Category: Behavior

If your high-school-aged teen has struggled getting up for school in the morning, you are not alone.  What has been commonly observed, that adolescents’ sleep cycle shifts as they hit puberty so that adolescents become night owls, have trouble waking up in the morning, and then experience excessive sleepiness during the day – has recently received national attention as a public health issue.

With the benefit of neuroscience we now know that teens aren’t just lazy; their natural sleep cycles make it difficult for them to fall asleep before 11:00 p.m. and wake up before 8:00 a.m.  This is because adolescents’ biological sleep-wake cycle begins to shift two to three hours later at the start of puberty.  This sleep-phase shift affects teenagers around the world, regardless of parenting methods, technology use, or sleep hygiene.  Even adolescents in pre-industrial cultures without cell phones or computers develop the same sleep-cycle delay.

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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.

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:

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Yes, it’s true: children have tantrums. Virtually every parent will, at some point, have to deal with a very unhappy child who shouts, throw things, or crumples to the floor in tears. The doctors at Willows Pediatrics can offer advice on how to help avoid and control tantrums, and reward good behavior. We are happy to answer questions during your child’s physical exams, or for a more in depth assessment we can schedule a behavioral consultation with you to discuss any concerns you might have about your child and his or her behavior.

Tantrums can range from whining and crying to screaming, kicking, hitting, and breath holding. They are most common during the second year of life when toddlers can understand more language than they can express. A toddler’s frustration at being unable to communicate can be a leading cause of tantrums. Other reasons a child might have a tantrum include being tired or hungry, or seeking attention. Read More

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.

Recently Time magazine featured a brief article about early detection of autism. The column correctly noted that because autism’s behavioral symptoms don’t become obvious until about age 3, pediatricians have been challenged to find ways to pick up indicators of the condition at an earlier age.

“But,” as the article stated, “researchers say it may be possible to detect subtle warnings of the developmental disorder as early as 12 months—and all it takes is a simple 24-item questionnaire that parents can complete in the pediatrician’s waiting room.”

Good news for patients at Willows Pediatric Group: we routinely offer the M-CHAT, a screening test like the one referred to above, to children at their 15-month checkup. M-CHAT, which stands for Modified Checklist for Autism in Toddlers, is widely recognized and recommended by the American Academy of Pediatrics. The M-CHAT does not provide a diagnosis, but it can indicate if a child is at risk and should receive further evaluation.

In terms of insurance coverage, we submit this service to your insurance company, but as is with all services provided in this office, we do not know or guarantee that your insurance company will pay for the service. At Willows we strive to provide the best care to your child without regard to reimbursement. If you have any questions about reimbursement please feel free to call us and we will help to guide you through the insurance maze.

At Willows, we are always available to discuss your child’s health and any behavioral issues that may be of concern. Child development is an integral part of child health and we are here to answer any questions you have about your child’s speech and language or social skills. If you have any questions about M-CHAT or other child development issues, please don’t hesitate to contact us!