Social thinking is our ability to relate to others using our bodies as well as our minds. It is a very complex skill that we begin in the first few months of life and that we continue to master throughout our lives. It is a person’s ability to interpret the needs and wants of others and to provide empathetic responses. This is called perspective taking; it includes responding to another’s motives and intentions and sharing thoughts and verbal communication that show our own intention and our interest in the person we are talking to. It is very difficult for children and adults who have deficits in their social thinking processing abilities to successfully navigate this nuance filled communication.

Social competency is the result of the lifelong learning process that involves thinking about another person’s intention and situation before responding to them. It also involves “whole body” listening, understanding expected vs. unexpected social behaviors and learning the subtleties that allow us to become a welcome part of a group of people. Those individuals that can do this successfully create positive opportunities with others in the home, classroom and at their workplace. Difficulties with this skill might be mild, moderate or severe. It may also change as the child matures especially if social skills do not follow development in other areas. 

Social thinking programs are designed to provide support, education and opportunity for those persons with social thinking deficits to better understand social communication. Children who participate in these programs reduce their stress, anxiety and negative feelings to afford a more positive interaction with others in all facets of their lives. We are not all born with the ability to gauge others reactions and feelings but these are skills that can be taught and, once mastered, can change an individual’s future.

Christine Lotierzo is is a local speech and language pathologist in private practice in Encinitas. Her therapy now includes working with children who have a variety of communication disorders and providing small group sessions for “Social Thinking.” For more information on these groups you can contact Christine Lotierzo at 760.942.9918.

Here are some tips:

• A booster seat allows the lap belt to fit across the child’s hips instead of across the stomach, which will create less risk of injury.
• Never ride in a booster seat with a lap belt only. They must be in the booster seat with lap AND shoulder belt which should cross the center of the shoulder and chest. You must use a harness certified seat if there is only a lap belt available in some older model cars.
• Children should ride in a safety seat with a complete harness system as long as possible. Most current models fit up to 50 pounds or more. Check the weight limit on the car seat instructions.

To tell if a child is ready to use a vehicle safety belt without a booster, they should pass this 5-step test:

1. Does the child sit all the way back against the auto seat?
2. Do the child’s knees bend comfortably at the edge of the auto seat?
3. Does the belt cross the shoulder between the neck and arm?
4. Is the lap belt as low as possible, touching the thighs?
5. Can the child stay seated like this for the whole trip?

If you answer “no” to any of these questions, your child needs a booster seat to make both the shoulder and lap belt fit right.

For more information visit:

http://www.ots.ca.gov/Child_passenger_safety.asp

or call 800-745-7233 and also

www.carseat.org

Starting at birth, most positional skull deformities can be prevented by working on ways to keep a baby from always laying on one section of the head. Here are some tips:

• Sleep babies on their back, but try to alternate them looking to right and left side when they sleep. (This is not the same as sleeping on the side).
• When awake, they should spend supervised time on their tummies for at least 30-60 minutes/day. Routine awake tummy time has been shown to enhance infant motor developmental scores during the first 15 months of life.
• Babies should spend minimal time in car seats when not in the car.

The prevalence of positional skull deformities generally peaks at 4 months and will begin to show more improvement by 6 months as babies spend more time sitting and then crawling. If positional skull deformity is found, most infants improve if other measures are started. These include:

• Positioning so that the more rounded side of the head is placed against the mattress.
• Change the crib position and place the infant more often so that the baby will look away from the flattened side to see people or interesting objects in the room.
• Continue to encourage supervised tummy time when awake.
• If a torticollis which is the tight neck muscle has also been identified, neck stretches can be performed. These should be done with each diaper change. There are 3 repetitions per exercise and hold each position for about 10 seconds. It is estimated that it will take about 2 extra minutes per diaper change. Basically, the child’s head is rotated gently so that the chin touches the shoulder (each side) and then the other exercise is rotating the head so the infant’s ear touches the shoulder (each side). Here is a YouTube video to describe these stretches.

If positioning and exercises are not helping, sometimes physical therapy is recommended and then the final treatment if skull deformities are more significant and not improving can be referral for a skull-molding helmet.

