to do so. In the Center for Handicapped Children I founded and directed in San Francisco for 23 years, we had a wonderful special education attorney. We survived by applying for grants, received some insurance payments and donations. There are some wonderful groups out there who will help, so a lot of networking is wise, as well as asking a lot of questions. Also, writing letters and calling your Senators and Representatives in Congress can be very helpful.

ER Doctors are not Pediatricians

I am wondering if pediatricians are no longer seeing patients after hours since many parents appear to be going to the ER with a child's problem rather than calling the child's doctor. ER doctors are usually well-trained in emergency procedures and trauma, but many have had little training in common childhood problems. Instead, they may order many unnecessary tests and often come up with a diagnosis that does not fit the child's symptoms. I am hearing more and more from parents in both the U.S. and other parts of the world that a diagnosis has been made based on a single abnormal lab test. Lab tests can be wrong or with the test, CPK, it can be markedly elevated if a child is crying or moving. If a child is seen for a stomach ache, I would first ask about constipation, the child's diet, urinary symptoms, allergies, or a foreign body. I certainly would not think of hepatitis or other major problems. One ER doctor even made the diagnosis of muscular dystrophy on the basis of an elevated CPK. Then if a child is referred to a neurologist who has not had neuromuscular training, the problem can get worse. Genetic tests are not reliable unless they fit the child's symptoms, history and family history. A great deal of emotional pain and grief could be avoided if ER doctors received more pediatric training during their residencies. Sadly, this does not seem to be happening. Even pediatric residents often receive training more focused on abnormal and unusual problems rather than everyday childhood disorders. Constipation and urinary symptoms are common in children and a foreign body can be a a possibility. An X-ray could easily identify the problem. I have an X-ray of a little child's abdomen showing a razor blade. Little children will swallow almost anything or stick foreign objects in every orifice!

Helping Children Develop Good Self-Esteem

Many children and teens spend so much time on social media sites, that their image of themselves and the world around them becomes greatly distorted. The need to be one of the group, wear the correct clothes, and be able to know tech-speak is all important. Somewhere along the way, the usual family functions  become lost. When both parents work outside the home, many kids are left pretty much to themselves. Social media then becomes their world. With all the bullying that goes on in social media, a child's self-esteem can become pretty damaged. If a child has no chores, does nothing to contribute to the family life, their world becomes even more restricted. They expect to be waited on by their parents and also use them as ATM machines. Many kids have no daily chores and are not even expected to keep their own rooms picked up or make their beds. Having daily chores help kids learn how to take care of themselves. Both boys and girls need to know how to make a sandwich, plan a meal, shop, clean, iron and sew. If they don't learn these things, they can  become extremely dependent on others and never really grow up. Chores help develop a good sense of self and good self-esteem. Contributing to the family life is important, because it makes kids feel needed. When I took a history and did a yearly physical examination I always asked what chores the kids were doing. One mother of a teen said "Well, he takes his own shower!" She kept her son very close and as a single parent was devastated when he moved in with a teenage girl. 

Time Outs for Mothers and Fathers

I know many parents use "time-outs" so their children can calm down and think about what they have been doing. I find that parents rarely allow themselves"time-outs" when they can relax, take a deep breath and figure out ways to take better care of themselves. Holidays seem to be particularly stressful, as is entertaining. Having to make everything perfect, look put together, and have beautiful children seems to be the focus of many parents, particularity mothers. One of the things I have always suggested to parents is to remember that they are unique individuals and need time to think and just "be". I certainly had to learn that as mostly a single parent, with first a Navy husband and then a busy doctor husband who was rarely around. 

Eating a healthy diet and getting some daily exercise can help a lot, but do find something you love to do, in addition to home and outside work. It may be art, music, dance, woodwork, or something else, but finding it is important. Having time alone or with a good friend can help a lot and some parents enjoy being part of a mothers' or fathers' group. But taking a least a few hours each week just for you and time with your partner is important. Children fare far better if they have parents who take care of themselves and don't always put the kids first.

Suicide in Teens and Netflix's- 13 Reasons Why

I do not understand why the executives at Netflix would allow the terrible film, 13 Reasons Why, to be made and shown. I  hope parents and the American Academy of Pediatrics protest loudly. Having cared as a pediatrician for teens who tried to commit suicide or thought about it, I am greatly concerned. Does the company have no understanding of the terrible effects the film could have? Teen suicides often occur in clusters and seeing Netflix's film could push a teen over the edge.

Being a teen today is extremely difficult today with all the bullying on social media, plus the need for girls to be thin, beautiful and wear the right clothes. I am so glad I no longer have teenage children and my grandchildren are also adults. It must be so difficult being the  parent of a teen today unless you can be firm, but loving, and let the kids know how important they are to you. Teenagers don't want their parents to be friends, but want them to be parents. That way they feel safe and secure if they know how important they are and also know the rules. If a teen is depressed, hides out in his or her room, or has few friends, some counseling is very much needed. These are all signs of depression. Just talking with a teen can help, but some professional help is also needed. It should not be put off. Suicide hotlines are very important, but some ongoing help from a good psychologist or psychiatrist can save a child's life. 

Protecting Children in Hot Weather

Now that the days are getting hotter and hotter with the Trump administration denying global warming, parents have to be particularly careful with their small children. I now live in a small beach town where tourists are beginning to come in droves. I am amazed at how even small babies are exposed to the hot sun. I see few hats or covering of any kind on most of the children. It is not yet summer, but some days are almost in the 90s. 

Sun screen is not advised by the American Academy of Pediatrics for children under six months of age. Older children should have on hats and sun screen. Some parents even have their children wear sun glasses which is a good idea but difficult for small children to keep on.

Adequate fluids are important for kids in hot weather, but it should be water, not soft drinks. Light clothing is needed and a fussy baby or small child may just be too warm. Some kind of protection for the feet is important because pieces of glass, nails and other sharp objects can cause a visit to the doctor or ER. Playgrounds covered with sand and beaches can contain all kinds of sharp objects, so parents need to be careful where they let their small children play when they are barefoot. Summer can be a relaxing fun time if adequate precautions are taken, but crowded beaches and playgrounds can be a source of trouble unless you are careful.