Category Archives: From the Real Experts at NYU

Starting Holiday Traditions with your Little Ones

 

cookies

It’s that time of year again! Young children are already full of holiday cheer and excitement at the prospect of presents, treats, and more family time. Making new holiday traditions with your toddler (or bringing them into your existing traditions) is a wonderful opportunity to strengthen family bonds and promote their healthy development. Here are few toddler-centered milestones to consider when making your own family traditions for this holiday season.

Independence: To foster the independence that toddlers crave, try giving them a job that makes them feel central to the ritual and they can continue to do every year as they grow. For example, letting them light the candles (with supervision!) on a menorah, advent wreath, angel chimes, or centerpiece before a family meal can make them feel proud to be trusted with such a grown up responsibility. Toddlers just want to feel included and to be able imitate what they see you doing. Another fun tradition could be to bake special cookies together and make your toddler the “Chief Decorator” or “Sprinkles Fairy” to give them their special role. For families considering the long term goals of independence, gifting each child a new ornament every year to eventually move with them to their own homes as adults is a thoughtful and heartfelt tradition.

Empathy building: Toddlers are also the perfect age to learn more about empathy and civic mindedness. They will learn and embody these characteristics best by watching you model these values, and participating in the experience of giving back. Take them to buy a present and bring it to a local charity or event for children who do not have resources. Sing Christmas carols or spend time with the elderly at a local nursing home. Make meals for the homeless. Any volunteer opportunities that are family friendly will benefit the cause you are helping as well as your child’s sense of belonging to a community that values each other.

Family Bonding: Match your family vibe to a tradition that creates warm family connections. Are you a favorite movie with a big blanket and snacks family? A creative family that can make up songs or decorate ornaments together? A family who embodies “the more the merrier” mantra who can host a festive holiday get together? I know many families who create traditions that incorporate games and reading aloud during the lead-up to holidays. One family unwraps a new board game each Christmas Eve and they play all together in their pajamas while they snack on sweets. Another family asks each member to write a letter to the other members to express their love and gratitude for that person or something that happened that year (the two year old dictates hers). The letters end up in their stockings to be read aloud Christmas morning. What a wonderful lesson that would be for little ones learning about gratitude and love for others!

Making Good Memories: Whatever you decide to do to mark the holidays in your home, think about making a family tradition that will feel special and exciting to your little ones. It could be as simple as breaking routine at bedtime to stay up for a special treat or a family sleepover. You want a tradition to stand the test of time as your child grows up and ideally is something everyone looks forward to when the holidays roll around. (This may be a tall order for some adolescents who eye roll their way through family time). Make your traditions and rituals a multi-sensory experience that will make good memories filled with warmth, scents, sounds, tastes, and vibrancy. Fond memories of family holidays are treasured far longer than most gifts we receive. After all, it’s not just about getting matching family pajamas; it’s what you do together while you’re wearing them.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Lauren Knickerbocker, Ph.D., is a clinical assistant professor in the Department of Child and Adolescent Psychiatry at NYU Langone Medical Center. Dr. Knickerbocker specializes in treating selective mutism and anxiety in young children, ADHD and difficulties with organization and time management, disruptive behaviors, and parent management training. She is also the co-director of Early Childhood Service at NYU Langone’s Child Study Center.

American Girl’s Diabetes Care Kit Helps Kids with Diabetes Play, Learn, and Teach Others

diabetesThis year, American Girl made headlines with the introduction of a diabetes care kit for dolls. As a pediatric endocrinologist specializing in the care of diabetes in children, I love this idea. The kit has a glucose meter, glucose tablets, a medic alert bracelet (a pretty one), and an insulin pump, as well as other equipment that my patients have to carry with them at all times. It is a wonderful tool for medical play and for helping to prepare children for the use of an insulin pump.

As a mother, I love the idea even more. American Girl has offered to customize dolls to look like their owners for a long time. This was very exciting news in my house when my daughter was younger. The fact that this is a popular idea tells us something about the psychology of play and the relationship a child can have with a doll. Having American Girl offer accessories that can help dolls look even more like their owners is a wonderful gift to give a child. It allows them to have their doll experience the things that they themselves experience.

Technology is improving the management of diabetes, but it often makes diabetes more visible: an insulin pump clipped to your pants, a continuous glucose monitor on your arm. Many of these things may make children feel different or alone. Being able to customize your doll to share in your experiences is therapeutic.

