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Managing screen time

Last year the Royal Children’s Hospital in Melbourne conducted a study asking Australian parents about the impact of screen based devises on their children.

The results were striking, with parents reporting half of all toddlers and preschoolers use screen based devices without supervision and nearly all Australian teenagers and most primary school age children now have their own smart phones. 

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On average parents reported that kids spend over 32 hours a week on screens at home (not including homework). Teens spent over 44 hours a week on screens. 

There is no doubting that screen usage is a big part of life for Australian families today but it there is increasing evidence of a detrimental impact on vision and eye health, weight gain, sleep and the mental health and well being of children. 

In the survey parents reported almost half of Australian children use screens at night, leading to sleep problems. Parents also reported many children experiencing online bullying and decreased physical activity due to screen use.

Tech elites such as Bill Gates, Steve Jobs and other Silicon Valley parents recognised this red flag on technology early and seldom let their children use the very technology they created. 

By now most parents are aware of the danger that technology poses. And yet is it one of the hardest challenges of modern parenting. We sat down with some Leading Steps Paediatricians and discussed how they manage these challenges with their own families.

Dr Eta Raicebe has two teenage boys, Dr Annelise Wan has four boys aged between 2-11, Dr Dylan Wilson and Catherine Stewart have four children aged between 3 -11, and Dr Victoria Matheson has three preschool aged children. 

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How do you manage the time your children spend on screens?

Dr Dylan Wilson: 
We have some family rules – no screen time during the week, no screens in bedrooms or at the dinner table and no social media accounts. 
The older two children are allowed up to an hour a day on the weekends depending on how much physical activity they have done, and whether they have done their homework. Usually on a Sunday they will have been at Nippers for two hours running on the beach and swimming in the ocean so we don’t have an issue with the older kids having an hour on a screen after that.
We encourage our kids to be busy, sporty, active and outside a lot. We live in a street where they play with the other kids for hours on the weekends, so a bit of time on a screen here and there seems reasonable, but we don't let it get out of hand and set time limits. 

Dr Annelise Wan:
We also have a family media plan - no screen time during the week, no screens in the bedroom or dinner table, no surfing the net randomly and no social media accounts like Facebook or Instagram.  
We set aside time over the weekend for recreational screen time for the older two boys, usually for an hour when the younger ones are asleep. 
We include the older ones in the decision making process by asking them how long they want to play for and then we agree on a time. I give them a five-minute warning when time is up and that’s it. 

Dr Victoria Matheson:
My children are still young so they don’t use any screen-based devices but they do watch one hour of children’s television a day, and we enjoy a family movie together on the weekend. The kids have never been allowed to play with our mobile phones. If the children are too restless while we are out doing something like eating a meal we will leave, rather than pull out a phone or device.

Dr Eta Raicebe
Our teenage boys are very much encouraged to be part of the decision making process about our rules around screen time and devices. Since they were tiny we’ve had a rule around no screen time during the school term except for homework. This year they agreed that this is a good rule to keep.
The boys look forward to using either their computer, PlayStation or watching a movie for two hours on the weekends. We like to watch a movie together, but inevitably these days they want to watch a rugby match instead.

Parents who use screen-based devices are more likely to have children with high levels of screen use.  Do you have rules around your own screen use?

Dr Annelise Wan:
We are really aware of parental modelling, but I must admit we sometimes fail badly.
I am becoming more aware of how often we check phones and generally use them for things other than calling people. 

Dr Dylan Wilson:
Annelise is right about modelling: breakfast is worst, I am usually reading my work emails (from Glenn), reading the news and eating breakfast at the same time. Could do better here for sure.

Dr Victoria Matheson: 
I am trying to start with the no answering of phone rule at the dinner table now as a good grounding for when the kids are older. Of course this doesn’t work when either my husband or I am on call because we have to answer the phone.

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What have you found hardest about encouraging healthy screen use?

Dr Eta Raicebe: 
My oldest threw a few tantrums when he was around 10 years old because he wanted computer games, which I didn’t buy for him. I told him it was non-negotiable. He just had to get over it! 
On the other hand I gave him other things that he could negotiate like choosing which sport he wanted to play and which music instrument he wanted to play.

