The boy in the picture is Quinn, an 18 month-old boy with autism. He is shown obsessively stacking cans. While repetitive behavior like this is a common symptom of autism, there are other signs of the disease that appear earlier.

The Earliest Signs of Autism

According are recent article in the journal of the American Academy of Family Physician (AAFP) titled, Primary Care for Children With Autism, the earliest signs of autism in children is the delayed attainment of social skill milestones. Here are some of the diagnostic criteria offered by the AAFP for physicians.

• a. Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
• b. Failure to develop peer relationships appropriate to developmental level
• c. A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
• d. Lack of social or emotional reciprocity

Language impairment is a common, but less specific, sign of autism. Repetitive behaviors and restricted interests may not be noted until after social skill and communication impairments are exhibited. Physicians should perform developmental surveillance at all well-child visits, and the American Academy of Pediatrics recommends administering an autism-specific screening tool at the 18- and 24-month visits.

The goals of long-term management are to maximize functional independence and community engagement, minimize maladaptive behaviors, and provide family and caregiver support. Physicians play an important role in coordinating care through an interdisciplinary team; referring families for specialized services; and treating children's associated conditions, including sleep disturbances, gastrointestinal problems, anxiety, and hyperactivity. Autism is a lifelong condition, but early recognition, diagnosis, and treatment can improve the prognosis, whereas associated medical conditions, psychiatric conditions, and intellectual disability can worsen the prognosis.

Perhaps no single parenting trend more clearly defines the current generation of parents than the widespread elimination of spanking as a tool to decrease unacceptable behavior and to promote positive behavior. Science is proving them right. "The best kept secret of American child psychology is that kids who are not spanked are the best behaved and do the best in life,"says sociologist Murray A. Straus, PhD of the University of New Hampshire, "You won't find that in a single child development textbook, but it is true." Dr. Straus, has studied the impact of corporal punishment on child development for decades. He is a vocal opponent of the practice.

Spanking Linked to Lower IQs

While numerous studies have linked physical punishment to aggressive behavior, far fewer have examined the impact of spanking on intelligence. Dr. Straus of the University of Hew Hampshire and colleague Mallie J. Paschall, PhD, of the Pacific Institute for Research and Evaluation analyzed data from 806 children who were 2 to 4 years old at enrollment and 704 children between the ages of 5 and 9. The children were tested for intelligence when they entered the trials and again four years later. Even after accounting for factors that could influence IQ scores, such as parental education and socioeconomic status, spanking appeared to have a negative impact on intelligence. The IQs of the younger children who were spanked were 5 points lower on average four years later than those of children of the same age who were not spanked. Scores among the older children were an average of 2.8 points lower among spanked children than children who were not spanked. While these differences are small they are statistically significant.

Second Study Links Spanking to Lower Mental Development

At Duke University, research scientist Lisa J. Berlin, PhD, and colleagues also linked early spanking to reduced intelligence in one of the most rigorously designed studies to ever address the issue. The researchers questioned 2,500 racially diverse, low-income moms about their use of spanking as a discipline tool for their toddlers. They found that children who were spanked at age 1 were more aggressive than those who weren't by age 2 and they scored lower on tests to assess mental development at age 3. "The research as a whole really paints a picture of the detrimental long-term effects of physical punishment," Dr. Berlin says. "The message to parents is find other ways to discipline your children."

Other Negative Effects of Spanking

A 2002 analysis of 88 spanking studies spanning six decades linked spanking to 10 negative behaviors including aggression, anti-social behavior, and mental health issues. More than 90% of the studies found spanking to be detrimental, says developmental psychologist Elizabeth Gershoff, PhD, who conducted the analysis. "Parents spank to decrease bad behavior in the short and long term and to promote positive behavior," says Dr. Gershoff. "What the research tells us is that spanking doesn't seem to be doing either of these things."

