Ask-a-Doc

Reading aloud with your child is one of the best ways to grow their listening and talking skills, vocabulary, and preparing them for being a successful reader. Education Coordinator a Becky Clem, shows how daily book reading can help your child with hearing loss grow their literacy skills.

Becky Clem, MA, CCC-SLP, LSLS, Cert. AVT, is the Education Coordinator for Rehabilitation Services. As a speech-language pathologist and listening-spoken language specialist (LSLS) with auditory verbal therapy certification, she is passionate about working with children with hearing loss and their families. She works to advance professional skills and education, mentor professionals towards LSLS certification, and supports family-centered care initiatives. She serves on the coordinating committee for SIG 9 on hearing and hearing disorders in childhood for the American Speech and Hearing Association. She presents at conferences at national and international levels and writes for publication on pediatric hearing loss intervention.

Previously she served on the AG Bell Certification Council. As a member of the Global Foundation for Children with Hearing Loss she mentors in the summer teacher-training program in Vietnam. Her publications appear in the ASHA Perspectives, Volta Review, Pediatric Audiology Case Studies (Flexer and Madell, 2010) and Auditory-Verbal Therapy (Estabrooks, 2016). She presents at state, national, and international conferences. When not working, Becky adores reading, cooking, yoga, TCU football, and most of all time with her husband Keith, their two adult daughters, and one-year old granddaughter.

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00:10

Hi, my name is Becky Clem, and I'm the Rehab Services Education Coordinator at Cook Children's Medical Center. Reading aloud with your child is one of the very, very best ways to grow their listening and talking skills, vocabulary, and preparing them for being a successful reader. So how can you help your child with hearing loss grow their literacy skills through daily book reading?

00:35

One way is to pick out books that are related to recent experiences. For example, if you take your child to the zoo, you could pick out Dear Zoo, Good Night Gorilla, Curious George Goes To The Zoo, any of those zoo related books, and then read and talk about that. You can also take pictures at the zoo and put them together in a digital book on your phone, or on the iPad, or hardcopy and then tell the story of you and your child going to the zoo.

01:06

Another one is to read familiar stories, or rhymes, so that they hear information in repeatable, predictable ways. When they hear rhyming words, it's important to lay the foundation for phonemic awareness and reading.

01:21

One of the ways that's fun for children when reading books is to change your voices in the story. For example, in the book, The Napping House, by Audrey Wood, everyone's falling asleep at the beginning. So we would want to use a sleepy voice. The napping house, there is a house, a napping house, where everyone is sleeping. And in that house, there is a bed, a cozy bed, in a napping house, where everyone is sleeping.

02:00

Later on in the book, everyone starts waking up. So we would change our voice to make it more like everyone in the house is waking up. A wakeful flea who bites the mouse, who scares the cats, who claws the dog, who bumps the granny, in a napping house where no one now is sleeping.

02:34

So we change our voices in the book to keep the child's attention. And also, we make it clear to the child what's happening in the beginning, everyone's going to sleep, and then everyone's starting to wake up.

02:47

Also talking about the book before you show it. "We're going to read a book about a mouse." And I might make the mouse sound, which for children with hearing loss, we say, "eeh, eeh, eeh," and talk about cookies, "I love cookies. I wonder what that mouse is going to do with the cookie? Look, we're going to read If You Give A Mouse A Cookie." So I've gotten the child's attention. I've gotten the child's attention through talking about the book. And now they're excited to see what's in the book, If You Give A Mouse A Cookie.

03:25

So one thing you want to do is talk about the page before you show it to them. "He's going to ask for a glass of milk." And then I might point to this and look at the child to see what they say. And maybe they'll say something about that they want a cookie or they want a glass of milk. So when you think about reading aloud to your child, pick books out that are related to recent experiences. Read familiar stories or rhyming words that happen in a predictable way. Change your voice in the story. Connect what happened in the book with real life. Talk about the book before you show it to them. Wait after reading a little bit and see what the child does.

