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2015

toothpaste_small.jpgPoor oral health can "severely" impact a child's overall health, confidence and well-being, says the president of the Ontario Dental Association.

"It can also affect their behaviour in school," says Dr. Arthur Worth. "Tooth decay is the second most common cause of school absenteeism and is five times more common than asthma in children."

Cavities hurt, even when they are in baby teeth, Worth says.

The number of kids suffering with serious tooth decay has been on the rise in recent years, affecting 28 per cent of all kids, says Dr. Sarah Hulland, pediatric dentist with the Canadian Dental Association.

Eating more often in the day and drinking less water with fluoride are two factors contributing to the increase, she says.

So what can parents do to keep their kids' teeth and mouths healthy? Below we’ve pulled together some tips for parents based upon fact sheets from the Canadian Dental Association and the Ontario Dental Association.

First, the Facts:
  • Early childhood decay affects 6 to 10 percent of all preschoolers
  • Tooth decay is a rapidly progressing disease, often rotting the two front teeth completely to the gum line within a year
  • At age 5, nearly 11 percent of kids had two or more teeth with wide-open, untreated cavities
  • 12 percent of all kids suffer dental neglect and require immediate care

 

Clean Teeth Tips:
  • Young children depend on their parents to clean their teeth properly
  • Children under the age of three need adults to brush their teeth for them
  • Children aged 3-6 should be helped to brush their teeth by a grown-up
  • When children can write (not print) their own name, they are ready to brush their teeth on their own, however, parents should still check to see they do a good job
  • Change your child’s toothbrush every one to three months and after every illness
  • Let your child watch you brushing your teeth to help them learn how and to teach the importance of dental health
  • Sugary drinks and snacks are a major culprit in rising rates of child tooth decay, so help your child to eat more healthy snacks and drink tap water (which contains fluoride)

 

How to Brush Teeth:

When your child is old enough to start trying to do it on his own, guide him along with these steps:

  1. Hold the toothbrush at a 45-degree angle to the teeth, pointing the bristles where the gums and teeth meet.
  2. Use gentle circles, do not scrub, and be sure to clean every surface of every tooth. Be sure not to hurt the gums by brushing too hard.
  3. Also be sure to use only a bit of toothpaste (with fluoride after the age of 3 or before if your dentist sees a need) and make sure the child spits all of it out.
Flossing:

Using dental floss is also necessary to get teeth properly clean. Here’s how:

  1. Take a piece of tooth floss about the length of your child’s arm.
  2. Wrap it around your middle fingers, leaving about two inches of floss between your hands.
  3. Use your index fingers to guide the floss.
  4. Slide the floss between the teeth and wrap it into a “C” shape. It should wrap around the base of the tooth where tooth meets gum.
  5. Wipe the tooth with the floss from bottom to top 2 to 3 times or more until squeaky clean.
  6. Move to a new part of the floss as you move from tooth to tooth.
Dental Development:
  • All of your child’s baby teeth come by the time your child is two or three years old.
  • Permanent teeth begin to come in by age 6 or 7 and continue to come right up to age 21.
  • Most kids lose all of their baby teeth by the age of 12.
  • For more information, including primary and permanent tooth charts, check out the Canadian Dental Association’s dental development page online.
  • When your child loses his or her first tooth, they can go online to get a Smile Certificate from the CDA here.

Summarized facts above reprinted with permission from the Ontario Dental Association and Your Oral Health.ca, 2013, and the Canadian Dental Association, 2013.

kids_coping_with_grief_644x362-625x352.jpgThe loss of a loved one is painful for adults and children alike; however, a child’s reaction may be very different depending on his or her age.  This reaction highly depends on their cognitive development and understanding of death. Here’s how you can help your child at different ages.