Critics Still Doubt the Research Results

But critics say that research is highly suspect because it has largely been conducted by investigators like Straus, Berlin, and Gershoff who strongly oppose the practice. In addition, the studies are often criticized for lacking scientific rigor -- a charge Gershoff acknowledges is hard to counter. "We can't very well do experiments in which we tell some parents to spank their children and others not too," she says. Straus likens the criticism to that leveled at the early studies linking smoking to lung cancer. "For years the tobacco industry was able to destroy the studies one by one because they all had problems," he says. "No single study was truly definitive. But in the end the Surgeon General concluded that the evidence as a whole just couldn't be denied."

Many of our age old beliefs about children's health have been shown to be untrue, but because we have heard them all of our lives, we continue to repeat these myths. Our children will benefit if we recognize these myths and don't pass them on to future generations.

1. No sugar. It makes you hyperactive.
Sugar will not make your child hyperactive. What made your son bounce off the walls at the Halloween party then? Probably the party itself - with the added excitement and attention drawn by the child's acting out. Numerous studies have failed to find a relationship between sugar intake and hyperactivity. There are lots of good reasons for your child to cut back on sugar, but less sugar intake will not necessarily make your child calmer.

2. Stop slouching. You'll get scoliosis.
Good posture will not prevent scoliosis. About 2 out of 100 children under the age of 16, (girls more than boys) are afflicted with scoliosis or curvature of the spine. In most cases, science provides no proven answers as to causes, but doctors do know that slouching is not a cause. Make sure your child gets plenty of calcium and vitamin D to help protect her from bone problems.

3. Put on your coat or you'll catch a cold.
Colds are caused by viruses. Colds are not caused by playing outside without a coat or going outside with wet hair. Feeling cold does not cause a cold. Usually, your child catches a cold from someone else who has a cold. Kids frequently get colds at school and more frequently in winter because they are inside more. It's also proven that if your child is tired, stressed, or poorly nourished, she will be more susceptible to catching a cold.

4. It's OK, you're no longer contagious.
It is generally believed that colds are no longer contagious after symptoms appear. Not true. Colds spread most easily when symptoms are at their worst. The likelihood of catching (or passing) the virus peaks when kids are most miserable. This is because coughs and sneezes spray the air around them with virus-laden droplets. Even though your child may be almost over his cold, he can still pass on the virus if a runny nose persists. Keep your child away from other children until all symptoms are gone. His teacher and other moms will appreciate it.

5. This antibiotic will make you get well quicker.
Antibiotics won't help your child recover any faster. Most colds take 7 to 10 days for symptoms to go away. Remember, common colds and stomach flu illnesses are caused by viruses. Antibiotics are used in treating bacteria. Your body builds immunity to antibiotics, so using this powerful medicine when it's not necessary can make it more difficult to treat serious bacterial infections in the future.

6. Mommy can't kiss you, because she has a cold.
It's actually difficult to spread a cold by kissing. (We're not talking about French kissing here.) Saliva in and around the mouth contains very little cold virus. A peck on the lips, probably won't hurt. It is sneezes and coughs, both laden with viral droplets from deep in your airway, that transmit colds and flu. Washing your hands, is the best way to keep your child from catching your cold.

Raising young children is probably more art than science. While you may or may not have been blessed with the innate ability to be a great parent, you can learn good parenting skills. Realize that life as a toddler can be very frustrating. They can't get what they want on their own and when they can't do it themselves, they may communicate their frustration by throwing a tantrum or other misbehavior.

Here are 5 keys to getting good behavior from your toddlers.

1. Head off tantrums before they begin

• If a tantrum breaks out, stay calm and try to distract your child. Don't worry about minor eruptions, but if your child is hitting, kicking, and screaming. You have to hold him or her close to you or if that doesn't work, try a short period of alone time (for the child that is).


• Recognize and avoid tantrum triggers. You should know if your child more often than not has tantrums in a certain setting, Avoid that place or situation if possible. If it's necessary to take her to a stressful situation, make sure she's not tired or hungry.


• Use a Mister Rogers voice - kind, soft, friendly - when you ask your child to do something. Use please and thank you a lot. "Taylor, please put the knife down... Thank you"


• Stay calm when you hear, "No". It may sound defiant to you, but it's just another word to your child if you don't overreact.


• Don't say, "No" to you child very often. Pick your battles.


• Make sure your child understands what you are asking of her. It may be crystal clear to you, but may be confused.


