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[Ear Tube Surgery]   [Education in Your 6 Year Old]   [Education in Your 9 Year Old]   [Education in Your 11 Year Old]   [Education in High School]   [Education in College]   [Employment of Teenagers]   [Hygiene Changes in Puberty]  

EAR TUBE SURGERY
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General Information:

Ear tubes also called ventilation tubes are tiny plastic tubes that are surgically placed in the ear drums to increase drainage in the middle ear so as to lower the frequency of recurrent ear infections and to help drain chronic fluid from the middle ear. The chronic fluid can lead to hearing and speech problems because the fluid behind the ear drum dampens the normal vibration of the ear drum, thereby muffling sound. About one million children a year usually between one and three years of age have ventilation tubes placed in their ear drums.

The benefits of the ventilation tubes include immediate improvement of hearing, reduction of ear infections, improved speech development because of better hearing, and prevention of severe thickening of the middle ear fluid (so-called "glue ear").  In most children the drainage of the middle ear improves naturally as the child ages, so that the tubes are only a temporary assistance to the ear drainage.

The risks of ventilation tubes include the risk of anesthesia when tubes are put in (about one in 15,000 people will die from anesthesia), the ongoing risk of ear infections, and the tubes needing to be replaced because they fall out too quickly. Usually the tubes fall out, but occasionally they can fall into the middle ear space and have to be removed by the ear-nose-and-throat specialist who put them in. If the tubes stay in the ear drum too long they can cause scarring or leave a perforation or hole in the ear drum that may have to be repaired.

Medical Indications for Ventilation Tubes:

  1. Fluid has been present behind the ear drum for several months and there is an associated hearing loss or speech problem.
  2. Both of the ears should be abnormal to opt for ventilation tubes. If only one side is involved, then your child should hear well enough to develop normal speech and probably does not need to have ventilation tubes placed.
  3. Recurrent ear infections have not been reduced with preventive antibiotic usage.

Reducing Chronic Ear Fluid and Ear Infections:

  1. Keep your child away from smokers as much as possible since the smoke they exhale (even an hour after smoking) and the smoke on their clothes will increase problems with ear infections and fluid.
  2. Stop smoking yourself if you smoke.
  3. Do not give your child a bottle while lying down and wean him off the bottle by one year of age.
  4. Reduce allergies in your children which can lead to middle ear fluid by nursing for at least several months and delaying feeding solids until at least 6 months of age.

 

EDUCATION IN YOUR 6-YEAR-OLD
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Your youngster has recently started kindergarten or first grade and has had a whole new world opened up to him or her. Many issues develop at this time that might need action from you, such as:

  1. School phobia - Many children do not want to go to school for various reasons. They might be afraid to be away from home.  They may be very shy and fearful of being around so many children. They might be afraid that they will not do well in the academic part of school.  Boys (who mature later than girls on the average) may have more problems with phobias. Treatment- Part-time kindergarten classes are probably best for children who do not seem to be ready for all-day school.  Holding your child back at this time is probably better than holding him back in later years although he will still tend to carry the mark of a child who was held back. If mom and dad can be very involved in school by showing up for lunches, being a parent-helper frequently, helping out during P.E., etc., the transition to all-day school can be made easier for him.
  2. Accelerated education- No scientific evidence exists to support the idea that the younger a child learns about computers, science, or most other subjects, the better accomplished she will be. Music and language are the only areas where study may be easier at this age than in later years because her brain is more receptive to these in the first few years of life. If your child is forced into a rapid learning mode by you then she is more likely to feel a lot of stress or to burnout. Treatment- Let your child be a child for as long as possible. If he shows interest in music, then encourage him to take music lessons. If he lives in a bilingual household, speak both languages so that he can be bilingual also. Otherwise, let him go at his own pace.
  3. Private versus public education- Most private school children as a group score better academically than children in public schools, despite 2 or 3 times as much money going to the public school child's education. The higher achievement has been due to factors which can be duplicated in the public schools. First, having smaller classrooms allows for more student interaction with the teacher. Second, more parental involvement in class, with homework, and in parent-teacher organizations leads to motivated students. Third, teaching better morals, citizenship, and discipline in the classroom, encourages a better learning environment.  Fourth, maintaining high standards for schoolwork, lifts all children up, even those children from divorced families, the inner-city, or troubled backgrounds. Treatment- The quality of your child's schooling is largely dependent on your involvement whether public or private. Smaller classrooms are often enforced by law. Motivate your child by showing enthusiasm for the work she is doing. Insist in your parent-teacher meetings that good morals, firm discipline, and high standards be maintained. Insist that children who need help have it even if it involves a volunteer like you.
  4. Being a role model for your child- Probably the most important role that you can play for your child in education is to show him that you value education for yourself and for your children.

