Internet Safety: Growing Up Online

Photo by Tanya Ryno

OK all you parents out there in cyberspace: HEADS-UP!

Recently I watched a Frontline show on Public Broadcasting called "Growing Up Online." I think every parent should see it. That means you, even if your kids are still too young to venture into the internet.

The focus of this program was not the well-publicized dangers to kids on the internet (like sexual predators). Instead, it delved into online social networking sites, such as MySpace and FaceBook. As I watched it, I realized that when it comes to this important generational cultural phenomenon, I've been totally out of it (not, alas, a first) and, unless you're pretty young, I'm betting you have been too.

* * *

I did not grow up with the internet and I've come to realize that the online environment - mothers' milk for our kids - is, in many ways, an alien zone to me. It's kind of like the differences in your fluency when you've learned a foreign language as an adult versus as a child.

Additionally, as a shy and private geezer myself, I am baffled. Why would anyone expose so much of themselves online for the world to see? Why would anyone want to have a few thousand anonymous friends with whom to communicate? What exactly is the nature of a relationship that is purely online, where you never have met the person, where you never really know their name, where you don't even know if their description of themselves is fact or fantasy?

And, most baffling of all, why is all disembodied cyberspaced communication so earthshakingly important to many young teens in establishing their own identities and in connecting with others?

* * *

Let me be clear: even though I don't get their appeal, I'm not railing against these sites. Nor am I claiming they will be the root of all evil in 21st century relationships. What I am saying is that, as parents and adults, we need to familiarize ourselves with online social networking sites and seek to understand what is going on and how they might affect the development of 21st century kids' social and intimate relationships.

Who knows, maybe it will prove to be a blessing. Then again, maybe not. Or maybe, in the end, it will prove to be just another passing adolescent phase of no real consequence. Still, I do worry that some aspects of growing up online could potentially affect our kids in ways that may not be so wonderful. Could that include social networking sites?

* * *

Here are a few more revelations I took away from the Frontline show:

• There are dangers on the internet, but many are different than we naive adults think.
  Turns out, for example, that most kids well know that if an online stranger asks for their real name and address, that's bad news and they should wipe them off their access list and out of their cyber lives. In fact, the kids who succumb to evil online predators are usually those who willingly collaborate with them. For some reason (I'd put the teens' sense of invulnerability at the top of the list), they too are looking to cross the line from cyberbuddy to an in-the-flesh relationship, sometimes with devastating results.
  


• Cyberbullying is the most devastating bullying in the history of the world.
  This kind of cruelty - which only kids seem capable of - doesn't end in the playground, but follows a child home. Plus, everyone and his uncle gets involved or at least knows about the humiliation. (The Frontline show has a tragic example of this.)

* * *

I contend that ensuring that your kids can safely negotiate and mine the riches of the internet without getting burned is one of the great new parenting challenges in the 21st century. That's no surprise to you. A previous two part Dr. P blog entitled "Big Mother is watching: Should we spy on our kids?" continues to generate more comments than anything else on which I have written. In another post, I opined on how to try to keep your kids safe from cyberbullying.

As is painfully obvious to you by now, I'm no expert at this stage and, probably, neither are you. But you and I need to become one, and soon. Watch the Frontline show so we can begin to address the real question for all of us: what should we do about it?

Here's another suggestion: do an experiment (as I plan to do and will report back to you) and set up your own account at one of these sites, pretending to be a bright innocent teen, and see what happens. Then let's share our experiences.

In the meantime I'd love to hear how you are dealing (or plan to deal) with your child and internet social networking sites.

* * *

You can watch the Frontline program online (+ read a lot of other good stuff) here.

Related Topics:

• Safety4Kids Safe Browser Download For Children
• Teen Internet Safety

Technorati Tags: MySpace, Facebook, internet safety, privacy, teenagers, parenting

ROUND 2: The FDA and OTC Cold Medications for Infants

The FDA has again reiterated their warning that over-the-counter (OTC) cold preparations NOT be given to children under 2 years of age.