It may also help children to explain diabetes to their friends. Many people have misconceptions about type 1 diabetes (which is the most common type of diabetes in children). One is that people who get diabetes get it because they ate poorly or did not exercise enough. This is not true. Type 1 diabetes is caused by a number of factors; approximately half of the risk is genetic and the other half is environmental. It isn’t clear what environmental triggers are responsible for the increase in the incidence of type 1 diabetes.

Another misconception is that people with type 1 diabetes can never eat treats like cake or ice cream. This simply isn’t true. We encourage people with diabetes to have a healthy balanced diet but most insulin regimens allow them to adjust their insulin doses depending on what they are eating. Children with diabetes can have treats occasionally, just like children without diabetes.

The Robert I. Grossman, MD, and Elisabeth J. Cohen, MD, Pediatric Diabetes Center at Hassenfeld Children’s Hospital of New York at NYU Langone recognizes the special needs of children with diabetes and we offer a multi-disciplinary approach to help families manage this complex condition. We have not only pediatric endocrinologists who specialize in diabetes care but also certified diabetes educators, nurses, dieticians, a clinical social worker, and a child life specialist. Soon we will also have American Girl Diabetes Kits.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Mary Pat Gallagher, MD, is an assistant professor in the Department of Pediatrics and the Director of the Robert I. Grossman, MD, and Elisabeth J. Cohen, MD, Pediatric Diabetes Center at Hassenfeld Children’s Hospital of New York at NYU Langone.

Keep Calm and Play On: How to Help Your Anxious Child Have Successful Play Dates

 

playdatePlay dates are important for both kids and their parents. They help kids build essential social skills (e.g., sharing, problem solving, and conversational skills), facilitate friendships, and improve self-esteem. Play dates can also deepen friendships among parents. However, not every kid will be a natural at play dates. You may notice that when your child is home, they seem comfortable, chatting up a storm, giggling and freely moving about. But during a play date, they may cry, cling to you, and appear generally frozen or tense.

Here are some tips to make play dates more enjoyable and successful for your child. Consider who, what, where, why and how.

Who? Let your child choose who they would like to have a play date with. Giving them choices increases their investment and perception of control in the situation. If they have difficulty selecting a peer, try to give them an option between 2 or 3 children (“Do you want to play with X or Y?”) to narrow down the choices. You can consult with your child’s teacher about classmates who they seem to gravitate towards or play with during recess. I recommend starting with one child, and once they have successful play dates with one child then you can slowly expand to having group play dates.

What? You and your child should pre-select the activities. By doing this, you are giving them some control, familiarity, and predictability with what is going to happen. Children (and adults) have increased anxiety when things are unknown and unstructured. Consider games that your child knows how to play, or activities that are of particular interest for them. Some suggestions include Uno, Guess Who, making bead bracelets, drawing, decorating cupcakes, and gardening. Discuss with them what is going to happen (e.g., your friend will come over, we will start by playing X, and then we will play Y, and then her mommy will come pick her up). You can also make a visual schedule of the activities and the children can cross them off when completed.

Where? Start at your home or another “safe” or comfortable place for your child, such as a local playground. By starting somewhere your child is comfortable, you’ll decrease the time needed for them to warm up. I recommend keeping play dates to an hour. You want it to be long enough for your child to warm up, but short enough to keep your child wanting more.

Why? Although it can be stressful and seem like you need to put in a lot of energy to prepare an hour long play date, it will be worthwhile when your child becomes more comfortable with their peers in a social setting. The more practice your child gets with having play dates, the easier it will be for them, and the less preparation it will take on your part.

How? Initially, parents should provide supervision to help structure the activities and promote comfort. Once you notice that your child has become more comfortable, you should gradually fade away from the interaction and check in as needed. Prior to the play date, you should enthusiastically discuss it with your child. After the play date, focus on the positive aspects. Prepare something fun following the play date (e.g., watching a television show, going for ice cream, or having special one on one time with parent). Most importantly, remain calm, patient, and positive!

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Brittany D. Roslin, Ph.D., is a clinical assistant professor in the Department of Child and Adolescent Psychiatry  at the Child Study Center at NYU Langone Medical Center. 

