Not a disability? My years of functional illiteracy suggest otherwise. Today’s educational environment exacerbates dyslexic weaknesses. Schools misidentify poor spelling and slow reading as a lack of intelligence; typically diagnose the condition only after students have fallen behind; and too often fail to provide dyslexic students with the audio and video materials that would help them learn. Until these disadvantages are removed, “disability” most accurately describes what young dyslexics confront.

Dr. Charlton’s concern applies to children with other specific learning disabilities as well as dyslexia, the most common one. Recent studies and experiences reveal many unique, important, and useful talents that lead people who learn differently to impressive academic, vocational, and social successes. Diagnosing a disability is not enough for children.  Recognizing a person’s strengths, and not just their weaknesses, and then providing them with the tools to succeed is so important:

I believe that scientific evidence and social observation will continue to show that defining dyslexia based solely on its weaknesses is inaccurate and unjust, and places too grim a burden on young people receiving the diagnosis. A more precise definition of dyslexia would clearly identify the disabilities that go along with it, while recognizing the associated abilities as well. If the dyslexic community could popularize such a definition, then newly diagnosed dyslexics would realize that they, like everyone else, will face their futures with a range of strengths and weaknesses.

Read Blake Charlton’s New York Times article here.

More PediaBlog on learning disabilities here.

If you are worried about how well your child eats, in terms of both quantity as well as quality — and what parent doesn’t? — then Katie Sullivan Morford offers some sound advice:

Wherever your child falls on the spectrum — whether they are fascinated with food or afraid of it — what’s most important is the way in which you respond. If you panic over every bite, they will absorb that anxiety like a sponge. Allowing feeding fears to develop into dinner table battles is not where any of us want to be.

Morford’s first piece of advice is spot on:

1. Get Clear on Who Does What – Consider it your job as the parent to decide what is served for meals and your child’s job to decide what and how much they’re going to eat. Translation: you put the chicken, green salad, and broccoli on the table at six p.m., your child chooses what goes on his plate and how much of it he is hungry for.

And that should be true with every meal and snack.  I would add that parents should try to serve children real (not processed) food as much as possible.  I know how hard that can be nowadays, but “food” that comes in packages have lists of chemicals and added sugars and salts that are not helpful (or healthful) for growing children or adults.

Read more advice at Mom’s Kitchen Handbook.

Some more PediaBlog posts on nutrition and picky eaters here, here, and here.

(Image: xedos4/freedigitalphotos.net)

Is your child an every-day pooper?  Are you sure?  A new study, done at Children’s Hospital of Pittsburgh and published in Pediatrics concludes that constipation is the leading cause of emergency department visits due to abdominal pain:

The most common diagnosis seen was constipation, with almost 20% of all patients and [greater than] 25% of children 5 to 12 years of age receiving this diagnosis.

The good news is that very few children needed to be admitted to the hospital when their diagnosis was constipation.  Unfortunately, some needed intravenous fluids and narcotics to control their pain, and many needed x-ray imaging of their abdomen to make a definitive diagnosis of constipation.  Acute appendicitis — probably the most feared diagnosis — was not common among children showing up in the ED with acute abdominal pain (4%).

So it’s probably a good idea that parents keep an eye on their kids’ stooling (frequency, consistency, amount — the whole poop!), even as they achieve independence with their private bodily functions.  Let your pediatrician know if your child is not having a bowel movement every day, or if they are complaining often of abdominal pain.  Awareness and a good strategy to keep poops regular should prevent many of those middle-of-the-night ED visits for severe belly pain.

(Image: arztsamui/freedigitalphotos.net)

Jessica Tully envisions a day when a life-threatening reaction from the ingestion of peanuts for those who are allergic is a fear of the past:

Moms love it for its simplicity; kids love it for its taste. Peanut butter and jelly sandwiches line the bottom of brown paper bags in cafeterias across the country — it’s a staple of elementary school lunches.

Yet many children are excluded from the universal experience for health reasons. At the moment, there is no treatment for peanut allergies. Managing peanut allergies comes down to avoidance and injectable epinephrine when a life-threatening allergic response begins.

The avoidance method could one day have an alternative, and Pittsburgh would have played a role. The Children’s Hospital of Pittsburgh of UPMC is one of the participating centers of a worldwide study attempting to desensitize participants allergic to peanuts through wearing a patch containing a peanut protein. There are 10 participating centers in the United States, six in France, four in Canada, two in the Netherlands and two in Poland.

Peanut allergy is common enough in children to spook parents and school districts into banning peanuts and peanut butter from school lunchrooms.  It doesn’t take much peanut exposure to trigger reactions that range from vomiting and hives to potentially fatal anaphylaxis.  Other than avoiding peanuts (which often means avoiding all nuts) and being prepared with Benadryl and self-administered,  intramuscular epinephrine (adrenaline) in cases of exposure, there is really nothing else that can be done for peanut-allergic people.  Until now.  By placing a patch containing minute quantities of peanut protein on the skin every day for a year, researchers are hoping to find a safe, simple, and non-invasive way to desensitize those at risk.

Desensitization by administering minute amounts of allergic foods by mouth is also being studied.  Read more about that here and here.

