Tag Archives: parenting tips

Supporting Young Adults with Autism through Life Transitions


The transition between high school and college or high school and other postsecondary opportunities brings a lot of changes to the lives of young adults and their families. In most cases, young adults suddenly experience much more flexibility in terms of daily activities and schedule—and unfortunately have fewer opportunities for structured social activities. For adolescents and young adults with autism spectrum disorder (ASD), such transitions can be extremely difficult due to their specific social challenges. Such challenges may interfere with the ability to successfully form friendships and romantic relationships, navigate college, and later on, seek and maintain employment.

Parents play an important role as social coaches and facilitators of vocational and social opportunities. Below are some suggestions for parents for supporting their adolescent or young adult through the transition to adulthood and toward independence.

Make a Plan

Identify goals
Adolescents and young adults tend to show interest in employment opportunities, greater independence, and social relationships, including romantic relationships and dating. If having close friends or dating is a priority to your child with ASD, it’s important to think about how to intentionally build in more support and social experiences to help him or her to be successful and included in his or her community.

Start small
Parents and young adults don’t need to do everything all at once! Once goals are identified, think about priorities. If the goal is to make new friends and build one’s social group, work with your young adult to identify his or her interests and find social activities or groups based on those interests. For example, if your child has an interest in chess, he or she can visit gaming stores, attend tournaments, join a chess Meet Up group, or join a chess club on his/her college campus. It can be helpful to talk about how to identify individuals who may have similar interests. If the primary goal is employment, starting small may include one of the following: visiting a parent’s place of work for a day, participating in extracurricular school activities related to career interests, learning about internship or service learning opportunities, or occupational mentoring to learn and practice work behaviors and gain awareness of a potential professional niche.

Practice together
In addition to the two planning steps above, a helpful tool for young adults is practicing the different skills or scenarios that might come up in vocational or social situations. Try role-playing interview skills or having a back-and-forth conversation, and give your child feedback or coaching. Common difficulties for individuals with ASD that may need coaching include inconsistent eye contact, dominating the conversation, perseverating on topics of personal interest, talking about inappropriate topics, and body boundaries.

Praise/recognize efforts
Individuals with ASD may feel misunderstood or disrespected, and become exhausted by social demands, or think of small talk as phony. It is important to praise their efforts and motivation, while continuing to coach around areas of difficulties.

April is National Autism Awareness Month. Learn more online at the Autism Society.

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

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

X-Ray Vision and Our Medical Superheroes: What to Expect in Pediatric Radiology


You care about your children’s health, and it can be extremely anxiety-provoking to see them in pain or discomfort. When they need medical attention, knowing what to expect can help you manage an already-stressful situation.

At NYU Langone Pediatric Radiology, we typically see patients from the newborn period through adolescence. We understand that kids are not just small adults; they have their own needs, and our approach is tailored to children specifically. It matters to us that your child has a positive experience, so we’ve made every effort to ensure they do.

Here’s what you can expect the next time you bring your child in for an imaging appointment:

Fluoroscopy: This type of imaging uses low dose X-rays to look at the inside of the body in real time, usually using a contrast liquid that will appear on our monitors. Some of our most common types of fluoroscopic procedures in pediatrics include contrast enemas, small bowel series, upper GI series, voiding cystourethogram (VCUG), and video swallow studies. Here are some helpful tips:

•  Patients for these exams should be as comfortable as possible. Any soothing comfort items your child would like—toys, pacifiers, etc.—are welcome.
• Babies and toddlers in particular should not eat before their studies.
• Fluoroscopy uses low dose radiation. We subscribe to the Image Gently campaign’s Pause and Pulse philosophy of using the lowest radiation dose possible as described.

CT and MRI: When your child needs imaging done with CT or MRI, there are a few things to keep in mind.

