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Your Child

The Benefits of Being Bilingual

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Do children who speak more than one language score higher on cognitive tests? Yes, according to a new Canadian study. Researchers say that bilingual students develop a deeper understanding of the structure of language, an important skill in learning to read and write.

Cognitive tests study the mental processes that allow us to perform daily functions such as paying attention, solving problems, producing and understanding language appropriately and making decisions.

Does being bilingual make a child smarter? Not necessarily, but previous studies have shown that children who learn two languages from birth are able to concentrate on the meaning of words better than monolingual children and have an advantage in developing multi-tasking skills.

In the Canadian study, researchers compared 104 six-year olds to measure their cognitive development. Some children were English speaking only. Others were Chinese-English bilinguals, French-English bilinguals, and Spanish-English bilinguals.

The experiments investigated the effects of language similarity, cultural background and educational experience on verbal and non-verbal abilities.

The children did a battery of tests that measured verbal development and one non-verbal task that measured executive control, in this case, the ability to focus attention where necessary without being distracted and then shift attention when required. The bilingual children demonstrated a superior ability to switch tasks.

"The results endorse the conclusion that bilingualism itself is responsible for the increased levels of executive control previously reported," the study's authors wrote.

To acquire language, bilingualism where the languages are similar in origin may have slight advantages, the researchers found. For example, Spanish-English bilinguals outperformed Chinese-English bilinguals and monolinguals on a test of awareness of the sound structure of spoken English.

Dr. Ellen Bialystok, one of the world's foremost experts on bilingualism among children, led the group of researchers from York University in analyzing the effects of bilingualism. Summarizing the results, Dr. Bialystok commented, "Our research has shown that reading progress amongst all bilingual children is improved" over monolingual children. In a separate statement, she said, "I think there's a lot of worry out there about other languages conflicting with a child's ability to learn to read in English, but that's absolutely not the case. Parents should not hesitate to share their native tongue with their children—it's a gift."

Because bilingualism is often tied to other factors such as culture, socioeconomic status, immigration history and language, the researchers partly took those into account by enrolling participants who all attended public schools and came from similar socio-economic backgrounds.

During the study, the children learned to read in both languages at the same time. Dr. Bialystok and her team thought that the additional time spent learning two languages might give the children an advantage. But, results showed that the advantages garnered by the children were independent of the instruction time in the other language.

Researchers noted in the online issue of the journal Child Development that "People always ask if the languages themselves matter and now we can definitively say no," study co-author, Dr. Bialystok, said in a release.

Learning a second language teaches children more about their first language. They understand the intricacies of grammar and acquire an additional awareness of how language is used to express thoughts.

The Canadian study was published in the February 8th, online issue of the journal Child DevelopmentThe study was funded by the U.S. National Institutes of Health.

Sources: http://www.cbc.ca/news/health/story/2012/02/08/bilingual-children-brain....

http://www.early-advantage.com/articles/learningtoread.aspx

Your Child

Young Baseball Pitchers Playing With Pain

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It’s that glorious time of year when pitchers pitch; batters swing and outfielders reach out to catch a fast and furious white leather-bound ball. Yep, it’s baseball season!

While the pros start their 162 game regular season, school teams and Little Leagues are suiting up and hitting the fields as well.

Although typically in good physical shape, professional players are not immune to injuries – just ask the Texas Rangers.

Kids on the other hand, play long and sometimes double games at tournaments on the weekends. Many of these kids are weekend warriors that love the game, but aren’t always in the best physical condition.

According to a pair of recent studies, young baseball pitchers are playing with arm and shoulder pain because they feel pressured by their parents or coaches. Playing through the pain may lead to injuries that won’t heal.

"Kids are playing harder and longer in more leagues than ever before," said Dr. Paul Saluan, director of pediatric and adolescent sports medicine at the Cleveland Clinic. "Kids also are not getting enough rest in between episodes of pitching, which may lead to insufficient time to heal smaller stress injuries. Over time, these smaller injuries add up."

Kids explained why they kept playing even though they were in pain.  "Players who experience pain often felt their parents and coaches were frustrated with them," said Dr. Christopher Ahmad, professor of orthopedic surgery at Columbia University Medical Center in New York City.

