It seems like every few months there’s a news story that looks at the way we as a nation medicate our kids—the increasing rates, the negative side effects that can come with medication, the off-label usage. All of it raises questions about the ways meds affect our children’s health and development. These stories are thought provoking at the least, utterly disturbing at the worst.

But who doesn’t know someone—perhaps it’s even in our own family—who has lived through the havoc that a serious mental or behavioral health problem can bring? Many families manage to reclaim a sense of healthy functioning after their child receives medication.

While there are some who argue against the use of any mind-altering medication in treating a child for mental or behavioral disorders, research backs what many children and their families witness firsthand—these medications often work. They can be effective in alleviating symptoms and treating problems that previously represented huge obstacles in a child’s ability to function at home, learn at school, or even live safely with family.

Still, there are those disturbing things, too. Some of the drugs are prescribed off label. Many have side effects. Parents need to weigh the benefits the drug provides with any side effects or risks that may come with it.

Like the rest of the nation, Texas has a severe shortage of child psychiatrists, and many parents turn to their pediatrician or family doctor for help in navigating these decisions. In fact, most prescriptions for psychotropic medication for children are written by pediatricians and family physicians, and not by child and adolescent psychiatrists, who have the most training in the appropriate use of these kinds of medications.  While primary care doctors play a critical role in addressing children’s mental health, many may find themselves ill-equipped to help families address the complex issues and needs that often come with serious children’s mental health concerns.

So while medication is a valuable tool that, when used appropriately, has its place in many children’s treatment plans, there are real concerns that children are being inappropriately prescribed medications when other treatment options could—and perhaps should—be used.  Several things may be playing into this. Doctors may be using the tool they are most familiar and comfortable with (you know, just like how carpenters like hammers, surgeons like scalpels…). Pharmaceutical companies are very adept at marketing to both doctors and parents, so not only are doctors are being to encouraged to prescribe the “latest and greatest” medication on the market, but parents desperate for solutions are now coming to their child’s doctor’s office asking for specific meds. And sometimes, well, a pill may just be a more convenient and cheaper way to fix a problem than using other, more appropriate, and less intrusive interventions, such as talk therapy or giving parents and teachers training and tools that help children manage their symptoms.

Perhaps most troubling are reports suggesting some kids are at particular risk of being overmedicated.  A recent federal report found that kids in the Texas foster care system are prescribed psychotropic meds at higher rates than kids in the foster care systems of other states.  This is even after Texas put in place some good policies to bring down its foster care prescribing rates (Texas’ rates have gone down, but we’re still higher than the other states). A couple of years ago, the New York Times reported low-income children covered by Medicaid were prescribed antipsychotic drugs four times as often as their peers covered by private insurance, and that these low-income children were more likely to be handed a prescription for smaller concerns.

As if having a child with mental health or behavioral concerns isn’t hard enough, parents find themselves having to make some tough calls on treatment decisions on what’s best for their child.  What can they do?  Well, I’m not expert, but I say:  Ask questions and research options.  Become educated, and be informed on both your child’s diagnosis and the different treatment options available to your family.  Medication may be the right choice, either alone or in combination with other strategies, or it may not be.  But always, ALWAYS advocate for what your mama-instinct is telling you your child needs—at their doctor’s office, with their therapist, and at their school.

Here are a few resources that might be of some help:

• Choosing the Right Treatment : What Families Need to Know
• Resources from the American Academic of Child and Adolescent Psychiatry
• Guide to Psychiatric Medications for Children and Adolescents
• Advocating for Your Child: 25 Tips for Parents

It’s also important for parents to advocate for their children at the Capitol, because decisions made at the Legislature affect the type of care that’s available in our communities.  There are real actions our state lawmakers can take to attract and keep good doctors and child psychiatrists in our state. They can help make sure other people who work with our children—like child care providers and teachers—have information and resources they need to help children with concerns.

Our lawmakers can also take action to increase the availability of effective mental health services and supports available in our communities, so that parents have real options when deciding what’s best for their children—and don’t have to settle for the first treatment that’s offered to them.

