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Posts for: June, 2013

June 26, 2013
Category: In the News
Tags: Untagged

Retro Toys and the Importance of Being Bored

Source: The Child Mind Blog

When I'm shopping for presents for young children, toys from the Melissa & Doug company stand out. Melissa & Doug toys don't do anything—they don't light up, they don't moo, and they definitely don't have an on/off switch. What you see is what you get—dress up costumes, a child-size toolbox, plastic kitchenware and groceries. As far as I know, their only toys that make noise are the musical instruments. Melissa & Doug aren't the only company making toys like this—an article in Sunday's Times profiling the company also mentions Haba and Alex, for example—but their brand might be the most recognizable.

In 2013, toys like this are decidedly retro. Handing kids the iPad or iPhone to play games is reflexive for many parents and these days even Lego has a line of video games. One mother interviewed in the Times story says she buys Melissa & Doug products as a kind of "rebellion against digitized toys," and acknowledges that they probably appeal more to her than her son. "The thing about Melissa & Doug toys, the problem with them, is they encourage you to be creative, which is great, but they also, speaking of it kind of concretely, are relatively one-dimensional," she explains. These toys are open-ended and require more work from kids. And without flashing lights and sound effects that provide constant feedback, they run the risk of being boring.

Melissa Bernstein, the Melissa half of Melissa & Doug, is okay with that. "Parents are so scared of having their kids say, 'I'm bored.' It's synonymous with, 'I'm a bad parent,' and so they never allow kids to feel boredom, which equals frustration, and so kids don't get to the point where they have to dig deeper and figure out what to do." Which is really too bad because the inventiveness that comes from figuring out how something works or how to keep yourself entertained is an important childhood lesson that our kids are increasingly missing out on. Open-ended play teaches children how to think critically and creatively—it's how most of us learned how to solve problems, work together, and control our impulses. Contrast that with the hyper-structured modern idea of play, where kids follow rules to complete a task and are rewarded with a "level up." As Bernstein tells the Times, "When you're using a computer or an app, it's giving you all the information you need. It's a completely reactive experience."

Learning how to be bored or frustrated and then how to self-regulate also helps kids build resiliency, something child psychologists consider essential to becoming a well-adjusted adult. Bernstein can attest to this personally. Growing up she described herself as lonely and miserable. In seventh grade she became anorexic. Her solace was her creativity. She wrote music and poetry and threw herself into arts and crafts. She told the Times that creating things "took me out of what could have been." "When I create it makes me so happy. I'm able to soothe myself." The ability to self-soothe is vital, but kids who are growing up in a constant state of occupation are getting fewer and fewer opportunities to learn how.

Play in general is being threatened for American children, and the movement away from basic, open-ended toys is reflective of that. Recess and gym are disappearing in schools, a casualty of our national obsession over test scores. Our kids have full schedules, with sports, tutoring, and extra-curricular activities filling up their downtime, which has become a dirty word. When kids are at home, they're still kept busy. If parents need to do the laundry or make dinner without getting hassled, they turn on a video or hand kids the iPad. Our desire to have accomplished, well-rounded children (and to get dinner on the table) is laudable, but an important part of being well-rounded is being able to think independently and self-regulate. The lessons learned from imaginative play are real, and it's important that we not discount them.  

June 13, 2013
Category: In the News
Tags: Untagged

Drowning Doesn’t Look Like Drowning

In many child drownings, adults are nearby but have no idea the victim is dying. Here’s what to look for.

By Mario Vittone

The new captain jumped from the deck, fully dressed, and sprinted through the water. A former lifeguard, he kept his eyes on his victim as he headed straight for the couple swimming between their anchored sportfisher and the beach. “I think he thinks you’re drowning,” the husband said to his wife. They had been splashing each other and she had screamed but now they were just standing, neck-deep on the sand bar. “We’re fine; what is he doing?” she asked, a little annoyed. “We’re fine!” the husband yelled, waving him off, but his captain kept swimming hard. ”Move!” he barked as he sprinted between the stunned owners. Directly behind them, not 10 feet away, their 9-year-old daughter was drowning. Safely above the surface in the arms of the captain, she burst into tears, “Daddy!”

