CenterLines
Front and Center with useful news for families!
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In this issue:
Good Night, Sleep Tight... Nighttime routines are the key
Introducing New Division Director Dennis C. Harper
Breaking News! New Developments in Treating Spasticity
Coming Soon in
CenterLines The Fall ’03 issue of CenterLines
Questions,
Suggestions, and Comments
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Nighttime routines
are the key
You can use what research tells us
about “sleep hygiene” – healthy sleep – to help your child (and yourself!) get
a better night’s sleep.
We all know that
sleep is essential to our well-being.
But
how much sleep do we need? That varies with age.
Typically, newborns sleep about 17
hours out of a 24-hour day. Toddlers need about 14, with 12 of those at night.
As they get older, children need less sleep – preschoolers, 12 hours a night;
six- to eleven-year-olds, about 11. Teenagers should get about 9 hours of
sleep; most adults need 8.
If your child or teenager is still wide
awake at midnight, does it mean she doesn’t need much sleep? Not really — most
of us can get by with some sleep deprivation. Instead, look at whether she gets
up on time and on her own, alert and energized, in the morning. If she doesn’t,
she’s not getting the sleep she needs.
What
makes it easier to fall asleep?
A
regular bedtime routine is the key. One of the most loving things you can do
for your children is to create just such a routine. For a preschooler, it might
look like this:
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7:00 - Brush teeth, go to the toilet, have a warm
bath. Baths are calming and help make us sleepy.
7:30 - Put on PJs, be tucked into bed, listen to a
story. Quiet routines help us relax and get ready to sleep.
8:00 - Kiss goodnight; bright lights turned off.
Falling
asleep is easier with dim light, quiet, and a cool (not cold) room.
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The key is to teach children –
beginning when they are about 6 months old –
to fall asleep on their own, without needing the presence of a parent,
being rocked or patted, a bottle, or a car ride.
Things
that make it harder to fall asleep include:
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• Naps after 4:00 in
the afternoon (for anyone older than 3 to 4)
• Vigorous exercise
just before bedtime
• Playing video or
computer games, watching TV in bed (bed should be associated with sleep, not
play or TV)
• Discomfort due to
such things as a lumpy bed, pajamas that don’t fit well, room too hot or cold
• A bedtime routine
that evolves to include “delaying strategies” like trips to bathroom, drinks of
water, after going to bed for the night
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For children,
it is important that once you have created a bedtime routine, you are firm
about expecting them to follow it. By setting limits from the beginning on
activities that disrupt the routine, you actually help your children get that
essential good night’s sleep.
Are you concerned
about your child’s sleep?
Deborah Lin-Dyken, MD, director of our
Pediatric Sleep Disorders Service, may be able to help. Contact her at
319-353-6132, or deborah-lin-dyken@uiowa.edu.
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Joni Bosch, PhD, ARNP, Family Nurse Practitioner
People, including our children, do
things for specific reasons – reasons that are sometimes surprising! As parents, we know that it is as important
to reward good behaviors as it is not to reward bad ones. But what parent would
reward bad behavior? Too many of us, actually.
For example, has this ever happened to you:
•
When Mom gets on the phone, Emily needs a drink, starts to whine, or picks
on her little brother. If Mom doesn’t
respond, Emily causes so much trouble that Mom usually hangs up the phone – and
then angrily scolds Emily.
•
When Dad asks Jacob to pick up his toys, Jacob pouts or cries. It’s really much
easier for Dad to give Jacob a time-out and pick up the toys himself.
What’s going on
here?
What Emily really wants is attention.
Even “bad” attention, like being scolded, is better than no attention at all.
Mom’s response teaches Emily that a good way to get attention is to mis-behave.
And Jacob? He wants to escape a chore
he doesn’t like. Dad’s response teaches Jacob that bad behavior is a good way
to avoid a job he doesn’t want to do. In fact, that time-out actually helps
Jacob “escape.”
Shaping good
behavior
Of course we want to teach our children
to behave well. What should we do?