• Let your child choose frequently. It teaches independence. "Which shoes would you like to wear this morning?


• Don't bargain. Don't make deals like, "If you stop screaming, we'll go to MacDonalds for lunch." You'll just be teaching your child to behave only when he's being rewarded.


• Make a game out of good behavior. He'll be more likely to do what you want if you make it fun.


• Establish a daily schedule and stick to it. Your child likes to know what to expect.

When your child breaks the rules, she needs to know what the consequences are and you need to be completely committed to enforcing the consequences. Dad and Mom, and Nanny all have to be on the same page. Rules must be enforced and consequences meted out uniformly. This reduces your child's confusion and need to test the rules.

Here are some ideas that will help.

• Make consequences logical. "If you don't put your train set away right now, you won't be able to play with it tomorrow. Taking away the use of the toy connected to the misbehavior is a logical consequence.


• Let your child experience the consequences of his actions naturally as long as he is not endangered. If he breaks a toy, he won't be able to play with it any more.


• Timeout. If after a warning, your child continues to misbehave, lead your child to a designated timeout spot. Make it short - 2 to 5 minutes for young children. If your child resists, hold him or her by the shoulders until time out is over.

With very young children, protect your child from harm with a few simple rules. You will add rules as needed, but watch for signs of confusion and frustration from your child indicating that you're expecting too much of them.

4. Accept Your Child

Your child will develop a unique personality, a complex package of genetic and learned traits. You may not like your child's personality because he or she is not like you or too much like you. Perhaps you'd prefer to have a more athletic son or a more outgoing daughter. Stop it. Accept your child. If they feel unaccepted, they will be more likely to behave badly.

5. Do It With Love

Show your child that you love him or her. Your child must feel that your love far outweighs any punishment or consequences. Reassure them of your love with frequent hugs and kisses. Praise them when they follow the rules. It will motivate them to more frequent good behavior.

Consumers with a pressing need to validate the paternity of a child can now buy a DNA Collection Kit offered by a Utah-based genetics company called Identigene. Available over the counter at Rite-Aid stores in 30 states. You pay $22.99 for the kit and another $119 processing fee for the results. The kit has swabs to collect cell samples from the inner cheek of the child and the "alleged" father and consent forms. You get the results in the mail in 3 to 5 business days.

Ethical concerns are plenty. Will samples be collected without consent while the alleged father sleeps? What if the samples are used to determine genetic conditions or diseases? What if mistakes are made?

According to Identigene the test is 99.9% accurate, but is not legally binding because there is no verification that the samples are from the people listed on the forms sent to the lab. Identigene offers a legally valid test that costs $350 where consumers go to a collection site that oversees sample collection and identity verification.

Where's the market? 60% of kit purchases were made by women. Most people purchasing the kits were in their 20s. No surprises there.

If you have a child, you know all too well how often they have upper-respiratory tract and sinus infections. According to recently published studies, commercially available sinus and cold medications are ineffective at best and in some cases even dangerous for use by children.

For treatment of cold symptoms, try using a nasal wash solution made from processed seawater. It can also prevent respiratory infection from coming back.

During the study, 390 children were tested over a period of 6 weeks. The noses of the children in the nasal saline solution group were less stuffy and runny. During the prevention phase, the children in the saline solution group had substantially fewer sore throats, nasal obstructions/secretions, and coughs compared to the children in the standard treatment group who did not receive the saline solution.

The researchers also found that during the prevention phase fewer of the saline group children were using fever-reducing drugs (9% vs. 33%), nasal decongestants (5% vs. 47%), mucus-dissolving medications (10% vs. 37%) or antibiotics (6% vs. 21%). Those in the saline group also experienced fewer days of illness and complications during the same period.

Available nasal wash products include Ocean Premium Saline Nasal Spray and SinuCleanse.

U.S.News Magazine has just published their expanded and improved 2007 list of the best Children's Hospitals in the United States. Parents now have better tools with these new rankings of pediatric hospitals. It can come down to life vs. death. The best hospitals have greater ability to treat kids successfully and send them home.

