Health - Parenting Hub

Expert Advice from Bonitas Medical Fund

What you need to know about Pneumonia

Lee Callakoppen, Principal Officer of Bonitas Medical Fund talks about pneumonia: According to the World Health Organisation (WHO), a child dies from pneumonia every 30 seconds. Which means that around 1.1 million children, under the age of five, die each year. This is more than malaria, AIDS and tuberculosis combined. What is pneumonia? Pneumonia is a lung inflammation caused by a bacterial or viral infection, it’s when the air sacs in the lung fill up with pus and can affect or one or both lungs. The flu shot and pneumonia Having a flu vaccine is the first line of defence when it comes to protecting yourself, with studies showing it reduces the risk by about 50 to 60%. The vaccine trains your body to recognise flu and fight it. Pneumonia is a relatively common and serious complication of flu.Supporting evidence from randomised clinical trials indicates that fluvaccines are effective in preventing influenza-associated pneumonia. Signs and symptoms of pneumonia may include: Chest pain when you breathe or cough Confusion or changes in mental awareness (in adults aged 65 and older) A cough, which may produce phlegm Fatigue Fever, sweating and shaking chills Lower than normal body temperature (in adults older than age 65 and people with weak immune systems) Nausea, vomiting or diarrhoea Shortness of breath How are flu and pneumonia different? Bonitas explains that pneumonia symptoms are similar to flu but last longer. The severity of the pneumonia depends on your age and overall health. In the case of newborns and infants, sometimes they show little or no infection and other times they may vomit, have a fever and cough, have difficulty breathing and eating. Pneumococcal vaccine There are a total of 80% Community Acquired Pneumonias (CPAs). These streptococcal bacteria can spread from the nose, throat and ears to cause pneumonia – a severe infection of the lungs. The vaccine protects you against: Infection that can result in Pneumonia, infection of the blood (bacteremia/sepsis), middle-ear infection (otitis media), or bacterial meningitis. Pneumonia is by the most common of these infections. Is it an annual vaccination? The pneumococcal vaccination is suitable for those over 65 years of age or immune compromised members a pneumococcal vaccination once every five years. Who should have the pneumonia vaccination? It is recommended for all individuals aged 65 years or older plus individuals aged 2-64 years with certain long-term health conditions, such as a serious heart or kidney condition. In fact for anyone with an increased risk, from a chronic disease, immune-suppressed people particularly those who are HIV positive, cancer sufferers and smokers who are more prone to respiratory illnesses. The cost of pneumonia In severe cases of Pneumonia, the estimated cost of spending a night in intensive care is R15 000 whereas a Pneumococcal vaccine costs around R1000. Most medical aids do cover the cost. Bonitas offers a free flu vaccine annually to members as well as a once off pneumococcal vaccine for people over 65 years of age. According to the New England Journal of Medicine (NEJM), ‘In addition to reducing the risk of hospitalisation for an influenza infection itself, the flu vaccinations appear to reduce the likelihood of hospitalisation for influenza-associated complications such as pneumonia. When to see a doctor? See your doctor if you have difficulty breathing, chest pain, persistent fever of (39 C) or higher or a persistent cough, especially if you’re coughing up phlegm.

June 12, 2019

Five facts about ‘flu

Gerhard Van Emmenis, Principal Officer of Bonitas Medical Fund gives five facts about flu: Flu strains, like fashion, change every year The latest flu strain South Africa can expect is nick-named ‘Aussie Flu’. This particular strain – H3N2 – is a subtype of influenza A. The virus has, in fact, been around for a whilebut unfortunately the flu strains have a built in survival mechanism, they mutate or change so they outwit the body’s immune response. Which is why each year flu vaccinations are updated, meaning last year’s won’t necessarily protect you this year. The symptoms of flu? These include high temperatures, body pain, sore throat, tiredness, loss of appetite and are the same year in and year out. However, some flu strains may cause the symptoms to last for a longer time and be more severe. The flu can also bring on headaches, muscle pain, vomiting and diarrhoea. In people with weaker immune systems, the flu is even more serious. The flu shot doesn’t gives you flu According to the Centre for Disease Control, ‘A flu shot cannot cause flu and serious allergic reactions to the flu vaccine are rare. However, if you are allergic to eggs you need to notify your doctor. Flu vaccines are currently made either with flu vaccine viruses that have been ‘inactivated’ and are not infectious or with no flu viruses at all. The most common side-effects from the shot are small amounts of soreness, redness, tenderness or swelling around the injection site. Protecting yourself and your family The flu vaccine reduces your chances of getting flu and, if you do get it, it will be milder.The vaccine trains your body to recognise flu and fight it. More importantly, if you are vaccinated you will protect others, via what is called ’herd immunity’. This includes vulnerable members of the family such as such as small babies and the elderly as well as those who are immune-compromised. Some of the reasons people don’t vaccinate Every year there is a debate about flu injections yet up to 11 000 people die from flu in South Africa every year, despite the flu vaccination being readily available and paid for by most medical aid schemes. There are a number of reasons, including the notion that: ‘I don’t get flu’, ‘the vaccine doesn’t work’, ‘it will hurt my arm’ or ‘the vaccine will give me flu’. However, according to Bonitas, there are very good clinical reasons why you should. Bonitas covers one flu vaccine for all members. Members can go Clicks, Dischem or Pick n Pay pharmacies for the vaccine at no cost, or attend a Bonitas Wellness Day.

June 5, 2019

Deciphering Medical Aid Speak

It can be rather daunting trying to understand the terms in your medical aid plan and all the detailed information about your benefits. Medical Schemes and the Council for Medical Schemes (CMS) use certain terms in reference to benefits. They can be tricky to fathom. Here are some of the most frequently asked questions, as highlighted by the Bonitas Medical Fund call centre. Prescribed Minimum Benefits (PMBs) PMBs are confusing even to those in the medical industry but simply put, it is a list of 26 chronic diseases and 270 treatments which have to be covered by all medical aid schemes as outlined in the Medical Schemes Act. PMBs are in place to make sure all members have access to certain minimum health services, regardless of their benefit option. The aim is to provide members with continuous care to improve their health and well-being and to make healthcare more affordable. Above Threshold Benefit Medical Schemes set an annual limit for day-to-day claims. Once you have reached this limit – or threshold – then your claims are paid from the ‘Above Threshold Benefit’. The amount available depends on the plan you are on as well as the number of dependants. Day-to-day limits Members and their dependants are given a pre-determined maximum amount of money for out-of-hospital expenses during a year. There is a limit to what you can spend after which you move onto the above threshold benefit. Pre-authorisation Unless there is a medical emergency, members are required to obtain pre-authorisation from their schemes before being admitted to a hospital for a procedure. If you do not organise pre-authorisation, the scheme can refuse to pay. Quotes for procedures Bonitas advises members to not only obtain pre-authorisation but to also ask for a detailed quote from the hospital and medical practitioner prior to being admitted to hospital (if it’s not an emergency). It means you can submit it to your medical aid ahead of the procedure to find out if co-payments will be required and if so, how much they are. Co-payment Medical practitioners and hospital often charge more than medical aid rates. This means medical schemes seldom cover the entire bill. A co-payment refers to the outstanding portion of the account, for which you will be responsible. A co-payment varies from one medical aid scheme to another and is sometimes not necessary if you use a designated service provider or network hospital. The medical aid can pay from 100% – 300% of the medical aid tariffs, depending on the plan you are on. ICD codes This is a coding system developed by the World Health Organisation (WHO) that translates the written description of medical and health information into standard codes. It means every medical treatment and diagnosis has a specific code – called an ICD 10 code. These are important as it allows the scheme to identify the code of the healthcare service you require and to make sure payment is made. The correct ICD Code must be included on every claim to ensure you are paid for the correct benefit and t the healthcare practitioners are paid for their service. Claim After you have seen a doctor or been in hospital, you can either pay the bill directly and claim the amount back from your scheme or your doctor can submit the claim on your behalf. Remember to ensure that all the correct information is on your claim, including your membership number and the ICD 10 Code. Chronic Medication Is medicine prescribed by a medical practitioner for an uninterrupted period of at least three months. This medicine is used for a medical condition that appears on your scheme’s list of approved chronic conditions. Payment of chronic medication is usually a separate allowance on your medical aid plan. Formulary Medical Aids have a list of medicines on what they call their formulary – or list – that are recommended to treat different diseases. If you opt for medication not on the formulary there might be a co-payment. Generic medicine There are a number of generic medicines on the market that are cheaper than the original, patented brands however they contain the same active ingredients and are just as effective. Most medical schemes encourage the use of generic medicines to save costs and help you stretch your benefits. Check with your pharmacist. Private healthcare in South Africa is not cheap and the best way to make the most of your medical aid or hospital plan is to understand what is and isn’t covered as well as the terms and conditions. Make sure you get to grips with the various terms used by your Scheme and Dr and if you are unsure … ask!

May 10, 2019

Pre-authorisation and payment: Do you know the difference?