• CT, which stands for Computed Tomography, uses radiation to generate very detailed 3D images of any part of your child’s body. A CT scan does involve a low dose of radiation, but we use the most state-of-the-art equipment to minimize exposure.
• MRI, which stands for Magnetic Resonance Imaging, produces detailed 3D images of the body without using ionizing radiation. MRI takes longer than a CT scan. The decision to image with CT or MRI depends on several factors, including the anatomical location of the problem.
• In order for us to obtain the highest-quality images, it’s important for kids to stay as still as possible during imaging. When necessary, the department of anesthesia is available to provide sedation to make the experience easier.

X-ray: It’s common for pediatricians to refer kids to us for X-ray imaging, often for the evaluation of possible broken bones or pneumonia. Here are some helpful tips:

• Unless otherwise instructed, you can feed your child before the exam so that he or she is kept as comfortable as possible. Other soothers, such as pacifiers and blankets, are also allowed for the exam.
• X-rays do involve radiation, but a very small amount. These procedures are non-invasive and nothing needs to be put into the body. The radiation is isolated to the specific part of the body that needs imaging and nowhere else, making X-rays extremely safe.

Ultrasound: Ultrasound is a very common pediatric imaging procedure. It can be used to evaluate almost every part of the body. One of the most common reasons we see pediatric patients is to evaluate abdominal pain. This procedure is particularly easy for our patients. Here are some helpful tips:

• The entire process is non-invasive, so there’s no stressing out about radiation or discomfort.
• We like to consider the simple things to make our patients more comfortable during medical procedures, so we use warm jelly that will feel more pleasant for the kids.

Imaging is central to any good patient care. Our pediatric radiologists are part of the healthcare team, working closely with your referring physician to gather relevant information as quickly and accurately as possible. We know imaging studies play a huge role in helping doctors diagnose exactly what is happening to a patient and determine which treatment steps to consider.

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

Nancy Fefferman, MD is an associate professor in the Department of Radiology at NYU Langone Medical Center, and the chief of Pediatric Radiology.

Five Important Standardized Test-Taking Strategies


test_takersBy: The Kumon Staff

There are five basic test-taking strategies that students of any age should have when approaching any exam or assessment. These strategies are applicable to students taking the Smarter Balanced Assessment Consortium exam in 3rd grade as well as those taking the SAT in high school.

1. Read the instructions carefully. Skipping the instructions can lead to errors. For instance, the directions may say that more than one answer is correct and you must select all answers. Or, the directions may say to select the vocabulary answer that is opposite in meaning.

2. Read each question carefully. After reading the problem carefully and paying attention to the details, underline key words that will help you to understand the question. Seek the information needed and narrow down the important information. Is the question asking for the sum? Does the answer require a synonym?
• Recognize and ignore what is unnecessary. Often math word problems will provide extra information that you don’t need in order to solve the problem.
• If you come across a difficult question, don’t spend all of your time on it. Move on and come back to it at the end.

3. On multiple choice questions, read each answer carefully before making a selection.
• Eliminate all answers that are not correct.
• Don’t fall into the trap of looking for patterns in the answers. There really can be four “B” answers in a row.

4. Select a strategy.
• Often there is more than one way to solve a problem. Chose the strategy that will work best for you. Will you draw a picture? Will you use the regrouping method? Will you use trial and error?
• Don’t second guess yourself by changing your first answers unless you are 100% certain.

5. Use all of your time wisely.
Pay attention to time passing in relation to the time allotment.
• Don’t get distracted by other students in the room.
• If you have time, go back over as many problems as you can to make sure that the answers are correct. When finished, look closely to make sure that you have answered everything and that you haven’t overlooked any questions.

As mentioned above, an important test-taking strategy is the process of carefully examining the directions and exercises, which is routinely practiced by Kumon students. When Kumon students write an incorrect answer, they try the exercise again by carefully reviewing the directions and other given information.

