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How to Make Back to School Feel Safe? a Pediatrician Perspective

Last updated on October 14th, 2018 at 08:24 pm

It is certainly understandable, given the amount of press and official and unofficial commentary through law enforcement, social media discussions, and easily seen news programs, that fear should arise in the minds of both children attending school and parents of those children about their safety in what has traditionally been a bastion of safety, their schools.

This publicly available information, easily seen by children, has always been centered around the person responsible for the shootings occurring in schools and other public places. The information made available in the news media is repeated ad infinitum after the event occurs and only later is there information about the victims.

This public, news-related, policy needs to be changed to include minimal information, if any, about the perpetrator and immediate coverage about the victims and their families.

The American Academy of Pediatrics refers to the situation surrounding school shootings as “a public health threat to children” and has shared their perspective on the general health of the Pediatric population with such statements as: “We can start by working to advance meaningful legislation that keeps children safe….We also call for stronger background checks, solutions addressing firearm trafficking, and encourage safe firearm storage….children and their families (should) have access to appropriate mental health services.”

As a Pediatrician, I absolutely agree with their statements.

This is an issue that should be taken up by the public as a whole, through local involvement in both federal and local government. This is only one method by which fear is spread. The fact that domestic terrorism has occurred at all promotes the initial terror also seen repeatedly on television and written forms of news media in all its gory details. Your child is exposed to this every couple of months in our society. It’s no wonder there is some fear of the school environment.

To balance my professional opinion with my personal experience, I have three grandchildren who live in Connecticut, not far from Newtown where the Sandy Hook killings took place. I am probably biased, but I consider them to be stable, “normal” children, with good, close ties to their parents compared to the general population.

Although there has been no clinical PTSD, they have certainly become more aware and somewhat fearful of their surroundings. I consider the awareness to be a positive result of this episode, as every person in America has become more aware of their surroundings since 9/11. A fact that has possibly contributed to the absence of further attacks of this magnitude having taken place. They have also become much more tolerant and even thankful for the occasional practice drills in their school.

What can be done to decrease and hopefully eliminate such events and fearsome coverage of those events?

  • The ultimate answer to this is involvement by you and your children in local, civic activities. The Federal government can only do so much and every time it tries there is resistance from many sides. The real power lies in local and state governments who can exert a lot of power if supported by their constituency, something that changed in this respect after 9/11.
  • Get involved. There is much improvement possible at the local and state levels, but it must arise from the grassroots. To start, sale and ownership of assault rifles and large magazines capable of carrying large volumes of ammunition should be limited. There is always pushback on this and officials are slow to act as a result. We must push such acts, as statistics do not necessarily show either side to be correct on this issue.
  • You must answer your children’s questions honestly in an age-appropriate format and up-play the quality and determination of those people in their schools who are there to protect them from harm: from teachers to any law enforcement officers in place. If your child can grasp the concept of statistics, you might point out to them that 56 million students attend US elementary and secondary schools, and only a relative handful (159, less than 3/1000 of one percent) have been affected by such school tragedies, and many of these involved single episodes. Try to relate those numbers to things in their personal lives that at that statistical rate they clearly would not be involved.

  • In the extreme, especially if such events have occurred near to your home and school districts, your child might require a short period of counseling. Although child psychiatry services are not readily available in many smaller communities, a parent can ask his/her Pediatrician, the local medical society or the nearest large children’s medical center for such references.

Understand their fear and as parents there will be no trouble empathizing 

The bottom line is, as always, good communication with your children is of paramount importance! Never stop talking to your children, keep all the channels open, and you will be greatly rewarded as your children grow to maturity.

How To Teach Kids Storytelling To Improve Their Friendships

Last updated on September 27th, 2018 at 02:09 pm

Thinking, speaking or acting impulsively without planning or thinking things out poses social challenges for children. We can help children better manage their impulsive thoughts, words, and actions by using a storytelling activity we call The Thought Bubble Technique. In this visual conversation activity, we help children think, write, draw, and talk about what characters in a story might be thinking, feeling, saying or doing. The Thought Bubble Technique encourages children to use their imaginations while building their thinking skills.

Here is how you do it…

Open a book with vivid imagery such as a Dr. Seuss book. Let your child or student turn the pages until he discovers a page he finds interesting. Tell your child, “We’re going to use our imaginations. We’re going to imagine a thought bubble is over the head of each of the characters on the page. Then we’re going to imagine what they might be thinking.”

