Learning disorders: Know the signs, how to help

Many children who have learning disorders, also known as learning disabilities, struggle for a long time before being diagnosed. This can affect a child's self-esteem and motivation. Understand how to identify signs that might signal learning disorders and what you can do to help your child cope.

What are some common types of learning disorders?

A learning disorder is a disorder that affects a person's ability to acquire and use academic skills, such as reading and calculating. Learning disorders aren't the same as mental or physical disabilities, and don't reflect a child's intelligence. Instead, learning disorders affect a child's ability to complete a task or use certain skills, particularly in school.

The most common learning disorders include:

• Dyslexia. Dyslexia is a learning disorder characterized by difficulty reading, spelling and recalling known words.
• Dyscalculia. Dyscalculia is a learning disorder related to math concepts. Signs include difficulty solving even simple math problems or sequencing information or events.
• Nonverbal learning disability. This learning disorder is characterized by difficulty with nonverbal cues, such as coordination and body language.

Some children might have more than one learning disorder.

What causes learning disorders?

Factors that might influence the development of learning disorders include:

• Genetics. Some learning disorders, such as reading and math disorders, are hereditary.
• Medical conditions. Poor growth in the uterus (severe intrauterine growth restriction), exposure to alcohol or drugs before being born, and low birth weight are risk factors that have been linked with learning disorders. Head injuries might also play a role in the development of learning disorders.
• Environmental exposure. Exposure to high levels of lead has been linked to an increased risk of learning disorders.

What are the signs of learning disorders?

Identifying a learning disorder can be difficult. Your child might have a learning disorder if he or she:

• Experiences a delay in achieving a developmental milestone, while most other aspects of his or her development are normal
• Has difficulty understanding and following instructions
• Has trouble remembering what someone just told him or her
• Lacks coordination in walking, sports or skills such as holding a pencil
• Easily loses or misplaces homework, school books or other items
• Has difficulty understanding the concept of time
• Resists doing homework or activities that involve reading, writing or math, or consistently can't complete homework assignments without significant help
• Acts out or shows defiance, hostility or excessive emotional reactions at school or while doing academic activities, such as homework or reading

Seeking help for learning disorders

Early intervention is essential for a child who has a learning disorder. Learning disorders can snowball. For example, a child who doesn't learn to add in elementary school won't be able to tackle algebra in high school. Children who have learning disorders can experience performance anxiety, depression and low self-esteem — and lose motivation. Some children also might act out in an effort to distract attention from the real issue.

If you or your child's teacher thinks your child might have a learning disorder, consider having him or her evaluated by a child psychologist or neuropsychologist. Many schools also offer tests to identify learning disorders.

First, your child will likely undergo tests to rule out vision or hearing problems or other medical conditions. A psychologist or learning specialist will then use tests, as well as talk with you and your child and look at your child's school history, to determine if your child has a learning disorder. In many cases, further assessment is needed to make a diagnosis.

Keep in mind that some children are naturally slower learners and might need time to develop reading, writing and math skills. Others, however, have disorders that affect their ability to learn.

Treatment options

If your child has a learning disorder, your child's doctor or school might recommend:

• Extra help. A reading specialist, math tutor or other trained professional can teach your child techniques to improve his or her academic skills. Tutors can also teach children organizational and study skills.
• Individualized education program (IEP). Your child's school might develop an IEP for your child to create a plan for how he or she can best learn in school. Find out if your state has legislation regarding IEPs.
• Therapy. Depending on the learning disorder, some children might benefit from therapy. For example, speech therapy can help children who have language disabilities. Occupational therapy might help improve the motor skills of a child who has writing problems.
• Medication. Your child's doctor might recommend medication to lessen the toll of a learning disorder. If your child has depression or severe anxiety, certain medications might help. Talk to your child's doctor about the risks and benefits.
• Complementary and alternative medicine. Some research shows that complementary and alternative treatments, such as music therapy, can benefit children who have learning disorders. Further research is needed, however.

Before your child's treatment begins, you and your child's doctor, teachers or therapists will set goals for your child. If, over time, little progress is made, your child's diagnosis or treatment plans might need to be reconsidered.

While learning disorders can cause long-term problems, there's hope. Early intervention and treatment can fully remediate some learning disorders. Family and teachers can also help children who have persistent difficulties achieve success in school, as well as in other areas of life.

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Cold medicines for kids: What's the risk?

Over-the-counter cough and cold medicines are the best way to help a child who has a cold feel better — right? Think again. Cough and cold medicines aren't recommended for children younger than age 2, and the jury is still out on whether cough and cold medicines are appropriate for older kids. So how can you treat a child's cold? Here's practical advice from Jay L. Hoecker, M.D., an emeritus pediatrics specialist at Mayo Clinic, Rochester, Minn.