Tricks and Treats to Keep Your Family Healthy This Halloween

halloween

With Halloween fast approaching, many households find themselves filled with mini bags of M&Ms and fun-sized candy bars scattered throughout the cupboards. Part of being a kid is trick-or-treating and trading candy for the best loot. Kids should always be kids and enjoy dressing up and collecting bags filled with chocolate, lollipops, and other sugary treats. This does not mean that they need to gorge themselves on candy, which will only lead to stomach aches and sugar crashes—a situation more frightening than a haunted house! Try these tips for keeping meals healthy and kids happy.

1. Keep a balanced perspective. To support healthy habits, set rules before Halloween treats flood your house about how much candy can be eaten on any given day. Try one fun-sized candy bar in lunch boxes balanced with their usual healthy sandwich and fruit. Decide ahead of time (with your kids) that 1 regular candy bar is equivalent to 2-3 fun sized bars and share after dinner. By keeping the usual healthy foods in your kids’ diet, the occasional shared indulgence can be part of that overall healthy lifestyle.

2. Freeze the leftovers. Have kids help organize candy by type and preference. After setting aside 15 fun-sized pieces to be eaten over the next week or two, put the rest away in the freezer to be pulled out for later occasions. It will take some of the temptation and immediacy away.

3. Mix it into healthy snacks. Consider taking extra M&M packs or other mini pieces and mix them in with dried fruit and nuts to pack as an after-school trail mix snack.

4. Give it to others. Encourage kids to make care packages for grandparents or other relatives, “trick or treat” it back to the doorman, or bring it to school for a favorite teacher. Nursing homes, children’s hospitals, and other charities also accept candy donations after Halloween. Giving candy back will help to encourage sharing, while keeping excess candy out of the house.

Remember, many kids have various food allergies that may affect their trick-or-treating experience. The Food Allergy Research and Education (FARE) organization has been working to promote the Teal Pumpkin Project, which encourages people to raise awareness of food allergies and support all kids participating in Halloween, while avoiding risk of allergic reaction. FARE asks participants to provide non-food treats for trick-or-treaters, place a teal pumpkin in front of your home or apartment door to indicate that you have non-food treats available, and consider displaying signs or posters from FARE to explain the meaning of the teal pumpkin and encourage others to consider joining in! For more information about the project, visit http://www.foodallergy.org/teal-pumpkin-project/faqs.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Bridget Murphy, MS, RDN, CDN is a registered dietitian and clinical nutritionist at the Child Study Center at NYU Langone Medical Center. 

Helping Young Athletes Prevent a Devastating Knee Injury

soccer-injury

A “popping” sound or sensation, sharp pain, buckling, and swelling in the knee—these are the classic symptoms of a tear in the anterior cruciate ligament (ACL), a major stabilizer of the knee. Many young athletes know these signs all too well. ACL tears have become a problem of epidemic proportions in youth sports, especially female sports like girls’ soccer and basketball.

How do ACL tears happen?
ACL tears are rarely a contact injury. They usually occur upon landing from a jump, particularly with straight knees, which female athletes tend to do more than their male counterparts.

How does a torn ACL affect young athletes?
A torn ACL makes the knee very unstable. Following an injury that damages the ACL, athletes can’t perform at their normal level, particularly in sports like basketball, soccer, lacrosse, and tennis that involve jumping, pivoting, and cutting (a sudden change in direction when running).

A devastating injury to a young athlete, an ACL tear not only has short-term consequences, but long-term consequences as well. In many cases after an ACL injury, patients will be at an increased risk for developing arthritis at a young age.

What does treatment involve?
Complete tears of the ACL do not heal, and the only way to fix them is surgical reconstruction. Treatment for an ACL tear involves arthroscopic (minimally invasive) same-day surgery, but a long recovery follows. Physical therapy begins the first week after surgery and continues for at least a few months. It generally takes about nine months before patients are able to fully return to sports.

Can ACL tears be prevented?
The good news is that young athletes can reduce their risk of this serious, potentially life-changing injury by taking steps to prevent it. Orthopedic studies have found that with the right ACL injury prevention program, 60 to 80 percent of injuries could be avoided, with some studies even finding a 90-percent reduction in ACL tears. More than just preventing ACL injury, participating in such a program could improve performance on the field.