Dr Annelise Wan:
Years ago I probably let my two older ones use it as a babysitter when they would wake early after I’d had a night shift. But it’s like red wine intake in some mothers, a slippery slope to too much, so now we make sure we set and keep family rules around screen usage. 

Dr Dylan Wilson:
I will admit that we do have the TV on during the day in the background when there's important sport on. Or “sport”, as I call it. For example, the Australian Open was on regularly in our house recently. During the Super Rugby season, the kids often don't even get to watch their weekend movie, as I usually overrule and we watch rugby instead.

Dr Victoria Matheson: 
I do feel for some parents as the need to have downtime and put your child in front of a screen can depend a lot on the personality of the child. 

We are glad to have finished our sabbatical in the dark rainy UK with a tiny garden, no pool and no green space in even visible. In Australia with the properties we live in and outdoor space we are set up to succeed.  Now we have returned to Australia we’re inspired to make the most the possibilities for a healthy lifestyle for the whole family.

What are your best tips for helping parents manage screen time so their children are happy and healthier?

1. Avoid screen use for young children (especially under two). This is time is extremely important for their cognitive, emotional and physical development and play, movement and interacting with humans is much more valuable.

2. Develop a family media plan and rules around screen use. Most children enjoy being part of the decision making process and this helps them establish good habits for their future lives.

3. Make rules about time and place for screen usage and watch with them and discuss what they see (joint media engagement). Ensure the games or shows are appropriate, interactive and high quality.

4. No screens in bedrooms or at the table (parents included!).

5. Talk to your children about cyber safety, cyber bullying and being good digital citizens. Keep communications channels open so are able to speak freely with you.

6. No social media accounts for preteens. When your child does use social media make sure you are familiar with the platform and that you and other family members are “friends” with your child online. A social environment where they are sharing information and photos with grandparents and aunties discourages poor choices.  

7. Encourage free play and quiet time with a book. There is developmental value in children having some mental space be creative and to entertain and think for themselves.  

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Terri and Caitlin - National Diabetes Week

Terri sat in the GP’s room for the second time that week, this time with her nine year old daughter Caitlin. It was a bit awkward because Terri had only recently bought her son in with boils, after a Google search showed it could be a sign of Type 1 diabetes.

So when Caitlin started drinking a lot and going to the toilet constantly Terri felt a bit embarrassed to turn up again, wondering if this time her daughter could have diabetes.

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“I remember saying to the doctor, ‘I haven’t got Munchausen by Proxy (a condition where carers invent or exaggerate illness for attention). I did feel embarrassed going back with a second child I thought could have diabetes,” laughs Terri

At the time Terri was a teacher at Caitlin’s school. Caitlin would pass by Terri’s classroom if she ever went to the bathroom and she’d always stop and say a cheery hello to her mother on her way past.

“I started noticing she was going to the bathroom a lot, until it got to the point that cheerful hello was happening as she went past every 20 minutes or so.”

Caitlin had lost weight and had been lethargic over the last few weeks, and had started losing races she normally would win.

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Terri had diabetes on her mind because her own mother had been diagnosed with type 2 at the same age Terri was now.

“I knew some of the symptoms from mum and it all started coming together in my mind,” says Terri.

One afternoon after school Terri rummaged through her cupboards to find her mother’s old testing kit.

When Caitlin’s finger prick test read “hi” she knew she had to go back to the GP, this time asking about her daughter and diabetes.

It didn’t take the GP long to send them straight off to hospital.

Terri says when they got the diagnosis they were relieved in some ways.

“Although we knew this was a serious condition, we were also relieved it wasn’t something more sinister. We thought, ‘ok we can deal with this’”.

A turning point came soon after diagnosis when Caitlin was due to play in a state Rep touch football tournament.

Terri called the coach to say she didn’t think Caitlin could play.

“The coach was adamant and said, “she’s playing.” It turned out she had coached other people with diabetes and knew it could be managed. That gave me a lot of confidence, and since then Caitlin has gone back to her sports and excelled.”

Caitlin self manages now very well, although her parents are always here for support.

“Now she is a teenager she has had some ups and downs, which is apparently common at this age. Dr Harte had to speak to her about it the other day and she is back on track after that.

“We have encouraged Caitlin to not let diabetes stop her life. It’s part of her life and she has to manage it.

