Office Schedule

 

 

 

Mouse-over any highlighted Day to see if there are Schedule Changes or Closings!

Find a Elmont Pediatrician at Practice Kids Care Pediatric Associates PC on ZocDoc  

Fan us on Facebook.

Facebook

Trusted Commerce
search engine by freefind advanced

Kids Health

 

kids healthA Guide to Toilet Training

Developmental & Behavioral Problems

Backpacks

Fever

Poor Eaters

 

 

 

A GUIDE TO TOILET TRAINING

                                      By Sharon M. Perlman, DO

 INTRODUCTION

 A child is considered fully toilet trained when he or she successfully uses a toilet or potty chair for bowel and bladder function while fully awake, and does not require reminders from his or her parents.  Most developmentally normal children will have achieved some degree of toilet training by age 3 years after approximately 3 months of training attempts.  Most parents will find that their children have daytime bladder and bowel control earlier than during the nighttime hours.

WHY TRAIN? 

Toilet training is beneficial for both children and their parents.  Most parents will have more time with their children if they are not required to constantly change or wash diapers.  In the long run, a great deal of money is saved when diapers no longer have to be purchased.  A toilet-trained child is definitely more mobile, making travel and day care situations a lot easier.  For children, toilet training gives them a sense of independence.

WHEN SHOULD YOU START?

 Most children are ready to begin toilet training by about age 2-2 1/2 years, but some can easily start at the age of 18 months.

IS MY CHILD READY? 

HOW CAN I HELP MY CHILD BECOME READY? 

TOILET TRAINING “DO’S” 

The main goal of potty training is to have children use the toilet without having to remind them.  It is best to make the potty easily visible and placed in a room where your child spends a great deal of time.  For boys, a bucket or dishpan may be used for urinating.  Try to have your child wear clothes that are easily removable (one layer), without belts, zippers or shoes.  Pull-ups are great for children who are not fully trained but who do not require diapers all day.  Use them only for bedtime and trips outside of the house.

It is also suggested that parents set aside a specific time frame for toilet training, free of other distractions in the home.  Increased rewards and signs of affection will help make your child more excited about the experience.

TOILET TRAINING “DONT’S” 

It is not wise to punish your child for accidents.  This only adds to uncooperative behavior.  Be patient, as the process may take up to 3-6 months on average.  Toilet training has been successful when 99% of bowel control and 95% of bladder control has been achieved.  Be aware that nighttime bedwetting may continue for 6-12 months after training and has been noted in up to 10% of children age 6 and above.

Most of all, be prepared and be patient with your child.  So, let’s get started!

 Parent's Guides:

 

DEVELOPMENTAL AND BEHAVIORAL PROBLEMS

What is developmental delay?

2kidsDevelopmental delay is when your child falls behind in the normal progress of development. Delay can be in one or many different areas such as motor, speech, social and thinking skills. It can have many different causes, but for the most part the cause is unknown. It is fairly common and is estimated that 12-16% of children in the United States have developmental problems. The first three years of a child’s life are the most important years of development and if there is a delay, the earlier the treatment the better the outcome for future learning.

 Normal developmental milestones

 Learning is a process that begins at birth. There is a wide range of what is considered normal development and is dependent on many factors such as hereditary, environment, etc. These are some simple guidelines to follow for newborns to age 5:

 Newborn:  Can fixate on an object, turn their head side to side, startle in response to sounds.

  •  1 Month: Lifts head briefly, makes soft noises.

  •  2 Months: Follows, coos, social smiles.

  •  3 Months: Holds rattle, reaches, lifts chest, laughs.

  •  6-8 Months: Sits well, transfers objects between hands, fear of strangers, babbles.

  •  9 Months: Crawls, pulls to stand, says dada.

  •  1 Year: Walks, says mama, dada specifically.

  •  18 Months: Jumps with both feet, knows body parts, imitates, says 5-20 words.