What is an ACL injury prevention program?
An ACL injury prevention program usually involves spending 15 to 20 minutes, two or three days per week, performing plyometric exercises. Typically directed by a coach, this type of program focuses on jumping and landing techniques, as well as building proper muscle strength and balance. The goal is to teach athletes to land properly while helping them improve coordination and proprioception, the brain’s awareness of the body’s position and movement.

What can I do to ensure my child receives proper prevention training?
ACL injury prevention is one of the most important issues in youth sports. All student athletes should have access to a program to prevent ACL injury. Unfortunately, even though very good prevention programs exist, only a small minority of schools and teams offer them. For those that don’t, I encourage parents to speak to their schools and directly to coaches about putting such a program in place.

Every parent whose young child or adolescent engages in school sports should make sure their kids are involved in an ACL injury prevention program, especially for sports involving cutting, pivoting, and jumping. Doing so could mean the difference between getting sidelined for a season with risk of arthritis at a young age—and enjoying all the physical, social, and psychological benefits that participating in sports can bring.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Dennis A. Cardone, DO, is Director of Primary Care Sports Medicine in the Department of Orthopedic Surgery and Co-Director of the Concussion Center at NYU Langone Medical Center, and Chief Medical Officer for the New York City Public Schools Athletic League.

Helping Your Child Make and Keep Friends

friends

Friendship is protective—having just one or two friends can make all the difference to a child’s development. Friends increase self-esteem, confidence, and independence. Having friends can also protect children and teens from bullying and victimization, and help buffer the impact of stressful life events.

But for some children and teens, making and keeping friends isn’t easy. Whether due to anxiety, ADHD, autism, or developmental disabilities, some lack the confidence and social skills needed to make a phone call, join a conversation, or play team sports. They may not pick up on verbal and nonverbal cues or empathize with others’ perspectives. And the consequences can be considerable: loneliness, depression, anxiety and isolation. This inevitably spills over into life transitions, including college, dating, and finding and keeping a job.

Fortunately, these skills can be taught. One place to start is building conversation skills including trading information with the goal of finding common interests, sharing conversations, and building awareness of nonverbal communication skills such as making eye contact and having good body boundaries. Another starting place is helping children and teens to choose appropriate friends by identifying a peer group and identifying extracurricular activities to find sources of friends who share common interests as a basis for building friendships.

The Child Study Center at NYU Langone Medical Center conducts social skills classes for children as young as three through young adults up to age 30 to help teach these skills. Our clinical faculty and staff use evidence-based interventions, the Children’s Friendship Program for elementary school children, and the PEERS® program for teenagers and young adults. The children, teens and young adults learn skills through in-class rehearsal and homework. It is a class; it is not a place to make friends, but a strategy on how to make friends in their real, outside lives.

The classes are developmentally appropriate for each age group. The youngest children learn how to play in groups. Elementary school children practice face-to-face conversations, make phone calls, and learn how to handle rejection. Older teens learn dating skills—how to ask someone out, how to behave, and what behavior is acceptable. All groups have homework, which involves practicing their new skills. This homework helps children gain confidence and solidify their new skills.

Parent participation is integral to the program’s success. In separate, concurrent classes, parents learn the language and skills being taught to their children—a requirement that not only enables them to help their children with homework, but also gives them the tools to be social coaches long after the program is over.

Each group meets weekly, for 60, 75 or 90 minutes, depending on age.
•Preschoolers attend 60-minute sessions for 15 weeks.
•Elementary school children between the ages of 5 and 8 attend 75-minute sessions for 12 weeks.
•Elementary school children between the ages of 9 and 10 attend 75-minute sessions for 14 weeks.
•Teens from 11 to 17 attend 90- minute PEERS® program classes for 14 weeks.
•Young adults with autism from 18 to 30 attend 90-minute PEERS® program classes for 16 weeks.

We perform an initial screening of all applicants and then meet with each child and parent to see if the child is appropriate for the group. Minimum requirements include approximately average cognitive and verbal functioning; a parent willing to participate; English language knowledge; and the child’s expressed interest in making and keeping friends.

Manhattan groups are conducted at One Park Avenue, 7th floor, New York, New York 10016. For more information, please call 646-754-5284 or email csc.sociallearning@nyumc.org.

