A new study reviewed in The Lancet reports that the overall risk of death associated with febrile seizures is extremely low. Research conducted by Dr. Mogens Vestergaard, and colleagues, at the Department of General Practice, Institute of Public Health, Aarhus University, Denmark, found that death following a simple febrile seizure is very rare. However, they also did find that the risk of death appears to double in the 2 years that follow a complex febrile seizure.

Simple febrile seizures last less than 15 minutes and do not recur within 24 hours; complex seizures last more than 15 minutes and / or recur within 24 hours. Children who had more complex seizures had a mortality rate twice as high as the general population in the 2 years following the seizures, but children with simple seizures had mortality rates similar to those of the general population.

Because little is known about the effect of febrile seizures on mortality in children, the Danish researchers studied 675,643 children born in Denmark between 1977 and 2004, analyzing mortality after febrile seizures and following them up to 28 years post-seizure: from 3 months old until they died, emigrated, or until August 31, 2005.

Of the original sample, 8,172 eventually died, which included 232 of the 55,215 children with a history of febrile seizure. Researchers found that 132 per 100,000 children died within the 2 year period following a febrile seizure. Sixty-seven per 100,000 died without having a history of the condition.

The authors note that, in spite of the increased risk associated with complex seizures, the absolute risk remains small.

The authors conclude that "Children with simple febrile seizures had a risk of death similar to the background population, whereas those with complex febrile seizures, febrile seizures triggered by temperature below 39°C, and febrile seizures occurring before 12 months of age had a two-fold higher mortality lasting for about two years. The excess mortality was at least partly due to pre-existing neurological abnormalities and subsequent epilepsy…Parents should be reassured that death after febrile seizures is very rare, even in high-risk children."

Further, Dr. Maitreyi Mazumdar of the Department of Neurology, Children's Hospital, Boston, states that "Vestergaard and colleagues' study again seems to refute, for infants and children who have simple febrile seizures, the idea of a shared cause between febrile seizures and sudden death.”

Mazumdar adds that the study “suggests that there is a subset of children with febrile seizures - notably those with complex features and underlying neurological abnormalities - that may warrant closer attention and follow-up."

The significance of play in the lives of children is widely recognized. Child's Play is a valuable tool that offers strategies that support the play of children.  However, rarely do we talk about the importance of unsupervised play.  Is this because we are constantly fearful for our children? And, are they consequently being overprotected? Are they missing out on adventure because parents fear for their safety? A major study by Play England, part of the National Children’s Bureau, has found that half of all children have been stopped from climbing trees, while 21 percent have been banned from playing “conkers” (a game in which a child swings a horse chestnut on a string to try to break that of another player), and 17 percent banned from playing chase or tag. A recent article describes the extreme lengths some parents go to, to protect their children.

“Children are not being allowed many of the freedoms that were taken for granted when we were children,” said Adrian Voce, director of Play England. “They are not enjoying the opportunities to play outside that most people would have thought of as normal when they were growing up.”

Voce argues that allowing younger children to be out only when accompanied by an adult is a “social norm” and that “Logistically that is very difficult for parents to manage because of the time pressures on normal family life. If you don't want your children to play out alone and you have not got the time to take them out then they will spend more time on the computer.”

Voce says that some decisions to keep children safe are illogical: last year, nearly three times as many children were admitted to a hospital after falling out of bed than falling out of a tree.

According to research, 70 % of adults say they had their biggest childhood adventures in outdoor spaces of rivers, woods, and trees; only 29 % of children today take part in those activities. The majority of young people surveyed say their biggest adventures were on playgrounds.

Voce said Play England is determined to spread the message that children ought to be taking risks. He states that it is “'not the end of the world if a child has an accident.” The latest study shows that play providers feel that opportunities for children to “test and challenge themselves in play involving a level of risk” have reduced over the past decade. They blame the decrease on fear of litigation and overly cautious health and safety officers.