By looking at the images on the page ask your child to make up a story about what’s happening on the page. What are the characters thinking? What are the characters saying? What are the characters doing? How are the characters feeling?

Help the child “THINK OUT” how is the thought, feeling or action helpful or not helpful? How might the other characters respond? How can the characters shift their thoughts, words, feeling or actions so that each story has a happier ending?

The key is to use the creative exploration of images to help the child thoughtfully reflect on how words, thoughts, feelings, and actions are prosocial, facilitating relationships or challenging causing others to feel uncomfortable, unhappy or withdrawn. Use your own creative license, adapt the “Cognitive Conversation” with the child to help him or her see things in a new way. Thoughtful exploration leads to the mindful development of new thinking skills.


70-play-hi-res-150x197Written for teachers, educators, and clinicians whose work involves playing, talking or teaching children who would benefit from better executive function and social-emotional learning skills, 70 Play Activities incorporates over 100 research studies into printable worksheets, handouts, and guided scripts with step-by-step directions, to empower children to learn and behave better. “With 70 Play Activities we aim to improve the trajectory of children’s learning by integrating the newest neuroscience with activities children love!” With over 70 activities designed to improve thinking, self-regulation, learning and behavior, your tool-kit will be full and your creative brain will be inspired to craft your own meaningful exercises. 70 Play Activities is available at

How To Prepare When You Are Expecting Healthy Twins

Last updated on September 27th, 2018 at 02:09 pm

If you’re pregnant with more than one baby, a healthy diet and lifestyle will help you cope with your pregnancy and give your babies the best start in life.

The advice for keeping healthy in pregnancy is similar whether you’re expecting twins, triplets or just one baby. Eat well, take gentle exercise, drink lots of fluid and, if you feel stressed, get support from friends and family, or talk to your midwife. It’s also important to attend all your antenatal (*prenatal) appointments so your maternity team can keep a close eye on you and your babies.

Healthy eating with a twin pregnancy

Expecting two babies doesn’t mean you have to eat significantly more than during a single pregnancy. However, it’s normal to put on more weight than a woman who is only carrying one baby.

Aim to eat a healthy, balanced diet that includes plenty of fruit, vegetables and wholegrains. These will help you avoid constipation and provide a range of vitamins and minerals.

You also need some protein foods, such as lean red meat, well-cooked eggs, and nuts and seeds. Dairy foods such as milk, cheese and yoghurt are important for calcium.

If you feel peckish, it’s best to fill up on healthy snacks, such as fresh fruit, low-fat yoghurt or sandwiches filled with grated cheese, lean ham or mashed tuna. Try to avoid foods with empty calories, such as sugary snacks, crisps and fizzy drinks.

You’re more at risk from anaemia during a twin pregnancy. You’ll be offered extra blood tests and may be offered iron supplements. Good sources of iron include lean red meat, leafy green vegetables, beans and fortified breakfast cereals.

Read more about healthy eating in pregnancy and foods to avoid in pregnancy.

Staying active with a twin pregnancy

Gentle exercise will help you tone your muscles and protect you from aches and pains. Exercises that won’t overstress your joints are recommended, such as swimming, walking, antenatal yoga, pilates and tai chi.

Doing pelvic floor exercises regularly will help your pelvic floor get back to normal after your babies are born. Even if you’ve had a caesarean birth, you pelvic muscles can still be weak from your pregnancy.

Read more on how to keep active in pregnancy.

Common pregnancy health worries with twins

  • It’s not necessarily true that you will have more morning sickness if you’re expecting twins.
    • Although some women expecting twins or more report lots of morning sickness, others don’t experience any.
    • If you do experience morning sickness, you may find it helps to eat little and often, and to avoid getting hungry.
  • You’re more likely to experience piles and varicose veins during a multiple pregnancy, because of the weight of your babies pressing on the blood vessels of the pelvic area.
  • Pressure from your womb (uterus) pushing on your stomach may make you more prone to heartburn and indigestion as well.
  • You may also find you have backache and pelvic pain, particularly later in your pregnancy. Speak to your midwife, who may refer you to an obstetric physiotherapist.
  • If you register with Tamba** on their website, you can download their Healthy Multiple Pregnancy Guide for free.

For more information on how to have a healthy pregnancy, feel free to read:

Editor’s Note:  * Clarification Provided for our U.S. Readers

**Resources Available Outside the UK

  • Marvelous Multiples: provides links to support organizations throughout the world for expecting parents and families of multiple births.

