Grandparents, Nail Polish, Heroin and Driving – PediaCast 437

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Show Notes

Description

• This week we cover more news parents can use. Topics include abusive caregivers, grandparents and their dangerous drug habits, hazards of personal care products, teenage heroin use, teen suicide, driver education for those with autism and early preparation for flu season. We hope you can join us!

Topics

• Abusive Caregivers / Child Abuse
• Grandparents and Their Dangerous Drug Habits
• Hazards of Nail Polish and Hair Care Products
• Teens and Heroin Addiction
• Teenage Suicide
• Driving with Autism
• Preparing for Flu Season

Links

• Childhood Physical Abuse – PediaCast CME 030
• Teenagers and the Opioid Crisis – PediaCast 430
• Behavioral Health Playlist of PediaCast Episodes on SoundCloud

Transcription

Announcer 1: This is PediaCast.

[Music]

Announcer 1: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children's, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello, everyone, and welcome once again to PediaCast. It is a pediatric podcast for moms and dads. This is Dr. Mike, coming to you from the campus of Nationwide Children's Hospital. We are in Columbus, Ohio. 

It's Episode 437 for July 17th, 2019. We're calling this one "Grandparents, Nail Polish, Heroin, and Driving." I want to welcome all of you to the program.

I know it is a mishmash of topics today. We have a news parents can use edition of the podcast lined up for you this week. It's been awhile since we covered pediatric news. So there were lots of items to choose from. Hopefully, you'll enjoy our collection and find something useful to improve your family's health and wellbeing. 

0:01:19

Many more topics than were mentioned in the title of the show. I'll have the entire lineup for you in just a moment. First though, if you're interested in pediatric and parenting news, be sure to follow PediaCast on social media. And in particular, Facebook, Twitter, and LinkedIn, simply search for PediaCast. 

The reason is that we share pediatric and parenting news there on a daily basis. Really try to curate the best on the internet and share it with you. You won't find that kind of information in the podcast because we just don't have time to cover all of it. 

So lots more parenting news and information, pediatric, what's the latest in pediatric research, what are the recommendations for your kids and keeping your family healthy. We try to share that on a daily basis. So lots more on social media. 

Of course, we also will keep you up to speed on what we are covering from week to week on the podcast. But we really like to use Facebook, Twitter, and LinkedIn to share the latest research, recommendations, guidelines, on a daily basis as moms and dads and our audience undertake the important task of keeping your kids safe and healthy.

0:02:29

So please do connect with PediaCast. Again, Facebook, Twitter, LinkedIn, simply search for PediaCast.

We're also on Instagram. Although, in that space, we're more likely to share glimpses into the studio as we record as well as visual representations of family life, and by that I mean pictures, of what we're up to from day to day. And I love seeing your family pictures as well. So if you connect with PediaCast on Instagram, expect to get a follow in return, so we can share what's going on with each other including ideas for family fun.

0:03:04

All right, so what are we covering here on the podcast today? First up, there's going to be a story about child abuse. And I know it's not an uplifting topic at all. But it's an important one for a couple of reasons. We have some news on the characteristics of those who are more likely to physically abuse children.

And that's an important consideration for parents as you decide who can care for your kids in your absence. Also important for the pediatric providers in the crowd as we are called upon to differentiate child abuse from accidental injuries. 

Then, we're going to talk about grandparents and the dangerous drug habit many of them have, which consist of leaving their medications in their purse or their bag, on counters within reach, oftentimes in unlabeled containers that are easy for children to open. So we'll cover the risks and provide some tips on keeping your kid safe from the drug habits of grandparents. 

0:04:05

Speaking of poison, we'll also chat about personal care products, things like shampoo and soaps, nail polish, other hair and skincare products, things that are often left out in the open because parents don't perceive them as dangerous. And yet, they can be dangerous and they do send kids to the hospital.

So we'll cover the scope of that problem and reveal which products cause the most injuries. And then, it will be on the teenagers. We have several items related to the adolescent crowd this week, including teenage use of prescription pain pills and the association of that with heroine addiction before high school graduation. Yes, it happens and the parents need to know.