Organization Frustration: Tips to Help Your Child Stay on Top of Schoolwork

Child with learning difficulties. Tired boy doing homework.
Many parents of school-aged children complain that their kids lack basic organizational skills—they forget to complete assignments, leave important materials for homework at school, have messy backpacks, take too long (or not long enough) to complete homework each evening, and fail to plan ahead for projects and tests. Organization is not an innate skill; some children easily organize their materials and juggle multiple tasks while others struggle to keep up with school-related demands. If your child shows problems with organization, time management, and planning skills, consider these concrete strategies and routines for helping children stay on top of schoolwork.

Does your child have a clear, organized method for keeping track of assignments?
Help your child develop the habit of using a planner to record assignments. Even if teachers post some or all of the assignments on a class website, keeping a personal record will help your child stay organized. Look for a planner that is broken down by subject, has enough space to write details, and has an easily accessible monthly calendar for recording long-term assignments. A space to check off items that need to come home and return to school can help kids who often forget needed materials.

Does your child often lose papers, books, and other important items?
Think about where your child runs into trouble. Is he constantly misplacing one folder? Does she stuff papers into her bag because punching holes and finding the right section in a three-ring binder takes too long? Think about how you can step it down, or simplify the routine. We have found that an accordion file works well for many children; there are no holes to punch, and papers for different subjects are easily filed within one manageable tool.

Help your child develop a routine for checking that all important items are in the bag when packing up in school and at home. A visual checklist pinned to the inside of the backpack can be a helpful cue so your child doesn’t forget critical items.

Does your child struggle to complete tasks in an appropriate amount of time?
You can help your child gain control over his or her schedule by teaching critical time estimation and planning skills. Set aside five minutes each day to review what work needs to be done (consider what is due tomorrow as well as longer-term assignments), how long each assignment should take, what other events are on the schedule (e.g., extracurricular activities), and what your child would like to do to relax. You may find it helpful to create a written schedule, where your child can map out the evening’s activities in 15-minute time increments.

Does your child have difficulty planning ahead for more complex tasks?
If your child is unsure of how to start working on multi-step tasks or if he or she struggles to produce neat, complete work in advance of deadlines, you may need to work on task planning skills. Start by helping your child state the goal for the specific task, break the task down into steps, order the steps, think about materials that are needed, consider how long each step will take, and fit the steps into the schedule. You can write down the individual steps on a calendar so your child can clearly keep track of what to do and when.

Organizational Skills Training at the NYU Child Study Center
If your child has significant difficulties with organization, time management, and planning, he or she may require more intensive intervention to get on track with schoolwork. Organizational Skills Training (OST) is a manualized, empirically supported treatment that has been proven to improve the organizational skills and academic performance of children with Attention Deficit Hyperactivity Disorders. For more information on OST, click here.

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

Elana Spira, PhD, is a clinical assistant professor in the Department of Child and Adolescent Psychiatry at NYU Langone’s Child Study Center. She is co-author of the treatment manual for OST, Organizational Skills Training for Children with ADHD.

Your Child Has Autism: Now What?


Your child has just been diagnosed with autism spectrum disorder (ASD), and it may feel as though the ground has dropped out from under you. The challenges seem overwhelming at first, but you don’t have to face them alone. With so much going on, it can be hard to know where to start. Here are a few ideas.

Find Professional Support
You are beginning your journey as your child’s advocate and will need to identify the resources you need as soon as possible. Your child will have symptoms, abilities, needs, and challenges that are unique to him or her. With that in mind, a little research will help you evaluate who can best help your child. Be sure to ask questions about each therapist’s approach and methodology, including whether the treatment is grounded in evidence-based practice and how parents and caregivers are included in the treatment.

Make Time for Yourselves
Your child’s needs are paramount, but if you are going to be able to meet them, you must also take care of yourself. As parents, you are under a tremendous strain. It’s critical that you take a deep breath, step back a bit, and process your own emotions and needs. It will be hard at first—your impulse will be to throw yourself into protecting and helping your newly diagnosed child—but it is necessary for your own long-term health and that of the rest of the family.

