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Children's Health Articles
Autism is a developmental disorder of the brain. People with autism have problems communicating and interacting socially. They also may have unusual patterns of behavior, interests and activities.
Doctors use the term autism spectrum disorder (ASD). This term includes the five kinds of autism.
The three main types of autism are:
Asperger's syndrome — A milder form
Nonspecific pervasive developmental disorder (PDD-NOS) — Describes children who don't quite fit the criteria for the other types
There are also two rare autism disorders:
Rett syndrome — Affects mostly girls. It includes problems with movement and speech, along with autistic features.
Childhood disintegrative disorder — A severe type of autism. The child loses more physical, language and social skills than in classic autism.
Signs of autism spectrum disorder are typically first seen before a child's third birthday. However, only half of children with autism are diagnosed before kindergarten.
Rett syndrome appears to be caused by a genetic mutation.
The causes of the other types of autism remain unknown. Various studies suggest that autism may:
Be caused by infection or the effects of an environmental toxin
Result from a brain injury or abnormality that occurs in the womb or in early infancy
Result from abnormal levels of chemicals messengers in the brain
Studies have found no link between vaccines and autism.
All types of autism except Rett syndrome are more common in boys than in girls.
Langerhans' cells are white blood cells in the immune system that normally play an important role in protecting the body against viruses, bacteria and other invaders. They are found in the skin, lymph nodes, spleen, bone marrow and lungs.
In Langerhans' cell histiocytosis (formerly known as histiocytosis X), Langerhans' cells multiply abnormally. Instead of helping to protect the body, these cells, in massive numbers, cause tissue injury and destruction, especially in the bones, lungs and liver. Although this overgrowth of cells may be like cancer, most researchers do not consider Langerhans' cell histiocytosis to be a form of cancer. In fact, the cells appear to be normal. There are just too many of them. Instead, it seems to be disease of the immune system, in which immune cells multiply abnormally and promote inflammation and damage of surrounding tissues.
Langerhans' cell histiocytosis can develop in only one site or organ, or it can involve several different sites and organs. In most cases, Langerhans' cell histiocytosis that affects many body systems typically occurs in children younger than 2, whereas single-site disease may occur in people of any age.
The cause of the disorder is unknown. However, researchers are studying the possibility that some common substance in the environment — perhaps a viral infection — may trigger the disease by causing the immune system to overreact. However, researchers have not yet identified an infection or substance that triggers the disease. One intriguing observation is that almost all people with the disease whose lungs are involved are current or former cigarette smokers. However, even among smokers, this condition is rare, and smoking seems to play no role in the disease when it affects parts of the body outside the lungs. Other theories suggest that the primary cause of Langerhans' cell histiocytosis is an abnormal immune system.
Langerhans' cell histiocytosis is rare, affecting one in 250,000 children and one in 1 million adults in the United States. Although it can strike at any age, it is most common in children and young adults, with about 70% of cases occurring before age 17. During childhood, Langerhans' cell histiocytosis peaks between ages 1 and 3.
Langerhans' cell histiocytosis includes disorders previously considered separate diseases: diffuse reticuloendotheliosis, eosinophilic granuloma, Hand-Schüller-Christian disease and Letterer-Siwe disease.
When you are alone and have to perform cardiopulmonary resuscitation (CPR), your primary effort should be compressing the chest to help the person's heart pump blood. If there is a second person helping, providing breaths can be done at the same time as compressions are performed.
The brief review of CPR on the following pages can help you in an emergency; however, this information should not take the place of a certified course in CPR.
Immediate care Assess the situation. Call out for someone to get help or call 911 yourself if the person does not seem to need immediate assistance. You can determine this by gently shaking the person and asking in a loud voice, "Are you OK?" If there is no response, begin CPR and continue until help arrives.
Birth of the Placenta
If you are called on to help deliver a baby, remember that childbirth is a natural process and that your role is to assist the woman and offer encouragement. If a woman's contractions are very strong and 2 to 3 minutes apart or the water bag (amniotic sac) has broken, birth is very near. If the woman tells you that the birth will happen very soon, believe her.
You will see quite a bit of blood, which is normal. You may see bloody fluid coming from the vagina before and during the birth; this is also normal.