I agree with these guidelines, not because I think these meds are especially dangerous when given at the proper dose, but because I've never found them to do much good (except for the parent's need to do something for their snuffling child). And if a medication is ineffective, it isn't worth any risk, however small, especially with infants for whom side effects can be unpredictable and more severe than in older kids.

* * *

But that's just me. What do you, the parents, think? You beg to differ.

In a recent study*, 1522 parents with children under age 6 years were asked their opinion of OTC cold medications. Here's what they said:

• Only 1/3 of parents stopped using OTC cold medications following the FDA warnings in October, 2007.


• Most parents believe children's OTC cough medications to be at least somewhat effective in relieving cold symptoms and promoting sleep. ("Very effective" = 14-18%; "Somewhat effective" = 47-60%; "Not too effective" = 10-16%; "Not at all effective" = 4-14%).

* * *

Why is it that so many of you disagree with me and my contention that these preparations are pretty useless? There are three possible explanations:

1. You are right and I am wrong (hey, it happens). Especially since there is some evidence these may help a little in adults, it's possible they also provide some relief to infants and toddlers. Additionally, I'm so skeptical, I don't believe parents when they tell me the medications helped, so I'm hardly an objective judge.


2. I am right and you are wrong. It's simply wishful thinking (a "placebo effect") on your part. "Believing is seeing" and parents, desperate to provide comfort, judge any little improvement in the cold symptoms (which, after all, are going to get better on their own) to be due to the meds.


3. We are both right. Occasionally these meds provide a little relief, although not consistently, and not to any great degree.

* * *

How might we resolve our friendly disagreement?

That would take a scientific study - such as a "randomized controlled trial" in which some babies with colds got the medications while others got a "placebo" (like sugar water made to look and smell like the meds), followed by the parents rating their effectiveness.

But, alas, that hasn't happened and isn't likely to happen any time soon (certainly not with the under 2 years group). So we are left to guess and to wonder and to try to do the right thing without any scientific evidence. For now, I'm siding with the FDA and choosing to come down on the side of being extra cautious with little ones.

* * *

Final Thoughts
Perhaps this will sound cold to some of you, but I think parents need to learn to tolerate their kids experiencing some unavoidable discomfort. Your fond desire to banish all stresses from the lives of your kids is understandable and universal and...fruitless.

And it can even lead to trouble if the measures used to soothe might carry significant side effects. As we say in the trade, "First, do no harm." Anyway, learning to cope with and triumph over adversity isn't a bad lesson, even for young children.

Finally, remember that TLC is the greatest balm for discomfort. Most of us harbor cherished memories of when we felt lousy as kids and our parents (and others) soothed us with love and tenderness and back rubs and kind words and a loving touch and honey and lemon and... (fill in your fondest memories). TLC is surely the greatest placebo known to child and man, and that's a good thing: it has no known side effects, doesn't cost a penny, and has plenty of medical and emotional benefits.

* * *

* NPR/Kaiser Family Foundation/Harvard School of Public Health
Children's OTC Cold Medicines: The Public, and Parents, Weigh In

For the FDA advisory on this:
http://www.fda.gov/CDER/drug/advisory/cough_cold.htm

Related Topics:

• WebMD Video: Treating Baby's Cold
• Infant Cold Medicine Recall: It's Back to Chicken Soup

Technorati Tags: infant cold medicine, infant cough medicine, pediatrics

The Parent Blame Game

Sally is a two and a half year old with tight blond curls. She came to my Pediatric Developmental Clinic with her worried parents because of poor language and communication skills, along with unusual behaviors and interactions that concerned both her parents and her early intervention program.

Throughout the exam I noticed Sally watching toys from the corner of her eye and examining the perceptual qualities (like the color or shape) of objects but not their function. I noticed she got incredibly upset whenever I interfered with her lining up the toys. I noticed she made little eye contact with me or with her parents. I noticed she had no spontaneous meaningful words. I noticed her moods changed in an instant, often for no apparent reason.

