Behavior Archives

Developmental Screenings for Children are Important

Posted on June 25, 2021 by

If you are a parent or guardian of a child, you know the importance of regular doctor visits. In addition to the standard components of a visit, the American Academy of Pediatrics (AAP) recommends that pediatricians talk with families about their child’s development at every well-child visit between birth and 3 years old, and conduct developmental screenings at 9, 18 and 30 months of age.

During the first three years of a child’s life, their brain undergoes a remarkable period of development, and these years are considered the most important in a child’s development. These years are an important time for developmental monitoring and screening. According to Centers for Disease Control and Prevention (CDC), developmental monitoring observes how your child grows and changes over time and whether a child is meeting typical developmental milestones in playing, learning, speaking, behaving, and moving. A milestone checklist such as the one on MKSA’s website is a useful tool for this. All family members can participate in developmental monitoring. If you feel your child is not developing like other children of the same age, speak with your child’s pediatrician. At well-visits, doctors will do developmental monitoring and will ask you questions and will talk and play with your child. Childcare providers can also be a valuable source of information on your child’s development.

Developmental screening is a more in-depth look at your child’s development. Parents will complete a questionnaire about their child and your child may get a brief test. Screenings may be done by a doctor as well as other professionals in healthcare, early childhood education or school settings. Developmental screening is more formal and done less often than monitoring. Your child should be screened if you or your doctor have a concern, but developmental screening is a regular part of some well visits for all children. The AAP recommends developmental and behavioral screening for all children during well visits at the following ages: 9 months, 18 months, and 30 months. AAP also recommends that all children be screened specifically for autism spectrum disorder during well visits at 18 and 24 months. If your child is at a higher risk for developmental problems due to preterm birth, low birthweight, family history or other factors, your doctor may discuss additional screening.

Parents are sometimes hesitant about developmental screenings, believing that doctors are looking for problems. The opposite is often true. Parents—especially first-time parents—often have many questions about their child’s development. All aspects of a child’s development and life are considered, and doctors often reassure parents that behaviors and development are in fact typical. And if there is a concern, early help does make a difference.

If a developmental screening identifies an area of concern, a formal developmental evaluation may be suggested. An evaluation will identify and diagnose developmental delays and conditions and determine if a child is eligible for early intervention services. A developmental delay means a child has not reached age-appropriate milestones in one or more developmental areas. If the delay is significant enough to meet eligibility criteria, early intervention services are available at no out-of-pocket cost. To learn more about this, click here.

Many families have delayed well-child visits due to the pandemic, resulting in missed screenings. Schedules were altered, and ‘getting back to normal’ should include resuming regular checkups for children. Many milestones can only be measured by doctors in person. Parents can also discuss any concerns they may have about their child, and receive guidance, and resources if necessary. If well-visits were missed, now is the time to reconnect with your child’s doctor and discuss any concerns.

If you have any questions about your child’s development, MKSA is here to answer your questions. Please reach out by email at info@mksallc.org or call 516-731-5588.

Note: The information in this article is for informational purposes only. It is not an attempt to diagnose or treat any medical condition. Always consult your child’s pediatrician with any specific medical questions. MKSA is also available to answer questions about child development. Contact us at 516-731-5588 or www.mksallc.com.

Sources:

https://cdc.gov Developmental Monitoring and Screening

https://aap.org Developmental Screening

Strategies for Navigating the Holidays with a Special Needs Child

Posted on December 18, 2019 by

The holidays are a magical time of year for children, with plans for family get-togethers, gift shopping and gift anticipation, as well as other loud, colorful activities. For children with special needs this can be an immensely stressful time of year full of many challenges at home, in school and throughout the community. The holidays are full of potential triggers for children with autism, anxiety and other special needs. By planning ahead and having alternate plans, you can help make the holiday season less stressful for your child. It is important to speak with any visiting friends and family member as well as those whose homes you will be visiting. Share with them any special behaviors, quirks or sensitivities of your child so that they may better understand your child and his (and your!) needs and expectations.

For children with anxiety, anticipation is a big trigger in the time leading up to the holidays. This feeling often leads to anxiety overload, causing them to have a melt down just before, during or after the holiday. For these children, keeping the holidays low-key helps greatly. It’s okay to treat the holiday as an important day, but not in an over-the-top crazy way. To some children, piles of wrapped presents that cannot be opened can be stressful. Keeping these gifts out of sight can help children get stressed about waiting, and possible even opening gifts too early.

At this time of year, there is always an overload of sensory stimuli such as lights, music, bells, odors, tastes, crowds, and hugging. There are strategies for each of these situations; if you can speak with your child and discuss what elements are the most stressful, you can formulate a plan. For example, if certain smells upset your child, consider getting an artificial tree and battery-operated candles. If lights are a trigger, try ones that don’t blink. Decorate tastefully, leaving plenty of space throughout the home so that it doesn’t feel overdone or overcrowded with seasonal items. Try listening to instrumental, relaxing holiday music instead of loud, “busy” music. While planning visits to the mall, try to go during less-crowded times, when your child is well-rested and not hungry.

Family visits can be especially stressful for children with autism, sensory processing disorder, or other special needs. Prepare your child for any dinners or social events in advance. Discuss who will be visiting or where you will be going. Explain that it’s okay if he doesn’t want to hug or shake hands. Let him know there will be a quiet place where he can go to relax; this can be in your home or in someone else’s home (ask your host in advance). Be sure to prepare items such as noise cancelling headphones, a weighted blanket, a stuffed animal, tablet or books. Whatever soothes your child should be available to him, either in your home or in a backpack packed for the day.

It is important to let your child know that it is okay to feel a bit ‘off’ during the hectic, crowded time of the holidays. Let him know that his normal routine will return after the dinner/visit/outing. Work with your child to be sure to get positioned in a place (a corner of someone’s living room, a separate quiet room, a seat in a house of worship such as an aisle near the exit) that offers some comfort and an exit strategy.

An important element to consider is YOUR level of stress. If you are feeling out of sorts and overwhelmed, your special needs child will likely react to your stress. It is at this time that you need to take care of you. Breathe. Take a bath. Go for a walk. Take a break and ground yourself, so that your child will relax too.

