**Note to broadcast reporters: Children's has a studio where experts can be interviewed remotely. In addition, B-roll is available for sports-injury stories.
Newswise — It's a stressful time of year as children head back to school, and parents face a host of issues dealing with the transition. Children's Hospital Boston has several top experts who can help parents deal with many of the common issues and concerns they may have, as well as some that may go un-noticed. For example, millions of children will experience some level of anxiety as school begins, psychologist William DeFranc, Ph.D., has suggestions for parents on how to prevent or at least minimize such anxiety; substance abuse expert John Knight, M.D., provides tips on how to keep your kids away from drugs, alcohol, and tobacco; audiologist Marilyn Neault, Ph.D., tells us classroom acoustics can affect how children learn; sports medicine experts, Lyle Micheli, M.D. and Martha Murray, M.D. tell us how to prevent injuries in the most active kids as well as why girls are more susceptible to ACL injuries; and experts in infectious diseases explain who should get vaccinated against meningitis. Of course, these topics will also remain timely throughout the school year. Here are a few more details:
BACK TO SCHOOL ANXIETYStudents of any age can experience anxiety around the start of school for a variety of reasons. "Even a slight change such as starting school without a good friend can trigger significant anxiety in kids," according to William DeFranc, Ph.D., staff psychologist, and consultant to a Boston area public school. DeFranc says the best thing parents can do is be pro-active. Ask your children NOW if they are worried about anything as they head to school, rather than wait a week or two. DeFranc says sometimes kids feel unnecessary anxiety over things like missing the school bus or being unable to find new classrooms. He says parents should pay particular attention to their kids' potential anxiety if they are transitioning to a new school, or a new, more stringent academic level. He says a difficult start to the school year can impact the learning process for a substantial length of time.
William De Franc, Ph.D., works with children and families with a number of mood-related and behavior problems particularly those related to school. He devotes half of his time to seeing children at school, and has counseled numerous children with back to school anxiety.
AVOIDING SUBSTANCE ABUSEWhat parent doesn't fear that their child may be tempted to use drugs, alcohol or tobacco? Generally the peer pressure to abuse substances starts at school when parents are out of sight, and often out of mind. John Knight, M.D., director of the Children's Hospital Boston Center for Adolescent Substance Abuse Research, says, "The start of high school is a particularly critical time for parents to be vigilant about drugs and alcohol. This is when kids become mobile, that is, they begin riding in cars creating a very high risk." Knight adds the best thing parents can do is talk to their kids, knowing that if their kids don't complain about such talks, then the parents aren't talking enough. He says it's also important parents know where their kids are each day after school; he suggests calling the homes of friends to make sure an adult is present. "It may seem harsh to the teenagers, but parents can maintain control. That way their kids stay healthy and alive, and they'll thank them for it later." Knight stands by his own zero tolerance rule in his own home, that is, no alcohol until the age of 21, no drugs, and no tobacco.
John Knight, M.D., and his team at Children's created the CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble) test to diagnose substance abuse in 14 to 18 year olds.
HOW MUCH IS TOO MUCH? WHAT PARENTS, COACHES AND ATHLETIC DIRECTORS NEED TO KNOW ABOUT SPORTS TRAINING AND INJURY PREVENTIONKids are starting sports earlier and training harder. Incentives to win are growing, sometimes literally; we've seen trophies almost bigger than the little athletes who've won them! With higher stakes come pressures to perform better by being fitter and more skilled. Usually, this is achieved through repetition, repetition, repetition. Lyle Micheli, MD, a top expert in pediatric sports medicine and director of the Division of Sports Medicine at Children's Hospital Boston, says, "By maximizing safety, it is possible to minimize injuries." In kids' sports programs, fitness and skill development have to be balanced with the need to avoid overtraining; which happens when the athlete is required to do too much physically, mentally, or both. Parents need to be sensitive to changes in performance and attitude that suggest their kids are being pushed too hard. Such changes may be precursors of physical injury. According to Micheli, if parents, coaches and all those involved in overseeing young athletes understand what to do, many sports injuries in children can be prevented. That's why Micheli and his colleagues reach out to educate the public with tips to prevent and treat sport related injuries, especially overuse injuries, such as -- throwing injuries, stress fractures, knee problems, and the unique challenges facing young female athletes
Lyle Micheli, M.D., is co-founder of the world's first sports medicine clinic for children located at Children's Hospital Boston. He is the author of The Sports Medicine Bible, and Sportswise: An Essential Guide for Young Athletes, Parents, and Coaches.
GIRLS, SPORTS AND ACL INJURYSome 100,000 Americans each year suffer ACL injury, or tears to the anterior cruciate ligament of the knee, typically while playing sports like soccer or basketball that involve jumping and pivoting. In teenage girls, who are increasingly playing competitive sports, ACL injuries are epidemic: statistics show that girls are five times more likely than boys to tear the ligament. The reasons for their susceptibility are still a matter of research and debate, but theories center on several possibilities, including anatomical, hormonal, and muscular differences and differences in female athletes' body mechanics. Martha Murray, MD, an orthopedic surgeon at Children's Hospital Boston, says that the best way to combat ACL injury is extended preseason training for young athletes. "Preseason training doesn't require a lot of expensive equipment," she says. A regimen of exercises emphasizing key muscle groups can reduce ACL injuries dramatically and bring girls' risk down to that of boys, she says.