As you've no doubt surmised, I diagnosed Sally to be on the Autism spectrum.

* * *

Autism can be a hard diagnosis to make and harder still to explain to parents in a way that is factual and without sugar-coating, but not devoid of hope and empathy. After a long tearful discussion, the Mom said: "I don't know what to do. I can't tell my family about this."

"Why not?" I asked, perplexed. "Most parents of autistic kids need and get a lot of support from their families."

"They'll blame me for it." was her stunning response. "Already they say it's my fault that Sally is the way she is. They say I coddle her and give in too easily to her tantrums. If only I were firm, they tell me, she'd be fine."

"But" I sputtered, "that's completely ignorant. She's autistic. Nobody thinks it's caused by bad parenting anymore. It's a neurological condition. And, anyway, you're great parents."

"Well, they don't think so," she said softly. "I'm not sure if they will ever forgive me for this."

I felt doubly bad for these parents. Not only had they just received very distressing news about their child, but they carried the fear of being blamed by their family for it. I was reminded of the bad old days, when children were considered born with a "blank slate" and autism was blamed on emotionally distant, "refrigerator" mothers.

* * *

When the book on which I collaborated with Dr. Spock came out (my 15 minutes of fame), I was dutifully sent on a promotional book tour. One part of it consisted of sitting in a bare radio studio, looking at a blank wall, wearing headphones. Every few minutes some radio station talk show host from Anywhere, USA would call in and pepper me with a few questions.

The very first question (oft repeated throughout the hellish day) by a loud-voiced talk show host (you know the type) was "So, tell us, Dr. Parker, what are some of the worst things parents are doing these days to their kids?" I suppose parent-bashing makes for good ratings.

Why else might "blame the parents" be such a popular cottage industry? Part of it is ignorance, plain and simple. Most parent-bashers have no idea of the forces shaping children's development and behavior and harbor the archaic "blank slate" belief that all we become is due to effects of the environment, which has written on the blank slate with which we are born. If a child has any behavioral and/or developmental challenges, it must come from bad parenting.

These are the folks who often are parents and - by dint of luck and perhaps some skill - have not experienced any significant problems with their impeccably behaved, successful kids. Of course, they attribute 100% of this success to their marvelous parenting skills (nurture) and 0% to a lucky throw of the genetic dice (nature). They judgmentally wag their fingers: if only all parents were as good as me, all kids would do as well as mine.

These are the folks who, when I wrote about the difficult issues of using psychoactive medications in children, contended that using meds in kids is a travesty, that the parents who use such medications (like Ritalin) with their kids are those who just don't know how to parent, who can't tolerate any misbehavior in their lives and who, in their lazy selfishness, want to chemically restrain a normally unruly child. (By the way, I've never met such a parent).

These are the folks who tsk tsk tsk the beleaguered mom whose child is having a temper tantrum in the supermarket and reproach loudly, "Why can't you control your child?"

These are the folks who are, in short, self-righteous twits.

As my wise grandmother used to say (in a different language), "It's easy to beat on someone else's behind."

* * *

To be fair, my profession is no stranger to parent-bashing. Most pediatricians, alas, never took a course in developmental psychology in their lives (even worse, they don't think they need one). They become pediatricians and - poof! - they are considered experts in child development, which they most assuredly are not.

Rather, they are subject to the same "blank slate" prejudice as everyone else, so they don't recognize the child's contribution (such as a difficult temperament) to the problem. They often unsympathetically blame the parents for everything. They overgeneralize from their own limited personal family experiences (good or bad) and may be insensitive to problems they never personally experienced. And they overrate what did and did not work with their own kids.

All of this is magnified during pediatric training by being taught how magically effective (1-2-3 magic!) measures like time-out are (dream on). So, if a child continues to misbehave despite the wonderful advice we have given their parents, it must be that the parents are not doing their job. Rotten kid = rotten parent. Bash, bash, bash. End of discussion.

