Wellness Topics for Preschoolers/Elementary

Attention Deficit—This is perhaps the most topical, talked about, or suspected condition surrounding upper preschool children and early elementary ages (ages three to six or seven years old). You can read the literature and research on ADD or ADHD non-stop for months on end and you won’t find the definitive causes or the agreed-upon remedies. The current pattern of research is generally focusing on neurological issues, such as the brain’s inability to regulate neurotransmitters. But what causes that? No telling. What’s key is to watch for prolonged and repetitive patterns of disrupted focus or distraction in your children during these years; unresponsiveness to communication from others; lots of fidgeting; difficulty playing quietly and alone. It’s always okay to visit with the pediatrician to discuss these behaviors—your doctor will know how to size up the situation and whether to make a referral to a psychologist, who will then conduct the appropriate testing to determine what’s up. Medication may be in the picture down the road some years, but behavioral strategies should be attempted and exhausted first, before turning to medication.

Backpacks—The problem with overweight and asymmetrically worn backpacks is not just that lower back or dorsal pain is the likely outcome. The dragging around of heavy backpacks throughout the school day, especially when it’s happening in the younger elementary years, is highly problematic when it comes to teaching good student behavior, proper classroom routines, and many other matters related to organization of one’s belongings and schoolwork. This latter point can be a far more pernicious outcome of backpack usage in schools. While I’m a believer in handwriting, real books, and the postponement of daily laptop or iPad usage until the upper elementary or middle school years, there are definitely advantages to a school’s going virtual when delivering their curriculum. Lightening the load on one’s back, the clean organization of material that computer usage allows, and the ease of transition between home and school when not being burdened by backpacks all have to be factored into a school’s decision as to what extent backpacks will be encouraged or accommodated. IMHO: I’m not a fan of backpacks—they collect garbage and chaos; they are a tripping hazard in schools; and they can be injurious.

Biting—As much as it is alarming for many parents to learn that their child may be biting others at the day care center, this behavior is normal and very common in toddlers. Of course this doesn’t mean that it is okay—the point is that parents and caregivers need to respond promptly, firmly, and calmly, with a simple “no biting” command (and not by way of punitive measures such as biting the child in an effort to demonstrate what they are doing to others). Being punitive is the wrong approach. Realize that biting among toddles is a manner of communication, of demonstrating curiosity, of socializing in terms of seeking a response from others. If you issue a too-harsh tone that is punitive, berating or scolding, the child will learn that being mean to others is what is expected. When biting activity persists at age three or four, however, that’s when partnership with school teachers and professionals will be necessary. There could be more complex reasons, even physiological reasons, for the persistent biting—and this can be ferreted out by those in the know.


Soft Drinks and Sodas—As far as what drinks down the colored drink aisle are good for you—forget it. Nothing is on this aisle in the store. The food dyes in most colored drinks have been linked with hyperactivity in numerous studies (though, of course, nothing conclusive—so no labelling to be found on the bottles); the rest of the drinks are jacked with sugar and artificial sweeteners. Even the juices—bypass these, or perhaps dilute them with soda water when you get home. Take a look at the sugar content in orange juice—unbelievably high in sugar, which for young children is just slow-acting brain poison. Skip the happy meals at MacDonald’s and always buy your fast food a la carte (be sure to bring water with you in the car, always). Whole milk is certainly okay, but skim milk and 1%? There is literature out there that kids who drink skim and 1% are heavier than kids who drink milk, and it’s because those “slim” milks are heavily processed. Keep it simple with water as much as you can. Smoothies, too. Birthday parties in other homes will be difficult to manage, but maintain the standards at home and you’ll steer clear of the unfortunate impact those colored drinks have on children.