Medical aid members know that pre-authorisation ahead of a medical procedure is always required but does pre-authorisation mean it’s an agreement to pay in full? No, not necessarily. This is the cause of a great deal of confusion and unhappiness from medical aid members as well as doctors and hospitals. Gerhard Van Emmenis, Principal Officer of Bonitas Medical Funds says, ‘Pre-authorisation is required for all hospital admissions, including emergencies. However, it is not an agreement to pay all the costs and expenses in full.’ Why not? Let’s take you through the Ts and Cs. Why do they differ? Most medical aid plans have varying hospital benefits according the level of cover you have chosen. Van Emmenis says, ‘All of our plans provide hospital cover for major medical events when you or your dependant is admitted to hospital. But, each plan has different hospital benefits available. We encourage you to use the healthcare providers on our network and to get pre-authorisation for your hospital stay so the providers of your treatment or procedure are paid to the full extent of what your plan offers.’ Understanding your medical aid rate of payment‘ For example’, says Van Emmenis, ‘The Bonitas Rate is the rate at which we reimburse healthcare providers. Where we pay 100% of the Bonitas Rate, this is NOT necessarily what the healthcare provider charges. They may charge 200% of your medical aid rate which means you are responsible for half the payment. Each plan has a different rate according to the premium you pay. If you visit a healthcare provider that charges the Bonitas Rate, we will pay the bill in full (provided that you have benefits available). For this reason it is important to use designated service providers with whom Bonitas has negotiated rates.’ How much will your plan cover? If it is not an emergency the best way to find out how much your medical aid will cover is by asking the hospital and medical practitioners for a detailed quote. Submit this to your medical aid to check what they will cover and how much the shortfall, if there is one, will be. Co-payments The shortfall will be in the form of a co-payment. These co-payments differ from one medical aid scheme to another, and are often higher than anticipated, mostly due to medical practitioners and hospital charging higher than the medical aid rate. Minding the gap When there is this shortfall between what the medical scheme pays and what the hospital or specialist charges, it helps if you have taken out gap cover. Even if you have a top of the range medical aid plan, it doesn’t mean there will not be ‘gaps’ between the tariffs your scheme is prepared to pay and the amount your specialist charges. GAP cover is not a medical aid product but an insurance policy taken out to reduce or eliminate co-payments. Again the amount you receive depends on your GAP policy It is important to note that Gap Cover is an insurance ‘policy’ and is regulated under the Long and Short Term Insurance Act (1998). Medical schemes, on the other hand, are overseen by the Council for Medical Schemes Act (1998) and are not for profit. Ensuring you are covered 1. Make sure you get a quote. Medical aid members are advised to not only obtain pre-authorisation but a quote from the hospital and medical practitioners prior to being admitted to hospital (if it’s not an emergency). Submit this to your medical aid to find out if there are any co-payments and if so, how much they are. 2. Find a hospital on your medical fund’s preferred network in order to ensure maximum payment 3. Make sure you fill in provide all information required for pre-authorisation correctly: Have your correct membership number and the details of the member who the request is for The date you are going into hospital and the date of the treatment or procedure The name of the doctor who will be treating the member, their telephone number and practice number The name of the hospital where you will receive treatment, their telephone number and practice number The relevant procedure and diagnosis (ICD-10) codes for the treatment (ask your doctor for these) If your request for authorisation does not include all the information listed above, your request will not be approved. If your pre-authorisation is declined the reasons for doing so will be listed on the correspondence. If it is approved, you will receive a pre-authorisation number and this will also outline the approved length of your hospital stay and the status of all codes. However remember the pre-authorisation is not a commitment to pay the full amount. 4. Gap cover If you have Gap Cover, notify them of the co-payment required prior to being admitted to hospital as there are limits to the amount they will pay. What about emergencies? Emergencies must be pre-authorised within 48 hours of going into hospital or on the first working day after a weekend or public holiday. If you don’t get pre-authorisation, your account won’t be paid by the Scheme. ‘The most important thing’, says Van Emmenis, ‘is to find out, prior to being admitted, what your medical aid will pay and what payment you are responsible for. It will save a great deal of stress when you are recovering from surgery.’

April 5, 2019

Medical tax rebates stable after budget speech

Private medical aid members can breathe a sigh of relief after the budget speech. Treasury has been hinting for a while that they were considering reducing of the medical tax credit to fund the National Health Insurance (NHI), fortunately, it remains unchanged for the year ahead. Although it was a relief to members it was also a surprise tax sacrifice, considering the need to fund NHI. This equates to over R30 billion this year and around R35/36 billion for the coming year – a large sum indeed. It is believed the removal of tax credits would have upset too many people who are dependent on it to access private health care and are essentially being rewarded for not burdening the government health care. Before 2012, SARS deducted your medical aid contributions against your taxable income. ‘Originally,’ says Gerhard Van Emmenis, Principal Officer of Bonitas Medical Fund, ‘your medical aid contributions would be a deduction against your taxable income. However, from 2012, SARS introduced a medical credit, a ‘tax credit’ which is deducted from your overall tax liability.’ The medical tax credit consists of the following two amounts: The medical scheme fees tax credit This applies to the premiums paid by you to a registered medical scheme on behalf of yourself and your dependents. The main member, as well as the first dependant on the medical scheme, receive a monthly tax credit of R310 (for the 2018-2019 year). All additional dependants receive a monthly tax credit of R209 (for the 2018-2019 tax year). There are three categories: 1. Under 65 (without disability) 25% of the total contributions paid to the medical scheme Less (4X medical scheme fees credit) Plus qualifying medical expenses paid less 7.5% of taxable income 2. Under 65 (with a disability) 33.3% of total contributions paid to the medical scheme Less (3X medical scheme fees credit) Plus qualifying medical expenses paid 3. 65 or over (with or without disability) 33.3% of total contributions paid to the medical scheme Less (3X medical scheme fees credit) Plus qualifying medical expenses It is important to note that if your premium is a deduction from your salary or wages, your employer is obliged to use the credit system to adjust your monthly PAYE tax accordingly. If you contribute to a medical scheme independently from your employer, you will receive the tax credit on assessment when you complete your tax return. 2. The additional medical expenses tax credit This means that the overall amount of tax you need to pay at the end of the tax year is reduced. The amount of your tax rebate is made up of a percentage of all out-of-pocket expenses you have spent on qualifying medical expenses that weren’t covered by your medical scheme. This amount accumulates throughout the tax year. You will need to keep the slips for these expenses. To calculate the additional medical expenses tax credit, special formulas are used. The specific formula to use depends on your age and whether you or one or more of your dependants has a disability. The following out-of-pocket expenses qualify: Consultations, services or medications from a registered medical practitioner, arthropod, physiotherapist, dentist, chiropractor, herbalist, homoeopath, optometrist, osteopath or naturopath Admission to a registered hospital, including nursing homes Care at patient’s home by a registered nurse, nursing assistant, nursing agency or midwife Medicines prescribed by a duly registered physician (as listed above) and acquired from a duly registered pharmacist Medical expenses on services rendered or medicines supplied outside of South Africa and which are substantially similar to the services and medicines listed above Money paid towards the treatment of a physical impairment or disability (as long as it is a qualifying expense prescribed by the Commissioner). What about over-the-counter expenses It is important to note that unless these are prescribed by a registered medical practitioner and acquired by a pharmacist they don’t enjoy a tax rebate. Examples include medicines, such as cough syrups, headache tablets or vitamins. ‘Whether NHI is going to materialise or not’, says Van Emmenis, ‘The Government’s coffers need filling and the approximately 17% of the South African population on private medical should expect their medical aid tax relief to get less and less in the future.’

March 15, 2019

Bonitas gives back

Members of Bonitas Medical Fund will now have access to free lifestyle vouchers as well as discounted offers on gap cover and financial services products through the Fund’s new multi-insurer platform. This is not another Loyalty programme. ‘Our members’ health has always been a priority and we strive to make healthcare as affordable as possible,’ says Gerhard van Emmenis, Principal Officer of Bonitas. ‘And while our various plans offer a host of benefits, we know that in difficult financial times money matters can add to stress levels. For this reason, we have adopted a multi-insurer platform which offers members discounted lifestyle vouchers as well as exclusive offers on gap cover and various insurance products.’ The past 12 months have been extremely difficult for consumers, impacted by the increase in VAT, the fuel levy and the resulting escalating prices. This has increased the burden placed on consumers struggling to make ends meet. ‘In 2017 a Financial Wellness Indicator revealed that 73.5% of South African households were financially unwell,’ says Van Emmenis. ‘2019 is no different. Consumers are cash strapped so being able to align with strategic partners to offer a comprehensive and tangible way to relieve the money pressure while helping them find them some ‘extra’ money, will go a long way to keeping them physically and financially healthy.’ A report published last year, which reviewed rewards programmes in South Africa, indicated that there are around 100+ existing loyalty programmes with the average consumer subscribed to about nine. ‘The economic landscape is tough to navigate and we didn’t want to add to the pressure already placed on our members by offering a loyalty programme for which they would have to pay an additional monthly fee for. Our multi-insurer platform is premised on negotiating exclusive deals to the benefit of our members. ‘They are designed to add real value aligned to member needs.’ Van Emmenis explains. In brief: These do not cost anything There are no points No levels of membership You don’t have to work for rewards The model is split in two. One: Free monthly discount lifestyle shopping vouchers to offset daily living expenses These are available from over 30 retailers and 6 000 outlets countrywide, such as Shoprite, Takealot and Edgars, as well as for airtime and data purchases and electricity. ‘The deals are aimed at the average South African, with discount vouchers for groceries, data, airtime and electricity. There are also discounts on activewear and gym membership to encourage a healthier lifestyle,’ Van Emmenis says. Two: Discounted financial service products through Medgap and Indie MedGap offers comprehensive gap cover at a discount of up to 26% exclusively for Bonitas members. Indie offers various financial products such as a funeral, critical illness or disability cover, as well as income protection at a discounted premium, together with a free investment at no extra cost. Indie will match and invest up to 110% of Bonitas’ member’s life insurance premiums, with cash drops every five years. The multi-insurer platform is supported by a new, revamped member zone to allow members to manage their medical aid 24/7, on any device. This includes submitting claims, applying for chronic medicine and viewing benefits clearly signalling a new era of medical aid has dawned.