Temper tantrums are stressful, especially when you’re out in public, like shopping or at a social or family gathering. Cook Children’s pediatrician and mom, Dr. Christina Sherrod, has some tips to help you manage your child’s meltdown.

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00:00

So what a lot of us worry about as parents is, what do we do when a child has a temper tantrum and we're in public? Like we're at the grocery store, we're at a birthday party, or we're at grandma and grandpa's house and there's a whole bunch of people there. I think you want to be respectful of your child, and try to get them away from an audience.

00:28

So if you're at the grocery store, and you're checking out and your kid sees that Snicker bar, and they want the Snicker bar, and you say no, and they decide to lay on the floor, and kick and scream, what you really, the best thing to do is to pick them up, and take them to the car calmly, not with a lot of mad emotion being non-verbally communicated, but very calmly, pick them up, kindly take them to the car, and let them calm down in the car. And then you can talk about it.

00:57

You don't want to give them the candy bar, which is easier said than done. I can admit, as a parent, sometimes you really just want to get things done, and you don't want to deal with the temper tantrum. And it might be tempting. And we may not even think about it, but we may just give them the candy bar because that's what we want to do at the moment. But try not to do that because it just teaches them that they're going to get what they want.

01:18

Same thing like at birthday parties and big crowds and gatherings, you know, toddlers get extremely overstimulated at those types of things. And it is, it is the perfect setup for temper tantrums because not only is there a lot of things that they might want that they really can't have, or they have to wait their turn and they don't like that. They're tired. Sometimes they're eating candy and not getting nutritious food. So just make sure that you think about and plan your time. Don't overstimulate your child. Don't over schedule them. Make sure they're getting enough sleep. Make sure that they're getting a regular, you know, scheduled three meals a day and snacks before you put your child in those situations, and yourself.

Ah, the dreaded temper tantrum. They’re no fun, but they are a normal part of childhood, and parenting. Cook Children’s pediatrician and mom, Christina Sherrod, M.D., shares why kids have tantrums, when they’ll outgrow them, and what to do when your child is having one.

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Transcript

00:10

If your child is having tantrums, the first thing to know is that it is a very normal part of childhood and you have a normal child. They usually start when a kid turns one, and peak up until about the age of four. But tantrums are pretty normal and a regular part of childhood up until age seven.

00:31

The first thing to learn when your child is having a temper tantrum is nothing about your child. The first thing to think about is how you're going to respond. And that it's really important as a parent, that you stay calm, because your child is going to read and act based off of how you respond.

00:46

And I think the thing to realize about tantrums is that your child is just overwhelmed with emotions. And you can't make that go away for them. Your job as a parent is to help them learn how to handle those very strong emotions.

01:04

You can't yell at them and get those emotions to stop. Often, that makes it worse. You can't spank them to get those emotions to stop and you can't punish them. What you really need to do is let them ride that ride. Give them a calm, safe environment to learn how to calm down. And then, once they're calmed down, try to talk to them about it. And how you talk to them about it really depends on how old they are.

So an 18 month old can't really understand long sentences, but they will have tantrums when they're tired, when they're hungry. And they'll definitely have tantrums when you don't give them what they want.

01:39

All of those are instances where their emotions are just overwhelming them. And they're screaming and crying and hitting and kicking. And what you want to do is, first set really good boundaries that they are not allowed to hit or kick or hurt anyone else when they're having a tantrum. If they do that, you tell them no, and you put them in timeout.

01:58

If they're just kicking the floor, and not hurting themselves and screaming and crying, then you really just want to give them a minute. You just want to keep yourself calm. Try not to say anything, and let them just get to a place where they're out of that part of their brain that is illogical, and not hearing you and not understanding what you're saying.

And then when they calm down, that's when you say, "Man, you were so upset because I wouldn't give you the remote control. I know that made you mad, but it's not a toy. And I'm sorry that you're upset. Do you feel better now?" And that's all you do.

