7 tips on when to give children their first phone

When should parents give children their first cellphone or smartphone? What factors should be considered? How do maturity, development and sleep considerations play into it all?

St. Louis on the Air host Don Marsh talked about the issues with two doctors:

  • Ken Haller, SLUCare pediatrician at SSM Health Cardinal Glennon Children’s Hospital
  • Mini Tandon, Washington University child psychiatrist at St. Louis Children’s Hospital

Maturity matters, not a specific age: “The issue is not an age, it’s not a grade. It’s actually the maturity level and the responsibility level demonstrated by that child.” – Dr. Tandon

Start early and build trust: “It’s common practice in our practice to hear ‘everyone’s doing it, everyone has one, how come our family is different?’ But everybody’s family is different. Again, it depends on what the purpose of the cellphone is and the responsibility level of your child. I think contextually, it’s true, if you’re using it just for safety purposes, why not, there’s going to be some embarrassment but you could also use it as a way to build trust and say, ‘look, yes you have this very archaic flip phone and yes, it may be embarrassing but what were’ trying to do is build trust. Once you can show us the responsibly level of just this bare skeleton version, as you age and as we can trust that you’re using it appropriately, maybe we build in the extra products that are available.’” – Dr. Tandon

“We have to start much earlier in terms of parents looking at their interactions with their children and when they put them in front of screens, how much time they put them in front of screens versus how much time they sit down and read them a book, and point out things and talk to them and just interact in that way.” – Dr. Haller

Maintain control: “You have to think about how smart you want that phone to be: what it can do and what it will have access to. If you have that conversation with your children and you decide that they can handle a cellphone, it really is important for parents to have controls where they have full access to everything on the cellphone.” – Dr. Haller

Model appropriate behavior: “If you want to model good behavior, you’re going to not text when you drive as an adult, you’re going to have to set some standards. If you don’t want your kids at the table during dinner on their phones than you might have to actually show that you can do the same.” – Dr. Tandon

Parenting style: “What we really want is more of an authoritative parenting model where the parents say to the kids, ‘We’re in a partnership here but I am your parent and there are certain rules I’m going to make in your best interest. You can ask me about that and I’m going to explain it but still the rules will be my rules and you’re going to have to meet certain standards and certain benchmarks in order to move from the flip phone to a more advanced phone.’” – Dr. Haller

Limit screen time: “I am amazed sometimes when I get kids in my office and they’re in for a regular physical and one of the questions we ask is how much time do you spend in front of a screen for recreation – this isn’t homework – this is computers, video games, various things like this, tablets – and some kids will go, 7, 7 hours a day!”

“I don’t think that’s a good thing. While this is a lot of time to be doing this one thing, my bigger problem is that it is cutting into actual time spent with friends, time spent with family, time spent with physical recreation.”– Dr. Haller

Develop a Family Media Use Plan: Dr. Haller suggests a tool developed by the American Academy of Pediatrics. Among the suggestions are:

  • Keep screens out of kids’ bedrooms.
  • For children under 2, substitute unstructured play and human interaction for screen time.
  • Take an active role in your children’s media education

St. Louis on the Air brings you the stories of St. Louis and the people who live, work and create in our region. St. Louis on the Air host Don Marsh and producers Mary EdwardsAlex Heuer and Kelly Moffitt give you the information you need to make informed decisions and stay in touch with our diverse and vibrant St. Louis region.

Toxic stress gets the spotlight at St. Louis med schools

It’s June, and the third-year students at St. Louis University School of Medicine are getting out of anatomy labs and lecture halls and into their first clinical rotations with patients.

The doctors in training can be easily identified by their short, white coats and stethoscopes around their necks.

Earlier this month, when those students listened intently to their first grand rounds presentation of the new academic year, it was telling that the topic was toxic stress and children.

It was presented by SLU Associate Professor Kenneth Haller, head of the Missouri Chapter of the American Academy of Pediatrics. It was held at Cardinal Glennon Children’s Hospital, where the effects of toxic stress on children can be seen firsthand: asthma, obesity, child abuse, hyperactivity and depression — all associated with chronic levels of household stress.

“This is their first rotation,” said Haller of the students. “It really challenges them to figure out, what are you going to do with this public health problem?”

SLU neonatologist Dr. William Keenan went so far as to say the presentation was “the most important grand rounds we’ve had this year, probably this decade.”

As the Post-Dispatch chronicled in a February special report based in Ferguson, toxic stress occurs when children and adults don’t get a mental break from chronic worries and extreme burdens. Though such stress can afflict anyone, it is particularly common among families living in poverty and compounded by experiences of past trauma.