(Image: texnik/Wikimedia.org)

One of my new patients yesterday had gone to, let’s say an “alternative” healthcare provider, for her asthma, at the recommendation of a friend. After telling this person she did not want her neck adjusted or manipulated, it was done anyway. So, of course she still has asthma, and now she has neck pain and a damaged nerve root causing arm weakness. It brings up some interesting questions:1. How is it that certain aspects of healthcare are allowed to say they can do things, yet they have absolutely no proof ? Giant Eagle can’t sell horsemeat and say it’s beef, BestBuy can’t tell me the LCD television is LED…so why can these people tell the public they can do things that have no evidence to back it up?

2. Implied consent gets tossed out the window once a person notes they don’t want a certain treatment….yet this seems to happen over and over….people getting their necks adjusted even after saying they decline that treatment. My sister will attest to that

3. Why aren’t people taking more time to research this stuff on their own? I’ll read Amazon customer reviews for a garden hose nozzle to make sure it’s OK before purchase, yet people will blindly go get a treatment they never researched, or from someone they’ve never checked into.

Done ranting.

PicPic and Patatrac by Loan Torres on Vimeo.

Noah Gasch is a Senior at Seneca Valley High School and chose to create a nutrition and fitness website as his Senior Project.  He is an inspiring young man who takes his personal journey with health and weight loss and encourages others to do the same.  

Check out Noah’s story and help him develop his website here!

To pediatricians, gun control is a public health issue, not a political one. But they’re treading a fine line, and they know it.

The American Academy of Pediatrics has begun a renewed push to try to get Congress to pass gun control measures, sending more than 100 pediatricians to Capitol Hill earlier this month. But others who have taken on the issue over the past decade have a warning for them: they can run afoul of the National Rifle Association and other pro-gun groups that are quick to paint anyone who advocates for gun control as a political extremist.

So what!  Most (but not all) pediatricians are afraid of what people do with guns, and what guns do to people.  But they’re not afraid of the NRA.  No one should be.  The worst that can happen is the NRA will disagree.  They may make arguments that make us uncomfortable — because some of their points may be valid and some are clinically delusional and paranoid.  But if you take the NRA at its word — that its membership is made up of USA-loving, law-abiding citizens — then fearing the NRA is paranoid as well.  It’s not like they are going to disagree with you AND shoot you, right?

Most (but not all) pediatricians believe — as do 90% of surveyed Americans — that Congress should improve laws regarding background checks.  Most pediatricians (not all), like most Americans (not all) want more done:

What the doctors want is an assault weapon ban, mandatory background checks and waiting periods before all firearm purchases, a ban on high-capacity magazines, handgun regulations and requirements for safe firearm storage under federal law.

Most of us also want scientists to be allowed to do evidence-based research regarding gun violence in America.  (Current legislation, supported by the NRA,  limits that.)  We want to be able to discuss gun safety with families at office visits.  (Half-a-dozen states want to prohibit doctors from this act of appropriate anticipatory guidance.)

And then, there’s this:

Founded by the pro-gun-ownership Second Amendment Foundation, DRGO says the the AAP and the American Medical Association are “motivated by deep-seated prejudice against gun owners.” “DRGO’s mission is to expose the poor medical scholarship — and the anti-gun bias behind it — held out as truth by organized medicine and medical journalism,” the group says.

Sorry.  They can’t have it both ways.  You can’t criticize the quality of “medical scholarship” when you prohibit scientific inquiry into the matter.  And you can’t say that doctors “are motivated by a deep-seated prejudice against gun owners” in one breath, while saying: “Guns don’t kill people, people kill people” in the next.  Bias against guns, absolutely.  Prejudiced about crazy or violent people with guns, yes indeed.  Bias against law-abiding citizens who own guns?  Nope.

Pediatricians shouldn’t be afraid of advocating for what is right for the children we care for.  I think parents want their pediatricians to advocate for the best interests of their children, and to be passionate about it.  Even parents who are members of the NRA.

More on The PediaBlog on gun safety here, here, here, here, and here.

A significant number of healthier choices were made when students pre-ordered lunch. When preordering was available, 29.4% of students ordered the healthier lunch entrée compared to 15.3% when no preordering took place. When ordering in the lunch line, hunger mixed with the aromas and sight of unhealthy foods won out in spontaneous food decisions: healthy entrée selection was reduced by 48% and less healthy entrée choices increased by 21%.

For some reason, Americans got it into their heads a long time ago that we needed to provide schoolchildren with a “hot” lunch at school.  As a result, they are served hot meals that are highly processed and densely caloric, very little of it looking like “real” food.  We also got it in our heads that kids needed to be offered dessert with lunch, and that simply offering milk or water as a beverage choice was insufficient without also offering calorically dense juices and nutritionally empty soft drinks.

The food doesn’t need to be hot!  The food does need to be nutritionally complete and healthy.  Our kids don’t need that many choices, either!  The choice they should be making is whether to pack their lunches from home or buy at school.  The choices the schools should be offering is an apple for dessert, or nothing; water or milk to drink, or nothing.

Pre-ordering food in the morning (or even better, online from home the night before, where parents can participate in the decision-making) is a great idea.  Unless we’re asking kids to make the same decisions about the same old same old.