Entries for September 2009

Parents of teenagers are justly worried about how to keep teenagers safe behind the wheel: Teenagers are the most dangerous drivers on the road, and car crashes are the leading cause of death among teens. But it turns out there's one simple way to keep kids safer: Don't give teens a car they consider their own.

Teenagers who reported that they were the main person driving a vehicle, rather than sharing it with other family members, were more than twice as likely to be involved in a recent crash. One in four drivers with primary access to a car had had an accident while driving in the past year, compared with 1 in 10 for shared access. That means 25 percent of the kids driving their "own" cars had at least one accident in the past year! The teens with their own car also were more likely to use a cellphone while driving (78 percent, compared with 55 percent) and to speed (70 percent vs. 54 percent). These figures come from a survey of 2,167 teenagers by researchers at Children's Hospital of Philadelphia. It is said to be the first survey to look at whether having primary access to a car affects safety for teenage drivers. It was published online today in Pediatrics.

Still confused about what's going to happen with swine flu shots next month? You're not alone. The federal government and individual states still haven't told us how they're going to distribute the vaccine, or when. Yesterday's chirpy press release from the National Institute for Allergy and Infectious Diseases made it easy to think that all children will need just one swine flu immunization, but that's not true. The younger a child is, the less well his or her immune system responded to the swine flu vaccine in clinical trials. So children under age 10 will need two doses of swine flu vaccine, one month apart, according to the NIAID itself.

You'd have a hard time figuring that out from the press release, which quoted NIAID director Anthony Fauci saying, "This is very encouraging news." Only if your children are over age 10, Tony.

Who knew that music can be hazardous to your health? It is when it's loud music, whether it's Metallica or the Jonas Brothers. And I'm forever turning down the music in the car, while my 6-year-old and my husband are cranking it back up. (Trust me, listening to "A Pizza the Size of the Sun" at heavy metal levels is no picnic.)

So I called Pam Mason, a certified audiologist who works often with musicians who want to protect their hearing. "Noise is pollution," Mason says. "Children don't often think that by putting themselves into a noisy environment, they're putting their hearing in danger." And once hearing is lost, it's lost for life.

Spanking is a huge hot-button issue for parents. Many psychologists say that spanking or any other physical discipline harms children and their relationship with their parents. But quite a few parents disagree, and some experts do, too. Lawrence Diller, a behavioral pediatrician in Walnut Creek, Calif., and author of The Last Normal Child, even argues that more parents should consider spanking to speed behavior improvements in young children.

I'm in the no-spanking camp myself, figuring I can't teach children that hitting is bad if I'm doing it myself. But that doesn't mean I've never given a balky toddler a swat on the fanny. Now that my daughter is in first grade, I wouldn't dream of smacking her. My challenges come more in trying to figure out how to reward appropriate behavior.

So I was fascinated by new research in the journal Child Development that followed a total of about 750 children from ages 5 to 16 and looked at how parents' choices of discipline in childhood were tied to teenage behavior. Researchers found that the children whose parents put aside physical discipline over the years demonstrated much less antisocial behavior than those whose parents continued to use harsh or moderate physical discipline. The physically disciplined children also had much poorer relationships with their parents. Of course, there's no evidence that the lack of spanking caused the improved behavior. It could be, for instance, that problem kids are more likely to be spanked and also more likely to be problem teens. "More difficult children elicit more punitive behavior in their parents," says Jennifer Lansford, who led the study. Researchers tried to factor that out by adjusting the results if children were considered badly behaved as 5-year-olds, as well as the family's socioeconomic status. Inherited behavior traits could also be a factor, says Lansford, a developmental psychologist and associate research professor at Duke University's Center for Child and Family Policy.

I would never text while driving. Except at stoplights, that is, or maybe just to take a quick peek at E-mail. Like many parents, I'm a hypocrite about this issue; I lecture my daughter about the dangers of any mobile-phone use while driving and snatch the BlackBerry out of my husband's hands when he's behind the wheel. Time to shape up, Mommy. One of the best ways to enforce no-texting-while-driving in your family is to forgo the practice yourself.

Easier said than done, I know. So I like the new Rules of the Road for Texting from Common Sense Media, a nonprofit that lobbies for safer media use. It's a practical way to start thinking about getting your family's texting-while-driving habit under control:

I don’t know about you, but I’m tired of worrying about swine flu. Although it’s cutting a swath through college campuses and schools, with the death of a 20-year-old student from H1N1 reported at Cornell University, so far most of the cases have been pretty mild. If all goes well with clinical trials, a vaccine against H1N1 flu will be available by mid-October. Today is the American Public Health Association’s annual Get Ready Day, when it urges families to prep for disaster, be that pandemic flu or a winter storm.