Be Open with Your Other Children
The diagnosis affects the whole family. Your other children will have questions and reactions, and their feelings about having a sibling with autism need to be validated. Don’t withhold information—it will neither protect them nor make them feel better. Encourage them to ask questions, and process what the diagnosis means for them.

Build a Support System
Don’t go it alone. It’s impossible to overstate how important it is to have family, close friends, parents of children with ASD, and therapists who support you as you start on this new path. Other parents will be particularly supportive—who else knows truly understands what you’re going through? They can be an invaluable source of information on family dynamics as well as on therapists and other resources.

Approach the Internet with Caution
While the Internet is a great source of information, it also contains a great deal of misinformation; you must be discerning. When reviewing websites, check to see if the author has a background in ASD and is professionally qualified to provide reliable information. Also, note whether the site’s information has been subjected to rigorous testing and research. Put another way, does the site share information on evidence-based practices?

One last, but important, note. Your child is the same child he or she was before the diagnosis and will continue to develop in his or her own way, and build unique strengths, skills, and interests for you to embrace and celebrate.

April is National Autism Awareness Month. Learn more online at the Autism Society.

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

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

Breastfeeding Tips for New Moms


Breastfeeding has proven to have wide-ranging health benefits for infants: breast milk provides essential vitamins, protein, and fat to help babies grow. It is also easier for babies to digest than formula and contains antibodies to help fight off viruses and bacteria that cause illness or infection. Both the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists strongly recommend the practice. Still, breastfeeding is a personal choice that can be influenced by family support, the personal health of the mother, breastfeeding education, and the necessity for mom to return to work.

These factors can influence different cultural groups in a variety of ways, and the staff at NYU Lutheran Family Health Centers’ Women, Infant, and Children’s (WIC) Program found that in particular, most Chinese moms they saw were bottle-feeding rather than breastfeeding. The WIC program collaborated with the NYU Lutheran Labor and Delivery Unit to provide Mandarin- and Cantonese-speaking peer counselors five mornings a week, to facilitate prenatal discussion with Chinese moms on the importance of breastfeeding. This education resulted in a significant increase in breastfeeding among that population.

We asked two front-line community physicians, Girish Gowda, M.D., a neonatologist and partnering physician with NYU Lutheran’s WIC breastfeeding support program; and Sharon P. Joseph-Giss, M.D., medical director and pediatrician at NYU Lutheran Family Health Centers Sunset Park for Women and Children for their top tips for new moms struggling to make breastfeeding work for them:

  • The first milk produced is called colostrum. It may seem like it’s not enough but it is sufficient for your baby. In fact, it is necessary to give your baby important nutrients and ingredients such as antibodies to fight infection. The full milk supply will take a day or two to begin, so put your baby to your breast—they are getting plenty of nourishment, and more milk will be produced in a couple of days.
  • Breastfeeding improves health for both mom and baby. For mom, it helps decrease uterine bleeding after giving birth. Exclusively breastfed babies have a smaller chance of ear infections and illness, as well as fewer hospitalizations in the first six months.
  • Put the baby to your breast often! Supply and demand is in effect here, and the more the baby suckles, the more milk the body will produce.
  • When your baby is hungry, make sure his mouth opens WIDE, and put as much of the dark part of your breast and nipple in his mouth as possible. This will ensure a good latch. If the baby just suckles the nipple, this will make you sore.
  • You will need to nurse about every 1.5–2 hours. Better yet, nurse on demand! This will ensure good growth for your baby, and ramp up your milk supply.
  • If your baby has six to eight wet diapers per day that means he or she is getting an adequate intake of milk.
  • Be careful of your diet. Foods that give you gas (broccoli, onions, garlic, beans) can give your baby gas as well.
  • You will know that your baby is drinking if you hear gulping sounds and the baby seems satisfied—sleepy and content—at the end of the session. Since there is no way to measure the milk your baby drinks directly from your breast, this is the best indication that she is getting enough.

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

Girish Gowda, M.D., is a neonatologist and partnering physician with NYU Lutheran’s WIC breastfeeding support program.