"Throwing with pain is a signal that injury is occurring," added Ahmad, who is the New York Yankees' head team physician.

In Ahmad's study, he and his colleagues surveyed 203 healthy players, aged 8 to 18. Just under one-quarter of them had experienced a prior overuse injury, they found.

Almost half of the players -- 46 percent -- said they had been encouraged to continue playing with arm pain, and 30 percent said their arm pain sometimes made playing less fun.

Those most likely to report being encouraged to play despite pain had a previous overuse injury. They were also more likely to report feeling arm pain while throwing and to experience arm fatigue during games or practice.

The second study looked at whether parents were monitoring their child’s pitch count during a game. Sixty parents of baseball pitchers were surveyed and just over half of the parents were not aware of safe pitching guidelines and did not actively monitor their child's pitch count.

The most important aspects of safe pitching guidelines are a maximum number of recommended throws based on a child's age and the number of days of rest needed between throwing stints, said Saluan.

"The focus has been on creating a better athlete who can throw harder, faster and more accurately than ever before," Saluan said. "Injury prevention has taken a back seat."

One in five parents did not know how many pitches their child threw in a typical game, but 64 percent recalled that their child had experienced pain in the upper extremities because of pitching, the survey found. For one-third of the pitchers, the pain required a medical evaluation.

"Kids who continue to pitch through pain end up with significant injuries that may have lifelong consequences," Saluan said. "Younger pitchers who are still growing are much more vulnerable than adults to sustain an injury to the growth plates around the shoulder and elbow.”

Injuries to the growth plates usually heal with rest, Ahmad said. But he noted that more young pitchers are also damaging their ulnar collateral ligament, an important ligament in the elbow.

"Unfortunately, these injuries do not always heal and often require surgery," he said.

Most of the injuries are caused when kids are playing too many games, specializing in one aspect of the game, using poor pitching mechanics and throwing too hard.

In the pitching study, half the young pitchers threw in at least two leagues at a time, one-quarter pitched more than nine months of the year, and just over half participated in extra showcase situations.

"We have fallen into the trap of 'too much too soon,'" said Saluan. "This has resulted in a rise in injury rates in kids whose bodies are not prepared to handle the stresses that are encountered."

If you’re unsure of how to monitor your child’s pitching, the Major League Baseball website has a “Pitch Smart” guidelines page for young and adolescent pitchers listed at the end of this article.

The studies were presented at the American Academy of Orthopaedic Surgeons' annual meeting in Las Vegas. Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

Sources: Tara Haelle, http://consumer.healthday.com/fitness-information-14/baseball-or-softball-health-news-240/young-pitchers-often-pressured-to-play-despite-pain-study-says-697197.html

http://m.mlb.com/pitchsmart/pitching-guidelines

Your Child

Concussions May Last Longer in Girls

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New research suggests that girls who suffer a concussion may have more severe symptoms that last longer compared to boys.

No one seems to know why there is a difference, but other studies have come to the same conclusion.

"There have been several studies suggesting there are differences between boys and girls as far as [concussion] symptom reporting and the duration of symptoms," said Dr. Shayne Fehr, a pediatric sports medicine specialist at Children's Hospital of Wisconsin.

In his new study, Fehr also found those differences. He tracked 549 patients, including 235 girls, who sought treatment at a pediatric concussion clinic.

Compared to the boys, the girls reported more severe symptoms and took nearly 22 more days to recover, said Fehr, also an assistant professor of pediatric orthopedics at the Medical College of Wisconsin.

In the new study, Fehr tracked patients from 10 to 18 years old. All were treated between early 2010 and mid-2012. Each patient reported on their symptoms, how severe they were and how long it took from the time of the injury until they were symptom-free.

Girls reported more severe symptoms and took an average of 56 days to be symptom-free. In comparison, the boys took 34 days. Overall, the time to recovery was 44 days when boys and girls were pooled.

The length of time it took for patients to fully recover from concussion is quite a bit longer than people usually think.

"Commonly you hear that seven to 10 days [for recovery] is average," Fehr said.

The patient’s who were part of this study went to concussion clinics, so their injuries may have been more acute.