We'll also give you an update on teen suicide and talk about teenagers with autism who are eager to drive. What are the best practices for teaching driving skills to this population and when is it safe for them to hit the road? We'll talk through the answers. 

0:05:01

Finally, a news item for the pediatric providers in the audience. I know it's summer, but before you know it, kids will be heading back to school and it will be time for annual flu vaccines. We all know that vaccine hesitancy is on the rise with only about half of children actually getting a flu vaccine last year.

So this season, what can we do to increase that percentage as well seek to decrease the number of childhood deaths from the flu? Researchers at Columbia University have an idea for us which we'll pass along near the end of the program. 

Don't forget, we love to hear from you, the PediaCast audience, it's easy to get in touch. Just head over to pediacast.org. We have a contact link for you there. You can fill out the form and send it in if you'd like to suggest a show topic or you have a question that you would like answered on the program. We also have telephone number, 347-404-KIDS. That's 347-404-5437 if you rather phone it in.

Also, I want to remind you, the information presented in every episode of our podcast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for a specific individuals. So if you have a concern about your child's health, be sure to call your doctor and arrange a face-to-face interview and hands-on physical examination.

0:06:18

Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement which you can find at pediacast.org.

Let's take a quick break, and then I will be back to talk more about grandparents, nail polish, heroin, driving and much more. That's all coming up right after this. 

[Music]

0:07:05

Dr. Mike Patrick: Over 1,700 children die from child abuse each year in the United States and far more sustained injuries that result in hospitalization. These deaths and severe injuries are preventable but effective strategies require a deeper understanding of the caregivers causing the harm and the circumstances surrounding the child's injuries.

The odds of child physical abuse versus an accidental injury increases substantially when the caregiver at the time of injury is a male. This according to a study recently published in The Journal of Pediatrics. 

When the male was the boyfriend of the mother or another caregiver, the odds of abuse were very high. Injuries were also more severe when the child was with a male caregiver.

In contrast, abuse as the cause of injury was substantially less likely when a female caregiver was present, with the exception of a female babysitter. Caregiver arrangements that were different than usual were also associated with an increased risk of abuse. Researchers say these findings may help improve early recognition of abuse when a young child is injured and may also inform future abuse prevention strategies.

0:08:15

Study author, Dr. Mary Clyde Pierce, who's a professor of emergency medicine at Northwestern University Feinberg School of Medicine and a physician at Lurie Children's Hospital of Chicago, she says, "Given that we found strong associations between certain caregiver features and the likelihood of abuse, it is vitally important for clinicians evaluating the child to ask who was present at the time of injury. 

"Through a better understanding of caregiver features, screening for child abuse can be refined, evidence-informed clinical decisions can be made, prevention efforts can be focused on populations at greatest risk, and policies can be tailored accordingly."

The study looked at 1,615 children younger than four years of age who sought injury treatment in a pediatric emergency department. Twenty-four percent of these children were determined to be physically abused. 

However, of severe injuries under the age of four, 77% were classified as abuse and nearly all cases of severe injury in which fathers or boyfriends were present involved abuse.

0:09:17

Dr. Pierce adds, "Child abuse prevention efforts frequently target mothers, but our study confirms previous research that the presence of male caregivers poses a greater risk of abuse. Therefore, we must shift our focus for prevention strategies to be successful. Future prevention strategies should also educate parents that leaving their young children in the care of people unfamiliar with the challenges of caregiving, even for brief periods of time, can be dangerous."

So a couple of take-home points with this story. First, for the moms and dads in the crowd, the last quote from the research team is really important. Leaving your young child in the care of people unfamiliar with the challenges of caregiving, even for brief periods of time, can be dangerous. 

0:10:05

Now, on the other hand, sometimes you need a break. It's healthy to get away and have some grownup time away from the kids. And, of course, work often necessitates outside care for young children.

