Child Psychology in the Tsunami's aftermath

With the recent Tsunamis hitting the Indian shores, more may be at stake than just the people in its path. Viewing the frightening pictures and emotional coverage of this disaster on tv may be leaving scars on your young child's mind. Here's how to talk to your young child about disasters and calamities.
What You Need to Know: How children react to disaster depends on their age. When exposed to a calamity or emergency children experience a variety of emotions and need your special attention. Two typical DISTRESS reactions in children are "a-typical behaviour" or doing things they have never done; e.g. a normally friendly child becomes shy;

And "regressive behaviour" that is behaving much younger than their age; e.g. a toilet trained child starts bed wetting again.

These reactions may occur immediately after exposure to a disaster or after a few weeks. Most of the times these symptoms pass away when the child re-adjusts. If you are directly affected by the disaster, cope with it in a way that the children do not develop a permanent sense of loss.
SYMPTOMS BY AGE
1-5 Years: Bed-wetting, fear of darkness, clinging to parents, night terrors, stammering, loss of appetite, fear of being left alone, confusion.
What You Can Do: Talk reassuringly, hold and hug the child, give frequent attention, encourage him/her to express his feelings through play or words, allow to sleep in your room till they have overcome their anxiety.

5-11 Years: thumb-sucking, irritability, whining, fighting at home or school, fighting with younger sibling for parental attention, school avoidance, nightmares, withdrawal from friends, poor concentration at school, regressional behaviour, headaches or other physical complaints, fear about safety.
What You Can Do: Be patient, arraneg their play sessions with friends or adults, encourage discussions with friends and adults, temporarily reduce your expectations at school or home, give more structure to time at home including non-demanding chores, rehearse safety measures for future disasters (discuss in detail how you will cope if a similar disaster affected you in the future).

11-14 Years: Lack of sleep, poor appetite, rebellion at home, refusal to do chores, school problems like fighting, withdrawal, attention-seeking behaviour or loss of concentration; physical symptoms like headache, vague pains, upset stomach, and loss of interest in peers.
What You Can Do: Involve them with same age group activities, help to resume lost routine, encourage group discussions, give stuctured responsibilties which are non-demanding, temporarily relax expectations and give extra individual attention.

When is Professional Help Needed ?

If symptoms continue, most likely a deeper emotional problem has occured and it is advisable to seek the help of a mental health professional who has experience with children and trauma. In the absence of such a professional, your pediatrician may be consulted.

Remember, children are adept at realising the concerns of their parents and this is especially true at the time of a crisis. As parents, you should admit your concerns to your children, and also stress your abilities to cope with the situation.
Compiled with the help of New York State Office of Mental Health.

Goodbye Mr Walker!

Most parents are very anxious about their kid’s milestones, and would like them to achieve walking, talking sitting etc. as soon as possible, even though there is no scientific basis for this.To this end many parents want to know if putting their child in a 'walker' will help make the child walk faster.I feel that there are a few disadvantages to using a walker and these must be kept in mind before the use of walker is decided upon,

Disadvantages:

Children using walker actually walk 'later'. This is because their inherent need to move quickly from on e place to another is satisfied by using a walker; also while in a walker a child is not really walking he/she is just sitting and cruising around. This leads to the use of calf muscles, rather than the hip muscles which are needed to walk, thereby delaying walking.Another issue with a walker is safety; a child in a walker is very likely to trip on even a small bump on the floor (like the edge a carpet, uneven floor etc.). Also fall from a staircase is likely to result in worse injuries if the child is in a walker.

Advantages:

The reason why most parents use a walker is to see the child move around and generally feel independent; children love it for the same reason;Another important feedback mothers give is that it helps them to do other household chores like cooking etc. because they know the child will not be sitting on the floor, putting various undesirable things in their mouth, catching a cold by sitting on the cold floor etc.

All things considered my advice is that if you have not bought a walker... don't buy one. Consider buying a push-toy where the child stands with the support of the toy and pushes it, this is not only more physiological (natural) but also avoids the problems associated with the walker. If you have already bought one and your child is happy in it, let it be but be careful especially if you have stairs around the house. If you want to keep your child busy and safe while you are doing house work, consider buying a play pen wherein you can put all the toys so that the child can play and remain safe!