Treatment- Read to your child daily at this age and let him read to you. Show enthusiasm for the reading skills he is learning. Always be encouraging to him first and foremost. Allow him to read books that he wants to read because reading is the basic skill needed for all education.

 

EDUCATION IN YOUR 9-YEAR-OLD
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Your child is probably now in the 3rd or 4th grade and should be fairly comfortable with school. He should have several good friends who probably change frequently. Having one best friend this week and a new one next week is normal. You should only be concerned if he does not seem to have any friends. 

In the 3rd or 4th grade depending on the school district, the amount of school work and level of maturity required of your child increases dramatically over the previous grade. Because of this increased work, certain problems may become more apparent, such as a slower developing child (usually boys), a child with attention deficit disorder, a dyslexic child, or simply a child who is less organized or less mature. If your child is having problems making grades that are at the level of her ability, then be aggressive with the school to attempt to discover her problem. By law, they have to respond to your satisfaction, not theirs.

Other Problems Include:

  1. Accelerated Education - No scientific evidence exists to support the idea that the younger a child learns about computers, science, or most other subjects,  the better accomplished he will be. Let your child be a child for as long as possible. Let him go at his own pace.
  2. Private versus Public Education- Most private school children as a group score better academically than children in public schools, despite 2 or 3 times as much money going to the public school child's education. However, the higher achievement has been due to factors which can be duplicated in the public schools, such as smaller classrooms, more parental involvement, teaching better morals, and maintaining high standards.  Motivate your child by showing enthusiasm for the work she is doing. Insist in your parent-teacher meetings that good morals, firm discipline, and high standards be maintained. Insist that children who need help have it even if it involves a volunteer helping such as you.
  3. Being a Role Model for Your Child - Probably the most important role that you can play for your child in education is to show her that you value education for yourself and for your children. Read to your child daily at this age and let her read to you. Show enthusiasm for the reading skills she is learning. Always encourage her first and foremost. Allow her to read "fun" books that she wants to read because reading is the fundamental skill needed for all education and the extra reading is beneficial.
  4. Limiting the Amount of TV or Video Time- Television, even educational television,  is of very limited value to your child since it tends to take away time from true study.  Children who watch more television tend to study less often, have more problems with weight, exercise less, and tend to snack more often. Try to involve your child in activities that are educational including visits to the Children's Museum, the library, and nature walks. By doing so you will open a whole new world to him.
  5. Social Time with Education- Your child may have assigned projects that she does with other children in her class. Because learning to work with others is an important process for your child, this is a worthwhile approach. However, do not expect a very extensive amount of work to be done. The project will usually  very quickly become play time, but this is normal at her age.

 

EDUCATION IN YOUR 11-YEAR-OLD
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At the 3rd to 4th grade level, your child had a large increase in his academic challenge. At this age, because he is in middle school where he has several classrooms and many teachers,  he has an increase in organizational and social challenges.  Common problems include:

  1. Organizational Challenge- Prior to the 6th grade your child had 1 primary teacher and maybe 1 or 2 specialty teachers that she would see 1 or 2 hours a week. Now she is going through extensive hormonal and body changes and must also be able to go to 6 or 7 class periods, a similar number of teachers and homework, and remember her locker combination as well.  Do not be discouraged if she occasionally forgets her homework or is late for her classes because of talking to friends.
  2. Organized Sports- Organized sports are actually good for your preteen. It teaches him discipline, new skills, hand-eye coordination, and self-confidence that are valuable in the upcoming years. His sports can become a problem if he is so committed to them that he neglects his schoolwork, family, church activities, or other important areas.
  3. Interest in the Opposite Sex- Your preteen has a dramatic increase in her sex hormones which means that she is becoming interested in boys. She will also have a new complex relationship with her girlfriends so that she will spend a lot of time talking to them on the phone about clothes, earrings, and boys.  Her telephone use will increase substantially and needs to be limited so she does her homework.
  4. New Complex Thinking- He is entering into the phase of life where he will think rationally. He can then think about his future and be anxious about his attractiveness and his abilities as a future worker. So when he takes a drama class, he may decide that he wants to be an actor. When he takes a biology class, he may decide to be a biologist. When he takes P.E., he may decide that he wants to be a baseball star. All of these changing ideas are normal.
  5. Private versus Public Education - Most private school children as a group score better academically than children in public schools, despite 2 or 3 times as much money going to the public school child's education. However, the higher achievement has been due to factors which can be duplicated in the public schools, such as smaller classrooms, more parental involvement, teaching better morals, and maintaining high standards.  Motivate her by showing enthusiasm for the work she is doing. Insist in your PTA that good morals, firm discipline, and high standards be maintained.
  6. Being a Role Model for Your Child- Probably your most important role for your child's education is to show him the high value you place on education. Encourage his fun reading. Go to the library often. Show enthusiasm for the skills he is learning. Always encourage him first and foremost.
  7. Limiting the Amount of TV or Video Time- Television, even educational television, is of very limited value to your child since it tends to take away time from her true study.  Children who watch more television tend to study less often, have more problems with weight, exercise less, and tend to snack more often. Try to involve her in activities that are educational including visits to museums, the library, and nature walks. By doing so you will open a whole new world to her.

