ADHD by David S Katz, MD

Attention Deficit Hyperactivity Disorder, or ADHD 

As I sat down to write this article, Daniel came by to offer his assistance.  Daniel is 29 years old. He happens to have Down Syndrome. He grew up in our office as a patient and now works here part time. When I told Daniel what I was writing, he offered me some excellent advice.  He said that each child comes from a different situation and needs to be treated as an individual. Continue reading “ADHD by David S Katz, MD”

5-2-1-0 AAP Diet Plan -John Roth MD

A few simple numbers to help solve the very complicated and growing problem of obesity.

According to data from the Centers for Disease Control and Prevention, Louisville ranks eighth as the fattest city in the United States.

Thirty-nine percent of Kentucky children are overweight led by greater than 50 percent of the urban and rural poor. These numbers foreshadow significant health problems for these children in the future with heart disease, liver disease, diabetes, gallstones and joint breakdown most likely. Besides the personal suffering this entails, our society will have the burden of increased healthcare costs and an unhealthy workforce. Continue reading “5-2-1-0 AAP Diet Plan -John Roth MD”

Empty Nest – Mark Newstadt, MD

Empty Nest. Time to Start Living?

Now that our daughter, the youngest of five, has gone off to college, the house seems desolate and lonely. Being a pediatrician, I see lots of teenagers in the office embarking on their college careers and so I thought I would be prepared for the next stage in her and our lives. If you also feel anxious, empty, down or even devastated since your youngest has left home then you’re certainly not the first nor the last parent to miss your “baby.” While this can initially be a very sad and trying time for some, there are advantages. Continue reading “Empty Nest – Mark Newstadt, MD”

Best Buddies Kentucky

Best Buddies Kentucky Welcomes You!

We are excited to be one of the newest state operations for Best Buddies International.  Our venture was launched in the fall of 2009, and we already have ten college programs, one high school program, one middle school program, and 18 e-Buddies!  We also have a wonderful Advisory Board recruited and our first annual Champion of the Year campaign held this past fall was a great success!

As we move forward as a new nonprofit in the state of Kentucky, we are looking for volunteers, donors and participants for every aspect of our business.  If you have a talent you would like to share, I welcome an email or call from you!

Thank you for visiting our web site.  We look forward to meeting you in person soon!

Different But The Same by David S. Katz, MD

Different But The Same

Recently, Alex Rodriguez, the often injured New York Yankees third baseman, has started working with a new athletic trainer. Instead of focusing on his hip, to the surprise of many fans, Dr. Mike Clark instead treated his whole body. He explained his approach to the problem this way: “We look at the body as an integrated unit…(and) retrain the entire body.”

Children with special needs likewise have to navigate the same broad developmental stages as all children.

A parent of an 18-month-old child with a significant speech delay has recently been getting calls from the daycare teacher, that their previously loving child is now pulling his friends hair, hitting them and then grabbing their toys.

Not infrequently, a distraught mother of a 13 year seventh grade boy with ADHD (Attention Deficit Hyperactivity Disorder) will come to speak with me about his unexpectedly difficult year at school. Her son is forgetting his homework, or books, not completing his work, talking more, becoming the class clown, and talking back to his parents at home. As a result, his grades are dropping and the teachers are frantically contacting the parents about his recent poor overall school performance.

A father of a 15 year old boy, with developmental delays, tells me that his son is telling all his friends at school that he is going to “get someone pregnant”. His father is very upset and embarrassed about this behavior.

The key to understanding these situations was taught to me by one of my mentors in developmental and behavioral pediatrics, Dr. James Kavanaugh child psychiatrist at the University of Virginia. Parents often feel that their child’s behavior is due to their longstanding developmental issues. In reality, however, normal developmental milestones occur in a child with learning differences, just like any child. These developmental paths are shaped by the child’s limited ability to respond to these challenges.

The toddler mentioned above is in the normal stage of increased aggressiveness and attempts to assert himself. Toddlers are well known to hit and bite each other to get what they want. When a child with speech delays reaches this stage, his or her inability to express desire leads to frustration and therefore increasingly aggressive behavior.

All 13 year old boys are a puddle of hormones. Or as one of my pediatric partners has said, their blood flow goes to other areas than the brain. All pubertal preteens and teens struggle to stay focused on their school work, when changes to their bodies and minds serve as major distractions. I refer to the concurrent drop in school performance, maybe less eloquently stated, as an academic brain fart. An older teen, looking back at her early teens, told me, “Our bodies were changing and we didn’t know what to do about it.”

Superimpose this normal development phase onto a 13 year old with ADHD and you can understand why he would be having an extraordinarily difficult year at school.

In high school, sexuality is even more overt. Kids want to be accepted and to be “popular”. A student who is not socially adept will often suffer with issues of low esteem. In an attempt to compensate he might make statements filled with bravado to overstate his acceptability or attractiveness, as the 15 year old teenager mentioned above.

Children with special needs have unique hurdles to surmount, but also experience the same developmental challenges as their peers. It can be a special challenge for parents, teachers and caregivers of these children to resist solely viewing these kids through the “special needs lens.” Rather, one must look at these challenges as the interaction between their special needs and normal stages of development.

Parenting any child is a contact sport!

