PediaCast 160 * Meningitis Vaccine, Radon, Homeschool

Do you have questions about The Toxic Substance Control Act, exam room chaperones, the meningitis vaccine, flame retardant chemicals, or radon?  Listen as Dr. Mike talks about these topics and more, and discusses homeschooling with two special guests in the studio.


  • The Toxic Substance Control Act

  • Exam Room Chaperones

  • Meningitis Vaccine

  • Flame Retardent Chemicals

  • Radon

  • Homeschooling



Announcer: Bandwidth for Pediacast is provided by Nationwide Children’s Hospital for every child, for every reason.


Announcer: Welcome to Pediacast, a pediatric podcast for parents. And now, direct from Birdhouse Studios, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello, everyone and welcome to Pediacast. It is a pediatric podcast for moms and dad. And we are coming to you from the campus at Nationwide Children’s Hospital.

It’s Episode 160 for April 27th, 2011 and we’re calling this one "Meningitis Vaccine, Radon and Homeschool". Of course, those of you who are familiar with the program know we're going to cover lots more topics that just those three. We’ll give you the rundown here in just a couple of minutes.

First, I wanted to remind you about the “Miracles at Play” campaign that we have going on right now at Nationwide Children's. For more information on that, just go to The basic gist of it is this: we just want you to help us earn $100,000 for the hospital.

What is it exactly we’re going to do with the money. Well, it all goes to helping kids. So it helps us take care of kids. It helps with the research end in coming up with new therapies and treatments for children.

So it’s just a way that you can support Nationwide Children’s. It doesn’t cost you a thing, only a couple of minutes of your time. So, if you go to, there’ll be a place there for you to sign up with your email address. And I can promise you that we don’t send your email address to anyone else. We don’t sell it and we don’t spam you. You just get information now and again on child health topics – good stuff.


So if you would please support the hospital here, just go to Couple of other ways that you can do this, if you go to our Facebook page or our Twitter page and if you like us on Facebook or follow us on Twitter, then that’s another way that money can be donated to the hospital.

Again, it doesn’t cost you anything. To make it really easy for you, if you just go to and go to the Show Notes for Episode 160, we’ll have links to, our Facebook page at Nationwide Children’s and our Twitter page which is nationwidekids. Again, if you like us on Facebook, follow us on Twitter or sign up with your email at, each time you do one of those three things, we get a dollar donated to the hospital.

So right there, you can help us earn three dollars by signing up for Miracles At Play, liking us on Facebook, following us on Twitter. I know it’s getting old, saying the same thing, but we’re trying to get to $100,000 and we’re not quite there yet. If you have done it, thank you. If you haven’t though, really it will take like three minutes of your time to sign up for all three of those.

OK, exciting times here at Nationwide Children’s and for Pediacast. Our studio space is complete. So, we are actively scheduling interviews. I know I’ve been hinting at those for quite some time now. But we have the first one today.

We have a little bit of an atypical start for you. Instead of having a pediatric specialist or a parenting expert as the first guest in the brand new studio, I thought it would be appropriate to invite children into the studio for our very first interview. So later on the show, we’ll have a chat with a couple of school-aged kids on the topic of homeschooling to get their impressions on what it’s been like, what they like about it, what they don’t like, and generally how it’s going.


So that’s coming up, if you’re interested in homeschooling and getting the low-down from a kid’s perspective. We’ll have that in our interview segment coming up a little while later.
But first, we’re going to be talking about toxic substance – actually, The Toxic Substance Control Act. It’s not been updated since 1976 and the American Academy of Pediatrics has so much wise words to say about that.

Exam room chaperons, doctors plus teenagers in the exam room, should they be alone? We’re going to discuss that.

Also, the meningitis vaccine, the FDA has lowered the age of approval. So we’re going to talk about who should get the meningitis vaccine and when.

Also, flame retardant chemicals, they’re actually showing up in our children’s blood. Is it a bad thing and, you know, what’s the alternative? So we’re going to discuss that.

We had a listener call in and asked a great question about radon. So we’re going to tackle that topic.

Also, calling kids by their names and an infant who is not crawling.

And then, we’ll wrap things up with my interview with a couple of homeschooling kids from the new studio here on the campus of Nationwide Children’s.

Don’t forget, if there’s a topic you would like us to discuss or o you have a question for us, it’s really easy to get a hold of me. Just go to and click on the Contact link. You can also email or call the voiceline at 347-404-KIDS. That’s 347-404-5437.

I want to remind you that the information presented in Pediacast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child’s health, call your doctor and arrange a face-to-face interview and hands-on physical examination. The show should never be a substitute for doing that.


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

And with all that in mind, we will be back with News Parents Can Use right after this break.


Dr. Mike Patrick: Our News Parents Can Use is brought to you on conjunction with news partner Medical News Today, the largest independent health and medical news website. You can visit them online at

The American Academy of Pediatrics is calling for an overhaul of the nation’s chemical management policy. Why? Because they believe the current system fails to protect women and pregnant women who just happen to be the two populations most vulnerable to hazardous chemical exposure.

Over the past few decades, tens of thousands of new chemicals had been introduced into the environment, often in extremely large quantities. But the primary federal law that governs chemical management in the US, the Toxic Substances Control Act has not undergone any meaningful revisions since it was first passed in 1976. And since that time, the Act has only been used to regulate five new chemicals.

In a new policy statement, "Chemical-Management Policy Prioritizing Children’s Health" published in the upcoming May 2011 issue of the Journal of Pediatrics, the AAP recommends that chemical management policy be substantially revised to consider the consequences on children and their families.

So what changes should the US government consider? Well, the policy statement goes on to make these specific recommendations: the regulation of chemicals must be based on evidence but decisions to ban chemicals should be based on reasonable levels of concern rather demonstrated harm. That makes sense. I mean, do you want to wait until there's actual harm done? If you have reasonable level of concern, maybe you should act before the harm is seen.


Any testing of chemicals should include the impact on women and children including potential effects on reproduction and development. Chemicals should meet safety standards similar to those met by pharmaceuticals or pesticide residues on food. There should be post-marketing surveillance of chemicals and EPA must have the authority to remove a chemical if needed. Federal funding should be provided for research to prevent, identify and evaluate the effect of chemicals on children's health.

Other groups including the American Medical Association, the American Public Health Association and the American Nurses Association had all independently recommended changes to the Toxic Substances Control Act.

So, this is a point long overdue and well taken. The FDA has a strong track record of protecting children from dangerous pharmaceuticals but the EPA has dropped the ball in offering similar protections for hazards in the everyday environment of children and not-yet-born babies. But you can make a difference. So please consider contacting your representatives and senators and urging them to support needed reform to the Toxic Substances Control Act.

And we'll have some resources for you in the Show Notes at I have a link to the original 1976 EPA Toxic Substance Control Act, the scanned version. There were no PDFs back then. So this is a copy of the original Act. Kind of cool, just for nostalgia sake. If you want to see what types that looks like from an old typewriter, you can check that link out. It actually is a PDF but it's a scan of this original document.


There's also a link to the American Academy of Pediatrics' policy statement, "Chemical- Management Policy Prioritizing Children's Health". That does contain the full text of the group's recommended changes. And then, I put links to both the US House of Representatives and the US Senate where you can easily look up your congressman or senator and contact them regarding this issue.

OK, moving on from government advocacy to chaperons in the examination room – not the smoothest transition, I realize, but that's all I have for you today, folks. The use of chaperon during a physical examination of a pediatric patient should be a shared decision between the patient and the pediatrician.

In the revised American Academy of Pediatrics policy statement, use of chaperons during the physical examination of the pediatric patient – which is also in the May 2011 issue of the Journal of Pediatrics – they looked at issues of patient comfort, privacy and confidentiality. If the patient is old enough to understand, the purpose and content of the examination, it should be communicated clearly to the patient and parent in advance. If any part of the exam is physically or psychologically uncomfortable, every effort should be made to alleviate the discomfort, which may include using gowns or drapes to protect privacy.

A chaperon is recommended during female breast exam, genital exams, or anal rectal exams and should be preferably a nurse or medical assistant, not a friend or family member. However, offices are not required to have a chaperon. In certain situations, a chaperon may not be present because of a patient's choice or a chaperon from the office is not available.

Pediatricians should develop their own office policy on the use of chaperons in the office. And, they should document it in the patient's medical record if and why they are unable to follow their office policy.

This is two-way protection folks. I understand that the main goal here is the patient's comfort and well-being. And these are very, very important. But there are also cases of fraudulent abuse allegations against practitioner, so medical chaperons in the room during these sensitive examinations, especially of teenagers, is important.


