1. It is EDUCATIONAL.  There are lots of ways to learn everywhere, including the park.  You count –“ 1, 2, 3. “You practice vocabulary – “ready, set, go.” We take walks around and describe the equipment, the trees, the community, and even the sky and clouds. We work on our communication skills with each other and with new friends that we make.
2. We practice following the RULES. We get to practice taking turns. We figure out how to share things with strangers. We practice learning self-control because we have to wait our turn. We also see the ways that other families handle situations and discuss later the pros and cons. We also review and practice playground etiquette and safety – do not walk in front or behind the person swinging, go down the slide (not up) and only after the person in front of you has cleared their path, when climbing up equipment do not trample over the person in front of you.
3. It is HEALTHY. We play outside enjoying the fresh air and the sunshine. We exercise in a fun manner using different muscles on all of the different equipment. We use our legs in climbing, practice balance on the bridges, use our arms on the monkey bars and rock climbing. We run and jump and swing.
4.  It is good for our DEVELOPMENT. We practice being independent once we climb up the stairs and go down the slides without mommy and daddy right there. We challenge ourselves physically and mentally with the heights that we climb, the places that we swing and the speed that we slide down. And when we finally learn how to make ourselves go on the swings, or climb up that rock wall, or slide down that big, curvy slide, we feel a sense of pride in our accomplishments and we gain some sense of self-confidence.
5. It is FUN FAMILY time. We laugh and make memories. We spend positive time together. We look forward to the next time that we can enjoy the experience again.

As I opened the windows for the first time this spring, I realized how low to the ground they are – I would say probably 18 inches to 2 feet from the floor in our bedrooms. While we do have window screens, the height really concerns me because Mary is also at a perfect height to lean a little too much and potentially fall out of a window – and in the injury prevention world we say “screens are made to keep bugs out – not children in.”

According to Safe Kids Worldwide, there are 8 deaths and 3,300 injuries from falls from windows annually in children younger than age 5. Each year, Dayton Children’s sees 2-3 window falls – typically from a second or third story window. There are a few things that you can do to keep kids safe from window falls.

• Don’t rely on window screens to keep kids from falling out of windows.
• Open windows from the top or use window guards to prevent your child from falling through screens or open windows (kids can fall from windows opened as little as 5 inches, or 12.7 centimeters).
• Make sure window guards are childproof but easy for adults to open in case of fire.
• Move chairs, cribs, beds, and other furniture away from windows to prevent children from climbing onto sills.

And of course, always supervise children around open windows.

Enjoy this beautiful spring weather!

1. Eat a gluten free diet to lose weight- When my friend, Julie, and I started hearing that eating gluten free (GF) will help you lose weight, we said to each other, “Huh?!”.  There is no magic weight loss with eating gluten free!  Going GF does force you to re-look at your diet – cutting out the processed, eat more whole foods including more fruits and vegetables.    These diet changes, for anyone, can promote weight loss!
   Does eating gluten free help with weight loss?  NO – Gluten free products outweigh the non-gluten free with more calories, fat and sugar. Extra fat and sugar add taste and texture that are lost when gluten is removed.  Plus, the GF diet lacks several nutrients and one will have to supplement (please read on to find out more!).
2. Avoiding gluten makes my stomach feel better- Why do more and more people avoid gluten?  Could it be with the growing number of GF products?  Could it be that GF choices taste better than ever?  Are we self-treating because of possible bloating, stomach cramps and pains?
   Should I continue to eat GF if it helps my stomach feel better?  Seek your physician’s approval of such a diet change and work with a registered dietitian to optimize your diet.  Maybe there are other reasons for such stomach issues.   Yes, 1 in 133 people have been diagnosed with Celiac.  But, treating yourself will not give you the correct diagnosis.  (See this site for specific steps in diagnosing Celiac). And, one needs to be savvy when following this diet!
3. Eat Gluten Free to cure Autism- Will going gluten free cure my child’s Autism?  It is a mixed answer out there – research does not support going on a GF (and casein free) diet to “cure” Autism.  But, some parents say such a diet does help alleviate symptoms of Autism.  If you choose to feed your child follow this strict diet, do so under the guidance of your physician and work with a registered dietitian to ensure your child meets all nutrient needs.