The stress turns toxic when the body overproduces stress hormones. An expanding body of research suggests exposure to incidents of trauma and chronic stress adversely changes children’s genetic, neural, physical and behavioral development. Those changes can sometimes start before birth if a pregnant mother suffers from toxic stress.

For the students, much of this was new information and not something they had encountered in their own childhoods. Third-year student James Arpin from Hutchinson, Kan., said there was always food on the table, stable housing and a harmonious family to support him while growing up.

“You realize these families have a lot of problems that you and I may never have to face,” he said.

Arpin said the presentation was the first time he had heard about dire adult health statistics associated with adverse childhood experiences. Research suggests four or more traumatic events in childhood drastically increases chances of developing chronic adult conditions like high blood pressure, diabetes, heart and kidney disease, stroke, obesity, cancer and mental illness.

Seeing it firsthand

As the recent grand rounds presentation indicated, the topic of toxic stress is steadily gaining traction in medical, public health and mental health fields as a major health issue potentially affecting millions of children — many of them growing up in poverty.

The recommendation is intended to bring up the topic of poverty because of its health risk to children. The Academy wants physicians to make better efforts to link families and children to supports like food or diaper banks, or early childhood supports.

But the question remains, are doctors adequately prepared to address toxic stress and its roots in poverty, both in their examination rooms and in the public domain?

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“I learned not to sweat the small stuff,” said Ruth Coleman, whose son Ian, 4, (right) cuddles with her as she fills out a reading log for an older son, Dylan, 8, on Tuesday, Jan. 26, 2016, in their mobile home in Truesdale, Mo. Coleman and her husband John Coleman took a parenting course through a head start program as part of a federal trial study in St. Louis called, “Buffering Toxic Stress.” The couple recently moved after losing their Warrenton home to foreclosure. Photo by Laurie Skrivan, lskrivan@post-dispatch.com

Robert Block, past chairman of the American Academy of Pediatrics, said medical schools are mostly doing a good job educating students on the issue and teaching them ways to better interact with families and children facing toxic stress.

But because many practicing pediatricians and family doctors are wedded to traditional billing and scheduling procedures, “there are not systems in place for established practices to make big changes to include conversations with families on their parenting circumstances and resources,” he said. It will take years for new doctors to enter those practices and effect change.

At Washington University School of Medicine, for example, students learn about toxic stress and trauma within the first week of school through a program that sends them out to various low-income neighborhoods and medical clinics. They see firsthand the general burdens of poverty including neighborhood violence, food need, debt, housing insecurity and domestic conflict, said Dr. Michael Awad, associate dean of medical education.

“Some of the students are quite moved, quite shocked, and it really gets them from an very early point on in their education thinking about patient care in a different way,” he said.

Awad said the medical students are also tasked with bringing their knowledge into the greater medical community.

“Our students in some way may know more than our experienced physicians on this topic,” he said. “The students do become the teachers, and that’s OK.”

Supporting parents

In February, the Post-Dispatch ran a special report, “The Crisis Within: How toxic stress and trauma endanger our children.” It focused on the stresses among three families in Ferguson already coping with the traumatic shooting death of 9-year-old Jamyla Bolden who lived nearby and was a friend to some of their children. The report further chronicled daily struggles with housing, debt, lack of transportation and past trauma and proposed solutions to lessen that stress on children.

During Haller’s presentation, he referred to two of the children featured in the series as they dealt with this stress. One of them, Destiny Sonnier, had a routine when she played outside with a cousin. They’d stop their cartwheels and pray so they wouldn’t get shot.

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Darlene Evans takes a walk with her five youngest children on Wednesday, Aug. 12, 2015, in front of their home in the Northwinds apartment complex in Ferguson. From left are to right, are Warren, 10, Alex, 2, Aaron, 3, Lexi, 2, and Destiny, 9. Since some of her children witnessed a shooting outside their apartment four days earlier during Destiny’s birthday party, Evans has limited her children’s outside playtime. Photo by Laurie Skrivan, lskrivan@post-Dispatch.com

Haller said he treats at least one child a day showing signs of toxic stress at Cardinal Glennon’s Danis Pediatrics, a practice that serves mostly poor and uninsured families. Many parents come to the office seeking help for extreme behavioral problems in their children because of that stress.

He recalled a single father bringing a baby and older boy for a check-up. The father described feeling helpless because of a low-paying, part-time job, lack of parenting support and no child care. He could not give one positive attribute about his child. Haller said the staff linked the father to child care and other support, enabling him to get a break and better bond with his son.

Haller urged physicians to have empathy for families. He said physicians can help empower parents so they better bond with their children and buffer them from stress, he said.

He also told the students their future medical degrees could give them great influence in developing better public policy to help children and families thrive:

“Every single day we can use the power of our white coat.”