March 2, 2019

Advice from the experts

Beating The Baby Blues

Having a baby is a momentous event. The kind of event that kicks you so far out of your comfort zone that you don’t even know what planet you’re on. We all know about the nice side of it – the miracle of a new life, the immense and overwhelming love, the snuggling baby at your bosom. In fact, we’re inundated with images and articles and information about how wonderful it is to have a baby. But what about the dark side? What people seldom talk about is how tough it is – how those first days and weeks are so overwhelming and scary and strange and intimidating. Nobody tells you how difficult it is to care for another little being when you are trying to recover both physically and emotionally from a birth. Nobody speaks about the terror of leaving the hospital with a stranger in your arms – one that doesn’t even speak your language. Your antenatal classes were unlikely to show you video footage of what prisoners of war look like after a few weeks of sleep deprivation. The magazines are not filled with pictures of mothers crumpled on the floor in their pyjamas weeping. We see movies of mothers doting on their newborns, not mothers calling the cops to take their screaming baby away from them before they kill it. We hear stories of overwhelming love, not overwhelming disinterest. We get advice on how to breastfeed not advice on how to not commit suicide. And I feel that it is the lack of this other side of life that causes half of the problems with post-natal depression. All depression has an element of fantasy in it. We become depressed because we compare reality with how we hoped or wished it would be (the fantasy) and then find our life to be somewhat lacking. Now if you are bombarded with information telling you that motherhood is instantly wonderful, that you will fall in love with your baby at first sight, that your life will be changed forever in wonderful ways, and then this is not your experience, you’re already on the slippery slope to depression. I believe that new mothers ought to have a more balanced perspective and a more realistic picture of what they’re in for. Of course there are good sides to having kids, but they don’t always surface immediately. It is normal, for instance, to not love your baby instantly. You are tired, emotionally and physically recovering, in shock, overwhelmed, confused and often feeling a bit panicky. There may not be space in your internal world for a rush of love and affection. That’s ok. It doesn’t mean you will never love your child or that you won’t care for them, or that there is anything wrong with you. It is also normal to really struggle in the first weeks and months. Everyone tells you that caring for your child is a natural instinct, but how many of us are in touch with our natural instincts? Some things you may figure out on your own, some things you’ll mess up and others you may need to ask for help. That’s ok. You are not a bad mother if you don’t know what to do or if you can’t interpret your baby’s every cry. It is normal to lose it sometimes. Go and watch those videos of sleep-deprived soldiers! Even the toughest, trained men will fold under the pressure of not getting some much-needed rest. You may collapse in a weeping heap, you may shout at your baby, you may think you’re losing your mind, you may do crazy or irrational things. You are not insane, you are not a bad person, you are not unable to cope. Having a baby will turn your world upside down. It takes time to adjust. It takes time to find a rhythm. It takes time to feel like yourself again. You may even go through a period of resenting your baby, your partner, yourself. You may question your choices. You may want to run away. You may throw things. It does ultimately settle down. You will eventually find the good side. And if you don’t, there are plenty of people out there who can help you. Find a coach or a therapist or a good friend (particularly one who has gone through what you are going through). Most importantly, know that where there is a positive there is a negative and where there is a negative there is a positive. Babies are like life, they come with both sides. The more prepared you are for reality (and not fantasy) the more likely you are to take it in your stride.

January 9, 2017

Healthy skin tips for your little one

Glossy magazines keep us well-informed on keeping adult skin moisturised, cared for and looking beautiful. When it comes to our children, especially babies, looking after their skin is just as vital, if not more important. “When our children enter this world, we are armed with equipment that took much care and consideration to select. The same care and consideration needs to be taken for your child’s skincare products,” says Su-Marie Annandale, Krayons’ brand manager. Krayons’ baby skin care products have been providing South African babies and children with the necessary products to keep their skin protected for over 20 years. “Healthy baby skin is just as important to Krayons as it is for parents,” says Annandale. When bringing your little one home from the hospital, and even as they grow, Annandale provides 5 tips on how to keep your baby’s skin healthy: Although babies love playing in the bath, and splashing about – limiting the time they spend in the bath can help keep their skin from drying out. Make every second or third day “fun” bath time, and the others can be short washes. After bath time, keep your little one moisturised. Using Krayons’ Aqueous Cream after every wash accompanied by a soft and gentle baby massage will give your little one’s skin all it needs to be kept moisturised throughout the day. It is recommended that you wash your baby’s new clothes and linen before use, but be sure to use a gentle fabric conditioner that will ensure that baby’s clothes are soft and won’t cause any skin irritations. Personal Touch boasts a Baby love variant which boasts the Krayons scent. It is soft and delicate, just like your baby’s skin. The weather outside dictates how your baby should be dressed to keep them comfortable and also to protect their skin, but no matter if it is hot or cold your baby needs to be protected from the sun. Your baby’s skin is too sensitive to be exposed to the harsh sun and needs to be kept covered. For more, like Krayons on Facebook: www.facebook.com/krayonsbabies

December 19, 2016

Ambidextrous kids – disorder or gift?

I watched a film once where the main character was completely ambidextrous – he could write a poem with one hand while drawing a picture with the other. How I would have loved to have a skill like that. So why is it that teachers push kids to choose a dominant hand? The reason teachers and OTs will encourage a child into one-handed dominance is predominantly for practical reasons in the classroom – the sooner they choose a hand, the sooner they perfect their control with that hand, and the sooner they will learn to write quickly and efficiently. I strongly disagree with this. The majority of children will naturally slip into right or left dominance at around 7 or 8 years of age and shouldn’t be forced into writing exercises before the body is naturally ready. Unfortunately this doesn’t fit in with the school curriculum, which requires kids to be practicing pre-writing skills from as early as 3 or 4. Very very few children are truly ambidextrous (and usually this only happens when one hand is injured for a period of time or some other environmental factor), but there are a fair amount who are mixed-handed (i.e. They will tend to use one hand for certain tasks and another hand for different tasks e.g. Writing with the right hand and cutting with the left hand). The schools will try to discourage this as sometimes it slows kids down as they’re still trying to decide which hand to use for what and not getting on with the task at hand. There are some things that will be helped by choosing a dominant hand – for example crossing the midline or bilateral integration, but these can easily be included in a child’s life with some simple exercises to ensure that they don’t miss out on any brain integration that may come from choosing one hand as dominant and using the other as a helper. For example, pushing a car round a track, holding the car with one hand and the track with the other; reaching over the body to grab something on the opposite side of the body; holding paper with one hand and cutting it with the other; or my personal favourite, playing “Twister”. In OT they will essentially do these kinds of exercises with a child, but it will cost you. If you hop onto Google you can find plenty of exercises like these and do them yourself. You can have a lot of fun and your child never needs to wonder about why he/she is in “therapy”. Most researchers on the subject agree that it is useful for everyone to sometimes try using their less-preferred hand for tasks normally done with the dominant hand as it improves brain function and dexterity! Being mixed-handed can also have great advantages in sports like baseball and snooker where you can switch hands to get a better shot. The only real concern with a child who isn’t naturally finding a dominant hand is a learning disorder known as dysgraphia, which involves problems with motor skills. This disorder would not only affect their ability to choose a hand to write with, but would also manifest with other noticeable problems such as struggling with the concepts of right and left, difficulty catching a ball or skipping or even basic motor movements like walking and jumping. It is unlikely that your child would have problems of this nature without you noticing them and they definitely would be picked up in an assessment with an OT if you choose to have one. The other thing to consider is that your child may be gifted. Around 48% of gifted children are ambidextrous at some stage of their development. Take a look at some of the other criteria for gifted kids and if you think your child is, then it is definitely worth getting an IQ test done as gifted children do need additional stimulation in order for them to develop optimally. · Unusual alertness, even in infancy · Excellent memory · Learn to speak early and have an unusually large vocabulary and complex sentence structure for their age · Understand word nuances, metaphors and abstract ideas · Enjoy solving problems, especially with numbers and puzzles · Often self-taught reading and writing skills as preschooler · Highly sensitive · Thinking is abstract, complex, logical, and insightful · Idealism and sense of justice at early age · Longer attention span and intense concentration if something interest them · Preoccupied with own thoughts—daydreamer · Learn basic skills quickly and with little practice (1-3 repetitions) · Asks probing questions · Wide range of interests (or extreme focus in one area) · Highly developed curiosity · Interest in experimenting and doing things differently · Puts idea or things together that are not typical · Keen and/or unusual sense of humor · Desire to organize people/things through games or complex schemas · Vivid imaginations (and imaginary playmates when in preschool) If your child is still in preschool, he/she may just not be ready to choose a dominant hand and making a child ‘wrong’ for this seems unfair and unnecessary. Ultimately you will have to make a decision based on your own child whether your child would benefit from having an assessment or if it is worth waiting to see what naturally develops. Please remember to trust yourself. You know your child better than any teacher or therapist and if you feel that their opinion is incorrect, trust that. You can always get a second opinion or even just hold off on getting an opinion at all. Whether your child’s ambidexterity is a gift or a disorder is often determined by how it is handled, and that is up to you as the parent.