If you do follow the gluten free diet, be savvy:

What do I miss when eating gluten free?  Gluten free products are made with refined flours.  They lack iron, folic acid, calcium, B-vitamins and fiber normally rich in the original whole grain.

How do I get all these missed nutrients back into my diet? Start with supplements.  From there, work with a registered dietitian to identify ways to boost your nutrient intakes via whole foods.

Suppliers of GF Vitamin and Mineral Supplements

• Freeda Vitamins: Entire line is GF; www.freedavitamins.com; 800-777-3737
• Nature Made: Entire line is GF; www.naturemade.com; 800-276-2878
• Solgar: Most vitamins are GF; www.solgar.com; 877-SOLGAR4
• Twin Lab: Most vitamins are GF; www.twinlab.com; 800-645-5626
• Whole Foods 365 Vitamins: Most vitamins are GF; www.wholefoods.com

Obtained from: PRACTICAL GASTROENTEROLOGY • SEPTEMBER 2006

Are GF foods really gluten free?  If you truly need to follow this diet, take note!  In 2007, the FDA initiated a proposal for regulation of gluten free foods.  The comment period started almost 6 years ago; the public keeps waiting on guidelines for labeling of gluten free food products.    Right now, foods can be labeled as gluten free, but, without the regulations- the unknown prevails to the consumer – how much gluten is really in my food?  As I was grocery shopping with Julie when she was first diagnosed with Celiac disease (CD), we noticed many foods labeled as gluten free. But, in small print, several would say, “Manufactured in a plant that manufactures wheat.”  Contamination – these products are not truly gluten free!  Let’s hope for the release of an update in labeling laws for GF products to happen soon.

If you follow a GF diet, bottom line:

• Ask your physician if the GF diet is for you.
• Work with a registered dietitian to optimize your nutrition.
• Take a multi-vitamin; eat foods rich in fiber, calcium, iron and B-vitamins.
• Beware – the GF diet can be expensive!
• One must be savvy in following this diet if you have Celiac disease.  Don’t be fooled by the fad!

There are times when values come in conflict. We want honest children but we also want our kids to be respectful of others, and not do anything to intentionally hurt someone else’s feelings.  We advise our kids to be thankful of a birthday gift and tell the recipient that they liked it, even if they don’t. They tell Grandma that her horrible beef casserole tastes great. In these situations, the value of treating others nicely becomes more important than being sincere. We’ve even made up a name of such deceit, calling them white lies to justify such behavior.

Psychologists call this dishonesty “prosocial lie-telling” and it is very common with both adults and kids. Children begin telling white lies around age three. At that age, they are developmentally sensitive enough to be aware of others’ reactions and tell lies in social situations to avoid hurting someone’s feelings. Younger children have a difficult time with lying, as their words don’t always match their nonverbal behaviors. In one research study, kids who told an experimenter that a bad picture looked fine actually smiled less during the interactions than a control group of kids.

I’m not sure how well we could function if everyone always said how they felt. The values of politeness and respect help us get along with each other.  How do you explain the conflicting values of honesty and politeness to kids?

1. Model the behavior you want. An occasional white lie will have no impact on your child’s ethical development if it is an exception to the way you live your life. Children learn from watching us deal with all of the routine tasks of daily life, and will be most affected by our pattern of behavior, not an isolated lie.
2. Don’t lie to avoid tough situations. These are tests of your ethical principles and your kids are watching what you do. Let your kids know that honesty isn’t always easy, and at times can cause distress to you and them.
3. Label and discuss white lies.  If you’ve observed your child lying in order to be polite, talk about that at the dinner table. Avoid criticizing their behavior (since they learned it from you), but caution them in its use.
4. Honesty within the family. Create a family where honesty trumps politeness. This may be uncomfortable for you and your kids at times, but it sends a strong message about the importance of honesty over politeness.

Now that Winter is finally behind us, and longer days and warmer weather are here, it is a great time to make healthy lifestyle changes. With 1 out of 3 kids now identified as overweight or obese in our country, there is no time like the present to help your child and your entire family adopt healthier lifestyle behaviors. The younger that kids learn healthy lifestyle behaviors, the more likely they are to adopt these healthy habits and make it a part of their own routine.