But it's also very important to consider your options carefully and realize that fathers and boyfriends and any other caregiver for that matter really must be equipped with patience and gentleness and a commitment to constantly supervise in a loving and trustworthy manner. And if you're not 100% confident that these attributes describe your child's caregiver, then you may want to consider someone more appropriate.

For the pediatric providers in the audience, I think the numbers from the study bear  repeating. 24% of injuries presenting to the pediatric emergency department in this study in kids under the age of four years were classified as abuse. A quarter of all the injuries and 77% of the severe injuries were thought to be abuse. And nearly all of the severe injuries in which fathers or boyfriend were present involve an element of abuse. That's telling.

0:11:13

If you like to know more about childhood physical abuse especially for the providers in the crowd, we did a pediatric CME. That stands for Continuing Medical Education. Those podcasts, you listen to those, go to the website at pediacastcme.org and then look for the show notes for the particular episode. 

We have all of the CME information for you there as well as the post-test. You simply sign up for a free account, log in to your account, take the post-test after you've listen to the podcast and you can claim free Category 1 Continuing Medical Education. Again, that's PediaCast CME and our episode on childhood physical abuse was Episode 30.

Whether it's a rare treat or a weekly routine, spending time with grandchildren brightens life for many older adults. But a new poll suggest many of them could do more to reduce the risk of their medications harming their grandchild. 

More than 80% of the grandparents polled say they keep their medication in the same place as usual when their grandchildren visit their house. And 72% keep them in their purse or bag when they go to visit their grandchildren. Nearly one-third say they store their prescription medications in something other than the container they came in, with the vast majority of them using an easy-to-open container.

0:12:28

For older grandchildren, the easy access may lead to misuse of certain medications that hold the potential for abuse, for instance, pain medications and sedatives.

Researchers from the University of Michigan say these practices may put children at risk of accidental poisoning and provide opportunity for older children and teens to abuse drugs if they get into their grandparent's medications. 

Investigators obtained data from the National Poll on Healthy Aging and suggests that grandparents need more education about safe medication storage when they're around children and teens, whether for a holiday visit or a regular childcare.

0:13:07

The poll asked more than 2,000 adults between the ages of 50 and 80 about their medication storage habits.

According to the US Centers for Disease Control and Prevention, nearly 40% of children treated in emergency departments for medication-related poisoning took their grandparents' medicines.

The poll's director, Dr. Preeti Malani, says, "Prescription medicines, and even over-the-counter medicines and supplements, can harm children and teens who find them in grandma's purse or on grandpa's kitchen table. Meanwhile, opioid painkillers and sleep medicines can be diverted for recreational use by teens. No matter how old your grandchildren are, you need to think about medication safety."

The poll also found that two-thirds of grandparents say they provide care for their grandchildren -- 42% care for them monthly, while 18% care for them weekly. One in ten grandparents live with their grandchildren year-round and 86% said their grandchildren had visited them at some point in the past year.

0:14:06

During those visits, the poll found 84% of older adults do not change their routine regarding where they store their medicines. Those usual places include cupboards or cabinets, countertops and tables, purses or bags or other locations. . Only 5% said they routinely keep their medications in a locked cupboard or cabinet.

The poll also suggests that when grandparents are the ones visiting grandchildren, the chance of easy access may go up because nearly three-quarters of grandparents keep their medicines in their bag, as compared to 7% who leave them on a counter or table and 7% who place them in a locked cupboard or cabinet.

Dr. Alison Bryant, senior vice president of research for the American Association of Retired Persons, says, "We know that grandparents love spending time with their grandchildren. But a few simple steps can keep those little ones safe when you're together. Don't leave medications in your purse or in the kitchen counter. It's best to keep them locked up. It's also a good idea to go through your medications every few months and safely discard any that are expired or no longer needed."

0:15:09

Dr. Preeti Malani says that childproof prescription drug vials and bottles were developed and required starting years ago, specifically to protect children from accidentally swallowing medicine not prescribed to them. However, those "childproof" containers can be difficult for some adults to open. So the poll asked grandparents if they ever used alternate containers, ones that could be easier for children to open.

Twenty-nine percent of the older adults polled said yes, they do transfer prescription medicines, over-the-counter medicine and supplements to other types of containers. All of these products can be harmful to children especially when taken in larger than recommended amounts.

Dr. Malani says, "If you put your pills into day-of-the-week pill sorters so you can remember whether you took your medicine each day, that's great. But keep that sorter out of the reach of little ones. Make sure you explain to them, and their parents or older siblings that it's important to stay away from your medicines and that those pills are for you and you alone, not them." 

0:16:07

She adds that grandparents should have the national Poison Control number stored in their phone, memorized or otherwise available. That phone number is 1-800-222-1222. Again, 1-800-222-1222. 

Actually, if you can do so, please hit the Pause button now and enter that number into your mobile device. Again, it's the national Poison Control Center number. Regardless of where you live in the United States if you call this number, you're going to get in touch with your local Poison Control Center. 

Again, 1-800-222-1222. Unless you're driving or engaged in some other potentially dangerous activity that involves your hands, please pause and add that to your phone now. 

I'll also place that phone number in the show notes so you can find it easily there.

In homes across the country, there are dangerous products hidden in plain sight on bathroom counters and bedroom dressers. Personal care products like shampoo, lotion, makeup, nail polish, and cologne seem like they should be safe since they are intended for use on our bodies. However, in the hands of young children, these products can quickly lead to trouble. 

0:17:16

This is according to a new study conducted by researchers at the Center for Injury Research and Policy here at Nationwide Children's Hospital. They found that 64,686 children younger than five years of age were treated in US emergency departments for injuries related to personal care products from 2002 through 2016. That's the equivalent of about one child every two hours.

The study, recently published in Clinical Pediatrics, found that most injuries from these products occurred when a child swallowed the product or the product made contact with a child's skin or eyes. These ingestions and exposures most often led to poisoning or chemical burns.

Rebecca McAdams, co-author of the study and senior research associate in the Center for Injury Research and Policy at Nationwide Children's, says, "When you think about what young children see when they look at these products, you start to understand how these injuries happen.

0:18:12

"Kids this age can't read, so they don't know what they are looking at. They see a bottle with a colorful label that looks or smells like something they are allowed to eat or drink, so they try to open it and take a swallow. When the bottle turns out to be nail polish remover instead of juice, or lotion instead of yogurt, serious injuries can occur."

The top three product categories leading to injuries were nail, hair, and skin care products, followed by perfumes and other fragrances. Nail polish remover led to the highest number of visits to the emergency department. And the most serious injuries, those requiring hospitalization were most often caused by hair care products, with hair relaxers, and permanent solutions leading to more hospitalizations than all the other products.

Also, of concern, is the ease of access to these items. Investigators say, "Children watch their parents use personal care products and may try to imitate their behavior. Since these items are often stored in easy-to-reach places and not typically in child-resistant containers, it can be easy for kids to get to and open the bottles." 

0:19:19

They add, "Because these products are currently not required to have child-resistant packaging, it is important for parents to put them away immediately after use and store them safely up, away, and out of sight, preferably in a cabinet or closet with a lock or a latch. These simple steps can prevent many injuries and trips to the emergency department."

Researchers also recommend that pediatricians discuss these safe storage guidelines with caregivers during well-child visits.

Parents and child caregivers can help children stay safe by following these tips. Again, store all personal care products safely up, away and out of sight. In a cabinet that can be locked or latched is best. Never leave personal care products out unattended and put them away immediately after us. 

Store it now. It is never too soon to store these products safely. Almost 60% of the injuries in the study were in children younger than two years of age. So even when you think young kids can't reach, no, they often find a way. 

0:20:18

Use original containers. Keep all personal care products in their original bottles and boxes. That way, you know what's what. And you can pass important information along in the case of an emergency. 

Finally, know how to get help. Save the national Poison Control Help Line in your mobile device and posted in your stationary phones in your home. That number once again, 1-800-222-1222. 

