Some good, if preliminary, news for those trying to reduce childhood obesity: American kids, on average, are eating fewer calories now than they did roughly a decade ago.
That’s the major takeaway from a new report from the Centers for Disease Control out today that also looked at adult consumption of fast food (from which, by the way, adults are getting fewer of their calories). The surprising drop, while encouraging, is modest: boys’ caloric intake fell 7 percent overall, while girls’ energy intake dipped 4 percent. The decrease, researchers think, is likely in part because kids are eating fewer carbohydrates, but more protein.
While the data may foreshadow a future drop in obesity rates, that hasn’t happened just yet. “A harbinger of change is a good phrase,” R. Bethene Ervin, a CDC researcher and co-author of the report, told theNew York Times. “But to see if it’s really a real trend we would obviously need more years of data.”
As for adult fast food consumption, researchers found that 11.3 percent of adults’ average daily caloric intake was from fast food in 2010, down from 12.8 percent in 2006. That percentage goes down sharply with age, according to the study. And while income status didn’t seem to make a difference when it comes to fast food consumption, the authors note that, perhaps unsurprisingly, obese adults on average eat more fast food.
While these cases are certainly extreme, experts say that any punishment that shames or embarrasses a child is not an effective way to discipline youngsters, and may cause long-term psychological damage.
“The research is pretty clear that it’s never appropriate to shame a child, or to make a child feel degraded or diminished,” said Andy Grogan-Kaylor, an associate professor of social work at the University of Michigan. Such punishments can lead to “all kinds of problems in the future,” Grogan-Kaylor said, including increased anxiety, depression and aggression.
Malicious punishments can also damage a parent’s relationship with their child, and lead to a cycle of bad behavior, experts say.
Instead, parents should use other discipline strategies, such as setting clear rules for kids and taking away privileges. Overall, parents should aim to create a supporting environment for their child.
“Positive things have a much more powerful effect on shaping behavior than any punishment,” Grogan-Kaylor said.
Out-of-the norm punishments can have social repercussions for children, said Jennifer Lansford, a research professor at Duke Univesity’s Center for Child and Family Policy. An odd punishment can make a child stand out, and provoke bullying, Lansford said.
In addition, children evaluate their own experiences in the context of what they see their peers experiencing, Lansford said. If children are disciplined in ways that are not condoned by society, “it can lead children to perceive they are personally rejected by their parents,” Lansford said.
Humiliating punishments can also disconnect parents from their children, making kids less likely to want to behave and do what their parents say, said Katharine Kersey, a professor of early childhood education at Old Dominion University in Norfolk, Va., and author of the upcoming book “101 Principles for Positive Guidance with Young Children” (Allyn & Bacon, August 2012).
“Each time we [embarrass children with a punishment] we pay a price, and we drive them away from us, and we lose our ability to be a role model for them,” Kersey said.
“When you disconnect from a child, he no longer wants to please you, he no longer wants to be like you. You’ve lost your power of influence over him,” Kersey said.
Children who are punished in these ways usually still commit the behavior, but do it behind their parents’ backs, Kersey said.
Better ways to discipline
To properly discipline a child, experts recommend the following:
Focus on the positive — the behaviors you want to see more of — rather than the mistakes, Kersey said. “If a child is running, instead of saying stop running, you say use your walking feet,” Kersey said.
Be proactive: establish rules you want your kids to follow, and be reasonable in your expectations, Lansford said.
Listen to your kids: Often times, bad behavior is a mistake, Grogan-Kaylor said. Parents should listen to why their children did something, and explain why the behavior is inappropriate.
Timeouts are appropriate for younger kids. For older kids, taking away privileges such as watching TV may be effective, Lansford said. In a classroom setting, teachers may consider rewarding kids for good behavior, Lansford said.
Parent should model the responsible behaviors they want children to repeat, Kersey said.
Pass it on: Humiliating punishments don’t work to discipline children, and may have long-term consequences.
