On Parenting

Oh, sheesh, I thought, not another screening test that requires dragging kids to the doctor. But that's just what the American Academy of Pediatrics now recommends for many children as young as 2. And it's a fasting cholesterol test, no less—the kind where you don't eat for 14 hours before giving up blood. Imagine a hungry, cranky toddler facing a needle. No fun.

Still, Frank Greer convinced me that we parents should take this new directive seriously. "I think this is pretty important," says Greer, a professor of pediatrics at the University of Wisconsin and chairman of the committee on nutrition for the AAP. "If the kid is overweight, he's definitely at risk for cardiovascular disease." One third of all children are now in the danger zone. Greer says, "This will bring it home to the parents that this kid is at risk if they don't do something about it." The new guidelines also for the first time call for kids to get cholesterol-lowering drugs if needed.

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As a science writer, I'm used to dissecting a medical study in order to figure out if the results are strong enough and reliable enough to use to make decisions about healthcare. I'm no genius; I'm just following the big push in the past decade to test the value of commonly used medical treatments, a trend called "evidence-based medicine." I'm also following the time-honored journalistic practice of obsessively picking at facts, trying to figure out what's most true and what might be useful to people facing life decisions.

I'm a parent, too, so it seemed only natural to start wondering if it would be possible to have "evidence-based parenting," a subject I recently wrote about in an article on eight ways where even the best-intentioned parents go wrong. Why not use the scientific process of randomized clinical trials to test what "treatments" are best when it comes to raising children? I'm short on grandmotherly advice; my grandmothers are long gone, and my mom lives 3,000 miles away. I'd love to know if timeout really works, or if I'm just mucking things up. At the very least, some solid data might help me navigate through the parenting books section on Amazon, which is awash in bestsellers promising to produce a model child by snack time, all with precious little information as to what forms the foundation of that advice. A reality check.

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Over the years I've talked with Lawrence Diller, a behavioral pediatrician in Walnut Creek, Calif., about how society deals with children with attention deficit hyperactivity disorder. He often prescribes Ritalin for children with ADHD, but he also thinks that Ritalin is prescribed too often. He seems like a thoughtful, reasonable guy. So imagine my surprise when I saw an article by Diller in which he asked: "Could it be that America would rather give unruly kids a pill than a swat?" Spanking instead of Ritalin? Wow. So I called him and asked what's up. Excerpts:

Spanking is probably the most controversial issue in child rearing. You treat children with ADHD. What on earth compelled you to write that spanking may not be so bad?
I was provoked. About a year ago, a California assemblywoman from the South Bay put out a proposal to make the spanking of children 3 years old and under criminal. I thought, please, please! The reason it gets to me is that in 30 years of practice as a developmental pediatrician, issues of discipline cause 80 percent of the problems that I see. The families that are struggling with children's behavior are also struggling with spanking. Often, they've taken a vow of abstinence. They figure if spanking is bad, then all forms of conflict are bad, and they hesitate to discipline their children. They wait too long before taking effective action. This doesn't have to be spanking; it could be removal of a toy or imposition of a timeout. I am talking about middle-class, upper-middle-class families that love their kids, that have the resources for their kids.

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Children often miss getting recommended vaccines on schedule, leaving parents and pediatricians scratching their heads as to how to catch up. A new Internet scheduling tool from the federal Centers for Disease Control and Prevention is designed to make that chore a little easier.

It took me about 10 seconds to download the tool on my desktop, then click to bring up the scheduler and type in my daughter's name and birth date. The parent or pediatrician adds in which shots the child already has received, and the scheduling software (designed by a professor and graduate student at Georgia Tech), weighs the complex and often conflicting rules for each immunization, and then cranks out a nifty, printable color-coded chart showing how much space to leave between catch-up doses, as well as regular shots.

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