Concussion Care for Active Children and Adolescents in Fairfield County
Despite taking precautions, active children and adolescents may experience head injuries, need to be evaluated, and appropriate return to school and play guidelines must be provided. Year round, Willows Pediatrics is committed to providing complete, consistent and comprehensive concussion management for our patients. However, with school starting and “Concussion Season” upon us, we want to review the services and expertise Willows Pediatrics can provide to children and adolescents who experience a head injury. Read More
Bacterial meningitis (infection around the spinal cord and brain) or sepsis (infection in the blood stream) is an extremely serious illness. The bacterium Neisseria meningitis (meningococous) is a cause of meningitis or septic shock in adolescents and young adults.
Even with appropriate antibiotics and intensive care, between 10 and 15 percent of people who develop meningococcal disease die, and another 10 to 20 percent suffer complications, such as brain damage or limb loss. Read More
Whether it’s the CMTs, the SATs or a middle school math final, the doctors at Willows Pediatrics know that test-taking can cause anxiety in students. In fact, children who are anxious might even perform below their true abilities when taking a test.
According to Sian Beilock, a cognitive scientist at the University of Chicago and the aother of Choke: What The Secrets Of The Brain Reveal About Getting It Right When You Have To, “when students are anxious, their worries use up some of their working memory, leaving fewer cognitive resources to devote to the test.”
The good news is that test anxiety can be easily relieved. A recent article in Time magazine said that having students spend about 10 minutes prior to taking a test writing about their thoughts and feelings—a practice called expressive writing—proved helpful. Students’ test scores significantly improved after engaging in expressive writing.
Another writing exercise asked students to write briefly about something they valued and to describe why it matters to them. This values-affirmation exercise also improved test performance.
In addition, it’s important for students to learn how to prepare for a test. Instead of just reading over notes, they should practice answering questions in the same way they will be posed on a test. As one psychologist in the Time magazine article said, “You would never just read over your lines and show up on the opening night of the school play, right?” It’s the same thing with test-taking.
Finally, never underestimate the power of deep breathing. Relaxing before a test by focusing on breathing and on tensing then relaxing muscle groups can have a huge effect in reducing test anxiety!
If your student has severe test-taking anxiety, please feel free to talk make an appointment for a behavioral consultation. We can also refer our patients to mental-health professionals when necessary.
Please Note: Even though head lice may be a nuisance, before checking or treating your child it is helpful to remember they don’t cause serious illness or carry any diseases.
What are head lice?
Head lice are tiny insects. They are about 2 mm to 3 mm long. Their bodies are rectangular shaped and usually pale gray in color. Head lice feed on tiny amounts of blood from the scalp. Lice typically survive less than a day if not on a person’s scalp.
When a child has lice, the first thing you may notice is itching, especially in the nape of the neck or behind the ears. If you look, you will probably see nits – these are tiny white eggs and shell casings that are attached to the hair. Nits are oval or teardrop shaped and attach to the hair via a sticky substance that holds them firmly in place. After the eggs hatch, the empty nits remain attached to the hair shaft until they are physically removed. It is also possible to see lice moving on the scalp, but more commonly parents see the nits first. Read More
One of the questions we are asked fairly often here at Willows Pediatrics is, “when is it appropriate to leave my child home alone?” It’s an interesting topic, and one we will address today.
Most states, like Connecticut, do not have laws regarding a minimum age for a child to be left alone. Here’s what our state has to say about it:
Connecticut law does not specify at what age a child may be left home alone. When deciding whether or not to leave a child home alone, a parent should consider the child’s age. Many experts believe that children should be at least 12 years of age before they are allowed to stay home alone. Experts also believe that children should be over the age of 15 before caring for a younger sibling. Read More
Much of what we do at Willows Pediatrics concerns combating disease and maintaining physical health. Yet there is also a large behavioral and emotional component to being a pediatrician, and we do our best to counsel our patients and their parents as they go through developmental stages and experience life’s challenges.
We’ve read studies reporting that 20-30% of students in school are involved in bullying (either as the bully or the victim), making bullying an issue we would like to address.
