Tuesday, April 28, 2009


Autism can be managed with early intervention

The word Autism is something parents with young children dread, especially with recent publicity surrounding the disorder. April is Autism Awareness Month, a good time to learn more about this fairly common condition.

During my daily practice, I come across parents concerned about autism and second guessing the benefits of immunization, thereby exposing their children to many preventable diseases. There have been many controversies and debates about childhood immunizations as the cause, but to date there is no documented evidence that this is true.

Autism is one type of what we call Autism spectrum disorders (ASD’s), which are a group of developmental disabilities caused by a problem with the brain. These disorders affect a child's behavior, social, and communication skills.

Approximately 1 in 150 children are diagnosed with an ASD. ASD’s are lifelong conditions with no known cure. However, children with ASD can progress developmentally and learn new skills. Some children may improve so much that they no longer meet the criteria for ASD, although milder symptoms may often persist.

The scientific community strongly believes in the importance of early and continuous surveillance and screening for ASD to ensure that children are identified and receive access to services as early as possible. The sooner autism is identified, the sooner an intervention program can start.

What are some of the signs of ASD? They can include:

- Having trouble relating to others or not having interest in other people at all.
- Avoiding eye contact
- Lack of emotions or affection towards parents or other siblings
- Repeating actions over and over again. Some may have a routine, which when disturbed may throw a tantrum.
- Having trouble with expressing their needs in words
- Losing skills they once had (for instance, stop saying words they were using).

If you think your child has ASD, talk with your child’s doctor. A pediatrician will review the developmental milestones and after a thorough examination should be able to provide an appropriate course of action. In most situations, the pediatrician would refer you to see a developmental pediatrician or a children’s hospital with a team dedicated to children with developmental disorders.

The cause of ASD’s remains unknown, and there is no cure. Evidence- based treatment for ASD’s is intensive, structured teaching of skills -- often called behavioral intervention. This usually involves a team approach including specialists from many fields, including a developmental pediatrician, speech therapist, occupational therapist, etc…

There are specialized educational centers for children with profound problems. Others can be mainstreamed with extra help. It is very important to begin this intervention as early as possible in order to help your child reach his or her full potential. Acting early can make a real difference.

Ravi Prakash, MD, is a pediatrician on the Backus Hospital Medical Staff with a private practice in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Dr. Prakash and all of the Healthy Living columnists at healthyliving@wwbh.org, or comment on their blog at www.healthydocs.blogspot.com.

Monday, April 20, 2009


Warm weather means its time to think outdoor safety

Although you wouldn’t know it by the current weather, temperatures are predicted to rise close to 80 degrees by week’s end.

Summer fun can’t be far behind, so it’s important that families take safety precautions to avoid the bumps, bruises and ailments that typically accompany the warmer weather.

One way to do this is to attend Backus Hospital’s Safety Camp, to be held Saturday, May 16, 10 a.m. to 1 p.m. in the Backus Hospital Parking lot. Children and parents can learn more about summer safety through games and activities. They will also receive free bicycle helmets that are properly fitted by experts, 911 training, fire safety training, learn about water safety and have the chance to climb aboard LIFE STAR helicopter and numerous fire apparatus. Free food and giveaways will also be available.

If you aren’t able to attend this fun-filled event, here are some warm weather safety tips that will help you as the sun gets stronger and the bugs more prevalent:

Fun in the sun

Sun burn is one of the common problems. Following a few general rules will help prevent some of the nasty sun burns I have seen in my office:

* Avoid exposure to sun and dress infants younger than six months with long pants and long sleeve shirts, cotton of course.
* Keep infants in shade at all times possible and avoid using sun screen. For infants older than six months and young children, use of sunscreen with a minimum Sun Protection Factor (SPF) 15.
* Apply sun screen 30 minutes before going out if possible. Perhaps apply sunscreen before you start your trip to the beach rather than apply just before getting in the water. Remember to apply every two hours while you stay out especially after swimming.
* Be sure to apply enough sunscreen - about one ounce for a young adult.
* Stay in the shade whenever possible, and limit sun exposure during the peak intensity hours - between 10 a.m. and 4 p.m., and do not forget sun glasses.

Keep the bugs out

Another common problem is insect bites, including tick bites. Here are some tips to avoid them:

* Avoid areas where insects nest or congregate, such as stagnant pools of water, uncovered foods and gardens where flowers are in full bloom.
* Avoid using scented soaps, perfumes or hair sprays on your child or yourself.
* Don’t where bright colors, which can attract insects.
* Don’t use a combination sunscreen/insect repellent products, because sun screen needs to be reapplied every two hours, and bug spray should not be reapplied. Choose sprays containing DEET, as it is one of the most effective insect repellent against mosquitoes and ticks. Please note DEET should not be used on children younger than 2 months of age.
* If you are bitten by a tick or bee, gently scrape the tick or the stinger with a credit card or similar object. Start from where the tick buried its head towards the body and not the other way, if you want remove the tick in its entirety. Deer ticks are small and only one in three tick bites are at risk of developing Lyme disease. Always check your children for ticks after you have visited parks or wooded areas.

Ravi Prakash, MD, is a pediatrician on The William Backus Hospital Medical Staff with a private office in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Dr. Prakash and all of the Healthy Living columnists at healthyliving@wwbh.org, or comment on their blog at healthydocs.blogspot.com.

Monday, April 13, 2009


Think "P's" at the grocery store for better health

Grocery shopping is often a task on that lengthy list of errands each week. Stop approaching it as a task and embrace it as an opportunity – and don’t forget the “P’s” (or peas).