For group offerings at our Long Island campus in Lake Success, please call 516-358-1808 or email Bonnie.Schwartz@nyumc.org.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Sarah Kuriakose, PhD, is a clinical assistant professor in the Department of Child and Adolescent Psychiatry and the clinical director of the Autism Spectrum Disorder Clinical and Research Program at the Child Study Center at NYU Langone Medical Center.

Sarah Kern, LCSW, is a clinical assistant professor in the Department of Child and Adolescent Psychiatry at the Child Study Center at NYU Langone Medical Center.

Celiac Disease, Wheat Allergy or Gluten Sensitivity: Negotiating a Gluten-Free World with Your Child

As the gluten free diet becomes increasingly popular, I often have parents expressing confusion regarding when their children should eat gluten free products. A common question is, “My child tested negative for celiac disease, but has symptoms when eating gluten. What does that mean?”

To answer this, it’s important to note that there is a difference between celiac disease, wheat allergy, and gluten sensitivity.

Celiac disease is a lifelong diagnosis that is caused by a combination of genetic and environmental factors. When gluten is eaten it damages the intestines, which can cause a variety of symptoms both inside and outside the gastrointestinal system. Thankfully, celiac disease has a very successful treatment: a lifelong gluten free diet. This diet limits wheat, rye, barley, and in some cases, oats. Children should remain on this diet exclusively to ensure that they are healthy through their childhood, adolescence, and adult years.

• A wheat allergy is caused by intolerance to wheat only. Children with a wheat allergy can usually eat rye, barley, and oats without a problem. This allows for a less restricted diet than the gluten free diet. In contrast to celiac disease, when wheat is eaten it triggers a different allergic pathway and children often present with “allergic symptoms.” These include runny nose or eyes, itchy throat, rashes, or even difficulty breathing. Your child will likely be diagnosed with a wheat allergy early in life and may outgrow it later on. Unlike celiac disease, depending on their symptoms your child may need to carry certain medications such as an EpiPen with them.

Gluten sensitivity is how we characterize children who do not have a wheat allergy or celiac disease, but their gastrointestinal symptoms—such as abdominal pain and bloating—improve when they stop eating gluten. Compared to celiac disease, these symptoms do not put children at risk for other nutritional deficits, permanent gastrointestinal damage, or other medical problems.

What does this mean?
If your child has symptoms when eating gluten, before just grabbing the yummy looking gluten free food in the supermarket aisles, bring them to a medical provider who can help differentiate the cause of their symptoms. Remember that you are not alone—if you feel confused navigating the gluten free world, reach out to your medical providers and support staff for assistance.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Leora Hauptman, MS, RN, CPNP is a nurse practitioner in the Pediatric Celiac Disease & Gluten-Related Disorders Program at NYU Langone Medical Center. Mrs. Hauptman has many years of experience working with children with gastrointestinal disorders and developmental disabilities.

A Picture’s Worth a Thousand Words: Creating the Perfect Visual Schedule for Your Child with Autism Spectrum Disorder (ASD)

asd

Establishing a predictable and structured daily schedule for your child with Autism Spectrum Disorder (ASD) can make a huge difference in her ability to meet behavioral expectations throughout the day. Unexpected changes in schedule may be upsetting and trigger challenging behavior that impacts the whole family. Follow these simple steps to create a thoughtful daily schedule:

1. Review your child’s daily activities: Begin by writing out your child’s activities on a typical day. Make note of the activities that are associated with challenging behaviors and focus on those activities first.

