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Welcome to the wonder that is 2014! (Can you feel it already?) Our Christmas was good, but then we were not swimming in the Parana River in Rosario, Argentina, like the 70 bathers who were attacked by piranhas while trying to escape a 100-degree heat wave. Some lost parts of digits, but there were no deaths, the piranhas having just skeletonized a cow.
While the story was widely reported in the media, few outlets carried the fact that I find most alarming: within 30 minutes of the attack, people were back in the water. I want to meet that first guy (and you know it was a dude) who was, like, “Well, I don’t see any more fish, so I’m going in!” That’s who I want with me in 2014, on Black Friday.
A nice CHAT
Do you find some questions unclear? Like last night, my wife asked me, "Honey, would you like to come help me fold laundry?" and I said, "No, I'm watching TV." Based on her reaction, I think I missed something. Few places in pediatrics are more fraught with unclear questions than the Modified Checklist for Autism in Toddlers (M-CHAT), a developmental screening tool we use for all 18- and 24-month-old children in our office.
Perhaps you’ve never had to administer an M-CHAT, but the version we give includes 23 questions about normal development. Some are straightforward, like #16. "Does your child walk?” Others are so unclear that they inevitably lead to a 5-minute conversation with worried parents (15 minutes for the upper-income brackets): #22. "Does your child sometimes stare at nothing or wander with no purpose?” Heck, I sometimes stare at nothing and, at age 45, purposeless wandering is how I exercise!
The study’s designer, Diana Roberts, Ph.D., must have gotten tired of calming down parents herself, because she and her research team just developed and validated a shorter, clearer version of the test, the Modified Checklist for Autism in Toddlers, Revised With Follow-Up (M-CHAT-R/F). The new test comes with only 20 questions, and she eliminated altogether the dreaded #22. The M-CHAT-R/F has a nearly 50% positive predictive value for identifying autism spectrum disorders and is 95% accurate in detecting any developmental problem or concern. This is going to be great for our office, but what I need now is a similar instrument that will keep me out of trouble 95% of the time.
Talk the talk
Okay, fellow pediatricians, what are you talking about during your adolescent health maintenance visits? According to research done right here of North Carolina, we’re spending only 36 seconds on average discussing sex and sexuality with our teen patients, and the way we talk here in the South, that’s not even time for a whole sentence! Does the scoliosis check really take that long?
Investigators recorded and analyzed 253 teen wellness exams, counting time that doctors spent on sexual history-taking and counseling. In 35% of visits, the issue didn’t come up at all. Did I mention the patients were all adolescents? We all know that about 50% of high school students are sexually active, right? And that sexual activity can lead to, like, diseases and pregnancy and stuff? Just checking.
The study offers more disappointments, which at least put the findings in context, in a depressing way. The average face-to-face time teens spent with their doctors during wellness visits was only 9 minutes, which, in the South, is how long it takes us to say “hello.” Many doctors did not talk privately with the teens, even though N.C. state law explicitly protects this privilege. I, for one, hope this study starts a conversation within our profession, one that lasts longer than 36 seconds.
Gummed up
I just finished watching a local production of "Willy Wonka the Musical," and I was struck that I share something with author Roald Dahl: a serious dislike of chewing gum, in both noun and verb forms. Apparently, Dr. Nathan Watemberg of the Child Neurology Unit and Child Development Center, Meir Medical Center, Tel Aviv University agrees, since he and his colleagues got a whole grant to study the impact of prolonged gum-chewing on pediatric migraines.
He found that of 30 young chicle-loving migraineurs, 19 were able to completely eliminate their headaches simply by sticking their gum permanently under a table where someone else would find it and be all grossed out. Six more experienced substantial relief by flicking their gum on the sidewalk, where it would stick to someone’s shoe and get tracked into the house and ruin the carpet.
Soon, I hope, “Don’t chew gum, it will give you a migraine!” will enter the pantheon of classic parental advice, alongside my personal favorite, “Don’t swim within 30 minutes of eating or a mass piranha attack.”
