Monday, April 21, 2014
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W. Douglas Tynan

POSTED: Monday, January 27, 2014, 9:38 AM
Filed Under: W. Douglas Tynan
(iStockphoto)

We know that firearm injuries are the second leading cause of death among American children and a major contributor to injury and long term medical costs for survivors, but little information exists about children and teens who are hospitalized for firearm injuries.

A study released online today in Pediatrics reviewed national data on deaths and injuries in children from 2009, and found that there were 7,391 hospitalizations for firearm-related injuries in US children.

The overwhelming majority, 89 percent of hospitalizations, occurred in males. Hospitalization rates were highest for 15- to 19-year-olds and for black males. The rate in African American boys was 10 times the rate for other groups. Deaths in the hospital occurred in 6.1 percent of children and adolescents. About 35 percent of children died who were hospitalized after suicide attempts, an extremely high death rate for any hospitalized condition. 

POSTED: Monday, October 28, 2013, 9:33 AM
Filed Under: Parenting | Tips | W. Douglas Tynan
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Parents should make a media use plan, including mealtime and bedtime curfews for media devices, advised the American Academy of Pediatrics, when it announced new recommendations for media use by children at its annual meeting today.  

The last time the AAP touched on this subject was in 2001 and the world has changed dramatically since then. The previous guidelines said no more than two hours of screen time each day, but even then, surveys indicated that the typical American child was in front of a screen for more than five hours per day.  As the new guidelines point out, the average 8 to 10 year old in 2013 may be in front of a screen up to eight hours a day, some teens up to 11 hours a day, with 75 percent of teens owning their own phones and nearly all teens texting. Thus the old “two hours per day” limit no longer fits the world as it exists. 

To help cope with this changing media world, pediatricians are now being asked to assess media use during annual checkups and evaluate whether there is a television screen and internet access in the child’s bedroom and to counsel parents to turn devices off well before bedtime.  

POSTED: Friday, October 25, 2013, 4:21 PM
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Do you think guns in the home make your children safer? It’s usually not the case. Last January, high school student Anthony Krueger locked himself in his room and shot himself under the chin twice after his mother called the police about his drug use.  Stories like this highlight that one of the largest risk factors for teen suicide is the presence of a gun in the home. 

In Krueger’s case, the 17-year-old from Dover, Del. survived, but faces a long slow recovery from his injuries . Without access to a gun, an emotional argument can lead to broken doors and objects, screaming, tears and even a fist fight, but rarely does it end in death.  With a gun present, the circumstances change.

Krueger’s mother had bought the gun for protection, and allowed him access so he could “protect” his younger siblings while his mom was at work.  His suicide attempt was featured in a Wilmington News Journal article earlier this month that looked at an adolescent suicide cluster in the state last year.

POSTED: Monday, October 14, 2013, 12:00 AM
Filed Under: Sleep | W. Douglas Tynan

Guest blogging today with regular contributor W. Douglas Tynan, PhD, is Meghan Walls, PsyD, a pediatric psychologist at Nemours/AI duPont Hospital for Children.

Do your children go to bed at the same time every night? Do they get the same set amount of hours of sleep before waking in the morning? Does it matter?

A Pediatrics study released online today takes a distinctive stance on these questions: Certainly. Researchers from University College in London, England analyzed data from more than 10,000 children in the UK Millennium Cohort Study, with bedtime data collected at 3, 5, and 7 years, as well as reports from the children’s mothers and teachers on behavioral problems.

POSTED: Tuesday, August 20, 2013, 5:45 AM
Filed Under: Obesity | W. Douglas Tynan
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Should schools send letters home to parents indicating their child’s Body Mass Index percentile and weight category? An opinion piece in Pediatrics released online earlier this week discusses how the BMI screening letters have come under harsh criticism in Massachusetts and are now being called “fat letters.”

Currently, 21 states have enacted policies or made recommendations regarding the collection of height and weight data or assessment of body composition in public schools. Pennsylvania began to phase in BMI screening for all students in the 2005–2006 school year. New Jersey does not have a state policy. However, its State Board of Education Administrative Code requires annual height and weight screenings for each student in kindergarten through grade 12.

