Common Concerns

 

Asthma

Asthma is one of the most common chronic diseases of childhood.  Good asthma management requires knowledge, and a good partnership and good communication between parents and doctor.

What is asthma?
Asthma occurs when the main air passages of the lungs, the bronchial tubes, become inflamed and swollen. The muscles around the bronchial tubes tighten and extra mucus is produced, causing your airways to narrow. The result could range from a mild cough or wheeze to difficulty breathing.

Take steps to control asthma:
Think about when your child’s asthma got worse.  Triggers can include being near someone smoking, being with cats or dogs or other allergens, or exercising hard.  The most common trigger for children can be difficult to avoid: an upper respiratory infection, or the common cold.

Medications:
Quick relief medications:  Albuterol and Xopenex work by opening the airways
Control medications:  Flovent, Qvar and Pulmicort are inhaled steroids that decrease inflammation in the lungs. 

http://www.aaaai.org/patients/publicedmat/tips/inhaledmedications.stm

Asthma action plans:
http://www.mayoclinic.com/health/asthma/HQ00273

 

Attention Deficit Disorder

What is Attention Deficit Disorder?


Attention Deficit Hyperactivity Disorder (ADHD) is characterized by three essential features: inattention, impulsivity, and hypermobility.  Attention Deficit Disorder (ADD) is characterized by inattention and impulsivity, without hyperactivity.  ADHD/ADD affect 4.1% of youth, and occur 2 to 3 times more often in boys than girls.

How do I know if my child has it?

A child is evaluated for ADHD/ADD by the use of screening scales which reflect the child’s typical behaviors; examples are Vanderbilt, Connor, SNAP-IV. The rating scales are completed by both parent and teacher, to see if problems are seen similarly at home and school.  Academic performance, school testing, relationships with teachers and friends all provide important information about the child’s level of functioning.

How is ADHD/ADD treated?

ADHD and ADD are commonly treated with a combination of stimulant medication and behavioral therapy. Stimulant medications, such as Ritalin, Adderall, and Concerta increase the child’s ability to focus by increasing dopamine in the brain.  Stimulant medications have a 30-year history of efficacy and safety in children and adolescents who have ADHD/ADD. Side effects can include decreased appetite, weight loss and insomnia.

      What about Complementary and Alternative Medical Therapies (CAM), if I don’t want my child to take medication?

      Alternative therapies include:

      􀂃 Nutritional interventions – eliminating food additives, eliminating sugar, Essential fatty acid supplementation, vitamin supplementation
      􀂃 Biofeedback
      􀂃 Herbal treatments
      􀂃 Yoga and Massage
      􀂃 Play in green spaces

      Many of these therapies are good for children! However, at this time, these alternative therapies have not been rigorously studied and research documenting their efficacy in treating ADHD doesn’t exist.

What are the components of behavioral therapy?

Some effective behavioral techniques for children with ADHD involve providing rewards for demonstrating the desired behavior (positive reinforcement) or consequences for failure to meet the goals (punishment).  Environmental modifications providing more structure, closer attention and limitations of distractions can also be helpful.


Tips for parents include:

􀂃 Give yourself a break if getting too angry with the child.
􀂃 Turn off TV and computer at least 1 hour before bedtime
􀂃 Use music or books on tape for settling
􀂃 Sense of humor, pick your battles
􀂃 Parent Management Training


  • What is the school’s role in helping my child’s issues with inattention?

  • There are several bodies of federal law that protect the rights of children with disabilities.  The first, IDEA (Individuals with Disabilities Education Act), governs “Special Education” and provides direct programming for children with  disabilities. Each child with a documented disability – in one of 13 categories - is given an IEP (Individualized Education Plan) to document the modifications necessary for the student’s success.

When there is an identified disability not covered by Special Education, a child may qualify for a 504 plan (from Section 504 of the Rehabilitation Act of 1973). Parents or school personnel identify a concern (i.e. ADHD), and the principal convenes a meeting of the 504 planning team. The team determines (from standardized measures, rating scales, teacher records or medical reports) if the child is disabled and the modifications to which the student is entitled.  Once the plan is developed, the general education team is responsible for implementing the plan. For the child with ADHD, adaptations may include preferential seating, decreased assignment and homework load, and behavior therapy implemented by the teacher.

 

Eczema

Eczema, or atopic dermatitis, is a particular type of skin inflammation that is marked by dryness, associated itching, and a characteristic pattern of rash on the body. It usually starts in infancy from the ages of 2 to 6 months.  The rash may involve the face or it may cover a large part of the body.  As the child gets older, the rash is commonly on the legs, feet, hands and arms.

http://www.eczemacenter.org/eczemaprimer.htm

Tips for eczema care

The main objective is to relieve itching and decrease skin eruption. Because the skin is excessively dry, lubricants will be prescribed that will effectively decrease the dryness.

  • Baths should be no more than 10 minutes, and always use moisturizer immediately afterward, applying it to still-damp skin. Try to keep the temperature and humidity in the home fairly constant, using air conditioning in the summer and a humidifier in the winter. Avoid contact with substances that cause itching, such as soaps, grass, wool and other types of scratchy clothing. Expect to use cortisone cream (prescribed by the doctor) when flare-ups occur.  When the area is clear, it is best to discontinue the use of the cortisone, but continue vigorous lubrication to try to prevent further dermatitis.

Resources: http://www.eczemacenter.org/familyresources.htm