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

Peanut Butter Recall

Two brands of Skippy peanut butter have been recalled due to potential salmonella contamination.Over the weekend, a pantry staple was recalled.  Unilever Company recalled two brands of reduced-fat Skippy peanut butter.

Routine tests by the company suggest that the products may be contaminated with salmonella bacteria. Salmonella is a frequent cause of food poisoning and can cause severe infections. The specific brand recalls include 16.3-ounce plastic jars, are Skippy Reduced Fat Creamy Peanut Butter Spread and Skippy Reduced Fat Super Chunk Peanut Butter Spread. UPC codes for the recalled products are 048001006812 and 048001006782. Check the jar lid for best-if-used-by dates including:

  • MAY1612LR1
  • MAY1712LR1
  • MAY1812LR1
  • MAY1912LR1
  • MAY2012LR1
  • MAY2112LR1

The products were distributed in 16 states: Arkansas, Connecticut, Delaware, Illinois, Iowa, Maine, Minnesota, Missouri, Nebraska, New Hampshire, New Jersey, New York, North Dakota, Pennsylvania, Virginia, and Wisconsin. Symptoms of salmonella infection may include are fever, diarrhea, nausea, vomiting, and abdominal pain. Consumers who have purchased the recalled products should immediately discard the product and contact the company for a replacement coupon at 800-453-3432.

Your Child

Are You Making Your Child More Anxious?

2.00 to read

When a child shows that he or she is anxious or in distress, a natural response is for a parent to want to remove whatever is causing the discomfort. However, according to a new study, it may not be the best reaction for your child in the long run.

Researchers call it the “protection trap.” Basically it means smothering children with too much attention or making the menace go away.

The research showed that certain parental coddling behaviors might actually boost anxiety in a child, although the study doesn't prove a cause-and-effect relationship.

"We found evidence that when parents try to help their anxious children they do a lot of things," said study co-author Armando Pina, an associate professor of child developmental psychology at Arizona State University. "Some of them are good, like promoting courage with warmth and kindness. Others are less helpful, like promoting avoidance by overprotecting, which many times leads to more anxiety."

Other experts have also weighed in on this topic.

"Left untreated, anxiety disorders in youth are associated with greater risk for other psychological problems such as depression and substance use problems," said Donna Pincus, director of research at the Child and Adolescent Fear and Anxiety Treatment Program at Boston University. Anxiety problems can also disrupt families and cause kids to perform worse in school, she added.

So what should a parent do or not do?

"When children are in distress or upset they need parental comfort, reassurance and extra love. This is good," said study lead author Lindsay Holly, a graduate student at Arizona State University. "Sometimes, however, parents end up providing excessive reassurance and doing things for the child, like making excuses for why a child who is anxious in social situations won't go to a birthday party or talking for the child by ordering at restaurants."

Here’s how the study was conducted.

Researchers examined the results of a survey of 70 kids aged 6 to 16 who were treated for anxiety and/or depression at a clinic. The kids were equally divided among boys and girls and among whites and Hispanic/Latinos.

The investigators found that some kids were more likely to have anxiety and depression symptoms if their parents reinforced or punished their anxiety through various approaches. Among the two ethnic groups, "the only difference was that Latino parents seemed to attend more frequently to their children's anxiety," Holly said.

Pina noted that previous research has indicated that a certain kind of therapy can help kids become less anxious and more resilient by teaching the importance of facing fears. One of the goals of the therapy is to teach parents how to promote courage in the kids through a combination of warmth and kindness, Pina said.

Some experts believe that by exposing children to anxious situations in a controlled, supportive environment, they can learn how to handle their anxiety better.

Holly suggests that parents encourage their children "to do brave things that are small and manageable." A child who's afraid of speaking in public, for instance, might be urged to answer a question about whether they want fries with their meal at a restaurant.

While every child is going to be anxious at one time or another, a more difficult situation is when children suffer from an anxiety disorder. That is a more serious problem where someone experiences fear, nervousness, and shyness so much so that they start to avoid places and activities.

According to the Anxiety and Depression Association of America, anxiety disorders affect one in eight children. Research shows that untreated children with anxiety disorders are at higher risk to perform poorly in school, miss out on important social experiences, and engage in substance abuse. Anxiety disorder often shows up alongside other disorders such as depression, eating disorders, and ADHD.