Sharon P. Joseph-Giss, M.D., is medical director and pediatrician at NYU Lutheran Family Health Centers Sunset Park for Women and Children.

The ABCs of AT: A Primer on Assistive Technology


A
ssistive technology (AT) can be loosely defined as the use of equipment to facilitate independence in a person with a disability.

Both children and adults can benefit from the many types of assistive technology.

Children’s needs can differ greatly from adults due to the nature of their disability and their educational needs.

Here’s what you need to know about high and low tech assistive technology:

• Low Tech AT is usually less invasive and easy to incorporate. Examples include adaptive pencil grips, large print text, line guides for reading, or a picture scheduling system for a child that has a hard time understanding text or numbers. While these changes are simple, they can make a big difference in independence for everyday tasks such as handwriting and reading.

• High Tech AT refers to complex devices that have a power source. For children, high tech devices are often used for communication impairments and include adaptive hardware or software to access a computer, equipment to participate in leisure tasks, and home automation devices.

• Computer Technology: AT for the computer includes adaptations to hardware or software. Keyboards can be made larger or smaller and keyboard letter keys can be given alternate layouts. A mouse can be adapted to a joystick or trackball, or made to be controlled by the head or eyes. On-screen keyboards, voice to text or text to voice software, and word prediction software can all help to make communication easier.

• Alternative and Augmentative Communication: These are devices that enhance or replace speech when a child is unable to make his or her needs known. Devices like iPads can be used as children’s communication tools with appropriate applications. There are also “dedicated” devices; these are meant for communication only but have accessibility built in for use with head movement or eye gaze.

• Home Automation: With the advancement of technology, it’s much easier for a child with a disability to control his or her environment, including lights, TV remote, fan, door locks, etc. With the use of a simple remote, smart phone, or tablet, a child can access all of the electronics at home independently.

The use of assistive technology can greatly improve the life of a child or adult with a disability or mixed abilities, and the inclusion of accessibility options in mainstream technology makes access of the necessary easier for a person with an AT need.

Want to learn more? Join the experts from Rusk Rehabilitation at NYU Langone Medical Center for a discussion on the use of assistive technology to enhance independence of children outside the classroom:

Date/Time: Thursday, February 25 at 5pm
Location: Ambulatory Care Center, 240 East 38th St., 11th Floor Conference Room

To RSVP for this free lecture, click here.

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

Holly Cohen, OTR/L, ATP, SCEM, CDRS is the Program Manager of Assistive Technology and Driving Rehabilitation at NYU Langone Medical Center’s Rusk Rehabilitation.

How to Talk to Your Kids about Internet Safety


Internet safety is a complicated and multifaceted issue, in part because a family’s culture and outlook on technology must be considered. As such, there is not necessarily a “one size fits all” method to raise your children with technology and the Internet.

It is important to view the Internet as a tool—in fact, picture a chainsaw. Like any tool you will want to set clear expectations and teach the user safety measures, as well as skills for handling the tool efficiently, and discuss hypothetical situations for what to do if there is an accident or emergency. The same can be said for the Internet and your children. Unlike a chainsaw, however, there is no operations manual for the Internet, so consider the guidelines below as you map out your family’s personal safety manual:

Parenting has not changed. Technology, particularly the Internet, has changed our lives, but it has not necessarily changed the rules of parental engagement! The world may be new, but the problems are not.

Content matters. Setting clear expectations for your child’s Internet use is a necessity. If your child were to play in the neighborhood, you would want to know who they are meeting, where they are going, what they plan to do, and when they will return home. Having that information allows you to set more targeted boundaries. Similarly, becoming more familiar with your child’s Internet use is an important hurdle to overcome.

Learn from each other. As you teach your children how to use the Internet, it will also be your responsibility to learn from them about the ways in which they use it and about dangers they may encounter.