Fast Foods

—Very difficult here in this marvelous first world of ours keeping your children away from fast foods. Unless you’re a super strict tiger mom, you frequently fumble on this one and thus let loose on the standards of healthy foods that are dear to your heart. While there is no such thing as farm-to-table-fast-food joints serving happy sprouts and wheat grass fries, you can find some healthy options in such places as Panera Bread, Jason’s Deli, Corner Bakery, Chipotle, Einstein Bros. Bagles, and Taco Del Mar. I’m sure there are many more not mentioned here—I’ll be happy to add to this list in a future blog or onto these wellness pages. Here’s the 101 on fast foods: These foods are extremely high in sodium, saturated fat, trans fat, and cholesterol. The list of additives can last pages, but essentially they are just weird chemical stuff thrown in to bolster taste, preserve the food, and to enhance addictiveness. The health consequences are disturbing: mental illnesses, hyperactivity, heart failure vulnerability, cancer risks, and of course there is obesity. Much of the research linking fast foods with these health problems are teting those who partake in fast food just once or twice a week. Get on the health bandwagon when kids are young—dial it down on the fast food activity—and chances are good your children will be less hyperactive, less moody, and more cooperative

Language Disorders—It’s possible these can be detected at a young age—4 or 5. Expressive language disorders refer to problems children have in getting their meaning across to others; whereas receptive language disorders occur when children have trouble understanding when others are communicating with them. There can be any number of causes for these disorders, and when there is no originating cause (such as caused by damage to the central nervous system, or aphasia) they are referred to as developmental language disorders. One thing researchers and specialists do know—language disorders do not reflect lack of intelligence. Be careful not to mix these disorders with “delayed language,” which is basically normally developing language but occurring slower or later than others. The language disorders I’m referring to mean abnormal development of language. If your child is having a hard time understanding others, has difficulty following directions, finds it challenge to organize thoughts, can’t put words into sentences, struggles to find the right word when talking, leaves words out when talking, messes up on verb tenses a lot, or repeats phrases frequently—these are indicators that it is time to see a specialist. When these disorders go un-addressed, the difficulties can mount, including problems with social interaction or poor academic performance.

Oppositional Defiance Disorder—Expect all children, even the best-behaved children, to exhibit mean and angry and defiant behavior toward you and other adult figures like teachers from time to time. But the ODD determination will be clear if such bellicosity persists over time, and it’s happening with no known or obvious trigger. No need to fret when opposition or defiance shows its ugly face once or twice, then dissipates and doesn’t emerge again for many weeks or months. It’s the frequency and the hours-long tantrum that will indicate the seriousness of the condition. Typically, this dark and aggressive tone will show up in the preschool years, although it can emerge later in the elementary school ages. You’ll know when it is happening to a serious degree. That’s when it’s time to check with your pediatrician and/or a pediatric psychiatrist. There will likely be no known cause for ODD behavior, but certainly if there is abuse and a aggressive, punitive tone around the house, the child who exhibits ODD traits is probably echoing the harsh tone in the environment. Still, the vast majority of cases aren’t stemming from such households. The key here is early intervention—when these characteristics are brushed off or just tolerated over time, the condition can be cemented in the psyche of the child, making it difficult to find solutions down the road.

Physical Activity

One of the main brain feeders in a child’s early years is sufficient, and proper, physical activity. The classic image of the kid couch genius—the tubby kid who happens to be gifted and therefore untouchable or unmovable—is neither a cute, nor a precious image to be celebrated or revered. Don’t be suckered by this archetype. Physical activity is crucial for activating the neurons in the brain and for establishing healthy brain growth. Make sure your preschools and elementary schools are taking kids outside to run around and play, every day. Also, when selecting a school, know what playthings and play stations are out in the recess yard—you’ll want to see swings, tire swings, spring riders, tunnels, climbers, bridges, ramps with ropes, trolley sliders, seesaws, and any number of other pieces of play equipment that will exercise and develop balance, core muscles, upper/lower body, and motion stamina just to name a few of the main body activities that will contribute to mind/body coordination and connection. One of the best benefits of physical activity? Following physical activity, and with a teacher who understands how to guide successful transitions back to the classroom, there is a much better chance for moderating stress and anxiety, and even for achieving mindfulness, calmness, stamina, focus—all the attributes necessary for academic success.