Andrea Quaintmere, manager of Toffee Park Adventure Playground in London, admits that there are fears that parents will sue if their children are injured, but that “We need to educate parents who are worried about their kids having accidents and hurting themselves. Children can learn from small accidents. Parents do get nervous and tell us ‘don't let them do that.’ I try to remind them of their own childhood,”

The Play England study quotes one play provider who says that “Risk-taking increases the resilience of children;” another who said that “It helps them make judgments.”

The research gives examples of risky play that should be encouraged: fire-building, den-making, paintballing, climbing trees, and other behaviors.

Justine Roberts, founder of Mumsnet.com, an online forum for mothers, says that parents only want to protect their children. “It is the mums and dads that have to deal with the bruises and cuts. But broadly speaking I think that we will have to be brave and allow our children to take physical risk because, within reason, that is the way that they learn.”

The number of children diagnosed with autism spectrum disorders is growing, yet most are not diagnosed until around age 4 through the conventional method of behavior detection. Presentation such as, "How Infants and Their Brains Develop: Early Signs of Autism Spectrum Disorder" offer guidance and information to parents and professionals.  However, parents may not recognize symptoms – or don’t know what symptoms to look for – until children are about 30 months old.  When they do express concerns about the development of their child they may be told,"don't worry, he will grow out of it!"

If risks, even in the absence of a diagnosis, can be identified earlier, children are at a greater advantage of receiving treatment.  Studies indicate that preschoolers who receive intensive treatment have greater IQ scores and language gains than those whose treatment begins later.  Scientists are now using new techniques to study children as young as a few months old to screen them for possible autism, as reported in this Wall Street Journal article.

One screening tool is an eye-tracking test.  Canada’s McMaster University and Yale University’s Toddler Developmental Disabilities Clinic are using this technology to study children as young as 3 months.  The systems administer eye-tracking tests and use eye-movement sensors to predict the risk of autism in young children.
"Children with autism in general have difficulty extracting affective information from faces, and also difficulty in recognizing faces," says Katarzyna Chawarska, director of the Yale clinic. Chawarska says that through tracking eye movements, "we can begin to understand what interests them, how they examine objects they select for processing, and what motivates them intrinsically.”
Eye-tracking won’t detect all children with autism, however, since not all children will cooperate with the testing equipment and autism manifests itself in different ways at different times.
One example of using this technology successfully comes from the Yale clinic, where Caleb Scott, 17 months, has been monitored from birth. Caleb's older brother is autistic, which raises his odds of developing autism.  Dr. Chawarska and her team performed standard autism evaluations and then tracked Caleb's eyes while he watched clips from "Sesame Street" and images of faces. Caleb’s mother, Katie Scott, is encouraged by the patterns.  “I see him watching the eyes and the mouth, I see him looking at the right-side-up face instead of the upside-down one. All of that gave me hope right away."
Autism specialists don’t intend for this new technology to replace traditional assessment, which includes human observation, but rather to complement existing assessment tools.  "There is something about a clinician that adds to the predictive value," says Catherine E. Lord, director of the University of Michigan Autism and Communication Disorders Center. Dr. Lord headed up the team that, in the 1980s, developed the Autism Diagnostic Observation Schedule that became the standard assessment for autism.

There is no available genetic or blood test to prove autism, although most experts agree there is a biological basis to autism, and that autism may be inherited.

Early intervention is helpful, however.  "By providing very intensive early intervention, we can significantly reduce the symptoms of autism," says Geraldine Dawson, chief science officer of advocacy group Autism Speaks. But, she says, "there is huge variation in how children respond to early intervention."
According to the Centers for Disease Control and Prevention, about 560,000 Americans under age 21 are affected by autism spectrum disorders, including Asperger's syndrome and the disorder is found in 1 in every 150 children by age 8.  This number is more than 10 times that reported in the 1980s.