Bullying is defined differently in different venues, but one accepted definition is that, “a person is bullied when he or she is exposed, repeatedly and over time, to negative actions on the part of one or more other persons, and he or she has difficulty defending himself or herself.” The Westport Public Schools have a detailed bullying policy, which includes punishment for bullying behavior that takes place in school, on school property or at school-sponsored events.
Talking to your child is the most important part of keeping him or her safe. For young children you can play-act a bullying scenario and practice what he or she should say to a bully. It’s important to teach your child to use words like “Please do NOT talk to me like that” and actions like staying calm and knowing when to walk away. It is also important to let your child know that bullying is not his or her fault … and that he or she should not be afraid to ask an adult for help.
For older children, bullying can be more subtle and can also involve Cyberbullying. Since it can be harder to get teens and adolescents to open up, keep alert for changes in your child’s behavior such as frequent headaches, stomachaches, and frequently feeling down. Any of these could be a sign of bullying.
On the flipside, if your child is bullying others, we encourage you to take this very seriously. The AAP has noted that when bullies become adults they are much less successful in their work and family lives, and may even have trouble with the law. It’s best to treat these behaviors when children are young. Some things you can do include:
Willows Reports: Your Child & Social Media
Adolescents and even children are spending more and more time on the Internet. Online activities can provide our kids with entertainment, technical skills and the ability to communicate with others. However, social interaction via the Internet—social media—can sometimes become unhealthy and unsafe, and Willows Pediatrics is here to help advise you of the Internet’s potential hazards.
The American Academy of Pediatrics recently issued a clinical report on “The Impact of Social Media on Children, Adolescents, and Families.” The report concludes that not all social media sites are healthy environments for children and adolescents and that parents should be urged to monitor for potential problems that can include cyberbullying, “Facebook depression,” sexting and exposure to inappropriate content. In addition, young people who spend too much time on the Internet have been found to have problems that include Internet addiction and sleep deprivation.
As pediatricians, we want to remind you that many of these online behaviors are extensions of issues that are affecting our children off-line in the real world, like bullying, popularity and status, depression, social anxiety and sexual development. Facebook, for example, can be difficult for kids already dealing with self-esteem issues, according to Dr. Gwenn O’Keeffe, a Boston-area pediatrician and lead author of new American Academy of Pediatrics social media guidelines. “With in-your-face friends’ tallies, status updates and photos of happy-looking people having great times, Facebook pages can make some kids feel even worse if they think they don’t measure up.”
With these issue in mind, we (and the AAP) advise parents to:
(1) talk to your children and adolescents about their online use;
(2) become better educated about the technologies your kids are using;
(3) develop a family online-use plan that includes family meetings and emphasizes citizenship and healthy behavior; and
(4) supervise online activity through active participation and communication.
Please note that age 13 is the minimum age for most social media sites. Falsifying ages so your child can participate on these sites can open the door to an unhealthy social media interaction, and it also sends mixed messages about lying. Online safety must always be the primary message being emphasized.
As with all aspects of adolescence, it’s important to find the right balance between giving your child freedom and autonomy and also maintaining a certain amount of control. As parents, it is our job to keep our children safe. Just as we would want to meet our child’s friends and their parents or do some background research on a school or summer program, we should take the time to understand the social networking they are involved in … and to monitor for potential problems.
If you have any specific questions in this regard, please let us know. As pediatricians and parents, we are doing our best to keep up to date on these technologies and their benefits, as well as their potential dangers.
Last fall, we blogged about the importance of correctly using car seats and booster seats to keep babies and older children safe while driving. Just a few weeks ago, however, the AAP released new recommendations relating to car safety, and we wanted to share them with you.
The AAP issued two important revised recommendations:
(1) Parents are now advised to keep toddlers in rear-facing car seats until age 2, or until they reach the maximum height and weight for their seat.
(2) The AAP now recommends that children ride in a belt-positioning booster seat until they have reached 4 feet 9 inches tall and are between 8 and 12 years of age.
More detailed information on these guidelines can be found at the AAP’s website.
According to the CDC, in 2008, an average of 4 children ages 14 or younger were killed in motor vehicle crashes every day, and many more were injured. Willows Pediatrics is here to answer questions about car seats or child safety in general. In addition, most of our local communities offer car seat check services.