The good news is that with treatment and support, a child can learn how to successfully manage the symptoms and live a normal childhood.

The study conducted at Arizona State University, looked at typical child anxieties and how parent’s interactions either helped or prolonged the anxiousness.

The study was published recently in the journal Child Psychiatry and Human Development.

Sources: http://www.cbsnews.com/news/overprotective-parenting-could-worsen-kids-anxiety/

http://www.adaa.org/living-with-anxiety/children/childhood-anxiety-disorders

Your Child

Brita Recalls Children’s Water Bottles

1:45 to read

Brita is recalling approximately 242,500 children's water filter bottles due to a possible laceration hazard.

The company said Tuesday that the lid of the hard-sided bottles can break into pieces with sharp points.

Brita has received 35 reports of lids breaking or cracking. No injuries have been reported.

The recalled bottles include a violet bottle with Dora the Explorer, a pink bottle with Hello Kitty, a blue bottle with SpongeBob Square Pants and a green bottle with Teenage Mutant Ninja Turtles. Each bottle has a Brita logo and white lid.

The bottles are 6 inches tall and hold 15 ounces of liquid. They have fold-up straws and filters that sit inside the straw below the lid.

The removable plastic wrap on the bottle at time of purchase has model number BB07. The following UPC codes were used:

  • 60258-35883 on the Dora the Explorer
  • 60258-35914 on the Hello Kitty
  • 60258-35880 on the SpongeBob Square Pants
  • 60258-35882 on the Teenage Mutant Ninja Turtles.

The bottles were priced between about $13 and $19. They were sold online at Amazon, Target and Drugstore.com. They were sold at stores including Alaska Housewares, Associated Food Stores, Bartell Drug, C Wholesale Grocers, Quidsi, Royal Ahold, Shopko, Target, US Navy Exchange and Walmart.

Consumers are advised to immediately stop using the bottles and to contact Brita for a postage-paid shipping package to return the bottles for a full refund. Brita can be reached at (800) 926-2065 from 8 a.m. to 5 p.m. ET Monday through Friday. Individuals may also visit www.brita.com and click "Safety Recall" for more information.

Source: http://abcnews.go.com/Business/wireStory/brita-recalling-childrens-water-bottles-25032799

Brita water bottle recall

Your Child

It’s Time to Register Your Child for Summer Camp!

1.45 to read

I know, you just got through the holidays and things are beginning to settle down and feel normal again. Guess what? If you’re planning on sending your child to summer camp- you better get busy.

Summer camp registration seems to starts earlier every year.  While the population growth of youngsters has remained pretty steady, the number of children wanting to attend either day camps or overnight camps is increasing. Summer camps fill up quickly and to meet the demand, camps are opening registration much sooner than in years gone by.

Early registration can also save you money. Many camps give a discount for parents who are willing to prepay early.  February looks to be a common open registration month, but some camps are offering online registration now. The most popular camps fill up quickly, so get your checkbook or credit card ready.

Many parents depend on day camps to help cover childcare during the summer months. The range of camps that are available is truly astonishing. I wish I had the choices kids have today when I was little. There are sports camps, science camps, special needs camps, cheerleader camps, arts camps, religious camps, health camps, adventure camps, academic camps – you get the point. If your child has a particular interest, there’s probably a camp that’s just right for him or her.

Not only do camps offer young children a variety of activities during the summer months, they can also offer your teen employment. With over 11 million children heading off to camp this summer, camps need employees. According to the American Camp Association, there are more than 12,000 day and resident camps in the U.S.  Those camps need temporary staff to help run them. If your teen is over 16 years of age, he or she may qualify.

The great thing about your teen working at a summer camp is they can apply at camp that suits their interests. Like music? Apply at a music camp! Summer camp jobs offer wonderful insight into others and while the work may be hard, it’s often very rewarding. Oh, and I forgot, they make their own money too.

Even though the temperatures are still dipping to freezing at night, if you’re planning on letting your child attend summer camp, you might want to start the research and registration now!

 

Your Child

What to Do If Your Child Is Choking

2.30 to read

It’s more common than you probably think. On average over 12,000 children a year, under the age of 14, are treated in hospital emergency rooms for food-related choking. That’s about 34 kids a day according to a new study.

