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Westwood-Mansfield Pediatrics
Newsletter

FEBRUARY 2010
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GET YOUR SECOND FLU SHOTS!!!!
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Most of our children have gotten their first flu shots, both seasonal and H1N1.  However, we want to get the word out that there are some children who need a second.  

All children under 10 years of age need a second dose of H1N1 flu vaccine.  This is regardless of the form they received for the first.  It ideally needs to be 4 weeks after the first shot.  Please call today to set up an appointment to receive the second dose.  Although we are not seeing H1N1 now, we do expect a resurgence in the spring.

All children who have received the seasonal flu vaccine for the first time this year and are under 9 years of age require a second dose of seasonal flu as well, 1 month from the first (it may be later, but no earlier than 1 month from the first).  Please call if you haven't received the second dose of seasonal flu. 
In This Issue
Exciting Changes
Talking with Children About Natural Disasters
Practice Innovation Getting Closer Look
Autism Conference
Newborn - 4 Year Olds: Cabin Fever
3-6 Year Olds:Death and the Young Child
3- 17 Year Olds:Preparing for your IEP Meeting
8-11 Year Olds: New Screening Tool for Anxiety
10 -21 Year Olds: Acne
Reaching Beyond Ourselves
Westwood/Mansfield Pediatrics
Exciting Changes: Patient Portal, New Hearing Screen
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We are pleased to announce that by the end of February we are expecting to have a patient portal up and running. This will provide secure internet access to order medication refills, and request appointments.  In the future you will be able to contact your physician, view lab results, and review consults from Children's Specialists.  As with any new endeavor, there may be some bumps a long the way, but we feel this will be an exciting new tool to improve and streamline communication.
 
We are also excited to announce a new screening tool for our hearing tests.  The test is called select picture audiometry and it is much more reliable and actually quite fun which makes it easier for  our test subjects to cooperate.  As opposed to the old way, where we asked children to raise there hand when they here a sound, this tool uses pictures and the child selects which picture corresponds to the word they heard.  
Talking with Children About Natural Disasters ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The following are ideas for talking to children  about natural disasters taken from Michael Grose who wrote and article for Episcopal Relief and Development.
  • Reassure children that they are safe.  The consistency of the images can be frightening for young children who don't understand the notion of distance and have difficulty distinguishing between reality and fiction . Let them know that while this event is indeed happening it will not affect them directly.
  • Be available.  Let kids know that it its okay to talk about the unpleasant events.  Listen to what they think and feel.  By listening, you can find out if they have misunderstandings, and you can learn more about the support that they need.  You do not need to explain more than they are ready to hear, but be willing to answer their questions.
  • Help children process what they see and hear, particularly through television. Children are good observers but can be poor interpreters of events that are out of their level of understanding.
  • Support children's concerns for others.  They may have genuine concerns for the suffering that will occurs and they may need an outlet for those concerns.  It is heartwarming to see this empathy in children for the concerns of others.
  • Let them explore feelings beyond fear.  Many children may feel sad or even angry with these events so let them express the full range of emotions.  They may feel sadder for the loss of wildlife, than or loss of human life, which is impersonal for them.
  • Help children and young people find a legitimate course of action if they wish.  Action is a great antidote to stress and anxiety, so finding simple ways to help, including donating some pocket money can assist kids to cope and teaches them to contribute.
  • Avoid keeping the television on all the time.
  • Be aware of your own actions.  Children will take their cues from you and if they see you focusing on it in an unhealthy way then they will focus on it too.  Let them know that it is happening but it should not dominate their lives.
  • Take action yourself.  Children who know their parents, teachers, or other significant caregivers are working to make a difference feel hope.  They feel safer and more positive about the future.  So do something.  It will make you feel more hopeful too.  And hope is one of the most valuable gifts we can give children and ourselves.
WMPA Practice Innovation getting Closer Look ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
When we started providing strep tests for our patients to do at home, many practices questioned why we would want to keep patients at home when we could make money by seeing them.   We thought better and have found that both patient families and providers have found that home strep tests have been a valuable tool to help families come in only when they need to.
We are excited to announce that a large health care organization called Molina Health Care, based in California, is taking our home strep test to a new level.  They are planning to do a study involving 50,000 to 100,000  children in their organization.  They will look at how effective the home strep test is and will work to get FDA approval which will allow for you to buy strep tests over-the-counter.  We feel this is a wonderful way to cut down on unnecessary healthcare costs and empower parents to care for their children.