Greater screening, a wider range of diagnostic standards, or an actual increase in the number of cases may be at work here, but regardless, some advocacy groups like the Autistic Self-Advocacy Network, are against the search for a cure.  "We are very supportive of early diagnosis and early education," says Ari Ne'eman, the group's president. "We shouldn't be trying to force normalcy on autistic children, but rather help children acquire skills, communication, and quality of life," he says.  However, the group wishes for autistic children to be accepted for who they are.
The McMaster University study, according to researchers, is the first to find statistical differences in young children.  Of the 43 children studied, 13 had siblings with autism, which increases their risk for autism by a factor of 8.  The group with an increased risk did show lower scores than those with no known risk.  The lead researcher, Mel D. Rutherford, says that the study only compares the two groups, but she expect that, after refining the study, her lab "will be able to construct a predictor score for each individual infant."  A report of the study is available at www.earlyautismstudy.org.

Early intervention does help some children.  Debbie Page says early action helped her son Gabe, diagnosed with autism at 30 months, who spent 6 months, 250 hours of therapy, in an early-intervention study at the Kennedy Krieger Institute Center for Autism and Related Disorders in the Page's home town of Baltimore.  Page reports that her son became more socially engaged and stopped his nervous humming.  "He came out like a songbird," she says.
MIT's Media Lab researchers are developing software to analyze videos of autistic children and are collaborating with the Groden Center, a school and treatment center for autistic kids in Providence, R.I.  Video analysis, according to Deb Roy, director of the Cognitive Machines Group at the Media Lab, can help families track their child’s progress.  Early intervention is expensive, but may ultimately reduce costs for parents by allowing them to avoid sending their children to specialized, private schools.
Only 8 states have passed bills that mandate private insurers cover autism and related disorders; a Pennsylvania bill is waiting to be signed by the governor. (To find out what states require coverage, go to autismvotes.org and click the State Initiatives tab.) According to Elizabeth Emken, vice president of government relations for Autism Speaks, 27 more states have autism initiatives in the works.

Parents and educators know the value of reading and the adage “reading is fundamental.” Emphasis is typically focused on the early years such as with the Emergent Literacy Series. However, the Center Grove Community School Corporation in Indiana is taking that adage to heart by weaving literacy and vocabulary into nearly every lesson across all grades and developmental levels. The Indystar explains the new program.

Lisa Plank, West Grove Elementary principal, explains: "We really believe literacy is the touchstone for everything that follows in [students’] lives." Plank hopes that students will learn more than just reading comprehension and fluency, but will also learn that "reading is an enjoyable pastime."

Based on research that shows that personalizing literacy education can boost understanding of literature, the program will expose elementary students to a variety of books at their reading level, and will recruit parent volunteers to work with students. Plank says that the school will “dedicate at least 90 minutes of the instruction day to literacy.”

In middle school, the focus will be on vocabulary, writing, and reading strategies, and staff members will emphasize subject-specific vocabulary words. Matt Kaiser, Center Grove Middle School North principal, says students will learn these skill-based words, such as “analyze,” so that when asked to make an analysis of a situation, they will know what is being asked of them.

SAT vocabulary words will also be worked into weekly student announcements. Greek and Latin roots and prefixes and suffixes will also be emphasized so that students can figure out what words mean.

Kaiser says success comes when students incorporate these strategies into everyday practice. "You teach these reading strategies, you know these reading strategies, but to see the kids use them [is rewarding]" he said.

Students at the high school level will also participate in the initiative. Center Grove Superintendent Steven Stephanoff said that an adult literacy audit done last year “gave us some very pointed suggestions" and that the high schools were doing a good job, but could improve.

There are conflicting perspectives on understanding and managing the behavior of children with
ADHD.  One important view is offered in ADHD and the Nature of Self Control.  Another view is reveled in an interview by Nancy Shute with Walnut Creek, California, pediatrician Lawrence Diller.  In this interview Dr Diller reveals his controversial ideas on ADHD, Ritalin, and spanking. Sparked by an article by Diller in which he asked, “Could it be that America would rather give unruly kids a pill than a swat?”  Shute had to know more. The following excerpts are from her recent interview.

Shute asked: Spanking is probably the most controversial issue in child rearing. You treat children with ADHD. What on earth compelled you to write that spanking may not be so bad?