Fehr did not find age to be linked with severity of symptoms. Most of the injuries -- 76 percent -- were sports-related, with football accounting for 22 percent of the concussions.

The top five reported symptoms were headache, trouble concentrating, sensitivity to light, sensitivity to sound and dizziness. Boys and girls, in general, reported the same types of symptoms, Fehr said, but the girls reported more severity and for a longer time period.

Fehr will present the findings at the American Medical Society for Sports Medicine this week. Studies presented at medical meetings are typically viewed as preliminary until published in a peer-reviewed journal.

Whether it’s a boy or a girl that suffers a concussion, it's important to be seen by a doctor and not return to play prematurely, which can be dangerous or even fatal, according to the American Academy of Pediatrics.

Anyone with a history of concussion is also at higher risk for another injury.

Source: Kathleen Doheny, http://www.webmd.com/brain/news/20140410/girls-suffer-worse-concussions-study-suggests

Your Child

Heat & Your Young Athlete

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Football season usually means cooler weather and exciting times for high school and college age kids.

This year though, the extreme heat is not only causing great concern among parents, students and coaches- it’s been responsible for at least 3 deaths. So far this year, there have been four football-related deaths; two teenage football players from Georgia, a high school player in South Carolina, and a 55-year-old football coach in Texas.

According to a recent study excess weight, along with the high temperatures, could be a contributing factor for certain athletes.

An analysis of 58 heat-related deaths among U.S. football players from 1980 to 2009 showed that about 80% involved players who were obese by the conventional definition of a body mass index of over 30.  Ninety-five percent were overweight or obese.

The rate of heat-related illness and death among football players has increased since the mid-1990s, according to Andrew J. Grundstein, PhD, of the University of Georgia in Athens, first author of the study.

The reason for the increase is not entirely clear but could reflect the increasing body weight of players, he said.

Most of the deaths occurred in August, when fall practice typically begins, and most occurred within the first two weeks of practice. Surprisingly, a majority of the deaths occurred during morning practices.

"Mornings may be cooler, and a lot of coaches may recommend having practices in the morning because it is cooler, but high humidity levels can make the conditions very oppressive and stressful," Grundstein said during a teleconference, sponsored by the Union of Concerned Scientists.

"I think people may put their guard down because they think the risk of heat-related illness is less in the morning," he added.

Grundstein also noted that more than 60% of the deaths happened on days when practice should have been cancelled.

Your Child

Playing With Food May Help Picky Eaters

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If your child is a picky eater, encouraging them to play with their food may help them overcome the reluctance to try new foods according to a new study.

Researchers in the United Kingdom asked a group of 70 children – ages 2 to 5 – to play with mushy, slimy food while their parents observed, watching to see if kids would happily use their hands to search for a toy soldier buried at the bottom of a bowl of mashed potatoes or jelly. Children who wouldn't use their hands were offered a spoon.

Parents and researchers each rated how happy the kids were to get their hands dirty on a scale of one to five, with a higher number indicating more enjoyment. Children could get a total score as high as 20, a tally of the scores from researchers and parents for play with both the mashed potatoes and the jelly.

Researchers also gave parents a questionnaire to assess children's so-called tactile sensitivity, quizzing them about things like whether kids disliked going barefoot in the sand and grass or avoided getting messy.

The study found that kids who liked playing with their food were less likely to have food neophobia (the fear of trying something new) or tactile sensitivity.

"Although this is just an association, the implication is that getting children to play with messy substances may help their food acceptance," lead study author Helen Coulthard, a psychology researcher at De Montfort University in Leicester, U.K., told Reuters Health by email.

Previous research has linked food neophobia to limited fruit and vegetable consumption. Courtland and her team wanted to see if they could establish a link between touching food and tasting unfamiliar foods.

Courtland suggested that parents of picky eaters begin introducing new foods to their child by creating “food art.” Food art is making pictures or images with different foods on a plate.  The first step is letting your child make a picture or design by arranging various colored foods on the plate.  Don’t pressure them to taste their creation, but wait till they are ready to give it a try. Make it a game and eventually begin encouraging them to taste what they have created. Start small and expand to larger food groups and pictures.

Offering as much variety as possible from a young age also helps children experience lots of textures and flavors, which may minimize their fear of unfamiliar foods.