So parents and teenagers, expect them. And providers, you should develop a written office policy regarding the use of chaperons and then, stick with that policy. And if you're going to deviate from your office policy, then document why in the medical record.

Bacterial meningitis is a very serious and spreadable disease, especially amongst babies and toddlers. In an effort to combat this ailment, the Food and Drug Administration has approved the first vaccine to prevent a particularly severe form of bacterial meningitis in children under one year of age.

Menactra which is an immunization used for a long time in children above the age of two has now been approved for use in children as young as nine months. Meningitis occurs when bacteria from an upper respiratory infection enters the blood stream and it is highly contagious. Even though rates of meningitis are low in the United States, infants and toddlers are particularly vulnerable.

Menectra was originally approved six years ago for use in individuals ages 11 and up, and was approved three years ago for children as young as two. The form of meningitis in question is caused by a bacteria called meningococcus and it can develop in just a few hours or a few days. Even with proper care, the FDA says up to 15% of people who develop bacterial meningitis would die from the infection and another 25% will suffer complications such as permanent brain damage or hearing loss.

The classic symptoms of meningitis, high fever, headache and stiff neck may be difficult to detect and can be absent in really small children. According to the Centers for Disease Control and Prevention, infants with meningitis may appear slow or inactive, have vomiting, be irritable, or feed poorly. They may also suffer seizures.

Dr. Karen Midthun, director of the FDA Center for Biologics, Evaluation and Research said the highest rate of meningococcal disease occurs in children under one year of age. With today's approval, Menactra can now be used in children as young as nine months of age to help prevent this potentially life-threatening disease.


So here's an and coming way to protect your young child from these particular form of bacterial meningitis. Now, why do I say up and coming? Well, the FDA has approved Menactra down the age nine months but the American Academy of Pediatrics and the Centers for Disease Control have not issued recommendations for routine use of this vaccine in babies. So many physicians will be leery of adding this to the already crowded infant immunization schedule until official recommendations come down from the American Academy of Pediatrics and the CDC. Plus, without these organizational stamps of approval, many third party insurers will be reluctant will be reluctant to pay for Menactra that's given to babies.

So there's more information that come with this as experts at the AAP and CDC examine the issue of baby Menactra. And if and when the official word comes down to add this routinely to the immunization schedule, Pediacast listeners will be among the first to know.

I also want to point out very quickly, if you do look at the CDC guidelines for Menactra, it does mention that younger children… No, can be considered for younger children if they are particularly high-risk for developing meningitis and particularly, those kids who have suppressed immune systems or don't have a functioning spleen, that sort of thing.

So, you know, even though we say, "Well, it's not recommended under the age of two." Yeah, there may be some instances where some doctors now will start to use it even without official word from the American Academy of Pediatrics adding it to the immunization schedule. We're just saying, the FDA is saying it's approved. From their point of view, it's approved for down to nine months.

And so, if you’re going to be going in for your ninth month well checkup or your 12th month well checkup, you might want to bring it up. Say, "Hey, I heard the FDA the baby meningitis shot, are you giving it yet? And if not, when? And why? And who you're waiting to hear from?" And all those things. So, all these things are definitely coming into play.


All right, moving on, blood levels of polybrominated diphenyl ethers, otherwise know as PBDEs among Mexican-American children living in California are considerably higher than in Mexican children who live across the border, in Mexico. This was recently revealed in the journal "Environmental Health Perspectives" by researchers from the Center for Environmental Research in Children's Health at the University of California-Berkeley. As background information, the authors explained the PBDEs, which are used as flame retardants in a wide variety of products, including upholstered furniture, child car seats, crib mattresses and carpet pads, these chemicals have been found to be higher among kids living in California than in other parts of the United States and in Mexico.

The research team set out to determine what impact immigrating from Mexico to California had on Mexican children's blood level of PBDEs. They compared PBDE concentrations among 264 first generation Mexican-American children aged seven years with 283 children aged five years who were raised in Mexico from birth and still live in Mexico.

Researchers found that PBDE serum concentrations among the Californian Mexican-American kids were three times higher that their mother's level when they were pregnant. PBDE serum concentration among the California Mexican-American kids were seven times higher than kids born, raised and still living in Mexico. Such factors as how long the pregnant woman had lived in California, whether the child was breastfed, or how long the child was breastfed had no impact on the results.


The experts believe that post-natal exposure is what determines these children's PBDE serum concentrations. In their abstract in "Environmental Health Perspectives", the authors conclude Latino children living in California have much higher polybrominated diphenyl ethers serum levels than their Mexican counterparts. Giving the growing evidence documenting potential health effects of PBDE exposure, the levels in young children noted in the study potentially present a major public health challenge, especially in California.

In addition, as PBDEs are being phased out and replaced by other flame retardants, the health consequences of these chemical replacements should be investigated and waived against their purported fire safety benefits. Polybrominated diphenyl ethers are organobromine compounds. Humans use them as flame retardants.


Dr. Mike Patrick: I like how the story puts it, "Humans use them as…" You know, like animals aren't using them. I'm sorry. Humans use them as flame retardants in a wide range of products, including airplanes, automobiles, building materials, electronics, furniture, plastics, polyurethane foams and textiles. Health hazards associated with PBDE have attracted recent attention as links have been shown to reduce fertility in humans, as well as thyroid problems.

So, this really boils down to another risk-benefit analysis, folks. I mean, this is something we talk about often on Pediacast. Is the risk of health problems from PBDE exposure worth the benefit that the chemical provides? And, how many kids truly have health issues related to PBDE exposure? Not just what theoretically what could those chemicals do but what health problems do kids truly have. What's the rate of thyroid problems and infertility when kids grow up from exposure to these flame retardants chemicals? What do these health issues really look like?


And, what health issues are associated with other flame retardants? So, if you're going to take the PBDE out and use something as a flame retardant, what health effects could that have? Do we make our children more healthy or less healthy if we use the alternatives? And, how many children would have had serious complications or died from burns if flame retardant materials weren't used at all? How many burn complications and deaths were seen in the kids living in Mexico compared to the Mexican-Californian children?

These are all questions I think we have to ask. And they are questions which do not currently have concrete answers. But this study is a great first step in looking into these issues and determining if we should take a different approach to flame retardants and burn prevention.

All right, that wraps our News Parents Can Use. We will be back. We're going to answer your questions right after this.


Dr. Mike Patrick: OK, first up in our Listener Segment is Jessica. Jessica said, "Hi, Dr. Mike. I have listened to your shows since my son was born almost three years ago."

And we're like old friends, Jessica. Thanks for sticking around with us. And we do have lots of listeners out there who've been with us since we started the show five years ago. And I just want to… Just a special shoutout to the original crew out there who's still sticking with us. We really appreciate your loyalty to the program.

OK, Jessica goes on to say, "I'm so excited you're back on the air, back in Ohio, and part of Nationwide Children's. What an exciting opportunity for you and your family."

"I have a question for you. My husband and I are looking to finishing off our basement and just had a radon test done. Our results were 12.4 picocuries per liter and the recommended level is less than four. I work from home and my son who is almost three, and I also have a nine month old girl in the house. This finding makes me nervous that my children had been exposed to this on a daily basis. Even though we have spent most of our time on the main level, I feel the radon level on the main level must be high as well."


Is there any research done on this and how this could affect their growing bodies? We have lived in the home for two years. Obviously, we're going to take action on this and get it fixed as soon as possible. But we'd still like to understand how radon affects young developing bodies. Thank you for any information you can provide. Sincerely, Jessica."

Well, thanks for the question, Jessica. So radon, particularly those of you who live in locations where you have basements, I'm sure it's something that you've heard about, thought about – really kind of been in the news recently. Less so in places like Florida, you know, where there are no basements for the most part. Radon can still be an issue even in houses built on a slab foundation, so you don't have to have a basement to have radon problems. But, you certainly hear about it more in locations where you have basements.

So, what exactly is radon. Well, it's a radioactive, colorless, odorless, tasteless gas. So in other words, it's the gas that you're not going to be aware of in any way and it's radioactive. Isn't that lovely? It occurs naturally as a decay product of uranium.

So how does a gas, decaying from uranium, that's radioactive, end up in your house? Well, uranium as it turns out is an element found abundantly in the earth's crust. So there's lots of it, down in the ground, under your house, surrounding your basement. Beneath the slab floor of your house, there is uranium there.

Now, it may not be the kind of uranium that they're going to be able to ore and to purify for nuclear power plants or to make nuclear bombs, but it is uranium. And it's underground, and in the rocks and around your homes, everywhere around the earth's crust. So, uranium is there and it’s decaying and it’s turning into radon, which is the radioactive gas. If there's an abundance of uranium in the ground, it follows, there's going to be lots of radon gas being produced.