  •  2 Years: Runs, 2-3 word phrases, 20-50 words, 50% intelligible speech.

  •  3 Years: Rides tricycle, draws circle, 3-5 word phrases, 500 words, 80% intelligible speech.

  •  4 Years: Hops on 1 foot, copies cross, asks lots of questions.

  •  5 Years: Skips, copies square, speech is fluent and clear.

How will your child be evaluated?

 At every well-child visit, we will be evaluate your child for any delays in development. Parents may also have concerns and can discuss any questions they may with us.  Delays can be found in speech, hearing and motor or social development. If a delay or concern is found, your child will be referred to the appropriate team of specialists.

For further information you may contact:

Dept. of Developmental Pediatrics, LIJ-SCH: (718)-470-3540

North Shore Hosp: (516)-365-3860

Early identification of infants, children, or preschoolers with developmental delays can lead to treatment with early intervention.

Early intervention may begin at any time from birth to school age. These services are provided through public or private offices and is offered in various settings such as hospitals, clinics, offices, or home based.

For children from birth- 3yrs contact:

 

  • Long Island Center For Child Development  (516)-371-1818

  • All Children's Therapy (516) 374-7914

For children 3-5 yrs contact:

  • Committee on Pre-School Special Education

            (Contact the School District of Residence)

  • All Children's Therapy (516) 374-7914

For further information contact:

For hearing and speech delay:

Universal hearing screens are now done on all newborns. Early diagnosis and treatment are especially important in the first 6 months of life to prevent future speech and learning problems. In addition to newborn screening, on going hearing evaluations are given by your pediatrician at routine visits. For infants and children of all ages, a test called OAE (otoacoustic emissions) is now done in the office. It is a simple, quick test which measures acoustic( hearing) signals in the ear canal and can be done whether the infant is awake or asleep. If a hearing problem is detected, the child will be referred to a pediatric  ENT specialist and an audiologist.

For speech problems, a speech and language pathologist will be recommended.

For further information you may contact:

  • LIJ-SCH Hospital Hearing and Speech Center                (718)-470-8914

  • American-Speech-Language-Hearing Assoc

  • All Children's Therapy (516) 374-7914

For motor delays:

Motor delays can range from problems with fine motor skills such as feeding and dressing self, to gross motor problems with sitting and walking.

Physical therapists are used for the treatment of gross motor disabilities through the use of massage and exercise to improve the use of muscle and joints.

Occupational therapists are used for the treatment of fine motor skills and coordination used in daily living.

For more information and recommendations:

  • Schneider’s Consultation Center (718) 390-8687
  • All Children's Therapy (516) 374-7914

Autism or Pervasive Developmental Disorder (PDD) is a type of developmental disorder which affects speech and language, It interferes how a child communicates and relates to others socially. Signs of autism always present before age 3 yrs. Children with autism do not babble and have severe speech delays. They do not interact with other children and have poor eye contact and repetitive patterns of behavior. Typical behaviors include: repetitive body rocking, hand flapping, and excessive attachments to objects. As with other developmental delays, it is also important with autism to have early diagnosis and treatment to improve future learning and functioning.

For further info you may contact:

Learning Disorders:

According to the National Institute of Mental Health: Learning disorder is a disorder that affects a persons ability to interpret what they hear or see and express it through spoken and written language, academic, social skills and attention.

Under federal law, these children with special needs are entitled to receive special services through the public school system at no cost to you. As a parent, you can request an evaluation in writing to your school. The results of the evaluation will determine your child’s eligibility to receive these special services under this law called the IDEA or

Individuals with Disabilities Education Act:

Entitles all children with learning disabilities, including physical, mental and social disabilities, and vision and hearing impairment.

Section 504 requires schools to provide these children with all special program or activities whether public or private.

 If they do not find a problem, you can ask the school system to pay for an independent evaluation IEE. Following the evaluation an IEP is developed.