You’re probably going to have to join in on the taste experimentation to show how good these food pictures taste! You might also take a picture of your child with their creation on your phone and then show it to them – to make it a little more fun.

It’s fairly normal for kids to go through a period of refusing to try new foods, though most kids will grow out of this phase by the time they start school. However, there are some children that carry new food aversion on into adulthood. It isn't necessarily harmful as long as the children maintain a healthy weight for their height, pediatricians say.

But over time, neophobia can make it very difficult to enjoy social engagements. Parents that have a hard time trying or enjoying new foods themselves too often pass that trait onto their own children.  Most of the time it’s just a phase that kids go through and finding creative ways to help them work through it eliminates the problem.

Source: Lisa Rapaport, http://www.reuters.com/article/2015/05/19/us-food-fears-children-idUSKBN0O41MD20150519

 

 

 

Your Child

Antibiotic Resistance Rising in Kids with Urinary Tract Infections

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Urinary Tract Infections (UTI) affect about 3 percent of children in the United States each year and account for more than 1 million visits to a pediatrician.

The most common cause of a UTI is the bacterium E.coli, which normally lives in the large intestine and are present in a child’s stool. The bacterium enters the urethra and travels up the urinary tract causing an infection. Typical ways for an infection to occur is when a child’s bottom isn’t properly wiped or the bladder doesn’t completely empty.

Problems with the structure or function of the urinary tract commonly contribute to UTIs in infants and young children.

UTIs are usually treated with antibiotics but a new scientific review warns that many kids are failing to respond to antibiotic treatment.

The reason, according to the researchers, is drug resistance following years of over-prescribing and misusing antibiotics.

"Antimicrobial resistance is an internationally recognized threat to health," noted study author Ashley Bryce, a doctoral fellow at the Center for Academic Primary Care at the University of Bristol in the U.K.

The threat is of particular concern among the younger patients, the authors said, especially because UTIs are the most common form of pediatric bacterial infections.

Young children are more vulnerable to complications including kidney scarring and kidney failure, so they require prompt, appropriate treatment, added Bryce and co-author Ceire Costelloe. Costelloe is a fellow in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, also in the U.K.

"Bacterial infections resistant to antibiotics can limit the availability of effective treatment options," ultimately doubling a patient's risk of death, they noted.

The study team reviewed 58 prior investigations conducted in 26 countries that collectively looked at more than 77,000 E. coli samples.

Researchers found that in wealthier countries, such as the U.S., 53 percent of pediatric UTI cases were found to be resistant to amoxicillin, one of the most commonly prescribed primary care antibiotics. Other antibiotics such as trimethoprim and co-amoxiclav (Augmentin) were also found to be non-effective with a quarter of young patients resistant and 8 percent resistant respectively.

In poorer developing countries, resistance was even higher at 80 percent, 60 percent respectively and more than a quarter of the patients were resistant to ciprofloxacin (Cipro), and 17 percent to nitrofurantoin (Macrobid)).

The study team said they couldn’t give a definitive reason about cause and effect but said the problem in wealthier countries probably relates to primary care doctors' routine and excessive prescription of antibiotics to children.

In poorer nations, "one possible explanation is the availability of antibiotics over the counter," they said, making the medications too easy to access and abuse.

"If left unaddressed, antibiotic resistance could re-create a world in which invasive surgeries are impossible and people routinely die from simple bacterial infections," they added.

In an accompanying editorial, Grant Russell, head of the School of Primary Health Care at Monash University in Melbourne, Australia, said the only surprise was the extent of the resistance and how many first-line antibiotics were likely to be ineffective.

If current trends persist, he warned, it could lead to a serious situation in which relatively cheap and easy-to-administer oral antibiotics will no longer be of practical benefit to young UTI patients. The result would be a greater reliance on much more costly intravenous medications.

The problem of antibiotic resistance for bacterial infections has been on the minds of scientist for some time now.  Cases are increasing at an unprecedented rate causing alarm and a call for more public education and due diligence on the part of physicians that prescribes antibiotics.