And as an antidote to all that worry and preparation, we can vote for our favorite swine flu prevention videos on YouTube. Are you going with the seriously yucky toothbrush? It’s used to curry-comb a cat! Or the rapping doctor? Yes, it’s time for some H1N1 fun!

I was thrilled to read the headline in today’s Washington Post: “Swine Flu Vaccine Works With One Shot.” Woohoo! I had just blogged about what a logistical nightmare it’s going to be for parents and pediatricians to get children vaccinated against 2 strains of flu virus this fall: the regular seasonal flu, and the new H1N1 swine flu, which is hitting children and teens hard. Wouldn’t it be great if children could get just one shot instead?

Alas, I read the fine print. The new clinical trial that found an immune response to swine flu after just one shot was conducted with adults. (Updated information about the swine flu vaccine trials can be found at flu.gov.) About 600 children and teenagers are participating in a nationwide test of the swine flu vaccine that started in August, but results aren’t out yet. Researchers are trying to figure out what dose will work best for children, and if there are dangerous side effects. It will also help determine if children will need two doses to gain immunity. But the presumption is that they will, since that’s been the case the first time children get a seasonal flu vaccine. So no news yet.

This may go down in history as the most confusing flu season ever, given that a vaccine for the new H1N1 swine flu isn’t yet available, but the plain old seasonal flu vaccine is. Parents are being told that almost all children, from 6-month-old babies up to 18-year-olds, should be vaccinated against both viruses. Since a child who has never had a flu shot should have two doses, that means four doses of vaccine for some kids, should the protection against H1N1 become available.

Talk about a recipe for pandemonium at the pediatrician’s office! "It’s not going to be pretty,” David Tayloe, president of the American Academy of Pediatrics, said today at a briefing by federal health officials and other medical big guns, organized by the National Foundation for Infectious Diseases. “But if we can get the kids in now for their seasonal vaccine, then we can tackle H1N1.”

If your teenager's having a hard time with friendships and isn't getting with the program at school, it might not just be attitude: It could be the lingering effect of depression. That's the heads-up I got from Lisa Jaycox, a psychologist with the Rand Corp., a nonprofit think tank, who studies how depression affects teens and what families decide to do about it.

"Depression isn't always just a passing phase," Jaycox says. Instead, she says, it can sabotage academic performance, social life, and family relationships, "not just when they're down but even next semester and next school year."

Swine flu has hit college campuses, with 165 schools reporting 1,640 new cases of flulike illnesses last week, according to a nifty new system that will help parents stay up to speed on the situation at their children's schools. It's just one of a growing number of tools designed to keep us civilians in the know on the pandemic flu outbreak, which public health officials expect to hit children and young adults hardest.

Click on the American College Health Association's new Pandemic Influenza Surveillance Report, and you'll find that Georgia and Washington state reported the most flulike illnesses on campus, with 283 reported at Georgia schools and 233 in Washington. The association also provides a helpful chart of attack rates, which tracks what percentage of students have become ill. This week, Washington has a higher attack rate than Georgia, even though Georgia has more cases. Of course, many of these cases will turn out to be caused by something other than the H1N1 virus. But over time, the numbers should give public health officials—and parents—a good idea of where the flu is hitting hardest. If I had a child in college in Washington or Georgia, I'd sure as heck want to know now how the school plans to reduce the risk of infection and take care of sick students. I'd also want my child to know the symptoms of swine flu (sudden onset of fever and cough) and to call home if they even get as much as a sniffle. The ACHA report will be updated every Tuesday, and I hope an RSS feed or E-mail update will be added to the report to make it supereasy to stay up to date.

What a delightful surprise I had this morning. I opened my E-mail and found that the OnParenting blog had been named one of "100 Pediatric Health Blogs Every Mom Should Read" by the Nurse Practitioner Schools Web site. Thank you, nurse practitioners! Of course, if every mom read 100 pediatric health blogs she'd have no time to be a mom, let alone do laundry, cure cancer, and bring peace to the Middle East. But this list is chock-full of terrific blogs of all flavors and is well worth a browse, whether you're looking for information on a particular topic or just for a good excuse to procrastinate a bit. It's educational, really! From that rich list, here are a few of my personal favorites:

For a blog by a doctor, check out drgreene.com, from pediatrician Alan Greene, a dad of four. He's so friendly and down-to-earth that when I see him in person, I feel like we're sitting in the backyard talking kid stuff over a beer. He was one of the first doctors to blog, way back in the 1990s, and he's deeply interested in how new forms of communications and technology can improve healthcare.