“Caitlin is learning that when you do elite sport you need to be upfront about the condition with teammates and coaches.  It’s hard for a teenager but she’s learning not to be embarrassed and have the confidence to speak up,” says Terri.

 

 

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Ali and Finn - National Diabetes Week

Life is busy for parents of toddler twin boys.

Ali and her husband had given up hope for a good night’s sleep and were already exhausted when 23 month old Finn started waking up even more.

Too little to communicate, Finn was waking up crying with thirst. He drank so much he was wetting through at least two nappies a night.

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“I think we were already too exhausted to think straight – Finn seemed to want water at night, then we were changing his nappies and the sheets because he was wetting through his nappies,” remembers Ali.

It was at that time the family took their first trip, flying to Melbourne with the boys.

“When we had to change Finn’s nappy twice on the two hour flight, we knew that  something was wrong,” remembers Ali.

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After their holiday they went straight to the GP where the practice nurse performed a finger prick test. 

“The result read ‘Hi’ and no-one knew what that meant.  They thought there was something wrong with the machine so had to ring a hotline for advice.”

When they figured out his blood sugars were higher than the device could read, their GP sent them directly to Pindara, where Finn was officially diagnosed and started on an insulin pump.

“It’s a lot to take in. Our GP warned it that it’s like doing a 3-year degree in a month; there is so much to learn. Plus there is the grieving process that comes with a serious, life long diagnosis in a toddler,” remembers Ali.

Ali’s advice – connect with other parents, get used to speaking up and asking questions of your medical professionals, and find an older child with diabetes who is doing well and is a great role model.

Finn is five now and starting to ask questions that are difficult to answer.

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“It can be heartbreaking when he says, ‘mummy I don’t like diabetes, I don’t want to have it anymore’.  How do you deal with that?  It’s heart breaking, so I ended up going to a psychologist to learn how to talk about it with him and how to frame it.  This disease is never easy, but that has definitely helped.”

 

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Rebecca and Amelia - National Diabetes Week

It was a humid January day when Rebecca realized something wasn’t right with her ten-year-old daughter Amelia.

Since Christmas she seemed increasingly lethargic and was drinking a lot of water during the long hot days.

She had lost weight too, but Rebecca put it down to a growth spurt.

Amelia had been looking forward to a trip to the local theatre to see a friend perform. One of the other mums there was Rebecca’s friend and Leading Steps Paediatrician Dr Catherine Wilson.

Catherine and Rebecca watched as Amelia drained her drink bottle before the performance then finished all her friends’ drink bottles between visits to the toilet.

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“At the end the friend invited Amelia onto the stage and under the harsh stage lights I was horrified to see she looked like a skeleton,” remembers Rebecca.

Catherine walked them straight over to Leading Steps Paediatric Clinic where a finger prick test showed worrying levels of sugar in Amelia’s blood.

By that afternoon they had their bags packed and were admitted to Pindara Children’s ward.

“At the time I was very focused on getting to hospital before things got any worse. We all had to come to terms with the fact that Amelia now had a lifelong serious disease.”

These days Amelia is the happy owner of a pump and at 12 years old is becoming an expert in managing her diabetes (with gentle but steady oversight from mum and dad).

Her memories from that summer were of an unquenchable thirst and constant trips to the bathroom.

If Rebecca thinks back on it the classic signs of Type 1 Diabetes started a few weeks before diagnosis.

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“Amelia was drinking a lot, and getting up at night to go to the toilet. She has lost weight and was increasingly lethargic – warning signs I would now recognize.”

The day Amelia was diagnosed she was already quite ill, but it happened slowly so her parents didn’t notice straight away.

“Amelia was due at a friends house for a sleep over that night. I often wonder what would have happened if she had gone. Without the proper treatment diabetes can be life threatening. We’re thankful we didn’t wait a minute longer before getting to hospital.”

Amelia and Rebecca say they try not to let diabetes control their life.

“You can still do everything, it just takes a bit more planning,” says Rebecca.

"It’s an ongoing process. We try not to stress when things aren’t perfect. Our motto is ‘the numbers are there just to tell you what to do.”

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Looking back now Rebecca is grateful for the simple finger prick test that meant Amelia went to hospital rather then becoming dangerously unwell.

“If parents notice any of the signs of type 1 in their child a simple finger prick test is what they need to insist on when they visit their doctor, it will either rule it out or get them into hospital sooner therefore avoiding severe and life threatening illness,” says Rebecca.

