Since we now understand how ear infections occur (see Ear Infections – Part I), it’s time to deal with the child who seems to get repeated ear infections. Ear infections, particularly the middle ear type, are responsible for providers ordering more prescription antibiotics than any other childhood disease.
There are a certain number of children who just seem to get an outer ear infection (otitis externa) every time they get their ears under water, usually during the warmer months of the year. There are even some who get this when they do not get their ears under water, but usually these episodes are also in the warmer months. I spoke about the treatment of the sudden or acute ear infection, but what to do about the repeated episodes. The best answer to this is using either a prescription medication or better yet, one not costing you anything at all. Mix ½ to ½ mixture of white vinegar and rubbing alcohol and place a couple drops of this into your child’s ear as soon as they get out of the pool or lake or ocean and try to limit the time those ears remain submerged. This has a way of drying out the external ear canal and helping to change the acid content of the eardrum. Ear plugs may be effective under certain circumstances but in general if you force a plug into the ear it may just irritate the skin which is exactly what we wish to avoid.
Middle ear infections (otitis media) are a different matter entirely. Remember that these are primarily due to a blockage in the normal valve system of your middle ear, with resultant pressure, fluid and infectious results. (Please refer back to part I if this is confusing). These changes happen in a progression that can occur suddenly or can develop over time.
While the obvious answer would be to use a “cold medicine” early on in the process this does not seem to influence the course of events as outlined, when looked at in controlled studies. The other end of the spectrum for treating the occurrence of multiple recurrent middle ear infections is to alter the normal anatomy in such a way as to prevent buildup of pressure in that small space which can then lead to fluid accumulation and bacterial secondary infection. This is accomplished through the use of very small tubes that can be surgically inserted through the eardrum and will serve to equalize the pressure on both sides of the eardrum. The system will calm down and the incidence of new infections will drop tremendously.
But that is a surgical procedure under some type of anesthesia, and even with tubes in the proper place, there can still be fluid production which then drains out of the ear chronically. Also, the mere act of making a hole in the eardrum through which a tube can be put in place, can slightly damage and scar that eardrum. Depending on the type of tube implanted in the eardrum, it usually comes out by itself after six to twelve months and the eardrum heals. Occasionally, the ear drum fails to heal completely and there is a perforation that might need to be surgically repaired in the future.
We treat middle ear infections for one of several reasons: to control the pain, to prevent any further extension of the infection into sensitive areas, and to preserve speech and hearing in your child.
Fortunately there are other approaches to the treatment of recurrent middle ear infections. Each significant ear infection should recognized and treated appropriately and the fluid buildup behind the eardrum monitored for resolution.
Fluid constantly in touch with the ear drum will dampen the usual vibrations and dull the hearing while it is there. Hearing testing can be run routinely to follow any changes in hearing.
All types of medications have been tried at one time or another: preventative doses of antibiotics have and still are being used for several weeks to months in an effort to prevent the bacterial infections, but the increasing number of bacteria becoming resistant to common antibiotics have caused physicians to re –think the use of long term medication.
Cortisone preparations by mouth have been tried to help with the middle ear inflammation, with varying results.
Occasionally, when all forms of treatment fail it is up to the ENT surgeon to place those tubes and let the middle ear system calm down.
So, there are many things to consider in finding a course of action for your child with recurrent ear infections and your Doctor will be familiar with each of the methods and can discuss them with you.
When was the last time you checked your child’s credit report? According to a recent report on NBC’s TODAY Investigates, identity thieves are stealing baby social security numbers and racking up thousands of dollars of debt without anyone knowing. In fact, there are thousands of victims nationwide – and most don’t get discovered for years.
How is this possible? There is a problem with our current system of using social security numbers (SSNs) as identification
- First – the way the number is generated. You probably don’t know this but your social security number is basically a code, whereby the first 3 digits indicate the state of birth, and the last 6 stand for an approximate date of birth. With very little effort, thieves can predict social security numbers – even before a child is born.
- Next – there is a flaw in the way the number is used.
- When someone applies for a loan, banks typically only check the social security number to see if the credit is good. Most banks do not even check if the name on the loan application matches the social security number because there is a fee to do this.
- According to a 2011 Carnegie Mellon CyLab report, there is also currently no process for organizations, like an employer or creditor, to check what name and birth date is officially attached to a SSN. As long as an identity thief has a SSN with a clean history, the thief can attach any name and date of birth to it.
- Finally, because many commercial and public sector entities do not treat Social Security numbers as unique identifiers. It is possible for one SSN to appear on multiple credit files, employment reports, criminal history – all mapped to different names.
How big a problem is this? Really big. In fact:
- According to the CyLab report – out of 40,000 children, approximately 4,300 had someone else using their social security number. This is >10%!
- The largest fraud was for $725,000
- The youngest known victim was 5 months old.
What are the consequences? According to TransUnion, one of the 3 national credit reporting companies:
- Identity theft will affect your child’s credit and employment history if the thieves obtain credit cards or even get jobs.
- If the thieves are arrested for other crimes, those crimes will go on your child’s record.
Things to watch for:
- Your child begins to receive suspicious mail, like pre-approved credit cards and other financial offers normally sent to adults, in his/her own name.
- You try to open a financial account for him/her but find one already exists, or the application is denied because of a poor credit history.
- A credit report already exists in his/her name. If the child has one, he/she probably has been targeted already, since only an application for credit starts a report.
What can you do?
As of June 25th 2011, new SSN’s will be more randomized – which will make this more difficult for identity thieves – but if your child already has one, their number may already have been compromised
- If you’ve seen any of the signs, it may be a good idea to run a credit check. Note – you cannot use standard free credit check reporting systems to run a check on a child…however, TransUnion has a great site that can help guide you through the process
- If you see signs that your child’s identity has been stolen, immediately put a freeze on your child’s credit. (State by state information on this can be found here)
- The Identity Theft Resource Center, for free, will assist parents in disputing all erroneous entries on credit reports. The agency will also help parents address the possibility that an imposter is using their child’s identity to obtain a driver’s license or escape conviction records or child support payments.
- Finally, if you suspect your child’s identity has been stolen, call the police and the Federal Trade Commission which oversees and polices this type of activity. An FTC guide to disputing errors can be found here.
Keeping our eyes open today, will hopefully prevent heartache down the line.
- NBC TODAY Investigates report: Identity Thieves Now Targeting Babies
- 2011 Carnegie Mellon CyLab Report: Child Identity Theft
- TransUnion: Child Identity Theft page
- Federal Trade Commission: How to Dispute Credit Report Errors
Back in the day, my biggest distractions in class were note-passing and idle doodling. But today, 66 percent of kids ages 8 to 18 use cell phones, and 76 percent have iPods or other MP3 players, according to the Kaiser Family Foundation. On top of that, most schools offer some amount of Internet access. That’s why almost all schools today require kids and parents to sign a document that didn’t even exist for our generation: Internet Acceptable Use Policy.
The Internet Acceptable Use Policy explains the school’s philosophy on Internet use and the rules regarding online behavior. It also gives an overview of the consequences of violation and a list of students’ and staff members’ rights. An Acceptable Use Policy should both recognize students’ right to benefit from technology and protect them from harm.
Parents are an important part, says Doris Stephen, education programs assistant in the Education Technology Office of the California Department of Education: “They need to know what their children are being taught in school and how they are going to use the Internet. They need to know that the children are doing it in a safe manner.”
Here’s what to do if your child’s school district doesn’t require your signature, or if you’re a little hazy about what you signed at the beginning of the year.
Get a copy of the policy
Check the school’s website. Many schools post their Acceptable Use Policies online so parents and kids can easily reference them. If it’s not there, call the school and request a copy or ask your child to bring one home.
Talk about the policy. Discuss scenarios that might seem innocuous but are actually prohibited. For example, does your child’s school prohibit using Internet resources to lobby for a political candidate? Can kids visit file-sharing sites and download music? Are there any penalties for using profanity in email sent via the school’s computers? Help your child read between the lines too: If the policy prohibits harassment, ask, “What constitutes harassment?” Talk about your child’s typical Internet use at home and ask whether these things are prohibited at school.
Most important, discuss the consequences of violating the policy. Most policies include penalties that range from warnings and account suspension to expulsion and legal action.
Because Acceptable Use Policies include a lot of language about what not to do, they can seem to imply that kids aren’t to be trusted. But a good policy is centered on the educational value of the Internet and keeps free speech in mind. So don’t just discuss the things your child shouldn’t do; talk about all the useful ways they can use the school’s technology to get more out of class.
Post it somewhere accessible
Whether it’s on the fridge or saved as a shared document in your Google Docs accounts, keep the policy on hand. If it’s top of mind, your child may be more likely to follow it and avoid getting into trouble that could affect his — or someone else’s — future.
You may think your kids are ready for organized sports, especially when so many of their peers are signing up. But many young kids don’t develop the physical, emotional, or mental skills it takes to compete until second or third grade.
Kids who start too soon may end up feeling frustrated or humiliated, or suffering physical injuries. Most experts agree that 6 is the youngest age to start playing organized sports, and many recommend waiting until your kids are 8. But kids develop at different times, so readiness depends more on their size, skill and maturity than on age.
To make sure you’re not jumping the gun, look for the following signs before considering sports for your kids. They will be ready for sports when they:
- Show an interest in sports. There’s no reason to push your kids into team sports if they have no desire to play. In fact, forcing them can make them resent all organized sports. So if your kids aren’t ready yet, let them run around outside with their friends; it will give them the exercise they need until they find sports they’d like to try.
- Are strong and skilled. If your kids are smaller and weaker than their peers, or if they can’t throw, bat or catch very well, they’ll be at a huge disadvantage. They’ll also be more likely to get injured. Before you send them onto the field to compete with kids who are naturally more able, spend another year practicing with them in the backyard so they can build their physical strength and skill.
- Can understand and follow directions. Processing and acting on information from multiple sources – coaches, parents, teammates and bossy siblings – is a real challenge for many young kids. Most won’t have that ability until they are 6 or 7, at the earliest.
- Focus on an activity for two hours. When you see young kids picking weeds or staring up at the clouds during practice, you know they don’t have the attention span to stick with an entire game. The ability to sustain focus comes with age, not experience, so it’s better to wait until your kids mature.
- Get the concept of teamwork and taking turns. Playing organized sports means sharing the spotlight and giving everyone their turn at bat. Hogging the ball – and everyone’s time and attention – won’t make your kids very popular.
- Get along with other kids. If your kids have trouble navigating social situations or working in a group at school, they’ll have an especially tough time with the dynamics and competitive nature of a team. Give them more time to build up those skills off the field.
- Can handle losing without losing it. Winning is easy; losing can be devastating. If your kids tend to cry or get angry when they lose at sports or board games at home, they are probably not ready for a graceful defeat in public.
Organized sports are a great learning experience and an excellent way for kids to stay fit – but they’re also supposed to be fun. Your kids will enjoy themselves more when they’re ready for it.
We first heard about “Sensory Friendly Movie Screenings” a little over a year ago, in a post by our Special-Needs Parenting Expert Rosie Reeves. For those of you not familiar with this fantastic program, AMC Entertainment (AMC) and the Autism Society have teamed up to bring families affected by autism and other disabilities a special opportunity to enjoy their favorite “family-friendly” films in a safe and accepting environment.
The movie auditoriums will have their lights turned up and the sound turned down. Families will be able to bring in snacks to match their child’s dietary needs (i.e. gluten-free, casein-free, etc.), and it’s totally acceptable to get up and dance, walk, shout, talk to each other…and even sing.
To borrow from Rosie’s post: “It can be challenging enough to bring a child to a movie theater – they are dark, the sound is very loud, there are tempting stairs and rails and they are expected to sit still and stay quiet. When a child has special needs all these elements and many others can prove too daunting to even attempt such an outing. And yet getting out, being with the community and sharing in an experience with an audience can be invaluable for just such children – and their caregivers, too”.
Coming July 2nd: Cars 2
Editor’s note: Kung-Fu Panda 2 is rated PG for sequences of martial arts action and mild violence. Please check the IMDB Parent’s Guide for a more detailed description to determine if this movie is right for you and your child.