NHS Choices logo



How to Keep Kids From Getting Bit Helping with Dog Training

Last updated on September 16th, 2018 at 02:57 pm

As a professional dog trainer for many years, there are many things I have had to learn to do differently when working with the dogs around children versus what I would normally do.

Things that I would not typically think twice about, I must when kids are around…. Because they tend to copy everything – and some things may be quite dangerous for them to copy without the know-how and quick reflexes.

Some commands are simple to teach, and for those, the children can be around without encountering any issues, for example:


All of those commands are simply taught using some treats and simple leash work.  Not only are they simple – they’re predominately safe – meaning if your child is practicing this with the pup later on, and he or she hasn’t mastered the art of “sitting”, it is highly unlikely (unless it a 180 lb mastiff and sits on your 3 year old) that there’s a hospital trip in your future

There are however, other commands that I would highly suggest teaching the dog when the children are NOT around, and show them the after-results – such as:

  1. Corrections of negative behaviors
  2. Drop It
  3. Leave It

There are very specific reasons these aren’t taught around children, and I will explain these in detail below.  However, the one reason above all that I want to emphasize is that we train our dogs because it keeps our whole family safe, including our pup. The 3 commands I mention above (correcting negative behaviors, Drop it and Leave it), while not particularly complicated, have the potential to endanger your child if they attempt them on their own (ranging from simple emotional distress to a bite).

Correcting negative behaviors

I typically avoid teaching this when working around children because sometimes a pup may require firm quick corrections on a leash – which can cause problems for children:

  • A more sensitive child can get upset when a negative behavior such as jumping on people or guarding a toy or food requires a quick, firm correction with the leash. They do not always understand that corrections of bad behavior are just as imperative as praising the positive, and that we are not hurting the pup or dog.
  • On the flip side of that, a more confident or bold child may try to emulate what we are doing, but in the process may unintentionally hurt the pup or dog because they do not yet know or understand the amount of pressure required on the leash to make the correction yet not hurt the dog in the process.

Drop It and Leave It

These two commands are typically not taught around children for safety reasons.  Kids do much better working with these commands after your pup has mastered them.

I also want to clarify here that when I say ‘teaching these commands’, I am not just referring to specific focused moments of training, like when you’re with a trainer, or even when you plan a specific time to work with your pup.  I am speaking in general. Any time training takes place – because impromptu training takes place ALL THE TIME.  You feed the dog, you want him to sit before he eats, you’re training.

You need to be careful though with impromptu “Drop It” and “Leave It” training.  Remember – kids copy everything. Take for instance a dog that just grabbed the TV remote.!  The dog has obviously not taken it to switch channels, so chances are it’s taken to become a new chew toy! And they are not cheap to replace! That is when our ‘protect the item’ Instinct kicks in.

Usually the first thing we do is call them to us. We are never thrilled in these moments, so the call unintentionally gets done in an angry voice (“COME HERE!!”) which clearly told Fido you are not happy with him! Of course, now that he knows you are angry, not only does he ignore your call, but he took off in the opposite direction!  So what happens next?  We jump up to chase them and retrieve the item back.

It is at this point that one of two scenarios ensue:

  1. The kids join the chase… it becomes a big game to both kids and dog, and you end up with more aggravation and pandemonium on your hands, or:
  2. You ran to chase the dog (which was loads of fun for the dog, as he now has your full attention and is playing the “You can’t catch me” game!) and when you finally get him, your kids see you reach in and grab the item from his mouth.

Now some time passes, and you may have forgotten all about this incident…. But your kids haven’t. So the next time Fido grabs something he should not have, such as one of their toys, your kids repeat what you did… only now the dog also remembers it, and also remembers once you caught him, you took the item away, so this time he is more possessive and guarding the item. This is behavior your child did not see last time, and the next thing you know, they reach out to grab the item back, and the dog strikes out and bites.  Impromptu Drop It training gone really wrong.

So how could all of this have been avoided?  We start with PLANNED Drop It training when the kids aren’t around.

The “Drop-It” command is a simple task to teach, and can be accomplished using one of their simple rope toys:

  1. Get them interested in a toy by playing with it with them.
  2. Once they are engaged in the play, bring the hand holding the toy closer to your body to stabilize it and hold it still…. This ‘discontinues’ the ‘tug’ action of the game.
  3. Grasp the toy with your free hand right in front of their mouth, and start creeping your hand forward, all the while saying, “Drop-It”. This forces them to lose their grip on the toy.
  4. As soon as they do, praise them, and begin again.