Story source: Alan Mozes, http://www.webmd.com/children/news/20160316/antibiotic-resistance-common-in-kids-urinary-tract-infections

 

 

Your Child

Kid’s ATV Safety Tips

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With the end of another school year and summer knocking at the front door lots of kids will be outside doing what kids do- playing. These are the months when a child's boredom level has a short fuse and they can easily be persuaded to ramp up a little danger and excitement when playing with friends.

ATVs (all terrain vehicles) can offer just such a challenge, along with dirt bikes, regular bikes and skateboards. All of the transportation apparatuses listed here can offer a lot of fun and excitement on long summer days. But, as a parent, you already know that they can also be quite dangerous when adults aren’t around to supervise activities. Of course, having an adult nearby is no guarantee that safety will prevail if they themselves aren’t acting responsibly. But let’s assume they are and they want their child to have fun and be safe.

Of all the activities listed above, ATVs bring their own particular set of safety concerns.  While you most likely won’t be present the entire time your child is riding his or her bike through the neighborhood, you should be present if your child is on a dirt bike or an ATV. The U.S. Consumer Product Safety Commission (CPSC) reports that ATVs continue to be the fourth most deadly product the CPSC oversees, with more than 700 ATV-related deaths per year.

CPSC notes that in 2011, ATV –related deaths decreased. However, the number of estimated injuries per year remains at more than 107,000, with an increase in estimated injuries to children younger than 16 years of age to 29,000. More than half of these injuries were suffered by children younger than 12.

There are some basic guidelines on ATV safety that every parent of a child who is going to be riding one of these vehicles needs to insist upon. This list is a compilation from CPSC’s website on ATV safety and ClassBrain.com.

- Do not allow children younger than 16 to drive or ride on adult ATVs. The American Academy of Pediatrics strongly recommends that children under the age of 16 should not operate an ATV. This is especially important, since younger children are usually injured on ATVs due to their size or inexperience with operating vehicles. Even once a child is 16 and able to operate an ATV, adult supervision should be present at all times.

- Never allow a child younger than 6 on an ATV.  ATVs are simply too dangerous for children under the age of six. Allowing a child under the age of six to operate an ATV is illegal in some states.

- Choose an appropriate ATV size for your child. Your child may be larger than some other children his or her age, but that doesn’t mean they are more capable of controlling a larger than recommended ATV. Riding an ATV safely is not only a matter of size – but skill and strength as well as coordination and maturity. Kids, especially those with little or no prior experience, can easily panic if they find themselves engaged in an unfamiliar situation. A typical situation might be if they accidently open the throttle too much and the ATV takes off quickly. The heavier and more powerful the ATV- the more likely a serious or even fatal accident can occur.

- Most ATVs are designed for only one person.  Do not ride on a single-rider ATV as a passenger or carry a passenger if you are the driver. ATVs are designed for only one rider at a time. Since you have to manipulate your weight in order to control the vehicle, two riders on a vehicle is incredibly dangerous. Also, the ATV may be unable to successfully hold the combined weight of two riders, making it less stable and more apt to roll over. Finally, having an additional rider can distract the driver from the task of properly operating the vehicle.

- Always wear a helmet and protective gear when riding ATVs. Just like operating a motorcycle or bike, riding an ATV requires you use proper protective gear. ALWAYS wear a helmet. Most serious or fatal accidents occur when the rider is not wearing a helmet and falls on his or her head. A helmet may not be the most stylish accessory, but it can literally save your life. Also, since most riders operate ATVs in wooded environments, be sure to wear proper eye protection, as a rock, branch, or even a bug can fly into your eye and cause damage. Furthermore, be sure to wear boots and gloves to protect your hands and feet while operating the ATV.

- Do not drive ATVs on paved roads. When it comes to where to ride your ATV, ensure you choose a proper setting. Avoid roads and streets, since ATVs are not designed nor intended to be driven on concrete or asphalt with larger cars and trucks. Also, avoid improper terrain that may encourage the ATV to roll over due to instability in the ground.

- Take a hands-on safety-training course. This is especially important for young or first-time riders. Before you drive a car, you take a safety course, so why should driving an ATV be any different? Safety courses educate riders of the correct way to operate and ride an ATV to ensure he or she knows how to handle the vehicle. Also, safety courses will teach riders of all ages the appropriate behavior when riding an ATV, making it critical for teens and adults to attend.