 

 

 

 

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Melissa and Max National Diabetes Week - "It's about time"

This year's theme of National Diabetes Week is "It's About Time" - to raise awareness about the importance of early detection and early treatment for all types of diabetes.

It’s common for many children diagnosed with type 1 diabetes to end up seriously ill in the Emergency Department before they are diagnosed.

Max has a different story. His mother Melissa knew the signs and Max was diagnosed and on treatment before he developed any dangerous complications such as Ketoacidosis.*

Max is now 15 years old and an excellent student and athlete, but six years ago life seemed very different.

Max’s mother Melissa had just picked him up from a sleep over when the other mother remarked on how thirsty Max had been during the stay.

“It raised a red flag for me because my brother had recently been diagnosed at 39 with type 1 diabetes, and my best friend’s daughter had been diagnosed the year before,” says Melissa.

Still, Max seemed fine and he headed off for touch football with his dad. Melissa mentioned the comment to her husband and asked him to keep an eye on how much he was drinking.

Before the match had even started Max had chugged 2 litres of water.

Melissa had gestational diabetes when she was pregnant and still had the glucometer in a cupboard.

“When they got back from touch I did a finger prick test and the reading went straight to ‘HI’.  

When I saw it all I could think was crap - he’s got diabetes!” remembers Melissa.

Melissa rang her friend whose daughter had recently been diagnosed and told her about his thirst and high blood sugar readings. They were patients of Dr Harte’s and had recently changed to a pump for diabetes management.”

“She said ‘go to hospital….. and make sure you get a pump.’”

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Melissa took Max to Pindara Emergency and informed the somewhat bemused doctor that her son had just developed type 1 diabetes and she didn’t want to leave without a pump.

Max was officially diagnosed at 11am and had a pump by 1pm that day.

“At the time life felt frantic with four boys, especially because our one year old was born with congenital glaucoma and needed surgery and frequent visits to specialists in Brisbane. I just knew we had to make sure we had the best treatment and the best system that would work for Max,” says Melissa.

Melissa says the diagnosis of diabetes takes some getting used to. At first the information overload can be overwhelming, and life can seem complicated. But as time passes, it does get easier.

Melissa felt for nine-year-old Max as he came to terms with the changes.

“It felt like his childhood innocence was over. He had to grow up overnight and understand what was a pretty serious health condition. No more of his beloved sleep overs with friends, at least for a while,” says Melissa.

Since then Melissa and Max have learnt that diabetes “has to fit in with Max’s life, rather than being his life”.

“Lucky for us Max at 15 is very responsible with his diabetes. He knows he has to keep his blood glucose level below seven for optimal performance so he can achieve at school and sport. His HBA1C is in the 6’s and hopefully this will lead to a life without diabetic complications down the track.”

“He is a competitive athlete so he manages his pump for training and to prepare for races and games.

“He is very disciplined and responsible  – not because we made him that way, but lucky for us, that is just the way he is,” says Melissa.

* Diabetic Ketoacidosis is a serious condition associated very high blood glucose levels in type 1 diabetes. It develops gradually over hours or days and leads to accumulation of dangerous chemical substances in the blood and urine called ketones. 
This is a serious medical emergency and can be life threatening if not treated properly. If these symptoms are present, contact your doctor or go to hospital immediately.

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Food for thought – when a child’s weight is too heavy for their height.

By Dr Annelise Wan
MBBS BAppSc MPHTM FRACP

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In paediatrics we often see families with multigenerational obesity and unhealthy attitudes towards eating. The conventional approach of dietary and exercise plans often yield no long-term rewards, which is disappointing and frustrating for the families involved.

In my practice I tend to come at things from a different angle and work less on food groups and calories and far more on the social behaviors that drive children to eat.

First the family has to recognise that there is a problem and decide to do something about it

It's very common to hear parents use language such as- well built, big boned, chunky, just like me, puppy fat, built for comfort not for speed. These terms can down play the problem and the impact on the child’s health now and in the future.

Once a child’s BMI gets to the 85th percentile or higher, we consider the child to be overweight.

While factors such as portion sizes, more exercise and veggies, less unhealthy fat, sugar and salt are important, my focus is to begin with lifestyle modifications that are much easier for parents to undertake, rather than instructions on healthy foods and exercise that they’ve probably heard many times before.