Diller responded that he thought “please, please!” when a California assembly woman proposed making spanking a child under age 3 a crime. Diller’s reaction was due to his seeing issues of discipline cause 80 percent of the problems he sees. Diller says that families who struggle with a child’s behavior struggle with spanking, and “They figure if spanking is bad, then all forms of conflict are bad, and they hesitate to discipline their children. They wait too long before taking effective action. This doesn't have to be spanking; it could be removal of a toy or imposition of a timeout. I am talking about middle-class, upper-middle-class families that love their kids, that have the resources for their kids.”

These children, according to Diller, have “determination, stubbornness [and] a simple ‘no’ doesn’t work.” These children are also intensely happy when they’re happy, and intensely angry when angry.

Shulte asked: What form of discipline do you recommend to parents?

Diller responded that he keeps copies of the book 1-2-3 Magic, by clinical psychologist Thomas Phelan, in his office, and that he likes it a lot. The book contains a simple discipline system that involves counting to 3 and then putting the child in timeout. Diller gives “parents of 4-, 5- and 6-year-olds a guarantee that in 72 hours their child will be better if they follow these methods.”

Diller says that the component he added to this system is spanking or other physical intervention. He says this makes the system 80 to 90 percent successful for 6-and-under children. Diller states that “There's good solid evidence that when you give parents permission to give one or two smacks on the child's bottom if the child defies the rules of the timeout procedure, the family is more often successful with the approach. For parents still uneasy about a spank, they can use a specific restraint technique I call ‘the hold’ [holding a child against the parent's chest]. But kids actually prefer a spank because it's over with right away.”

Shulte stated: But spanking's not recommended in 1-2-3 Magic.

Diller responded that no, Phelan does not recommend spanking, but rather recommends that if the child won’t go into timeout, the parents restart the timer and add another consequence. Diller thinks “that [method is] extremely hard for small children to use to make the right decision.”

Diller says he prepares parents “for the likely initial very intense negative reaction from the child,” and that “with their understanding that they are not hurting their child long term and this is what's called for to demonstrate their consistent strength and steadiness, they are ready to persevere. When children are out of control, you may be sparing this kid and family months of treatment and the risk of being labeled mentally ill. If you don't deal with the bad behavior, it takes you to ADHD-land; it takes you oppositional-defiant-disorder-land, to generalized anxiety-land, and obsessive-compulsive-disorder-land.”

Shulte asked: One of the big concerns is that spanking will increase the physical abuse of children. Are there parents who shouldn't spank?

Diller responded that parents with major marital problems, substance abuse problems, or major depression should not spank, and that spanking in desperation or anger leads to “negative outcomes, like increased violence, associated with corporal punishment.”

Shulte asked: Aren't you worried that parents will say: Larry Diller says if I spank my kid, he won't get ADHD?

Diller responded, “That is my big worry. And that's why my friends tell me to keep my mouth shut.” He further clarified that “to say that all ADHD kids should be spanked is a misreading of my position. But I expect parents and schools to do something before we give out pills. And I give out pills.”

Diller goes on to say that, in mild ADHD, “a more organized and coherent system of discipline can make the difference in whether your kid will be on Ritalin or not. You don't have to spank. But if you're using spanking as one of an array of tools to get control of your kid, you're not hurting them in the long term.  Lively, impulsive, spontaneous kids who know when to shut up don't get medicine.”

Diller says that “nobody wants to be pro-spanking,” and that he is not pro-spanking, but thinks “a well-thought-out spank ain't so bad and shouldn't be banned.”

Researchers at the Center for Research on Culture, Development, and Education (CRCDE) in New York University published a study in the July/August 2008 issue of the journal Child Development, that found that mothers who had greater social and economic resources were more supportive parents than those with fewer resources, as reported in a review of the study. This increased support influences a child’s cognitive performance.

The researchers studied 2,089 low-income mothers and their children who were participants in the Early Head Start Research and Evaluation Study. Researchers visited homes when the children were 14, 24, and 36 months old and measured, by observing mother-child interaction and the home environment, the quality of parenting as well as the families’ economic resources. In addition, they studied the mother’s education, the children’s birth weight, where the children’s’ fathers lived, and how often the mother read on her own.