The most common choking hazards appear to be hard candy, followed by other types of candy, then meat and bones. The study noted that most of the young patients were treated and released, but around 10 per cent were hospitalized.

"These numbers are high," said Dr. Gary Smith, who worked on the study at Nationwide Children's Hospital in Columbus, Ohio.

What's more, he added, "This is an underestimate. This doesn't include children who were treated in urgent care, by a primary care physician or who had a serious choking incident and were able to expel the food and never sought care."

The estimated 12,435 children ages 14 and younger that were treated for choking on food each year also doesn't include the average 57 pediatric food-choking deaths reported by the U.S. Centers for Disease Control and Prevention annually, the researchers noted.

Smith and his colleagues analyzed injury surveillance data covering 2001 through 2009.

They found that babies one year old and younger accounted for about 38 percent of all childhood ER visits for choking on food. Many of those infants choked on formula or breast milk.

Children who choked on hotdogs, nuts and seeds were the most likely to be hospitalized.

"We know that because hot dogs are the shape and size of a child's airway that they can completely block a child's airway," Smith told Reuters Health, noting that seeds and nuts are also difficult to swallow when children put a lot in their mouths at once.

Supervision is the most important choking prevention. Parents or guardians should make sure that a small child’s food is cut up into manageable bites that can be easily chewed and swallowed. An example might be grapes and raisins. A whole raisin is probably okay to be given to a toddler, but a grape should be sliced.

What should you do if your child is choking?

For children ages 1 to 12:

1. Assess the situation quickly.

If a child is suddenly unable to cry, cough, or speak, something is probably blocking her airway, and you'll need to help her get it out. She may make odd noises or no sound at all while opening her mouth. Her skin may turn bright red or blue.

If she's coughing or gagging, it means her airway is only partially blocked. If that's the case, encourage her to cough. Coughing is the most effective way to dislodge a blockage. If the child isn't able to cough up the object, ask someone to call 911 or the local emergency number as you begin back blows and chest thrusts. If you're alone with the child, give two minutes of care, then call 911.

On the other hand, if you suspect that the child's airway is closed because her throat has swollen shut, call 911 immediately. She may be having an allergic reaction to the food.

Call 911 immediately is your child is turning blue, unconscious or appears to be in severe distress.

2. Try to dislodge the object with back blows and abdominal thrusts.

If a child is conscious but can't cough, talk, or breathe, or is beginning to turn blue, stand or kneel slightly behind him. Provide support by placing one arm diagonally across his chest and lean him forward.
Firmly strike the child between the shoulder blades with the heel of your other hand. Each back blow should be a separate and distinct attempt to dislodge the obstruction.

Give five of these back blows.

Then do abdominal thrusts

Stand or kneel behind the child and wrap your arms around his waist.

Locate his belly button with one or two fingers. Make a fist with the other hand and place the thumb side against the middle of the child's abdomen, just above the navel and well below the lower tip of his breastbone.
Grab your fist with your other hand and give five quick, upward thrusts into the abdomen. Each abdominal thrust should be a separate and distinct attempt to dislodge the obstruction.

Repeat back blows and abdominal thrusts Continue alternating five back blows and five abdominal thrusts until the object is forced out or the child starts to cough forcefully. If he's coughing, encourage him to cough up the object.

If the child becomes unconscious If a child who is choking on something becomes unconscious, you'll need to do what's called modified CPR. Here's how to do modified CPR on a child:

Place the child on his back on a firm, flat surface. Kneel beside his upper chest. Place the heel of one hand on his sternum (breastbone), at the center of his chest. Place your other hand directly on top of the first hand. Try to keep your fingers off the chest by interlacing them or holding them upward.

Perform 30 compressions by pushing the child's sternum down about 2 inches. Allow the chest to return to its normal position before starting the next compression.

Open the child's mouth and look for an object. If you see something, remove it with your fingers. Next, give him two rescue breaths. If the breaths don't go in (you don't see his chest rise), repeat the cycle of giving 30 compressions, checking for the object, and trying to give two rescue breaths until the object is removed, the child starts to breathe on his own, or help arrives.

A good rule of thumb for parents and guardians is to take a CPR class. Many hospitals and clinics also offer classes on what to do if your child is choking.