02:34

You just want to name the feeling that you think that they were having. You don't want to try to have that conversation in the middle of a tantrum, it is not helpful. They are not hearing you. And it just makes, it just gives positive reinforcement to continue to scream and yell and I will pay attention to you. What you want to do is don't pay attention. Let them calm down, and then go and chat with them about it.

02:57

The other thing is, if you know they're tired, and you know they're hungry, that's not a big time to give a big spiel. It's really let them calm down. "Man, you were so upset. I wonder if you're tired. Should we have a nap?" That's it. Leave it at that.

03:12

I think the other really important thing to do with young toddlers when they have a tantrum, and it's really any kid of any age, when they have a tantrum, once they're calmed down and you've had a short little debrief about it, make sure you give them a hug and let them know either with words or with your nonverbal communication that you still love them and everything's okay. And eventually the tantrums will calm down.

We all need sleep, but the big question is, how much? For kids, the amount of sleep they need varies by age. From babies to teens and all ages in between, pediatrician Kim Matlock, M.D., has quick tips to help ensure your child gets sleep they need.

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Transcript

00:00:02

Hi. I'm Dr. Kim Matlock and I would like to talk to you about sleep tips for your child.

00:09

You know, sleep is an incredibly important topic for our children. It affects them in so many different ways, including growth and development, learning, behavior.

00:19

The appropriate sleep is very age dependent. Usually young infants between zero and four months are sleeping more than they're awake. And as they get to be older infants, they still require quite a bit of sleep.

00:29

Our preschool aged children need 12 hours of sleep at night, plus a two to three hour nap during the day.

00:39

As they get a little older, our early elementary age children need about 11 hours of sleep at night. And as they grow a little bit, our later elementary age children need an average of 10 hours of sleep at night.

00:52

Our adolescents don't get as near as much sleep as they need. They need 10 hours at night, but most adolescents don't get near that.

01:01

Giving kids good, adequate sleep will help them maintain healthy, active lifestyles. And those are my tips on sleep.

How do you change a newborn baby’s diaper and prevent diaper rash? Cook Children’s pediatrician, Kim Mangham, M.D., guides new and expectant parents through the steps of diaper changing and explains what to do to help prevent diaper rash.

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Dr. Kim Mangham is here with some simple tips to help you protect your baby and steps you can take in case of an emergency.

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Transcript

00:05

Hi, I'm Dr. Kim Mangum. I'm so happy to be here today to talk to you about infant safety and give you an overview of infant CPR. I work in one of the primary care clinics at Cook Children's on Keller Parkway. Let's talk first about infant safety. There are three points I'd like to make.

00:29

The first point is sick contact precautions. So it's really important for newborns not to be exposed to anyone who has any sick symptoms. So it's important to limit visitors and also if you yourself get a cold or a fever please wear a mask when you're caring for your baby.

00:45

Secondly, it's very important that babies are rear-facing in a car seat that is installed correctly. The Academy of Pediatrics recommends that you keep your infant rear-facing in the car seat until at least two years of age and older, until they exceed the height or weight specification of the car seat.

01:04

It's also very important for babies to be on their back in their own bed to sleep at night to prevent sudden infant death. The other thing that can contribute to infant death is tobacco exposure, so it's important not to have any smokers in your home.

01:17

If you go to Cook Children's.org you can see a really nice video on infant safety

01:26

The main things to know for infant sleep are number one, to make sure they're on their back in their own bed without any additional objects. And also in your room but not in your bed until twelve months of age. You can put your infant in a sleep sack or in a fitted pajama, flat on their back without swaddling. The Academy of Pediatrics prefers that you put the baby on their back rather than on their side to decrease the risk for sudden unexpected infant death.

01:52

Now I'd like to talk to you about infant CPR. It's important to know that what I will review today is for only infants zero to twelve months of age. Over 12 months of age CPR is done differently. I advise all my families to take a full CPR class because before you know it your baby will be over a year of age. The other thing we recommend is to go to cpranywhere.org and purchase the video and the mannequin because there's good data that shows the more you practice CPR the more effective it would be in the case of an emergency.