So then, how does that radon gas get into your house? Well, it seeps into cracks in the concrete slabs, cracks in concrete block wall, through construction joints, gaps around service pipes, cavities inside the wall and even through the water supply. So, it gets in pretty easily.

Now, radon is a dense gas . In fact, it’s one of the densest of all gases. So once it gets inside, it tends to settle in the lowest level of your house, because it's heavier than the surrounding air. And, it will be in the highest concentration where you have enclosed spaces with poor air circulation. This is why radon is measured in basements, if you have one, because that's where the highest concentration is likely to be found.

So, how do we measure the amount of radon gas that gets into your home? Well, the radon gas itself is not the issue. It's the amount of radiation exposure that the radon is causing. So that's really what we measure, radioactivity levels. The unit of measurement that you talked about, Jessica – picocuries – that's a measurement of radiation in your home.

The unit is named after Madam Marie Curie who discovered the first radioactive element, which was radium. And her story is actually quite interesting. It's sort of beyond the scope of our discussion here. But if you'd like to know more about her and the discovery of radium, I have put a link for you in the Show Notes that goes to a page at the American Institute of Physics and they have a whole biography of Madame Curie.


It's interesting. You probably heard that name before. If you've never checked it out, please do. It's interesting. I don't know, I'm kind of a history buff, so I like that sort of thing, anyway. Some of you may be in the same boat.

OK, so we've established that radon can get in homes, particularly in basements, and we can measure the amount of radiation that it's producing. So the next question becomes how is radon dangerous to your health? How much is too much and how do you get rid of it?

Well, radon is dangerous to kids and adults alike. Now, exposure in kids is a little more concerning because they have a longer lifetime for the exposure to continue and eventually cause a problem. Like any other form of radiation, the primary health issue is cancer and in particular, lung cancer, because your breathing this heavy gas into your lungs and it's dense and it tends to congregate in the depths of your lungs and stay there. So, it's not displaced by air very easily since it's so heavy. And then, the radiation from that gas can have its effect deep down in the lung.

Now, in simple terms, radiation damages the DNA that's in your cells and that leads to the formation of cancer-causing cells. So lung cancer is our biggest concern in both kids and adults.

So the next question becomes how much is too much? This is a little bit hard to figure out with traditional scientific studies. Because you don't want to do a prospective study where you intentionally expose people to various levels of radioactive gas and then, follow them along and see how many of them have lung cancer and how many of them die from their lung cancer. That would not really be a popular research study, right?

So you basically have to look at people with lung cancer. Try to find out what kind of environments they were around, go to where they live, check out the radon level and really do more a retrospective-type study. So the government has done that and looked into it. And so, the EPA has some guidelines on how much is too much.


Now, if you're a smoker, the combined effect of radon and smoking is very dangerous. And if you're a non-smoker, the risk of radon causing lung cancer is reduced compared to if you're a smoker but it's not eliminated.
So let's talk numbers. Jessica, you said your basement has a radon radiation level of 12.4 picocuries per liter.

According to the EPA, they don't actually have some numbers for us at the level of 12. So we're going to look at the level of 10. So it's a little bit below your level of 12.4, Jessica. But at the level of 10, if your radon radiation is 10 and you were to expose a thousand smokers to this level of 10 over the course of their lifetime – so it's in their house. It's not constant but they're exposed to it a great deal and you did that over the course of your lifetime – about 150 of those thousand would get lung cancer. To put that in perspective, that's about 200 times the risk of dying in a house fire.

Now, let’s look at non-smokers, if you took a thousand of them, and again you expose them to a level of 10 over the course of their lifetime, instead of 150 , about 18 out of that thousand would get lung cancer. And that's about 20 times the risk of dying in a house fire.

So to me, it's a pretty high risk. Now, how do you reduce the level and reduce the risk. Well, the answer is with a radon mitigation system. And this is simply a system that improves air circulation in the lower levels of your home. Since radon is a dense gas, if you blow out air from the lower levels of your home to the outside, then that's going to be replaced with air from the upper levels of your house which has less radon, less radioactivity, less risk.


Notice I say, less radon, not no radon. So it's often unrealistic to expect to be able to achieve a radon radiation level of zero. But we do want to get it down to a more reasonable risk by blowing air out of the lower level of the house to the outside. So that then, the upper air with less radon in it replaces that lower air. And that's what the radon mitigation system does.

The EPA says a level of 2 or less is best. But they also recognize that this is not always possible. And often, it's not possible. So they use 4 as sort of a cut-off recommendation even though they would prefer levels more around 2. But really at 4, there's still risks.

So what is the risk at the level of 4 and what are the risk at the level of 2, just to give us some comparisons? Well, let's look at those 1,000 smokers again. If you have a level of 4 in your house, in the basement, of those thousand smokers, about 62 of them would get lung cancer which is five times the risk of dying in a car crash during the course of your lifetime. If you have a level of 2, then 32 of those thousand smokers would get lung cancer, which is six times the risk of dying from a poison ingestion.

Hey, these are the EPA comparisons, by the way, not mine. So I take no credit and no responsibility for these comparisons.

OK, let's look at the non-smokers now. So take a thousand non-smokers, expose them to a level of 4 and you can expect about 7 of them to get lung cancer. But that's about the same risk as dying in a car crash during your life. And at level of two, you would expect about four of those thousand non-smokers to get lung cancer from a radon level as low as two. That's about the same risk as a dying during your life from poison.

So a couple of unsettling observations, in my opinion: first, you aren't going to get the radon risk down to zero. And that's life, folks. I mean, it's unsettling but it's true. We all have to live with that. Well, you know, you could build a tree house and live in the tree house. But then, you got other problems. A big wind can come along and your house falls and you die that way. I am being silly here. I mean, there are ways to make it zero. But if you want a house on the ground, you'll probably not going to get it to be zero. It's one of the risks of living in a house.


The second thing I find unsettling is the abuse that goes on with radon testing and mitigation. Often, the risk is presented as much higher when you have the radon testing done. I mean, the testing person gives you this number and says, "This will cause problem. It needs fixed." And, "No one will buy your home and you'll all die from cancer."

And here's the kicker: "I'll make your house saleable and keep you from getting cancer. But it's going to cost you close to a grand to do it. And I'm going to charge you a thousand bucks to install a radon mitigation system, but you'll be safer and you'll be able to sell your house and you won't die from cancer." A thousand dollars, and you know what it amounts to is PVC piping and a fan and the parts altogether cost the person installing it less than $50.

So, you know, there's room for abuse with this radon mitigation systems, unfortunately. And a lot of local governments have made it so the people who are installing this have to be certified. And so, then, it's "Hey, I'm a certified radon mitigation installer. So I can charge a thousand dollars to put in a fan." There's abuse that goes on with this, unfortunately.

I would, to sort of minimize this to some degree, be sure whoever is testing your home for radon is not going to be the person who installs the mitigation system. You don't want conflicts of interest here. I mean it's like the old Jon Lovitz character on Saturday Night Live, "Yeah, the level's 20. Yeah, that's the ticket. I'll fix it for you. I'll get it down to 2. Yeah, that's the ticket." You don't want any of that going on, if you know what I mean.


So that's radon in a nutshell, Jessica. I hope that helps. If you're hungry for more information, we'll have the link to you in the Show Notes at to the EPA's – they call it – "A Citizen's Guide to Radon". And it has lots of great detail, diagrams, more relative risk scenarios for you. So just go to, look in the Show Notes page for Episode 160 and we'll have a link to the EPA's "Citizen's Guide to Radon".

OK, let's move on to a question from Allen in Los Angeles. And Allen says: My wife and I just added a son to our family. We have a four-year-old daughter and all is going great. Well, there's one thing. Suddenly, my wife is not referring to the children by their names anymore, at least not to me. She now says thing like "Can you feed this one?" "That one needs to go to bed." "You won't believe what that one did today." And, "I need help strapping this one in." This bothers me to no end mainly because I feel like she is objectifying them and treating them like interchangeable objects. Are my fears unfounded because I want to either stop correcting her or have her stop? Help.

This is a tough one, Allen. You know, I, too, would be annoyed by this. How you handle it, in my opinion, really depends on your wife's disposition and sense of humor. I mean, in our family, we'd probably lovingly make fun of each other in a sarcastic manner. But that's us. And as I recently learned the hard way, not everyone understands or appreciates sarcasm.