Before Age Five:

Often, children who are younger than the age of five do not fully understand the concept of death.  Although they may initially be upset about the departure of the person, they can’t comprehend the finality of death.  In their minds, nothing is permanent and their loved one will soon return.   At this age, children think in a very concrete manner.  When discussing death, it is important not to use euphemisms and be very straightforward with them.  Explain that the loved one is safe and not hurting, but that he or she is not coming back.  Understand that this is a very difficult concept to grasp at this age. The child may ask questions like “when is mommy coming back?” and “how far is it to heaven?” Repeated questions surrounding a loved one’s departure are completely normal for children this age and require consistency with your answer.

iStock_000001515501Small-300x200.jpgBehavioural regression and acting out are normal parts of grieving and may occur long after the death of the individual. For example, if your child was fully potty-trained previously and starts peeing her pants following the death of the individual, this may be a sign of grief in your child.  It is important to encourage ongoing use of the toilet but not to reprimand your child for the regression. Open discussion is important with all children, but you must use appropriate language for their age so that they can better understand how they feel.

If the behavioural change involves acting out and bad behaviour, treat it as you would any other bad behaviour, but allow for discussion to find out how they are feeling afterward.  Discuss appropriate ways to deal with anger and sadness, such as talking to someone, or cuddling and giving hugs to a loved one.  If you are at all concerned, consult with your physician for ongoing support.

Age Five to Ten:

At this age, children begin to grasp the idea of death and dying as well as the irreversibility of it. However, they are still very concrete in their thinking.  If their loved one died of lung cancer from smoking, they may assume that anyone who smokes will die of lung cancer. As a parent, you can gently explain that this is not always true, but that you understand that it hurts them to see people smoke. Validate their feelings and don’t be afraid to ask your kids how it makes them feel.sad_kids_460x260-300x170.jpg

Children in this age group often see death as something that happens to others but not to themselves or their family.  Once again, behavioural regression and acting out are common responses and need to be recognized as such in order to be dealt with appropriately. For example, if your eight-year-old has not thrown a temper tantrum in the grocery store for several years and suddenly has the patience of a toddler, treat the tantrum just as you would any other bad behaviour and let your chld know that it is not acceptable.  Once your child has cooled off, ask why the tantrum happened and how he is feeling.  Kids may say they were mad, because they don’t quite have the insight to see that the behaviour is related to the death of their loved one.  Discuss this possibility with them and offer suggestions on how they can deal with their anger.  This may include talking about it, remembering their loved one with a photograph or keepsake, or even throwing a ball in the backyard.

iStock_000007687221Small-300x449.jpgAge Ten and Up:

Most pre-teens and adolescents can think about death in a more abstract manner.  They can usually see the long term consequences of death and get fixated over injustice/justice.  Children and teens in this age group often have very strong reactions to grief and may act out with violence or self- harm, especially if they have a history of depression.

The best way to predict this is to allow for open discussion with your child.  Parents are often scared to discuss self-harm and suicide with their kids for fear that they will “give them the idea”.  This is not the case, and in fact open discussion may save your child’s life.  If you are concerned about violence or self-harm in your child, see your physician for information on treatment, counselling, community resources and telephone crisis lines in your area.

How Parents Can Help:
  • Remember that grieving is a process.  Just like in adults, it may take some children longer than others to adjust.
  • Give the child ways to remember their loved one, such as photographs or keepsakes.  Never force a child to go to a funeral, but encourage them to remember in their own way such as lighting a candle or writing a letter.
  • Never lie to a child, at any age.
  • Don’t assume that kids understand death just because they are a certain age. Take the time to discuss what it means and encourage questions along the way.
  • Build a community of support around the child.  Make teachers and friend’s parents aware of the tragedy.  Encourage communication with people willing to offer support.
  • When in doubt, talk to your family doctor or pediatrician.  Your doctor can provide you with community resources, counselling information and suggestions about behavioural /mood changes in your child.

The loss of a loved one is hard on everyone, regardless of age.  Being aware of your child’s developmental stage will help you understand how they are grieving so that you can guide them through the process.