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Instead of language describing a child “going on a diet” or “losing weight” its best to talk about being “too heavy for their current height”.

Below are some helpful lifestyle modifications that can be the first step to a healthier family.

Stage one:

1. Eat only at meal times and define what is a “meal time”. 
Many families have lost the concept of mealtimes. It’s not uncommon to see families eating meals in food courts at 3 pm or 10 am.  It can be challenging for some families who are busy or under pressure to stick to a good household routine with clear mealtimes, but this is necessary to prevent constant grazing throughout the day.

The concept of control and a period of fasting is often new in these days of instant gratification, and food is no different. Families may need reassurance that some feeling of hunger between meals is normal.

The first step is for the family to declare three proper meals a day, with nothing in between until the next declared meal. The only foods recommended between meals if ‘starving’ are carrots and celery.

When the family has established a routine and restricted eating to meals times topics like portion control and healthy food choices can then be broached.

2. All eating should be done while still.
Eating should take place at a table rather than walking or moving around. Screens should not be in view (including ipod, iPad, TV, games etc). Meals should be social, enjoyed with other people and conversation.

3. Only water to drink
Juice, sweetened milk, sports drinks and soft drinks are not a necessary part of a child’s life.

Stage two:

1. Once the family has made these simple lifestyle changes we can spend time exploring What, Why, When, How and Who of eating.

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Why do you eat? Parents often begin to see reasons for eating (or allowing children to eat) other than hunger, such as loneliness, habit, or to pacify or please children. 
When do you eat? Is the family still eating late at night? Or at times other than meal times?
How do you eat? Is eating rushed, consuming calories with little enjoyment or even awareness?•  Who do you eat with? Avoid children eating alone and try to have someone there to chat while eating. This topic brings up many interesting discussions.

2. Kitchen Control

  • Parents need to take control of their cupboards as well as meals.
  • Little children should not have free access to kitchen contents.
  • Parents need to be empowered to say ‘no’ to their children when they complain, especially straight after they have just eaten.
  • The kitchen should be a “rubbish free zone” and parents need to be motivated to only bring healthy food into the house.

3. Organized sport and disorganized play

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  • As well as the food/meals/behaviour it’s important to recognise the need for organized sport and/or disorganized play
  • Not all children can or want to participate in organized sport, but given the opportunity for active (disorganized) play, especially in an environment with potential, most children will naturally enjoy the sort of activity they need to be fit.  On the Gold Coast there are many parks and beached to explore for active play opportunities.
  •  Active play is essential for all children, regardless of their weight. Swapping one hour of screen time for one hour of active play or sport can be enormously beneficial. 

4. Sleep and screens
Sleep and screen usage are huge areas for discussion. Healthy routines around quality and quantity of sleep and screen use are important for healthy weight and mental well-being.

Clearly weight prevention is much better than the cure. There is no one proven management strategy that will work once the child has become obese and often the only way to effect long lasting change is bariatric surgery.

A recent study in JAMA Pediatrics offered some evidenced based food for thought. The study compared conventional medical exercise and dietary treatment with bariatric surgery for adolescents who were severely obese with type 2 diabetes. The findings showed 70% of those who underwent surgery achieved a normal A1c at two years and had lost 30% of their initial weight, compared with only 3% body weight decrease in the medical treatment group. 

Lifestyle and behavioural modifications are important to prevent a child becoming severely obese and it’s crucial for the whole family to be involved to ensure the most successful and happy passage through childhood into healthy adult life. 

The take home message is that doctors and families should focus on identifying and acting early to avoid unhealthy weight gain and obesity in the first place, because conventional lifestyle and medical solutions, once the young person is obese, are very difficult with often disappointing results.

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Newborn care

Newborn babies are a joyous and challenging responsibility. It’s reassuring to know that you have the guidance and support of your Paediatrician every step of the way.
Our priority is to ensure your baby has the best start to reach their full potential.
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Although most babies are born healthy, a few babies have unexpected disorders and, occasionally, life threatening emergencies. 

Leading Steps Paediatricians are on call 24/7 to provide the highest-level care if difficulties arise.

Your Paediatrician will carefully examine your baby and review their antenatal history, and then monitor their feeding and progress through their hospital stay. They will follow up any abnormal screening tests and provide advice and assistance.

At private hospitals babies are under the care of a private Consultant Paediatrician, so parents know their baby is receiving the highest quality care. 

The Paediatrician will attend regularly to check the baby’s progress. Many parents take this opportunity to ask some of the many questions that come up once the baby is born.  

Once home, new parents are encouraged to ring their Paediatrician directly if they have any concerns about their baby, especially during the first six weeks.

In Australia the Royal College of Physicians recommends well babies have a full check at birth, before discharge and then at six weeks. 

The six-week check is an important time for the Paediatrician to look at growth and development as well as fully examining the baby. Cardiac problems often don’t become apparent until the baby is a few weeks of age. Much of the consult is devoted to helping with routines and settling.

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Fees: Babies admitted to the Special Care Nursery are fully covered under their parent’s private health insurance. Leading Steps Paediatricians do not charge a gap for this care.

Babies who are not admitted to Special Care Nursery (those on the postnatal ward) are generally not covered by private health insurance funds but costs of consultations are partially covered by Medicare.

If families reach the Medicare Safety Net in a given year (often the case for patients who have paid a private obstetrician) the Medicare rebate covers 80% of private paediatric care.

For all enquiries including estimated fees please call the Leading Steps Paediatric Clinic  on  07 5564 9668

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Outgrowing paediatric care

After two decades as the Deputy Director of General Paediatrics at the Royal Children’s Melbourne, there isn't much in paediatrics that Associate Professor Lionel Lubitz hasn’t seen.

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One thing that has concerned him over the years has been the issue of transition from paediatric care to adult care, particularly for vulnerable young people with Intellectual Disability and/or Autism and mental health issues. 

Families with a child with long term health or development problems often develop a strong relationship with their paediatrician.

It can be daunting when the child is grows up and moves to care in the adult system.

Dr Lubitz spends his time between Leading Steps Paediatric Clinic and The Royal Children’s Hospital in Melbourne where he is supervising a major transition study for adolescents with autism, intellectual disabilities and mental health problems.

Dr Lubitz says this transition has been on the agenda for a while, and concerns were highlighted recently in a survey at Royal Children’s Hospital involving paediatricians and patients with ASD/ID who had transferred to adult care previously.

“It was overwhelmingly clear that most practitioners, patients and carers felt transition was inadequate at best and terrifying at worst,” says Dr Lubitz.

“It confirms what most doctors know about the risk of young people falling through the cracks without appropriate support once they graduate from paediatric care.

“We’ve embarked on this project to create a better, smoother transition from the cocoon of paediatric care to the adult system,” says Dr Lubitz.

According to Dr Lubitz a lot comes down to the natural difference in the way paediatricians and adult physicians manage their patients.

“Paediatricians tend to be family focused, developmentally attuned, involve parents in decision-making and utilize multidisciplinary teams. Adult care tends to be more patient focused, with expectations of independent consumer skills and fewer interdisciplinary resources,” says Dr Lubitz.

To improve the transition the team developed a program of shared care between the patient’s paediatrician and general practitioner starting from the age of 15 in a process of gradual transition to adult care.

“The GP will have direct access to the project paediatrician to enable support with practical issues that may arise in the consulting room,” says Dr Lubitz.

Other resources are being developed such as better paper and electronic communication and a GP tool kit to assist the GP in understanding the needs of patients with ASD/ID including coexisting medical and mental health conditions.

Dr Lubitz says the toolkit includes the use of and potential problems with medication, particularly in the management of challenging issues such as anxiety disorders and ADHD, as well as suggestions on behavioral management difficulties and other comorbidities that are commonly found in this group of patients.

“The plan is that by the time the patient reaches 18 it will be a seamless move from the paediatrician to adult based care,” says Dr Lubitz.

We hope that information gained from the transition study will improve the experience of all our patients who inevitably must transition to adult care.

 

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The gift of a healthy start

Is your under five fit?

by Dr David Pincus

Getting healthy eating and active play right from the start is a lifelong gift parents can give children.  So what can parents do to ensure their children start school as fit and healthy as possible?
 Dr David Pincus

Dr David Pincus

It's a depressing and familiar statistic - over a quarter of Australian children are overweight or obese. But it gets worse. A study published recently shows this baby fat often doesn’t go away. 

The study published in the journal Pediatrics looked at 4000 school students in the US. They found nearly all the kids who were overweight or obese in grade five remained that way in year 10.

It turns out that hoping kids slim down as they grow doesn’t work out that well.

Probably not coincidentally, at the same time a study from the University College of London uncovered data that showed at the beginning of last century children were 50% more active than today.

Researchers refer to this as the “global collapse of physical activity”. It affects adults too, but it is children who will bear the consequences into the future.

In Australia by the time children enter prep 20 per cent are already overweight or obese, and those children are four times more likely than normal weight children to be obese by grade eight. Just like in adults, once fat is established losing it becomes a difficult, life long battle.

So it makes sense that more focus is now being placed on the very early years, before the age of five.  The aim is to prevent baby fat from even starting, so kids begin school fit and healthy, with their potential undimmed by the threat of obesity.

So what can parents do to keep baby fat at bay? Parents and carers need to get healthy eating and active play right from birth.

Start early

From the beginning mothers should breastfeed if possible and never start juice or soft drinks.

Early weaning foods should be consistently healthy. Kids may like the salt and fat in chips but they will grow to love a healthy diet if that is all they know.

And it’s not just diet.

A study from Deakin University found that half of 19 month olds do not meet the daily physical guidelines for their age group. Babies and young children need plenty of time for active play. That means floor time and gentle movement games from infancy. Sitting in strollers, highchairs and car seats for long periods isn’t good for children’s health and development and goes against their natural tendency to be active and play.

Off and running

Ensuring a child is fit and active from the start builds the habits and capacity for a lifetime of good health.  When screens are off children have more time for the active play they need. That can include floor time for infants, crawling games for older babies, walking and dancing play for toddlers and more structured active play for older kids.

Choose toys that encourage reaching, stretching, crawling and moving activities for infants such as balls, pots, streamers and hoops. For toddlers and pre-schoolers, choose toys that encourage movement and develop skills like running, kicking, throwing and catching, such as balls, bats, tricycles and kites.

Parents provide, kids decide

Parents provide children with a healthy selection of foods and let them decide how much to eat. As a rule of thumb half of every plate should be vegetables. In the same way parents should provide a range of active play opportunities and kids decide which activities to engage in.

Set the example

Children learn most from how their parents care for themselves. Parents can set the example by incorporating healthy eating and active play as a regular part their own lives, so everyone benefits.

Encourage positive body image
The researchers in the Pediatrics study also looked at the effect of body image on obesity. It turns out the overweight children who were ashamed of their weight were more likely to be obese in year 10 than the overweight children who felt better about their body image. That means parents should talk about healthy habits rather than losing weight and make sure the children know they are loved and special for who they are, regardless of their weight.

 

 

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Small kicks to big dreams

From small kicks to big dreams

by Caireen Franklin (Billy's mum) 

Billy clutched his medal as we made our way back to the hotel on a warm spring day last year. 

I put my arm around his shoulders and we walked together, cocooned in unexpected happiness.

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He said, “I can’t believe it Mum, my dreams are coming true.”

I couldn't believe it either. Billy was 10 years old and had just won his first Australian Karate Championship and World Titles.

It wasn’t always like this. 

I knew Billy had problems from when he as a baby. He was extremely regimented and would “crack it” if we went did anything different, like walk out the wrong door.  

When he was six he was diagnosed with autism, ADHD and anxiety.  He was a dear little boy but I had to face the magnitude of the challenges ahead. 

Starting school seemed like an impossible dream. Billy literally clung to me, obsessed that something might happen if he let me out of his sight.  

The trauma of getting him to school made us consider homeschooling but that didn’t seem to be an answer. 

Once he did get to school things were even worse.  Billy was intensely shy and couldn’t make eye contact. With poor social skills he was lonely, confused and overwhelmed, despite the efforts of caring teachers. 

He knew he was different and hated it.  As a mother it was heartbreaking to hear him say he “hated himself”. 

“We are all different in lots of different ways, and you really are a lovely boy,” I reassured him time and time again.

The world told him otherwise. 

At the time the future seemed bleak. I struggled to see how he would ever get through school, or cope in life.  Would he ever be happy, make friends and value himself for the worthwhile person he was?

The worst part was seeing him suffer and blame himself. Having meltdowns and feeling overwhelmed are not good feelings for anyone. Life seemed hard when it should have been happy. 

Somewhere we knew in our hearts life could get better. But how?

The first turning point came from getting the right support. Our paediatrician organized for us to see a specialist psychologist and she began the long process of teaching us the tools to succeed in life.

Billy worked hard with all the strategies, slowly improving his social skills and self-regulation and in turn, his self esteem.

Sometimes I’d see him using his new strategies. When he got upset in the playground I saw him hide his hand in his pocket, doing secret “finger breathing” to calm down. 

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We began to see more positives, even in the very things we had despaired about. Being different can have advantages.  We started to realize how many successful and happy people have autism and ADHD. 

I learned how minds can think differently and how tough some challenges can feel, especially when you are little and just trying to make your way in the world.  

Billy’s brain was different. He wasn’t trying to be naughty; he was confronted with challenges that would overwhelm most adults.

The second turning point for Billy was starting karate at 6 years old.  Billy was getting bullied at school and was suffering from high anxiety ASD and ADHD. 

Doing an individual rather than team sport suited him and karate required Billy’s developing skills of concentration, self-regulation and self-esteem.

Karate made a huge difference in Billy’s life. His anxiety decreased, he could concentrate for longer and worked hard, successfully remembering 5 Kata’s – something that previously wouldn’t be possible. 

Billy won his first karate trophy when he was eight. Each tournament boosted his self-confidence. The excitement and thrill to perform his kata in front of his peers, officials and an audience was high and the change in him was dramatic. 

He self esteem improved. He was proud of who he was and what he was achieving. 

Each tournament boosted his self-confidence. He couldn’t wait to get to school on Mondays to share his achievements with the principal, teachers and classmates. 

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Speaking in front of his class was incredible for Billy. He went from not wanting to be away from me to talking to anyone and making more eye contact, sharing his achievements and his passion. 

Next he surprised us by participating in the school musical and The Opti-Minds Challenge where he received The University of Queensland’s “Spirit of Opti-Minds Regional 2017” award.

Meanwhile Billy kept working with our paediatrician and psychologists, growing through excellent courses such as “REEF” (Recognising Emotions and Establishing Friendships) run through Griffith University, where he made his first true friends. 

I was learning too, doing parenting classes run through FSG and Bond Uni.

Billy continues to grow in strength and confidence. Last year at the ISKA Australian titles he ranked 1st in Sword Combat and was named Australian Champion in his division. At the ISKA World Cup Billy ranked 3rd in Sword Combat and 4th in Board Breaking and became World Champion in his age division.

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This year he is an ICT Leader at school, which means he runs the assembly with his ICT mates using the tech equipment.

His dreams haven’t stopped with his achievements. Now he aims to become an Olympic Karate Champion and a police officer. 

I don’t see any reason why these dreams won’t come true.

As parents our dreams are also coming true, and we are so proud to see our son happy and confident in himself. 

We’re realistic about Billy’s ongoing challenges. He is currently dealing with food phobia and smell sensitivity as well as other issues. We are currently working with an occupational therapist, dietitian and psychologist to get on top of these issues. 

He starts high school next year and we know the road won’t always be easy, but Billy is developing the tools to cope with the challenges and now has the confidence and strength to value his self worth, and accept, even embrace, his difference. 

If there was one thing I would tell parents who are starting on this journey it is  this-  there is light at the end of the tunnel, but there is a lot of hard work in-between. 

The more informed you are, the more you can understand and support your child and help them be the best they can be. 

Embrace what you have and put the work in. 

Billy says it best. "Try your best and never give up. Your dreams can come true if you just believe and give it your all." 


Billy Franklin is honoured to be a Commonwealth Games Queen's Relay Baton Bearer. He was nominated by his school Principal, who said he chose Billy because he never lets his challenges stand in the way of his goals and dreams.

Billy will be carrying the baton on Tuesday 3rd April 2018 at 1.33pm at the intersection of Lido Promenade and Collyer Quays Robina. 

 

 

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Dr Syed Fasihullah has seen an enormous change in Billy over the years. From a shy small boy, overwhelmed and confused by significant challenges, to a young man brimming with confidence and ready to take on the world. Dr Fasihullah says, "Billy is an impressive character and an inspiration for lots of children as well as me."

 

 

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