Essentially what this does is show them that you are not just taking the item away from them (which can create some ‘possession aggression’) but rather that the game can continue…. but only if they drop the item when you tell them to.

Now, let’s revisit that scenario.  To start with, during the early training stages with your dog, the leash needs to be a vital part of his everyday life. Leash equals control.

  • Dog grabs remote, but since the leash was on, you can step on it and then reel him back in!
  • You have already taught the dog the ‘drop it’ command so the kids never see you reach into his mouth to retrieve the item.
  • You can calmly tell the dog to drop it, they do, you praise them, and the moment is done.

Now, the biggest difference between “Drop-It” and “Leave-It” is that Drop It is used when they already have the item they are not supposed to have, while Leave It teaches them not to pick it up in the first place! To teach “Leave-It” we use desirable ‘training traps’ (things that your dog loves to grab) and the leash. Throw the item on the floor, and when they run to grab it, give a quick, firm tug on the leash and say Leave-It!”. Continue doing this until you can drop the item and they do not lunge forward to get it.

Leave-It is especially important for the safety of BOTH the kids and the dog…. if you accidentally drop a pill on the floor, with the Leave-It command, they will not lunge for it. Also, if your child is eating and they drop a piece of food, using the Leave-It command will avoid the dog racing to grab it, and more importantly, the child reaching into their mouths to get it back!

My last piece of advice…. If you have not had the option to teach them yet what ‘Drop It’ or ‘Leave-It’ means and how it is done, and Fido gets ahold of something you do not want him to have, Distraction is always a great alternative. Grab a very high-value treat (a piece of cheese, a piece of hot dog, etc.) something they do not get often, but they will choose over a tasteless remote. Start off standing still and show it to them, and if they do not come immediately, take tiny steps backwards (movement is very interesting to dogs and gets their attention quicker… moving away from them means they should follow or they may miss out on that treat) Try to make it a treat or an item that they can’t gobble up in one bite, giving them ample time to return to the discarded item faster than you can. What you do not want is a race back to the original item…. I can pretty much guarantee they’ll get back there first.

I also want to note that this last piece of advice should be used as an emergency back-up plan, and not a go-to plan of action. The reason being we do not want the dog to learn that if they want a good high-quality treat, all they need to do is grab something they re not supposed to have, and we’ll replace it with something awesome!!

Being one step ahead of a potential disaster is always preferable to the alternative! So teaching your dog these basic manners when the kids are not present will keep everyone safe, happy and healthy!!!

How Can My Allergic Kid Join In When It’s All About the Food

Last updated on September 16th, 2018 at 02:57 pm

Parents of food allergic children dread anything that has to do with food. This includes group activities, crafts that involve food, birthday parties, recipes for school classes, holidays at the family’s house and on and on. It’s stressful for the parents and it can be stressful for the child with food allergies. It’s a simple thing that we all enjoy, that symbolizes family tradition and warmth and comfort. Except, for those with food allergies, it does but it doesn’t. And yes, many parents have been heard asking “Why does everything have to revolve around food?!” but at the same time, realistically, so much actually does.

Let’s look at this as simply as we can. Regardless if you have a food allergy or not, typically we are a society that involves food in many aspects of our lives. Consider some of your early childhood memories- do you remember a special snack or the smell of a favorite food that sticks with that memory? It was a food that offered comfort. Not because it was meant as something to taunt those who can’t have it or to punish people with food allergies- it’s simply a food connected to something within a space in time. As anyone with food allergies can tell you, most of those special foods can easily be substituted using other ingredients. The memory can be shared, continued and enjoyed safely for everyone. Isn’t that what everyone would like to do- share that amazing moment with everyone?

Food is very often involved in crafts as well. Whether it be a cut out cookie, an adorable edible craft or some type if holiday –themed whatever, parents and their children have done this as a bonding experience for a long time. Teachers in school have asked class mothers to help them do this during class festivities as a way to teach the children different ways to use their foods but also to enjoy their foods. Parents have seen how happy their child is when they use their own hands to create these items- the look of being able to do something with little or no supervision, while enjoying their food craft full of creativity. The flip side- a food allergy parent has also seen their child’s face when this happens and they were not given information about it. These parents don’t always get to see the happy face. Most often, it’s the face that makes their heart bleed for their child. It’s the face of a child that is not included, was not able to touch the food or taste the food. For those parents, that is not the tradition or memory that they want their child to remember.

