Nightmares and bed wetting o Drastic changes in appetite o Over-compliance or excessive aggression o Fear of a particular person or family member o Older children may lie to protect their parents o Important to interview parent and child separately Which of the following symptoms would be the LEAST likely to cause to you be concerned for abuse? A 12-year-old who has suddenly lost interest in eating An 11-year-old who is asking questions about sex - normal! A 4-year-old who attempts sexual acts with a classmate A 10-year-old who is pregnant Bullying
Signifcantly more prevalent in school age than in any other group Studies show between 20% and 50% of children report having been bullied Factors that contribute to being a bully, being bullied, or both: o Age (school age) Preschoolers don’t really bully – too complex o lower socioeconomic status o parents have lower educational level – less likely to discipline about this o poor health status o special needs o physical appearance o poor achievement o sexual orientation Safety and Injury Prevention Trauma is a leading cause of death in all pediatric age groups after 1 year Bicycle helmet Aspiration and suffocation – put everything in mouth Gun safety Falls: toddlers can climb on chairs and furniture Top-heavy furniture bolted to the wall Cribs Burn and cold injuries o Scald most common type Water heater set to 120 degrees Takes 10 minutes for full thickness burn o Flame burn most fatal o Frostbite o Hypothermia Bites and Stings o Insect, animal, snake, human Drowning o Swim lessons are not the answer – NOT A SUBSTITUTE o Supervise at ALL times – can drown in an inch of water Poisoning o Toddlers are the highest age group at risk o Prefer to access things at eye level but at this age they can climb o NO syrup of ipecac o Lead Lead Poisoning/Screening
Toddlers & preschoolers – tastes really sweet Lead can produce adverse effects on many body systems: o Kidneys o Nervous System (brain) o Reproductive System It is especially harmful to the developing brains of fetuses and young children Lead screenings at age 1 and 2 years old Lead poisoning risk factors: o Living in a home built before the 1978 , where lead paint may have been used o Low SES cheap homes/rent may not be regulated by gov’t Move around a lot o Food insecurity 2yo, hungry, in poor house, paint tastes good, will eat paint o Pica (iron defciency can lead to odd cravings) Low iron triggers pica in children crave non-food eat more lead things worsen anemia Sits on the iron binding to site of RBC Iron deficiency anemia Treatment: o Check lead levels routinely at 1 & 2yo o Chelation therapy : drug given that binds to lead & removes from body o Tx for iron defciency anemia as well Car Seat Safety Car Seat Safety: Please Review infants and toddlers must be rear-facing until age 2 years due to their proportionally larger head size
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- Spring '17