Written by: Josette Saxton

Of all the unsettling things about 2011, few felt like a punch in the gut the way the scandals at Penn State and Syracuse University involving sexual abuse of kid did. The year also brought a series of CNN reports on a stomach-churning parenting book that advises using “a rod” to discipline children . . . and the child deaths that followed.

Thinking of out-of-control adults targeting helpless kids leaves most of us feeling pretty powerless. So, if I’m not supposed to hide or scream, what can I do?

That’s what I’ve spent the first part of the new year trying to figure out: whether there’s some way I can protect not just my daughter, but kids in general from abuse. It turns out, there’s a lot I can do to put the power back where it belongs: not with the abusers but with children and those of us who want them safe. If all of us who hate child abuse made a new year’s resolution to do a few of these things, our kids would get a much safer 2012. Here are four things I found I can do:

• Get informed. The Children’s Advocacy Centers of Texas says 1 in 4 girls and 1 in 6 boys will be sexually abused before they reach adulthood. Children are also victims of other types of abuse and neglect—and few ever tell. It’s up to us as adults to be there for kids. You can learn the signs of child abuse here.

• Talk to your kids. Yes, even your little kids. There are age-appropriate ways to arm children with the ideas and words that could protect them in a dangerous situation. Stop It Now has some great suggestions for how to talk to your child or teen about abuse. Letting your child know you are there to listen, whatever he or she wants to talk about, is important. Another good idea from the experts: reinforce that your child’s body is his or her own. If something you don’t think is a big deal makes your child uncomfortable—whether it’s hugs hello for Auntie or tickle wars with brother—go ahead and honor your kid’s desire to put some boundaries around his or her body. Kids should get in the practice of making that call for themselves.

• Help child victims. We, the community, are responsible for the little ones who need protection most. It’s not just about reporting suspected abuse, though that’s important. (The Texas Abuse hotline takes calls 24 hours a day: 800-252-5400.) You can also volunteer your time or make a donation to an organization like Texas CASA, which matches each of its volunteers to a child in the foster care system in need of mentoring and support. To learn about other local groups working to address child abuse and neglect, try I Live Here, I Give Here’s “Connect with What You Care About” online tool.

• Pressure elected leaders to act. Imagine if there were services out there so effective that they cut in half the chance that a child will ever be abused.  It’s not a fantasy. These programs exist, and vulnerable kids need grown-ups to speak out for them. Let the people in elected office know that keeping kids safe is your priority. It takes only seconds to call the office of your representative or to jot a quick email of support. Sign up for action alerts from Texans Care for Children (where I work), and we’ll let you know when your action matters most and what you can say to have the greatest impact on decisions about child protection.

We as moms know we can’t live in fear all the time, and we don’t want to instill paranoia in our children. But we also need to be responsible. I’d love to hear fellow moms’ experiences with striking that balance. How did you broach talking about abuse with your child? What tips do you have about leveling with kids without scaring them unnecessarily?

photo credit: Edmund Garman: A display for child abuse awareness

Written by: Christine Sinatra

Except for the periodic shots, my daughter actually enjoys her well-child visits. She likes to perform, so when the doctor asks her questions, sees if she can demonstrate various poses, and has her read numbers off a chart, she gladly shows off her skills. This is great fun!

Little does my praise-seeking child realize how important this relatively simple checklist is to make sure she’s growing and developing on track. Regular screenings help catch areas of concern early, enabling parents and doctors to address concerns before they develop further and when they are often the most responsive to intervention. Can you say nip it in the bud? Case example: it was during a well-child exam that we realized the wax-producing factories that are my daughter’s ears were interfering with her hearing, which ended up impacting her speech. If it wasn’t for her failed hearing test at age 5, we wouldn’t have known about the problem until much later. She would have experienced difficulties and frustrations in kindergarten and beyond, and we would have ended up spending much more money on speech therapy.

photo credit: edenpictures

Detecting problems early is a no-brainer. It should come as no surprise that the American Academy of Pediatrics recommends children receive periodic developmental screenings during well-child visits. What is alarming is that many young children aren’t getting them. A recent study found that more than half of pediatricians caring for children under age three failed to use a formal developmental screening tool as part of their routine care. This is especially concerning for kids with social and emotional or behavior concerns, because when doctors rely on their clinical judgment alone they have been found to miss more than 50% of children with serious emotional and behavioral disturbances. Missed identification leads to missed opportunities to intervene early, before concerns become more serious and harder to address.