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Welcome to the wonder that is 2014! (Can you feel it already?) Our Christmas was good, but then we were not swimming in the Parana River in Rosario, Argentina, like the 70 bathers who were attacked by piranhas while trying to escape a 100-degree heat wave. Some lost parts of digits, but there were no deaths, the piranhas having just skeletonized a cow.
While the story was widely reported in the media, few outlets carried the fact that I find most alarming: within 30 minutes of the attack, people were back in the water. I want to meet that first guy (and you know it was a dude) who was, like, “Well, I don’t see any more fish, so I’m going in!” That’s who I want with me in 2014, on Black Friday.
A nice CHAT
Do you find some questions unclear? Like last night, my wife asked me, "Honey, would you like to come help me fold laundry?" and I said, "No, I'm watching TV." Based on her reaction, I think I missed something. Few places in pediatrics are more fraught with unclear questions than the Modified Checklist for Autism in Toddlers (M-CHAT), a developmental screening tool we use for all 18- and 24-month-old children in our office.
Perhaps you’ve never had to administer an M-CHAT, but the version we give includes 23 questions about normal development. Some are straightforward, like #16. "Does your child walk?” Others are so unclear that they inevitably lead to a 5-minute conversation with worried parents (15 minutes for the upper-income brackets): #22. "Does your child sometimes stare at nothing or wander with no purpose?” Heck, I sometimes stare at nothing and, at age 45, purposeless wandering is how I exercise!
The study’s designer, Diana Roberts, Ph.D., must have gotten tired of calming down parents herself, because she and her research team just developed and validated a shorter, clearer version of the test, the Modified Checklist for Autism in Toddlers, Revised With Follow-Up (M-CHAT-R/F). The new test comes with only 20 questions, and she eliminated altogether the dreaded #22. The M-CHAT-R/F has a nearly 50% positive predictive value for identifying autism spectrum disorders and is 95% accurate in detecting any developmental problem or concern. This is going to be great for our office, but what I need now is a similar instrument that will keep me out of trouble 95% of the time.
Talk the talk
Okay, fellow pediatricians, what are you talking about during your adolescent health maintenance visits? According to research done right here of North Carolina, we’re spending only 36 seconds on average discussing sex and sexuality with our teen patients, and the way we talk here in the South, that’s not even time for a whole sentence! Does the scoliosis check really take that long?
Investigators recorded and analyzed 253 teen wellness exams, counting time that doctors spent on sexual history-taking and counseling. In 35% of visits, the issue didn’t come up at all. Did I mention the patients were all adolescents? We all know that about 50% of high school students are sexually active, right? And that sexual activity can lead to, like, diseases and pregnancy and stuff? Just checking.
The study offers more disappointments, which at least put the findings in context, in a depressing way. The average face-to-face time teens spent with their doctors during wellness visits was only 9 minutes, which, in the South, is how long it takes us to say “hello.” Many doctors did not talk privately with the teens, even though N.C. state law explicitly protects this privilege. I, for one, hope this study starts a conversation within our profession, one that lasts longer than 36 seconds.
Gummed up
I just finished watching a local production of "Willy Wonka the Musical," and I was struck that I share something with author Roald Dahl: a serious dislike of chewing gum, in both noun and verb forms. Apparently, Dr. Nathan Watemberg of the Child Neurology Unit and Child Development Center, Meir Medical Center, Tel Aviv University agrees, since he and his colleagues got a whole grant to study the impact of prolonged gum-chewing on pediatric migraines.
He found that of 30 young chicle-loving migraineurs, 19 were able to completely eliminate their headaches simply by sticking their gum permanently under a table where someone else would find it and be all grossed out. Six more experienced substantial relief by flicking their gum on the sidewalk, where it would stick to someone’s shoe and get tracked into the house and ruin the carpet.
Soon, I hope, “Don’t chew gum, it will give you a migraine!” will enter the pantheon of classic parental advice, alongside my personal favorite, “Don’t swim within 30 minutes of eating or a mass piranha attack.”