So your mileage on that approach may differ considerably. I mean, you could mention it in a more loving way, I suppose. But it sounds like you've been doing that. Or you could just to choose to pick your battle and say, "Hey, she's making meals, and changing diapers and looking after the house while I'm at work." Or, you know, "Hey, she works more hours than I do and when she gets home, she's loving to the kids and spends lots of quality time with them. I'll just make sure I answer her questions in a way that uses my child's name and let it be at that."


So , when she says, "Can you feed this one?", you can say, "Little Jimmy? Sure I'll feed him." Or when she says, "That one needs to go to bed,", you say, "Which one?" She says, "That one," you say "Which one?" She says, "That one." OK, wait, wait, that's the sarcasm coming back into play. All right, you can say, "OK, little Jimmy, it's time for bed." So you get my point – lots of ways to deal with this and it really depends on your wife and your relationship.

So is this a good question for Pediacast? It is. These are the kind of questions that pediatricians get asked in examination rooms across America everyday. It's not always, "Why is my kid keep getting ear infection," "Why won't a strep throat go away," or "When are we going to take out his tonsils?" It's also one parent coming in and saying, "You know, his mom never calls him by his name. Is that a problem?" So thanks for the question, Allen. Thanks for keeping it real.

Moving on to Jennifer in Santa Clara, California. She says: We are new listeners and my husband suggest that I contact you about our issue. Our daughter will be one in two weeks and she's still not crawling. We alternate between concern and just letting her be on her own timeline. She refuses to get up on her knees. In fact, she severely resist when we try. And although she does swivel around on her stomach, she does not push up or move forward. Once in a while, she will push and go backwards. We try to encourage her by putting toys just out of her reach and she will make a few attempts and then put her head down and start sucking her thumb. Should we be worried and seek physical therapy for her? Thanks for your help. Jennifer.

Thanks for the question, Jennifer. The simple and quick answer is that yes, you should be worried. But my reaction would not be to seek physical therapy for her right away, even though in the end, that maybe what's needed. It might prove helpful. But my reaction would be to share this concern with your child's doctor and do it sooner rather than later and let him or her decide the best course of action.

Your doctor's opinion should matter. How worried is he or she about this and what course would he or she like to take because of it, that's going to depend on the answers to lots of question that your doctor would have for you and the result of a thorough physical exam.


Now, I know this answer seems to be the easy way out. I'm just saying, "Go ask your doctor. Why are you asking me?" But it's because this is a complex issue and you really need to know way more information about family history. Had there been other kids in the family who weren't crawling at this age or moving around much at this age? What other physical milestones have they reached and when did they reach them?

Physical exam is going to be extremely important in a situation like this. What's the muscle tone like? What are the reflexes like? You just get a general gestalt of the patient and what's the problem when you ask and ask the parent questions and examine.

So I'm not going to be able to tell you what is wrong with your child. But, I can tell you that there is enough here that would make me concern. Most kids are moving easily from point A to point B by the time they're a year old. Now, that may not be by traditional crawling. I mean, from a kid's point of view, they want to get from A to B. They aren't about learning to crawl, right? They're about learning to move. By now, they should be moving easily in some fashion from one place to another.

So a 12-month-old who stays in one place for the most part or tries to move, is not very successful and gives up – at 12 months – that is worrisome. Now, by rushing off to physical therapy, you'll best learn how to stimulate your baby to want to to move and how to strengthen the muscle groups they need to move. But you aren't addressing potential, underlying reasons why this is happening in the first place. And it sounds to me, like the most immediate thing that you need to do is get to the bottom of why your child is not moving around like most 12-month-olds should be moving around.


Now, lots of kids aren't walking at 12 months. So, the traditional thing, you know, we say they should be sitting up by the time they're six months and crawling by the time their nine months and walking by about the 12th month. But not all kids are walking at 12 months. That's not a concern. But nearly all of them should be able to get from point A to point B in some fashion

Notice I say nearly all. Some kids don't follow the rule books. There may not be anything going on under the surface. And physical therapy will help and they'll be moving from point A to point B in a month or two and walking at 15 to 18 months of age, and develop or proceed normally or be in a delayed fashion after that. That is certainly a possible scenario. But I would not assume that would be the case. And in my experience, a twelve-month-old who's not mobile at all is very concerning. And you should definitely talk to your child's doctor about this sooner rather than later.

OK, that wraps up our Listener Segment this week. We're going to take a quick break and we'll be back to talk with a couple of homeschooling kids right after this.


Dr. Mike Patrick: All right, those of you with really good hearing probably noticed a couple of times during our interludes, right off at the beginning, there was a little click in the background. And it's because I've kind of adjusted things here a little bit. So I'm facing a bit of a different direction with the microphone. I have my scripts and the notes on my iPad in a different location. I've had my arm resting on my headphone's cord and as I move around when we go to the break, I moved the wire and there was a slab click. You think I would learn, but I think I've done it three times now.



Dr. Mike Patrick: I do like this position a little bit better. In terms of interviewing, I'm a little bit more facing across the table where our other microphone is. And incidentally, we're going to have a revamped and completely new website coming up here in the next few weeks which will have a great search function and lots of new functionality to the site. We’re also going to put up some pictures from the studio so you can just see exactly what the home of Pediacast here at Nationwide Children's looks like.

All right, let's move on to our homeschooling segment. In 2003, 2.2% of all students in the United States were homeschooled and that amounted to about 1 million kids. By 2008, that number had doubled and it continues to grow by leaps and bounds. There's a plethora of well-developed curricula making it fairly idiot-proof for parents who have the opportunity and interest to go down this path.

Social opportunities abound. SAT scores are high. And many prestigious colleges actively recruit homeschooled kids because they are known to work well independently. On the other hand, when thing go wrong with homeschooling, they can go very wrong. And if parents aren't actively involved and disciplined to keep the child up-to-date and involved socially, the results can frankly be an unsocialized and under-educated child.

There are many paths we can take, of course, in addressing the topic of homeschooling here on Pediacast. But I thought an interesting one would be to talk to a couple of kids who are homeschooled and just get their impression on the whole experience.

Now, before we begin, I have a couple confessions to make. These particular homeschooled kids are my own kids. But, I can guarantee you, you're going to get honest and blunt answers from them which goes back to the whole humor-and-sarcasm thing which seasons our family life.


And the other confession is that, you know, our studio is based here at Nationwide Children's, as I pointed out, is ready to roll. We're gearing up. We're actively scheduling interviews and I really needed a mock interview of sorts to check out sound levels and get some practice with the equipment. And I wanted to do it with some well-behaved folks. And my kids are very well-behaved.

And I also wanted it to be someone who's not going to be getting upset at me when we have to do Take Number 23 if we have to go down that path because we're having equipment problems with the second microphone and our mixing stuff and software issues and sound levels and all that. So, I really wanted someone with the patience who would not get too upset at me but that would be fun to do.

And there's also some history here, because five years ago, prior to my very first Skype interview, my daughter and I basically did the same thing. So, we did a sort of homeschooling interview five years ago at the beginning of our series of Skype interviews. And now, we’re going to do another one at the beginning of our studio interviews. So, you see, there's a little bit of historical issue here as well.

Then, I thought too, OK, the first interview with my daughter on homeschooling was five years ago. I thought it would be interesting to see how her thoughts and impression have changed over the five-year period. So, I'm going to actually start by rolling the interview from five years ago.

It's about a 12-minute interview or so. So, it's not incredibly long. We're definitely by the time all said and done, going to go over our hour. It's probably going to be an hour-and-15-minute show. So you probably got a half hour here left to go. Just to give you a little bit of an idea, when we do the first interview and then, we'll finish that. After that, we'll do the current interview from our studio at Nationwide Children's.

So without further ado, here then is the original interview with my daughter on the topic of home schooling from five years ago.

[Start of audio clip]


Dr. Mike Patrick: We have a special guest this week on Pediacast. I'd like to introduce everyone to Katie. Katie is a 12-year old seventh grader who homeschools rather than going to a public school.

Katie: Hi.

Dr. Mike Patrick: How are you today?

Katie Patrick: I'm good.

Dr. Mike Patrick: I appreciate you coming on Pediacast to talk to our listeners. So you go to school at home. You don't get on a bus or walk to a different building. You actually do your classes in your house. Is that right?

Katie Patrick: Yeah, it's down the stairs and through the hall.

Dr. Mike Patrick: [Laughter] So do you like learning at home or do you wish that you were going to school?

Katie Patrick: Well, it varies. Most of the time, I'm glad though that I'm homeschooled.

Dr. Mike Patrick: Who teaches you? Your mom and dad at home?

Katie Patrick: Yeah, both of them. They share subjects.