02:27

So this is for CPR for babies less than 12 months of age. The first thing to know is that you'll need, to do CPR on a firm flat surface. The next thing is, how do you know if a baby needs CPR? So you need to tap & shout and if the baby is not responsive go ahead and call 911 and start CPR.

02:46

The first thing to do for CPR is to do chest compressions. These are the baby’s nipples and if you imagine a line between the nipples your fingers go right below the nipples straight up and you'll want to go down about an inch and a half and come back up

03:10

The next thing that you'll do is give breaths. So it's important to do 30 chest compressions to 2 breaths. The way that you do the breath is you tilt the baby's head back and you lift the chin up and your mouth will cover a bit of the baby's nose and mouth. You can sort of turn your head a little bit to watch the chest rise and you'll give one breath over the course of about one second, and then give a second breath. So if we put it together, we'll do 30 chest compressions with two breaths. And then you return to chest compressions again. You will continue doing CPR until the baby becomes responsive or until help arrives.

04:15

Let’s talk about infant choking. If a baby is choking and you can see the object in his or her mouth it's okay to pull it out, but it's important not to do blind sweeps. In other words, don't put your finger in the mouth trying to get something out that you can't see because what will happen is that object will be lodged further in the baby's throat. If you determine that an infant is choking then it's important to do five back blows followed by five chest thrusts, which are similar to the chest compressions you did with CPR. Now, it is important that you don't get overexcited and put your hands on the baby's face or the baby's neck. Support the baby here and do five vigorous back blows, one, two, three, four, five, followed by five chest thrusts, one, two, three, four, five. You will repeat that series of five back blows and 5 chest thrusts until either the object shoots out of the baby's mouth, or the baby becomes unresponsive. If the baby becomes unresponsive it is important to ask for help. Call 911, lay the baby on a flat surface and start CPR.

Dr. Alice Phillips is here with some simple steps to help you prepare for childbirth and the arrival of your baby

So you're having a baby! It's such an exciting time, filled with high expectations. It can also be a time of high anxiety. As a mom and a pediatrician herself, Dr. Alice Phillips is here with some simple steps to help you prepare for childbirth and the arrival of your baby

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Transcript

My name is Dr. Alice Phillips, I am a pediatrician at Cook Children's. I have had the pleasure of working for Cook for 25 years now. So, you're expecting your first baby, maybe not your first. And now you want to know what to do.

So step one is, I want to encourage you to be as prepared as you can. I always think that's kind of a funny thing to say. How are you completely prepared for a newborn? There's no way to be completely prepared. But there are definitely some steps that you can take that will make that transition from being pregnant to having a newborn much easier. First, and most important is I think you need to find your pediatrician. It's surprising to me always, how many families don't do this. How they don't do research and figure out who is a good match for their family. So ask your friends, ask your family, who do they trust? Search online to the Cook Children's website for physicians in your region, and then call those offices. Many of the pediatricians will do prenatal consultations where you can actually come into the office, meet the physician, ask them any questions that you have, and get a feel for the layout to see if it's a good match.

Second, it's who can you protect that's going to be in that child's world? Since newborns can't have many of the vaccines that are so important to protect them, you want to have them in a wrapping of protection. That means everyone who's going to be around that infant has had a flu shot, if it's flu season. Everyone who's going to be caring for that baby is protected from whooping cough with an up-to-date Tdap. And that includes dads too. I find that you dads sometimes are a little bit reluctant on that shot thing. So we need moms, dads, grandparents, friends, caretakers, everyone to be protected so that that baby is protected.

Then you want to pack your bag. I remember when I was a mom packing my bag and thinking I needed all of these things, fancy clothes, stuff for the photos, and realizing when I got there, really all I needed to do was take care of the baby. So pack what you think is important. But remember, you're not going to use most of that stuff.