• Back to sleep for every sleep – nighttime and naps is the recommended.  Side sleeping is no longer recommended. Babies with gastroesophageal reflux disease (GERD) should also be back sleeping unless they have life threatening risks from complications of GERD as in infants with impaired nervous systems who can not protect their airways normally. Normal healthy babies with GERD should continue to back sleep. Babies should also be placed on the back position until a year, but once they are rolling over (usually around 4-6 months) they can be allowed to remain in the sleep position that he or she assumes.
• Use a firm sleep surface using a sleep environment (crib, bassinet or crib/play yard) that conforms to safety standards and make sure that these items are not on recall lists or have broken or missing parts.
• Pillows, cushions, quilts, comforters or sheepskins, even if covered by a sheet should not be placed with the sleeping infant. Bumper pads for cribs should also not be used. There is no evidence that bumper pads prevent injuries and these are also a risk for suffocation, entrapment and strangulation.
• Sitting devices such as car seats, strollers, swings and carriers are not recommended for routine sleep in the home environment.
• Room sharing IS recommended but bed sharing is NOT recommended. There is evidence that room sharing can decrease the risk of SIDS by as much as 50%. However, bed sharing with the infant in the parent’s bed is NOT recommended due to risks of suffocation, strangulation and entrapment with the infant in the adult bed. Co-sleepers are NOT recommended and do not make bed sharing safe. Infants can be brought into the parental bed for feeding but should be returned to their crib or bassinet when the parent is ready to return to sleep.
• Avoid smoke exposure as this increases risks of SIDS.
• Consider pacifier use at nap or bedtime. Although the reasons are unclear, studies seem to show a protective effect of pacifiers on the incidence of SIDS, even if it falls out of the infant’s mouth. However, there is no need to force a baby to take one if they do not like it and generally with breastfed babies, we recommend waiting until after 3-4 weeks of age to introduce a pacifier. Pacifiers should not be attached to the baby with a cord or hung around the neck when babies are sleeping.
• Avoid overheating of babies. Generally about 1 layer more than an adult would wear to be comfortable is a good rule of thumb.
• And remember to avoid positional flattening of the skull (positional plagiocephaly), give babies opportunities to have tummy time when awake. See ideas for doing this on our website under the General Links with Tummy Time Tools handout.

Asthma affects over 5.3 million children in the US and the number of pediatric asthma cases is on the rise.  It is the most common childhood chronic disease and accounts for more school-related absences than any other disease and can affect sleep and physical activity limits.   Symptoms are unique to each individual but can include: wheezing, coughing, chest tightness, and shortness of breath.  One study found that 17% of children displayed asthma-like symptoms without actually being diagnosed.

Natalie McNally, PNP is trained to do many of the following:

• Evaluate and manage medications for asthmatics, for new, acute and chronic patients according to the latest Asthma Practice Guidelines as set by the American Academy of Allergy Asthma and Immunology
• Create an asthma action plan for your child
• Teach inhaler, nebulizer and peak flow techniques with hands-on training
• In-office spirometry (lung function) testing to monitor patients
• Do regularly scheduled follow-up asthma management to work on maintaining asthma patients on optimal medication programs
• Counsel families on environmental triggers and order testing for allergies and review the results

October 4, 2011 — Millions of children use the computer every day, either at home or at school. Computer use at a young age is thought to improve school readiness by teaching the child good motor skills and improving cognitive development. Unfortunately, too much computer use at a young age could cause eye problems that can carry on into adulthood. With computers becoming a part of children’s everyday life, it’s worth considering what effects computer use might have on your children’s eyes and their vision.

Children can experience many of the same problems related to computer use as adults. Extensive computer viewing can cause dry eyes, fatigue, blurred vision and headaches. Prolonged computer use in children can also cause premature nearsightedness (myopia) and focusing (accommodative) problems that could affect the child’s eyes as an adult. Performing near-tasks for long periods of time can lead to progressive myopia, a condition in which the nearsightedness is progressing quicker than expected. It is important to have your child’s eyes examined before starting computer use and then annually to monitor for any of these changes.

Computer work-stations are typically set up for adult use. This set-up can cause muscle strain on children’s smaller bodies as they are reaching to read the screen and use the keyboard. It is important to adjust your computer screen to decrease the tension placed on the child’s neck, back and arm muscles and to take frequent breaks to stretch out and relax the body’s muscles. 

Here are some tips for setting up a child-friendly computer station: 

• Make sure the computer workspace fits smaller bodies
• The screen should be tilted slightly downward at a 15-degree angle
• There should be about two feet between the computer and the child
• Use desk lights instead of ceiling lights to help prevent eyestrain
• Position the computer to eliminate glare and reflections on the computer screen
• Remind your child to blink frequently to keep the eye lubricated and prevent dry eye
• Teach children to take frequent “eye breaks” -take 20 minutes off for every hour of computer use to look in the distance and give the eyes a break from near work
• During “eye breaks” have the child stand and stretch out his or her body to relieve muscle strain 

Computers are a very important part in your child’s life and education. Every child should see their eye doctor for a comprehensive eye exam at the start of every school year to make sure their eyes are ready for computer use at school and at home. This eye exam should include near vision testing as well as distance vision testing.

Tell your eye doctor if your child has shown any signs of computer vision problems such as squinting, eye rubbing, red eyes, near complaints and even avoidance of the computer altogether. A comprehensive eye exam will help your child feel comfortable on the computer and confident in his or her schoolwork.

 Morris Eye Group (Office 760.631.3500) has two locations:

• 477 N. El Camino Real, Suite C202, Encinitas, CA
• 3909 Waring Road, Suite B, Oceanside CA