- Avoid tricks and stunts on ATVs. There are thousands of YouTube videos showing kids and young adults using their ATVs as if they were performing in a circus. What they don’t show are the funerals and life-altering results of children who have lost control of their ATVs. These are heavy machines that can crush a head or a back in an instant. Young boys are particularly fond of showing off their skills and feel they are invincible. They are not.

There’s no turning back the sales of ATVs for young kids, that horse has left the barn.  Most of the time, kids will be ok and have a good time. As parents, you make the decision on whether your child will be riding one of these machines or not. Make sure your child is prepared as best they can be before he or she hops on board and turns the key.

Sources: http://www.cpsc.gov

Donna Somerkin, http://www.classbrain.com/artteenah/publish/atv_safety_tips.shtml

Your Child

Asbestos Found in Children’s Crayons and Toys

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Coloring with crayons has been an American tradition since the late 1800s.  Since that time, the wax crayon has been instrumental in teaching children how to draw and imagine the world in a rainbow of colors.

Although the words “non-toxic” appear on crayon boxes designated for children’s use, a new report from the Environmental Working Group (EWG) Action Fund says that asbestos fibers have been found in crayons and other toys sold in the United States.

The fibers were found in four brands of crayons and two children’s crime-scene toy fingerprint kits.

The contaminated crayons included Nickelodeon's Teenage Mutant Ninja Turtles crayons, Disney's Mickey Mouse Clubhouse Jumbo Crayons and Saban's Power Rangers Super Megaforce Jumbo Crayons and ones by Amscan, according to the new report.

Asbestos was also found in two crime lab toys: EduScience's Deluxe Forensics Lab Kit, and Inside Intelligence's Secret Spy Kit.

The U.S. National Institutes of Health (NIH) notes that asbestos, which is composed of long, thin mineral fibers, once was common in insulation material.

Though tiny and invisible to the naked eye, airborne asbestos fibers are easily inhaled. With time, scarring, inflammation and breathing impairment can occur, as can lung cancer and mesothelioma, a rare cancer of the lining of the lungs and abdomen, according to the NIH.

Asbestos is no longer widely used in manufacturing in the United States. It is banned in nearly all other developed nations, the research group said.

EWG hired an independent company, Scientific Analytical Institute from Greensboro, N.C., to conduct so-called transmission electron microscopy tests to look for asbestos. This is said to be the most sensitive and accurate method of testing available.

EWG said that a second independent lab reconfirmed the crayons and toys that tested positive.

"Just a couple of fibers can lodge in your lungs and be there forever," said Sonya Lunder, a senior analyst with the Washington, D.C. based group. "And there's very clear evidence that asbestos leads to two forms of cancer, and thousands and thousands of Americans have been killed by fiber exposure."

Former U.S. Assistant Surgeon General Richard Lemen welcomed the report.

"These are important findings, because asbestos is being placed in children's products," said Lemen, now an adjunct professor with Emory University's Rollins School of Public Health in Atlanta.

"Even if the absolute risk is relatively low, children are more vulnerable to toxic material and carcinogens," he said. "And because they are so young they have a longer latency in which to develop these diseases, which are known to be diseases that develop over time."

The crayons were purchased between February and May of this year at two national chains -- Party City and Dollar Tree -- in a suburban county near San Francisco. The group said it ordered the two crime scene toys through Amazon.com and Toys"R"Us.com.

For analysis, 28 brands of crayons were tested and 21 toy fingerprint kits. All the products that tested positive were made in China.

A spokeswoman for Toys "R" Us, which distributes the EduScience Deluxe Forensics Lab Kit, responded to the report, saying customer safety is the company's highest priority.

"We require that every product we carry meets or exceeds all applicable state and federal laws, industry standards, codes and requirements. At this time, we are reviewing the referenced report, along with supplier test reports, to ensure full compliance to our strict safety standards," Kathleen Waugh, vice president of corporate communications, said in a statement.

The tests discovered the highest concentration of asbestos was found in the toy crime-scene fingerprint kits.

If your child is one of the millions that play with crayons or the crime lab kits, be sure to check the brand to make sure they are not one of the contaminated products or kits that tested positive for asbestos.