We hope you will take these new recommendations into consideration when putting your children in the car. Use your best judgment and try to adhere to the weight/height guidelines, even if the age guidelines might not be appropriate for your child. For example, as Dr. Czuzcka notes, “The new 4’9” advice to stay in the back booster seat would mean that my wife’s grandmother would be a in a booster seat until she died in her 80s!” In other words, while these are important safety recommendations, each child is unique and there are times when exceptions may be made. (Feel free to ask us about your own child and your specific concerns at your next appointment.)
Thanks for checking in today … and, please, drive safely!
Heather Buccigross, PA-C
Lately, concussions and head injuries have been making national headlines; the NFL has even changed some of its rules regarding permissible tackles to address the issue. On a more local level, concussions during sports—and the impact they have on the brain—are something we take very seriously here at Willows Pediatric Group.
With that in mind, we offer ImPACT testing, a computer-based testing program specifically designed for the management of sports-related concussion. ImPACT testing is widely used in concussion management and has been implemented in many high school and college athletic programs.
The test measures attention, memory, processing speed, and reaction time. In addition, it asks for the individual taking the test to indicate the presence and level of concussion symptoms, if they exist. One of our Physician’s Assistants, Heather Buccigross, has been specially trained in this area and can help manage and treat children ages 12 years and up. (Some schools perform baseline ImPACT testing on students playing contact sports. Results of the testing can guide when it is safe for an athlete to return to sports. If your child does not have a baseline test done at school, we can perform one-please speak to your physician or PA about scheduling one.)
Recently, Heather spoke to parents and coaches in Fairfield about concussions and sports, and we thought we would share some of the highlights of her speech. If you would like more information, please let us know.
A concussion, known in the medical world as MBTI (mild traumatic brain injury), is a disturbance in brain function that occurs following either a blow to the head, or as a result of the violent shaking of the head. The CDC reports 300,000 sports related concussions occur annually in the U.S, and it is believed that sports concussions are under reported and this does not reflect the true incidence.
If your child participates in sports, here is a list of some of the most common symptoms reported by athletes with head injuries:
- Balance problems or dizziness
- Double or fuzzy vision
- Sensitivity to light or noise
- Feeling sluggish
- Feeling “foggy”
- Change in sleep pattern
- Concentration or memory problems
- Also, here is a list of the most common behaviors others have observed in athletes with head injuries:
- Appears to be dazed or stunned
- Is confused about assignments
- Forgets plays
- Is unsure of game, score, or opponent
- Moves clumsily
- Answers questions slowly
- Loses consciousness (even momentarily)
- Shows behavior or personality change
- Forgets events prior to hit (retrograde amnesia)
- Forgets events after hit (anterograde amnesia)
Even if you don’t think your child was hit in the head, if he or she is experiencing these symptoms, it is best to have him or her evaluated. Something called “Second Impact Syndrome” occurs in athletes with an unreported, prior concussion who return to play before resolution of the symptoms and can cause a very serious increase in intracranial pressure.
This is one of the reasons coaches are encouraged to remove athletes from the game after any head injury and to perform an on-field mental status evaluation. When in doubt, it’s best to keep an athlete out of the game and refer him or her for a full evaluation in a medical office. With proper diagnosis and management, we can maximize recovery after a concussion and take steps to avoid risk from returning to play too soon.
Your child’s safety is very important to us, and the proper management of head injuries is crucial. Again, if you would like to schedule baseline ImPACT testing or have any concerns about your athlete, please contact us.
Take care, and enjoy the spring sports season!
When babies are little, we feed them first thing every morning. Yet somehow, as kids get older and the morning routine gets more rushed, children (and especially teenagers) are leaving the house without breakfast.
Breakfast has been touted for years as the “most important meal of the day,” and there’s actually a lot of truth in that statement. Not only does it get the body’s metabolism up and running in the morning, but it also affects school performance. (And a caffeinated soda or coffee on the way to Staples, Ludlow, Warde or Prep just doesn’t cut it!)
“Study after study shows that kids who eat breakfast function better,” says Dr. Marcie Beth Schneider, a member of the AAP’s Committee on Nutrition, in a recent article entitled The Case for Eating Breakfast. Not only does a morning meal improve behavior, but it also enhances memory and school performance in general.