 

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Dr. Courtney Manser is a family physician and mother who has a strong interest in preventative care and in providing parents with information so they can make the best choices for their children.

stuttering_637x424.jpgIf your child isn't meeting the speech milestones for his age, then there might be an underlying issue or it could just be a simple problem cured by time and patience. If you are worried, contact your province's preschool speech and language program for help.

Here are some common speech problems that many parents encounter:

My child isn't talking. What's wrong?

There are serious communication disorders like autism that can cause a delay in speech, but sometimes kids don't talk for less complicated reasons.

They may not understand you. "Some children really do have a hard time breaking down the meaning of things that they hear being said to them," says Margit Pukonen, Director of the speech program at the Speech and Stuttering Institute. There are some ways to help:

  • Speak slowly and clearly.
  • Use very simple words.
  • Speak in short, slow sentences

If they are still having problems, speak to your doctor about speech therapy.

They may not even be aware that they are not communicating. If that's the case, there could be other developmental issues going on. But, if they are gesturing or using other ways to communicate then they are aware but don't know how to fix it. Once again, talk to your doctor about speech therapy.

My child can't pronounce 'sh,' 'th' or 'r' sounds. What's wrong?

These sounds are often the last to develop. Some kids have the ability to pronounce those sounds early on but others don't grasp these sounds until they are seven or eight. Do not panic.

If you are concerned, get a speech therapist to do an assessment. Most of the time, this issue clears up with time but sometimes a little therapy can help.

Most people do not understand my child. What's wrong?

This becomes a concern after the age of four. By that age, most strangers should understand them. If not, there could be other underlying developmental disorders. It is important to go to your doctor and ask for your child to get tested.

My child stutters. What's wrong?

The good news is that 80% of children will outgrow stuttering. Click here to learn more about stuttering and treatment.

Conclusion:

Speech problems can be frustrating for parents and children. If you are concerned, talk to the professionals and learn how to help.

speech_milestones.jpgAs parents we constantly compare our child's progress to that of others - especially when they are young. If your child isn't communicating the same way as other kids his age, it can be worrisome and frustrating.

It is important to rule out common problems or more serious communication disorders, but there are things you can do every day to help improve your child's communication skills.

One of the most important things you can do at home to help your children is to read to them everyday - no matter their age. Here are some other tips:

When They Are Babies (under 6 months):
  • Talk to your baby in whatever language you want. You can also speak more than one language if you wish.
  • Play out loud. "Mommy is putting the cow in the barn. The cow says 'moo'"
  • When they coo, coo back. They are talking to you.
  • Exaggerate your facial expressions when you're talking to them.
  • Be very responsive. Attribute meaning to the cooing to get a conversational routine going ("You sound like you're hungry. Are you hungry?"). They love listening to the tone of your voice.
  • Label things. If your child is looking at a cat, say "cat." Tell them what they are seeing.
  • Don't use too much or complex language. Keep it simple.
  • Play back-and-forth games like peek-a-boo.
  • Sing songs that require a response like Old MacDonald.

 

When They Are Older (6 months to 3 years):

 

  • Do not yell and try not to get frustrated when your child is having trouble with words. They are not doing it on purpose. What may seem simple is actually a huge developmental mountain for them to climb. They will master it with help, not stress and pressure.
  • Speak in simple sentences using simple language.
  • Try to talk to them as much as you can. They learn to communicate from you so do as much of it as possible.
  • Break it down. Try clapping out the different words in a sentence.
  • Count syllables. Kids need to recognize that there are different sounds in a word. Try clapping out each syllable in words.
  • It's rhyme time. Rhymes are a really good way to teach kids how to manipulate sounds. Sing rhyming songs together or look for books with rhymes in them.
  • Emphasize the first letter in a word. Try, "Look, there's something that starts with the sound 'mm.' It's a mm-an."
  • Make sure you are doing these things in a natural way. Flash cards and video games are really not necessary.