2. Choose prevention strategies that make sense for you and your child: Consider whether any of the following strategies could be used to prevent problem behavior from occurring.
• Reorder activities: Sometimes children engage in their most naughty behavior when they are asked to stop a favorite activity and transition to a nonpreferred activity. For example, a child might scream and protest when his father asks him to turn off the TV and begin homework. To prevent challenging behaviors that arise during these difficult transitions, simply reorder the activities (i.e., ask him to complete his homework and then offer TV time as a reward).
• Provide warnings: To reduce challenging behaviors associated with transitions, use visual and auditory cues to remind the child about the upcoming change in activities. Setting a timer that signals the end of activity at the 10-, 5-, and 2-minute mark—or simply stating the remaining number of minutes left in the activity—will prepare them for the end of the activity.
• Change the timing of activities: Children may engage in challenging behavior when they are asked to do a difficult task in a short amount of time. If your child engages in disruptive behavior when he is asked to quickly pick out his clothes in the morning, have him complete this activity at the end of the day, when he has more time and there is less pressure to get out the door and catch the school bus.
• Modify the environment: Children sometimes become more distractible when tasked with activities that require sustained mental effort, such as homework or practicing an instrument. Help minimize distractions for your child by creating a distraction-free zone for activities that require continued attention (e.g., provide a quiet work space away from siblings, give your child special headphones, remove technology from the room).
• Build in breaks: If your child engages in problem behavior or is very active when asked to sit down and complete schoolwork, schedule short breaks for her in advance. For example, after completing 10 math problems or engaging in 15 minutes of homework, provide your child with a 2 minute break. During breaks, encourage your child to do something relaxing, like look at a book, or release energy through short exercises or games, such as jumping jacks or a quick round of Simon Says.
• Establish routines: Creating daily routines for activities that are associated with challenging behaviors may help increase compliance and independence with daily living skills. For example, many children demonstrate behavioral difficulties surrounding bedtime; establishing a bedtime routine that incorporates 4-6 steps, which may be completed in the same sequence each night (starting with the more demanding and ending with the more enjoyable), will help your child learn the expected and appropriate behaviors.

3. Set up a visual schedule: After you have developed the schedule of activities for your child, you can create a visual schedule with basic art supplies (e.g., foam board, markers, and Velcro) or on the computer that may be shared with him. Visual schedules promote predictability and increase comfort and independence with daily activities. You can draw pictures of the activities, take photos, or find images online—incorporating simple pictures into the schedule may increase your child’s understanding of the behavioral expectations and the appropriate sequence of activities. Print the pictures, laminate them, and apply Velcro to the backs so they can be placed on the board.

4. Introduce the schedule to your child: Decorating the schedule with your child can be a fun way to introduce the idea. Gather some art supplies that she enjoys and encourage her to make the schedule her own.

5. Post your schedule in a high traffic area: To maximize the impact of the schedule, find it a good home! Posting the schedule in a place where you and your child spend time regularly, such as the kitchen or his bedroom, will facilitate greater exposure. Be sure that the schedule is at his eye level so he can reference it with ease throughout the day.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Rebecca Shalev, PhD, BCBA, is a clinical assistant professor in the Department of Child and Adolescent Psychiatry at the Child Study Center at NYU Langone Medical Center.

Children’s Eye Safety 101

eye-injuries

August is Children’s Eye Health and Safety Month, and as the prevalence of eye injuries is highest among children, it’s important for you and your kiddos to be aware of steps you can take to prevent them. While an eye injury can occur at any time and in any environment, close to 50% of injuries occur during sports and recreational activities. Adequate prevention is important and can probably eliminate most eye injuries. Here’s what you need to know about your child’s eye safety:|

What causes eye injuries?

Injuries to the eye and surrounding structures can be caused by an object hitting the eye—something blunt, such as a ball or fist, or sharp, like a stick or projectile—or exposure to a caustic substance like a cleaning solution or pool supplies.

What are some common injuries to the eyeball itself?

The clear surface of the front of the eye (the cornea) can be scratched, and often causes pain, redness, and tearing. Treatment usually involves antibiotic eye drops or ointment and occasionally a pressure patch on the eye.

Sharp objects (like a stick, a shard of glass, or metallic item) can actually cut the surface of the eye, causing a laceration. This type of injury places a child at risk for permanent loss of vision, and requires prompt attention (usually surgical intervention) by an ophthalmologist to prevent complications and assure the best visual recovery.

Blunt trauma can cause bleeding inside the eye (hyphema). The blood in the eye can cause elevated pressure, which can result in permanent vision loss if not treated.

What about injuries to the area around the eye?

Injuries to the eyelid or bones around the eye could also affect eye health, and should be evaluated by an ophthalmologist. Eyelid injuries usually occur as a result of sharp trauma—if the eyelid tissue becomes cut or torn, it could also affect the structures that drain tears from the eye. A cut or torn eyelid or draining structure may require repair in the operating room using microsurgical techniques. Any injury to the eyelid can also be associated with injury to the eyeball, so a complete examination of the eye must be performed to make sure there’s no injury deeper than the surface of the eye.

Fractures of the bones around the eye usually occur from blunt trauma, such as from a sports injury or a fall. Fractures are often detected by x-rays or a CT scan. These injuries may require prompt surgical treatment to prevent long-term complications such as double vision, loss of vision, and abnormal appearance.

Sounds scary! What can I do to prevent these kinds of injuries?

Make sure your child protects her eyes during recreational activities. Racquetball, squash, tennis, soccer, golf, baseball, basketball, field hockey, lacrosse, and paint ball are the most common culprit sports for eye trauma.

Protective glasses or face shields are available for most sports. The best protective eyewear is a sports frame with polycarbonate lenses. If a child has a need for better vision with glasses, this prescription can be placed in the sports glasses. Although many athletes wear contact lenses, they do not provide adequate protection against injury.

What should I do if my child has an eye injury?

If there is a chemical injury, immediate irrigation with water is critical. Flush the eyes and face with any available source of water for at least 10-15 minutes. Follow up immediately with a trip to the emergency room or ophthalmologist.

If a sharp object has penetrated the eye, do not pull it out, but transport the person to the emergency room as soon as possible.

Other blunt or sharp injuries should be examined by an ophthalmologist, since the serious nature of the injury may not be readily apparent.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Mark Steele, MD, is Chief of Pediatric Ophthalmology and a clinical associate professor in the Department of Ophthalmology at NYU Langone Medical Center.

Tips to Help Kids Avoid Overuse Injuries in School Sports

sports-injury

Taking part in schools sports can help kids build friendships, learn teamwork, and enhance muscular and coordination skills, as well as set the stage for a healthy lifestyle into adulthood. But “too much of a good thing”—overdoing athletic activity—can lead to what are known as “overuse injuries,” such as tendonitis, damaged ligaments, and stress fractures.

What Causes Overuse Injuries?

When an athlete performs the same activity over and over without giving the body enough time to rest, overuse injuries may gradually occur in response to the repetitive stress placed on muscles, ligaments, tendons, and bones. Younger children and adolescents whose bodies are still developing are especially susceptible. Pain and inflammation are common, and may eventually lead to surgery in some cases.

Overuse injuries have become a major problem in youth sports. For instance, more and more young baseball players are sustaining elbow injuries and undergoing “Tommy John” surgery, named after the first baseball player to have surgery for damage to an elbow ligament caused by prolonged pitching. To prevent such injuries in student pitchers, several years ago New York City’s Public Schools Athletic League (PSAL) implemented a per-game pitch count limit and mandatory rest periods. Once pitchers hit the limit, they are removed from the game, and must take a few days off until their next pitching assignment.

That’s one example of the role school policy can play in helping prevent overuse injuries. But parent involvement is crucial, too, in protecting kids’ health and encouraging safe sports participation.

What Parents Can Do

Many kids feel pressured to specialize in a single sport and train intensively—often year-round—at a very young age. Perhaps their coach is very competitive, or their parents think it’s necessary to be good enough for a college scholarship or to join an Olympic or professional team one day. Unfortunately, specializing in one sport before late adolescence (ages 15 to 18) puts kids at higher risk for overuse injuries, as well as burning out and losing interest in athletic activities.

The best thing parents can do to prevent overuse injuries is ensure that their young children and early adolescents follow these do’s and don’ts:

• Do not specialize in a single sport. To help kids improve their overall coordination and sports-related skills, encourage them to try a variety of sports. Specialization in late adolescence may be appropriate for some kids, but younger children are better off enjoying diverse athletic activities. In fact, some of the best athletes who receive college scholarships or join professional teams do not specialize at a young age.

• Do not play the same sport on multiple teams. The damaging effects of repetitive stress are cumulative. Rather than, say, play on a local team, travel team, and all-star team, pick just one.

• Take a break from any one sport for at least two to three months per year. This time off will give kids’ growing bodies time to recover.

• Go outside and play freely with friends—in other words, spend unstructured time without a coach or parent directing specific exercises.

• During time away from a team, avoid taking part in the same sport or activity. For instance, if playing with a team Monday through Friday, participate in different types of activities on Saturday and Sunday. Mixing it up will also prevent burning out on a particular sport, as well as boost kids’ enjoyment of it.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Dennis A. Cardone, DO, is Director of Primary Care Sports Medicine in the Department of Orthopedic Surgery and Co-Director of the Concussion Center at NYU Langone Medical Center, and Chief Medical Officer for the New York City Public Schools Athletic League.