[Music]

0:21:12

Dr. Mike Patrick: It is an unforeseen side effect of the nation's opioid epidemic -- adolescent heroin users. 

A recent study from the University of Southern California, published in JAMA Pediatrics, reveals that teens who use prescription opioids to get high are more likely to start using heroin by the time of their high school graduation.

Dr. Adam Leventhal, a professor of preventive medicine and psychology and director of the USC Institute for Addiction Science at the Keck School of Medicine, says, "Prescription opioids and heroin activate the brain's pleasure circuit in similar ways. Teens who enjoy the 'high' from prescription opioids could be more inclined to seek out other drugs that produce euphoria, including heroin."

The group's study, conducted from 2013 to 2017, is the first to track prescription opioid and heroin use in a group of teenagers over time. In 2017, 9% of the nation's 47,600 opioid overdose deaths occurred in people under the age of 25, according to data from the US Centers for Disease Control and Prevention. 

0:22:16

In addition to overdose, health risks of heroin use are devastating and include severe addiction, hepatitis C, HIV and other infections.

Using twice-yearly surveys to track high schoolers' use of various drugs, researchers followed 3,298 freshmen from 10 Los Angeles-area high schools through their senior year. Participants were asked about their previous and current use of prescription painkillers, such as Vicodin, Oxycontin and Percocet, to get high.

The researchers also asked the students if they used heroin or other substances like marijuana, alcohol, cigarettes, methamphetamine and inhalants. They made statistical adjustments to account for differences in family environment, psychological disposition, family history of substance use and other factors associated with non-medical prescription opioid use.

0:23:08

Of the nearly 3,300 students in the study, 596 reported using prescription opioids to get high during the first three and a half years of high school. The researchers found that prescription painkiller use made a big difference in who later used heroin. 13.1% of current prescription opioid users and 10.7% of previous prescription opioid users went on to use heroin by the end of high school. In contrast, only 1.7% of youth who did not use prescription opioids to get high had later tried heroin by the end of high school.

First author of the paper, Dr. Lorraine Kelley-Quon -- she's a pediatric surgeon and assistant professor of surgery and preventive medicine at Children's Hospital Los Angeles and the Keck School of Medicine -- she says, "Adolescents are sometimes overlooked in the opioid epidemic discussion. The association between non-medical opioid use and later heroin use in youth is concerning and warrants further research and health policy interventions."

0:24:11

To further confirm their results, the researchers also evaluated whether marijuana, alcohol, and methamphetamine use were linked to later heroin use. However, they found the association between prescription opioids and heroin use was stronger than the associations for heroin use following other substances.

Dr. Leventhal says, "While we can't definitively conclude that there is a cause-and-effect relationship, there may be something unique about opioid drugs that makes youths vulnerable to trying heroin. The results do not appear to be driven by the tendency of some teens to act out, rebel, or experiment with many types of drugs."

So one observation that we've made here on PediaCast as we consider teenagers and the opioid epidemic is that heroin tends to cause less than prescription pain killers sold on the street and yet produce a similar effect. So that's certainly one possibility for the association. For some of these kids, heroin then may be easier to get and cheaper.

0:25:11

If you like to hear more about the opioid crisis and how it is affecting teenagers, be sure to check out PediaCast episode number 430 where we really devoted the entire episode to this. That one is called Teenagers and the Opioid Crisis. Again, PediaCast Episode 430, wherever podcasts are found.

A large-scale study from The University of Toledo of young African Americans who have attempted or died by suicide suggests there is a greater need for mental health services in urban school districts, and that we need to do a better job in convincing parents and caregivers to safely secure firearms and ammunition in the home. 

Dr. James Price, professor emeritus of health education and public health at the University of Toledo says taking these measures could save lives. 

His study, recently published in the Journal of Community Health is the largest study to date that examines suicidal behaviors of African American teenagers between the ages of 13 and 19. And it reveals that the rate of  suicide deaths among young black males increased by 60% from 2001 through 2017.

0:26:20

Researchers documented a 182% increase in the rate of suicide deaths of young black females during that same time period. 

Georgia had the highest rate in the nation, with 5.8 deaths per 100,000 people, followed by Texas, Florida, North Carolina and Ohio.

Dr. Price says, "There are far more African American adolescents attempting suicide than has been recognized in the past, and their attempts are lethal." 

Currently, suicide is the second leading cause of death after homicide for African Americans between the ages of 13 and 19, and the rate continues to climb. Equally troubling is that the methods black youth are using in suicide attempts are among the most deadly.

0:27:03 

Investigators found 52% of the males used firearms with a fatality rate approaching 90%. Another 34% used strangulation or suffocation, which has a fatality rate of about 60%. Among the females who died by suicide, 56% used strangulation or suffocation and 21% used firearms.

Dr. Price says, "When we look at research with these teenagers, we find their attempt at suicide is a cry for help. Two-thirds of the kids did not really want to die, but they're using the most lethal form of attempting suicide. If you can make these lethal forms of suicide inaccessible, then that period of crisis and not seeing the irreversibility of the impulsive decision will pass. And with adequate mental health services available to young people, you may actually reduce the chance that they will try again." 

Previous surveys have found that among inner-city elementary school students whose parents own a handgun, three-quarters of the kids knew where the gun was kept.

Dr. Price says keeping firearms locked away, unloaded and separate from ammunition without a doubt reduces unintentional firearm injuries and impulsive suicide attempts.

0:28:15

The research also suggests a far greater need for mental health services in African American communities. Public health researchers have repeatedly documented that black youth are less likely to receive adequate mental health treatment, setting the stage for situations that contribute to self-harm.

Dr. Price says, "What needs to be done early on is to make sure that young people have adequate access to mental health-care services which have always taken a backseat to other forms of health care". He adds, "If you look at where young people in urban areas, especially teens, are getting mental health care, it's often in the schools."

Previous studies have found increasing mental health access in urban public schools could reduce suicide attempts by as much as 15%.

Dr. Price says, "While that does not solve all the problems, it is a good first step toward reducing the incidents of severe self-violence." 

0:29:06

If you 're interested in learning more about this topic, be sure to check out our behavioral health playlist of PediaCast episodes on SoundCloud. The topics you'll find in that playlist include anxiety in children and teenagers, cutting and self-harm and more on the prevention of teen suicide. We'll put link to that playlist for you in the show notes for this episode, 437, over at pediacast.org.

Teenagers with autism need the support of parents or guardians guiding them toward independence as they prepare to drive. This according to a study of specialized driving instructors who have worked specifically with young drivers with autism. Findings were compiled by researchers at Children's Hospital of Philadelphia and recently published in the journal, Autism in Adulthood. 

Just a quick aside, a few weeks back, a listener of this program asked about adults with autism. We talked about supportive resources and I included some in the show notes for that episode, 435. Turns out there's also a scientific journal on the subject called Autism in Adulthood, which I become aware of for the first time researching today's show. 

0:30:15

Now, this particular study in that journal, reveals that specialize driving instructors emphasize the need to develop and refine best practices to guide assessment and delivery of highly individualized instruction for teenage drivers with autism. 

Dr. Rachel Myers, lead author of the study and a scientist with the Center for Injury Research and Prevention at Children's Hospital of Philadelphia says, "Through our interviews with specialized driving instructors, we learned they believe parents are a critical partner in preparing for and undertaking independent driving." 

Instructors recommended that parents help their children develop independent life skills, including the use of alternative forms of transportation such as bicycling or mass transit, and to practice pre-driving skills, such as navigation, before taking on the road driving lessons.

0:31:06

Driving instructors are an important resource for families, especially for those with teens challenged by autism. However, because not much is known about the specific experience of teaching teens with autism to drive, the ability to provide proper help and guidance is often limited. 

To help bridge this gap, researchers conducted in-depth interviews with specialized driving instructors who had experience working with those impacted by autism. This is the first study to examine the process and experience of driving instructors who provide behind-the-wheel training specifically for this population.