Remember that all children develop differently and at different times. If your child is meeting the basic milestones, then you have nothing to worry about.

worried_2_5_215x210.jpgHow do you know when a child has been too anxious for too long? TVO and the child mental health experts at the Hincks-Dellcrest Centre have pulled together the following lists of anxiety-related behaviours for ages 3-5 to help you decide when worry has become a problem.

 

Worried behaviours are divided into three categories below; Typical (not to worry), Monitor (reason to continue monitoring behaviours) and Seek Help (behaviours that may indicate a mental health problem). These are only some of the highlights from the ABCs of Mental Health on the Hincks-Dellcrest site. Click here to see the full lists of behaviours for a worried child in this age range and things you can do to help.

 

green_light_small_3.jpgTypical

 

The following are considered normal and are not cause for concern. Click here for a full list of  behaviours for your anxious child.

 

  • A range of fears and anxieties as the child explores his world.
  • Fears and worries changing as children grow older.
  • Girls displaying more fears than boys, but boys hiding their fears better than girls.
  • A child asking a lot of questions about ‘what if this or that happens.'

 

yellow_light_67x152_3.jpgMonitor

It can be hard to know when something is cause for concern. If your child is displaying the following worried behaviours, it could be a sign of a problem. It’s best to continue to monitor the situation and watch for any progression or worsening. Click here for a full list of behaviours for your anxious child.

  • Sad mood.
  • Tantrums, negativity, aggression, non-compliance and crying.
  • Separation fears and clinging behaviour.
  • Preoccupation and inattentiveness.
  • Change in eating patterns.
  • Loss of previous control of bladder or bowels.
  • Change in sleep patterns.
  • Delay in reaching developmental milestones, or regression to a previous level.
  • Social isolation and withdrawal.
  • Nose picking, thumb sucking, nail biting.
  • Stuttering.
  • Pulling on clothes.
  • Picking at skin.

 

red_light_67x161_3.jpgSeek Help

The following signs of worry in children aged 3-5 may be cause for serious concern, particularly if they interfere to a significant extent with the child’s functioning in school, social situations or normal family life. These signs may indicate the need to see a health practitioner for possible referral to a mental health professional. Click here for a full list of behaviours for your anxious child.

  • Worried behaviours that last for a long period of time, over weeks or months.
  • Significant change from previous mood or behaviour pattern without being able to regroup.
  • Combination of behaviours, such as uncharacteristic sad mood, accompanied by angry and aggressive outbursts.
  • Inability to contain worries at school, to learn and to socialize as expected.
  • Worries so extreme that he does not accept your reassurance.
  • Persistent talking about the same fear and refusing to stop. Even though talking about it at the time is inappropriate, they can’t put it aside, even for a few minutes. They express an urgent need for others to be involved in their fear.
  • The child’s speech is pressured when talking about their fear and conveys a great deal of intensity and urgency.
  • This obsession with the fear continues even though the child has encountered the object of the fear many times and each time nothing terrible has happened and you reassure her that she is safe.
  • The above behaviours may be accompanied by a significant change in the family environment.

 

Need Help? What To Do:

 

  • If the behaviour is having a significant impact on the child and/or his family, it’s time to see a doctor about getting help.
  • Avoid blaming the child or becoming angry at the fearful behaviour.
  • Focus on reinforcing the child when he is acting brave. Try to catch his attempts at bravery in order to reinforce it.
  • Try to evaluate how much of a normal life is being sacrificed because of the fearful behaviour. This may also be affecting the lives of other family members.
  • Document the behaviour with as much detail as you can.
  • Ask your child what she thinks is at the root of her fears and allow her to express herself as much as possible.
  • Send a clear message that fear is not a good reason to avoid doing an activity that everyone else is expected to do.
  • Do not make exceptions for your child because of an irrational fear.

Find more recommendations for your worried child in the ABC's of Mental Health section of the Hincks-Dellcrest website.

sad_2_5_167x208.jpgHow do you know when your child has been too sad for too long? TVO and the child mental health experts at the Hincks-Dellcrest Centre have pulled together the following lists of sadness-related behaviours for kids aged 3-5 to help you decide when sadness has become a problem.

 

Behaviours are divided into three categories below; Typical (not to worry), Monitor (reason to continue monitoring behaviours), and Seek Help (behaviours may indicate a potential mental health problem).  These are only some of the highlights from the ABCs of Mental Health on the Hincks-Dellcrest site. Click here to see the full lists of behaviours and things you can do.

 

green_light_small_3.jpgTypical

 

The following signs of sadness are normal and are not cause for concern. Click here for the full list of behaviours for your sad child.

 

  • Loss of interest in favourite toys, crying and the appearance of sadness when the child is tired or there have been changes in caregivers.
  • Showing signs of sadness when the child's natural desire to learn new things is met with rejection, e.g. they want to try something but are told ‘no.’
  • Irritability and crying when separated from mother or primary caregiver, for instance, during the first few days at a daycare.
  • Showing signs of sadness when the child is not feeling physically well.
  • Showing signs of sadness at the loss of a pet or similar upset.
  • Sadness as a result of any major change, such as moving house, changing schools or starting school.
  • Sadness when they are not getting enough of their parents attention.

 

yellow_light_67x152_3.jpgMonitor

The following signs of sadness in children aged 3-5 are not necessarily reason for concern, but are reason for continued monitoring to see if the child’s emotional state worsens. Click here for the full list of behaviours for your sad child.

  • The child shows signs of sadness for days without any improvement.
  • Soothing is not very helpful in changing the child’s sad mood.
  • The child stays irritable, whines or cries at small things most of the time.
  • The child becomes aggressive, such as hitting a sibling or hurting a pet intentionally.
  • Very few activities seem to engage the child; he seems generally passive and often speaks negatively about himself.
  • The child dismisses her achievements, has low energy and fatigue and complains of headaches and/or stomach aches.
  • The child has difficulty concentrating, can’t make basic decisions easily, is easily moved to tears and throws things when irritated.
  • The child is careless about her possessions and doesn’t get excited about new toys or doing new things.
  • The child moves frequently from one activity to another and tends not to talk to anyone.
  • The child sleeps too little or too much, eats too little or too much, and appears sluggish.

 

red_light_67x161_3.jpgSeek Help

The following signs of sadness in children aged 3-5 may be cause for serious concern, particularly if they interfere to a significant extent with the child’s functioning in school, social situations or normal family life and have been going on for more than two weeks. Click here for the full list of behaviours for your sad child.

  • Frequent sad, angry or anxious behaviour most of the time, most days.
  • Sadness and worry so severe that parents can’t reassure the child.
  • These behaviours are combined with a number of Yellow Light signs.
  • The child loses interest in activities and objects he used to enjoy. He gives away his things.
  • Almost nothing engages the child and she has trouble concentrating.
  • The child looks very unhappy and tends to cry or scream at the slightest provocation.
  • The child’s frequent temper tantrums last longer than 15 minutes at a time.
  • The child doesn’t laugh or show excitement when given the chance to engage in activities of his choice.
  • The child talks clearly about hurting herself.
  • The child is eating too much without enjoyment or eating very little.
  • The child is sleeping too much or too little.
  • The child is negative most of the time, complains of low energy and headaches and/or stomach aches.
  • The child is highly sensitive, highly self-critical, is easily moved to tears and rejects positive feedback.
  • The child hurts others, such as poking the cat in its eye or hitting other children.