Martha Murray, M.D., and her research team are working to improve ACL repair. Their cutting-edge findings on new and improved techniques for tissue repair will soon be published. QUIET PLEASE! THE IMPORTANCE OF GOOD CLASSROOM ACOUSTICSThe teacher stands in the front of the classroom and projects her voice over the hum of air conditioners, air vents, or in some cases jet engines flying over head. Director of Rehabilitative Audiology at Children's Hospital Boston, Marilyn Neault, Ph.D., says, "We are now learning that classrooms must be constructed or renovated with acoustics in mind. Children must be able to hear the teacher in order to learn properly." In fact studies have shown a connection between ambient noise exposure and reading problems in elementary school students. Neault adds, "It just makes sense that noise will impact learning. The old model of the classroom echo chamber is out, and sound acoustics are in." Neault says it's important that parents ask their children if they have any trouble hearing the teacher in class, and if so take action. She suggests asking that the child's seat be moved, or in some cases having a classroom acoustics expert assess the problem to bring the findings before the school board. In many cases soundproofing material can be added to the classroom to alleviate the problem.
Marilyn Neault, Ph.D., is a top expert in classroom acoustics. She also diagnoses and treats children with hearing impairments.
LUNCHBOX "MAKEOVER" Getting your kids to eat any lunch can be difficult enough, but getting them to eat a healthy lunch can be next to impossible. Jan Hangen, M.S., R.D., clinical nutrition specialist at Children's Hospital Boston, says there are lots of simple ways to entice kids to eat healthfully while at school. "You've got to make the lunch cool, otherwise forget it—they simply won't eat it in front of their friends," says Hangen. So depending on the age of their child, parents should let the kids make some choices. For instance, give them several options for breads, spreads, and veggies. "For elementary school kids, try something creative like peanut butter and banana on a hot dog bun," suggests Hangen. Also, lots of nutritious snacks are important for kids to have on hand—small cheese snacks, yogurt or fresh fruits or veggies are nutritious choices and easy to carry. Hangen says, "Every lunch should have about 4 or 5 items in it and you can't forget about presentation. You have to make sure the lunch box and inside containers are as cool as the lunch itself," insists Hangen. Peer pressure is the major hurdle to overcome at lunch or snack time. If your child is proud of her lunch box and its contents, she will be more likely to open it and eat what's in it.
Jan Hangen, M.S., R.D., has been with the nutrition program at Children's for more than eight years. Prior to that she taught middle and high school, where she experienced first-hand the issues surrounding school lunches.
WALK, DON'T RUN! INJURY PREVENTION DURING SCHOOL COMMUTESBefore sending children to school in new carpools or letting them commute alone by bicycle, there are a few things parents should consider. Motor vehicle crashes are the leading cause of death for children ages 2 to 12 in the United States. But car seats and booster seats"when used and installed correctly"can significantly reduce the risk of injury and death. David Mooney, M.D., director of the Trauma Program at Children's Hospital Boston, says parents should make sure children are using the appropriate car seat or booster seat and not riding in the front seat until they are big enough. Also, parents should have a child passenger safety technician confirm that the seat is properly installed. As for cycling to school, children age 5 to 14 are seen in hospital emergency rooms for bicycling injuries more often than for injuries from any other activity. But many bicycling injuries can be avoided. Bicycle helmets reduce the risk of head injury by as much as 85 percent, and the risk of brain injury by as much as 88 percent.
David Mooney, M.D., researches the causes and outcomes of accidents in children and adolescents, including trauma sustained while skiing, snowboarding, bicycling and driving or riding in cars. The data collected have provided a basis for accident prevention programs.
VACCINATIONS, COLLEGE AND BACCTERIAL MENINGITISHearing bacterial meningitis mentioned on the evening news can strike fear in any parent, especially if their child is in a high risk setting such as a high school or college dorm. Although rare, this illness can be life threatening, and is particularly alarming because it appears suddenly and can progress rapidly even in healthy children and teenagers. New vaccines have helped lower the incidence of bacterial meningitis significantly in the past decade, but it's still important to know the symptoms that should raise concern, especially if meningitis occurs in your community or child's school. Don Goldmann, M.D., senior associate in medicine at Children's Hospital Boston, says it is important to emphasize that children may not display all of the signs and symptoms. Rick Malley, M.D., associate in the Division of Infectious Diseases at Children's Hospital Boston, adds, "It's important that a patient shows up at the hospital quickly or it may be too late in the game." Although there is no way a parent can definitively tell if a child has bacterial meningitis, Goldmann says, "Parents are generally pretty aware of when their child is sick and in need of medical care."
Don Goldmann, M.D., specializes in bacterial infections, clinical effectiveness, and infection control; and Rick Malley, M.D., specializes in bacterial infections, pediatric infectious diseases, and travel and geographic medicine.
Children's Hospital Boston is the nation's premier pediatric medical center. Founded in 1869 as a 20-bed hospital for children, today it is a 347-bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families. More than 100 outpatient specialty clinics are located at Children's. Children's Hospital Boston is the primary pediatric teaching affiliate of Harvard Medical School, home to the world's leading pediatric research enterprise, and the largest provider of health care to the children of Massachusetts. For more information about the hospital and its research visit: http://www.childrenshospital.org/research/.
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