What's the concern about cough and cold medicines for kids?

Over-the-counter cough and cold medicines don't effectively treat the underlying cause of a child's cold, and won't cure a child's cold or make it go away any sooner. These medications also have potentially serious side effects, including rapid heart rate and convulsions. The Food and Drug Administration (FDA) discourages use of cough and cold medicines for children younger than age 2.

Are cough and cold medicines a problem for children older than age 2?

FDA experts are studying the safety of cough and cold medicines for children older than age 2. In the meantime, remember that cough and cold medicines won't make a cold go away any sooner — and side effects are still possible. If you give cough or cold medicines to an older child, carefully follow the label directions. Don't give your child two medicines with the same active ingredient, such as an antihistamine, decongestant or pain reliever. Too much of a single ingredient could lead to an accidental overdose.

What about antibiotics?

Antibiotics may be used to combat bacterial infections but have no effect on viruses, which cause colds. If your child has a cold, antibiotics won't help. It's also important to remember that the more your child uses antibiotics, the more likely he or she is to get sick with an antibiotic-resistant infection in the future.

Can any medications help treat the common cold?

An over-the-counter pain reliever — such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) — can reduce a fever and ease the pain of a sore throat or headache. Remember, though, low-grade fevers help fight infection and don't necessarily need treatment.

If you give your child a pain reliever, follow the dosing guidelines carefully. Don't give ibuprofen to a child younger than age 6 months, and don't give aspirin to anyone age 18 or younger. Aspirin has been associated with Reye's syndrome, a rare but potentially fatal illness.

If you want to give your child an herbal or alternative remedy, consult your child's doctor first.

How can I help my child feel better?

There's no cure for the common cold, but you can help your child feel better while he or she is toughing it out. Consider these tips:

• Offer fluids. Liquids such as water, juice and broth can help loosen congestion. Chicken soup — which can have a mild anti-inflammatory effect — is another good choice.
• Encourage coughing. Coughing can help clear mucus from your child's airway.
• Use a suction bulb for a baby or young child. This device draws mucus out of the nose. Squeeze the bulb part of the syringe, gently place the tip inside one nostril and slowly release the bulb.
• Moisten nasal passages. Run a cool-mist humidifier in your child's room. To prevent mold growth, change the water daily and follow the manufacturer's cleaning instructions. Steam from a hot shower may help, too.
• Use saline nasal drops. Over-the-counter saline nasal drops — or saline spray, for an older child — can loosen thick nasal mucus and make it easier for your child to breathe. For babies, follow up with a suction bulb.
• Soothe a sore throat. Ice cream or frozen fruit pops might feel good on a sore throat. Warm or cold beverages sometimes help, too. For an older child, gargling salt water or sucking on a piece of hard candy or a throat lozenge might offer additional relief. Remember that hard candy and lozenges — both choking hazards — aren't appropriate for younger children.
• Encourage rest. Consider keeping your child home from child care, school and other activities.

When should I contact the doctor?

Most colds simply need to run their course — which generally takes about five to seven days. It's important to take your child's signs and symptoms seriously, however. If you suspect something isn't right, consult your child's doctor. It's especially important to seek medical attention if your child:

• Has a high or persistent fever — or is younger than age 3 months and has any fever
• Has trouble drinking
• Isn't urinating as often as usual
• Has trouble breathing
• Has a persistent cough
• Has yellow or green eye discharge
• Has thick, green nasal discharge
• Seems to have ear or sinus pain

What's the best way to prevent the common cold?

For parents and children alike, simple preventive measures can go a long way toward preventing the common cold. To help your child stay healthy:

• Keep it clean. Teach your child to wash his or her hands thoroughly and often. When soap and water aren't available, provide an alcohol-based hand sanitizer or hand wipes. Keep toys and common household surfaces clean, too.
• Cover up. Teach everyone in the household to cough or sneeze into a tissue — and then toss it. If you can't reach a tissue in time, cough or sneeze into the crook of your arm.
• Don't share. Avoid sharing utensils, drinking glasses, washcloths, towels and other items that might harbor germs with anyone who has a cold or fever.
• Steer clear of colds. Avoid close, prolonged contact with anyone who has a cold or other communicable infection.

It's also important for your child to eat a healthy diet, get plenty of sleep and stay current on his or her vaccinations — including a yearly flu vaccine.

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Iron deficiency in children: Prevention tips for parents

Why is iron important for children?