Dr. Mike Patrick: I see. And you have a brother at home, I understand.

Katie Patrick: Yeah. I think he's in fourth grade. He's nine.

Dr. Mike Patrick: You think he's in fourth grade?

Katie Patrick: Yeah, I'm pretty sure. I don't really keep up with him very much.

Dr. Mike Patrick: And it is a little bit harder to remember what grade you're in, isn't it?

Katie Patrick: Yeah. I always almost say, "Oh, I'm in sixth… seventh grade."

Dr. Mike Patrick: Yeah. It's a little harder to keep track. What's your favorite subject in homeschooling?

Katie Patrick: I like Science and Composition.

Dr. Mike Patrick: Why do you like those the best?

Katie Patrick: Because in Science, you can do experiments and learn about how stuff works and all that. And Composition, it's fun to make up stories and write on the computer.

Dr. Mike Patrick: So you do Science Lab at home, too?

Katie Patrick: Yeah, every once in awhile there's an experiment. But sometimes, there are some that we don't do because they don't seem like they're going to work. Or we really don't need to do it to explain anything anymore.

Dr. Mike Patrick: So you feel like you understand it and sometimes, it's just a little busy work.

Katie Patrick: Yeah, if it's something cool like putting Drano in Jell-O then, yeah. Without eating it, of course.


Dr. Mike Patrick: Putting Drano in Jell-O, I have to make a comment. Please don't try that at home, at least without homeschooling supervision.

No, but seriously, it doesn't sound like such a good thing to put Drano in Jell-O. Where do you come up with the material that you use? Who's telling you to put Drano in Jell-O?

Katie Patrick: We use this program called K12 and they provide all of the experiments and online lessons and materials that you need for… Well, mostly materials.

Dr. Mike Patrick: Oh, I see. So, you actually do your schoolwork on the computer for the most part?

Katie Patrick: No, it's about half-and-half. There are online lessons that explain stuff but then, you do like reading and stuff offline most of the time. But then, when you're done reading – for that lecture when you're done reading – you go back and check your reading and it asks questions about what you just read and you answer them like a little film that bob along the computer.

Dr. Mike Patrick: Oh, that sounds neat. So you can kind of blend the traditional stuff with the technology as well.

Katie Patrick: Yeah.

Dr. Mike Patrick: Now, let's say you're doing this laboratory experiments, where do your parents get the equipment that they would need to do lab experiments? Is there a lab store nearby or something and you take a supply list and go pick things up? How do you get all the materials?

Katie Patrick: No. For a lot of the materials, they send it to us when they send us all of our books. They'll send us like graduated cylinders and thermometers and stuff like that. But a lot of it is, there'll be this thing that pops up. It will say, "Advance Preparation" and then, it'll say like, "You need to have this for a few lessons later."

Dr. Mike Patrick: So you said that the material that you use comes from a place called K12, is that right?

Katie Patrick: Yeah.

Dr. Mike Patrick: And I did a little bit of research before we started the interview and apparently, folks can find out more information about K12 if they go to and we'll put a link to that in the Show Notes too, so people will be able to find it pretty easily.


OK, what about your brother, does he use that same curriculum, too?

Katie Patrick: Yeah, he just does a different grade of it – easier problems.

Dr. Mike Patrick: I see. So he does all the stuff that you did a couple years ago?

Katie Patrick: Yup, basically.

Dr. Mike Patrick: Does he get hand-me-down materials?

Katie Patrick: For some of the things, yeah. A lot of the things though, we'll re-order from K12 for him. But like some of the things like my Math books which this year and last year was really nicer than it was last year or two years ago. So he'll use some of that stuff but most of it, we got new. Because you do write in a lot of the books.

Dr. Mike Patrick: What's your least favorite subject?

Katie Patrick: Definitely Math.

Dr. Mike Patrick: Math?

Katie Patrick: Yeah.

Dr. Mike Patrick: Yeah, I was never a big Math fan either, to be honest with you. But still, you hang in there and you get it done, right?

Katie Patrick: Yeah, I usually pass all the assessments.

Dr. Mike Patrick: But it doesn't come as easy to you, huh?

Katie Patrick: Yeah.

Dr. Mike Patrick: Now, who's your Math teacher?

Katie Patrick: My mom does that.

Dr. Mike Patrick: And does she answer all your questions pretty well? Does she explain thing so that you can understand it?

Katie Patrick: Yeah. Sometimes, I have to wait because she's working with my brother but, yeah.

Dr. Mike Patrick: I see. So since you're doing this school stuff at home, what parts of public school do you feel like you're missing? Like, what do you think the advantage that the kids have who are going to public school, what kind of advantage do they have over the experience that you're getting?

Katie Patrick: They spend all day with their friends and I can't do that because I'm at home most of the time. But I do spend time with my friends.


Dr. Mike Patrick: So you just have to find different times to be with them that's not necessarily during school hours.

Katie Patrick: Yeah, and …

Dr. Mike Patrick: I guess that… Yeah, go ahead. I'm sorry.

Katie Patrick: I'm on different schedule type things, with vacation at different times and stuff.

Dr. Mike Patrick: Now, one of the biggest complaints that you hear out there about homeschooling is the lack of socialization. You know what I mean by that?

Katie Patrick: Yeah.

Dr. Mike Patrick: Like being with other kids the same age and maybe, because you don't spend as much time with other kids, that you might have problems forming friendships and getting along with others. Is that a problem for you?

Katie Patrick: Not really. We do all sorts of activities. We act in plays and do theater and sometimes, we'll take swimming lessons. There's a lot of kids around us who are the same age, so yeah.

Dr. Mike Patrick: So you have experienced being with other kids and making friends and that sort of thing comes pretty easy for you?

Katie Patrick: Yeah.

Dr. Mike Patrick: I see.

Katie Patrick: And I go to camp every year, so I make a lot of friends there.

Dr. Mike Patrick: Right. And do you go to Sunday school?

Katie Patrick: Yeah.

Dr. Mike Patrick: So you have friends there too that you see.

Katie Patrick: Yeah.

Dr. Mike Patrick: Now, your friends, are most of them also homeschooled? Or do you have a lot of friends who also go to public school?

Katie Patrick: I got one friend, I think, who's homeschooled. But most of them go to public school, which makes it a little bit tricky to get together with them unless it's in the summer.

Dr. Mike Patrick: Now, do you think that you'll continue to homeschool throughout all of your schooling? Or is this just something that you're going to do until high school and your parents are going to have you go to public school at that point?

Katie Patrick: No, I'll probably go through high school. But I'm going to go to college. Normal, obviously, because I don't even think they have a homeschool for college.

Dr. Mike Patrick: You can't do college at home , though.

Katie Patrick: No.

Dr. Mike Patrick: Well, do you feel like your homeschool experience is going to prepare you for college?

Katie Patrick: Yeah, a little bit with the studying on your own.


Dr. Mike Patrick: So when you're studying at home, you take notes and that kind of thing, too?

Katie Patrick: For some of the subjects, I do. For Science, I do, when there's something really important and same with history. But for Math and stuff like that, I usually don't.

Dr. Mike Patrick: So you’re learning how to take notes and try to filter out what's important and what's not important and learning to study for tests? Do you take tests?

Katie Patrick: Yeah, at the end of every lesson, we have assessments. And at the end of each semester, we have a big assessment for everything we've learned.

Dr. Mike Patrick: I see. So you are getting some practice at taking tests, and taking notes and that sort of thing.

Katie Patrick: Yeah.

Dr. Mike Patrick: It sounds like you'll be fairly prepared for college.

Katie Patrick: Yeah, probably.

Dr. Mike Patrick: Now, what about music class? Does your mom, does she help you learn how to play an instrument or do choir or something like that?

Katie Patrick: No. We do piano lessons. I don’t know where it is, but we have piano lessons every week. So I know how to play the piano.

Dr. Mike Patrick: That's excellent. What about art class and gym class, do you do either those kind of things?

Katie Patrick: Sometimes we go to this thing called Swim Gyminar at the YMCA. It's got swim lessons. And then, there are art classes and projects and painting stuff. And then, there's a gym class, too.

Dr. Mike Patrick: Well, that sounds interesting. What kind of things do they do in the gym class?

Katie Patrick: Mostly play games, like dodgeball and stuff. But sometimes, we'll do hockey or basketball or something.

Dr. Mike Patrick: Yeah. I was never very good at dodgeball.

Katie Patrick: No.

Dr. Mike Patrick: Did you ever play crab soccer?

Katie Patrick: No.

Dr. Mike Patrick: That was one we had. You walk on your hands and legs but with your back facing down and your belly button facing up in the air. And you're kind of like walking around like a crab with your arms and legs. And you have…


Katie Patrick: That doesn’t sound very good.

Dr. Mike Patrick: And it was like soccer, you had to kick this ball back and forth. No, it wasn't very good at all, to be honest with you. I'm glad they don't do it anymore.

Katie Patrick: Yeah. I like dodgeball where they have things that you can hide behind.

Dr. Mike Patrick: Yeah. That would have been the bigger kids for me. How about drama class? Are you involved in any drama kind of stuff?

Katie Patrick: Yeah, I just auditioned for a play not too long ago. I didn't get it and my brother got a call back, but he didn't get in either. But there's a show that's coming up and auditions are Sunday or something like that. And I'm going to audition for that.

Dr. Mike Patrick: Now, is that through your local school?

Katie Patrick: No, that's actually through this place in Columbus called the Children's Theater. And I've also been in the show with The Davis and my brother's done things at the Phoenix and Columbus South.

Dr. Mike Patrick: So you guys are really into acting, huh?

Katie Patrick: Yeah, I am. My brother hasn't appreciate how easy he gets parts.

Dr. Mike Patrick: Why does he get parts so easily?

Katie Patrick: Well, there's typically more girls auditioning than boys. So it's much harder to get a part than it is for a boy to get a part. And usually, they have fewer girl parts anyway.

Dr. Mike Patrick: Oh, I see. So he doesn't appreciate the parts that he gets and you really want the parts but it's harder because there's a lot more girls who are trying out.

Katie Patrick: Yeah, he appreciates them but not as much as I would.

Dr. Mike Patrick: [Laughter]

I see, so…

Katie Patrick: He doesn't even want to do acting when he gets older.

Dr. Mike Patrick: And you do.

Katie Patrick: Yeah, I want to be in movies.

Dr. Mike Patrick: Oh, that's great. Well, you know, it sounds like you're pretty busy. You have all your homeschool stuff that you do. And then, you have piano lessons and you do this drama stuff and Swim Gyminar and then you're…

Katie Patrick: And I used to do ballet.

Dr. Mike Patrick: And you used to do ballet, too?

Katie Patrick: I'm not going to do it this year, though.

Dr. Mike Patrick: Just little bit too much on your plate.

Katie Patrick: Yeah. I've been doing it five years, though.


Dr. Mike Patrick: Oh, wow, five years of ballet and you're going to stop. Why?

Katie Patrick: I want to do more for acting. Last year, there was a play I already auditioned for, Little Women. And I couldn’t do it because I would have missed like half of my ballet rehearsals for the recital at the end of the year. So, I decided not to do it and open up more possibilities for acting.

Dr. Mike Patrick: Well, that sounds great. Well, it sound like you got your priority set and you’re happy with the way school's going.

Katie Patrick: Yeah.

Dr. Mike Patrick: And I think you'll do well. So I really appreciate you coming on the program today and letting our listeners get an idea of someone who homeschools and what's it like at home.

So, thanks for coming and will you come back and join us…

[End of audio clip]

Dr. Mike Patrick: All right. So that was five years ago. So let's fast forward to the present and let's see how my daughter's thoughts and impressions have changed.

Incidentally, I notice as I was listening to that, I said, "Oh, you can't go to college online." Well, things have changed in five years, because now, you see commercials, and billboard and online ads for being able to earn degrees through some reputable universities online. So, that's definitely something that's changed in the last five years.

All right, now, in addition to my daughter, this time, we're also going to bring my son into the studio and talk to him about homeschooling as well. With him, I do need to point out that the soundbyte of the cute boy's voice as Pediacast begins to roll with each episode, that was my son five years ago. And not so much of the cute little boy's voice anymore, which for me, as a dad, is sad. They grow up way too fast.

So anyway, here we go back to the present and in our new studio with the very first interview here on the campus of Nationwide Children's.


All right, we are joined in the studio today by two homeschooling children. First, we have Katie who is 16 years old.

Hello, Katie.

Katie Patrick: Hello.

Dr. Mike Patrick: How are you today?

Katie Patrick: I'm good.

Dr. Mike Patrick: And we're also joined by Nicholas, who is 12 years, old. Oh, wait…


Katie Patrick: Twelve! Ouch.

Nick Patrick: Ouch. Ouch.

Dr. Mike Patrick: OK, wait, I take that back. He's not 12 years old. He's 14. Do you know why I have 12 on my brain?

Katie Patrick: Kids, go to school. Please.

Dr. Mike Patrick: No, no.


Dr. Mike Patrick: The reason I have 12 on my brain is because, Katie, the last time that you and I did an interview about homeschooling, you were 12 years old. So that's the reason I had that on the brains. And Nick, I apologize. We'll give you your two years, we're adding them on right now.


Katie Patrick: If we're being specific though…

Dr. Mike Patrick: Tacking, nailing the two years on.

Katie Patrick: For being specific, it's actually technically 16 and three quarters.

Dr. Mike Patrick: I remember the day when you count the halves and the three-quarters and the quarters. When you get to be my age, you actually stop doing that. And in fact, and then what happens is, you’re like 39 for an extended period of time. You’re like more than one year.

Katie Patrick: So, you have a third anniversary of your thirty-ninth birthday.

Dr. Mike Patrick: Exactly. That's how it works.

OK, well, we're not here to talk about birthdays , ages and how we messed up our own children's ages. But what we are here to talk about is homeschooling, because a lot more parents are going with this option than used to be the case. It used to be there was kind of stereotype for what the homeschooling student and their family look like. And I think we have definitely broken the barrier of that stereotype and now, a lot more people are actually doing it.


So, the first question that I have for both of you – Katie, we'll start with you – do you like learning at home? And I asked you this question five years ago. Katie has not been privy to hearing that interview while we’re discussing this, but she will listen to it after we're done. So it would be interesting to see how you answer now compared to then.

So what do you think? Do you like learning at home?

Katie Patrick: Yes. That's a poor question choice of yes or no answer. Yes, I do like learning at home because I can learn in my pajamas. I can take breaks throughout the day and I don't have to get up at five in the morning to catch a bus. I can sleep in until nine and still get school done.

Dr. Mike Patrick: Yeah, that is definitely an advantage, isn't it?

Katie Patrick: Definitely.

Dr. Mike Patrick: What about flexibility in terms of doubling up your school work on one day and then, having a break so the family can go do something on another day. Can you speak to that?

Katie Patrick: That was easier in elementary school and middle school than it has been in high school when the work is a lot harder and there's much more of it. But you still have flexibility to an extent where you can double up some things some days or work extra on weekends to make it up.

Dr. Mike Patrick: Right, What do you think, Nick? How's this homeschooling thing treated you?

Nick Patrick: It's good. Yeah.

Dr. Mike Patrick: You like it? You think that if you had to do it over again… What grade you are in, now?

Katie Patrick: Nick, he doesn't know.

Dr. Mike Patrick: Well, I know. I mean, I do know that you’re in eighth grade. That did sound bad. He's your father and he doesn't know what grade he's in.

Katie Patrick: He's twelve and he's in fifth grade, you know.

Dr. Mike Patrick: Well, that would be good, right? He's not 12, he's 14.

Katie Patrick: You totally missed my sarcasm there, but that's OK.

Dr. Mike Patrick: You're right. Anyway, let's try. I missed your sarcasm. You're right, I did. It just went in one ear and out the other.

Katie Patrick: Oh, dad.

Dr. Mike Patrick: Tell me … We'll just skip right over that.

Katie Patrick: Right.

Dr. Mike Patrick: So if you had to do it over again, would you choose homeschooling or… I know you didn't really have a choice. But I mean, if we gave you the choice and said, "Hey, you can homeschool or you can go to public school." Do you wish that we have made a different choice. And it's OK to say, you know, one way or the other, it don't matter. What do you think?

Nick Patrick: No. Really, I don't. I love homeschooling and it's very good, all the time.

Dr. Mike Patrick: OK, all right. So you think it's a cool thing.


What about you, Kate? Do you have regrets? Do you sometimes wish that you had gone to a brick and mortar school?

Katie Patrick: Sometimes, yeah. Especially when I realized that most of my friends, I know online, and I never get to see him in real life. And I think, "Oh, if I went to regular school, I would have friends that I can hang out with at school."

Dr. Mike Patrick: Right.

Katie Patrick: And actually see them face to face. But I think the pros somewhat outweigh the cons a little bit. I don't know, I feel like our family is closer since I was home, too. And I mean, I still have friends. It's not like I'm a complete recluse, but you know.

Dr. Mike Patrick: Right.

Katie Patrick: Six to one, half a dozen to another.

Dr. Mike Patrick: Right, right. Gotcha. You talk about your friends being online. I guess, we have to clarify something here really fast. You technically aren't homeschooled, right? Why don't you explain that to people.

Katie Patrick: Technically, for you all people who are wondering, I go to an online private school. So I have teachers for each subject who I email – not email, but it's the equivalent of email – my assignments to and who watch my grades, and host meetings and stuff with other classmates. And we have clubs and stuff so I know my peers from that. Usually, I see the same ones over and over in certain clubs and stuff.

Dr. Mike Patrick: And with Facebook, and Twitter..

Katie Patrick: … and texting and Skype.

Dr. Mike Patrick: … and texting and Skype and all that.

Katie Patrick: Yeah.

Dr. Mike Patrick: You really are able to. Because when we talked five years ago, there weren't really Facebook and Twitter and Skype and those. We actually did our interview on Skype, but Skype was in its infancy at that point.

Katie Patrick: Yeah. Plus, it was only in high school that I actually started making online friends because that's when I transitioned doing online private school rather than just plain homeschool. So I didn't actually had any online friends then.


Dr. Mike Patrick: Right.

Katie Patrick: And it's not just people who are like I see every once in awhile at a meeting. They are actually my friends, sort of, you know.

Dr. Mike Patrick: But there's a clear difference between when it was straight K12, the curriculum, as a homeschooling thing and now with the private online school – with the K12 International Academy is the name of it.

It's different because now, we turn to Nick who really… He'll start the more online private school type scenario when he starts ninth grade. You don't really have any interaction, Nick, do you, with other students who were doing the same curriculum?

Nick Patrick: No. Not at all.

Dr. Mike Patrick: You're going to need to speak up.

Katie Patrick: Don't whisper.

Nick Patrick: Not at all.

Dr. Mike Patrick: Not at all, OK. This is one of the complaints about homeschooling, is that kids aren't any socialization. So Nick, respond to that, if someone says to you, "Well, you're not around any other kids. You don't know how to act around kids your own age. You don't have any social abilities." What would you say to them?

Nick Patrick: Well, first, I'm going to punch them. But after that, I would say, "No, I go to youth group and church and acting stuff."

Dr. Mike Patrick: So you do opportunities to interact with…

Nick Patrick: Yes.

Katie Patrick: I mean, even school kids have extra curricular hobbies that they do. So it's just we're not seeing our friends and talking to them for 10 minutes between a period here and there.

Dr. Mike Patrick: Right.

Katie Patrick: The time that we do spend with our friends is long at youth group, or theater or various and sundry other activities.

Dr. Mike Patrick: Right. Right. Exactly.

OK, now I asked before and will ask you again this time, what is your favorite subject? Nick, why don't you go first on this one, what's your favorite subject, if you have to pick one?

Nick Patrick: Science.

Dr. Mike Patrick: Science? Now, do you have a particular field of science that you like the most? Like life science, earth science….

Nick Patrick: No.

Katie Patrick: If you say chemistry, I will hurt you.

Nick Patrick: Ouch.

Dr. Mike Patrick: Now, what's area? Just like science in general.

Nick Patrick: A-huh.


Dr. Mike Patrick: OK, cool. Now, that brings up the issue then, if you're doing Science in the realm of homeschooling, how do you do like the labs and things. Because normally, if you think about school, Science is probably one of the harder things to do at home because you don't have a lab. So how do you do that, Nick?

Nick Patrick: How do I do it?

Dr. Mike Patrick: Yeah.

Nick Patrick: Well, let me see. I just do it in the kitchen.

Dr. Mike Patrick: OK. So the supplies…


Dr. Mike Patrick: Because you know, most people don't have a Bunsen burner…

Katie Patrick: Let's just go over the pantry and grab some hydrochloric acid, not a big deal.

Nick Patrick: Mom lets me keep that in the pantry all the time.

Dr. Mike Patrick: OK. So the physical location where you do science labs would be in the kitchen…

Katie Patrick: So does food.

Dr. Mike Patrick: But where do the supplies come from? Well, OK…


So, from Nick's point of view, they just appear because they come in the mail, right?


Katie Patrick: OK, the school… Remember this, the school sends you all the supplies that you need…

Nick Patrick: Yes.

Katie Patrick: And the instructions and how to do it.

Nick Patrick: Yeah.

Katie Patrick: Remember? Yeah? Got it.

Dr. Mike Patrick: This is ringing a bell now. [Verbal Noise]

Katie Patrick: I just need to make a clarification to all of you who totally missed sarcasm. We have a very sarcastic relationship, my brother and I. So if you think I'm offending him in any way, I'm grinning at him as I'm saying it and he understands that I'm not serious. So you should practice sarcasm more and then…

Dr. Mike Patrick: And then, you'll understand it.

Katie Patrick: And you'll understand my point of view.

Dr. Mike Patrick: OK. Yeah. So to me, that's why I didn't really recognized it as sarcasm per se, because it's just like normal life. You know what I mean?

Katie Patrick: I know what you mean.

Dr. Mike Patrick: OK, so we talked about the socialization issue and friends. Now, this is interesting. When we talked about this before, you made a comment about the fact that you probably, you saw yourself doing homeschooling throughout all of high school. But that you would go to college. You'd rather go to brick and mortar college. And I had made a comment, "It's not like you can go to college online."


But in the last five years, there's been an explosion of programs that are available online and you can get degree programs even through reputable universities online. So what are your feelings about that now?

Katie Patrick: I will not be doing college at home.

Dr. Mike Patrick: OK.

Katie Patrick: I will still going to be a regular college.

Dr. Mike Patrick: So, a brick and mortar college; you want to live in a dorm.

Katie Patrick: Yes, I do. Yes.

Dr. Mike Patrick: Get the whole slice of college life, kind of thing.

Katie Patrick: It's an experience.

Dr. Mike Patrick: Any particular colleges or universities that you're looking at, more than others? And again, this is… You know, your father's sitting across the table but, I mean, seriously, just in your heart, where are you thinking about going?

Katie Patrick: Let's see. That's a hard choice. Let me think, Go Buckeyes! Ohio State though.

Dr. Mike Patrick: OK, that's good. See, I like that. But, of course, I mean we talked about this and it's not like we're saying, "You have to go there!" But it would be a good choice.

Katie Patrick: No, I'd want to go there even if you didn't want me to.

Dr. Mike Patrick: Yeah, that's a good place.

So, Nick, with regard to testing, you have to have some accountability that you're actually learning the material that is being presented to you. Tell me how testing, how that works out.

Nick Patrick: Well, I know one plus one is two. And two plus two is four. And three plus three is eight.

Katie Patrick: No, no, no. How do they quiz you on it?

Nick Patrick: Oh, you just take it online.

Dr. Mike Patrick: OK, I have…

Katie Patrick: He's going to expound here. Well, I'm going to expound for him, psychically reading his mind there. Online assessments that you take – most of the time, you have an online quiz after each lesson. And then, you have a mid-unit test that focuses on the whole half of the unit that you just did.

And then, you have unit test and that has an online part where you answer multiple choice questions online. And then, it has a written part that you print off, do, scan in and then send to your teachers. So for Math, you have to show your work and stuff and how you're doing it. And, for History, it's more short answer, essay type thing, et cetera, et cetera.


Dr. Mike Patrick: Gotcha. Would that be a good summary of things, Nick?

Nick Patrick: Yes.

Katie Patrick: Oh, God, straight out of his brain.


Nick Patrick: I got my brain back.

Dr. Mike Patrick: For those of you listening out there who have 14-year-old boys at home, this is not a surprise to you. And those of you who don't have 14-year-old boys at home and you have littler kids, this is what's coming.

Katie Patrick: Just wait.

Dr. Mike Patrick: Yeah.

Nick Patrick: Danger.

Katie Patrick: Just wait.

Dr. Mike Patrick: Danger.

Danger, Will Robins. Wasn't that from… "Danger, Will Robins!" from Lost in Space? Yeah, that was before your time.

Katie Patrick: Yeah, still.

Dr. Mike Patrick: OK, do you still want to be in the movies, Katie?

Katie Patrick: No.

Dr. Mike Patrick: You don't want to be in the movies?

Katie Patrick: No. I've seen too many actors go bad, who are in the movies.


Dr. Mike Patrick: Yeah, OK. And you had talked in the last one that you missed doing ballet because you have some other things on the horizon. Do you wish that you had kept with ballet?

Katie Patrick: No, not really. I mean, I got over it. The next year, I would have been en pointe and I wasn't ready for that. And yeah.

