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!

Coughing is a common problem of the respiratory tract and often indicates a deeper problem. It can be very irritating and can affect eating habits and socialization. A cough which persists for more than 4 weeks is believed to be chronic in nature. Tuberculosis (TB) is the most common cause of chronic cough in India. TB is an airborne bacterial infection caused by the organism - 'Mycobacterium tuberculosis', that primarily affects the lungs, although other organs and tissues may be involved. Cardinal features are: 

Chronic cough with or without sputum.
Fever more in the night time. 
Poor appetite. 
Unintentional weight loss. 
Read on to know about other common causes of chronic cough and how to manage them.

Allergies: People with allergies usually have a chronic cough, which gets aggravated when exposed to the allergens such as pollen or environmental dust. Staying away from allergen provides relief. Antihistamines are also useful, which most people detected with allergies keep in handy. Inhalers might be required, if there is associated congestion or shortness of breath.
Asthma: This is a very common chronic condition, caused by inflammation and swelling of the lungs, in addition to wheezing and shortness of breath. Asthma patients often suffer from a chronic cough. An asthma attack usually happens during the night or early morning, and is triggered by colds, cigarette smoke, air pollutants or allergens, which can even include certain foods. Most asthmatics usually carry their steroids, inhalers, and bronchodilators, as the onset of attack can be unpredictable.
Bronchitis: This condition of inflammation of the bronchial region is very common among smokers and among the elderly. There is excessive mucus accumulation, which the body tries to clear via coughing. The lungs are weakened and therefore, the coughing is painful.
Gastroesophageal reflux disease (GERD): This is a problem of the digestive system, but regurgitation of food into the airway induces cough. GERD is a chronic issue and so most people also end up with a chronic cough. It is worse with sitting up than with sitting down. Treatment includes H2 blockers to suppress acid production and dietary changes including small, frequent meals and avoiding spicy food items.
Upper airway cough syndrome: There could be multiple problems in the upper airway, which leads to a constant postnasal drip. Here, there is constant dripping of the sputum into the air passage, which can lead to a chronic cough whenever there is impaired air flow. This can be caused by various forms of chronic sinusitis and rhinitis. People diagnosed with this condition usually resort to antihistamines and decongestants for relief.
Other causes: There are a number of other causes as noted below. Smoking, tuberculosis, congestive heart failure, pertussis or whooping cough, foreign body in the airway, cancer in the airway passage, chronic aspiration of foods, etc. can all lead to chronic cough.
The key is to identify the reason that is causing the chronic cough. Most people who are diagnosed are educated to handle it and carry the required medications including steroids, bronchodilators, and inhalers.

Suffering from Chronic Cough - How to Manage it?

It is no longer so surprising to read about alarming air pollution levels in our cities. On more than one occasion, these levels have risen above the danger levels. For some people, this may simply create an annoying fog that makes it difficult to see. For others, it can cause serious health issues. Air pollution is one of the most common reasons for the growing instances of asthma and allergies. Children are most susceptible to such diseases caused by air pollution.

Asthma and Allergies
Asthma can affect children even before their fifth birthday and the condition is characterized by breathlessness caused by a constriction of the airways. While the root cause of asthma is unknown, it is usually seen that asthmatic patients are more sensitive to others to particles in the air such as pollutants, dander, dust, smoke etc. Thus, the airways construct as a reaction to these allergens. Changes in the weather, a sudden cold draft or the flu can also aggravate asthma.

Can you Protect Your Children from Asthma?
Wheezing, panting, finding it difficult to breathe and a persistent cough are some of the signs of asthma. If you notice these symptoms, you must consult a doctor immediately. At home, here are a few things you could do.

Avoid exposing your children to smoke: Do not smoke around your children or allow others to smoke around them. If you cannot give up the habit, wear a smoking jacket when you smoke and take this off before you play with your children. When you ll go out, drive with the windows up so that your child does not inhale exhaust smoke. Set your air conditioner to circulate air within the car itself.
Dust often: Try and keep your home as dust free as possible. Use a wet cloth to clean so that the dust does not fly in the air. Wash all your bed linen once a week. Carpets and rugs should be vacuumed regularly or dusted outside. It may also be a good idea to invest in dust mite impermeable covers for your child s mattress and pillows.
Keep your Pets clean: If you share your home with pets, bathe them once a week and brush them daily. Do not let them climb on to the furniture or your beds. Also, avoid having their toys lie on your beds.
Wear a face mask: Try and time your child s outdoor activities when the pollution levels are low. Buy yourself and your child a face mask that will filter the air they breathe in. These should be worn whenever they play outdoors.
These simple steps could help your child be healthier and can prevent asthma and other such allergic reactions.

Increasing Asthma & Allergy In Children - What Should You Do?

While children can light up your life with joy and laughter, sometimes they can appear to be monsters with their temper tantrums and their stubbornness. Stubborn or obstinate children can be very difficult to deal with and could end up disrupting your life as well. However, there are a few techniques that mental health professionals have suggested that can help you deal with your stubborn and obstinate child. These are mentioned here briefly  

Hear Them Out: It s often the case that children tend to be stubborn or obstinate and start screaming when they think they weren t heard. This makes them feel helpless and thus forces them to bottle up and then take out their frustration by either not doing what you are telling them to do or doing exactly the opposite of that. The best treatment in this scenario is to hear them out and patiently try to resolve their problems.