The study found that the families’ economic resources and quality of parenting contributed to the children’s cognitive development. Mothers with greater economic resources were more supportive in parenting, which influenced the children’s cognitive performance. Cognitive performance in turn influenced parenting: mothers displayed more encouragement of cognitive stimulation, warmth, and sensitivity and were more supportive in response to developmental achievements of the child.

Julieta Lugo-Gil, who conducted the research, says that “These findings point to the importance of examining parenting resources and parenting quality as joint contributors to children's development. Programs that aim solely at supplementing family earnings may not have a strong impact on children's cognitive development; programs that offer a combination of cash assistance and services designed to improve the quality of parenting may be more effective."

Family support programs need to focus on addressing literacy and education, reducing parental stress and providing high-quality child care as well as financial circumstances.

Certainly war affects everyone, but a new study by psychology professors at the University of Utah report that children who grow up in war zones are particularly affected. One finding of the study, published in the journal Child Development, is that children growing up in war zones begin to believe that stealing from others or hurting them in revenge are okay. In short, these children lose their moral centers, according to a recently published review of the study.

The study’s findings were based on interviews with 96 Colombian children and indicate that war will encourage children to steal when they feel physical threatened, almost always expect violent behavior from anyone in daily life, and view acts of violence as an option in any circumstance. Furthermore, these children exhibit a sense of distrust of others. There is a sense among these children that violence and stealing become an alternative, particularly the older the children are.

The research, however, does not address how being around childhood violence might induce violence. In nearly 50 countries worldwide, children are growing up in the midst of armed conflict, including Colombia, where nearly 2 million children have been forces from their homes over the past 15 years. Researchers are seeking the affect of these circumstances on a child’s sense of right and wrong.

Study co-author Cecila Wainryb said that "Overall, these findings unveil a reservoir of moral knowledge among war-affected children. Even the impoverished environments of war and displacement present youths with opportunities for reflecting on the intrinsic features of actions that harm others."

Wainryb and Roberto Posada, a Colombian native and doctoral student at University of Utah, say that there are a number of "vulnerabilities" for the moral compasses in these children of war. Because the children are concerned with survival, their ability to view themselves as moral agents may be compromised, and revenge may create cycles of violence.

Many of the children in the study endorsed hurting and stealing for revenge; all participants said it is wrong to hurt other or steal; most said it was wrong to hurt others or steal from them even when doing so can help ensure one’s own survival. A majority of the subjects said they expected others would steal from and hurt other people in most situations. That view was strongest among teens.

The authors cite other research that children everywhere violate moral behavior expected of them, but that those who are exposed to and perpetrate violence don’t get a chance to discuss or learn from those violations.

Gas prices may be high, but many families are still  making roadtrips. No doubt boredom and complaining will make an appearance, but BradentonHearld.com offers some suggestions for warding off boredom and encouraging family learning time without resorting to electronic entertainment.

From Lisa Church’s book Everyday Creative Play, here are some suggestions for engaging kids in learning during car trips:

Borrow books on tape from the library or friends and listen as a family.

Tell a collaborative story. Let one person start with a line, and have other family members continue.

Count cars, dogs, churches – you name it. Choose a category, and count how many items you see that fit that category.

Play measurement games by deciding which is bigger – a rhino or an elephant? Which is farther away – Grandmother’s house or Aunt Nancy’s? Discuss what we measure and why.

Take the measurement game farther by playing money games. Get the children to point out places where people spend money, how much things cost, and what has greater value.

Talk about where you’re going, what road you’ll take, and what you’ll pass on the way. Turn this into a running travelogue.

Bring along magnetic games; many games are now designed specifically for travel and have magnetic boards that allow for play while moving.

Play “look and see” games. There are many variations, like looking for different shapes, or letters of the alphabet.

Build in “quiet time” when everyone is just silent and still. This may be hard, so start of with short periods of time, and make this time part of the daily routine.

Car trips can encourage interaction between family members and can provide lots of learning time if creativity and patience are employed.

There are numerous benefits to pretend play, among them, a venue for children to express and talk about a variety of emotions within a safe, fun environment. Some children have difficulty expression emotion, particularly children with developmental delays such as autism.  A recent article by Sandra Russ, she suggests some ways to help children express emotions through make-believe play.