Click Here to read the full article on STLToday.com

Pediatricians group: Ask parents about poverty

Eyes, ears, throat, check. Parents’ income, check. Pediatricians will soon be asking parents about their financial status because of the negative effects of poverty on a child’s health.

In recommendations to be released Wednesday, the American Academy of Pediatrics urges doctors to ask parents this question at each appointment: “Do you have difficulty making ends meet at the end of the month?”

The question should be asked in all areas of the country, since economic insecurity can affect families in cities, suburbs and rural areas. Parents who answer “yes” will be directed to community resources for housing, nutrition and job assistance.

As detailed in the recent Post-Dispatch special report “The Crisis Within: How toxic stress and trauma endanger our children,” one in four children in Missouri lives in poverty — putting the child at higher risk for asthma, allergies, diabetes, obesity and other long-term health problems.

Poverty can impair children’s development and shorten their life spans. A study from Washington University used brain scans to show that local children living in poverty had smaller areas of white and gray brain matter. Poverty is also linked to teen pregnancy, drug and alcohol abuse, and lead poisoning.

“We need to do something about poverty in childhood because it affects kids’ health,” said Dr. Katie Plax, professor of pediatrics and medical director of SPOT (Supporting Positive Opportunities with Teens) health care. “We really want families and kids to get help.”

In addition to help from local charities, the pediatricians’ group is in favor of policies that support school lunch programs, Medicaid, food stamps and other government assistance for families.

Spending upfront to help children living in poverty will save the state in future health care costs and allow children to become productive citizens, said Dr. Kenneth Haller, president of the Missouri chapter of the American Academy of Pediatrics and associate professor of pediatrics at St. Louis University.

Haller said children living in poverty have stress-related health problems which can turn the body’s immune system against itself.

Stress hormones can cause inflammation in the body’s circulatory system, leading to heart and breathing problems. The hormones can accelerate fat storage and suppress the immune system. The constant stress can permanently change a child’s genes, potentially shortening their lives. The damage is not only physical but mental, causing problems with attention and learning.

Pediatricians already talk to parents about safety concerns such as bike helmets, car seats and guns in the home. Questions about financial security are also of critical importance to a child’s well-being, doctors said.

“Our job as pediatricians is to address the health and welfare of a child, not just whether they have a bad cold or ear infection,” Haller said. “If we can do some screening to help people early in life to meet some minimum goals in terms of nutrition and housing security, it’s not going to be good just for the kid and family but the entire society.”

SLU Care Doctor Worried About Children’s Health Around Landfill

SLU Care Doctor Worried About Children’s Health Around Landfill

 

BRIDGETON, Mo (KMOX) – Parents living in the West Lake Landfill area are worried what might happen to their kids if an underground fire eventually makes contact with nuclear waste next door.

SLU Care pediatrician Dr. Ken Haller at Cardinal Glennon Children’s Medical Center says an adult getting exposed to radiation might not be a big deal. But the younger you are, the worse it could be due to the rapid production of new tissues found in younger human beings.

“Radiation tends to attack the parts of our body that are replicating and creating new tissues. That’s what kids are, that’s what babies are,” Haller says. “In fact one of the most vulnerable populations is pregnant women because the fetus can be damaged by radiation.”

Haller says the biggest frustration for everyone is no one knows how the situation is going to play out.

“Right now there are more questions than answers,” Haller says.

Click Here for Full Article on StLouis.CBSLocal.com

‘We Need People Working Together’: Discussing Protests, Evidence And How To Talk To Children

 ERICA SMITH

Ferguson and St. Louis residents are trying to cope with and understand a grand jury’s decision not to indict police Officer Darren Wilson in the August death of Michael Brown, and the response, sometimes violent, to that decision.

Wednesday on “St. Louis on the Air,” we discussed an upcoming march organized by the NAACP; protests in St. Louis; the response in Washington, D.C.; the grand jury evidence and how to talk about Ferguson and protests with children.

Guests

  • Cornell William Brooks (@CornellWBrooks), NAACP president and CEO, will talk about the Journey for Justice march that starts Saturday.
  • Dr. Ken Haller Jr. (@KenHallerMD), a pediatrician and associate professor at the Saint Louis University School of Medicine, will discuss how to talk to children about events related to Ferguson.
  • St. Louis Mayor Francis Slay (@MayorSlay) will discuss the city’s response and plans.
  • Jim Howard (@jimhoward529), St. Louis Public Radio’s Washington correspondent, will update us on the Department of Justice investigation.
  • St. Louis Public Radio reporters Camille Phillips (@cmpcamille) from protests in downtown St. Louis, and Chris McDaniel (@csmcdaniel) and Rachel Lippman (@rlippmann) who have been combing through grand jury evidence.