Sources: Genevra Pittman, http://www.reuters.com/article/2013/07/29/us-choking-food-idUSBRE96S04K20130729

http://www.babycenter.com/0_first-aid-for-choking-and-cpr-an-illustrated-guide-for-child_11241.bc

 

Your Child

Bullying Leading to PTSD in Some Kids

2.00 to read

Most people probably associate post-traumatic stress disorder (PTSD) with men and women who have been in battle during war or experienced a traumatic life-changing event such as 9-11.

A new study says that children who are victims of bullying can also suffer from PTSD and the effects can last into adulthood. The study, published by Thormod Idsoe, Atle Dyregrov, and Ella Cosmovici Idsoe, found that about 33 % of bullying victims suffer from PTSD. In addition, 40 to 60 % of adults who have been bullying victims suffer from high levels of the signs of PTSD as well.

PTSD can have a very disruptive effect on one’s daily living. PTSD is a mental health disorder defined by nightmares, severe anxiety, flashbacks, uncontrollable thoughts about the event, and avoidance behavior.

"Pupils who are constantly plagued by thoughts about or images of painful experiences, and who use much energy to suppress them, will clearly have less capacity to concentrate on schoolwork," Idsoe said in a statement. "Nor is this usually easy to observe - they often suffer in silence."

Researchers at the University of Stavanger, in Norway, analyzed data from 963 students who were 14-15 years old. While boys were more likely to report they were being bullied, they found that girls were more likely to display PTSD symptoms. 

Of the students who reported being bullied, 27.6% of boys and 40.5 % of girls had symptoms of PTSD.  Researchers were not sure why some bullied children suffered from PTSD and some did not. "We...found that those with the worst symptoms were a small group of pupils who, in addition to being victims of bullying, frequently bullied fellow pupils themselves," Idsoe said. "One explanation, for example, could be that difficult earlier experiences make the sufferers more vulnerable, and they thereby develop symptoms and mental health problems more easily."

What are some of the symptoms of PTSD?

-       Reliving the event over and over.

-       Avoiding situations that remind you of the event.

-       Feeling numb or unable to express feelings.

-       Not interested in activities or able to enjoy them.

-       Feeling keyed-up or jittery. Always on the look out for dangerous situations.

Children can experience all the above symptoms or have other symptoms depending on their age.

-       Children age birth to 5 may get upset if their parents are not close by, have trouble sleeping, or suddenly have trouble with toilet training or going to the bathroom.

-        Children age 6 to 11 may act out the trauma through play, drawings, or stories. Some have nightmares or become more irritable or aggressive. They may also want to avoid school or have trouble with schoolwork or friends.

-        Children age 12 to 18 have symptoms more similar to adults: depression, anxiety, withdrawal, or reckless behavior like substance abuse or running away. 

Many schools are finally beginning to take bullying seriously. They have instituted anti-bullying programs and sometimes provide counseling - although allotted counseling time is often too short.

There are two types of treatments for PTSD, psychotherapy and medications. If your child is experiencing PTSD make sure that you find a therapist trained in pediatric PTSD therapy. PTSD can persist for years in some children and follow-up care is necessary to help your child heal and move forward.  

There are also many excellent online resources for how to deal with bullies and suggestions for what to do if your child is being bullied.

The study was published in the Journal of Adolescent Psychology.

Sources: http://www.medicaldaily.com/articles/13284/20121127/bullying-lead-ptsd-victims.htm#atskrsqZmiFdMBtR.99

http://www.ptsd.va.gov/public/pages/what-is-ptsd.asp

Your Child

Kids’ Type 2 Diabetes Difficult to Treat

2.30 to read

Type 2 diabetes was once considered an adult disease. Not so anymore. Kids are being diagnosed at an alarming rate, and now a new study says that these children are going to have a tougher time getting the disease under control.

Obesity and lack of physical activity are two of the most common reasons someone gets type 2 diabetes. During the past three decades, the tripling of obesity in children has gone hand in hand with an increase of type 2 diabetes in children.

What is type 2 diabetes? It begins when the body develops a resistance to insulin and cannot use insulin properly. The pancreas is no longer able to produce sufficient amounts of insulin to control blood sugar. Hyperglycemia is the medical term for high blood sugar levels. The reason it is so bad is that hyperglycemia can damage the vessels that supply blood to vital organs, which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems.