 

Need Help? What to Do:

 

  • Something has gone seriously wrong if your child is hurting or threatening to hurt himself or someone else. In this case, you may want to take the child to the doctor and consider referral to a therapist.
  • Talk to your child’s school or her teacher to the possibility of referring the child to a counsellor within the school system.
  • Consider, with the child’s teacher, whether an adjustment to the school day is advisable.
  • Document your child’s behaviour, what happens, when and how often.
  • Accentuate the positives in your child.
  • Be careful not to ‘bubble wrap’ your child so she can learn to cope with real life situations.
  • Shape situations in which your child can feel successful, to help him get on the right emotional track.
  • Try to maintain normalcy in your home and the child’s life as much as possible.
  • Be creative in asking your child questions and engaging her in conversation.
  • Reduce stress at home.

Find more recommendations for your sad child in the ABC's of Mental Health section of the Hincks-Dellcrest website.

Angry_2_5_210x198.jpgHow do you know if your child's anger has been too intense for too long? TVOParents and the child mental health experts at the Hincks-Dellcrest Centre have pulled together the following lists of anger and aggression-related behaviours for ages 3-5 to help you decide when anger has become a problem.

 

Behaviours are divided into three categories below; Typical (not to worry), Monitor (reason to continue monitoring behaviours) and Seek Help (behaviours may indicate a potential mental health problem). These are only some of the highlights from the ABCs of Mental Health on the Hincks-Dellcrest site. Click here to see the full lists of behaviours and things you can do.

 

green_light_small_3.jpgTypical

When at home, it’s not unusual for young children to occasionally display anger or aggression.

These behaviours will also change as your child gets older. Typical behaviours you might see for kids 3-5 include the following. Click here for a full list of  behaviours for your angry child.

  • Yelling.
  • Angry outbursts.
  • Temper tantrums.
  • Drawing angry or aggressive pictures.
  • Confrontations with peers, parents or even other adults.
  • Throwing things.
  • Damaging or destroying property.
  • Threatening or intimidating others.
  • Hitting, kicking, biting and fighting.

 

yellow_light_67x152_3.jpgMonitor

It can be hard to know when something is cause for concern. If your child is displaying the following behaviours, it could be a sign of a problem. It’s best to continue to monitor the situation and watch for any progression or worsening. Click here for the full list of behaviours for your angry child.

  • Angry outbursts so intense that the entire family is disrupted, siblings are upset, or the child is exhausted by the event.
  • Aggression toward other children that results in rejection and difficulty finding playmates.
  • Aggressive incidents happening as much as once a month or more.
  • An instance of anger or aggression that goes on for more than a few minutes and the child cannot be distracted.

 

red_light_67x161_3.jpgSeek Help

The following signs of anger and aggression in children aged 3-5 are cause for serious concern, particularly if they interfere to a significant extent with the child’s functioning in school, social situations or normal family life. Frequent, intense or long-lasting anger and/or aggression episodes signal there is a need for a referral to a mental health specialist. See the full Hincks-Dellcrest list for behaviours for your angry child.

  • A pattern of ongoing aggressive behaviour, whether obvious or subtle.
  • Frequent threats or intimidation.
  • Frequent temper tantrums severe enough to disrupt the environment at home or at school.
  • A strong need for power and control (often displayed in arguments and power struggles).
  • A strong need to dominate others (e.g. always has to be the boss or always needs to win).
  • Frequently damaging or destroying property either in anger or in a vindictive way.
  • Frequent fighting or physically assaulting others.
  • Any evidence of cruelty toward younger children or animals.
  • Any fire setting, especially if it may have been on purpose.

 

Need Help? What To Do:
  • Professional help is almost always needed when a child is displaying Red Light signs.
  • Talk to your doctor about connecting with a mental health professional.
  • Document your child's behaviour, what happens, when, how often and the severity.
  • Determine a reward for your child's good behaviour.
  • Think about some negative consequences or punishments for bad behaviour.
  • Formulate a plan of how to deal with these incidents while waiting for professional help.
  • Execute the plan and stick to it.

Find more recommendations for your angry child in the ABC's of Mental Health section of the Hincks-Dellcrest website.