Since play is a way for children to learn adaptive skills like how to understand social cues, how to negotiate fairness, and express feelings in a thoughtful way, it promotes empathy by allowing children to think about and attempt to express how others are feeling.

A child playing the “bad guy” in a game may express anger, or, conversely, in the role of “hero,” he may express joy.

Pretend play also lets children label their feelings and is linked to their creativity.

Some suggestions for fostering this exploration of emotions through play are:

Comment on your child’s play through narration. For instance, you may say of a playmate, ”He looks really happy that he won the game!”

Demonstrate for younger children what emotions look like. Jump up and down and use a high-pitched voice to show happiness.

Ask open-ended questions such as, “I wonder how she feels?”

Encourage your child to demonstrate emotions by suggesting he make up a sad story about a child who has lost a favorite toy.

Managing the behavior of young children is an ongoing challenge for many parents and caregivers.  Positive Discipline without shaking, Shouting  or Spanking addresses these concerns and offers effective strategies for the best ways to manage aggressive behavior in young children. This  is an ongoing and important topic of discussion among parents and teachers. In a recent article Carolyn Tomlin also discusses  some of current theories and practices in managing aggressive behavior and offers her suggestions for best practices.

Developmental theorists generally concur that early experiences shape behavior, laying down neural paths in a child’s brain at a time of crucial development: when brain pathways can be created more quickly than at times later in life. This consensus makes it that much more important that early aggressive behavior be treated effectively.

A recent new approach to disciplining young children was developed by Seth Scholer, MD, MPH, Assistant Professor of Pediatrics at Vanderbilt University. Scholer’s program, called Play Nicely, is a CD ROM that teaches parents, counselors, child care providers, and health care professionals the basics of agression management for children ages 1 to 7. Through the training, participants learn that there are more effective responses than speaking angrily, physical punishment, or ignoring the aggression.

Dr. Scholer says, “early childhood aggression is one of the strongest predictors of violence later in life.” Scholer’s interest in managing aggression was influenced by a presentation by Dr. Richard Tremblay. After the lecture, Scholer realized that “we need tools to help teach caregivers why and how to manage aggression in the early years.”

Scholer believes that Play Nicely gives caretakers and parents insight into cognitive skills depicting social adjustment of children, teaching important lessons, including setting the rule that aggressive behavior is not allowed. The program also covers redirecting – that is, that children have other options instead of hurting, and promoting empathy by showing that others can be hurt by aggressive behavior.

Suggestions for Managing Aggressive Behavior

Caregivers need to know how to handle aggressive behavior in young children: what to do when a child hits? How to know when to encourage parents to seek professional help? Some strategies that will help parents and teachers are as follows:

Teach children not to be a victim of aggression. Encourage children to say to an aggressor, “That hurts,” followed by discussing with both children their feelings and how to resolve the conflict together. Set a firm rule that hitting will not be tolerated.

Decrease exposure to violence. Know what television shows children watch or what video games they play. Television time should be limited to two or fewer hours per day for children over age 2; no television for children under age 2 is best.

Show lots of love by giving individual attention, and play with children and be consistent with rules. Do not ignore a child’s rule-breaking, follow thorough with what you say or say nothing at all. Make sure parents and caregivers agree on the rules.

Some situations may warrant professional help, and warning signs of these situations may include frequent aggressive acts towards others, toward the self, or toward pets. Children who never follow directions or listen may need professional intervention, as may those who seem unattached. If the child does not return to his parent or caregiver in strange situations or frequently chooses violence on television or in video games, he may need professional assistance.

Founder and President of the High/Scope Educational Research Foundation Dr. David P. Weikart said that "When we accept that learning comes from within, we achieve a critical balance in educating children. The adult’s role is to support and guide children through their active learning adventures and experiences. Helping children to learn to help themselves is one of the most important ways adults can be of service to them.”

Certainly considering Scholer’s suggestions and striving to manage aggressive behavior in a positive way will help children to learn from within.