Psychotherapist and ADHD expert Terry Matlen, ACSW, agreed. Because most parents can’t mimic the tight structure of school, kids often get bored — and may get into trouble, she said. That’s because when kids with ADHD get bored, they seek out stimuli, which can be anything from picking fights with their families to playing with fire, she said.
Some parents discontinue their child’s medication during the summer, which poses another challenge, said Matlen, also author of Survival Tips for Women with ADHD. “That can create a situation where the child has a hard time with self-control, mood regulation [and] social behaviors.”
But while the summer can be challenging, you can absolutely overcome these obstacles and enjoy a fun break. Below, Sarkis and Matlen offer their excellent suggestions.
1. Create Structure
Again, structure keeps your child focused. You can create structure by engaging your child in activities at the same time each day or meeting on the same day each week.
Because ADHD runs in families, one of you may have ADHD as well, making it harder to establish structure. Enlist the help of your non-ADHD spouse to assist with planning out the day.
2. Incorporate Physical Activities
Physical activities are especially helpful for kids who are impulsive and hyperactive. It helps them direct their energies in acceptable, healthy ways. If your child is clumsy, try non-competitive activities such as swimming, running and biking. (Some kids with ADHD have fine and gross motor skills that may not be on par with others their age.)
3. Start a Rotating Playgroup
Sarkis suggested that parents set up a weekly playgroup with other parents around their neighborhood. You can meet once a week at a different home for a few hours. This is an inexpensive way of providing structure to a child, and it also giving parents time off in the process.
4. Consider Camps
According to Matlen, young kids do great in day camps that offer outdoor, structured activities, while overnight camps with physical outlets are ideal for older kids. If your child has a specific interest, such as art, horses or computers, specialized camps are another excellent option, she said.
Both Sarkis and Matlen also suggested camps for kids with ADHD. To find a camp, contact your local CHADD group or post on an ADHD forum, Sarkis said. “Look in your local paper, and ask your pediatrician, teacher, or school counselor,” she added.
(Also, this article has several helpful suggestions on finding a good camp.)
5. Try Local Facilities
If camp isn’t feasible, try a local swim club or the Y, Matlen said. These facilities offer an array of fun activities at an affordable cost.
6. Get Creative
Parents can also set up a badminton set in the backyard, purchase a trampoline [or] set up an obstacle course with tunnels and objects to hop over.
7. Engage Them in Nature
For instance, show your kids how to garden. Kids can get dirty while learning about nature. Also, setting up bird feeders and tending to the food gives kids the opportunity to learn how to care for living creatures.
8. Visit the Library
Kids with the inattentive type of ADHD often prefer quiet and calm activities. During the summer, many libraries offer either free or low-cost programs for kids.
9. Check out the Arts
Kids who prefer quieter activities also might enjoy attending concerts, plays and art classes.
10. Encourage Older Kids to Work
If your kids are older, talk to them about the many ways they can earn money, such as dog walking, pet sitting or even having a lemonade stand. This improves math skills and promotes a healthy independence and solid self-esteem.
11. Let Your Child Have a Say
Ask your child what they’d like to do this summer, including the new skills they’d like to learn, such as playing the guitar, camping or cooking. Once he sees that he has input and that his opinion is valued, the parent has a much better chance at getting him to try new things.
If your child already has a certain skill, ask if they’d be willing to teach that skill to a younger child. According to Matlen, this can “do wonders for his self-esteem, which for many kids, can get pretty battered during the school year.”
12. Consult your Doctor about Medication
Some parents take their kids off medication during the summer since there’s no schoolwork. However, it’s important to thoroughly discuss this decision with your child’s doctor, Matlen said. She’s seen kids significantly struggle without their medication. For instance, because of their hyperactivity and impulsivity, they may lose friends, she said. And their behaviors might cause tremendous stress on the family.
In addition to creating structure and engaging your child in a variety of enjoyable activities, don’t forget to find some alone time for yourself, Sarkis added.