Iron is a nutrient that's essential to your child's growth and development. Iron helps move oxygen from the lungs to the rest of the body and helps muscles store and use oxygen. If your child's diet lacks iron, he or she may develop a condition called iron deficiency. Iron deficiency in children can occur at many levels, from depleted iron stores to anemia — a condition in which blood lacks adequate healthy red blood cells. Red blood cells carry oxygen to the body's tissues, providing energy and giving skin a healthy color. Untreated iron deficiency in children can cause physical and mental delays in areas such as walking and talking.

How much iron do children need?

Babies are born with iron stored in their bodies, but a steady amount of additional iron is needed to fuel a child's growth and development. Here's a guide to iron needs at certain ages:

Age group	Recommended amount of iron a day
7 to 12 months	11 milligrams
1 to 3 years	7 milligrams
4 to 8 years	10 milligrams
9 to 13 years	8 milligrams
14 to 18 years, girls	15 milligrams
14 to 18 years, boys	11 milligrams

What are the risk factors for iron deficiency in children?

Infants and children at highest risk of iron deficiency include:

• Babies who are born prematurely — more than three weeks before their due date — or have a low birth weight
• Babies who drink cow's milk before age 1
• Breast-fed babies who aren't given complementary foods containing iron after age 6 months
• Babies who drink formula that isn't fortified with iron
• Children ages 1 to 5 who drink more than 24 ounces (710 milliliters) of cow's milk, goat's milk or soy milk a day
• Children who have certain health conditions, such as chronic infections or restricted diets

Adolescent girls also are at higher risk of iron deficiency because their bodies lose iron during menstruation.

What are the signs and symptoms of iron deficiency in children?

Too little iron can impair your child's ability to function. However, most signs and symptoms of iron deficiency in children don't appear until iron deficiency anemia occurs. Signs and symptoms of iron deficiency anemia include:

• Fatigue or weakness
• Pale skin
• Poor appetite
• Shortness of breath
• Irritability
• Inflammation of the tongue
• Difficulty maintaining body temperature
• Increased likelihood of infections
• Irregular heartbeat
• Behavioral problems
• Unusual cravings for non-nutritive substances, such as ice, dirt or pure starch

How can iron deficiency in children be prevented?

Take steps to prevent iron deficiency in your child by paying attention to his or her diet. For example:

• Breast-feed or use iron-fortified formula. Breast-feeding until your child is age 1 is recommended. Iron from breast milk is more easily absorbed than is the iron found in formula. If breast-feeding isn't possible, use iron-fortified infant formula. Cow's milk isn't a good source of iron for babies and isn't recommended for children younger than age 1.
• Encourage a balanced diet. When you begin serving your baby solids — typically between ages 4 months and 6 months — feed him or her foods with added iron, such as single-grain, iron-fortified baby cereal. For older children, good sources of iron include egg yolks, red meat, chicken, fish, beans and dark green leafy vegetables. Limit foods that are high in calories and low in vitamins and minerals, such as soda and potato chips.
• Enhance absorption. Vitamin C helps promote the absorption of dietary iron. Although citrus juice isn't generally recommended for children younger than age 1, you can help your child absorb iron by offering other foods rich in vitamin C — such as melon, strawberries, apricots, kiwi, broccoli, tomatoes and potatoes.
• Consider iron supplements. If your baby was born prematurely or with a low birth weight or you're breast-feeding after age 6 months and your baby isn't eating two or more servings a day of iron-rich foods, such as fortified cereal or pureed meat, talk to your child's doctor about oral iron supplements.

Should I have my child screened for iron deficiency?

Iron deficiency and iron deficiency anemia are typically diagnosed through blood tests. Some experts recommend that all infants be screened for iron deficiency anemia starting between ages 9 months and 12 months and again 6 months later. Others recommend screening only infants ages 6 months to 12 months who have an increased risk of developing iron deficiency anemia. Ask your child's doctor about his or her screening recommendations, especially if you're concerned about iron deficiency. Be prepared to provide details about your child's diet. Depending on the circumstances and possible screening results, the doctor might recommend an oral iron supplement or a daily multivitamin.

Iron deficiency in children can be prevented. To keep your child's growth and development on track, pay attention to how much iron your child is getting through his or her diet and talk to your child's doctor about the need for screenings and iron supplements.

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Healthy snacks for kids: 10 child-friendly tips

Snacking is a major pastime for many kids — and that's not necessarily bad. Nutritious snacking can help your child curb hunger throughout the day, as well as provide energy and important nutrients. Find out how to make healthy snacks for kids.

No. 1: Keep junk food out of the house

Your child won't clamor for cookies, candy bars or chips if you don't keep them on hand. Set a good example by choosing healthy snacks yourself.

No. 2: Go for the grain

Whole-grain foods — such as whole-grain pretzels or tortillas and high-fiber, whole-grain cereals — provide energy with some staying power.

