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Tips of the Week for October, 2013

Behavior Problems Outside the Home

A child's misbehavior often occurs at the home of friends or relatives, in the car, or in public places such as shopping malls and restaurants. These situa­tions are very difficult to handle. In instances like these, anticipating the prob­lem and taking some preventive action is best.

Decide upon the type of age-appropriate and achievable behavior you want your child to exhibit in these outside-the-home situations, and then discuss it with your youngster in terms of what you both expect. If your child is having greater difficulty in some specific situations away from home, you might mod­ify your expectations accordingly. Do not put your child in situations that you know she cannot handle.You may find that the most helpful approach is to use immediate rewards and praise when good behavior is exhibited. Be willing to utilize timeouts, de­layed timeouts, or behavior penalties in public situations. (Delayed timeouts are those that are implemented once you return home.) The use of logical con­sequences is also often helpful.

Try bringing along a child's favorite toys and books, and plan to give her some positive attention on a trip or on a visit to relatives.

In general, scolding and nagging will not work. It is embarrassing to every­one, tends to reinforce negative behavior, and could spoil a family outing for everyone.

Once you find the behavior modification techniques and punishments that work, apply them at home before using them outside the house so your child is familiar with them. 

Some parents have difficulty implementing timeouts away from home, and in cases like this you and your child may have to take a timeout together. In a res­taurant a timeout may require that you and your child sit in the car for a while. In a mall she might sit on a bench while you stand beside her; in a park or at the zoo, use a bench or a rock as a place for a timeout. If you are driving, stop the car at the side of the road and sit quietly until she settles down. You might use a delayed timeout when you arrive at a hotel, a restaurant, or a rest stop.

In the weeks ahead, evaluate and discuss positive changes in the frequency, duration, and intensity of any continued undesirable behavior, and point these out to the child with praise.

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Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 American Academy of Pediatrics)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Halloween Safety Tips

Halloween is an exciting time of year for kids. Here are some tips from the American Academy of Pediatrics (AAP) to help ensure they have a safe holiday.

All Dressed Up:

  • Plan costumes that are bright and reflective. Make sure that shoes fit well and that costumes are short enough to prevent tripping, entanglement or contact with flame.
  • Consider adding reflective tape or striping to costumes and Trick-or-Treat bags for greater visibility.
  • Because masks can limit or block eyesight, consider non-toxic makeup and decorative hats as safer alternatives. Hats should fit properly to prevent them from sliding over eyes.
  • When shopping for costumes, wigs and accessories look for and purchase those with a label clearly indicating they are flame resistant.
  • If a sword, cane, or stick is a part of your child's costume, make sure it is not sharp or too long. A child may be easily hurt by these accessories if he stumbles or trips.
  • Obtain flashlights with fresh batteries for all children and their escorts.
  • Do not use decorative contact lenses without an eye examination and a prescription from an eye care professional. While the packaging on decorative lenses will often make claims such as “one size fits all,” or “no need to see an eye specialist,” obtaining decorative contact lenses without a prescription is both dangerous and illegal. This can cause pain, inflammation, and serious eye disorders and infections, which may lead to permanent vision loss.
  • Teach children how to call 9-1-1 (or their local emergency number) if they have an emergency or become lost.

Carving a Niche:

  • Small children should never carve pumpkins. Children can draw a face with markers. Then parents can do the cutting.
  • Consider using a flashlight or glow stick instead of a candle to light your pumpkin. If you do use a candle, a votive candle is safest.
  • Candlelit pumpkins should be placed on a sturdy table, away from curtains and other flammable objects, and should never be left unattended.

Home Safe Home:

  • To keep homes safe for visiting trick-or-treaters, parents should remove from the porch and front yard anything a child could trip over such as garden hoses, toys, bikes and lawn decorations.
  • Parents should check outdoor lights and replace burned-out bulbs.
  • Wet leaves should be swept from sidewalks and steps.
  • Restrain pets so they do not inadvertently jump on or bite a trick-or-treater.

On the Trick-or-Treat Trail:

  • A parent or responsible adult should always accompany young children on their neighborhood rounds.
  • If your older children are going alone, plan and review the route that is acceptable to you. Agree on a specific time when they should return home.
  • Only go to homes with a porch light on and never enter a home or car for a treat.
  • Because pedestrian injuries are the most common injuries to children on Halloween, remind trick-or-treaters:
    • Stay in a group and communicate where they will be going.
    • Remember reflective tape for costumes and trick-or-treat bags. 
    • Carry a cell phone for quick communication.
    • Remain on well-lit streets and always use the sidewalk.
    • If no sidewalk is available, walk at the far edge of the roadway facing traffic.
    • Never cut across yards or use alleys.
    • Only cross the street as a group in established crosswalks (as recognized by local custom). Never cross between parked cars or out driveways.
    • Don't assume the right of way. Motorists may have trouble seeing trick-or-treaters. Just because one car stops, doesn't mean others will!
  • Law enforcement authorities should be notified immediately of any suspicious or unlawful activity.

Healthy Halloween:

  • A good meal prior to parties and trick-or-treating will discourage youngsters from filling up on Halloween treats.
  • Consider purchasing non-food treats for those who visit your home, such as coloring books or pens and pencils.
  • Wait until children are home to sort and check treats. Though tampering is rare, a responsible adult should closely examine all treats and throw away any spoiled, unwrapped or suspicious items.
  • Try to ration treats for the days following Halloween.

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Experiencing bullying is challenging and upsetting. It’s one of those situations that leaves a permanent mark on a person’s inner fabric and can forever alter the path a person takes, depending on how the situation is handled.