This list describes your priorities in an emergency situation. Follow these steps:
ITEMS TO GATHER:
A child's world is full of dangers, real and imaginary, that many adults forget they ever experienced. Most childhood fears are normal, temporary, and eventually outgrown, but studies still show that anxiety disorders are among the most common childhood psychiatric conditions. In a high proportion of cases, it turns out that the symptoms of an adult anxiety disorder first appeared in childhood, so treatment of abnormal childhood anxiety is not only important for its own sake but may help prevent adult disorders.
Children's minds and emotions are constantly changing and developing, and they do not all develop at the same rate, so it is not always easy to distinguish normal fears from those that require special attention. Newborns typically fear falling and loud noises. Fear of strangers begins as early as six months and persists until the age of two or three. Preschool children usually fear being separated from their parents; they may also be afraid of large animals, dark places, masks, and supernatural creatures. Older children may worry about death in the family, failure in school, and events in the news such as wars, terrorist attacks, and kidnappings. Adolescents have sexual and social anxieties and concerns about their own and the world's future. These anxieties become a problem only if they persist and cause serious distress, destroy family harmony, or interfere with a child's development or education.
Generalized anxiety disorder. Formerly called overanxious disorder of childhood, these days generalized anxiety in children is recognized as the same disorder of uncontrolled worry that occurs in adults. Children with this disorder are self-conscious, self-doubting, and excessively concerned about meeting other people's expectations. They need constant reassurance and approval from adults. They may worry about school grades, storms, burglary, hurting themselves while playing, or the amount of gas in the tank. They often feel restless and tense and complain of headaches, stomachaches, and other physical symptoms.
If your child is rubbing his ear, should you run to the doctor's office to demand antibiotics? Probably not. Your child may simply have fluid in the ear and not the classic ear infection that parents and children dread.
Over 2 million American children experience fluid in the middle ear each year, often following a cold or an acute ear infection. The condition is also called a silent ear infection because many children have no symptoms. Some children, though, may rub their ear or experience mild pain, sleep disturbances, unexplained clumsiness, muffled hearing, or delays in language and speech development. The condition may be diagnosed during a routine well-child visit with the use of a pneumatic otoscope, which allows the doctor to see how easily the eardrum moves.
Billions of dollars are spent in the U.S. for diagnosing and treating fluid in the ear each year. However, the fluid most often disappears of its own accord and does not lead to acute ear infections. Also, antihistamines and antibiotics have little effect on the condition and do not help prevent delays in learning or language and speech development.
No one wants his or her child to be unhappy, let alone clinically depressed. So when a diagnosis of childhood depression surfaces parents may be tempted to go along with a doctor's suggestion or even ask the doctor for a prescription of antidepressants for the child. But what is supposed to help may actually end up causing harm.
The Food and Drug Administration (FDA) has issued a warning of a possible suicide risk in children and adolescents treated with a certain class of antidepressants that includes Prozac and Paxil. The available data from clinical trials suggest selective serotonin reuptake inhibitors (SSRIs) may be associated with an increase in suicidal behaviors and attempts shortly after the start of treatment. Although Prozac is the only SSRI known to have a benefit in children and approved for such use by the FDA, other drugs in this class may be prescribed "off-label" at a physician's discretion.
Already the British counterpart of the FDA recommends against using SSRIs in children. And recently, a review in the British journal The Lancet showed Prozac is the only SSRI not associated with negative outcomes in children. The review involved an analysis of data from published and unpublished studies. When comparing data from studies published in medical journals, all the SSRIs offered a greater benefit than risk. But when unpublished studies, which tend to have negative results, were also included they showed that the risks outweighed the benefits for all the SSRIs except Prozac.
While going to and from school many kids these days look like they have the weight of the world on their shoulders. Although it might not be quite so heavy, some kids actually do carry around a lot of weight in their backpacks. These heavy loads place stress on the spine and shoulders of children, causing muscle strain and fatigue. For some kids the aches and pains are bad enough to seek medical attention. Too much weight can also lead to bad habits such as poor posture and excessive slouching.
Unfortunately, doing homework and being prepared in class means carrying books back and forth between school and home. You can help your child lighten the load by teaching him or her organizational skills. By using folders for individual subjects your child can bring home just the work he needs for the day as opposed to lugging everything home. At school, encourage your child to take frequent trips in between classes to his or her locker to replace books.
You can also buy a suitable backpack and follow guidelines for proper use: