Beginning in 1998, infectious disease and mental health experts have identified children who develop symptoms of obsessive-compulsive disorder (OCD) or tic disorders such as Tourette’s syndrome after an infection. First thought to be linked only to the group A streptococcus bacteria that cause strep throat or scarlet fever, it has been seen with other kinds of infections. Experts propose calling this frightening disorder pediatric acute-onset neuropsychiatric syndrome (PANS). It probably happens when the infectious agent gets into the brain and inflames the basal ganglia. Rapid treatment with antibiotics can reverse the symptoms.
The FDA’s approval this week of an old drug called ivermectin for treating head lice comes as good news to folks who shudder at the thought of using a nit comb to remove lice. It will be sold as a lotion under the brand name Sklice. Ivermectin works by interfering with nerve and muscle cells in […]
It is normal for children at some points in their development to be concerned about sameness and symmetry and having things perfect. But when such beliefs or behaviors become all-consuming and start interfering with school, home life, or recreational activities, the problem may be obsessive-compulsive disorder (OCD). Obsessions are irrational thoughts, images, and impulses that a person feels as unrealistic, intrusive, and unwanted. To relieve the anxiety caused by these obsessions, a youth may engage in compulsive rituals. Two main types of treatment are used to help youths better manage OCD: a form of talk therapy known as cognitive behavioral therapy, and medication. The ideal approach is to try cognitive behavioral therapy before turning to medication.
New guidelines for from the American Academy of Pediatrics recommend that all kids between the ages of 9 and 11 have their LDL (bad) cholesterol levels checked. The rationale is that atherosclerosis (the fatty gunk in arteries that causes heart attacks, strokes, and other serious problems) starts during youth. Atherosclerosis is fed by high LDL. The guidelines aren’t aimed at getting kids to take cholesterol-lowering statins. Instead, they are about getting kids, their parents, and their doctors to talk about making healthy lifestyle choices. The hope is that more doctor time spent coaching and counseling now will mean less time treating cardiovascular disease later.
A new study involving 1.2 million children and young adults provided reassuring evidence that the drugs used to treat ADHD do not increase the risk of death from heart disease. Researchers analyzed medical records from a nationwide private insurance plan along with health plans based in Tennessee, California, and Washington State. They compared children taking stimulant drugs (like Ritalin and Adderall) that are commonly used to treat ADHD to children not taking these drugs. Cardiac problems were no more common among children using a stimulant as among those not taking one.
Although current recommendations call for pediatricians to ask their adolescent patients about alcohol and drug use at every visit, many don’t. To make it easier for doctors and nurses to do this, the American Academy of Pediatrics has just published a set of questions to guide the confidential conversation, along with advice on what to do with the answers. The first question is a simple one about drug or alcohol use. If the answer is no, the health care provider should praise the teen and encourage him or her to continue making good decisions about health and safety. If the answer is yes, six follow-up questions called the CRAFFT questions) can help separate those who are experimenting from those who may be headed for serious trouble and need more in-depth help.
Heart disease, stroke, diabetes, asthma, osteoporosis and other common chronic diseases are often blamed on genes, pollution, or the wear and tear caused by personal choices like a poor diet, smoking, or too little exercise. An intriguing hypothesis is that these and other conditions stem from a developing baby’s environment, mainly the womb and the placenta. During the first thousand days of development, from conception to age 2, the body’s tissues, organs, and systems are exquisitely sensitive to conditions in their environment during various windows of time. A lack of nutrients or an overabundance of them during these windows, so the thinking goes, programs a child’s development and sets the stage for health or disease.
A few years back, my colleague Michael Miller wrote an interesting article about the adolescent brain in the Harvard Mental Health Letter. I had only a passing interest in the topic at the time, being far more focused on raising a 9-year old and a pair of 8-year-olds. Fast-forward six years, and I now have […]
As summer winds to a close, many school age children are reluctant to greet another school year. Who can blame them? Swapping swimming, lazy days, camp activities, and late nights for classrooms, homework, and early morning bus rides isn’t much of a trade at all. For some children, reluctance turns into school refusal. This goes beyond an occasional “I hate school” or “I don’t want to go to school today.” Children with school refusal may sob, scream, or plead for hours before school in an attempt to stay home. They may often complain of illness and run home from school if forced to go. Absences can last weeks or even months. The problem may start at any point but common triggers are the start of a new school year, making the transition to a new school (middle school to high school, for example), or returning from school vacation. School refusal often stems from an anxiety disorder, according to Coping with Anxiety and Phobias, a new Special Health Report from Harvard Medical School. Helping a child through school refusal often takes concerted effort from the parents, school staff, a therapist, and the child.
Confused about how to extend analog parenting into the digital world? New guidelines from the American Academy of Pediatrics offers practical advice to pediatricians (and parents) to help children use social media tools safely and in ways that encourage them grow socially and emotionally. Michael Miller, M.D., editor of the Harvard Mental Health Letter, says the guidelines are “anchored in what we know about child and adolescent development rather than any perceived special influences of the social network.”