Dr. Mike Patrick: And, you know, one of my colleagues today at lunch… This is unlike patient confidentiality. If you talk about something with the co-worker at lunch, I don't think that's…

Katie Patrick: Just don't say any names or make-up fake names or something.

Dr. Mike Patrick: OK. She had mentioned, because they were talking… I work with a lot of woman and the other guy on our team, here at Nationwide Children's, we were talking about baseball. And the women were talking about pedicures. And one of them had said she had done so many years en pointe with ballet and she said she had ugly feet. And that's why she didn't want to go get a pedicure because she was embarrassed for the person doing the pedicure and see her feet. And she attributed her ugly feet to the fact that she had been en pointe in ballet for many years.

So anyway, I think, maybe, we saved you from ugly feet by you not sticking with it.


Katie Patrick: I don't know. Hey, you were with me last night when I realized that my feet were completely asymmetrical and I almost flipped out, so you know.

Dr. Mike Patrick: Yeah, so mix…

Katie Patrick: Not the sight of them, but…

Dr. Mike Patrick: So, I think everyone thinks their feet are ugly. Maybe, they're just kind of ugly, in general.

Katie Patrick: Yeah, but at least they're symmetrical than mine. Mine are strange, but OK.

Dr. Mike Patrick: Well, see, I don't think that.

OK, so we talked about homeschooling. I think in general, it sort of depends, like anything in life, it's what you put into it. So, I think, from our family's point of view, homeschooling has been very good to us.

Of course, you still going to have to take the SAT. The fact it's a private online school, you still have a diploma, a record of all your grades the college entrance folks can look at.

And of course, the K12 International Academy is very reputable and people can find out more about that in – and maybe We'll find it out, we'll put it in the Show Notes. We'll put links to both the K12 curriculum and the K12 International Academy.

Katie Patrick: Well, it's all the K12 curriculum, I think it's the same website. You just go to a different link on said page.

Dr. Mike Patrick: Yeah. We'll find out and put it in the Show Notes for sure, so people know.

But then again, there are some people who use homeschooling as a little bit of a cop out. I mean, things aren't going well in the public school and so they're going to homeschool their kids and they don't put the work into it to make sure they have a good curriculum and keep their kids on task.

Talk about that a little bit here real quick, Nick. In terms of your motivation to do school, do you think you'll be more motivated if you're accountable in a public school system? Is it easier to just kind of put things off until tomorrow? Do your parents let you put things off? Speak to that.

Nick Patrick: I think it's easier to put things off till tomorrow.


Dr. Mike Patrick: When you're…

Nick Patrick: Yeah. And then… Yeah, you want me to put stuff off because you're like, "Can we go somewhere today?"

Katie Patrick: You’re going to put off an entire year of Composition.

Nick Patrick: Ouch.

Dr. Mike Patrick: OK, hopefully, the school officials aren't listening to that.

Nick Patrick: Editing…

Dr. Mike Patrick: No, just kidding.


Katie Patrick: Wait, I need to add something though. He is in middle school right now so his curriculum is a little different than the high school one. The elementary and the middle school programs for K12, the parent is technically the teacher. So, there's no outside force saying, "Did he do this? Did she do that?" et cetera.

I mean, I can say, "Mom, there are eight questions on this Math lesson thing. Can I just do four of them?" And you know, "I guess, sure, as long as you understand it." But the high school program there is, if you don't have motivation, it can really catch up to you because I mean, you have to stay on a certain track and you have to do all the assignments or it affects your grade negatively.

Dr. Mike Patrick: Right. Right.

Katie Patrick: So, you know, having lower motivation isn't as important in elementary and middle schools for K12. But it's super important to be self-motivated in high school or you will be completely lost and overwhelmed.

Dr. Mike Patrick: Yeah, and be behind and get that grades.

Katie Patrick: And that has happened to me before, too.

Dr. Mike Patrick: Because we're not always the best parent in terms of … We're more likely to say, "Can't you work on that tomorrow and let's go to the zoo."


Katie Patrick: Yes, so like that.

Dr. Mike Patrick: All right. Well, I want to thank both of you for joining me in the studio today. I think it's been a good conversation for some other parents to listen and decide about homeschooling on their own. Or, hey, do my experiences with homeschooling match up with yours and that sort of thing.

OK, we're going to take a break. And we will be back with more Pediacast right after this.



Dr. Mike Patrick: All right, we're just going to wrap up the show here very quickly since we are running pretty late.

Again, thanks for Katie and Nick for stopping by the studio. It was great. Maybe it's just because I'm their dad. But it was great here and that and it would be great here and that in ten years, too.

I want to thank Nationwide Children's, Medical News Today, Vlad over at Vlad Studio, Wizard Media and of course, all of you for being a part of the show.

Don't forget if there's a topic you would like to discuss or you have a question or comment, just go to and click on the Contact link. You can also email If you do that, make sure you let us know where you're from.

The voice line is open and available for you at 347-404-KIDS. That's 404-404-5437. And again, if you leave a message that way, make sure you let us know who you are and where you're calling from.

iTunes Reviews, we mention this pretty much every week. And those are very helpful. So please, if you have not taken the time to review Pediacast on iTunes, I would appreciate it.

Also, talk us up in your blogs and on Facebook and in Twitter. And of course, tell your doctor. When you go in for the next well check up or sick office visit, say "Hey, I found this really cool pediatric podcast from a board-certified pediatrician who's been doing this for five years and they talk about evidence-based medicine."

So if you could just spread the word. And again, it's not just for self-promotion here. Really, it's just to grow our audience and provide the best information available, accurate and up-to-date for parents everywhere.

And we also have an Android app. So if you have a phone with an Andriod, you can look for that in the Android Store. I'm not an Android user. I'm an iPhone user and we don't have an iPhone app yet, but one continues to be in the works.


All right, so that pretty much wraps up our show this week. It's been great spending time with you and I'm looking forward to doing it again very soon. And until then, this is Dr. Mike saying stay safe, stay healthy and stay involved with your kids.

So long, everybody!


Dr. Mike Patrick: OK, we are back in the studio and right now, I am joined by two fabulous wonderful children. But then again, I might be a little biased about that. So, one of the things that we're going to talk about today is actually roller coasters.

Nick Patrick: No kidding,

Dr. Mike Patrick: Now, I know that you have a definite opinion about wood versus metal roller coaster, Katie. Can you please speak to that.

Katie Patrick: My opinion about it?

Dr. Mike Patrick: Yeah.

Katie Patrick: Like, which do I prefer? By which do I prefer to ride or which do I prefer historically?

Dr. Mike Patrick: Both. Let's start with history. Historically, what do you think?

Katie Patrick: I love the wooden coasters for the historical part. Like, I love to look at the old wood ones like The Beast at Kings Island and imagine them when they were first built and new. I mean, The Beast was the tallest and longest wood coaster in the world when it was opened.

So it’s interesting to stand there and pretend that you're a person from when it first opened looking at this thing. And you're like "This is insane, crazy!" And now, we go on and it's like, "Oh, that's nothing."

And it's all worn down and the wood is rotting, but at one point, that was new, you know.

Dr. Mike Patrick: And I remember when that particular roller coaster was actually quite scary.

Katie Patrick: Yeah.

Dr. Mike Patrick: I mean, that was as big as they went and as long as they went and as fast as they went.


Katie Patrick: Well, I mean, it's still little scary and the fact that it's so rough and jerky, because it's old, it feels like you're going to die. But scary in the height and the speed and stuff, too.

Dr. Mike Patrick: Right. But in terms of the preferences to ride, what do you prefer?

Katie Patrick: To ride, then I prefer the newer steel metal ones, whatever it’s made out of.

Dr. Mike Patrick: Right, right.

Katie Patrick: Because it's smoother and they can do more things, like you know. You can't really have very many loops and stuff with a wood coaster.

Dr. Mike Patrick: Yeah. Nick, why don't you jump in here. Tell me what's your favorite? Wood or metal? Metal, is that right?

Nick Patrick: Steel.

Katie Patrick: Steel. Steel, yes.

Nick Patrick: Steel, metal.

Dr. Mike Patrick: Well, because steel would be the better thing to use. You wouldn't want to use like aluminum.

Katie Patrick: Iron.

Dr. Mike Patrick: Aluminum.

Katie Patrick: Tin foil.

Dr. Mike Patrick: I don't think I'll ride that tin foil coaster. No, what's your favorite, Nick?

Nick Patrick: Steel, definitely.

Dr. Mike Patrick: Steel?

Nick Patrick: Yes.

Dr. Mike Patrick: OK.

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