Ensure They Follow Your Example: If one or both of the parents are extremely stubborn, then this would translate into a stubborn kid as well. Doctors have said that obstinacy is often in the genes. Also, environmental influence is a big deal for them as well. Ensure that you are flexible enough with your partner and the child picks up on it.

Teaching Kids About Give And Take: This is a very important lesson in life as it teaches kids to choose priorities. If you teach your kid to always give, then it sends a message that putting themselves second is the best option. However, if he or she is always fighting to take first priority, it may lead to too many conflicts later. Thus it is best to teach them that it is okay to fight for what is yours but also let others have their way sometimes. This attitude will help them develop a balanced attitude and lessen their obstinacy.

Give Them The Illusion Of Choice: Children are very malleable when it comes to their minds and you can use this trick to do certain things that make them appear they have some control when they actually may not. For example, if they are unwilling to go to sleep, you can say that you cannot make them sleep, but they have to stay in bed. Your child would then automatically fall asleep after some time due to boredom which would end up serving your purpose.

Use Scolding Or The Parent Card As A Last Resort: If any of the techniques mentioned don t work, then you can scold or warn your kid with consequences which may result in capitulation. For example, if you child is not willing to come back and study, then try and stop them from whatever they were doing and make them sit with their books. This lets them know that certain areas you will absolutely not compromise on and they will understand the limits better.

How To Deal With Stubborn Or Obstinate Children?

Infantile spasm is a seizure-related disorder that is witnessed among infants and young children. The average age for getting affected with infantile spasm is four months, but some kids might experience this disorder within a month of the birth. This disease can have a subtle appearance, and as such it is difficult to recognize as a serious condition. While a full seizure in an adult is scary, the one observed among infants can be as little as a minor head drop, along with minor body shakes. This might appear to be that serious, but infantile spasm is more serious as compared to a full body convulsion in adults. Unfortunately, an infant suffering from infantile spasm is at great risk of developmental disability, if the condition is not detected and treated early.

Anticonvulsant Medication:
There are very few medicines that are approved by the FDA for treating infantile spasms. The two medicines that are widely used by doctors include Adrenocorticotropic hormone (ACTH) and Vigabatrin.

ACTH: This is the oldest approved medicine by the FDA that was first discovered in the year 1958. This injection needs to be pushed twice in a day. Children tend to gain weight and feel hungry when this injection is injected.
Vigabatrin: Vigabatrin is very well tolerated by young kids and has a successful track record of treating infantile spasms. Studies have proven that Vigabatrin can tackle tuberous sclerosis and plays an important role in improving developmental outcome.
Second line therapies:

Pyridoxine: Dependency on Pyridoxine as a cause of infantile spasm is very rare. High dosage of oral administration of pyridoxine has fetched good results for patients, who do not suffer from pyridoxine related seizures.
Valproic acid: Valproic acid has the best anecdotal rate of success. However, doctors do not recommend this medicine for kids less than 2 years of age because of possible complications.
Clonazepam: This is one of the earliest non-steroid medicine for the treatment of infantile spasm. Some of the popular medicines used are nitrazepam, benzodiazepines, and clonazepam.
Ketogenic Diet: This is a decade old practice that has come back to popularity again. Studies have shown that ketogenic diet can help 20-35 % patients of infantile spasm to keep the condition under control.
IVIG: High dosage of IVIG has been reported to be very helpful in tackling infantile spasms. The dosage ranges from 100-200 mg/kg/dose ranging for about 2-3 weeks at stretch.
Surgery: The final part of the therapy includes a surgery that removes the abnormal part of the brain. It should only be considered for patients who have not responded to therapies including Vigabatrin and ACTH. It should also be investigated whether the patient has any structural abnormalities of the brain.


Infantile Spasms - How They Can Be Treated?

Iron is an essential nutrient and mineral that is required by adults and children alike. Iron helps move oxygen from the lungs to the rest of the body and helps muscles store and use oxygen. It is especially important for children because it aids development and prevents anaemia. Untreated iron deficiency in children can cause physical and mental delays. It can lead to less healthy red blood cells in the child's blood stream which will cause a delay in the growth of physical and mental faculties.

Risk factors for iron deficiency in children

Infants and children at highest risk of iron deficiency include:

Babies who are born prematurely 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
Children ages 1 to 5 who have been exposed to lead
Adolescent girls also are at higher risk of iron deficiency because their bodies lose iron during menstruation.
Symptoms of iron deficiency anaemia

The signs and symptoms of iron deficiency anaemia in children may include:

Pale skin
Fatigue or weakness
Slow cognitive and social development
Inflammation of the tongue
Difficulty maintaining body temperature
Increased likelihood of infections
Unusual cravings for non-nutritive substances, such as ice, dirt or pure starch
Prevent iron deficiency in children

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. If you don't breast-feed, use iron-fortified infant formula.
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 iron-fortified baby cereal. For older children, good sources of iron include red meat, chicken, fish, beans and dark green leafy vegetables. Between ages 1 and 5, don't allow your child to drink more than 24 ounces (710 milliliters) of milk a day.
Enhance absorption. Vitamin C helps promote the absorption of dietary iron. You can help your child absorb iron by offering foods rich in vitamin C, such as melon, strawberries, 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 a baby older than 4 months and he or she isn't eating two or more servings a day of iron-rich foods, talk to your child's doctor about oral iron supplements.
Make sure that you watch out for the tell tale signs of iron deficiency and take the necessary precautions to avoid the same. If you wish to discuss about any specific child related problem, you can consult a specilized pediatrician and ask a free question.

Iron Deficiency In Children

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