The emotional and physical scars from being bullied or exposed to other types of violence as a child may go deeper than imagined.
New research shows that the genetic material, or DNA, of children who experienced violence shows the type of wear and tear that is normally associated with advancing age.
“Children who experience extreme violence at a young age have a biological age that is much older than other children,” says researcher Idan Shalev. He is a post-doctoral researcher in psychology and neuroscience at the Duke Institute for Genome Sciences & Policy in Durham, N.C.
Youth violence is widespread in the U.S. today. The CDC states that it’s the second leading cause of death among people between the ages of 10 and 24, and that nationwide, about 20% of students in grades 9-12 were bullied in 2009.
Bullied Kids Age Faster Than Others
To see whether youth violence affects vulnerability to aging, the study authors focused on telomeres, or tiny strips of genetic material that look like tails on the ends of our chromosomes; think of a cap on an end of a shoelace. Telomere shortening is an indicator of cell aging.
The researchers analyzed DNA samples from twins at ages 5 and 10 and compared telomere length to three kinds of violence: domestic violence between the mother and her partner, being bullied frequently, and physical maltreatment by an adult. Moms were also interviewed when kids were 5, 7, and 10 to create a cumulative record of exposure to violence.
Children who were exposed to cumulative violence showed accelerated telomere shortening from age 5 to age 10. What’s more, children who were exposed to multiple forms of violence had the fastest telomere shortening rate, the study shows.
“Children who experience violence appear to be aging at a faster rate,” Shalev says.
Whether or not these changes are reversible is not clear. Shalev and colleagues plan to study the children for longer periods of time to see what happens later on in life. Their findings appear in Molecular Psychiatry.
Bullying Scars Run Deep
Bullying and other violence experienced during childhood may cause a physical erosion of DNA, says Paul Thompson, PhD. He is a professor of neurology at the David Geffen School of Medicine at the University of California, Los Angeles.
“We now have a physical record that violence during childhood could be damaging later in life,” he says. This is a “big surprise.”
Victor Fornari, MD, director of child and adolescent psychiatry at the Zucker Hillside Hospital in Glen Oaks, N.Y., says the new findings make perfect sense. “This article really points to a potential biological [indicator] that helps explain some of the differences in the brains of children who have experienced significant trauma and stress,” he says.
A small but growing number of teens and even younger children who think they were born the wrong sex are getting support from parents and from doctors who give them sex-changing treatments, according to reports in the medical journal Pediatrics.
It’s an issue that raises ethical questions, and some experts urge caution in treating children with puberty-blocking drugs and hormones.
An 8-year-old second-grader in Los Angeles is a typical patient. Born a girl, the child announced at 18 months, “I a boy” and has stuck with that belief. The family was shocked but now refers to the child as a boy and is watching for the first signs of puberty to begin treatment, his mother told The Associated Press.
Pediatricians need to know these kids exist and deserve treatment, said Dr. Norman Spack, author of one of three reports published Monday and director of one of the nation’s first gender identity medical clinics, at Children’s Hospital Boston.
“If you open the doors, these are the kids who come. They’re out there. They’re in your practices,” Spack said in an interview.
JOSIE Romero looks and acts like any other eight-year-old girl – but was born a BOY named Joey.
Switching gender roles and occasionally pretending to be the opposite sex is common in young children. But these kids are different. They feel certain they were born with the wrong bodies.
Some are labeled with “gender identity disorder,” a psychiatric diagnosis. But Spack is among doctors who think that’s a misnomer. Emerging research suggests they may have brain differences more similar to the opposite sex.
Spack said by some estimates, 1 in 10,000 children have the condition.
Offering sex-changing treatment to kids younger than 18 raises ethical concerns, and their parents’ motives need to be closely examined, said Dr. Margaret Moon, a member of the American Academy of Pediatrics’ bioethics committee. She was not involved in any of the reports.