How did this captain know—from 50 feet away—what the father couldn’t recognize from just 10? Drowning is not the violent, splashing call for help that most people expect. The captain was trained to recognize drowning by experts and years of experience. The father, on the other hand, had learned what drowning looks like by watching television. If you spend time on or near the water (hint: that’s all of us) then you should make sure that you and your crew knows what to look for whenever people enter the water. Until she cried a tearful, “Daddy,” she hadn’t made a sound. As a former Coast Guard rescue swimmer, I wasn’t surprised at all by this story. Drowning is almost always a deceptively quiet event. The waving, splashing, and yelling that dramatic conditioning (television) prepares us to look for is rarely seen in real life.

The Instinctive Drowning Response—so named by Francesco A. Pia, Ph.D., is what people do to avoid actual or perceived suffocation in the water. And it does not look like most people expect. There is very little splashing, no waving, and no yelling or calls for help of any kind. To get an idea of just how quiet and undramatic from the surface drowning can be, consider this: It is the No. 2 cause of accidental death in children, ages 15 and under (just behind vehicle accidents)—of the approximately 750 children who will drown next year, about 375 of them will do so within 25 yards of a parent or other adult. In some of those drownings, the adult will actually watch the child do it, having no idea it is happening.*Drowning does not look like drowning—Dr. Pia, in an article in the Coast Guard’s On Scene magazine, described the Instinctive Drowning Response like this:

  1. “Except in rare circumstances, drowning people are physiologically unable to call out for help. The respiratory system was designed for breathing. Speech is the secondary or overlaid function. Breathing must be fulfilled before speech occurs.
  2. Drowning people’s mouths alternately sink below and reappear above the surface of the water. The mouths of drowning people are not above the surface of the water long enough for them to exhale, inhale, and call out for help. When the drowning people’s mouths are above the surface, they exhale and inhale quickly as their mouths start to sink below the surface of the water.
  3. Drowning people cannot wave for help. Nature instinctively forces them to extend their arms laterally and press down on the water’s surface. Pressing down on the surface of the water permits drowning people to leverage their bodies so they can lift their mouths out of the water to breathe.
  4. Throughout the Instinctive Drowning Response, drowning people cannot voluntarily control their arm movements. Physiologically, drowning people who are struggling on the surface of the water cannot stop drowning and perform voluntary movements such as waving for help, moving toward a rescuer, or reaching out for a piece of rescue equipment.
  5. From beginning to end of the Instinctive Drowning Response people’s bodies remain upright in the water, with no evidence of a supporting kick. Unless rescued by a trained lifeguard, these drowning people can only struggle on the surface of the water from 20 to 60 seconds before submersion occurs.”

This doesn’t mean that a person that is yelling for help and thrashing isn’t in real trouble—they are experiencing aquatic distress. Not always present before the Instinctive Drowning Response, aquatic distress doesn’t last long—but unlike true drowning, these victims can still assist in their own rescue. They can grab lifelines, throw rings, etc.

Look for these other signs of drowning when persons are in the water:

  • Head low in the water, mouth at water level
  • Head tilted back with mouth open
  • Eyes glassy and empty, unable to focus
  • Eyes closed
  • Hair over forehead or eyes
  • Not using legs—vertical
  • Hyperventilating or gasping
  • Trying to swim in a particular direction but not making headway
  • Trying to roll over on the back
  • Appear to be climbing an invisible ladder

So if a crew member falls overboard and everything looks OK—don’t be too sure. Sometimes the most common indication that someone is drowning is that they don’t look like they’re drowning. They may just look like they are treading water and looking up at the deck. One way to be sure? Ask them, “Are you all right?” If they can answer at all—they probably are. If they return a blank stare, you may have less than 30 seconds to get to them. And parents—children playing in the water make noise. When they get quiet, you get to them and find out why.

This article is reprinted from Mario Vittone’s blog. Join him on Facebook.

Correction, June 5, 2013: This article originally cited a CDC statistic in referring to the number of child drownings in which a nearby adult watches the child with no idea a drowning is occurring. According to the CDC's Division of Unintentional Injury Prevention, no CDC studies have measured the number of such occurrences. The reference has been removed. (Returnto the corrected sentence.)