How to choose the 'RIGHT' child specialist? (Part -2)

This is in continuation of the previous article wherein we had discussed the role of a pediatrician and the training needed to become a pediatrician (child specialist). Now coming to some more important questions
When Should You Look For A New Pediatrician?
Parents may seek a new pediatrician for several reasons.
The most common is that they are expecting a first child.
They may have moved to a new area,
They maybe unhappy with their prior child specialist.
Whatever your reason for looking for a pediatrician, it is important to choose one as soon as possible and not wait for your child to be ill. During pregnancy, it is wise to find a pediatrician by the beginning of the third trimester, or seventh month, of gestation.
Finding The Right Pediatrician: Where Do You Start?
Many people spend more time choosing a stock broker than they do picking a doctor for their children!
You should plan to meet with several pediatricians before choosing one, so be sure to give yourself enough time. Begin by compiling a list of candidates to interview.
You may get their names in a number of ways:
Ask friends, family, coworkers and neighbors you trust.
Contact your insurance plan for eligible pediatricians; many plans have Internet web sites.
Call local hospitals, many of which have referral services.
If you are expecting, ask your obstetrician.
You may also ask your primary care physician or another physician you trust.
Some Internet sites that may be useful in finding pediatricians in your community in India:
Pediatric on call
Indian Academy of Pediatrics - This website offers a list of registered pediatricians
Setting Up An Interview
In the west, most pediatricians offer free interviews, although some may charge for this preliminary visit. This is actually a good idea since in an emergency you would know where to rush your child to in case of any problems.
How do you decide whether the pediatrician is 'right' for you?
Screening begins with the initial telephone call: Before deciding to visit the pediatrician, you may gather some useful information from the office staff, including:
What are the doctor's office hours?
Does the pediatrician accept your insurance?
Are laboratory facilities on site? If not, where would your child be sent for these?
Don't forget to notice how easy or difficult it is to get through on the telephone.
Also, decide if you are more comfortable in a small office practice, or in a larger hospital based practising pediatrician.
Meeting The Pediatrician: Questions to Ask
It is useful to come to the interview with a list of questions. Be prepared not only to listen to the responses, but also, to pay attention to the way you feel about your interaction with the doctor.

Communication between the pediatrician, parents and child are
key

Some things to think about are:
How well does the doctor listen?
Do your questions get cut off, or do you feel rushed?
Does the doctor treat you as a partner in the care of your child?
Do you feel a sense of trust in the doctor?
Does the pediatrician ask you important information about your home or family?
The safety of your home environment, presence of other children or pets, and family health problems can all affect the health of your present or expected child.
Look around you:
Does the office seem clean and organized?
Is the staff courteous?
Is there a separate waiting area for sick and well children?
Check credentials:
Remember that you want a doctor who is knowledgeable to handle both common and unusual health problems.
What is the pediatrician s educational background?
How long has she been in practice?
Is he certified by IAP (check the listing at Indian Academy of Pediatrics website)?
How does she keep up-to-date with medical knowledge?
Does she have any special medical interests?
Determine the doctor's availability:
Children get many acute illnesses, and it is important to know how available your pediatrician is to see your child, on the same day if necessary.
How do you reach him for routine questions or urgent problems?
Does he have specific telephone call-in times?
Can you reach him by e-mail?
Does he have a web site?
What if your child becomes ill? If your child is ill, will she usually be seen in the office?
When would she be referred to the emergency room?
If your child needs to be hospitalized, what hospital would the doctor use, and who would be responsible for your child's care?
Who covers the pediatrician when he is away?
What type of staff is in the office?
Are there nurses, nurse practitioners, resident physicians or medical students on staff in the office?
Will any of these staff care for your child?
Are you likely to see different providers at each visit?
How much time will the pediatrician spend with you and your child at a typical visit?
Care of newborns:
When is the first newborn exam in the hospital?
Will your pediatrician be doing it?
When is the first newborn office visit recommended?
Is there office staff supportive and knowledgeable about breast-feeding?
How often are subsequent visits?
What is the physician's recommended vaccine schedule?
After the first visit, recommended checkups in the first 2 years are at 1.5, 2.5, 3.5, 6, 9, 12, 15, 18 and 24 months.
Explore the doctor's attitudes about things that are important to you:
If you use complementary or alternative health methods, or traditional health practices, ask about the pediatrician s knowledge and acceptance of these.
If you have important cultural, religious or moral beliefs related to your child s health care, express these to the pediatrician and observe the response.
When does he prescribe antibiotics?
I personaly that this is a very important point and you need to tell your doctor if you are comfortable in getting a prescription without antibiotic, many doctors will give antibiotics because they believe that the parents want it!
Going To The Interview As A Family
It is useful to go to the visit with your spouse or partner, so that you may both get a sense of the interaction. Also, if you are interviewing the pediatrician after childbirth, you may want to bring your child along to the visit. It could be helpful to see how the doctor and your child relate to each other. However, if you are considering leaving another physician to whom your child has become attached, you may want to be careful about how and where your child meets a new doctor. Remember that your choice of pediatricians is not permanent. If at any time you are not satisfied with your child's care, discuss your concerns with the pediatrician. If the problem continues, it may be time to find a new doctor.
This article is largely copied from the original article here by Dr. Daniel Neuspiel; however it has been suitably modified for an Indian perspective.
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