Now the baby's been born, what's going to happen when you're at the hospital. One thing that's important when you're choosing your pediatrician is to ask them do they make rounds at the hospital. Some do many don't. With the birth of the hospitalist service in American medicine, many pediatricians choose to focus their time on their families in the clinic. But if your doctor does come to the hospital, it's a very important time that they can have that first contact with you. And they'll check your baby daily while you're there. So what's going to happen, there's a whole lot of stuff. But what's important for you to know is none of this happens without your consent. And so you need to know what you're going to be signing before you get there. So the baby will be born, they're going to dry, the baby baby will not get a bath anymore until they're about 24 hours of age, so that you can bond with them and they don't get overly cooled. The baby's going to have a hearing test done to rule out any type of congenital hearing loss. They're going to have a test done of their heart, it's just a simple oxygen test, it doesn't hurt them a bit. They put a little tape around their finger, they measure their oxygen level. And it's a good clue to us if there's any kind of underlying heart disease that we can't hear. They're going to have a newborn screen at 24 hours of age. This checks them to make sure that they don't have one of a wide array of inherited medical diseases that if we know about them early, we can prevent a lot of serious consequences. Additionally, if you sign they're going to get that first vaccine, so important Hepatitis B, it not only protects them from Hepatitis B that they could have gotten, in rare cases from mom, but it also protects them from the rest, for the rest of their life from any type of transmission via blood, bodily fluids, anything of that nature. Then, daily, your pediatrician or the hospitalist will come by to check your baby. They'll make sure their exam is normal. They'll talk with you about everything they found. And if you're in one of the hospitals that has a lactation service, you're going to get a consult with a lactation consultant daily. These are so important so that you make sure that you feel very comfortable with your breastfeeding before you head home.

Is your child is having trouble hearing or complaining about an earache? If so, it may be caused by wax buildup in the ear. Frank McGehee, M.D. has a simple—and kid-friendly—tip for unclogging your child’s ear.

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Transcript:

00:00:04

Hi, I'm Dr. Frank McGee from the Magnolia pediatric office and we're going to talk today about how to get earwax out of your child's ear. The importance of that is that sometimes earwax can get so blocked that the child can't hear normally.

00:00:17

More practically, if the child has a large chunk of wax in the external ear canal, the pediatrician can have trouble seeing the tympanic membrane and telling if there's an earache or not.

00:00:27

So there's a simple way to clean earwax and keep, basically keep the flow of earwax, and avoid an impaction. That involves a cotton ball and hydrogen peroxide. And what you do is put hydrogen peroxide on a cotton ball so that it is moist and you hold it to the child's ear for four or five seconds during bath time.

00:00:46

You don't have to drip or stuff the cotton ball there, you just hold it to the to the outside of the ear canal and the moisture from the hydrogen peroxide softens the wax and helps it flow out of its own accord.

00:01:00

So that's how you remove earwax or keep it flowing in a very simple way. If you have any other questions, please feel free to call our office. Thank you.

Watch Now

Is your child afraid to swallow a pill or vitamin? Pediatrician Amani Terrell, M.D. demonstrates a way to make swallowing a pill easier for your child. And, of course, it makes getting your child to take their medicine a little less stressful for you.

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00:00:05

Hi, I'm Dr. Terrell, and I'm going to teach you how to get your child to swallow a pill. Children as young as five and six can certainly learn how to swallow a pill. And here's a good way to teach your child how.

00:00:17

First, you get a cup of ... I have yogurt here, but you can use pudding or apple sauce, or mashed potatoes or anything that you like for your child that has kind of like a mushy consistency.

00:00:30

And yeah, and then I have a spoon right here. I like to practice with a small piece of candy. So I have an Icebreaker here. But you can use Skittles or a Tic Tac or an M&M.

00:00:45

You want to place your piece of candy onto the spoon and bury it into your yogurt or your apple sauce. And then have put the spoon in the child's mouth and have them swallow it whole, just like this.

00:01:01

It's simple and it's easy and it's a good way to get your child to swallow a pill.