Some kids may get a psychiatric diagnosis when they are just hugely uncomfortable with narrowly defined gender roles; or some may be gay and are coerced into treatment by parents more comfortable with a sex change than having a homosexual child, said Moon, who teaches at the Johns Hopkins Berman Institute of Bioethics.
It’s harmful “to have an irreversible treatment too early,” Moon said.
Doctors who provide the treatment say withholding it would be more harmful.
These children sometimes resort to self-mutilation to try to change their anatomy; the other two journal reports note that some face verbal and physical abuse and are prone to stress, depression and suicide attempts. Spack said those problems typically disappear in kids who’ve had treatment and are allowed to live as the opposite sex.
Guidelines from the Endocrine Society endorse transgender hormone treatment but say it should not be given before puberty begins. At that point, the guidelines recommend puberty-blocking drugs until age 16, then lifelong sex-changing hormones with monitoring for potential health risks. Mental health professionals should be involved in the process, the guidelines say. The group’s members are doctors who treat hormonal conditions.
Those guidelines, along with YouTube videos by sex-changing teens and other media attention, have helped raise awareness about treatment and led more families to seek help, Spack said.
His report details a fourfold increase in patients at the Boston hospital. His Gender Management Service clinic, which opened at the hospital in 2007, averages about 19 patients each year, compared with about four per year treated for gender issues at the hospital in the late 1990s.
The report details 97 girls and boys treated between 1998 and 2010; the youngest was 4 years old. Kids that young and their families get psychological counseling and are monitored until the first signs of puberty emerge, usually around age 11 or 12. Then children are given puberty-blocking drugs, in monthly $1,000 injections or implants imbedded in the arm.
In another Pediatrics report, a Texas doctor says he’s also provided sex-changing treatment to an increasing number of children; so has a clinic at Children’s Hospital Los Angeles where the 8-year-old is a patient.
The drugs used by the clinics are approved for delaying puberty in kids who start maturing too soon. The drugs’ effects are reversible, and Spack said they’ve caused no complications in his patients. The idea is to give these children time to mature emotionally and make sure they want to proceed with a permanent sex change. Only 1 of the 97 opted out of permanent treatment, Spack said.
Kids will more easily pass as the opposite gender, and require less drastic treatment later, if drug treatment starts early, Spack said. For example, boys switching to girls will develop breasts and girls transitioning to boys will be flat-chested if puberty is blocked and sex-hormones started soon enough, Spack said.
Sex hormones, especially in high doses when used long-term, can have serious side effects, including blood clots and cancer. Spack said he uses low, safer doses but that patients should be monitored.
Gender-reassignment surgery, which may include removing or creating penises, is only done by a handful of U.S. doctors, on patients at least 18 years old, Spack said. His clinic has worked with local surgeons who’ve done breast removal surgery on girls at age 16, but that surgery can be relatively minor, or avoided, if puberty is halted in time, he said.
The mother of the Los Angeles 8-year-old says he’s eager to begin treatment.
When the child was told he could get shots to block breast development, “he was so excited,” the mother said.
He also knows he’ll eventually be taking testosterone shots for life but surgery right now is uncertain.
The child attends a public school where classmates don’t know he is biologically a girl. For that reason, his mother requested anonymity.
She said she explained about having a girl’s anatomy but he rejected that, refused to wear dresses, and has insisted on using a boy’s name since preschool.
The mother first thought it was a phase, then that her child might be a lesbian, and sought a therapist’s help to confirm her suspicion. That’s when she first heard the term “gender identity disorder” and learned it’s often not something kids outgrow.
Accepting his identity has been difficult for both parents, the woman said. Private schools refused to enroll him as a boy, and the family’s pediatrician refused to go along with their request to treat him like a boy. They found a physician who would, Dr. Jo Olson, medical director of a transgender clinic at Children’s Hospital Los Angeles.
Olson said the journal reports should help persuade more doctors to offer these kids sex-changing treatment or refer them to specialists who will.
“It would be so nice to move this out of the world of mental health, and into the medical world,” Olson said.