* * *

Most tragically, it is parents (like Sally's) who have kids with significant developmental and behavioral challenges that are the most likely to be criticized by an unholy trifecta: by the media and popular pundits because it makes for good, simple-minded talk radio and TV and book sales, by other parents who lack the imagination and empathy to understand what another parent is really going through, and by their own pediatricians who blame it all on their imperfect parenting skills.

I think the vast majority of parents love their kids passionately and are trying with all their might to do the right thing by them. And, all in all, most do a pretty darn good job of raising their kids and make the right decisions when there are challenges to be faced.

Parent-bashing is almost always unfair, misguided and, worst of all, cruel. Just remember that the next time you are tempted to cast the hairy eyeball on some poor mom whose child is out of control in a public place.

At the very least, you can remember there but for fortune... Better still, lend them a helpful hand and a sympathetic ear and a kind word.

Related Topics:

• WebMD Video: Spotting Autism Early
• WebMD Video: Autism and the Family

Technorati Tags: autism, parenting, blame game, pediatrics, special needs

The World's Best Children's Cough Medicine

STEP RIGHT UP, FOLKS!

DR. P HAS SUCH A DEAL FOR YOU!

Original collage/cartoon by Jack Maypole, MD

You say you want to help your child sleep at night when he cough, cough, coughs. You say you've read that children's cough medicine doesn't work and could have side effects. You say you're frustrated and upset and sleepless in Cheboygan. What's a parent to do?

Relax. Dr. P is here for you.

Behold Dr. P's Miracle Cough Syrup (Active ingredients: buckwheat honey, water, hot air + many double secret magic ions). It's scientific! It works! It's all natural! It's safe! It is beloved by kids and parents throughout the world! And it's made by your own Dr. P, the most trusted name in pediatric miracle medicine.

Here's all you have to do: Just send Dr. P three easy payments of $19.95 and he will send you six (6) full ounces of his magic syrup. But wait, there's more! As a thank you for reading his blog, send the cash now and he'll include an extra 2 ounces! That will cover two extra colds and one episode of coryza!

Listen to what parents just like you have to say about Dr. P's MCS:

• "At $59.85 for 6 ounces, it's a bargain. I'd pay twice that for a good night's sleep!"
• "You have saved my life Dr. P. I worship the ground you walk on."
• "Why have the evil drug companies suppressed this miracle medicine for all these years? You're a brave man, Dr. P."
• "My kids love to scarf it down. ( By the way, they claim there is something familiar about its taste and texture, but I tell them that's all part of the miracle.)"

* * *

Here's the scientific study* upon which I based my miracle cough cure:

Methods:

105 kids, ages 2-18 years with cold symptoms, were given cough medicine, a placebo (i.e., no medicine), or buckwheat honey at night to soothe their cough. Since each preparation was made to look and smell alike, parents were unaware of what they were giving their child. They were then asked to rate their child's cough for the next two nights in terms of severity, frequency, and effect on sleep.

Results:

Honey was the most effective cough suppressant, with 47% of parents reporting improvement (versus 25% for the placebo). The authors speculate that it may be due to honey's demulcent (a beautiful word meaning "a soothing film") effect and/or its antioxidant properties and/or its ability to induce saliva that thins out the mucus.

Dr. P's conclusion:

This is a good study because it is a "randomized controlled trial" (the best study one can do). Based on its effectiveness and safety and wonderful taste and texture, I now recommend 1-2 teaspoons or so of buckwheat honey as the best cough 'medicine' known to man and child (over the age of 12 months) for coughs due to minor colds.

Yes, it's true that in my beneficience I have created Dr. P's MCS for you but, I suppose, in a pinch you could go to your local health food store and get your own stash of buckwheat honey to use on the inevitable next night of hacking family coughs.

* * *

*Article cited: "Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents." Paul I, et al.
Archives of Pediatric and Adolescent Medicine. December, 2007.

Related Topics:

• WebMD Video: Treating Baby's Cold
• Children and Colds

Technorati Tags: cough, cold, cough syrup, home remedy, honey, pediatrics, children