It’s no surprise that as more of life has become digital and online, bullies have gone there too. The problem with online bullies is that they are faceless and often harder to identify and stop than bullies in the off-line realm. The effect, though, is no less significant, especially on children. In fact, online bullying—cyberbullying—is the most common negative situation that can happen in the online space to any of our kids.

What makes cyberbullying so challenging?

Kids don’t report it to adults and don’t want to rat out their friends. To add insult to injury, schools uniformly don’t have great strategies for handling it.

How do you know if a child is being bullied?

It can be challenging to figure out. Look for subtle signs in behavior:

  • Not wanting to go to school or an activity
  • Becoming upset after using the computer or cell phone
  • Seeming unusually sad, withdrawn, or moody
  • Avoiding questions from you about what’s happening

Kids who bully may have similar signs, but you may notice unusual computer activity such as switching screens when you walk in or multiple log-ins that you don’t recognize.

As with all childhood changes from normative behavior, anything that’s extreme and interfering with home, school, and friends warrants further investigation. Call the school to see if grades are slipping, and call your pediatrician to arrange an evaluation including a discussion of whether it would be appropriate to obtain psychologic input.

Why is bullying on the rise?

Bullying expert and psychologist Joel Haber, PhD, notes that bullying is on the rise due to technologic changes in our culture. Dr Haber feels as other experts do that it’s the accessibility coupled with technology that is part of the issue. The indirect nature of the Internet allows even good kids to be mean because of the faceless power that the screen builds in. Dr Haber notes that “it’s easier to have fun at someone else’s expense” and that being online removes the empathy that face-to face contact creates.

Ross Ellis, founder and CEO, Love Our Children USA, a national nonprofit dedicated to stopping all violence against children, including bullying, agrees: “Cyberbullying is huge.” E-mails and calls she receives from families confirm the statistics, and she’s learned about cyberbullying by instant message (IM), e-mail, and texting. Her best advice to parents is to take all threats any child informs parents of seriously: “You don’t know the hatred of the bully.” She is so right about that. It is very important to evaluate all threats a child informs you of to determine the level of intensity and how much danger your child may be in.

What should parents do if their child is being bullied? 

  • Save all e-mails, IMs, and texts
  • Try to talk to the other parents and determine what may have transpired
  • Talk to the schools and be prepared for the schools not wanting to get involved

When to call the police

Call the police if the situation seems to place your child in serious danger with a significant threat, or the other parent will not help you.

Studies show that the child being bullied often knows the bully. The police can track the IP address to find the bully and keep your child safe, which is the ultimate goal. Even if your child claims to know the bully, knowing for sure by tracking the IP is the best insurance policy, as there have been cases of mistaken identity in the online world with people using other people’s computers and cell phones to send harmful messages and bully.

“If a child says he or she was bullied, take it seriously,” Ross told me. “That’s a form of violence against a child. It must be taken seriously and the child needs help to look into it and the tools to work it out. Adults must listen.”

Any child online is at risk for being bullied. Our off-line senses for detecting that something is off with our child will help us pick up that something may have occurred and questions should be asked. And monitoring programs that help you uncover situations that your child may not know how to talk to you about can help facilitate conversations that kids find very difficult to bring up to any adult, including parents.

It’s important to keep an open mind and listen without overreacting if your child comes to you with hard-to-hear information. And be on the lookout.

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Gwenn Schurgin O’Keeffe, MD, FAAP

Last Updated



CyberSafe: Protecting and Empowering Kids in the Digital World of Texting, Gaming, and Social Media (Copyright © 2011 American Academy of Pediatrics)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances


Preventing the Flu: Resources for Parents & Child Care Providers

​Parents and child care providers can help prevent and slow the spread of the flu. The flu (influenza) is a respiratory illness caused by a virus. Flu infections are highly contagious. They spread easily when children are in a group with other children such as in a child care center or family child care home.

Flu is more dangerous than the common cold for children and can lead to serious health conditions like pneumonia or bacterial infections. Each year many children are hospitalized and some die from the flu.

The following resources provide information on preventing the flu. Materials and tools for child care facilities are also included.

Protecting Children with Chronic Health Conditions

Children and adolescents with a chronic health condition, such asthma, diabetes and disorders of the brain or nervous system are at high risk for flu complications.

Flu Vaccine Information

The flu vaccine is the best way to protect against getting the flu. All people 6 months and older need a flu vaccine each year. Babies cannot get vaccinated until they are 6 months old. It is critical that people who live with or care for children, especially infants younger than 6 months, get vaccinated. Vaccinating adults who are around an infant to prevent illnesses is often referred to as “cocooning.”

Fighting Germs

A few minutes killing germs can go a long way toward keeping you and those around you healthy. As adults, we know to wash our hands often with soap and water, especially after coughing, sneezing, or wiping noses. It is also important to cover your own mouth and nose when you cough or sneeze. Parents and child care providers can do their part to kill germs and also teach young children how and when to wash their hands.

Preventing the Spread of Illness in Child Care

Young children who have just entered child care are more vulnerable to infectious diseases. This is because it may be the first time they have been exposed to certain germs. In addition, they may be too young to have received enough doses of recommended vaccines to have developed immunity.

There are steps that caregivers and teachers can take to prevent the spread of infection in child care.

How Sick is Too Sick?

When children are healthy, they can go to child care or school, and parents can go to work. Getting the flu vaccine is the best way to make sure everyone can continue to participate in these important activities. However, when a child feels too sick to participate in activities, or requires care beyond what the caregivers can provide without compromising their ability to care for other children, that child may need to stay home.

Additional Resources for Parents & Child Care Providers

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American Academy of Pediatrics (Copyright © 2013)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


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