Separation Anxiety—This is bound to set in at some point… six months, eight months, maybe later. The best approach is to have caretakers/babysitters handle your child, so that there is some routine to having different people (meaning not always you) nearby to give comfort and assurance. Also, make departures quick and straightforward. Don’t linger or indulge every whimper or crying fit when you are heading out the door by heading back in for another hug. Say goodbye respectfully and lovingly, then leave. The cries will be short-lived, and you will have a better chance at limiting anxiety in your child down the road.

Shaken Baby Syndrome—Lots of literature and sites devoted to this troubling phenomenon of babies being shaken violently. There is a proliferation of support groups, seminars, and resources. There may be all kinds of reasons, disturbing and unfortunate, that adults/parents have the urge to shake their child aggressively or violently, but the impact can be tragic. A baby’s vulnerability to this action stems from head size/weight being disproportionate to the neck at these infant and toddler ages, while their brains are fragile and undeveloped. The force of the shake is more troubling because of the differential in size between the shaker and the baby—a crucial fact that adults prone to this behavior are typically not aware of or don’t care about. However you can intervene on a matter where this type of behavior is taking place, you must do so, and you must report it to the authorities.

SIDS—Sudden Infant Death Syndrome: Read up on this one—the experts don’t have all the answers since so many of these sudden deaths will go unexplained. However, many of the deaths that are explained happen during the nighttime hours, when babies are overly swaddled in blankets or have been sleeping on their stomachs. There are risk factors associated with SIDS, like smoking, drinking, and drug use during pregnancy; low birth weight; and very young (teenage) mothers. When you rule out accidents or unhealthy conditions or abuse, you’re left with few preventable factors associated with sleep, so researching sleep safety is crucial.

Preparing for Sleep-Away Camp—This might seem like no big deal, but getting it right the first time around will pay off big dividends for your child’s confidence, sociability, independence, and sense of worth beyond home and school (an often overlooked aspect of growing healthy children). Having success with that initial sleep-away camp experience is not about getting over the cries and the home-sickness after a few days or a week away from home for the first time. Preparation doesn’t mean eliminating these emotions. Instead, talk through what’s about to happen.  Be up front and sincere about the feelings of being nervous and being away from the comforting routines of home. At the same time, talking up new experience, making new friends, and emphasizing to your child his/her strengths and talents will set the table for success. Don’t forget to talk through exactly what day one and night one will look like and feel like. Don’t take the approach of keeping quiet and just dropping your child off at the bus then accelerating away. Tossing the baby into the deep-end and expecting them to swim is a stupid thing to do. So much better to walk through the camp brochures with your child, well in advance; have your child ask questions—and help them with question-asking; go through the packing with them, item by item. Make it like you are a partner with your child, every step of the way. They will experience appreciation just hours after being dropped off, even though they aren’t mature enough to express appreciation. And finally, don’t obsess over not seeing a photo of your child on the camp social media site, and don’t freak if your child writes a sparse message home, or maybe no message at all—their independence and growth depends as much on your own ability to let go and know that everything is going to be okay.

Kid Safety—According to the website “asecurelife.com,” there is an alarming number of injuries kids suffer right in their own homes every year. The site reports that there are more than 3.4 million injuries suffered at home by kids every year, and that “2,300 children under 15 die from these unintentional injuries.” For the youngest children, drowning is the leading cause of death, and in nearly all cases this happens when the caretaker or parent steps away or is not observing when the child gets near the bathtub or near the swimming pool. Most of the injuries kids suffer can be easily avoided—apart from keeping watch over kids when they are next to or playing in water, the prevention list of bullet points would be dominated by clearing away clutter, on the floors after playtime, on the stairs, and in the hallways. Kids will break into a run in a nanosecond, and before you know it they are scampering straight through all kinds of objects, toys, and even books—those books are a hazard as their glossy hardcovers will slip underneath your toddler’s feet and can mean serious injury to the head, neck, or back. Lots of sites can walk you through a safety checklist, but the sweet and simple here is to be aware of where your kids are, and keep their play area clutter-free, especially when they are not at play, since these are the times when they can race through a mess, as opposed to when they are actively playing, which naturally heightens their awareness of the objects around them.