First, ask yourself, “What is the real reason for my child’s behavior?” In
general, behaviors let a child:
• Get something they want
• Escape
something they don’t like
A time out is a sensible response to
Emily’s bad behavior, because it
doesn’t reward her bad behavior with
attention. Far better to give her the attention she craves when she is behaving
well — for example, when she plays nicely with her little brother.
For Jacob, a good approach would be for
Dad to actually put his hand over Jacob’s hand, and then pick up the toys with
him – with much praise for Jacob when
the job is done.
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Introducing New
Division Director
Dennis C. Harper
Meet Dennis C. Harper, PhD, the new Director of
the Division of Developmental Disabilities and of Clinical Services here at CDD.
Dennis
joined the UI faculty in 1972. Today, he is a professor of pediatrics at the University of Iowa Roy J. and
Lucille A. Carver College of Medicine, and of graduate studies in
rehabilitation in the UI College of Education.
A leading authority on pediatric
rehabilitation, his interests are wide ranging. He has expertise in the care of
children with chronic health conditions. As the result of his work, we now have
a better understanding of how aging affects adults with mental retardation. His
research has taught us much about how children, in our own and other cultures,
perceive disabilities.
Dennis has also played a key role in
developing CDD’s Telemedicine Service. As a result, by using the ICN, CDD makes
its services available to people in communities throughout Iowa.
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Breaking
news!
New Developments in
Treating Spasticity
Muscle groups usually work in pairs. As
one muscle tightens, its opposite relaxes. But some conditions can keep the
brain and the muscles from communicating. As a result, a muscle stays tight
when it should relax, and this is called spasticity.
It can make movements jerky or painful, and interfere with coordination,
mobility, and speaking.
Spasticity occurs when there is damage
to the part of the brain or spinal cord that controls movement. This damage may
be caused by:
• Cerebral
palsy
• Brain or
spinal cord injury
• Nervous
system diseases such as multiple sclerosis
New treatment
strategies
for spasticity include:
• Baclofen, a spasm-fighting
medication.
It is given via a surgically implanted pump. The pump provides precise doses of
Baclofen to the spinal cord, where it needs to work. This reduces spasticity throughout
the body.
• Botox, botulinum toxin
type A.
Botox is injected into specific muscles. While the muscles are relaxed, other
treatments like range of motion therapy can be used.
•
Selective dorsal rhizotomy, a surgical procedure. During the operation, the surgeon
identifies and cuts spinal nerves that don’t function normally. This
permanently reduces spasticity in certain muscles.
With each of these approaches, physical
therapy is also a key component of treatment.
If you have questions
about spasticity, or about the new CDD Spasticity Service, you might like to
talk with CDD physical therapist Karla Laubenthal. You can contact her at:
319-356-3075
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SUGGESTIONS?
COMMENTS?
We
invite you to share your questions, suggestions, and comments!
Send
them to:
CenterLines
Center for Disabilities and
Development
University of Iowa Hospitals and
Clinics
100 Hawkins Drive Rm 217
Iowa City, IA 52242-1011
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Coming
Soon in CenterLines
The fall issue of CenterLines will feature:
ADHD - What it
is, how it’s identified, treatments and resources
Sleep apnea -
When breathing briefly but repeatedly stops during sleep, it is cause for
concern. Learn more about this disorder and its effects.
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Do you know someone
who would like to
receive this newsletter?
If so, just ask them to send their name
and mailing address to: CenterLines, Center for Disabilities and Development,
University of Iowa Hospitals and Clinics, 100 Hawkins Drive Rm 217, Iowa City,
IA 52242-1011, or email
CenterLines@uiowa.edu.
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CenterLines, the newsletter of the Center for Disabilities and
Development at the University of Iowa Hospitals and Clinics, is published three
times a year. It provides families with current information on child and adult
development, issues affecting people with disabilities, and CDD resources
available to them and their families.
Newsletter staff
Editors
Susan Eberly
Elayne Sexsmith
Graphics editor
Lori Popp
Editorial board
Joni Bosch
Barbara Nidey
For
correspondence relating to the newsletter,
or
to request permission to reproduce information
from
it, please contact:
Barb Nidey
Center for
Disabilities and Development
University of Iowa
Hospitals and Clinics
100 Hawkins Drive
Iowa City, IA
52245-1011
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