December 15, 2016

Flying with kids? Remember your tablets and rooibos

As the December holidays loom, many of us are planning some well-earned family time. Reconnecting with loved ones often involves travelling by air and for those of us with kids, that prospect can fill us with dread. It needn’t be that way, says Shaun Pozyn, Head of Marketing at British Airways (operated by Comair), who offers these timely tips for managing youngsters in the air and en route to your destination. Give yourself enough time: rushing while trying to marshal kids and their kit can be harrowing and conjures images of Kevin McCallister (played by Macaulay Culkin) being left abandoned by his family in the 1990 comedy, Home Alone. One way to score yourself a little time is by using apps like ba.com to check your family in online. Know the rules: documentation requirements when flying domestically are fairly simple: you need to carry identification. But if you’re travelling internationally with children you need an unabridged copy of their birth-certificates. Get the squad to help: the cabin-crew are your allies, so don’t be afraid to ask them for assistance. You can, for example, use a push-chair to the door of the aircraft, and on international flights, infants can be accommodated in bassinettes. Take your tablets: mobile devices can largely alleviate the need for toys, and picture-editing apps like Prisma, or games like MineCraft can temporarily replace Lego, for example, which can be lost in the cabin. Just make sure your devices are charged and consider investing in a power-bank to ensure that have plenty of power. Handle the pressure: one of the major irritants for small children and infants when flying is pressurisation. This is because their ears haven’t fully developed yet, so they can’t equalise changes in air-pressure when the aircraft ascends and descends. Swallowing and chewing can help with this, so depending on the child’s age, drinking fluids or snacking on chewy foods can help. Foods with less sugar can help prevent the child from becoming too energetic: opt for biltong, fruit-rolls, nuts and fruit-juice diluted with rooibos tea rather than sweets and cool-drink. Don’t plan too much: travelling can be very exciting for kids, but too many activities in one stint can leave them tetchy and overstimulated. If a child is enjoying a particular pastime – working on a travel-log to document their journey, say – leave them to it. That can also give you, the parent, the chance for a welcomed breather. See: http://www.britishairways.com/en-gb/information/family-travel for more information.

December 14, 2016

The monster around your middle

Metabolic syndrome is a health condition that everyone’s talking about. Although it was only identified less than 20 years ago, metabolic syndrome is as widespread as pimples and the common cold. It is estimated that around 20-25 per cent of the world’s adult population have metabolic syndrome. Indeed, metabolic syndrome seems to be a condition that many people have, but no one knows very much about. So what is this mysterious syndrome — which also goes by the scary-sounding name Syndrome X — and should you be worried about it? Keep reading for some insight. UNDERSTANDING METABOLIC SYNDROME Metabolic syndrome is not a disease in itself. Instead, it’s a collection of the most dangerous risk factors: high blood sugar, pre-diabetes, diabetes, high cholesterol levels, high blood pressure and abdominal (tummy) fat. Obviously, having any one of these risk factors isn’t good. But when they’re combined, they set the stage for serious problems. People with metabolic syndrome are twice as likely to die from and three times as likely to have a heart attack or stroke compared with people without the syndrome. They have a fivefold greater risk of developing type 2 diabetes!! The underlying cause of metabolic syndrome continues to challenge the experts but insulin resistance and central obesity (excess tummy fat) are considered the most significant factors responsible for this syndrome. What comes first, the chicken or the egg? Insulin resistance is very often the starting point of metabolic syndrome. Insulin is a hormone that helps your body convert food into glucose and enter your cells to be used as fuel. Insulin resistance occurs when cells in the body (e.g. muscle cells) become less sensitive and eventually resistant to insulin. Glucose can no longer be effectively absorbed by the body cells and therefore remains in the blood, so your body keeps making more and more insulin to cope with the rising level of glucose in an attempt to process the glucose. Eventually, this can lead to diabetes. Even long before diabetes happens, excessive amounts of insulin is causing damage to the body. The dangerous part of this syndrome is the long term effects of raised insulin levels to your blood vessels often leading to premature heart attacks, strokes and type II diabetes. METABOLIC SYNDROME – ARE YOU A VICTIM? To identify if you have metabolic syndrome it is necessary to take a few basic measurements. There are five risk factors that make up metabolic syndrome. To be diagnosed with metabolic syndrome, you would have at least three of these risk factors. Body Mass Index (BMI) BMI of 30kgm/m2and higher Waist circumference For men: 102cm or larger For women: 88cm or larger Cholesterol: High Triglycerides Either 1.7mmol/L or higher or Using a cholesterol medicine Cholesterol: Low Good Cholesterol (HDL) Either For men: Less than 1.03mmol/L For women: Less than 1.3mmol/L or Using a cholesterol medicine High Blood Pressure Either Having blood pressure of 135/85mm Hg or greater or Using a high blood pressure medicine Blood Sugar: High Fasting Glucose Level 5.6mmol/L or higher Even if you don`t have these measurements available it`s possible for you to know if you are at risk by asking yourself a few basic questions. The American College of Endocrinologist has identified that if you have 2 of the following risk factors you are at risk for developing metabolic syndrome, or may have insulin resistance already: You have ever been diagnosed with coronary heart disease, high blood pressure, polycystic ovarian syndrome, non-alcoholic fatty liver disease. You have a family history of type II diabetes, high blood pressure or coronary heart disease. For women: you have a history of pregnancy-related diabetes or impaired glucose tolerance in pregnancy. You have a sedentary lifestyle and do not engage in regular exercise. You are overweight with a Body Mass Index (BMI) of greater than 25kg/m2 OR if you have a waist circumference measurement greater than 102cm (male) or greater than 88 cm (female). You are older than 40 years of age. CAN METABOLIC SYNDROME BE REVERSED? YES!! Controlling and normalising insulin levels is key to improving metabolic syndrome. Physical activity, weight loss and healthy food choices help the body respond better to insulin. Studies showed by losing weight (through cutting carbohydrates, fat, calorie intake) and being more physically active, people with metabolic syndrome may avoid or delay developing type 2 diabetes or suffering a stroke or heart attack. WHAT TO DO? Weight loss Research confirmed that people with metabolic syndrome can significantly improve their health by losing 5 to 10 percent of their body weight. Weight loss is often a difficult task when you are insulin resistant and have metabolic syndrome. Not only will you have cravings for carbohydrates most of the time, your body is resistant to fat breakdown due to the high amounts of circulating insulin. Normal weight loss diets and quick fixes are ineffective to aid weight loss seeing that the raised insulin levels are not treated. Not only do we need to decrease the calorie content of the diet, one need to look at what your diet consist of. Certain foods are known to worsen insulin resistance and others to improve insulin resistance. Rethink refined carbs and sugar Carbohydrates and sugar in your diet is known for increasing the amount of insulin in your blood. It is therefore necessary to exclude sugar as much as possible. The other concern lies with the amount of carbohydrates that is consumed per meal as well as during the whole day. Insulin levels can be dramatically increased by the amount of carbohydrate as well as the type of carbohydrate consumed. It is crucial to eat only carbohydrates which are low in Glycaemic index (GI). The Glycaemic Index is a ranking of foods based on their immediate effect on blood glucose levels. It is a physiological measure of how fast, and to what extent, a carbohydrate food (starch containing food) affects blood glucose levels. If the glucose reaches the blood stream quickly, your insulin levels will rise dramatically. Low GI foods will result in a smaller insulin response and help with losing

November 30, 2016

So what does dyslexia really mean?

(All information was obtained from Stark – Griffin’s book Dyslexia) Definition of dyslexia – A neurological-functional problem manifesting as a deficit in word decoding (reading), encoding (spelling) and nemkinesia (writing) due to a minimal brain dysfunction and/or differential brain function. More use full information regrading dyslexia Eidetic: give meaning to text in general and recognising words from previous experience. Phonetic: allocating a sound to each letter and using these sounds in groups to produce words. People suffering from dyslexia usually have an average to above average intelligence. 10% – 20% of all children suffer from dyslexia. Children suffering from dyslexia feel confusion, frustration, anxiety, withdrawl and compensating behavioural patterns. These children are often teased and humiliated by their classmates.Dyslexia may lead to poor self image and even depression. These feelings may manifest in behavioural problems which inlcude aggression, vandalism, disruption of class and a hostile attitude. Types of dyslexia Dysnemkinesia Deficit in the ability to develop motor engrams (memory trace) for written symbols Child wil revers letters A child should have no letter reversals by Gr. 4 When writing the alphabet 1 reversal is acceptable in Gr. 3 When writing the alphabet 3 reversals are acceptable in Gr. 2 When writing the alphabet 5 reversals are acceptable in Gr. 1 Dysphonesia Deficit in visual-symbol and sound integrations Child will struggle to read unknows words as he cannot decode them / will have difficulty spelling e.g. slow/solw, does/dose Dyseidesia This type of dyslexia is genetic Deficit in the ability to perceive whole words and to recognise words from previous experience. Child will struggle to read words that he cannot relate to a picture e.g. did / will struggle to read sight words / will struggle to read word that cannot be divided /will spell word the way they sound e.g. does/duz Dysphoneidesia Mix between dysphonesia and dyseidesia Dysnemkinphonesia Mix between dynemkinesia and dysphonesia Dysnemkineidesia Mix between dysnemkinesia and dyseidesia Dynmemkinphoneidesia Mix between dysnemkinesia, dysphonesia an dyseidetia One has to rule out the following deficits before a diagnosis of dyslexia can be made: Problematic vision and/or eye muscle functioning Impaired visual perceptual skills Impaired auditive perceptual skills Cognitive impairment Emotional problems/psychological factors Attention deficit disorder Health factors: e.g. nutrition, infections, allergies, trauma Environmental factors Treatment The child needs to be evaluated by a professional (usually an occupational therapist/speech therapist/educational psychologist/optometrist) that is registered with RADA (Red Apple Dyslexia Association). The test used is called the Dyslexia Test developed by Stark-Griffin. If dyslexia is identified it needs to be specified which type of dyslexia as each one has a different treatment approach. All types of dyslexia can be improved although the percentage differs from person to person. Dyseidesia cannot be 100% cured as it is genetic. Dysphoneidesia is the most difficult type of dyslexia to treat. Dysnemkinesia is easily treated. Build on the child’s strengths and later give attention to the weaknesses. Work around the problem to improve reading/writing and spelling. Famous dyslexics No matter what your dissability – you can still be successful !!! Just look at these famous dyslexic people: Pable picasso Tom cruise Richard Branson Leonard daVinci Thomas Edison Whoopi Goldberg Development of the child checklist The Developmental checklist will assist you in determining whether you child is functioning according to his/her age level. Download your order form Here It is divided into 29 categories namely: Movement (Activities of daily living) Communication skills (Cognitive skills) Personality traits / temperament (Playing) Ball skills (Coordination) Perception (Grasps & hand function) Basic concepts (Body concept) Number concept (Form concept) Colour concept (Size concept) Building with blocks (Working with beads) Cutting with scissors (Drawing / painting) Drawing a person (Picture-reading) Story-time (Writing) Eating / feeding (Sleeping) Prepositions (Senses) Teeth When determining if your child is developing according to his/her age level it is important to remember that each child is unique. Each child develops at his/her own pace; therefore no 2 children’s milestones will be achieved at exactly the same time. Please give a 2 – 3 month leeway to either side of the time frame given (e.g. if it says that a child has to walk when he is 1 year old it can mean that the child may start walking when he is 9 months old or 15 months old). When you see that your child has a delay in more than 2 important areas, please consult your developmental paediatrician and take him/her for an occupational therapy assessment. A child that has a developmental delay usually reaches a plato when 12 years old. Thus it is so important that a child receives therapy from as early an age as possible.