David S. Katz, MD
Kaplan Barron Pediatric Group

other related sites

Best Buddies Kentucky

The Council on Developmental Disabilities

Kids Center for Pediatrics Therapies

American Academy of Child and Adolescent Psychiatry

Inspired To Lose by Mark Newstadt MD

Inspired To Lose by Mark Newstadt MD

Inspired by the significant weight loss by a fellow staff member, the administrator of Kaplan Barron Pediatrics suggested that our office initiate a biggest loser contest with a financial incentive. At that time, we did not know that this program would prove to be a successful office wellness model, with improvements at each succeeding phase. Fourteen months ago, the program began, directed by our office administrator with assistance from our lab manager. The office is currently running the sixth phase of this program. Each phase has been a little different in terms of exercise options, points and incentives. We have had teams and individuals competing for the title of biggest loser. Points can be earned for weight loss or maintenance of weight (in those employees with normal BMI) and exercise in and out of the office. Some phases have required monetary contributions and small penalties for weight gain. The exercise option was only incorporated this year. Classes are now led four times a week at noon by our office manager or lab manager. Money has been contributed by individual employees and the physician employers into pools; individuals or teams who have earned the most points through weight control or exercise receive the winning prize. Our office wellness program has been very successful, resulting in significant weight loss in several employees (180 lbs total so far), increased involvement in exercise in and out of the office, improved morale and improved worker productivity. The success of our program has resulted in a reduction in our health insurance premiums. An office wellness program encourages employees to lead healthier and more active lifestyles. More than 80% of businesses in the United States with at least 50 employees offer some type of office wellness program. More than 60% of adult Americans are overweight according to the Centers of Disease Control. They continue to promote office wellness programs as a way to improve health and quality of life for workers while reducing healthcare costs. The Maine Move And Improve program reduced employee inactivity from 50% to 5%. Unhealthy workers cost employers an average of $11,196 per year according to a survey reported in National Real Estate Investing in February 2011. Office wellness programs offer convenient affordable ways to get or stay fit. Programs can vary greatly and be designed according to the needs and interests of the staff. Office wellness programs are not just about diet and exercise. Wellness includes emotional, spiritual and physical wellbeing. In addition to helping employees meet nutritional and exercise goals, an effective office wellness program should develop camaraderie and help to relieve stress. While employees are not required to participate, incentives may be provided for participation. Allowing employees to have input into the structure of the program as well as the incentives provided will help to make the staff more involved, committed and successful. Strategies encouraging competition and fun games help employees to stay committed to completion. Integral components of office wellness programs may include exercise classes, walking, zumba, jazzercise, gym memberships, nutrition classes, healthier food in the workplace and tobacco cessation classes. Monitoring of weight, body mass index, blood pressure, blood sugar and cholesterol may be included. Low fat food tasting sessions can introduce many new tasty options to individuals who had not previously experimented with these. Healthy cooking classes can be hosted to educate employees and families. Other useful options may include utilizing outside speakers periodically to inspire and educate the staff. Barriers should be removed to maximize participation in exercise programs. This may include the provision of shower facilities or flexibility in class schedules. Fitness and nutrition websites or apps such as My Fitness Pal can be used to monitor caloric intake and expenditure accurately. Teamwork and peer pressure provide positive enhancement in wellness programs. People do not want to let their fellow workers down. Team members put positive pressure on each other to succeed and meet weight and exercise goals on both a personal level and as a member of a team. It is important to provide incentives for participation as well as for reaching goals. Not everyone can be a biggest loser, nor reach their goal weight. Incentives such as points, gift cards or prizes can motivate more people to be involved. Establishing the right incentives will motivate employees to be involved in the wellness program and to succeed in reaching their individual and team weight, health goals and fitness goals. According to the Incentive Research Foundation in August 2011, involvement of employees in office wellness programs will increase from 20% to 80% if attractive incentives are provided. Incentives may be comprised of monetary or travel awards, gift cards, fitness clothes or equipment, low calorie recipe books, massages, paid time off, discounts on health insurance or contributions to a Health Savings Fund. Employer surveys may be used to identify the most popular and practical incentives, allowing office wellness programs to be more inclusive and successful. Workers may provide suggestions based on personal experience with smoking cessation, weight control and exercise. For an office wellness program to be successful, the employees’ progress needs to be tracked weekly with results openly visible to all involved so that comparisons can be made with other individuals and team members. Success can be measured by the monitoring of physical measures (blood pressure, pulse, weight, BMI, strength, flexibility and waist circumference), psychological measures (employee satisfaction, morale), and productivity measures (decrease in absenteeism and increase in productivity). In the office of Kaplan Barron Pediatrics, we hope to continue to improve and expand our wellness program while we constantly monitor its success. It is inspiring to see each other become slimmer, more fit and more toned; these changes have led to improved morale in the office. Food served at our office meetings is much healthier and many of our patients and their families have been inspired by our success. In light of the ever-increasing obesity epidemic, especially in the state of Kentucky, it is imperative to provide a workplace that fosters happy, healthy employees by approaching their well-being and satisfaction in a holistic way. A well executed office wellness program is one way to accomplish this essential goal for a successful workplace. Good luck and stay fit!