“No parent would be proud to receive a letter stating their child is in the overweight or obese category, but the awareness and acknowledgment that he or she could have a weight problem begins the process of a multidisciplinary approach to change. It is time to put aside this pride for the future of our children’s health,” writes author Michael R. Flaherty, DO, a pediatric resident physician at Baystate Medical Center, Springfield, Mass., and clinical associate at Tufts University School of Medicine in Boston.

POSTED: Monday, August 12, 2013, 9:51 AM
Children who experience unexplainable ab pain are more likely to develop anxiety disorders as adults. (istockphoto)

Abdominal pain in childhood with no determined physical cause predicts much higher rates of anxiety and depression in adolescence and early adult years, according to a study published online today in Pediatrics.  

It’s been estimated that anywhere from 8 to 25 percent of school-aged children experience recurring abdominal pain. Many of these patients have no evidence of a physical cause of the pain, and therefore have medically unexplained or “functional” abdominal pain.

This large, well run study followed over 300 patients with abdominal pain and a matched control group of about 150 patients from childhood into adulthood. The researchers from Vanderbilt University found of the adults who had abdominal pain as children, 51 percent had an anxiety disorder during their lifetime (and 30 percent had a current diagnosis), compared with 20 percent of adults in a control group who had an anxiety disorder in their lifetime. Forty percent of adults who had abdominal pain as children had depression during their lifetime, compared to 16 percent of adults in the control group.

POSTED: Thursday, July 25, 2013, 9:21 AM
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A recent study in Pediatrics found that African American and Hispanic children are less likely to be diagnosed and treated for Attention Deficit Hyperactivity Disorder than white children. It was a very well designed, carefully measured study based on a representative sample of over 15,000 children being followed in a longitudinal study. The problem is these now 20-year-olds, were all born in 1993 and the measurement was of how many were diagnosed between their kindergarten year of 1998 and eighth grade in 2003.  It is a great snapshot, but an old snapshot.

We’ve now seen diagnostic rates for ADHD rise dramatically in the past 10 years (a 53 percent increase), and the Centers for Disease Control and Prevention estimates that over 11 percent of children are now diagnosed with ADHD. This includes nearly one in five high school age boys who have been diagnosed over the course of their lives by a professional.  

It also appears that race or ethnicity no longer predicts how likely a child will be diagnosed with ADHD. Children from low income families who have Medicaid insurance are more likely to be diagnosed, as are children of single mothers. Poverty is now the strongest predictor. The CDC says that the differences between racial and ethnic groups are diminishing. The leadings states for ADHD diagnosis? Alabama, North Carolina, Mississippi.  The lowest numbers are in Wyoming and Utah. 

POSTED: Thursday, July 18, 2013, 5:30 AM
Filed Under: W. Douglas Tynan
(iStockphoto)

In the past few months, universal preschool fever has swept the county. On a daily basis, it seems like the President, multiple governors and newspapers are touting the positive impact that would be seen in school achievement, reduction in special education costs, high school graduation rates, college attendance, careers and raised lifetime earnings.

All we need to do is simply provide every four-year-old access to a high quality preschool experience in a safe stimulating environment with good nutrition and great teachers. 

The work of Nobel economics laureate James Heckman is often cited, with a frequent reference to a 7 to 1 return on this type of educational investment. We are told that past studies found a seven dollar return in reduced costs and increased earnings for every dollar spent on preschool.

About this blog
The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Stephen Aronoff, M.D., M.B.A. Temple University Hospital
Christopher C. Chang, M.D., Ph.D Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Mario Cruz, M.D St. Christopher’s Hospital for Children, Drexel University College of Medicine
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist - The Anxiety Behaviors Clinic, CHOP
Gary A. Emmett, M.D. Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Lauren Falini Bariatric exercise physiologist, Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Crozer-Keystone Health System
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, RD Children's Hospital of Philadelphia
W. Douglas Tynan, Ph.D. Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Flaura Koplin Winston, MD, PhD Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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