 

EDUCATION IN HIGH SCHOOL
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Many new concerns arise for parent and their teenager during this age. Your son or daughter has gone through many changes in the last 2 years physically, emotionally, intellectually, and socially. Your teenager is now a much more complex person. Education problems at this age include:

  1. Distractions- The hormones are raging, the mind is questioning his worth, and his coach is questioning his manhood. He is thinking about the future and his chances of marriage and family, a good career, and success in work or college.
  2. Sports- Unlike some detractors, we believe that the cooperation, the training, and the reality of victory and defeat which parallel life are valuable. If she is involved in sports, she is less likely to get pregnant, to have low self-confidence, and is more likely to finish school.
  3. Stress with Parents- This is a stressful time in your relationship since he is virtually an adult in size and shape and is becoming an adult in responsibility. Your young colt wants to bolt, but he still does not have the maturity to do so.
  4. Grades- School performance will now have an influence on her future that is permanent, meaning that it influences whether she graduates, gets a good job, goes to college, or trade school.  On the other hand, just because she is not doing that well in school does not mean that she will not do well in trade school or college. Many older teenagers thrive when they are studying something that they are really interested in. Also, just because she begins school in a college that has a lower reputation or a community college does not mean she cannot achieve all the goals she wants if she works hard enough.
  5. Sexuality- This is a dominant concern at this age. Your teenager has gone through recent dramatic body and mind changes that are going to concern him or her because they wonder about their desirability in the eyes of the opposite sex. In addition, we live in a world that seems to say that sex is all there is to life and your teen has grown up in such a world, regardless of how much you have tried to protect him or her.

It is extremely important for you to take the main role in sexual education of your teenager. The schools, periodicals, mass media, and even some spiritual institutions suggest that sexual activity is healthy for teenagers. Research says otherwise. Besides the tragedies of teen pregnancy and sexually transmitted diseases which are epidemic despite 2 decades of saturation teaching about condom use, many other problems occur for the sexually active teenager. These include: health problems (more alcohol and drug abuse), mental health problems (increase in self-esteem problems, depression and suicide), social problems (stress with parents and breakup of relationships), and educational problems (lower grades and higher dropout rates). Teach your teenager to wait on sexual activity until marriage, regardless of whether you did or not. They will be better off if they wait. Research shows that they do listen to this message from parents.

 

EDUCATION IN COLLEGE
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Many students who go off to college have a lot of unexpected difficulty because of the differences between high school and college. Usually the work is not all that more difficult, but the way the work is handled is quite different. Here are some tried and tested rules for taking college classes successfully.

  1. Try to take a light load for the first 2 semesters so that you can become accustomed  to college requirements.
  2. Try to have as much variety as possible in your classes early in your college experience so that you get a broad education and have exposure to enough information to choose well what your ultimate goals are.
  3. Try to stay up with your work as closely as you can. Trying to "cram" too much work in too short of a time is usually not an effective way to learn or make good grades.
  4. Choose a friend, roommate, or other person who will keep you accountable to your studies.  Someone who is in the same areas of study may work best.
  5. After having a hard week of study, tests, or written papers, try to relax for a day or so to regenerate your interest in your studies.
  6. It is really all right to have a tutor or an upperclass student help you with areas that you are having problems. Too many students will wait too long before requesting help at which point they are hopelessly behind.
  7. Try to mix some tough courses with interesting, "fun" classes in the same semester. This will also keep your interest strong.
  8. Get as much rest as possible before important exams. It is far better to study hard for a day or two before the exam and then have a good night's sleep the night before.
  9. Try to have balance in your life. Take care of your body through exercise, your mind through study, your emotions through entertainment and time with friends, and your spirit through helping others and going to church or Bible studies.
  10. If you go off to college, maintain close contact with family and friends back home. This contact will give you strength to go on when you feel most down.

 

EMPLOYMENT OF TEENAGERS
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Many teenagers want to have a part- or full-time job when they turn 15- or 16-years-old. The most common reason to begin a job is a desire to have extra money for clothing, stereo or computer equipment, and (the big one) a car. Jobs have the possible benefits of teaching your son or daughter responsibility, timeliness, people skills, and possibly a new job skill. The problems with the job and the buying spree that often accompany the job include jumping into adult stresses too soon, lowering of grades in school, and decreasing time with the rest of their family.