June 06, 2013
Category: In the News
Tags: Untagged

A Shot for Mom Gives Babies a Shot

Cases of whooping cough, or pertussis, have been increasing in recent years. Public health officials have been looking for the best ways to reduce the disease in young babies.

Pertussis involves extremely intense coughing that can last for many weeks or months, and it can kill babies.  A recent study found that giving mothers the Tdap shot during the second or third trimester of pregnancy may be a very effective method to reduce pertussis in young babies. The Tdap is the teen and adult booster vaccine shot that protects against pertussis, diphtheria and tetanus.  The shot should be given to all pregnant women, regardless of when their most recent booster shot was, according to the researchers.

That strategy may be the most effective and cost-saving. It also may be more likely to reduce deaths since deaths from pertussis usually occur in babies under 3 months old.  The study, led by Andrew Terranella, MD, MPH, of the Epidemic Intelligence Services at the Centers for Disease Control and Prevention, looked at the effectiveness of pregnant women getting the Tdap to protect their newborns from pertussis.  Approximately 63 out of every 100,000 babies under 1 year old get pertussis each year in the US.

The CDC recommends that all babies receive the DTaP shot at 2 months old to protect against pertussis, diphtheria and tetanus.  The DTaP and the Tdap are very similar vaccines that protect against the same diseases, but the DTaP is given to children under 8 years old. 

For this study, the researchers used data from 4,131,019 babies in 2009 who were followed for one year.  The authors analyzed three different strategies for protecting babies under 2 months old from whooping cough.  One strategy was having pregnant women get the Tdap vaccine during the second or third trimester of pregnancy to pass along some of the immunity to her newborn after birth.  A second strategy was for the mother to receive the Tdap vaccine after giving birth so that she was less likely to get sick and pass along whooping cough to her child.  The third strategy – referred to as "cocooning" – was for the mother as well as other family members to get the Tdap vaccine to protect a baby from whooping cough.  In the cocooning strategy, vaccinating the primary people around a baby creates a protective "cocoon" around the child to reduce risk of pertussis.  Parents are the ones who pass whooping cough on to their babies in 50 to 55 percent of all infant whooping cough cases.  In 6 to 8 percent of cases, it's the grandparents who pass it along, and in 20 percent of cases, it's the infant's siblings.

The authors created mathematical models to evaluate the effectiveness of each of these strategies based on data and assumptions about the effects of the vaccine.  The researchers estimated that vaccinating mothers after they give birth would avoid approximately 596 cases of pertussis in babies each year. That would represent 20 percent fewer cases than currently occur.  Having pregnant women get the Tdap during pregnancy would avoid approximately 1,012 pertussis cases in babies each year, the researchers estimated. That would reduce the cases by one-third from their current levels.  These reduced pertussis cases would primarily be among babies who were 1 and 2 months old – those at highest risk for whooping cough.  Using the cocooning strategy by vaccinating a baby's mother, father and a grandparent would avoid 987 pertussis cases in babies, also just under a one-third reduction, the researchers estimated.  However, cocooning would cost more money because of the higher number of vaccinations, and it may be logistically difficult for more people to be vaccinated than just the mothers during pregnancy.    Also, the reduced number of cases that would occur with cocooning tended to be among older age groups than the most at-risk group of babies under 3 months old.

When the researchers analyzed the possible reduction of babies' deaths from pertussis from different strategies, the strategy of vaccinating pregnant women appeared best.  "Pregnancy vaccination reduced infant hospitalizations by 38 percent and deaths by 49 percent relative to base case, compared with reductions of 32 percent and 29 percent for postpartum vaccination with cocooning," the authors wrote. 

Overall, therefore, the best strategy to reduce pertussis cases, especially among the youngest babies, appeared to be vaccination of pregnant women during their second or third trimester.

"Our analysis showed that a Tdap dose during pregnancy could avert more infant pertussis cases, hospitalizations, and deaths than postpartum or cocooning strategies," the authors wrote.

This strategy works primarily for two reasons. It offers "earlier indirect protection from vaccinating the mother" so that she is less likely to get sick and pass the disease to her baby.

It also provides some direct immunity to the unborn baby because the mother's antibodies against pertussis can cross the placenta to the growing baby.

Therefore, the CDC recommendation is that all pregnant women get the Tdap shot during their second or third trimester of pregnancy, regardless of when they last had the shot.

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