Co-engagement counts. For younger children, be prepared to monitor their use much more closely and use parental controls. Plan to use the Internet together with your young child. I recommend “saddling up” to children when they are engaged in a game or video and to simply participate with them—what better way to learn together? As youth develop through their teenage years, foster more exploration and independence with continued monitoring and coaching of appropriate use.

Role modeling is critical. Take a moment to consider the ways you and other caregivers use technology. Some adults use their phones during dinnertime, and others might use devices in bed before going to sleep. Make sure to talk with other caregivers to establish consistent expectations for what you want to model to your children.

Create tech-free zones. Consider creating tech-free times of day for the whole family! Dinnertime and bedtime are good places to start. Remember that if you frequently use devices during such times you will be hard-pressed to enforce such tech-free zones for your children. Work with other caregivers to make this expectation clear and consistent.

It’s OK for your child to be online. In many ways, the Internet is like a diet. Your children live in a world of screens, and the Internet will only become more integrated into everything they do. Your job is to teach them how to have a balanced diet of educational, social, and entertainment content.

Kids will be kids. There will be missteps, but you must use small errors as teachable moments. Continue to discuss hypotheticals with them; what would you do if . . . ? Be supportive and empathetic and help your child learn from their mistakes.

Most importantly, accept that you are ready to tackle this challenge. Be there with them from the beginning and be ready to learn together as you all navigate the digital landscape as a family.

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

Douglas M. Brodman, PhD, is a clinical instructor of Child and Adolescent Psychiatry at NYU Langone Medical Center’s Child Study Center. He provides clinical intervention and consultation to families and youth struggling from emotional and disruptive behavioral disorders.

The Art of Arguing: Tips for Handling Parental Conflict around Your Kids

Unhappy Girl At Home With Parents Arguing In BackgroundCarl Whitaker, one of the originators of family therapy, once said, “Conflict should rightly be considered the fertilizer for life. While it is not always fragrant, it’s crucial for optimal growth.” How you deal with conflict is more important than whether or not you have it in your relationship. Parental conflict is a natural part of family life and as a rule ought not to be avoided. All parents (or anyone in a primary caretaking role) argue, and all children learn a lot about how to manage disagreements from hearing and observing their parents. This is simply a fact about family life and childhood.

However, parents may understandably worry about the ill effects of fighting in the presence of their children. Many city-dwelling parents lack the living space to take their disagreements out of earshot, or have young children who can’t be left unattended. And there are occasions where addressing some issue can’t easily be put off until after the kids are asleep (when parents are often exhausted as well). Finding time and space to deal directly with conflictual issues can be a challenge. Below are some general guidelines that can help.

Conflict in front of the kids isn’t in and of itself problematic. What counts is what you are showing them. Are you showing them:

• A way of disagreeing with mutual respect?
• How to listen and take another person’s perspective?
• How to assert yourself without putting the other person down?
• How to regulate your emotions and not be blaming or defensive?

If so, you are providing an invaluable model of how to engage in dialogue in the context of conflict and disagreement. In many ways, this is as important for their development as a stress-free family interaction (though plenty of those are good too!).

If you find that you can’t do any or most of the above, then it is best to de-escalate and table the interaction for another time. This can be difficult, but not impossible. It requires an agreement that either parent can call for a “time-out.”

That person is then responsible for bringing up the issue at a “cooler” time, ideally when kids are not present and both parties have had the opportunity to calm down and collect their thoughts.

•  This shouldn’t be used to avoid the topic. Using this method appropriately will build trust for both parents that important issues will not be dismissed or avoided.
• Finally, resist the urge to enlist kids in your conflict!
• Having to take sides in a parental dispute is highly stressful for a child, so putting a kid in this position should be strongly avoided.
• Children have a right to love their parents equally and ought not to be asked to take sides, directly or indirectly.