November 28, 2016

What is Klinefelters syndrome?

Klinefelters syndrome (KS) is not as rare as one may think, it is not life threatening but has life altering consequences. About one in 500 boys are born with an extra X chromosome, this affects learning, behaviour and growth. This was identified in 1942 by Dr Harry Klinefelter who was working with male patients at a hospital in Boston Massachusetts. This is a genetic condition where a male baby is born with 1 extra X chromosome. This due to an error in meiosis at conception known as meiotic nondisjunction. The condition is also known as XXY. Normal boys are XY while girls are XX. The KS baby develops an abnormal pituitary gland and hypothalamus part of the brain. Klinefelter syndrome is a random disorder and it is not hereditary. It appears that its occurrence may be linked to the age of either parent. It is not more prevalent in any specific race .This is the most common sex chromosome disorder. According to research done in Australia only about 20-30% of males with KS are ever diagnosed, partly due to the hesitancy of men to seek medical attention and the somewhat non-specific nature of the symptoms. Often men only find out they are KS when they present with fertility issues. They are almost always sterile. Unfortunately there is little awareness about the syndrome, even amongst health professionals, which often sends parents on a diagnostic odyssey trying to find out why their boys are different and the underlying cause remains unidentified. Another difficulty with it is that the symptoms are highly variable, sometimes subtle and sometimes not present at all. Only about 35% present with stereotypical symptoms but up to 80% have learning difficulties and behavioural issues. Many will have developmental delays and trouble with their muscles (low muscle tone) and motor skills. Dyslexia, reading difficulties and data retrieval problems are common. A large percentage are attention deficit (ADD) While their intellect is not compromised, their verbal IQ is below average, they often have difficulty expressing themselves. This often leads to frustration and angry outbursts. It is unclear whether some behavioural difficulties are directly caused by the syndrome or are exacerbated by early speech and learning difficulties. KS in very young boys is especially difficult to recognise and only at puberty do some of the more obvious signs begin to show. The physical characteristic common to all KS males is that they have very small underdeveloped testicles. It is because of this that they cannot produce enough testosterone to produce sperm. This androgen masculinising hormone is also responsible for producing secondary sexual characteristics. Other more common signs are: They are often somewhat taller than genetically expected, their limbs are slightly proportionately longer. They often have knock knees (genu valgum) and high arches (pes cavus). Taurodontism (Large molar teeth with thin enamel) is common. They will have more feminine fat distribution and rudimentary breast development, (gynecomastia) high pitched voice and sparse hair. They usually have “softer more girlish faces and are generally more sensitive than most boys, they tend to be emotional and cry easily. 33% of KS males experience psychosocial issues particularly shyness and low self-esteem. KS men also have added complications whereby they have a predisposition to developing diabetes, osteopenia and osteoporosis It must be noted however that Klinefelter syndrome does not affect sexual orientation. When correctly treated with supplemental testosterone KS men can have normal sexual relations in adulthood. If you suspect your son may be KS you will need to consult a geneticist. They will probably request blood tests which will include a karyotype. An endochrinologist will monitor further treatment. Klinefelters syndrome symptoms can be mitigated by correct intervention. Testosterone supplementation must continue throughout life. This can be administered by injection or with creams or a patch. If KS is identified early there is a better chance of normal development. A thorough psychoeducational examination will need to be conducted to determine what educational interventions are required as KS boys need assistance with the learning issues most of them have. A speech therapist can assist them and occupational therapy is recommended. Many KS boys also have motor dyspraxia. While this all may seem alarming particularly that the syndrome is so relatively common yet somewhat unrecognised there are some positives. These are wonderful sensitive human beings. They can be encouraged that they are usually taller than average, tend to keep their youthful looks, have better intuition and emotional skills than most men and usually get on really well with women. Further reading : www.xxy47.co.za www.andrologyaustralia.org www.checkyourballs.com.au www.csvxy.org Plus information taken from: Lawley pharmaceuticals KS info brochure 2016 Amy Herlihy BSc, Grad Dip Genetic counselling : Thesis 2010 Exploration of prevalence and psychosocial aspects of KS in the context of population based genetic screening.

November 22, 2016

Childhood obesity in South Africa to soar unless we act now

If obesity in South African children continues to increase at the current rate, 3.91 million school children will be overweight or obese by 2025. On world Obesity Day, the Heart and Stroke Foundation South Africa, together with the World Obesity Federation, calls for decisive action from government, private sector and parents. Today is the second annual World Obesity Day and the theme is Ending Childhood Obesity: Act today for a healthier future. The Heart and Stroke Foundation (HSFSA) supports the World Obesity Federation (WOF) in this initiative to stimulate and support practical actions to address obesity. South Africa’s obesity epidemic could be described as complex. Our country’s past of poverty, inequality and a lack of education, coupled with rapid urbanisation has created a vulnerable population amidst a nutrition transition. The population group that is most vulnerable to this ‘obesogenic’ environment is children. Both children of overweight parents and children subjected to malnutrition during pregnancy or infancy are likely to become obese later in life. Children are brought up in an era of energy dense foods, increasing screen time and sedentary behaviour. The World Health Organisation (WHO) reports the fastest growth of obesity in the African region, where childhood overweight and obesity has more than doubled from 1990 to 2013 1. Childhood obesity in SA – our girls at greatest risk According to the most recent national survey, 14.2% of primary school children are already overweight 2. This prevalence is highest at 30% in girls living in urban areas. Being overweight as an infant increases the risk of being overweight as a child, which in turn increases the risk of being overweight as an adolescent and adult. Results from the Birth to Twenty study in Soweto recently showed that girls who were obese between the ages of 4 – 6 years, were 42 times more likely to be obese as teenagers compared to their normal-weight peers! 3 Clearly interventions should already be addressed at infants and toddlers. Cultural beliefs and poor knowledge of the consequences of obesity lulls many parents into inaction. Childhood obesity is not prevented, recognized or treated adequately. New figures from the World Obesity Federation estimate that by 2025, 3.91 million South African school children will be overweight or obese. This will result in 123 000 children with impaired glucose tolerance, 68 000 with overt diabetes, 460 000 with high blood pressure, and 637 000 with first stage fatty liver disease 4. The global action plan The complexity of the obesity epidemic is often cited to explain the little success in turning the tide and perhaps as an excuse not to make the changes we know are necessary. The 2016 WHO Report on Ending Childhood Obesityclearly outlines a comprehensive action plan. Recommendations include addressing norms, treating children who are already obese, promoting intake of healthy foods and physical activity, improved preconception and pregnancy care, healthier school environments, and curbing the marketing of unhealthy foods. The South African Department of Health have incorporated these guidelines in their own Strategy for the prevention and control in South Africa of obesity framework. Childhood obesity is singled out within this strategy as a specific area of focus, “given the large perceived benefit the interventions may yield”. We can end obesity if we act now Obesity is not a complex problem, for we have the tools to address it. We can end the childhood obesity epidemic if we act together. The President of the World Obesity Federation, Professor Ian Caterson, calls for decisive action “If governments hope to achieve the WHO target of keeping child obesity at 2010 levels, then the time to act is now.” Government action In the National Obesity Strategic Framework, Deputy Minister of Health Dr Joe Phaalhla writes “…It is our responsibility to empower people to make informed decisions and to ensure that they have access to healthy food by raising awareness and increasing the availability of effective initiatives and interventions.” The Government has shown intent by announcing tax on sugar-sweetened beverages, strategies to increase school sport, and draft legislation to restrict the advertising of unhealthy foods to children. Swift and effective implementation of these policies are vital. Professor Caterson from the WOF urges governments to act “Introducing tough regulations to protect children from the marketing of unhealthy food, ensuring schools promote healthy eating and physical activity, strengthening planning and building rules to provide safe neighbourhoods, and monitoring the impact of these policies.” Private sector and in particular the food industry There is no singular solution for obesity, and involvement of all sectors is needed. Food industry and especially fast food restaurants – still largely unregulated – needs to become part of the solution by producing healthier products and meals that are lower in added sugar, salt and fat, and by partnering with government and civil society to make healthy food choices more affordable. Collective advertising spend on unhealthy foods and meals are staggering, overpowering education efforts by government and NGOs. The HSFSA calls on the food industry to realise the vital role they play in South Africa’s obesity epidemic. It is time to make a choice to either help or hinder- practicing responsible marketing of foods aimed at children is a good place to start. Parents and caregivers Professor Pamela Naidoo, CEO of the HSFSA implores primary caregivers “Parents have the single biggest influence over their children’s risk of obesity. Mothers should aim for a normal weight before pregnancy, appropriate weight gain during pregnancy, and exclusive breastfeeding for the first six months. Parents should introduce healthy eating habits from six months onwards and lead by example to create an active lifestyle for the whole family.” Prof. Naidoo concludes “The HSFSA will continue its efforts to advocate for a healthier environment and create public awareness to prevent obesity as a major risk factor for heart diseases and strokes”. The Heart Mark is one such tool used to make it easier for consumers to make the healthier choice when faced with a variety of options at the supermarket. It helps

November 21, 2016

Why should we limit out children’s screen time?