Social integration—One of the more convincing theories that explains the explosion in the number of young children needing some form of formal social integration therapy may sound paradoxical. The theory says that parents and caretakers should be much more “hands off” with children when they are playing with others, and thus this will allow for a more natural and organic process of healthy social development to take place—in other words, it is precisely this penchant adults and parents have for directing play, or managing children’s play, or manipulating or even scolding them toward “correct” interaction with others, that brings about complications and difficulty with healthy and mutually supportive social integration. The less intervention on the part of parents, the more the child will develop appropriate integration skills. There is much to be said for this natural approach to a child’s development; children can be easily distracted and confused when adults intervene heavy handedly with rewards, punishments, or otherwise aggressively directive language. Children absorb the anxieties in the adults surrounding them, and this is often what can lead to stultifying or frozen responses to social situations that should elicit their empathy, sharing, joyfulness and creativity.

Teeth Health

It may be surprising to know that tooth decay is the most common chronic disease in children. Nearly 20% of children, age 5-17 have tooth decay. Certain foods and the absence of fluoridated water can quickly translate into bacteria breaking through teeth or producing acids that will create cavities. Untreated, cavities can lead to all sorts of learning and functional difficulties. Of course, when they do need to be treated with significant dental work, the anesthesia experience at such an early age, especially if nascent health conditions warrant repeated use of anesthesia, can harm normal brain development in children. Many of the dental care sites for infants and young children will recommend taking a brush to the gums at the time teeth are beginning to push through. These are crucial years to be habitual about proper oral hygiene as neglect in this area can cause serious complications later on. And as far as foods and drinks are concerned, for goodness sake limit and eliminate wherever possible the consumption of sugar, being especially aware of the juices that are packaged for children, which contain alarming amounts of sugar.

Time Out—The concept of “time out” as a classroom management strategy for preschool and lower elementary school teachers has been around for several decades. The idea is that as soon as a child exhibits frustration, anger, defiance, or meanness, then the teacher would take the child to a quiet corner, position the child toward the wall, and announce a two or three minute “time out” before allowing that child to re-enter the community of the classroom. The teacher tone was typically one of reprimand or punishment. Thankfully, these time out episodes have evolved in the good schools in more pro-active, supportive and sensitive ways, and the phenomenon of “time out” has been replaced with class-wide mindfulness techniques. Examples of classroom mindfulness include teaching breathing exercises, calming oneself down with body movement, or preparing oneself for transition to a new activity through humming a melody or closing eyes and visualizing an outdoor scene. The teachers who apply these techniques hardly have child meltdowns to deal with, and those students who might act up or whose anger will erupt in other classrooms will feel assured and supported and known in the classroom that practices mindfulness.

Understanding Autism Spectrum—In my brief paragraph here on autism, you are not going to know what symptoms or traits will mean your child is autistic. The key point here is that autism can be ascertained by a specialist at a young age, even as early as eighteen months, and early intervention can be enormously beneficial. What are the signs to watch for? Difficulty communicating—whether verbally or non-verbally—and trouble relating to others or relating to reality around one. Of course these alone don’t mean autism is the condition—these are just possible warning signs. Parents know best: they will know what constitutes quirky or odd behavior in their child. There is a huge difference between a child who is simply developmentally delayed and a child who is autistic—don’t guess at this. See your pediatrician to start the process of getting an evaluation. Don’t take a wait and see attitude when it comes to these communicative or awareness issues that you see emerging.

Disorders, Diseases, Syndromes—To get a comprehensive listing of the chief disorders, diseases, and syndromes during the preschool and elementary years, check out the amazing Stanfordchildrens site at https://www.stanfordchildrens.org/en/topic/category?id=29976.

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