The study revealed a set of common themes that underscored the importance of parents preparing teens with autism for the learning-to-drive process. Driving instructors view parents as essential partners in supporting their efforts in teaching driving skills and promoting independence. 

Participating instructors said parents can support and prioritize independence by encouraging teens with autism to develop life skills, such as mowing the lawn, cooking dinner, and taking public transportation, before they learn to drive.

0:32:14

Although the driving instructors identified a need to develop and refine best practices for assessment and instruction, they recognized that specific approaches must be tailored to meet the unique needs of each driver, reflecting the autism spectrum that affects each teenager differently. 

Other suggestions from the instructors include using state-level vocational rehabilitation services to provide financial support for instruction, identifying and promoting prerequisite life skills prior to undertaking driving, parent-supervised driving instruction in partnership with professional driving instruction, and tailoring instruction to address the particular needs of each driver.

Dr. Benjamin Yerys, study author and psychologist at the Center for Autism Research at Children's Hospital of Philadelphia, says, "What these specialized driving instructors told us about the disconnect between driving and other life skills was surprising. Some parents of teens with autism may not let their child use a stovetop oven, but they ask if he or she is ready to drive."

0:33:18

He says, "Parents should first move these teens toward greater independence by encouraging them to get around on their own. Traveling independently, whether it's by driving or other forms of transportation is key, of course, to continuing education, working, and staying connected with friends and family."

Obtaining a driver's license is a major milestone in the transition to adulthood. This milestone increases the independence and mobility of teenagers, which can potentially lead to improved access to occupational training, social, and community engagement opportunities.

According to previous research, nearly one-third of teens with autism do obtain a driver's license by the time they are 21 years of age, which as we have noted may improve their ability to transition toward independent living.

0:34:03

Our final story this week is primarily for the pediatric providers in the crowd. We are several months away from the next flu season, but here's an idea for improving flu vaccine rates among your young patients next year,  or next season, which is really just coming up in a few months. 

As you know, young children are more likely to suffer, severe even life-threatening complications from the flu, but only around half of children in the United States get the flu vaccine. 

A cheap and simple pamphlet about the flu handed to parents in their pediatrician's waiting room can increase the number of children who get the flu vaccine. This, according to researchers at Columbia University. 

The study, a randomized controlled clinical trial, is one of the first to look at the effect of educational information on influence of vaccination rates in children.

Dr. Melissa Stockwell, senior author of the paper and an associate professor of pediatrics and population and family health at Columbia University's College of Physicians and Surgeons, says, "Parents' concerns and misperceptions about vaccines are on the rise. Previous studies have shown that offering information to disprove vaccine myths, in some cases, reinforces a parent's belief about vaccines and can even reduce the number of vaccine-hesitant parents who intend to get their kids immunized."

0:35:27

In other words, sometimes, the information we provide has the opposite effect of what we would like it to have. 

Influenza spreads easily and affects about 8% of children each year. In young children, especially those under two years of age, the flu is more likely to cause pneumonia and severe inflammatory responses, which can result in hospitalization and even death.

The best way to prevent influenza is with the "flu shot," and both the CDC and American Academy of Pediatrics recommend annual flu vaccination for all children age six months and up.

0:36:00

Dr. Vanessa Scott, first author of the paper and currently an assistant professor of pediatrics at University of California San Diego, says, "In our study, we hoped to identify educational content that would encourage parents to get their children vaccinated against the flu."

The study included 400 parent-and-child pairs at pediatric clinics in northern Manhattan. The parents answered a brief questionnaire to assess their attitudes toward the flu shot and their intent to vaccinate. One-third received a one-page handout with local information about the flu, another third received a one-page handout with national information about the flu, and the rest received usual care, which meant no handout.

Both handouts emphasized the risk of getting the flu, the seriousness of the disease, and vaccine effectiveness. Providers were unaware of the parent's participation in the study.

So what did they find. Well, researchers say that nearly 72% of children whose parents were given either fact sheet were vaccinated before the end of the season, compared to 65% of those who did not receive a handout.