Evaluating the Benefits or Problems of Your Teenager's Job:

  1. Before taking a job your teenager and you need to discuss the realistic aspects of working.  Most teenagers at 15 or 16 will tend to see the monetary benefits, but will not see the possible problems with employment. 
  2. Have her begin with a temporary job such as one during the summer break or Christmas holidays. By doing that, she can become accustomed to the requirements of work while avoiding many of the problems associated with permanent employment.
  3. State clearly for him that his first "job" is his schoolwork and his relationship to his family members.
  4. Make sure that she understands before taking a job that her chores at home will continue to be similar. After all, when both parents are employed, they still have to do housework also.
  5. If he takes a part-time job during the school year, monitor his grades closely. Tell him before taking his job that if his grades drop significantly at any point he will have to quit.
  6. Do not allow her to sign up for some long-term commitment to a stereo, computer, or car payment which then forces her to continue to work. It takes a few minutes to sign up and years to pay for that choice. One way to decrease confrontation with your teenager is to insist that she put 25% or more down on any purchase. So if a teenager wanted to buy a $10,000 car, she would  have to save $2,500 before the purchase can be made (and usually with your co-signature). If a teenager is able to save that much money, then she is probably responsible enough to maintain the payments.  Most teens who try to save that amount will fall short because they spend their money on other items before they accumulate the 25%.
  7. It is better for a teenager to work as he becomes older. It is usually best not to simply buy your son anything he wants, because he will not appreciate the cost involved in acquiring such possessions and he will have a large shock when he is living on his own.
  8. Have prearranged times to evaluate the job your teenager is about to take. These discussions should occur at 6 weeks, 3 months, 6 months, and 1 year. Topics for discussion ought  to include: Does he feel a lot of stress because of the job? Have her grades fallen?  Has his time and quality of interaction with family members decreased? Should she decrease the amount of time she is working? Does he feel like he has taken on too much adult-like responsibility too fast? Is she tired all the time? Is he falling asleep at dinner time or while watching a movie with the family? Is she becoming sick more often because of being "rundown" due to the time put in on her job? Is his boss overbearing and difficult? What other positives or negatives have you and your teenager observed about her job?

 

HYGIENE CHANGES AT PUBERTY
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Between the ages of 9 and 11 years, children begin undergoing the changes of puberty including rapid growth and a change in hygienic needs. As they go through these body changes, one of the first changes that parents notice is that their child begins to have a body odor. As their hormones change the type of sweat produced in the armpits and genital area in particular, a small amount of exercise will cause a significant odor. Your child may be unaware of his body odor and needs to be told to shower when his odor is strong.

Along with the change in sweat patterns come two associated problems. The first problem is an increase in oil production in her face, back, and buttocks that can lead to acne in those areas of her body. Acne is a direct result of bacteria in the skin consuming oils in the skin producing irritating by-products that produce the typical red, tender areas and pimples. The second problem is an increase in low-grade staphlococcal infections of his skin particularly in oily areas. These occur because he is not cleaning up enough especially after gym class or other exercise. It is especially common in team sports like football where minor cuts and contact between players leads to spread of infection and invasion of bacteria under his skin.

Treatment of These New Hygiene Problems:

  1. Make sure that she is aware of these changes in the hygienic needs of her body.
  2. Make sure that he showers or bathes every other day with soap and water. Rinsing off alone is not enough.
  3. Emphasize these hygienic needs even more if she plays on team sports such as volleyball, track, or softball.
  4. He may begin using deodorant if he wants or needs it.
  5. She needs to wash especially well under the arms, genital area, and buttocks.
  6. Acne is genetically determined and does not depend on good washing or eating a wholesome diet.
  7. If his acne is becoming worse and he appears to be developing cystic acne (tender  lumps under his skin), then he needs to be brought to your doctor.
  8. If she seems to be developing blisters or scabs on some area of her body, she needs to go to her doctor.
  9. It is not necessary to shower every day as this will wash away the natural oils of the skin. According to dermatologists, it is best for him (and yourself) to wash every other day and clean under his arms and in his genital areas with soap and water on the non-shower days.
  10. Do not embarrass her concerning her body odor; merely inform her that she needs to take a shower soon.

 

 

The information contained within this website is no substitution for timely medical care.

Feel free to copy the information on this web site and give to friends and family. Contact Dr. Glenn Wood at
Carousel Pediatrics (512) 744-6000 We are located at 7112 Ed Bluestein Blvd., #100 - Austin, TX 78723

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