The Honor Roll

Children's Hospital (Denver)
Children's Hospital Boston
Childrens Hospital Los Angeles
Children's Hospital of Philadelphia
Children's Medical Center (Dallas)
Cincinnati Children's Hospital Medical Center
Johns Hopkins Children's Center (Baltimore)
New York-Presbyterian Morgan Stanley-Komansky Children's Hospital
St. Louis Children's Hospital-Washington University
Texas Children's Hospital (Houston)

Click here for the full article

Children's Health Insurance Programs (CHIP) are state programs supported by federal funds that provide the children (usually up to age 19) of families that fall within published low-income guidelines with health insurance coverage at little or no cost to the child's family. CHIP website

One of the main complaints of families who want to apply is the complex paperwork and long administrative delays. Some even believe that states deliberately increase the red tape to save money.

The state of Texas has more uninsured children than any other state in the U.S. Recently, the state hired and trained expediters to help families complete the enrollment paperwork. Also, the state Legislature recently passed a paperwork simplification bill. Another 100,000 children could enroll, but the governor has not signed it yet.

Thousands of parents believe their kids have peanut allergies and because the allergic reactions can be very serious, they place suffocating limitations on their kids. Some of these families are worrying unnecessarily.

A study* of 84 children who tested positive for peanut allergy on the skin-prick-test showed that a substantial number were found not to be allergic to peanuts when they ate peanuts under medical supervision. The study claimed that the skin-prick-test is not precise or specific enough.

Parents with a child who has tested positive for peanut allergy should consider a "peanut challenge" in a hospital environment. Especially if their child has never had an allergic reaction to peanut before.

* Study published in the journal Pediatric Allergy and Immunology. Dr Anthony Yee, Donna Jelley and Mary Ziegler, Sydney Children's Hospital.

Kids with chronic asthma symptoms should use corticosteroid inhalers daily. Yet Only 20% of kids with persistent asthma keep their symptoms under control. Even with inhalers, many kids had persistent symptoms, primarily because they weren't using inhalers daily. The drugs have to be used consistently. Also many of these kids had to deal with secondhand smoke and other triggers which make asthma worse even with inhalers.

A majority of kids with asthma have triggers in their home. The list includes: a wood burning stove or fireplace, cockroachs, dust mites, mold, and pets.

Controlling a child's asthma is not a simple matter, the parents, the child, and the child's doctors have to coordinate their efforts. Parents must first report the asthma symptoms to a doctor. Next the physician creates an tailored treatment plan, including daily use of an inhaler and perhaps oral meds as well, too. Daily use of these drugs is essential. But taking medicine isn't the end of the job.

Asthma is a dynamic disease. Kids' asthma can change and their triggers change. They need to re-evaluate their treatment plans several times a year.

Hundreds of thousands of toddlers and preschoolers in the U.S. get ear tubes each year, but a landmark study published in the Jan. 18 issue of The New England Journal of Medicine. shows that a most number may not need them for the purpose of avoiding future developmental problems.

Ear tubes are prescribed for fluid buildup, by itself is usually not painful, but it does affect hearing in the short term. The thinking has been that these early hearing problems could lead to long-term language and developmental impairment.

Early treatment with tubes was not shown to improve developmental outcomes, as measured by a battery of tests conducted throughout the children's lives, up to ages 9 to 11. The tests included checks of reading, spelling, writing, behavioral issues, social skills, and intelligence.

The report does not address the usefulness of tubes for the treatment of kids with repeated, painful ear infections. But it does show that tubes may not be an appropriate option for children who simply have persistent middle-ear fluid.

SOURCES: Paradise, J.L. The New England Journal of Medicine, Jan. 18, 2007; vol 356: pp 248-261. Jack L. Paradise, MD, professor emeritus, University of Pittsburgh. Stephen Berman, MD, pediatrician, Children's Hospital, Denver; professor of pediatrics, University of Colorado School of Medicine.

The Texas Legislature will consider two bills that would require girls entering the sixth grade to receive the human papillomavirus vaccine Gardasil - shown in clinical trials to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases.

The FDA approved the vaccine in July 2006 for sale and marketing to girls and women ages nine to 26, and the CDC voted unanimously to recommend that girls ages 11 and 12 receive the vaccine.