Thankfully, the need to improve screening rates in Texas has been recognized by folks working to improve the healthy development of children. The Texas Council on Children and Families and the Raising Texas Initiative are two state efforts working together to develop strategies to help ensure all Texas children receive recommended screenings so issues can be identified and addressed as early as possible. It’s encouraging to have the state focus attention on the issue, but it will take public will to have these strategies implemented.

So as you plan the birthday celebrations in your household, remember to make that appointment for your child’s well-check exam. During your visit, talk to your doctor about any concerns you have, and check out the “During the Visit” section of this Health Care Visit Checklist for some tips. If you’re unsure if your child is receiving a standardized developmental screening as part of the routine visit, ask your doctor for one. Consider it part of your child’s birthday gift!

Written by: Josette Saxton

I (perhaps unwisely) stubbornly refuse to think about shopping until after Thanksgiving. And although I had no intention of participating in any Black Friday sales, I couldn’t resist at least thumbing through the advertisements that came in the Austin newspaper, where inserts outnumbered news probably 3 to 1.

Although this is the first year I think my son will really pay attention to the presents he opens, I want to be careful about the number of “things” we accumulate. My husband and I have always been mindful of the gifts we give him and ask our families to respect this desire, not only because we want to lessen our impact on the Earth, but also because we want him to value experiences over material goods. If you would like to do the same, or encourage your families to give different kinds of gifts, here are some ideas:

• A family membership to the Austin Children’s Museum is $10 off until the end of the year (including renewals). It’s a great place to go as a family, take out of town guests or take along friends (the Basic Membership allows 4 visitors). It’s worth it financially if you can make it once a month and gives you an excuse to go explore downtown and get out of the house.
• Speaking of downtown, take a carriage ride to spend a fun night together taking in the holiday decorations (or any time of year).
• The UT men’s and women’s basketball teams play at the Erwin Center and getting tickets to a game on a weekend is a fun family excursion (and it doesn’t matter if you are in the nosebleed section).
• Asking relatives to help pay for a class (we love Sportball, or you could try art or dance lessons). Some of these are drop off, but you can also find some that are Mommy and Me if you’d prefer to participate.
• Planning a family getaway — either something major, like Disney, or something simple, like camping at a state park.
• Buy tickets to a performance, be it The Nutcracker, A Christmas Carol, Holiday Heroes or even a movie at the IMAX.

What other ideas might I be forgetting?

There are so many fun events coming up, so be sure to check out the Weekenders to experience the holidays as a family. You can also check out my Taming Holiday Treats post for ideas on reducing your family’s sugar intake this holiday season. Happy shopping!

Written by: Nicole Basham

I never thought it was so horrible to be an only child. I liked it that my parents brought me to lots of “adult” places and that I got to talk about grown-up things. I would go to friends’ houses and play with their siblings, and when I was ready, I could go home. As the only grandkid on both sides and with no cousins, I never knew holidays with houses full of children of all ages to play with. Since I didn’t know any different, I didn’t secretly pine away for a different existence.

My husband and I talked about having two kids, but it didn’t work out that way. The newborn stage is hard on most people, but I really struggled. I didn’t think I could do it again, particularly having another child to care for. It works for many people, just not me. My husband and I talked about it, and decided to stop at one.

After a while, my mama friends started talking about having more children, and we adopted a black Lab. We told our son this was his dog brother, and he was completely on board. To this day, he has not asked about a brother or sister, and when we have asked him, he says he likes our family the way it is (well, perhaps he would prefer more pets, but that’s another post). Our families stopped asking, and we put all the baby things on Craigslist or passed them on to the new baby brothers and sisters of my son’s friends.