IEP or Individualized Education Program:

A written education plan done yearly for school aged children done by a team of professional (teachers, therapist) and the parents describing what services the child needs These services include occupational therapy, physical therapy, speech and language therapy.

IFSP or Individualized Family Service Program:

A written plan for infants or toddler (birth- 2yrs) describing the child’s developmental level and services needed.

For further information:

uBehavioral Problems:

Although not considered a learning disability ADHD or Attention-Deficit/Hyperactivity Disorder is also included in the list of services provided by the school system since it affects school performance.

ADHD is a neurobehavioral disorder that affects 3-5% of school aged children. It affects males 3 times more than females and is diagnosed prior to age 7.There are three forms of ADHD

  1. Attention (ADD)

  2. Hyperactive (ADHD)

  3. Combination (most common)

Children with ADHD have symptoms and behaviors more frequently and severely than other children of the same age and developmental level

 It is characterized by persistent difficulties in:

  • inattentiveness or distractibility - poorly sustained attention span

  • impulsivity -  weak impulse control

  • hyperactivity – excessive activity or restlessness

A child with ADHD symptoms must have a comprehensive evaluation. The evaluation can be done in school by requesting it in writing to the school district.

Once the diagnosis is made treatment consist of a combination of therapies.

  • Medications

  • Behavioral management

  • Counseling and education

  • Classroom accommodations

Support groups

For more info contact:

  • Children and Adults with Attention Deficit/Hyperactivity Disorder: 800-223-4050

  • www.add.org

  • ADHD Center LIJ-SCH: 516-802-6130
  • Winthrop University Hospital Div. of Dev and Behavioral Pediatrics (Mineola) 516-663-4432
  • Support groups: John B. Ellis: 516-758-5614
  • Early Childhood Direction Center 516-364-8580
  • North Shore Child and Family Guidance Center (Roslyn) 516-626-1971
  • Peninsula Counseling Center (Woodmere) 516-569-4260
  • Family Counseling Associates (Syosset) 516-746-1709
  • Family & Children Association: 516-486-7200
  • Nassau Counseling Inc. (Mineola) 516-294-6969
  • South Nassau Communities Hospital, Mental Health Counseling Center (Baldwin) 516-546-1370
  • Child Development Center at Nassau County Medical Center (East Meadow) 516-572-5914
  • Hewlett Consultation Center 516-599-2290
  • Mental Health Association of Nassau County 516-489-2322

Behavioral problems and emotional problems are recognized at home by parents and in school.

Parents can consult with the child’s physician and teacher to address these issues.

When should a parent seek help?

For younger children:

  • Frequent temper tantrums

  • Hyperactivity

  • Aggression

  • Persistent nightmares

  • Persistent soiling

  • Refusal to go to school

 For older children:

  • Changes in eating or sleeping habits

  • Difficulty sleeping

  • Poor school performance

  • Isolation from friends and family

  • Destructive behavior

  • Abuse of alcohol and drugs

  • Aggression

 

If problems persist more than a 6month period of time consultation with a child psychiatrist or mental health professional is recommended.

For more information:

Or for other resources:

Backpacks


Backpacks are a popular and effective way for kids to carry their books to and from school, but an overloaded or improperly worn backpack may be more harmful than good. According to the Consumer Product Safety Commission, 3,400 children ages 5 to 14 visited emergency rooms with backpack related injuries in 1999.

The backpack is better than a hand held bag or shoulder bag because the properly worn back- pack takes the weight of the books and evenly distributes it over one of the strongest areas of our body, the trunk.

The problems start when the backpack:

  • Does not fit the child properly.

  • Is overloaded.

  • Is improperly worn by the child.

The American Physical Therapy Association (APTA) has come out with some guidelines to help protect your children from backpack related injuries. Injuries that can be more than just a nuisance, they can lead to life long impairments of the back, neck and shoulders. When choosing your child's backpack for the upcoming school year, please consider these guidelines to help reduce the risk of injury due to improper use of a backpack:

 

  1. Wear Both Straps:
    Slinging a backpack over one shoulder causes a person to lean to one side to compensate for the uneven weight. This leaning to one side can cause a curving of the spine. Over time, this can cause lower and upper back pain, strains of the shoulders and neck, and even a functional scoliosis. Teenage girls are especially susceptible to scoliosis.