Our kids are growing up in a technological age. They are confronted with tablets, smartphones, laptops, DSTV and so much more. Your phone is seen as part of your image and our kids want the latest and greatest. So why should we limit them? The biggest concern I have is that kids are not spending enough time outside playing. The reasons for this are: It’s not safe Preschools are focusing more on academic performance More and more screen time is available in different formats Safety In the society we live in in South Africa it is a valid concern that our kids are not safe to play outside by themselves any more. Kids are told to stay indoors and this force them to play stationary games or be involved in screen time. Screen time The inventors of children’s television shows and games/apps target the primitive brain. They use fast moving images and bright colours to target our visual system. They use loud and quickly changing sounds to target our auditory system. When I ask parents how long their child is able to concentrate they usually tell my ‘O he can watch television for hours’. This is not concentration ability!!!! This is your child’s primitive brain being targeted and activated. Our poor teachers have no way to compete with TV and games and apps and we wonder why our children cannot concentrate anymore and why ADD and ADHD is being diagnosed more frequently in our kids!!! According to research a child younger than 2 who watches television has a 15% higher risk of developing ADD/ADHD. Thus a child under 2 should not be exposed to ANY screen time. Another big concern is that parents don’t play with their children any more. Most families are dual income households and thus mom and dad work full day and are too tired to play with their kids. This is not ideal but this is what is happening. Out toddlers don’t know how to play any more as they are not used to thinking up games or spend time inventing games. Creativity suffers. We now have to teach our kids how to play house-house, how to play with cars and how to entertain themselves by playing in the garden. Screen time takes away creativity. Academic performance We as a society are placing more and more pressure on our children to grow up faster. Some pre-schools tend to focus more on academic performance like counting and getting to know the letters of the alphabet than playing outside. Children should be playing outside nearly all day long to facilitate the necessary skills they need for development. Benefits of playing outside: Bilateral integration Postural control Activating the proprioceptive system Activating the vestibular system Sensory integration Socialising Gross motor skills Eye-hand coordination Eye-foot coordination The impact of limited outside play: Poor postural control So what is postural control? It is the ability to have stability at your big joints and to maintain different postures. Our kids are not able to sit still any more. The reason for this is that they don’t get enough vestibular (movement) and proprioceptive (deep-pressure) input. These 2 systems underwrite postural control. Children tend to slouch in their chairs, support their heads while doing table top tasks, exhibits fidgeting, rides on their chairs, changes their posture frequently while sitting. All of this is their bodies craving movement and deep pressure input. So what happens in class? Most teachers tell the learners to sit still. This will cause postural control to diminish thus postural control will decrease. Now the learner with spend so much energy and effort staying upright and still in the chair that no energy is left to pay attention to what the teacher is saying or to complete given work. These kids tend to rush through tasks or tire easily and fine motor skills then decrease thus they write untidily and make unnecessary mistakes. Poor vision Kids start using ipads /phones at a very young age, when the visual system is not yet fully developed and not able to withstand this prolonged visual demand at near. This leads to a generation that is becoming increasingly myopic (nearsighted), as we have seen in China in the last 20 years. Digital screens also emit a lot of blue light, which has been shown to cause premature aging to our eyes – our children will need reading glasses 10 years earlier than what we do, and research shows that degenerative eye diseases due to this excessive blue light exposure is happening at a much younger age (up to 15 years earlier than in the previous generation). Weight gain Obesity in our kids is getting out of hand! This leads to many other health and self-esteem issues Poor communication skills This affects their ability in making friends, initiating conversations and to resolve conflict So what can we as parents do? I am a mom myself and I know we sometimes use the television as a nanny. When we want to prepare a meal or have some time to ourselves it is easy to switch on the television and entertain the kids. When you have to do this please then make sure it is a program of some value and appropriate for your child’s age No screen time for kids under 2 years of age Children’s screen time should be limited to 1 hour daily while in primary school and to 2 hours when in high school Have certain times during the day when no screen time is allowed e.g. while eating dinner/having a braai No televisions/X-boxes allowed in children’s rooms Set the parental control on your television and internet (especially google) Spend time playing outside with your kids doing gross motor tasks e.g. kicking a ball, rolling down a hill, playing in the sand pit or sliding down a slide. Have their vision and eye-muscle functioning evaluated by an optometrist If you suspect that your child has poor postural control – take your child to an occupational therapist to assist you in improving this

November 17, 2016

What people without special needs kids need to know

Parenting is a tough job. Parenting a special needs child is a tougher one. And as human beings interacting with a special needs parent, we have the opportunity to make things a little bit better or a little bit worse. Here are some things you need to know if you’re hoping to do the former. It is rude to stare. Kids with special needs will often look different or behave differently to other children. This does not give you the right to stare, judge or gawp at them. These kids and their parents already have their plates full. They don’t need the added discomfort of your judgements. What to do instead? If you see a child having a meltdown in the shopping centre, how about asking the parent if there’s anything you can do to help. Don’t offer sympathy. It may seem strange to those of you not in this situation, but parents of special needs kids want to be treated like normal families – not like some charity case to be pitied. Yes they have bigger challenges, yes they have things they feel sad about, but they’re also proud of their kids, and have incredible gifts from their children that you could never understand if you didn’t stand in their shoes either. Never use insulting labels. Believe it or not, there are still people who will call a child a ‘retard’ or other such derogatory names. Please be aware of the language that you use and how hurtful this can be. We’re very aware of racist or homophobic comments and so should we be with any kind of intolerance. Be inclusive. If there is a special needs child at your school or in your child’s class, include them in parties and play dates. Go beyond your own fear and discomfort and allow these children to be part of the greater community. You will be surprised how much you will learn from them and you will give your own children the opportunity to go beyond labels and judgements. Don’t judge the parents. Parents of special needs kids are likely to be more tired, stressed, and overwhelmed with daily tasks than you are. Give them a break. If you see them losing their temper, know that they have probably been pushed beyond their limits. Give them a break. Even better, lend them a hand. Stop talking about your perfect child. Parenting a special needs child can be scary and lonely, and parents can often feel jealous of others whose lives are less complicated. They may even resent you and your child for getting to do the ‘normal’ childhood stuff and celebrate the ‘normal’ childhood milestones. Of course you are happy for your child, but be sensitive about not rubbing it in. Watch your questions. Please do interact with parents of special needs kids, but don’t bombard them with questions. They will talk when they are ready to talk, and some days (like all of us) they just don’t feel like discussing the intricacies of what they are going through. Have normal conversations. Speak to them like other parents – they are. And don’t ask: “What is wrong with your child?” Special needs parents are parents just like you. They love their children. They have good days and bad. They have challenges and joys. They worry about their child’s future. They want to talk about their child’s achievements. They need friends and date nights and girl’s nights and time out and a shoulder to cry on – just like you. Every child is special. Every child is unique and has their own specific challenges, talents, gifts, and difficulties. Keep this in mind whenever you want to judge any parent, and particularly one with a special needs child. You have no idea what someone else is dealing with, what kind of a night they’ve had, when last they slept, what new obstacle has just been thrown in their path. If we start every interaction with another human being by first understanding where they’re coming from, we are more likely to be kind, considerate and compassionate. Every parent is trying their best. Let’s start with that assumption.