I wondered if seeing babies would make me want to have another. Turns out, it didn’t. I enjoyed the freedom of knowing I didn’t have to go through the hardships of those early months again, and was happy to be able to make meals or help out my friends who were battling through days with only a few hours of sleep and, in some cases, questioning their decisions.

I was surprised at how few other only children we came across. At first, it seemed like a secret club — people seem to just expect you’ll have more than one child, or if you don’t, that maybe there is a physical reason you can’t, so they don’t want to pry. I kept wondering if there was some handshake I was not privy to in order to gain entrance into this society. But slowly, I realized I wasn’t the only one.

I felt like I was coming out of the closet. There was nothing to be ashamed of, of course. I could tell some of my friends didn’t understand…”but you are so good with kids!?” I think to my son’s last tantrum and how I immediately felt that this was all I could handle.

As I am wont to do, I decided that I needed to read up on parenting an only child. I found the dad of my best friend in high school, Carl Pickhardt, wrote a book called The Future of Your Only Child: How to Guide Your Child to a Happy and Successful Life. The book certainly served as a mirror to illuminate some of my traits and foibles and gave me food for thought on how as a parent you can moderate some of the less positive characteristics of only children.

Now that my son is getting older, I daydream about the future, thinking about all of the amazing experiences we’ll have together as a family. Thinking about my future and all the possibilities that await as my son enters elementary school. Sure, there will be tough stretches. There will be cloudy days. But, I’m content knowing my family is complete and we’ll face it all together.

Written by: Nicole Basham

Which is one reason I found this article on The Nature Conservancy’s blog so compelling. The article speaks to another tough set of choices we face as parents: how to raise a child while attempting to reduce our impact on the planet. Specifically, how to stay green and stay on a schedule. The author discusses the trade-off between walking to school — the time for family togetherness, the ability to observe nature and the environmental benefit — versus the convenience of driving to school and getting up and ready a little later. As a night owl, I have a hard time thinking anything is worth getting up extra early for, although I admit that over time, mileage and gas emissions DO add up. It’s also hard with kids to embrace anything that adds MORE time to your morning routine.

I also like how the author points out ways to save time during other parts of the day to make up for the time spent walking, since that is certainly eating into some other priority. In particular, I like the idea of making sure you combine errands so you aren’t making one trip out for one thing (although I am occasionally guilty of that during the evenings, especially if I’m stuck at home all day).

Not having a school-aged child (yet), I also realize there is more to the equation. Is the route to school safe enough for a child to walk alone? Is the road well-lit throughout the year?

Has your family made any conscious choices to reduce your “footprint”? Do you have any ideas to share on making it easier to be green?

Written by: Nicole Basham

Monday

Pflugerville Pizza & Wing Pfactory

ZuZu’s

HangTown Grill

Tuesday

Serranos

Berryhill Baja Grill

Kerbey Lane Cafe

Central Market Cafe

Wednesday

Serranos

EZ’s

Moe’s Southwest Grill

Zen

Luby’s

Thursday

La Salsa (Mon-Thurs after 4p.m.)

Serranos

Saturday

Luby’s

Texas Land and Cattle

Iron Cactus

Here’s what Angela from Irie Bean Coffee Bar has to say about their place:

Glad you discovered us. We definitely consider ourselves family friendly. Children are very welcome and we have a lot that come in each day. We don’t have high chairs for children but we have coloring books, crayons and sidewalk chalk if you consider that equipment for kids We have a great back patio for them to run around on. We also have a monthly event called the Kids Decaf Club. These events feature activities like kids music, face painting, balloon animals, art projects, etc. Our next Kids Decaf Club event will be on Dec 15.

Maybe we can frequent their joint enough and convince them to get at least one high chair! Sounds like a nice place to chill out and people watch while the kids are busy. www.iriebean.com