In a large new trial looking at ways to slow the progression of type 2 diabetes in children and teens, the addition of a second drug to the mainstay treatment metformin was only marginally more effective at controlling blood sugar than metformin alone.

Within a year, on average, half of kids on metformin and some 40 percent taking both metformin and rosiglitazone (Avandia) ended up having to resort to insulin injections to control their blood sugar, researchers reported Sunday at the annual meeting of the Pediatric Academic Societies in Boston and in the New England Journal of Medicine online.

"The results of the study were discouraging," said Dr. David Allen from the University of Wisconsin School of Medicine and Public Health in an NEJM editorial. "These data imply that most youth with type 2 diabetes will require multiple oral agents or insulin therapy within a very few years after diagnosis."

All 699 children included in the study had been diagnosed with type 2 diabetes two years or less before enrollment, so the rapid advance of about half to needing insulin marks an early start to a potential lifetime of complications and side effects -- from the diabetes itself and the medications used to treat the disease.

Type 2 diabetes "progresses more rapidly" in youth, according to Dr. Phil Zeitler from the University of Colorado, Denver, who worked on the new study.

He and his colleagues were surprised at how quickly many of the youngsters needed to switch from oral medications to taking daily insulin shots, Zeitler told Reuters Health.

Also, Zeitler said, the teens in the study appeared to have complications, including infections and hospitalization, more often than adults do.

All the children in the study were overweight or obese, and ranged in age from 10 to 17 years old.

Children also may have a more difficult time taking their medications as instructed and are not usually in control of what is given to them to eat. Fast food dining has become a staple for many American families. School lunches are not much better in some regions, and kids are simply not as active as in past generations. Zeitler noted "the toxicity of your lifestyle must be pretty severe," for young children and teens to get type 2 diabetes before adulthood.

That's why all of the kids in the study got at least "basic lifestyle counseling," he emphasized -- for example, advice to stop drinking sugared sodas, eat less fast food, watch their diet in other healthy ways, take stairs instead of elevators and generally get more exercise.

Study enrollment began in July 2004 and follow-up continued through February 2011. All the kids in the study were taking metformin, a well-established diabetes drug, and a third were assigned to take the newer drug Avandia as well.

Another third of the kids were assigned a very intensive "lifestyle intervention," that involved more assignments for kids to complete, more interaction with counselors, and close involvement of at least one parent, in addition to taking metformin.

The kids' treatments were deemed failures if blood sugar and other signs pointed to their diabetes not being under control for a period of six months or more.

In the end, 52 percent of kids on metformin alone "failed" treatment, along with 39 percent of kids on metformin and Avandia and 47 percent of kids on metformin and lifestyle changes.

The median time it took for blood sugar control to be lost was just under a year.

The added benefit of Avandia was limited to girls, for reasons that are unclear, the researchers reported.

Also for unknown reasons, they noted, metformin alone was less effective for non-Hispanic black participants than other kids.

Overall, 19 percent of the participants developed serious adverse effects such as severe hypoglycemia, diabetic ketoacidosis and lactic acidosis.

The rate in the treatment groups was 18 percent in the metformin-only group, 15 percent in the double-drug group and 25 percent in the group that received the very intensive lifestyle intervention. The rate of specific problems such as hyperglycemia, were not significantly higher between the groups.

Fifty years ago," the editorial continues, "children did not avoid obesity by making healthy choices; they simply lived in an environment that provided fewer calories and included more physical activity for all. Until a healthier 'eat less, move more' environment is created for today's children, lifestyle interventions like that in the ...study will fail."

Type 2 diabetes can be difficult to diagnose in children because they may go without symptoms for a long time. A blood test to measure glucose metabolism is needed for an accurate diagnosis.

Mayoclinic.com gives these symptoms to be aware of. 

- Increased thirst and urination. As excess sugar builds up in your child's bloodstream, fluid is pulled from the tissues. This may leave your child thirsty. As a result, your child may drink — and urinate — more than usual.

- Increased hunger. Without enough insulin to move sugar into your child's cells, your child's muscles and organs become depleted of energy. This triggers hunger.

- Weight loss. Despite eating more than usual to relieve hunger, your child may lose weight. Without the energy sugar supplies to your cells, muscle tissues and fat stores simply shrink.