Adopting healthier lifestyle changes may seem overwhelming at first, but here are some helpful tips to make this doable for you and your family:

1. Set a goal. This should be a short-term, detailed, realistic goal, focusing on a behavior that you can control, and that you and your family are confident that you can complete. For example, instead of having a goal, “We are going to eat healthier,” try a goal of “We will try 2 types of new fruits or vegetables this week.”   Accomplishing one small goal, can increase your motivation to continue to set and reach goals in the future!
2. Change your environment.  If your goal is to eat healthier, then get the junk food out of your house! If the less healthy food options aren’t available at home, it is much harder to make an unhealthy food choice.  Set your family up for success!
3. Model positive behaviors.   Kids learn by observing their parents and other adults in their lives. If you want your kids and your family to be healthier, be a good role model and practice what you preach!  We can’t expect our kids to eat healthier, if we don’t ourselves.
4. Incorporate physical activity into a fun, family activity.    Maybe you can plan going for an after-dinner walk or play catch in the yard. How about trying to find a new park or hiking paths to explore as a family on the weekend?  Making physical activity fun, will make it more likely to be a habit to stick around.
5. Be positive!  Changing lifestyle behaviors, can be difficult. Give your kids (and yourself) positive words of encouragement to keep up your motivation to maintain changes. Notice the positive changes that have come as a result of your effort, and make it a point to verbalize the positive changes to your child.

By: Sarah Highstein, Psy.D

Dr. Sarah Highstein is a pediatric psychologist at Dayton Children’s Hospital where her primary role is within the diabetes team.  She received her doctorate at Nova Southeastern University in Ft. Lauderdale, Florida and completed her fellowship at Mt. Washington Pediatric Hospital in Baltimore, Maryland. Her primary interests encompass working with kids with medical conditions and helping families achieve healthy lifestyle goals.

The blog talks about a recent study published in Pediatrics where findings suggest that parents who “wash off” a fallen pacifier in their own saliva may actually be helping their children avoid developing allergies – particularly eczema and asthma.

According to the blog, scientists think that when parents suck their child’s pacifier to clean it, they may actually transfer some of the harmless bacteria in their mouths to their child. These bacteria may actually stimulate a child’s immune system so it doesn’t overreact to things such as peanuts or pet dander down the road.

One award I will never win is the award for keeping Mary’s pacifier, or more affectionately known as “The B,” all that clean.   These findings support the notion that we may be living in a world that is “too clean” – and if that is the case then my home might be a great place to raise a family!

Once diagnosed with Celiac Disease (CD), Julie contacted me. How does she follow a Gluten Free diet?!

What we did:

• I provided Julie with the Dayton Children’s Newly Diagnosed Celiac booklet from our gastrointestinal clinic dietitian and we went grocery shopping!  We went to several grocery stores, reading ingredient lists and comparing them to the VAST list of items that contain gluten.
• We reviewed foods that Julie enjoyed eating and investigated if they were truly gluten free.  One finding stood out: SOME items that were marketed as “Gluten Free” truly were not – simply for being manufactured in a facility that also manufactured wheat!
• I purchased a helpful text: Libonati, C “Recognizing Celiac Disease”. The easy read helped educate us more about WHAT was happening in her body, WHY she should follow the diet diligently and the COMPLICATIONS of Celiac Disease.

When someone lives with such different diet restrictions, they become the experts. Some of Julie’s, now-expert and helpful, hints to eating Gluten Free:

• Get a separate toaster and stop using family’s toaster
• Get a separate skillet
• Make a list of foods you like.  Investigate these food labels to see if they are truly gluten free.  Contact food companies for any questions on cross-contamination.
• Keep a binder for food labels and information obtained from food companies
• Keep handy a list of gluten containing ingredients for grocery shopping
• Try different gluten free breads.  Freeze the bread in slices.  Use as needed.
• Cook gluten free recipes in bulk.  Freeze serving sizes for meals.
• Gluten free foods now available: Rice Krispies, Chex Cereals (minus the wheat), Betty Crocker Gluten Free cake mixes
• Keep your eye open for Gluten Free options at restaurants and bakeries:
  • Fox’s Pizza in Tipp City offers gluten free pizzas and breadsticks
  • Check out Sinfully Gluten Free in Centerville
  • PF Cheng’s has a vast gluten free menu
  • Cupcakes by Kristy in Tipp City makes gluten free cupcakes on Friday’s
  • More restaurants have a gluten free menu
  • Subscribe to magazine: Gluten Free Living

Since Julie knew that Celiac is an Autoimmune Disorder and there is a history of autoimmune disorders in her family medical tree, she watched for signs in her own family. About one year later, when her son was not growing well, she asked for a CD evaluation and he, too, was diagnosed with CD.   As a result of following the Gluten Free diet, his blood levels drastically improved along with his growth in height.  (Interestingly, Julie’s brother has recently been diagnosed with CD)

Then and now, the challenges of her son eating outside the home, in daycare and at school are present. Some helpful hints when needing to follow a Gluten Free diet outside the home for your child:

• Contact the center/school and review their menu and food preparation method. Talk with the main teacher and create a plan on how to provide foods.
• Breakfast – pack GF cereal daily
• Lunch – Check with the center/cafeteria regarding meats as some may be okay. Confirm that the plain fruit and vegetables are really plain. Pack a sandwich or another kind of meat. Is the facility willing to warm things up for the child? Consider packing similar items for your child to eat (ie:  if pancakes or pizza are on the menu, send the same gluten free item).
• Snack – Provide the gluten free snack
  • Keep a box at school with prepackaged snacks so they are always on hand: Jell-O, pudding, raisins, GF pretzels and fruit snacks
  • Direct the teacher to communicate with you about future parties with special foods so you can try to send a similar gluten free item.
  • If going to a friend’s home:
    • Communicate with the family about your child’s diet.
    • Assist with identifying a plan for your child’s meals at their home.
    • Consider sending gluten free snacks, desserts and food alternatives to make the visit a pleasant one.

For additional information, check out Mary Sharrett’s blog “Is a Gluten-Free Diet Healthy For My Child?”

Recipes created for children with CD

Activities to Zucchini would like to thank Julie for sharing her story of living with Celiac Disease.

Research conducted last year by Commonsensemedia.org gives us some insight into this alternative world. Sixty-eight percent of teens text daily and 51% visit a social media site such as Facebook at least once a day. This is scary to many parents, but not to their children. They experience this electronic world in very positive ways. Teens report that social media sites help them feel less shy (29%), more confident (20%), and sympathetic to others (19%).  Kids 13 to 17 years of age report that such sites have improved their relationships with friends (52%) and family members (37%).  Only five percent of teens report that social media makes them feel more depressed.

We worry about things that we don’t understand and this digital world is foreign and frightening to many parents. Here are the four most common mistakes made by parents in attempting to guide their kids’ electronic lives.

1. Prohibit technology. Some parents take pride in the fact that they won’t allow their kids to text or use social media. That may work fine for some families, but please realize that our job as parents is to prepare teens for a time when we won’t be around. Wouldn’t it be better to learn how to manage this technology under parental guidance rather than let kids figure this out as young adults?
2. No supervision. Most parents go to extraordinary lengths to supervise their teens but think little of buying a smart phone for their child, with 58% of teens now owning such phones. At least for young teens, their access to such technology should come with an expectation that parents can access their texts and Facebook accounts.
3. Ambiguous expectations. I’ve been impressed by those parents who have their kids sign an agreement that clearly specifies parental expectations about the use of technology. This may include limits on when phones can be used, access to texts, and restrictions on visiting certain websites.
4. Over or under reaction to mistakes. Our kids are going to send inappropriate texts, post offensive information on Facebook, or spend excessive time on the internet. Don’t overreact to those situations. I admire those parents who can navigate these issues by implementing reasonable consequences. They avoid the extreme of either dismissing such mistakes as normal, or overreacting and taking away a cell phone for a year.

Our kids love this technology and experience it as mostly positive. Let’s help them learn how to minimize the risks when experiencing the many benefits.