November 17, 2016

An open letter to divorcing parents

Dear Parents, Divorce/separation sucks for the simple reason that when two people get together and have children, they make plans to build a future together. They do not plan for an eventual separation. So when it eventually happens, everything as they know it, crumbles. Everything will be different, and that is scary as hell. Today, thanks to extensive resources available, providing a wealth of information on all aspects of separation and referencing many people having gone through a separation before, separating parents are being presented with more options to separate with less trauma, and receive more knowledge on how to face and proceed mindfully with this life changing event. It gifts them a head start to engage on this journey in a manner that will not only allow them to move forward with less anger and bitterness, but mostly in sparing their children from broken childhood memories. Yet, there is increasing evidence of a rise in parental conflicts, court battles, evasion of parental roles and responsibilities, and using the children to control certain outcomes of their agreements not being met. Life is a never ending learning process. To discard available information and valuable support, is choosing to be a victim of your circumstances. Yes, a separation is distressing and hard on a person. It can make you feel like there is little justice and that life isn’t fair, but it should not become an excuse to waste your life focusing on a dream that did not materialise. Instead, evaluate if your conflicts are about hurting your ex or rather hurting your sons and daughters, because your conflicts are wounding your children in ways they cannot control. Recognise that there is in fact no problem. What you see as a problem is actually a change of direction. It’s not the end, it’s not a beginning. It’s a transition that allows you to plan for some different and new life choices. The time has come for separating and separated parents to address the crisis their families are in when going through a divorce/separation. Parents who are hostage to an acrimonious battle over custody and/or maintenance are not fighting for what is in the best interest of their children, they are out to hurt and destroy each other, no matter who stands in the cross fire. It is time to raise awareness that being in control of your emotions is the solution to forgiveness and healing, so that you can mend, and not destroy, your children’s families. The time is now to change the way you, parents, separate, so that you can give your sons and daughters a life which feels normal being happy and not which feels normal being broken. The Law doesn’t raise children, parents do! Nadia Thonnard

November 16, 2016

Choosing Medical Aid

Most medical schemes have launched their benefits and contributions for 2017 and it is the time when you should be re-looking at your existing medical aid cover or, if you are wanting to join a scheme, investigating which one suits you best. The medical aid landscape can be tricky to navigate so it is important to compare options and schemes to ensure you find a medical aid that works for you and your family’s health and is within your budget. Dr Bobby Ramasia, Principal Executive Officer of Bonitas Medical Fund, helps guide you through choosing the best plan, whether it’s through the open market or through an employer. If you are already on a medical aid scheme Before you choose the best medical aid option, you need an idea of what your typical health care costs are. You should also consider the following for you and your dependants over the past twelve months: How much you spent on day-to-day healthcare expenses Where you or any of your dependants admitted to hospital Did you need to visit a specialist regularly How much often do you or your dependants visit a GP Do you and your dependants have any chronic conditions How much do you spend on dentistry, optometry and over-the-counter medicine Did you exhaust your day-to-day benefits and/or savings this year How much did you pay in co-payments and/or deductibles Then consider which of the expenses listed above were once-off and won’t come up again soon (like childbirth) and which are likely to come up again and again (such as flu). You should be able to find a list of your medical claims on your current medical aid’s website. The day-to-day detail: Often the cost containment measures medical schemes apply for the day-to-day benefits are broad. So investigate, or bear in mind, the following: Does your medical aid contract with doctors and specialists and, if so, are you willing to use them? Using contracted or network doctors usually means obtaining full or improved cover levels, while using doctors outside of the network usually results in restricted benefits or co-payments. It also helps ensure you are getting more value for money as doctors on your medical scheme’s network will not charge you more than the rate agreed with your medical scheme. Must you be referred to a specialist by your GP? Does your medical aid offer additional GP consultations, which they will pay for, after you have exhausted your day-to-day benefits? Does your medical scheme offer any additional benefits such as maternity, preventative care or wellness benefits that are paid from risk and not savings or day-to-day benefits? You can also follow these tips to get more value for money: Use generic medication wherever possible – get into the habit of asking your doctor and pharmacist about this Try to keep your claims within any specified sub-limits, e.g. optometry Find out if your option has any day-to-day benefits that are paid by the scheme from risk (not from your day-to-day sub-limits or savings). Two examples where this sometimes applies are dentistry and optometry. Additional benefits: Ask what supplementary benefits might be available to you that can potentially save significant day-to-day expenses. These could include the following; Preventative care benefits, ranging from basic screenings (blood pressure, cholesterol, blood sugar and body mass index measurements) through to mammograms, pap smears, prostrate testing. In some cases this extends to maternity programs, dental check-ups, flu vaccinations and more. These usually require authorisation from the scheme, failing which they are simply met from your day-to-day benefit limits. A mammogram costs in the region of R900, so don’t look a gift horse in the mouth! Age impacts your decision If you have young children, ensure that the medical aid option you select provides sufficient child illness benefits. For young couples looking to start a family, check that your option provides sufficient cover for maternity benefits. However, if you are slightly older then ensure that the option you select covers chronic conditions and provides sufficient in-hospital cover in the event of hospitalisation. Ensure the affordability of the medical aid plan selected. When comparing the different medical aid options available, consider all the costs involved before you make your final decision, such as: The monthly contributions, as a rule of thumb, you medical aid contributions should not exceed 10%of your monthly income at an individual or household level Other costs associated with your medical aid option e.g. if your option only allows consultations with doctors on a network, then you must ensure that the cost of travel to a network doctor (including hospitals and other healthcare service providers) The cost of co-payments for various benefits claimed. A medical aid co-payment is a fee that the member is liable for when making use of certain medical services. The medical aid would not cover 100% of the costs and the member would have to pay for a certain percentage of the medical service before the medical aid pays their portion. These co-payments usually apply to specialist or elective medical procedures. This will differ from one medical aid scheme to another. It is one of the reasons why you should always do thorough research before deciding which medical aid scheme is the best option for you. The ideal option would of course be the one that does not require many or any co-payments from the member.

November 15, 2016

8 Kid-Friendly Yoga Poses for Peaceful Mornings

As parents, getting our sons and daughters out the door every morning can be a monumental task. Whether it is getting them to eat their breakfast, tie their shoes, find their homework, or brush their teeth, something inevitably goes wrong. However, by taking a few minutes everyday to teach our kids yoga, we can help our kids stretch, strengthen their cores, and naturally clear their minds. This can make a big difference in how our children’s and even our own day unfolds. Why Yoga For A Peaceful Morning? Each morning is a new day offering us the possibility to teach our kids confidence, relaxation techniques, and help them be a little more grounded as they start the day. Yoga offers to help our kids release pent up tension and emotions, while helping them physically. In addition, yoga can be done with the whole family, within a matter of minutes, without requiring a gym or host of athletic equipment. Adding yoga to our routines can help us all be more mindful throughout the day.. Yoga teaches our children to breathe, re-center, and notice their emotions, which is a life skill that they can carry with them into adulthood. Not only is yoga good for the soul, but research has repeatedly proven exercise helps kids perform in the classroom. Oh, and did we mention that it’s fun! 8 Kid-Friendly Yoga Poses for Peaceful Mornings Introducing our boys and girls to yoga while they are young is beneficial and helps them develop lifelong healthy habits. Whether you watch a child centered yoga class online or create your own workout, remember to have children breathe as they move. For example, stretch on inhale and release their muscles while breathing out. Listed below are poses to get the entire family started: The Sunrise and Sunset Pose. Stand tall and take 3 to 5 deep breaths. On the last inhale, raise your arms above your head and press your legs into the ground. Stretch your spine up, toward the sky. On exhale, bend at your waist and bring your upper body toward your feet, similar to diving in a swimming pool. Reach down as far as you comfortably can go and inhale again, slowly opening your arms as you stand, reaching for the clouds. Repeat 6 to 10 times. Help children see the resemblance to the rising and setting sun. The Mountain Pose. Once again, standing tall, press your feet down and straighten your spine. Slowly roll back your shoulders, bringing your palms together in front of your chest. Take several deep breaths. The Cat/Cow Pose. Get down on all fours, resembling a cat and cow. For the cat position, exhale and gently arch up your back with your head looking at your belly button. As you inhale, gently reverse your back and push your stomach to the ground for the cow. Exhale, and return to the cat pose. Repeat three or four more times. The Cobra Pose. Lay down on your stomach, stretching your legs back with the tops of your feet pressed on the floor so you resemble a snake. Spread your hands out and place them under your shoulders so you can raise your torso up. Stretch your head back to open the chest. Hold for 5 deep breathes. The Downward Facing Dog. You want to create a V shape by putting the palms of your hands on the ground and lifting your hips up toward the ceiling. As children get better at this, encourage them to straighten their legs or stand flat footed. The Fish. This pose resembles a fish jumping out of a river. Lay down onto your back and use your elbows to prop up your body, arching your chest up so your head rests on the floor. Hold for 3 to 4 breaths, coming down as you exhale. The Bridge Pose. While you are on your back, press your feet down into the earth and thrust your hips into the air. Hold for 3 to 4 breaths and come down slowly on an exhale. The Resting Pose. Lie down on your back and take in a deep breath. Exhale. Now, wiggle your body and then rest. As you breathe, imagine that you are filling up with a warm light that starts at your feet and spreads up your body slowly. When you are ready, sit up slowly. What yoga poses do you use with your children?