Source: Alan Mozes, http://consumer.healthday.com/cancer-information-5/lung-cancer-news-100/asbestos-found-in-kids-crayons-toy-crime-kits-701117.html

 

 

 

 

Your Child

Study: More and Younger Children Suffering From Concussion

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In order to develop statistics on how many U.S. children and teens are being diagnosed with concussion, the Centers for Disease Control and Prevention (CDC) analyzes emergency room data from around the country.

But, a new study finds that children’s concussions may be vastly underreported because family pediatricians, not ER doctors, are doing the examinations.

In the study, published today in the Journal of the American Medical Association Pediatrics, researchers from Children's Hospital of Philadelphia (CHOP) and the CDC used CHOP's regional pediatric network to figure out when and where children were diagnosed with a concussion.

They found approximately 82 percent had their first concussion visit at a primary care site like a pediatrician's office, 12 percent were diagnosed in an emergency department, 5 percent were diagnosed from a specialist, such as a sports medicine doctor or neurologist, and 1 percent were directly admitted to the hospital.

The authors noted that the findings indicate that many more children have suffered a concussion than recent stats suggest.

In another surprising turn, researchers found that one-third of those injured were under the age of 12.  Many reports have been focused on teen athletes instead of younger children.

"We learned two really important things about pediatric concussion healthcare practices," Kristy Arbogast, lead author and Co-Scientific Director of CHOP's Center for Injury Research and Prevention, said in a statement today. "First, four in five of this diverse group of children were diagnosed at a primary care practice -- not the emergency department. Second, one-third were under age 12, and therefore represent an important part of the concussion population that is missed by existing surveillance systems that focus on high school athletes."

Alex Diamond, a pediatric sports medicine specialist at Vanderbilt University Medical Center and director of the injury prevention program, told ABC News that these findings are important to help health officials understand how prevalent concussions really are. Diamond was not involved in the study.

Pediatricians are a good choice for seeking advice and diagnosis on concussions because they know the history of the child, Diamond said.

"That’s why it’s great for a pediatrician to deal with this," Diamond said. "They know the kid at baseline and they know the family."

The findings may have far-reaching implications for what we know about the number of concussions in the U.S., the authors said, noting that this study suggests that the condition is extremely underreported if the vast majority of concussions are diagnosed outside the emergency department.

"We need surveillance that better captures concussions that occur in children and adolescents," Dr. Debra Houry, director of CDC's National Center for Injury Prevention and Control, said in a statement today. "Better estimates of the number, causes, and outcomes of concussion will allow us to more effectively prevent and treat them, which is a priority area for CDC's Injury Center."

Concussions often happen without a loss of consciousness and can have long-term effects.

In fact, a brief loss of consciousness or "blacking out" doesn't mean a concussion is any more or less serious than one where a child didn't black out.

If your child might have had a concussion, go to the emergency room or see your pediatrician if he or she has any of these symptoms:

•       Loss of consciousness

•       Severe headache, including a headache that gets worse

•       Blurred vision

•       Trouble walking

•       Confusion and saying things that don't make sense

•       Slurred speech

•       Unresponsiveness (you're unable to wake your child)

•       Ringing in the ears

•       Nausea

•       Vomiting

Some symptoms of concussions may be immediate or delayed in onset by hours or days after injury, such as:

•       Concentration and memory complaints

•       Irritability and other personality changes

•       Sensitivity to light and noise

•       Sleep disturbances

•       Psychological adjustment problems and depression

•       Disorders of taste and smell

Symptoms in infants and toddlers may be more difficult to recognize because they cannot express how they feel. Nonverbal clues of a concussion might include:

•       Appearing dazed

•       Listlessness and tiring easily

•       Irritability and crankiness

•       Loss of balance and unsteady walking

•       Crying excessively

•       Change in eating or sleeping patterns

•       Lack of interest in favorite toys

Experts recommend that parents take their child in for an evaluation if their child receives more than a light bump on the head.

Story sources: Gillian Mohney, http://abcnews.go.com/Health/concussions-children-vastly-underreported-study-finds/story?id=39506549

http://www.mayoclinic.org/diseases-conditions/concussion/basics/symptoms/con-20019272

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