What gets talked about in front of kids is, to a large extent, a matter of individual parental values and beliefs. However:

• It is important to take into consideration a child’s level of development and individual sensitivity: e.g. an anxious child may easily misconstrue and overreact to parents arguing about money.
• One should have clear generational boundaries about adult issues that don’t directly concern the children (e.g. parents’ sex life, most financial matters). Arguments about in-laws and other extended family relationships can also be quite stressful for children.
• Either parent ought to have the right to indicate discomfort with the topic area when the kids are present and call for a “time out.”

Parents can have robust disagreements about a variety of topics in front of their children without necessarily causing stress and anxiety. The key here is for parents to do so in a way that shows their kids that that conflict can be managed and even resolved with love and mutual respect.

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

Andrew Roffman, LCSW, is a clinical assistant professor of Child and Adolescent Psychiatry at the Child Study Center at NYU Langone Medical Center, the director of the Child Study Center’s Family Studies Program, a training program in family and couples therapy, and a member of the Center’s Faculty Group Practice where he specializes in family/couples therapy and individual therapy for late adolescents and adults.

How to Protect Your Child’s Skin This Winter

Litlte girl in a bathrobe and towel
After a balmy fall, winter is finally upon us. It’s time to unpack the mittens, hats, scarves, and sweaters. As parents, it’s also time for us to brush up on our negotiation skills and convince our children to actually wear their coats! The next time you find yourself in a heated discussion with your little one on the necessity and virtues of covering up, remember to protect his or her true primary barrier to the world: the skin.

Our skin takes a beating during the dry, cold winter months. Indoor heat without humidification can make skin prone to drying out. This is particularly true for children with atopic dermatitis (eczema) who tend to make less natural moisturizers and who are at risk for having more eczema flares during the winter.

Managing dry skin involves two guiding principles:

• Avoid irritants
• Moisturize, moisturize, moisturize!

With those two principles in mind let’s tackle some basic questions.

Do baths help or hurt dry skin?
Bathing can help hydrate your child’s skin. The most common problem is forgetting to apply a moisturizer which helps “seal in” moisture. Daily baths are fine. Just don’t overdo it—limit bath time to no more than 15 minutes.

What is the best soap to use?
Dry skin (and particularly the skin of eczema patients) can be very sensitive to irritants. Avoid using perfumed soaps and cleansers—although they smell wonderful, the added fragrances can be irritating. Look for fragrance free, gentle cleansers. If your child has eczema, you may also want to limit the application of the cleanser to visibly dirty areas and areas where dirt likes to hide, like the diaper region, under the neck, armpits, and groin.

How often should I use a moisturizer and which one should I choose?
The skin care aisles in drug stores are overstuffed with numerous products, each of which makes various claims of benefit for the skin.

Unfortunately, there have been no large head-to-head studies comparing all of the different moisturizer options to clearly declare one superior to the other. Therefore, the best moisturizer is the one you actually use! Moisturizers don’t do any good sitting on shelves. Here are a couple of useful tips:

• Avoid fragranced moisturizers if your child has sensitive skin.

• If your child has moderate to severe eczema, the greasier a moisturizer is, the better—ointments and thick creams tend to work best (think of something you have to scoop out of a jar). Apply it to the whole body morning and night.

• Lotions, which typically come in pump bottles, have less “sealant” properties and may irritate the skin of children with severe eczema.

• Try to make moisturizing part of the daily routine and fun. For infants, consider making it part of the bedtime routine and incorporate infant massage. In older children, consider letting them take charge and help them apply their own creams.

When should my child see his or her pediatrician or a dermatologist?
If your child’s dry skin has worsened and has areas of redness, itching, and/or a bumpy rash, he or she may have eczema. A doctor can be helpful in advising you on whether a prescription cream or ointment could be of benefit.

So this season, think of your child’s skin! It has been working hard all year and surely could benefit from tender loving care this winter.

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

Vikash S. Oza, MD, is an assistant professor in the Ronald O. Perelman Department of Dermatology at NYU Langone Medical Center, where he serves as the director of Pediatric Dermatology. He is board certified in both pediatrics and dermatology and sees children of all ages with acute or chronic skin care conditions.