Working in a children’s hospital, I see many kids come in with injuries and illnesses that can cause a lot of physical pain. If you think back to a time when you were injured, you might recall an initial feeling of numbness and shock at what just happened. Then, the pain hit and may have even felt quite unbearable at times. You may have begun to worry about whether you were going to be okay. When you got help and aid for the injury, you began to feel better and your wound started to heal. There may always be a scar or the area may always feel a bit tender and sensitive. Although you might wish you never had the experience, you got through it and feel like a stronger person because of it.

The experience of grief and loss for children is similar to having a physical injury. When a loved one dies, it is natural to feel sadness, pain, and many other emotions. These feelings will come and go throughout the rest of a person’s life. At times, the pain and emotions are strong and intense. At other times, the feelings are more manageable. While the emotional wound of losing someone you love can be deep, there are ways to support a healing process to mend the wound and help children cope with their emotions. A scar will always remain and pain and sadness will resurface at times, but with support, children can find ways to keep living and loving in spite of loss.

Eight tips for supporting children through their grief process:

1. Use concrete words like death, died, and dying. Young children may become confused with other terms such as gone or sleeping.
2. Children may need information repeated over and over again as they are trying to make sense of it all. Be honest and provide information in terms they can understand. Use the opportunity to talk about the family’s faith, spirituality, and beliefs about life and death.
3. Give children choices about their involvement in funerals, rituals, etc. If they choose to participate, spend time before the event talking through what will be happening and answering questions they may have.
4. Encourage children to talk about their thoughts and feelings, but do not force it. Inform them that you are ready to listen when they are ready to talk.
5. It is okay to cry and show emotion in front of children. This will model to your child that his/her feelings are normal and allowed.
6. Make available physical outlets for letting out feelings, such as playing sports, hitting a pillow, or going to the playground. Some children also prefer to express emotions through journaling or artwork.
7. Share memories and encourage others to share memories of the loved one with your child. Give your child something tangible that belonged to the loved one to keep.
8. Find ways to keep the memory of the loved one alive through special activities on anniversary dates, birthdays, and other special occasions. Although death has changed the relationship with the loved one, the bond will always remain.

While it can be helpful to find distraction from painful feelings at times, it is important to remember that children can also find relief from confronting grief-related feelings. Author Earl Grollman stated, “Grief is not a disorder, disease or a sign of weakness. It is an emotional, physical, and spiritual necessity, the price you pay for love. The only cure for grief is to grieve.”

Some children find it helpful to work through their journey of grief by attending a grief support group. Such groups provide a place where kids can meet others with similar experiences so they don’t feel so alone and different. They also provide the opportunity to express feelings and memorialize loved ones through grief games, arts and crafts, and other activities.

For more information about children’s grief, visit The National Alliance for Grieving Children at www.childrengrieve.org. Information about a local grief support group, Oak Tree Corner, can be found at www.oaktreecorner.org or by calling (937) 285-0199.

By: Candace Beck, Psy.D.

Dr. Beck psychologist at Dayton Children’s Hospital. She received her degree from Wright State University School of Professional Psychology. She is part of the pain management team at the hospital where she helps children learn behavioral skills for coping with chronic pain. Dr. Beck also has an interest in working with grieving children and fostering their resilience. She completed her doctoral dissertation on the topic of sibling bereavement and is an active volunteer at Oak Tree Corner in Dayton.

Multiple times a day I hear, “Mom, Ethan did this… Aunt, Audrey did that…” and so many times I do not want to take action to solve whatever complaint I am hearing. So we have really been discussing what the differences are between telling and tattling. Here are our definitions:

• Telling – you tell on someone when they are at risk of harming themselves, others, or property.
• Tattling – you are tattling on someone when they do something you do not like and you do not know how else to deal with it. You are tattling when you are just trying to get them into trouble.

Telling is okay and we, being the authority figures, need to know about these instances to keep everyone safe. When it is tattling, we all need to take a break and discuss conflict management and how to resolve our differences. Our game plan now is when the kids come to us tattling, we first ask them, “Are you telling or tattling?”  If they are telling then we need to know who or what is getting hurt. If they cannot answer that part of the question then they get one chance to return to the play area and try to work things out without us getting involved. If we have to get involved then there are consequences; either they lose the toy or game they are playing with, or they all have to separate and play be themselves, or they have to take a moment of time out.

How do you handle disputes at your house?