Here are some tips from A Day in Our Shoes (adayinourshoes.com) that can function as a checklist for the holidays with children with special needs:

School Holidays and the Special Needs Child

Communication is key! Communicate with your child’s teacher, read the school website. Find out what changes are going to happen as best as you can. Prepare your child for these changes–different meals, assemblies, early dismissals, whatever it may be.
Ask your teacher to have a “one sheet” included in her sub-folder about your child. This should include the necessary information that a sub would need to know about your child and what may cause him anxiety.
Have daily briefings at breakfast and dinner. It sounds formal, but it doesn’t have to be. Just talk about what is going to happen that day or what did happen that day. What will be different?
Contact his therapists or whoever works with your child and ask if they can do more role-playing, scripting and/or social stories related to holiday festivities.

Holidays with a Special Needs Child at Home

If you haven’t sent out holiday cards in a while (not many people do it anymore!), consider sending them to the people you will come into contact with, might be visiting or might be staying with this holiday season. This is an easy and private way to share your child’s “quirks” and expectations.
Talk with your child. Find out what their expectations are and make sure everyone is on the same page. Prepare them as best you can. Again, consider the morning and evening daily briefings.
Pick your battles. Food doesn’t have to be an issue. Consider bringing some healthy snacks with you to family dinners. If your child refuses to wear a shirt and tie, it’s okay!
When visiting, bring things that are a comfort to your child, especially if staying overnight. A favorite blanket, pillow, and his own shampoo will go a long way in soothing a child that is not sleeping in his own bed.
Don’t force affection. This is another item you can explain to friends and family before your visit. If your child does not want to embrace and kiss relatives they barely know, or do not enjoy being hugged, respect that. Explain to the relatives that your child really does care about them, but that this is not how he shows it.
Have an escape signal or word. Give your child an “out” if it is more than he can handle.
Go visual. Have a color-coded calendar or some other method of visually outlining what your family is doing. Consider doing it with velcro so that items can be moved and removed if you need to alter your schedules.
Sensory-friendly events and Quiet Santas are very common around the holidays. These are a great opportunity to participate and be able to relax a little bit.
Set your child up for success. Pre-arrange conversations with relatives so that your child is included. A simple “I heard that you really enjoyed your school field trip to the museum” might be much more engaging for your child instead of “what’s your favorite subject at school?” but a relative may not know that.

Stress, Holidays and Special Needs Moms.

Remember that holidays and holiday breaks are intended to be a relaxing time and a “reset” so that you can go back to work/school rested and refreshed. Keep that in mind as you do your holiday schedule.
Say no. Often. You don’t have to do everything.
These are good opportunities to educate family and friends about your child’s issues. But, keep your child in mind–do not talk about them in front of them.

The bottom line is that families celebrate holidays in many ways. For families with special needs children, some additional planning may be necessary to comfortably experience this time of year. But with a lot of communication and much planning, it can truly be a magical time of year.

Wishing you and yours a healthy, happy holiday season!

Sources:
Adayinourshoes.com
Comfortinganxiouschildren.com

All About Separation Anxiety in Children with Special Needs

Posted on September 2, 2019 by

Separation anxiety is a normal stage in a baby’s development that helps them to understand relationships and master their environment. Crying, clinginess or tantrums are healthy reactions to separation and are a normal stage of child development. Typically, it ends around 2 years of age, as toddlers start to understand that a parent/caregiver may be out of sight but will return later. Separation anxiety disorder exists when the anxiety symptoms are excessive for the developmental age and cause significant distress in daily functioning.

At around 8 months old, a child may fear less familiar people and places. This usually peaks between 10-18 months of age and disappears by 2 years of age, however both attachment and the ability to easily separate may develop at an older age in a child with developmental delays or special needs. Some children experience severe anxiety—even as newborns—that does not improve over time and may even worsen. These children are often diagnosed later with a mood disorder or a neurological disorder such as autism or ADHD.

While some separation anxiety shows that a child has formed attachments with loved ones, leaving a child with child care providers or others can be stressful for everyone. To ease typical separation anxiety, parents can make partings easier for a child in several ways:

-follow a goodbye ritual; children with special needs find structure reassuring

-stay with him until he becomes familiar with a new person or place

-do not sneak away or scold a child for being upset

-reassure the child that you will be back after naptime or at dinnertime; keep that promise

-do not leave a child when he is tired, hungry or ill

-leave your child with his favorite blanket or other “lovey”

Separation anxiety disorder is not the same as separation anxiety and is not a normal stage of development. It is a serious emotional problem characterized by extreme distress when a child is away from the primary caregiver. Since both situations share many symptoms, it is sometimes difficult to differentiate which your child is experiencing. The main differences are the intensity of your child’s fears and whether these fears keep him from normal activities. Separation anxiety disorder is the most common anxiety disorder in children under 12 years of age. Symptoms must be present for at least four weeks for separation anxiety disorder to be considered.

Some causes and risk factors for separation anxiety disorder in children include: change in environment (new house, school, or day care), major stressor or loss (death of a loved one or pet, change of schools, divorce) and overprotective or intrusive parents.

Symptoms of separation anxiety disorder may include:

-excessive distress when separated from attachment figures or the home

-worry about harm coming to attachment figures

-refusal to go to school because of fear of separation

-refusal to sleep away from home or to go to sleep without attachment figures nearby

-nightmares involving themes of separation from home or attachment figures

-repeated physical complaints such as headache or nausea when separate has occurred or is anticipated

-clinging to the caregiver; the child may shadow you around the house or cling to your leg if you try to leave

-for a child with special needs, he may show distress by regressing or becoming hyperactive

It can be very upsetting to see your child stressed, and sometimes parents inadvertently reinforce the anxiety by helping a child avoid things they are afraid of. Instead of avoiding separation, it is helpful to learn more about the disorder and take steps to make a child feel safer. Strategies for dealing with separation anxiety include:

–start with very brief separations: begin with increments of 5 minutes and gradually increase time spent apart

–teachers should use positive language: try “your dad will pick you up after story time” instead of “he left”

–try a photo story: make a picture story that includes photos of your child with alternate caregivers and school classrooms; if possible, you can arrange for a school/teacher visit before school starts so you child can see the photo of his teacher and classroom before school begins; he’ll know exactly what to expect on the first day of school

-“magic bracelet”: this bracelet can chase away anxiety; it can be made of materials that remind the child of his parents, or it may be something that belongs to the parents; it is used as an attachment object to transfer emotional security from the parent to the child

–say goodbye with a smile: try to say goodbye while the child is engaged in something positive; tell him briefly what you will be doing while you are apart, and give a return time

–let your child walk away from you: for many children, it’s easier to leave than to watch a parent/caregiver retreat

–try field trips: take trips together to reduce sensitivities and increase awareness of other people and life experiences

–play therapy: a play therapist directs play to work through specific issues a child is having

For children with separation anxiety disorder, a common symptom is refusal to go to school. There are tips for both parents and teachers that may help reduce a child’s symptoms. Parents can try the following suggestions:

-help a child who has been absent from school return as quickly as possible: if a shorter day is necessary initially, symptoms may decrease once they discover they can handle the short separation upon return

-ask for late arrival accommodations: additional flexibility to talk and separate at a slower pace can help a child separate

-have a safe place: find a place at school where your child can go to reduce anxiety, perhaps the nurse’s office or the library

-allow contact with home: sometimes during times of stress, a brief phone call with family can reduce separation anxiety

-send notes for your child to read: a note in his lunch box can work wonders

-reward your child: every good effort deserves to be praised

Parents might also want to discuss the following classroom tips for dealing with separation anxiety with their child’s teacher.

-make sure the child is prepared ahead of time: be sure the child has a morning routine and knows what to expect, and knows an exact time a parent will pick her up

-be sure to share background information about your child with the teacher: share info about your child’s daily routine and how he copes with change, including methods for soothing

-consider providing a comfort item such as a stuffed animal or a laminated family photo

-provide distraction: picture books are good distractions; consider stories that explain how a parent comes back

-try a little extra TLC: sometimes a child just needs a bit more attention, whether it’s holding her close or just an extra hug or time to sit alone with the teacher

-engage the child: if a child is busy making a special art project for mommy or daddy, he will be distracted and excited to surprise them when he gets picked up

As your child moves through ages and stages, if you feel his/her separation anxiety is causing significant stress regarding daily activities, you should seek professional help. Your child’s pediatrician can refer you to professional specialists who can help your child and your family. Anxiety disorders can be effectively treated, and treatment should be based on a comprehensive evaluation of the child and family. Treatment often involves cognitive behavioral therapy for the child, focusing on helping the child learn skills to manage his anxiety and help him master situations that contribute to anxiety. Some children benefit from treatment with medication that helps them feel calmer. Family therapy and consultation with the child’s school may also be recommended.

Early detection and intervention can reduce the severity of the disorder, enhance the child’s normal growth and development and improve the quality of life experienced by children with separation anxiety disorder.

Sources:
https://www.thesteppingstonesgroup.com/6-classroom-tips-deal-separation-anxiety-children-special-needs/
https://www.friendshipcircle.org/blog/2012/06/27/10-ways-to-remove-separation-anxiety-from-your-special-needs-child/
https://eiclearinghouse.org/einotes/sepanxiety/
https://www.helpguide.org/articles/anxiety/separation-anxiety-and-separation-anxiety-disorder.htm
https://www.chop.edu/conditions-diseases/separation-anxiety-disorder

What to Do if Your Child Bites

Posted on June 14, 2018June 14, 2018 by

Parents of toddlers are often concerned about a common occurrence—biting. You are not alone! Most toddlers and preschoolers bite at one time or another, and it is a normal developmental occurrence. Children bite for a variety of reasons. Sometimes toddlers bite due to limited language skills or ways to express their feelings. Preschoolers may occasionally bite when they are so overly tired or frustrated and have lost control. The good new is there is much that parents and caregivers can do to reduce, and ultimately eliminate biting.

Why does my child bite?
It’s important to remember that while your child may bite, try not to label him/her as a “biter.” Labeling a child can often result in the child assuming the identity assigned to them, which would increase biting behavior.

Some reasons toddlers may bite include:
-they lack language skills necessary for expressing important needs or strong feelings such as happiness, anger or frustration. Without words to express feelings, biting can serve as a substitute (“I am very mad at you!”, “You are standing too close to me,” or “I am so excited!”)

-they are overtired

-they are teething

-they are overwhelmed by sounds, lights, or activity in a setting

-they need more active playtime

-they have a need for oral stimulation

-they are overwhelmed after intense play such as wrestling or tickling for an extended time

-they need more time to move from one activity to another

What are some solutions for biting?
Frustration/stress: watch for signs of increasing frustration; teach your child ways to show feelings appropriately and offer praise when he/she communicates appropriately

Teething: offer your child a teething biscuit, rubber teething ring or a partially frozen clean washcloth

Defense/Territorial: let your child know he/she is safe; ensure the area is not crowded, with plenty of space and toys

Attention-seeking: give your child attention when he/she is not biting, to make him/her less likely to bit for attention

Power/aggression: explain acceptable ways to interact with others; encourage positive behavior such as sharing and taking turns

How to discourage biting.
If you see your child on the verge of biting, there are strategies you can use to prevent biting:

Distract your child with a book or toy. Shift your child’s attention to reduce the tension.
Explain how your child can handle a situation that could lead to biting. You can say, “Johnny, it’s okay to tell Mary: ‘You are too close to me. I don’t like it when you touch my hair.’”
Be sure there is ample space, equipment and toys to keep all children occupied and to minimize having to wait turns.
Avoid overstimulation for a child who becomes easily frustrated. Keep groups small and make play periods shorter with less challenging activities.
Teach cooperation throughout the day, demonstrating words and phrases children can use to express their desires and feelings. Praise cooperative behavior.
Familiarize yourself with the child’s signals of rising frustration or anger.
Teach children to share; this is a common trigger for biting. Use a kitchen timer to provide a visual reminder of how long they can play with a certain toy. In a classroom setting, be sure there is more than one of popular toys.
Read books about biting. Ask your child how the characters might be feeling, and ask him/her what is happening in the pictures.

Some suggested books include:

-Teeth Are Not For Biting by Elizabeth Verdick

-No Biting by Karen Katz

-No Biting, Louise by Margie Palatini

What to do when your child bites
When a child bites, adults must intervene quickly, firmly and calmly. A child usually bites because he is out of control, which can be frightening to him. Parents and caregivers help a child the most by staying in control themselves. Reassure both the child who bit, as well as the victim. If possible, keep both children by your side as you inspect and wash the bitten area with warm, soapy water. By doing so, you demonstrate the consequences and seriousness of the behavior.

Young children may not understand that biting hurts. Make sure children understand that biting cannot be allowed and that you will stop it every time. A child who is out of control and frightened by his own behavior needs to know that adults will help take control until he/she is able to control himself.

In addition, many times when a child bites, adults pay much attention to him/her. Though it’s usually negative attention, it can still reinforce the behavior and cause it to continue rather than stop. When parents shift their attention to the child who was bitten, they communicate that biting will not result in more attention. Showing concern for the child who was bitten also teaches empathy.

When help is needed
Biting usually stops by age 3-1/2. If biting continues or increases in frequency, speak with your child’s pediatrician about the possibility of an assessment from a child development specialist.

We are available if you have any questions about your child’s development or behavior. We can be reached at 516-731-5588.

Some information shared courtesy of Children’s Home Society of California, www.chs-ca.org and www.zerotothree.org .

Safety and Injury Prevention for Children

Posted on April 25, 2018 by

As parents and caregivers, we always want to protect our children and ensure their safety. This means making sure indoor and outdoor environments are safe, and that we teach them how to protect themselves as well. This post, while not an inclusive list, covers several aspects of safety including household, outdoor, poison, fire and internet safety. If you have specific questions about your child’s safety, we recommend you first speak with your child’s pediatrician.

The first line of defense to keep your child safe begins in your home. Have you gotten down on the floor to take a look around, from a baby or child’s perspective? You’ll be surprised at what you see! Take a look at outlets, wires, tall bookcases, plants and more. If they are accessible, you’ll need to make adjustments so your baby cannot reach, pull or chew on any of these potential dangers.

Let’s go over some common danger areas in the home:

Windows: Window guards should be installed on all windows in your home. Be sure an adult can open them in case of fire. If a window is open more than four inches, a child can fall out. Screens offer protection from bugs, not from falling.

Blinds/Shades: There is a strangulation risk from corded blinds and shades! Ideally, install only cordless window treatments. Be sure to keep cribs, furniture and climbable surfaces away from any windows. Shorten pull cords to the shortest usable length. Tighten continuous-loop cords tight, and anchor with a tension device. Check manufacturer’s directions for more information.

Kitchen: Be sure to turn handles from pots and pans toward the back so they cannot be pulled off. Be sure to teach children that the stove and oven are not to be touched because they get very hot. Install a stove guard and knob covers. Knives must be kept out of reach of children. If you have a garbage disposal, warn children of its dangers.

Cabinets and drawers: Use safety latches so young children cannot open these. Even so, be sure to keep dangerous products (cleaning chemicals, medications) out of reach of children—safety latches are not guaranteed failsafes.

Electric appliances/wires: Cover any unused electrical outlets with safety covers. Be sure cords are out of reach; children can pull on cords, making objects fall, or children can trip over cords. Lamps pose an overlooked safety hazard as they can be pulled down. Try using Velcro or Command tape to secure lamps to tables. Watch for floor lamps that tip easily.

TVs: While many of us mount flat screen TVs on the wall, many are on top of stands or in wall units. Climbing or standing children can grab hold of the TV and pull it down, with the risk of it falling on them. Be sure your TV is secured to any stand or unit if it’s not mounted on a wall.

Bookcases: These look like large ladders to children, so be sure to install anchors for bookcases. These secure the unit to the wall behind it, preventing children from climbing or grabbing on and having the unit fall on them.

Plants: Be sure to purchase only nontoxic houseplants and keep out of reach of young ones.

Fireplace: For safety tips, visit https://parent.guide/how-to-baby-proof-your-fireplace/. Consider adding a padded bumper around the hearth, especially if it’s a raised ledge.

Batteries: Many toys and household items contain small round batteries, which pose a choking hazard to children. They can also leak chemicals and cause burns. Keep devices that use these small batteries out of reach of children, or place a piece of duct tape over the controller so children cannot access the battery. Store loose batteries locked away as well. If you suspect your child ingested a battery, contact the National Battery Ingestion Hotline at 202-625-3333.

Small items: Be extra careful about any small items throughout the house—pen caps, jewelry, magnets, soda bottle caps—and keep them out of reach of young children.

Heating: Cover or block access to radiators and heat vents. Do not use portable electric heaters near children.

Laundry room: Never let children handle single-use detergent packets; keep them in the original container unless actively placing one in the washing machine, seal the container after use, and store the container in a locked cabinet. Use child safety locks on front-loading washers and dryers to prevent your children from opening them or crawling in, especially during use.

Fire safety: Make sure there is a working smoke and CO alarm outside every bedroom, on every floor, and in the garage. Test the alarms and changes the batteries each time we change the clocks. Keep flashlight and fire extinguishers in your home and know how to operate them. Teach children never to play with candles, lighters or matches. Do not overload any outlet with too many plugs; never run cords under rugs or carpet. For more fire safety tips: https://www.nfpa.org/Public-Education/By-topic/Safety-in-the-home/Escape-planning/Basic-fire-escape-planning

Poisons: Open windows for ventilation when using cleaning products. Never use barbeques or other outdoor equipment indoors for cooking or heat! These can cause carbon monoxide poisoning. Lock up medicines, cleaning solutions, cosmetics and soaps out of reach of children. Teach children never to eat, drink or open products if they don’t know what they are. Know the poison control hotline phone number: 800-222-1222.

Outdoor safety is important too! Keep these tips in mind as the weather changes and more time is spent outdoors:

Streets: Teach young children to hold an adult’s hand and look both ways—twice—before crossing a street. Tell them never to run into the street to chase a ball or toy. Train your children to watch for cars backing out of driveways. Teach your child to use hand signals when on a bike.

Safety gear: Children should always wear a helmet and elbow pads when riding bicycles. For rollerblading and skateboarding, they should wear helmets, knee and elbow pads and wrist guards. Street safety rules apply here as well.

Sun safety: Babies younger than six months should be kept out of direct sunlight, as their skin is too sensitive for sunscreen. Babies older than six months must have sunscreen applied 30 minutes before going outside. Reapply every 2 hours, or after sweating or swimming.

Water: Never leave infants and young children alone near any water. They can drown in less than 2 inches of water—bathtub, bucket of liquid, toilet. Teach children 4 and older to swim, and supervise them at all times. If you have a pool or hot tub, be sure there is a locked fence at least 4 feet high enclosing it. Pool and beach toys are not appropriate flotation devices. For more details about water safety, see our previous post: https://mksallc.com/theres-still-plenty-summer-left-safe/

Important car safety information:

Use seats that meet or exceed Federal Motor Vehicle Safety Standards. For more information visit: https://www.nhtsa.gov/equipment/car-seats-and-booster-seats. Always use safety seats, even for short rides. Before installing a car safety seat, read the seat instruction manual and your car owner’s manual. You can get installation help with a car seat inspection and register your seat for recall notices: https://www.nhtsa.gov/equipment/car-seats-and-booster-seats#installation-help-inspection. If your child’s seat has been in an accident, replace it with a new one. For special needs children, contact your child’s pediatrician for help with finding an appropriate seat.

In addition to these tips, be sure to take classes in infant/child CPR and first aid, keep a first aid kit handy, and have important phone numbers nearby for caregivers (poison control, pediatrician, fire department). For a comprehensive safety checklist, https://www.safekids.org/safetytips/field_venues/home?gclid=EAIaIQobChMI9JOfgp2P2gIVQVuGCh37PQbUEAAYASAAEgLIR_D_BwE. It’s easy to have fun, but more important to be safe! If you have any questions, contact your child’s pediatrician. We are also available if you have any questions about your child’s development or behavior. We can be reached at 516-731-5588.

Some information shared courtesy of Children’s Home Society of California, www.chs-ca.org.

How to Handle Common Sleep Problems In Children

Posted on March 19, 2018March 19, 2018 by

Sleep. Glorious, restful, quiet sleep. For many, it’s the holy grail of parenting. If only your child would sleep for, what, 6 hours straight? Even 5—or 4!–would be, well, wonderful. Is good sleep just a pipe dream?

For parents of babies, sleep is one of the most commonly discussed aspects of childhood. Among myriad other issues to plan for, think about and figure out, sleep is one of the big ones. Sleep is an important component of child development, and lack of quality sleep can affect the entire family. Babies and children that don’t sleep well can experience increased irritability, more frustration and difficulty controlling emotions. Families, including parents and older children (that presumably sleep well) can be affected as well when their sleep is disrupted on a regular basis.

The good news is that by starting off with good habits, or making some modifications to routines, many sleep issues can be eliminated. We’ve put together a list of common sleep issues and suggestions. As always, if you have any questions about your child’s sleep habits, we suggest your speak with your child’s pediatrician first.

Start Your Infant Off With Good Sleep Habits
Infants – to about 4 months – cry because of physical needs. They can’t be “spoiled” at this age, so when your infant cries, pick him up and give comfort by rocking and cuddling. When your infant wakes up at night, take care of him quickly and matter-of-factly, without much social contact or play. Then put him back in the crib and leave the room, to discourage waking up for the rewards of play and attention.

If Your Baby Wakes In The Middle of the Night
Many older babies wake up at night for the privilege of sleeping in the parents’ bed. This desire often continues throughout childhood. Unless you believe in the family bed, avoid this attractive response to nighttime waking at all costs!

Tips for Helping Baby Sleep
Establish daytime routines, including consistent waking times. Regular meal and activity times promote regular sleeping times. Develop bedtime rituals (a story or song, bath); routines make it easier for a child to “wind down.” Provide an environment that promotes sleep. A cool, dark, quiet room is best. Discourage excess evening fluids. Be consistent!

SIDS And Steps Toward Prevention
According to the Center for Disease Control, Sudden Infant Death Syndrome (SIDS) is the sudden death during sleep of a seemingly healthy baby. Although there is no known cause of SIDS, there are things that parents can do to help with prevention:

-always place babies on their backs to sleep for every sleep

-use a firm sleep surface, such as a mattress in a safety-approved crib, with a fitted sheet

-have the baby share your room, but not your bed; your baby should not sleep in an adult bed, on a couch, or on a chair alone, with you or with anyone else

-keep soft objects, such as pillows and loose bedding out of your baby’s sleep area

-prevent exposure to smoking during pregnancy and after birth as these are important risk factors for SIDS; the risk of SIDS is even stronger when a baby shares a bed with a smoker

Don’t Postpone Bedtime
Don’t postpone bedtime in the hope that a tired child will be easier to put to bed. When an overtired child loses self-control, it can be almost impossible to meet the child’s needs and the child can’t fall asleep comfortably.

How To Put Your Older Baby To Sleep
The older baby (4 months and older) must learn to relax and fall asleep without help. After the rituals of bathing, quiet play and feeding, put your older baby into the crib while he is still awake. Your baby will become better at relaxing and drifting off to sleep without help, which will also help when he wakes up in the middle of the night.

If Your Preschooler Won’t Go To Sleep
If your older preschooler resists going to sleep, try allowing the child to stay awake-but only in his bedroom-as long as the child wants, but without the stimulation of television or other screens. Your child feels somewhat in control, while you maintain a define bedroom time. There’s little reason to stay awake once the child realizes that further contact with the family is unlikely, and the child is likely to drift off the sleep—perhaps while playing on the floor. Eventually, the child will find that a soft bed is a better place to spend the night.

When A Child Should Move Into A Bed
Generally, a bed is introduced at about age 2-1/2 or 3, when the child can get in and out of it easily. The American Academy of Pediatrics advises switching to a bed when a child is 35 inches tall. Other signs of readiness include if your child starts climbing out of the crib, or if he sleeps through the night and adheres to a regular bedtime routine. Some popular choices with regard to selecting a bed include:

-A junior bed is made for young children. It is low to the ground and has guardrails. However, as it uses a crib-size mattress, it will be good only until your child reaches age 5 or so.

-A twin-size bed will work, but push one side against the wall and use a guardrail on the other.

Be sure to keep the bed away from windows, and as your child will be mobile, remember to keep door and entrances to off-limit areas closed and locked, and install a safety gate at the top of stairs.

If Your Child Wets The Bed
This is a common problem for many young children. They often are very sound sleepers and have small bladders that can’t hold all of the urine made during the night. Suggestions include:

-limit the amount of liquids your child drinks 2 hours before bedtime

-have your child try to use the toilet just before going to bed and as soon as he wakes up

-cover the child’s mattress with a rubber pad

-praise him when he stays dry

-respond gently when he does have an accident; getting angry doesn’t help either of you

-tell him to use the toilet if he wakes up in the middle of the night; remind him he can come and get you for help

How Medication Affects Sleep
Medications can affect a child’s sleep. Many medications—over the counter and prescription-can cause or add to a sleep problem. Always check with your child’s pediatrician before administering medications of any kind.

How Much Sleep Children Need
As children grow, their need for sleep changes. Below is a guideline for the amount of sleep children need at various ages. The amount listed includes naps and sleep.

Age Amount of Sleep

0-3 months 14-20 hours

3-6 months 14-16 hours

6-12 months 13-15 hours

12-14 months 12-14 hours

2-4 years 11-13 hours

4-7 years 10-12 hours

7-11 years 10+ hours

Making small changes can reap huge rewards. When babies get into poor sleep habits, it can be trying to change routines. With a calm approach and consistent new routines, change is possible! If you have any questions about your child’s development, MKSA’s professionals are happy to speak with you. You can reach us at 516-731-5588 or email us today.

Be Sure Your Kids Are Playing!

Posted on December 12, 2017 by

“Just go play!” “Why don’t you play with your toys?” “Let the baby just play with a toy for a while.” If you’ve ever said any of these things, good for you! From the time a child is born, throughout his/her childhood, play is an important—and necessary—component of development. We’ve put together some play pointers to further elaborate on the ages and stages of play and why it is so important.

Why is play important?
Babies play at every stage of development. Infants learn about how the world works by looking at their own hands, grabbing rattles or hitting objects. Toddlers use play more creatively. Encouraging more complex play helps children with important thinking skills and with the social understanding of what they can do and how competent they are.

How do babies play differently than toddlers?
As soon as babies can grasp with their hands, they explore toys by putting them into their mouths. By 9 months, mouthing toys is not as much fun as banging, shaking, and dumping things. By age 1, babies are putting objects into containers, and they understand that pushing a button or pulling a string can make things happen. It’s exciting to watch how an 18-month-old uses objects to act out familiar activities like eating, drinking and telephoning. By age 2, children are able to use pretend objects in place of real ones. Learning how to pretend is the beginning of dramatic play and is an important first step in learning how to play pretend games with other children.

What are the usual stages of children’s play?
Solitary play – this is the first kind of play where children play alone with their own toys or activities and do not try to make contact with nearby children. Examples include banging, shaking, filling and dumping.
Parallel play – children play independently but near each other. Examples include manipulating a doll to do common things, and doing a series of pretend activities, such as pouring and drinking pretend milk.
Associative play – children play with the same toy but not together. Examples include building separate structures with blocks or playing with play-doh without exchanging tools.
Cooperative play – Children play with the same toy together. Examples include board games or using Legos to build one structure.

What can I do to encourage play?
Babies need you to talk and sing to them and provide many kinds of toys and materials for them to explore. When the baby is tired and no longer want to play, it is time to stop. Toddlers need you to play with them in games they choose. You can help by giving suggestions; withdraw from the play when your child can handle the activities alone.

What toys and playthings are recommended?
For babies, it’s good to have toys that you and the baby can look at together. Talking about and playing with toes, fingers and body parts is just as wonderful as having rattles or soft animals to touch, chew on or shake. After the first few months of life, give toys that your child can use to make something happen, rather than just watch or listen to. A toy that pops back up when pushed over is better than a stuffed animal. For toddlers, manipulatives such as ring stackers and blocks are a great addition to cause-and-effect toys.

What is sensory exploratory play?
We all learn from our senses – from seeing, hearing, tasting, smelling and touching. We also learn from the sensation of movement. Your play—and your child’s—should include all of these sensations.

How can I help my child use the senses to explore and learn?
Birth to age 1 – Hang mobiles across the crib to provide new sights. Babies enjoy sound games as they approach their first birthdays. Hide musical toys so you child can locate them.
The 1-year-old explores by touching. In a special drawer, keep objects that are safe to touch and play with, such as a wooden spoon, funnel and old pan. A flashlight is another toy for this age. Sand and water play is fun too.
The 2-year-old touches and tastes everything, so keep electrical outlets protected and cords out of reach. He is able to match textures and likes to play “name that smell” game with soap, coffee and other familiar smells.
The 3-year-old is learning more about the world. Imitation is how they act out this understanding: they “bake” mud pies, “drive” a car, and “sweep” the floor. He enjoys blowing bubbles, splashing in water, and playing in sand.
The 4-year-old loves to run and chase, and to kick a ball. He loves to pretend to be someone else and enjoys dressing up. He can roll sections of play dough and form people.
The 5-year-old can climb up steps to a slide, ride a bicycle and use a monkey bar. He can learn to swim, skate, ski, dance and use a trampoline. He adds details to drawings, and may print his name.

Encourage play, play with your child(ren) and enjoy this very special part of childhood development!

If you have any questions or concerns about your child’s development, MKSA is here for you. Our caring professionals will answer your questions in confidence. You can reach us at 516-731-5588.

Positive Discipline For Behavior Problems

Posted on October 19, 2017 by

As a parent, you’ve no doubt dealt with a child misbehaving, being mean, having a meltdown or throwing a major tantrum. Not fun. Been there, done that, not going back? Like it or not, our children’s behavior is something we will always need to address, whether it’s a child being pleasant and kind, or being downright cruel and loud. Learning strategies and coping mechanisms can help you deal with a variety of behaviors and situations. Positive discipline is a popular and effective way to manage and promote positive behavior.

Positive discipline is a program developed by Dr. Jane Nelsen, with fundamentals of the program based on work by Alfred Adler and Rudolf Driekurs. Positive discipline is designed to teach children to become responsible, respectful community members. Important skills are taught in a way that is encouraging and respectful for both children and adults.

According to Dr. Nelsen, parenting with positive discipline means being kind and firm at the same time, which is effective long-term and helps children feel a connection—a sense of belonging and significance.

Below are answers to common questions regarding positive discipline:

What is positive discipline?
Discipline and punishment are not the same. Discipline is guidance and teaching that promotes positive behavior; punishment is a penalty imposed in reaction to unacceptable behavior. Positive discipline is a discipline model that focuses on the positive points of behavior. It is more effective than punishment because desirable behaviors that last a lifetime must come from within the child rather than be imposed by external force.

What is an example of positive discipline?
Frustrated parents often describe a child’s personality with words like rebellious, lazy and selfish. Behavior can be altered, but personality is more resistant to change. If you focus your efforts on behavior, goals are more likely to be reached. For example, don’t say, “That’s a good girl!” This sends a message that being good all the time is the goal—an impossible expectation. You can say instead, “I like the way you spoke to Grandma just now.” No amount of “good boy” or “good girl” will build a positive self-concept. Give your child specific feedback on his actual good behaviors, because his self-image is composed of his accomplishments. The most effective way to build good behavior is to shape it with praise.

What is meant by specific praise?
The more specific your praise is, the better the child will understand what he’s doing right and the more likely he will be to repeat it. To increase desirable behaviors, you must emphasize the specific behaviors that please you. One morning, for example, you notice your child has made his bed. At that moment, he’s brushing his hair. If you simply say “Looks nice,” he won’t know whether you are referring to his bed or his hair. Instead, you can say, “I really like the way you made your bed so neatly this morning. Thanks.”

How can I praise progress if I hardly notice any?
Start praising every little step toward the target behavior, making a point of catching your child at being good. For example, tell your child he must clean up his toys when he’s through playing with them, though he’s never done this before. Praise every bit of progress, however minor. Start by praising your child for picking up one toy even though he’s left three others on the floor. You might say, “It was great the way you picked up your truck and put it in the toy box. Let me help you pick up the others.” The next time, praise him for picking up two items, and so on.

The goal of positive discipline is developing mutually respectful relationships between adults and children. Positive discipline boasts many benefits including improved classroom behavior, increased self-confidence, reduced destructive behavior, and enhanced adult-child relationships. For more resources, visit www.positivediscipline.com.

If you have any questions about your child’s development, visit www.mksallc.com or feel free to contact us at 516-731-5588 or by email at info@mksallc.com. Our dedicated professionals are happy to answer any questions you have.

How to Win the Food Battle with Your Child

Posted on October 11, 2016 by

If you’re a parent of a young child, you’ve been through it at least once. You know—your child won’t eat or will only eat orange things; your child will drink only juice and it has to be from the bottle with his favorite cartoon character on it; or your child only wants snacks—those delightful situations that surround mealtime. What should be a pleasant experience turns into arguments, ultimatums, bargaining and more. You’ve reached your wit’s end, and having your child sit quietly (albeit eating French fries and juice for dinner) is almost worth selling your soul to you know who.

But it doesn’t have to be like that. Sometimes when you are too deep in it, you can’t imagine a light at the end of the tunnel. However, by taking a step back (and a deep breath) along with a fresh approach, much progress can be made. It is important to remember that you should never argue, bribe or threaten your child with regard to food. While it is frustrating, to be sure, and worrisome to think that your child isn’t eating “properly,” bear in mind you are the parent or caregiver, and ultimately you decide what food and drink is kept in the house and offered to your child. Choices help (“do you want carrots or corn with your chicken?”) and maintaining a matter-of-fact tone in all discussions goes a long way toward fostering balanced conversations about food choices. Of course, if there is a serious concern or issue please speak with your child’s pediatrician. This post will cover 6 main food battle issues and suggestions, and hopefully it will help turn mealtime into fun time.

1. Basic Food Truths
One of the most basic truths about your preschooler is that he is a child—not an adult in kid’s clothing. Children have different physical and emotional needs than adults. These differences apply to the type and amount of food they eat, as well as to their behavior at eating time. Here are some things to keep in mind:

Children need smaller portions than adults. Approximately 1 tablespoon of each type of food for every year of the child’s age is an ample portion size in most cases. For example, a 2 year-old can be offered 2 tablespoons of chicken, 2 tablespoons of rice and 2 tablespoons of a vegetable.
Young children may be suspicious of new foods and recipes. Give them time to try out a new food. Try several times over the course of several months before declaring the dish a disaster.
The form a food takes can often determine whether or not it gets eaten. It isn’t uncommon for raw, crunchy vegetables to be preferred over soft, hot ones. Also, foods that can be eaten with the fingers are usually preferable to those needing utensils. Remember to cut hard-to-chew foods into very small pieces for younger children to avoid choking incidents.
Choices help. Offering your child choices—of snacks, side dishes, or type of sandwich, as examples—is important as they exercise their growing independence. It’s usually easier for a child to choose between two or three options than to make an open-ended decision. And it’s a win-win situation as you get to offer a choice of healthy options, and your child gets to select what he wants.

2. How Can I Get My Child to Give Up the Bottle?
Try to offer liquids in a cup at about 6 months old. Offer about ¼ of an ounce of liquid in small, open plastic cup. Hold the cup while your baby learns how to adjust his lips to the edge. If your child is having difficulty drinking from a cup, try the suggestions below:

Use thicker liquids. Your child’s little mouth needs practice to drink from a cup. Try using thick liquids or purees at first. A jar of strained pears makes a great shake; it’s a familiar taste and the puree is easier than milk or juice for your child’s mouth to control. The puree moves more slowly, and is heavier, making it easier to control.
Choose the right cup. Be sure the mouth of the cup is not too big. There are a variety of lidded cups available. For most children, a spouted cup is fine. If your child needs to learn more oral skills, consider using a lidded cup with no spout. This provides your child’s mouth with the same feeling as drinking from the cup lip, and prevents spills.

3. Why Should I Teach My Child to Feed Himself?
The main way to prevent feeding struggles is to teach your child how to feed himself at as early an age as possible. You can wait for your infant to show you when he is ready to eat (by leaning forward, for example) and allow him to pace the feeding himself (by such indications as turning his head). Do not insist that he empty the bottle, finish a jar of baby food, or clean the plate. By the time your child is 6-8 months of age, start giving finger foods. Such foods allow him to feed himself at least some of the time. By 12 months, your child will begin to use a spoon, and by 15 months he should be able to feed himself completely. This is your child’s first step towards independence.

4. Feeding Without Fuss
How many snacks? What about dessert? How much milk is too much? There’s much to be covered here, but we’ve simplified it into 11 helpful tips:

Prepare three meals a day with snacks in between. Your child’s stomach is small and his energy needs are high. He needs to eat every 2-3 hours.
Put your child in charge of how much he eats. Trust your child’s appetite center. The most common reason many children never seem hungry is that they have so many snacks that they never become truly hungry. Drinking too much milk can reduce a child’s appetite as well.
Provide comfort. Use a high chair or booster seat to get your toddler right up to the table. Give him a spoon and fork, but don’t make him use them. Sit down to eat with your toddler.
Help your child eat successfully. Choose foods that are easy to chew. Cut food into bite size pieces. Be careful about choking hazards, like round slices of hot dog. Let him use his hands—he needs to touch and feel the food in order to learn to like it.
Make one meal for everyone. Put a variety of nutritious foods on the table: a main dish, milk, fruit or vegetable, bread and another starchy food like rice, noodles or potatoes. Include at least one food your child usually likes.
Don’t force food. If you try to control how much your child eats, it’s hard for him to eat the right amount to grow well. If he eats only a little bit at one meal, he’ll make up for it at snack time or the next meal.
Be a good role model. Seeing you eat vegetables helps your toddler learn to like them too.
Dessert shouldn’t be a reward. If you make your toddler clean his plate to earn dessert, you teach him that dessert is better than dinner. Explain that a healthy diet includes a balance of food and dessert.
Learn some nutrition basics. Learn what foods give your child the nutrition he needs. For instance, eggs and cheese can substitute for meat, and fruits substitute for vegetables.
Plan the snacks. Think of snacks as little meals, not just sweets or treats. Offer a variety of nutritious snacks.
Be careful with juice and milk. Offer juice and milk only with meals and snacks. Keep in mind that milk contains as many calories as most solid foods. If you allow them out all day, your child may fill up and won’t eat well at mealtime. Daily milk requirements can be discussed with your child’s pediatrician, and is based on your child’s age, weight and height. If your child is thirsty, give water instead.

5. What to Do About Picky Eaters
We’ve all seen at least one of these: the child who says ‘no’ to every food offered, the child who eats only grilled cheese sandwiches, and more. Here are some suggestions for dealing with some food personalities:

The “Play” Boy – Your child loves to play with his food but doesn’t eat it.
At the end of the meal, clear the table without comment; gently refuse snacks until the next meal.
Big Eyes – Your child constantly leaves food on the plate.
Try offering your child a smaller serving size. Don’t worry if a little is left over, and never force your child to clean his plate.
Doctor No – No matter what you serve your child, he wants something else.
Don’t prepare a separate meal for your child, but don’t force your child to eat what he doesn’t want. Offer simple alternatives: a bowl of soup or a peanut-butter sandwich. If your child still refuses, have him wait until the next meal to eat.
Junk-Food Junkie – Your child eats only cookies, candy, chips and other sweets.
Offer healthful, sweet alternatives such as raisins, oatmeal cookies, dried fruits, and fruit-flavored milkshakes. If you don’t keep junk in the house, it’s easier to remove it as an option.
The Juice Addict – Your child drinks only juice and no other beverage.
For a balanced diet, your child needs to drink other beverages, and the sugar in juice quickly can become excessive. Dilute the juice by mixing with an equal amount of water. Offer low-fat milk and flavored milk.
The Trader – Your child bribes you by asking for promises and rewards in exchange for eating.
Avoid getting into a battle over food. Refuse to use food as a reward or to reward your child for eating.
The Food Jag – Your child eats one and only one food, meal after meal.
Ignore the jag. Let your child eat the food he wants, but continue to offer other foods as well. If the jag continues for more than a few weeks, call your pediatrician.

6. Can I Have a Snack?
How many times a day does your child ask this question? Snacks are an important part of daily eating, but offering healthy choices can go a long way in fueling your child properly and teaching good habits. Below are some healthy snack suggestions:

Yogurt (low-fat or nonfat)
Crackers (whole grain, low-fat)
String cheese (part-skim)
Carrot or celery sticks with low-fat or yogurt dip
Fruit
Pretzels
Dry cereal (low sugar)
Tortilla with low-fat cheese
Crackers (whole grain, low-fat)
Plain mini bagels or whole-grain bread with jelly, peanut butter or cream cheese
”Pizza” made with English muffin, tomato sauce & mozzarella cheese
Graham crackers, fig bars, animal crackers

In all, offering healthy choices, remaining calm during food conversations, and remembering that children have certain food needs and attitudes towards eating will go a long way in having meal time become a fun, family time. For more information on child milestones, visit our website at www.mksallc.com. And remember to Like us on Facebook (https://www.facebook.com/MKSA-261755423850561/ ) and follow us on Twitter (https://twitter.com/mksallc )! We love connecting with families.

Category: Behavior