You can do this by keeping it in perspective. Perspective is the first “P” to remember when you are dashing out the door on your way to the grocery store, and once you are there the other P’s will fall into place. Your grocery cart will appreciate a wellness tune-up – and so will your family.

Perspective: If you are looking to make changes in the way you eat, start by making changes in the way you think. If you are overwhelmed by all that you would like to change in your meal pattern, start with just one.

If, for example, you’d like to eat more vegetables every day, be specific and set a goal of eating a set amount at lunch every day.

Once you have made veggies a part of you lunch routine every day, then move on to dinner meals. This is the place to pack in the remainder of the vegetable servings you need. Once you get there, you can even sneak in extra veggies as snacks.

Plan your purchases: This two-step process takes place before you even set foot in the grocery store. First plan your meals and second create a shopping list. Planning is key when making healthy changes. Planning saves time, money (cuts down impulse buying) and mental energy later on when you are asking yourself: “What’s for dinner?”

If you need a little help, check out www.fruitsandveggiesmorematters.org. But the simplest method yet is a pencil and paper. Back to our veggie example above: This week add many different veggies to your list. Think ahead of which you’ll incorporate at lunch and which at dinner.

Perimeter is the place to be: The outer edge of the grocery store provides most of the raw materials you’ll need.

Strategic forays into the middle aisles will be required to snag whole grain (breads, rice, and cereals), beans and pantry essentials.

But be sure that take a quick detour around the many traps that may be lurking near the heavily processed and nutritionally void foods.

If a package is smiling back at you – (that cheery cartoon character on that box of “Super Sugar Swindlers”) then pick up the pace and keep moving.

Produce: In order to produce results on your way to wellness you need produce: vegetables and fruits. Consider aiming for a minimum of 5-6 cups of vegetables and fruit daily. This is achievable by including a variety of servings at meals and making these smart choices for snacking. Vary your choices to reel in a rainbow of colors. Choose whole foods over juices.

Place trust in the facts panel and ingredient list: Avoid spending too much time reading commentary on the front of a food package. A fair portion of what you read in the front of a package may be a gimmick to lure you in.

To be a savvy shopper you need to look at the whole picture. Turn the item over and scan the ingredient list. Items are listed in order of appearance (descending order).

Here are a few more “P’s” to keep in mind.

Pick: whole grains (like whole wheat, whole oats, and brown rice) and items with the shortest list of ingredients.

Pass on: hydrogenated oils, sodium nitrate, added sugars (beware of all its forms) and artificial colorings.

Your next tool will be the Nutrition Facts panel. For the ins and outs on label reading download a copy of the FDA’s label reading guide at http://www.cfsan.fda.gov/~acrobat/nutfacts.pdf

Pick a new food: This is where creativity captures your imagination and peaks your curiosity. Choose something out of your comfort zone. Pomegranate, parsnips, pumpkin, peppers, pears, plum or perhaps peas! Peas, humble as they may seem, pack some power. They are members of the legume family and contain some protein along with fiber, folic acid, and vitamins A and C.

One last P: Paper please! Pass on the plastic bags and pick paper or purchase your own reusable grocery satchels.

Now go ahead and shop your way to wellness, and don’t forget your “P’s!”

Renee Frechette is a registered dietitian who serves as the outpatient oncology dietitian in the The William W. Backus Hospital’s Radiation Therapy Center. This column should not replace advice or instruction from your personal physician. E-mail Frechette and all of the Healthy Living columnists at healthyliving@wwbh.org or comment on their blog at www.healthydocs.blogspot.com.

Tuesday, April 07, 2009


All juice is not created equal

It may have happened to you. You are just about to load juice into your grocery cart when the label catches your eye – “contains 7 percent fruit juice.”

Not exactly what you had in mind. This type sugary drink should be avoided at all costs.

Meanwhile, health experts continue to stress that eating more servings of fruits and vegetables is extremely important for good health.

Drinking 100% fruit juice is an easy way to boost your fruit intake. Plus, fruit juices add variety to your diet and taste good, too.

According to the American Dietetic Association and www.eatright.org:

* 100% fruit juices are a valuable source of certain vitamins, minerals and phytonutrients. Research is underway to determine how they actually maintain good health.

* 100% juice can count as a fruit serving. Nutrition recommendations in the 2005 Dietary Guidelines for Americans encourage increased intake of fruits, as well as vegetables, low-fat or fat-free milk and whole grains. Research shows that children who consume 100% juices have overall healthier diets than those who do not consume juices. One-half (4 oz) cup of 100% fruit juice equals 1/2 cup from the fruit group. While most fruit servings should come from whole fruits, a portion of the daily fruit intake can be from 100% fruit juice.

* To determine if a product is 100% juice, the container label must state that it is, usually near the Nutrition Facts panel on the back of the label for individuals above two years of age.

* According to the American Dietetic Association’s Evidence Analysis Library, juice intake is not related to obesity in children unless consumed in unusually large quantities. However, excess calories from any food or beverage can contribute to children and adults becoming overweight. The whole family can enjoy 100% juice as part of a healthy diet.

Despite the benefits of real juice, there are guidelines that should be followed for children. Infants under six months of age should not be given juice at all, and juice should never be fed by bottle to small children.

Additional information is available at www.fruitjuicefacts.org.

Wendy Kane is a registered dietitian and certified diabetes educator in the Backus Hospital Diabetes Management Center. This advice should not replace the advice from your physician. Email Ms. Kane and all the Healthy Living columnists at healthyliving@wwbh.org or comment on their blog at www.healthydocs.blogspot.com.

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