0:37:05

Parents who received the national handout were more likely to have their child vaccinated on the day of the clinic visit. And parents who had fewer concerns about vaccines were more likely to give their child a flu shot by the end of the season.  

Dr. Stockwell says, "We found that a low-cost handout, one that can be easily implemented in any pediatrics practice, had a significant and meaningful impact on influenza vaccination in children." 

Although investigators expected the handout with local information to have a bigger impact, the handout with national data improved vaccination rate on the day of the office visit.

Dr. Stockwell says, "The difference in magnitude of the number of deaths from influenza may have made the national handout more impactful." She adds, "Future research will compare the effectiveness, cost-effectiveness, and feasibility of different methods of delivering educational information about influenza -- including handouts, text messages, video, and interactive social media.

0:38:04

And here's a tip for the research team, you might want to add podcasts to your list of educational possibilities because they are another easy and convenient way to share educational information. In fact, we're doing it right now, with thousands and thousands of people.

So for the pediatricians and other pediatric providers in the crowd who are listening to me right now, this will be a perfect time to start designing your cheap pamphlet, just your handout, to give out in the waiting room before patients come back that has national data on it in terms of the number of flu deaths each year. And who knows? Hopefully, that will make a difference for your practice. 

[Music] 

0:39:12

Dr. Mike Patrick: We are back with just enough time to say thanks once again to all of you for taking time out of your day and making PediaCast a part of it. Really do appreciate that.

Don't forget, you can find us in all sorts of places. We are in the Apple Podcast app, iTunes, Google Play, Google Podcasts, iHeart Radio, Spotify, SoundCloud and most mobile podcast apps.

We also have our landing site at pediacast.org where you will find our entire archive of past programs, all of our show notes, transcripts to some of the shows, Terms of Use Agreement, and our handy Contact page if you would like to suggest topics for the show or ask a question of your own. 

Also, reviews are helpful wherever you listen. We don't charge anything for the great information we provide in PediaCast, all the interviews and parenting advice and recommendations. But all we ask in return, really, is that you leave a review in one of the places where you listen to the podcast. 

0:40:06

I think reviews are important because, at least with our family, pretty much anything new that we try, we read reviews first. Whether it is a healthcare providers, it's restaurants, movies, vacations spots, really anything, you read reviews first to get a sense of what you're getting into. 

And so, those are best done not by me but by you, the audience. And so, just taking a couple of minutes out of your day to write a review where you listen to podcast would certainly be helpful. 

Don't forget, we're also on social media -- Facebook, Twitter, and LinkedIn, in particular -- where we share parenting information, pediatric news, guidelines, recommendations pretty much on a daily basis. Also on Instagram where you can get a peek into the studio and our family life.

Don't forget to tell others about the program, not just on social media but really face to face. We really love it when you tell your family, friends, neighbors, co-workers, babysitters, anybody who has kids or takes care of kids. We really do appreciate you telling them about the program.

0:41:08

So many podcasts out there today. It's easy to just sort of get lost in the bulk volume of audio programs that are out there. So if you help guide friends and family to our evidence-based information, we really do appreciate it. 

And that includes, by the way, your child's pediatric healthcare provider. Please do let them know about the show so they can share this resource with their other patients and families.

And while you have their ear, let them know we have a podcast for them as well. I've mentioned it briefly on the show today already. It's PediaCast CME, which stands for Continuing Medical Education. It is similar to this program. We do turn the science up a couple notches and offer free Category 1 Continuing Medical Education Credit for those who listen. 

Shows and details are available at the landing site for that program which is pediacastcme.org. Those shows are also available in Apple Podcast, iTunes, Google Play, iHeartRadio, Spotify and most mobile podcast apps. Simply search for PediaCast CME.

0:42:10

Thanks again for stopping by. And until next time, this is Dr. Mike saying stay safe, stay healthy, and stay involved with your kids. So long, everybody.

[Music] 

Announcer 1: This program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast.