There is always a sense of anxiety, whenever we tend to start off with something new, as people are resistant to change. It is more so in the case of young children. School refusal refers to the refusal of children to attend school as a result of emotional distress. This school refusal can wreak a kind of havoc on families.

Elaborate on symptoms a little more and causes

Symptoms

There are certain symptoms related to the refusal of children to attend schools. They include:

Often it comes in the form of tantrums
Frequent complaints of stomachaches, vomiting, nausea, exhaustion, headaches or diarrhea
There could be loud meltdowns in an overwhelming manner, which include their refusal to leave the house, running down the street to avoid getting inside the car or on the school bus
Children might even become aggressive and lash out at their parents with physical blows
Child feeling fearful of being alone in a room or dark


Causes

Some of the primary causes include:

It arises out of students having a feeling of separation from their parents and homely atmosphere, hence, leading to anxiety
It comes out of an emotional attachment which children tend to have with their parents, especially mothers
Children tend to feel scared with the thought of getting into an unknown atmosphere all of a sudden.
Consistent fear of criticism, ridiculing, confrontation or punishment by the teacher or any other person in the school
Having learning difficulties
Being afraid of qualifying the tests
Not feeling comfortable with school activities like singing, playing or attending school assembly
Fear of being ridiculed due to appearance, clothes, weight, etc.
Fear of being bullied by a class or schoolmate
How Can Children be Helped to Get Rid of this Problem?

The ideal treatment to help all those children struggling with school refusal includes a team approach. It will be beneficial to have a strong team which includes the class teacher, family and if possible, a mental health professionals. The steps include:

1. Assess: The very first step is to complete medical and psychological examination. Given the fact that school refusal is usually linked to an underlying anxiety or depressive disorder, it is necessary to get to the root of the problem and begin there. This would include both family and teacher questionnaires for interviews.

2. Cognitive Behavioral Therapy: This is a very structured form of therapy, which helps children to identify their maladaptive patterns of thought and also learn replacement behaviours. It would help children to confront and work through their anxiety.

3. Desensitization in a Systematic Manner: Those children who struggle with school refusal, need a graded approach to return to school. They can return for a some increased amount of time and then gradually build upon it.

4. Training for Relaxation: This is extremely essential for all those children who struggle with anxiety. Some of the relaxation strategies include deep breathing, guided imagery and mindfulness, which kids practice at home and also utilize in school.

5. Plan for Re-entry: The treatment team even creates a plan to help children re-enter the classroom. The plan includes contingencies to help the student during anxious moments throughout the day.

6. Routine and Structure: Children who are anxious can even benefit from routines at home that are predictable. Establishing healthy sleeping habits and a regular sleep cycle during holidays and on weekends can yield positive results.

School Refusal - Symptoms, Causes & Treatments Of It!

Bedwetting or nocturnal enuresis, refers to the unintentional passage of urine during sleep. Enuresis is the medical term for wetting, whether in the clothing during the day or in bed at night. Another name for enuresis is urinary incontinence. For infants and young children, urination is involuntary. Wetting is normal for them. Most children achieve some degree of bladder control by 4 years of age. Daytime control is usually achieved first, while nighttime control comes later.

The age at which bladder control is expected varies considerably. Some parents expect dryness at a very early age, while others not until much later. Such a time line may reflect the culture and attitudes of the parents and caregivers.

Factors that affect the age at which wetting is considered a problem include the following:

The child's gender: Bedwetting is more common in boys.
The child's development and maturity
The child's overall physical and emotional health. Chronic illness and/or emotional and physical abuse may predispose to bedwetting.
Causes

No one knows for sure what causes bed-wetting, but various factors may play a role:

A small bladder: Your child's bladder may not be developed enough to hold urine produced during the night.
Inability to recognize a full bladder: If the nerves that control the bladder are slow to mature, a full bladder may not wake your child, especially if your child is a deep sleeper.
A hormone imbalance: During childhood, some kids don't produce enough anti-diuretic hormone (ADH) to slow nighttime urine production.
Stress: Stressful events, such as becoming a big brother or sister, starting a new school, or sleeping away from home, may trigger bed-wetting.
Urinary tract infection: This infection can make it difficult for your child to control urination.
Sleep apnea: Sometimes bed-wetting is a sign of obstructive sleep apnea, a condition in which the child's breathing is interrupted during sleep.
Diabetes: For a child who's usually dry at night, bed-wetting may be the first sign of diabetes.
A structural problem in the urinary tract or nervous system. Rarely, bed-wetting is related to a defect in the child's neurological system or urinary system.

Symptoms

Wetting during the day
Frequency, urgency, or burning on urination
Straining, dribbling, or other unusual symptoms with urination
Cloudy or pinkish urine, or blood stains on underpants or pajamas
Soiling, being unable to control bowel movements
Constipation
Most kids are fully toilet trained by age 5, but there's really no target date for developing complete bladder control. Between the ages of 5 and 7, bed-wetting remains a problem for some children. After 7 years of age, a small number of children still wet the bed.

When to see a doctor: Most children outgrow bed-wetting on their own, but some need a little help. In other cases, bed-wetting may be a sign of an underlying condition that needs medical attention.

Consult your child's doctor if: 

Your child still wets the bed after age 7
Your child starts to wet the bed after a few months or more of being dry at night
Bed-wetting is accompanied by painful urination, unusual thirst, pink or red urine, hard stools, or snoring
Self-Care at Home-
Here are some tips for helping your child stop wetting the bed. These are techniques that are most often successful

Reduce evening fluid intake.
The child should urinate in the toilet before bedtime.
A system of sticker charts and rewards works for some children.
Make sure the child has safe and easy access to the toilet.
Some believe that you should avoid using diapers or pull-ups at home because they can interfere with the motivation to wake up and use the toilet.

Bedwetting - 7 Possible Reasons Behind It

Best Way To Treat Fever In Children

Let us imagine a scenario: It is 4 in the morning. You are fast asleep and suddenly you hear the discomforting cries of your child. You sense that something is wrong and you immediately rush to the other room. As soon as you touch him, you realize that the child's body is burning up like a furnace? You immediately rush to get your thermometer and the figures on it do not make for a good reading - 102 degrees F. Panic dulls your response rate. Your first reaction is to call the doctor. It might be the right thing to do in some rare cases, but in most cases experts advise differently.

Stay Calm

The most important thing is for you to stay calm and relax and realize that it is still well within your hand to take care of the child. First things first, fever is not your enemy. Rather, it is body's way of telling you that your immune system is fighting alien elements in your body. Children of the age group 0 to 3 almost always face high temperatures at some point in their nascent lives.

The Need of the Hour

How you should go about it depends on your child's age and thermometer's readings. If your child is a newborn or is less than 3 months old and reading is above 100.4 degrees, then you must call the doctor at once.

Between 3 to 6 months, temperature threshold is 101 degrees F, while 103 degrees F is usually the limit for children older than 6 months. But, if the child is showing alarming symptoms such as body ache, fatigue, and diarrhoea, along with the high temperature of 101 degrees F or 102 degrees F, then you should consider calling the doctor on a priority basis.

Take the Hints - Be Wary of the Symptoms

Keeping an eye out on the symptoms is extremely important. If your child has a running nose and low-grade fever (99-100 degrees F), then he might be suffering from a bout of common cold. Vomiting and diarrhoea usually indicate stomach virus. For children with weak immune system or at higher risk than others, it is advisable to consult a doctor.

A 24 hours rest is generally advised in flu, till the patient is fever free without taking any antibiotics. Ailments like an earache, sore throat or discomfort in peeing should be brought to the notice of doctor as it might indicate soar throat, UTI or ear infection, all of which require antibiotic treatments. Certain signs warrant an immediate medical attention. Discomfort in breathing along with constant crying, difficulty in walking, unusual rashes and purple looking spots demand that he be taken to the E.R. right away.

The most important thing is to complete the treatment course diligently and let the fever run its course as it may actually aid the body in building immunity against the fever causing germs and fight them. One must remember that being calm and relaxed at taxing times go a long way in helping you take right decisions and treating fever in children is all about patience and right decisions.

Best Way To Treat Fever In Children

The appendix is a small, finger-shaped pouch attached to the large intestine in the right belly area. It is a vestigial organ as it has no specific role to play in humans, but the organ is still seen, though in a very small size compared to the earlier living beings in the evolutionary chain. Acutely inflamed appendix is the most common cause leading to it removal, often seen in the ages of 10 to 19.

Causes: the appendix gets infected by two main reasons - general infection in the abdomen that reaches the appendix or blockage of the appendix leading to inflammation and swelling within it. The appendix is a blind pouch, and there is a good chance for its blockage from food particles, lymphatic tissue, or even sometimes feces. Some of the potential risk factors for appendicitis include a diet low in fiber, high in sugar, gut flora, and family history.

Symptoms/diagnosis: in adults, the appendicitis has very characteristic symptoms including acute pain in the right upper part of the belly associated with fever and vomiting. However, in children, the pain may not be as tell-tale a sign but is still quite diagnostic of appendicitis. However, presence of the following symptoms together is surely indicative of appendicitis.
1. Right abdominal pain, especially rebound tenderness, where pressure placed in the right upper part of the belly and released leads to excruciating pain.
2. Fever, nausea, and vomiting
3. Abdominal fullness or bloating
4. Elevated white blood count (as with most infections)
Additionally, the younger the child, the symptoms are not very clear, but ultrasound will confirm the diagnosis. The inflamed, enlarged appendix will be visible on the images and could be surrounded by free fluid. Ct scan also can be considered if required to confirm the diagnosis.

Treatment: as noted above, children present with symptoms that do not pinpoint to appendicitis. Treatment usually takes two routes:

If diagnosed as appendicitis before rupture, then surgical removal is the best method to contain its symptoms. Other symptoms like fever and nausea and vomiting usually subside a couple of days after the surgery.
If the appendicitis goes unnoticed and ruptures, then the intestinal cavity can get infected, which is called peritonitis. Earlier, the preferred approach was to control the infection and then go for removal. However, lately, removing the appendix followed by antibiotics to control the infection is the preferred approach.
The prognosis and recovery from appendicitis is very good. Deaths have occurred only in very small infants, where they are not able to pinpoint the area and therefore it can go undiagnosed, leading to rupture and subsequent death.

Early identification is the key to proper identification, immediate treatment, and complete recovery from appendicitis.

Appendicitis in Children

Hearing loss is not something limited to elderly men or elderly women only. This is something that can affect any adult at any stage of life. The good news is that it can be managed. Today, there are a number of hearing aids that can help improve hearing ability. These aids allow an individual who has lost part of his or her hearing to live a normal life. For best results, hearing loss should be arrested in its early stages.

Here are a few signs you should look out for.

Muffled Speech: When you hear people talk, their speech should be clearly identifiable. If you hear muffled noises that you have to interpret as words, it could be a sign of hearing loss.
Difficulty understanding words: The human ear has the ability to separate conversational sounds from ambient noise. However, in some cases where the inner ear is damaged, a person might find it difficult to separate the two. In such cases, the person might not be able to understand words clearly as they get confused with background noise. This is a sign that must never be taken lightly.
Feeling the need to ask people to repeat themselves: Once in a while if you find yourself asking another person to repeat what he or she said, there is nothing to worry. However, if this becomes a regular occurrence and happens with many people, then the fault lies in your hearing. Thus, if you notice yourself needing to ask people to repeat themselves or talk slowly, consult a hearing specialist.
Increasing the volume of the radio or television: As children, we are taught that playing music or watching TV at a very high volume can damage the ears. The radio, television and other such appliances should be played at a volume where the information being relayed is clearly audible and people can have a conversation alongside without needing to shout. If you find yourself having to increase the volume constantly, it could be a sign of hearing loss.
Withdrawing from conversations: As hearing loss is aggravated, people begin to feel conscious of having to ask others around them to repeat themselves or talk slowly. This can make them withdraw from a conversation and other social situations. In many cases, the simple reason for avoiding a party could be the discomfort of not being able to hear the other person clearly in a conversation.
 All hearing problems can be better handled by proper investigation, different test, sign and symptoms of the patient, which are carried by a specialist of hearing, called as AUDIOLOGIST, who can look your hearing problems, plan out treatment plan, rehabilitation pre and post etc. Audiologist will definitely help you hear again. 

Common Signs Of Hearing Problems In Adults!

You may find out that your child is suffering from hearing loss when he is born or he may be diagnosed with the condition later in life. Hearing loss in children is commonly caused by otitis media, birth problems and on the account of certain injuries or illnesses.

Signs and symptoms

The early-stage symptoms of hearing loss in children are as follows:

No reaction to extremely loud noises

No response or reaction to your voice

The child makes some sounds, which taper off

The other symptoms which follow include:

He may pull and rub his ears.

He may act cranky constantly without any proper reason.

He might stop paying attention.

Low energy levels are indicated.

He may find it hard to follow directions.

He may ask you to increase the volume of the radio or TV.

Fever and ear pain are also likely symptoms.

Treatment

Early hearing loss can affect a child s language learning skills. If the problem is diagnosed and treated soon, the problem with language can be avoided. The method of treatment depends on the cause of hearing loss in your child and the severity of hearing loss.

There are certain medicines for hearing---prescribed by your ENT Surgeon. Please take the point watchful waiting. Even, if you have the slightest doubt of hearing loss contact ENT immediately.

The primary treatment methods of hearing loss in children include the following:

Watchful waiting: Sometimes, the condition may resolve on its own and the treatment involves simple monitoring of your child for positive changes.

Medicines: There are certain medicines for hearing loss in children, which may be prescribed by your pediatrician.

Ear tubes: Ear tubes may be recommended if medicines and monitoring do not work. The tubes allow fluid to drain and help in preventing infections. A minor surgery has to be undertaken on your child for getting the ear tubes placed. This will solve hearing loss and other related issues.

Hearing aids: Hearing aids may be used to allow your child to hear better. It is safe for children to use ear tubes after the age of one month. For the right hearing aid for your child, you need to consult a hearing specialist.

Implants: Cochlear implants are used to treat hearing loss in many children. These are electronic devices that are put in the inner ear to benefit hearing. These should be used only if hearing aids did not succeed and these are meant to be used only in the case of children with serious hearing problems.

There are several other devices, which can help your child with hearing loss. For suggestions and recommendations, you must take your child to a hearing specialist.

Hearing Loss In Children - Signs And Treatment Of It!

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