Logistically, replacing an allergic food with a safe, allergy-friendly food very often takes the same amount of time as it does when following the original recipe. All that it takes is for someone to help with replacement ideas.

Help for Parents

  • For those who may get frustrated, wondering why they cannot send a peanut butter and jelly sandwich to school – we have great news! You can just as easily send a SunButter and jelly sandwich or a turkey sandwich. Both take the same amount of preparation but one food poses risks whereas the others may be safe for most everyone. We understand the daily struggle for lunch ideas and sometimes having very little time to plan meal items. If you consider that utilizing the same time may actually help a child avoid a life-threatening allergic reaction, this may give you a bit more of an incentive to consider the options that we provide to you.
  • If you are someone who has a picky eater who “must pack that food” because your child will not eat anything else for lunch, please reach out to the parent that has an allergic child and ask them for ideas. They are masters of finding foods for children. They are a wealth of information and they can offer you ideas on many levels, not just foods. You just need to ask them. Even children with food allergies are picky eaters. Sometimes it takes another person to show you some easy ways to introduce different foods to your child, why not give it a try?
  • Get your own children involved. As parents, we already try to teach them the values of food and how long it takes to prepare meals so why not start with their own lunch? Have them make a list for the food store, ask them if their foods are safe for their friends and if not, help them research some new foods. The more your child is a part of the process, the more likely they are to eat what they asked to try.

Help for Teachers

  • What happens when you plan those fun school crafts that use a food item? Most every food item can be replaced with an allergy-friendly food. Please don’t hesitate to ask the parents of those who have food allergies- they are also there to help you teach what you need to teach.
  • Unless you have food allergies yourself, food allergy parents understand that you may not know what food replacements are safe to use. Ask a food allergy parent to be a class parent to have that extra level of safety on your side. This also gives you a second set of eyes and a built-in helper for that activity.
  • An added bonus- not only are you sharing the food lesson but your class can learn about the foods on a new level that will better educate them for future friends with food allergies.

Lastly, as I always say – food is something that should bring us together, not tear us apart. Children especially are so receptive to learn about their friends, especially if they are different from the other children. Think about how amazing it would be for your child to have a lifelong memory of how they met their best friend because of a food rather than how they were not able to make a new friend because of a food. In my experience as one of those food allergy parents, children are immediately drawn to wanting to learn more about what they can eat to be able to sit with their friends. They are amazed when food allergic children bring in delicious foods and are willing to let them taste it. Even though society tells us the opposite, parents need to listen to their children more often. They need to think about how their behavior is impacting their child’s behavior. Because in the end, if you choose to close that door, it will most likely be your non-allergic child that will be arriving home with the same disappointed look on their face but it will be because they were not able to be included with their friends who have food allergies. Inclusion and exclusion works both ways …because it IS about the food.

Should Special Kids Take Standardized Tests? Intelligent Lives

Last updated on September 16th, 2018 at 02:57 pm

While you and your child might be excited about the new backpack, lunch box and outfits back to school also brings a lot of anxiety for students with learning challenges and special needs and their parents. Not only will they be subjected to homework and (gulp) tests, there is something else looming on the horizon – intelligence testing.

You have probably heard the quote “Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.” Usually that is credited to Albert Einstein, although it has never actually been proven that he said it. I hope he said it, since he didn’t speak until he was three or four years old. Ironically, being unable to speak is sometimes defined as being ‘dumb” and yet Einstein was clearly very intelligent.

Intelligence testing, standardized tests and many other official exams are often unfairly biased against people with challenges, no matter how many accommodations are provided. It is disheartening and degrading to the student and the results can be devastating to the parents. We know our children are struggling, we know where they have strengths and weaknesses but we also know they have so much potential. The data presented in cold, hard print can be crushing.

Lately I have been opting my child out of as many of these tests as possible. I don’t need to put her through the frustration of a long test, and I don’t need a paper to tell me how she measures up against the rest of the students her age. She isn’t in a competition with the rest of the students in her grade in the state – she is only in competition with herself, to do her best each day and move along at her own pace. If you want to opt out of any standardized tests, contact your child’s school.

We don’t have to be at the level of Einstein to have a happy life. A new film called INTELLIGENT LIVES looks at three young adults with intellectual disabilities as they take on high school, college, employment and relationships. The film was directed by Dan Habib. Amy Brenneman served as the executive producer. Academy Award-winning actor Chris Cooper narrates the film and also shares the story of his son. You can host a screening in your area or attend one, just check out the website