  2. Make Sure The Backpack Isn't Too Heavy:
    Students of all ages seem to be carrying heavier loads, often toting a full day's worth of textbooks and a change of clothing for after school activities. It is recommended that a student put no more than 20% of their body weight into the backpack. For example, if your child weighs 75 pounds, their loaded backpack should weigh no more than 15 pounds. This is very important because even if worn properly, too much weight in the backpack will cause he child to lean forward in order to compensate for the added weight. This leaning forward can affect the natural curve in the low back, cause an increased upper back curvature, and cause a forward rounding of their shoulders. All of these can become significant problems with continued overloading of the backpack.

  3. Get A Backpack With Wide Shoulder Straps:
    Narrow straps tend to dig into the collarbone area of the shoulders, especially if overloaded. This can impair circulation to the child's arms as well as cause damage to the many nerves in the area. Often a child will complain of numbness and/or tingling in their arms if the straps are digging into their shoulders. Over an extended period of time, weakness in the hands may develop.

  4. Get A Backpack With A Waist Belt:
    Using a waist belt will help to distribute the weight of the pack more evenly easing the stresses on the neck and shoulders.

  5. Get A Backpack With Two Shoulder Straps:
    Some backpacks have only one shoulder strap ,which focuses all of the weight of the pack onto that one side of the body. Two shoulder straps will not only distribute the weight more evenly, but will prevent the child from leaning to one side to compensate for the weight on one shoulder.

  6. Consider The Weight Of the Backpack Itself:
    When purchasing a backpack assess the weight of it empty. If it feels heavy empty, imagine how heavy it will feel when textbooks are placed into the pack. Canvas bags are a strong lighter weight material while leather bags tend to be quite heavy for a child.

Childhood injuries are already an all to often occurrence. By purchasing a properly designed, proper fitting backpack and making certain your child knows how to use the backpack, you can reduce their risk of neck, back, and shoulder injuries – injuries that can follow them into adulthood.

‘poor eaters’ getting enough

Carla Kemp
Saarilehto S, et al. J Pediatr. 2004;144:363-367.[Medline]

The diet of children considered to be poor eaters by their parents was not substantially different or of poorer quality than the diet of their peers, according to a study of 494 Finnish children.
Although parents commonly express concerns about their children’s eating habits, little research has been done on children perceived to be poor eaters.
This study looked at whether 5-year-olds described by their parents as poor eaters differed from age-matched controls on growth, food intake or meal pattern.
Participants included children and their parents who also were taking part in a long-term prospective trial on a coronary risk factor intervention program. Just before the children’s fifth birthday, parents completed questionnaires asking them to rate on a five-point scale how often the child ate too little. Parents also completed a food diary for four consecutive days. The children’s weight and height were measured at seven and 13 months, and 2, 3, 4 and 5 years.
A child was classified as a poor eater if both parents agreed the child ate too little "often" or "sometimes." About 30% of the children met this criteria, and the rest of the sample formed the comparison group.
On average, poor eaters were lighter and shorter at birth and at age 5 years than the comparison group. However, the majority of 5-year-olds in both groups were of normal weight.
Results also showed poor eaters’ mean daily intake of energy adjusted for body weight was not different than comparison children. The two groups did not differ on mean intakes of carbohydrates, protein, fat, sucrose, vitamin C, iron or folic acid. The poor eaters did consume slightly less calcium, but the mean absolute intake was still above the recommended level. Finally, poor eaters received a smaller proportion of total calories from meals and a larger proportion from snacks than the comparison group.
The findings, according to the authors, indicate that there appears to be no reason for serious concern about growth and diet of preschool children considered to be poor eaters.