- Fatigue. If your child's cells are deprived of sugar, he or she may become tired and irritable.

- Blurred vision. If your child's blood sugar is too high, fluid may be pulled from the lenses of your child's eyes. This may affect your child's ability to focus clearly.

- Slow-healing sores or frequent infections. Type 2 diabetes affects your child's ability to heal and resist infections.

- Areas of darkened skin. Areas of darkened skin (acanthosis nigricans) may be a sign of insulin resistance. These dark patches often occur in the armpits or neck.

Treating type 2 diabetes is much more difficult than preventing it. Long-term diabetes can have devastating results on your health. That’s why it’s so important for families to be aware of the disease and what it takes to help prevent it.

Sources: http://www.mayoclinic.com/health/type-2-diabetes-in-children/DS00946/DSECTION=symptoms

http://www.reuters.com/article/2012/04/30/us-diabetes-kids-idUSBRE83T17K20120430

Your Child

Gender Identity Confusion

If your middle-years child seems to have distortions and confusions in gender identity, discuss boy and girl, male and female behavior directly with him or her. For instance, talk with your child about the specific gestures or behavior that may provoke reactions from others, and identify together some that might be more appropriate.On Wednesday,we talked about gender identity, and at what age children begin to understand the difference between being a boy or a girl. We also covered children who may not fit the stereotypical gender role.

An example would be little girls who love to play with trucks and climb trees, or young boys who might prefer reading instead of playing sports. These children may not feel comfortable with traditional gender role-playing activities, but that in itself, does not mean they are confused about their sexual identity. Gender confusion is more complicated. More than just lacking an interest in sports, for instance, some boys actually tend to identify with females. Likewise, some girls identify more with masculine traits. Conflicted about their gender, they may deny their sexuality. Rather than learn to accept themselves, they may come to dislike that part of themselves that is a boy or a girl. At the extreme, a boy may seem more effeminate and have one or more of the following characteristics: •   He wants to be a girl. •   He desires to grow up to be a woman. •   He has a marked interest in female activities, including playing with dolls or playing the roles of girls or women. •   He has an intense interest in cosmetics, jewelry, or girls' clothes and en­joys dressing up in girls' apparel. •   His favorite friends are girls. •   On rare occasions, he may cross-dress and actually consider himself to be a girl. An effeminate boy is sometimes ridiculed, teased as being "gay," and shunned by his peer group. This rejection may intensify, as the boy gets older. As a result, he may become anxious, insecure, or depressed and strug­gle with self-esteem and social relationships. On the other hand, girls who identify with boys are thought of as "tomboys." They usually encounter less social ridicule and peer difficulties than effeminate boys do. For many girls, some tomboy-ness seems to be a very natural course toward healthy adolescent gender identity. Yet there are rare girls who exhibit one or more of the following traits: •  They express a wish to be a boy. •  Their preferred peer group is male. •  When playing make-believe games, they prefer male roles over female ones. These traits suggest a conflict or confusion about gender and relationship with peers of the same sex. The possible causes of these variations are speculative and controversial. Research demonstrates a role for both biological factors and social learning in gender-identity confusion. What Should You Do? If you notice the above traits in your child, it’s normal to worry about your child’s happiness and their ability to fit in with society’s rules and roles. That’s what parents do. But, over-reacting or trying to force your child to change who they are, often brings about only more confusion and sadness. If your middle-years child seems to have distortions and confusions in gender identity, discuss boy and girl, male and female behavior directly with him or her. For instance, talk with your child about the specific gestures or behavior that may provoke reactions from others, and identify together some that might be more appropriate. Through a sensitive dialogue, you might be able to help your child better understand his or her behavior and why it gets the responses it does from peers. Providing a lot of support for your child can bolster his or her self-esteem and counteract the social and peer pressures he or she might be facing. In addition to your own efforts, talk with your pediatrician, who may suggest that you consult a child psychiatrist or child psychologist to help overcome the youngster's confusion and conflict. Sexual orientation cannot be changed. A child's heterosexuality or homosexuality is deeply ingrained as part of them. As a parent, your most important role is to offer understanding, respect, and support to your child. A non-judge-mental approach will gain your child's trust and put you in a better position to help him or her through difficult times.

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