No. 3: Mix and match

Serve baby carrots or other raw veggies with fat-free ranch dressing or hummus. Dip graham cracker sticks or fresh fruit in fat-free yogurt. Spread peanut butter on celery, apples or bananas.

No. 4: Broaden the menu

Offer out-of-the-usual fare, such as pineapple, cranberries, red or yellow peppers, mangoes, tangelos or roasted soy nuts.

No. 5: Revisit breakfast

Serve breakfast foods — such as scrambled eggs and whole-grain toast — as healthy snacks for kids in the afternoon.

No. 6: Sweeten it up

Healthy snacks for kids don't have to be bland. To satisfy your child's sweet tooth, offer fat-free pudding, frozen yogurt or frozen fruit bars. Make smoothies with skim milk, fat-free yogurt, and fresh or frozen fruit.

No. 7: Have fun

Use a cookie cutter to make shapes out of low-fat cheese slices, whole-grain bread or whole-grain tortillas. Make fruit kebabs or show your child how to eat diced fruit with chopsticks. Make a tower out of whole-grain crackers, spell words with pretzel sticks, or make funny faces on a plate using different types of fruit.

No. 8: Promote independence

Keep a selection of ready-to-eat veggies in the refrigerator. Leave fresh fruit in a bowl on the counter. Store low-sugar, whole-grain cereal and fruit canned or packaged in its own juice in an easily accessible cabinet.

No. 9: Don't be fooled by labeling gimmicks

Foods marketed as low-fat or fat-free can still be high in calories and sodium. Likewise, foods touted as cholesterol-free can still be high in fat, saturated fat and sugar. Check nutrition labels to find out the whole story.

No. 10: Designate a snacking zone

Restrict snacking to certain areas, such as the kitchen. You'll save your child countless calories from mindless munching in front of the TV. If your child needs to snack on the go, offer string cheese, yogurt sticks, cereal bars, a banana or other drip-free items.

Teaching your child to make healthy snack choices now will help set the stage for a lifetime of healthy eating. Start today!

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Children's nutrition: 10 tips for picky eaters

No. 1: Respect your child's appetite — or lack of one

If your child isn't hungry, don't force a meal or snack. Likewise, don't bribe or force your child to eat certain foods or clean his or her plate. This might only ignite — or reinforce — a power struggle over food. In addition, your child might come to associate mealtime with anxiety and frustration. Serve small portions to avoid overwhelming your child and give him or her the opportunity to independently ask for more.

No. 2: Stick to the routine

Serve meals and snacks at about the same times every day. Provide juice or milk with the food, and offer water between meals and snacks. Allowing your child to fill up on juice or milk throughout the day might decrease his or her appetite for meals.

No. 3: Be patient with new foods

Young children often touch or smell new foods, and may even put tiny bits in their mouths and then take them back out again. Your child might need repeated exposure to a new food before he or she takes the first bite. Encourage your child by talking about a food's color, shape, aroma and texture — not whether it tastes good. Serve new foods along with your child's favorite foods.

No. 4: Make it fun

Serve broccoli and other veggies with a favorite dip or sauce. Cut foods into various shapes with cookie cutters. Offer breakfast foods for dinner. Serve a variety of brightly colored foods.

No. 5: Recruit your child's help

At the grocery store, ask your child to help you select fruits, vegetables and other healthy foods. Don't buy anything that you don't want your child to eat. At home, encourage your child to help you rinse veggies, stir batter or set the table.

No. 6: Set a good example

If you eat a variety of healthy foods, your child is more likely to follow suit.

No. 7: Be creative

Add chopped broccoli or green peppers to spaghetti sauce, top cereal with fruit slices, or mix grated zucchini and carrots into casseroles and soups.

No. 8: Minimize distractions

Turn off the television and other electronic gadgets during meals. This will help your child focus on eating. Keep in mind that television advertising might also encourage your child to desire sugary foods.

No. 9: Don't offer dessert as a reward

Withholding dessert sends the message that dessert is the best food, which might only increase your child's desire for sweets. You might select one or two nights a week as dessert nights, and skip dessert the rest of the week — or redefine dessert as fruit, yogurt or other healthy choices.

No. 10: Don't be a short-order cook

Preparing a separate meal for your child after he or she rejects the original meal might promote picky eating. Encourage your child to stay at the table for the designated mealtime — even if he or she doesn't eat. Keep serving your child healthy choices until they become familiar and preferred.

If you're concerned that picky eating is compromising your child's growth and development, consult your child's doctor. In addition, consider recording the types and amounts of food your child eats for three days. The big picture might help ease your worries. A food log can also help your child's doctor determine any problems. In the meantime, remember that your child's eating habits won't likely change overnight — but the small steps you take each day can help promote a lifetime of healthy eating.

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