Save the Date!!!
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We are excited to announce our first Parent Workshop for parents of children on the autism spectrum.  It will be on Thursday March 25th from 7:00 - 9:00 pm at the Dedham Community House.  This workshop will include speakers who will provide parents of children on the spectrum with valuable resources as well as time for families to network with each other.  We hope to see you there.  More info to come soon.

Newborn - 4 years old:  Cabin Fever
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As we enter the depths of winter, having young children at home, especially more than one can be trying. This is especially true if you don't have a network of close family or friends nearby.  Try to make connections with your community through mother's groups, library programs, and getting your children involved in play groups or other activities.  Get outside when the weather allows, and find creative ways beyond TV and video games to keep your children entertained: arts and crafts, science projects, stage a play and even make your garage into a temporary bicycle/tricycle course.
3-6 year olds: Death and the Young Child
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by Dr. Lester Hartman
 
A wise old pediatrician once told me , "Have your parents buy a goldfish and when it dies have a funeral in the tradition the family values." Death of animals are a natural process children living on farms see. Urban and suburban children are not exposed to this experience nearly as much, so the death of a loved one such as a grandparent can be very shocking as permanency is not well understood until around age 8 or 9. Our first response is often to hide our grief and protect our children from the fear of the loss.  We must allow them to become part of the community and trust our senses as to how much they can tolerate. In my own tradition, we believe in an afterlife. When my  19 year-old was age 4, my wife and I received a package of her great grandmother's belongings after her death. My daughter was very upset and said to my wife and I, " Why couldn't Nana take it with her?" Children are amazing, I once heard a 9 year old say, "I wish I were plastic so I wouldn't die." Listen closely to your children and you will hear the most precious treasures. 

3-17 year olds: IEP Help
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When parents go to their child's IEP (Individualized Education Plan) meeting, they are often not sure of what to expect. PHP(Parents Helping Parents) has designed an IEP Preparation Tool to help
parents organize their thoughts and records before attending an IEP meeting, so
that ideally they enter the meeting feeling prepared.

Please connect to this link for more information.

8-11 Year Olds:   New Screening Tool for Anxiety
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From what we have observed over the years in our practice, anxiety in older elementary

school children is on the rise. The reasons are many, including the proliferation of 24 hour news coverage, universal internet access, and the influence of parental anxiety (both genetically and environmentally).

 

We are currently evaluating the incidence of anxiety in children 8-11 years of age in our practice. We will be using a  validated screening tool called SCARED.  There is both a child form and a parent form which we will be filled out independent of each other.  If the scores from these forms indicate anxiety as an issue, we will discuss this with you at the visit and give you more information.

 

We will be reviewing these forms with Dr. Dagincourt, a local pediatric psychiatrist, with a focus on developing  a program to manage anxiety issues at the level of the primary care clinician.

 

We know that this is additional paperwork for you and your child and appreciate your time and effort

10-21 Year Olds: Acne -  Most Cases Don't Need a Dermatologist 
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Acne is an extremely common condition among teenagers. It can be difficult socially and emotionally.   Except for the extreme cases, most can be managed by pediatrician.  With very effective topical and oral medications, we can help your child's skin be the best that it can.  Please call today to make an appointment. 
A Reminder
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As many of you already are aware, all of the forms that our part of our well-child visits are now on the web at www.wmpeds.com.  Many of you are bringing in those filled-out forms, which makes it much more unhurried and enjoyable for all.  Some of you fill out your forms and then forget them.  PLEASE FILL OUT YOUR FORMS AND THEN PUT THEM IN A PLACE YOU WON'T FORGET - EITHER THE BAG YOU WILL BRING OR EVEN INTO THE CAR YOU PLAN TO DRIVE TO THE APPOINTMENT.  This way all your hard work will be worthwhile.  See you soon!!!
Reaching Beyond Ourselves
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What to say?  Most of us have been shocked by the devastation we have seen in Haiti. As a place where Dr. Hartman, his family, and our practice have supported for quite awhile, it has hit close to home here at Westwood-Mansfield Pediatrics.  However, our hearts have been warmed by the interest we see in our practice to help others in need.  The last email with details about Haiti was very well received, and almost 1/3 of those who read it went on to look at potential places to donate.  Thank you.
Westwood/Mansfield Pediatrics

PROACTIVE IN YOUR CHILD'S CARE!