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Welcome to the wonder that is 2014! (Can you feel it already?) Our Christmas was good, but then we were not swimming in the Parana River in Rosario, Argentina, like the 70 bathers who were attacked by piranhas while trying to escape a 100-degree heat wave. Some lost parts of digits, but there were no deaths, the piranhas having just skeletonized a cow.
While the story was widely reported in the media, few outlets carried the fact that I find most alarming: within 30 minutes of the attack, people were back in the water. I want to meet that first guy (and you know it was a dude) who was, like, “Well, I don’t see any more fish, so I’m going in!” That’s who I want with me in 2014, on Black Friday.
A nice CHAT
Do you find some questions unclear? Like last night, my wife asked me, "Honey, would you like to come help me fold laundry?" and I said, "No, I'm watching TV." Based on her reaction, I think I missed something. Few places in pediatrics are more fraught with unclear questions than the Modified Checklist for Autism in Toddlers (M-CHAT), a developmental screening tool we use for all 18- and 24-month-old children in our office.
Perhaps you’ve never had to administer an M-CHAT, but the version we give includes 23 questions about normal development. Some are straightforward, like #16. "Does your child walk?” Others are so unclear that they inevitably lead to a 5-minute conversation with worried parents (15 minutes for the upper-income brackets): #22. "Does your child sometimes stare at nothing or wander with no purpose?” Heck, I sometimes stare at nothing and, at age 45, purposeless wandering is how I exercise!
The study’s designer, Diana Roberts, Ph.D., must have gotten tired of calming down parents herself, because she and her research team just developed and validated a shorter, clearer version of the test, the Modified Checklist for Autism in Toddlers, Revised With Follow-Up (M-CHAT-R/F). The new test comes with only 20 questions, and she eliminated altogether the dreaded #22. The M-CHAT-R/F has a nearly 50% positive predictive value for identifying autism spectrum disorders and is 95% accurate in detecting any developmental problem or concern. This is going to be great for our office, but what I need now is a similar instrument that will keep me out of trouble 95% of the time.
Talk the talk
Okay, fellow pediatricians, what are you talking about during your adolescent health maintenance visits? According to research done right here of North Carolina, we’re spending only 36 seconds on average discussing sex and sexuality with our teen patients, and the way we talk here in the South, that’s not even time for a whole sentence! Does the scoliosis check really take that long?
Investigators recorded and analyzed 253 teen wellness exams, counting time that doctors spent on sexual history-taking and counseling. In 35% of visits, the issue didn’t come up at all. Did I mention the patients were all adolescents? We all know that about 50% of high school students are sexually active, right? And that sexual activity can lead to, like, diseases and pregnancy and stuff? Just checking.
The study offers more disappointments, which at least put the findings in context, in a depressing way. The average face-to-face time teens spent with their doctors during wellness visits was only 9 minutes, which, in the South, is how long it takes us to say “hello.” Many doctors did not talk privately with the teens, even though N.C. state law explicitly protects this privilege. I, for one, hope this study starts a conversation within our profession, one that lasts longer than 36 seconds.
Gummed up
I just finished watching a local production of "Willy Wonka the Musical," and I was struck that I share something with author Roald Dahl: a serious dislike of chewing gum, in both noun and verb forms. Apparently, Dr. Nathan Watemberg of the Child Neurology Unit and Child Development Center, Meir Medical Center, Tel Aviv University agrees, since he and his colleagues got a whole grant to study the impact of prolonged gum-chewing on pediatric migraines.
He found that of 30 young chicle-loving migraineurs, 19 were able to completely eliminate their headaches simply by sticking their gum permanently under a table where someone else would find it and be all grossed out. Six more experienced substantial relief by flicking their gum on the sidewalk, where it would stick to someone’s shoe and get tracked into the house and ruin the carpet.
Soon, I hope, “Don’t chew gum, it will give you a migraine!” will enter the pantheon of classic parental advice, alongside my personal favorite, “Don’t swim within 30 minutes of eating or a mass piranha attack.”
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.