November 9, 2016

Cut to the chase…

I work with a lot of high-school aged people, in fact they form about half of my professional interactions. As a result of this, I come across many who self-harm in one way or another. It can be hard to understand why people deliberately hurt themselves. Cutting is a way some people try to cope with the pain of strong emotions, intense pressure, or relationship problems. They are often dealing with feelings and situations that seem insurmountable. Some people cut because they feel desperate for relief from their emotional state, while some people cut to express strong feelings of rage, sorrow, rejection, desperation, longing, or emptiness. It can also form a system of self-punishment or punishment to those who love and care for the person in question. People who self-harm may not have developed adequate ways to cope with their challenges, or their existing coping skills may be overpowered by emotions that are too intense. When emotions aren’t expressed in a healthy, regular way, tension can build up, like a pressure cooker, to the point of boiling over. Cutting and other types of self-harm are often attempts to release the pressure and tension felt. For some, it seems like a way of feeling in control. For others it’s just a way of feeling something…anything. How common is it? Much more common than it used to be. Studies from the 1990’s suggested rates of 3% or lower. But more recent studies focussed on females, suggest that as many as 20% of girls between 10 and 18 years of age are now self-harming. Researchers at Yale University recently reported that 56% of the 10- to 14-year-old girls they interviewed reported engaging in self-harm at some point in their lifetime, including 36% in the past year. Cry for attention? So many people will take one look at the behaviour and say that it’s just a cry for attention and should be pandered to. Sometimes they are half-right in that it is a way of drawing attention to themselves, but to ignore it? Never. Think of it this way: If your child does not know a better way of drawing attention to themselves and their emotional turmoil, that is a huge, flashing warning sign that they have inadequate skills for dealing with their challenges. Why don’t they just talk to us? The urge to cut might be triggered by strong feelings the person can’t express such as anger, hurt, shame, frustration, or alienation. People who cut sometimes say they feel they don’t fit in or that no one understands them. Cutting might seem like the only way to find relief or express personal pain over relationships or rejection. They often lack the perspective required to realise that even if we don’t fully understand what they are going through, we can still be of help and support to them. It’s addictive. When we are injured, you brain releases a bunch of dopamine (our most addictive happiness hormone) to compensate for the pain. It becomes like a distraction from the mental pain that a self-harmer goes through, a really exhilarating one at that. It’s something that can be leant on when they are not feeling happy and need an instant “fix”. Think about the stressed person who needs a quick smoke to relax and you’ll be a bit more in the picture. Except that this “smoke” can accidently kill you a lot more quickly and maim you in a much more visual way. It’s dangerous! Firstly, there is the risk of accidental death as a result of self-harm. An artery or vein pierced or nicked accidentally can be fatal. A head bashed against a wall can cause concussion or fitting that could lead to death or permanent brain damage. Burning can lead to full combustion… let me not go on. Aside from this there is the risk of infection and septicaemia. Take it from someone who nearly lost an appendage to a simple thorn-prick, it’s no joke. Types of self-harm to look out for: Scratching or pinching: severely scratching or pinching with fingernails or objects to the point that bleeding occurs or marks remain on the skin. This method of self-injury is probably the highest reported type. Impact with objects: Banging or punching objects to the point of bruising or bleeding. This is no joke and I’ve seen one person repeatedly break their wrist this way. This same individual took his own life many years later, sadly. Cutting: Usually synonymous with self-harm, this type of self-harm occurs in roughly 1/3 of cases and is more common among females. This is accomplished with anything from scissors to surgical blades and can be the riskiest in terms of accidental death. Impact with oneself: slapping or punching oneself to the point of bruising or bleeding. Ripped or piercing skin: This type of self-harm includes ripping or tearing skin, usually with objects like needles, pins, hooks or other jagged surfaces. Carving: this type of self-harm is when a person carves words or symbols into the skin and is considered separate from cutting. Burning/Branding: using lighters to brand themselves is a very common as its relatively quick and uncomplicated. Look for tell-tale “smiley” marks. One thing to note, 70% of those who repeatedly self-harm use multiple ways to self-harm with the majority reporting between 2-4 self-harm methods used.

November 8, 2016

When do we get back teeth?

This panoramic x-ray is fascinating in the detail that it shows of a seven-year-old child growing and developing. Let us look at the x-ray very closely so that you will understand why back teeth are so important in looking after from an early age. The first thing that you might notice is that the permanent teeth are in the process of development sitting under the roots of the primary(baby). All the primary teeth are still in the mouth except for the two lower front teeth. Both permanent lower central incisors are erupting. On the upper arch there is a full complement of primary teeth. The roots are still intact and these teeth except for the 2 upper front teeth will probably stay in the mouth for another four years. On the lower jaw the primary teeth are still firmly attached to the bone. As the permanent teeth develop and move upwards they cause the roots of the baby teeth to dissolve. At the age of approx. 11 these baby teeth loosen and fall out allowing the permanent teeth to erupt into the mouth. The permanent teeth that are most well developed are the first molar teeth which can be seen at the back of the mouth. These teeth have now erupted into the mouth at the tender age of between six and seven years old. These are called the six-year-old molars. All the teeth are in an ideal state of growth and development. These teeth should last a lifetime in a healthy pristine state…with proper care and good dentistry But, the reality is often not so. Why? Because they erupt into the mouth at such an early age, they are extremely vulnerable to ravages of dental decay. They need very special care and attention. They are precious. Great responsibility is needed on the part of the parent and child himself or herself to keep them sound and healthy. This involves effective plaque control; a controlled diet of as little sweets as possible; and possibly fissure sealants in the grooves on the biting surfaces of these teeth Little cavities must be detected early and treated appropriately. If not, further decay develops. It is important to understand what happens when these molar teeth become ravaged with the passage of time and inadequate care… A large filling may fail if improperly restored; the tooth then needs to be root treated; the root treatment fails; the tooth is then extracted; followed by leaving a space or placing an implant… A downward cascade with the negative consequences which all could have been prevented.

November 7, 2016

Exam Stress

A moderate amount of stress can be a good thing. It can sharpen concentration and performance and help to create the energy and motivation we need to keep studying. Too much stress, however, can be overwhelming and stop us from being able to study and function healthily in life. Undoubtedly, it would be disappointing if you do not do as well as you hoped. Thus, instead of thinking negative thoughts it is helpful to challenge the thoughts (I won’t get a good job, people will think I am stupid, my future is over) with a more realistic assessment of the situation. Enlist the help of a friend, counsellor or tutor to help you to do this. It is very common to think that we will be judged solely on our academic achievements rather than as individuals with contributions to make in all sorts of ways. If someone believes that his/her self-worth depends on academic achievement, there will be considerable anxiety surrounding any academic assessment. Too much anxiety can be paralysing. If the pressures to succeed from family or others is extremely high it may help to contact your local counselling service in order to talk about this. WHAT IS STRESS? Stress is part of the body’s natural response to a perceived threat. It causes our bodies to go into a fight or flight response. The main physiological reaction is the release of a rush of adrenaline which gives us the energy to act. If the perceived difficulty is not physical but psychological, the adrenalin is not used up and this can cause increased muscle tension, heart rate and breathing rate. This then leads to physical changes (headaches, neck aches, stomach problems), mood changes (irritability, tearfulness, feeling low or anxious) or behaviour changes (sleeping problems, increase or decrease in appetite, difficulty in concentration). Exams lead to stress because the marks will influence final degree results. Thus, the stress is derived mainly from the additional meanings which get attributed to exam results. ORGANISING YOUR TIME Draw up a weekly timetable including everything you need to do such as revision, eating, sleeping, lectures and relaxation. Allow for sufficient flexibility due to the unexpected. Be realistic about how much time you can spend revising – if you divide the week into 21 units (3 a day), you should work for a maximum of 15 units per week. You should have 6 units to do other things. Allow yourself time for relaxation as it will decrease your stress levels. This is not wasting time as it will help you work more effectively. Plan how you will use your time during your revision periods. Decide on the order of topics and how much time you will spend on each. Stick to your deadlines. Prioritise – do the most important topics first and allow more time for subjects you find difficult. Set specific goals for each revision period. WHAT FRIENDS AND FAMILY CAN DO TO HELP Listen to the individual’s concerns, be sensitive and give him/her support. Encourage him/her to take breaks and go out from time to time. Inform them about various strategies. Help them to seek additional help if the stress is getting too much for the person. Reassure them that this is a sign of strength, not weakness. Ensure that they are having regular meals, times of relaxation and emotional support. Give positive feedback. Keep distractions to a minimum. SLEEPING BETTER Do not work in or on your bed. Stop working at least an hour before you intend to sleep. Stick to a regular bed time and getting up time. Maintain good sleeping patterns – 6 to 8 hours a night are recommended. Do not drink too much alcohol – it will prevent you from sleeping properly. STUDY PATTERNS Take regular breaks from studying. When you notice that you are distracted, get up and take a break. Fifteen minutes when you can concentrate is better than three hours of staring into space and feeling guilty or anxious. TECHNIQUES TO COPE WITH STRESS Some individuals may use alcohol, smoking and drugs as a means to manage stress. These may have a calming effect in the short term, however, they are not ideal solutions since it may cause one to feel worse afterward and thus impair the ability to think clearly. Eat at least one proper meal a day and keep the body hydrated. Exercise. This increases the blood flow around the body which increases clearer thought. Just a 10 minute walk a day can be helpful, especially in using up some of the extra adrenaline created by the stress. BASIC REVISION METHODS Step One: Read your notes and seek answers to questions. Be as active in your reading as possible – talk to yourself, walk around the room, speak into a tape recorder. Step Two: Close up your notes. Step Three: Actively recall what you have just been reading, asking again the same questions without looking at your notes. Write down what you have recalled in brief notes. Step Four: Check the original notes with the new ones. If you recalled all the answers to the questions then you have created a master card which you can use to re-revise without having to consult lengthier notes. Step Five: If not all the questions have been answered, re-read your original notes, looking particularly to those you missed. Repeat steps two to four. ON THE DAY OF THE EXAM Do not try to learn any new topics since this may impair your ability to recall those you have learnt previously. Look at some brief notes or revision cards. Do not study for the last hour before the exam. Time your arrival at the exam room so you do not need to wait about outside with others who may increase your anxiety level. Give yourself time to settle before reading the questions and starting to write. Use a breathing exercise to regulate your breathing and calm yourself down. Have a plan for how you will use your

November 3, 2016

Four Ways We Teach Children – Can you think of others?

Asking Questions. Our children are smarter than we give them credit for. We are so worried that they are not going to do what is right, or we are in such a hurry that it just seems easier to give our children marching orders. But asking them questions is a far more effective teaching tool. Often, they know exactly what to do and when they come up with solutions to their own questions or challenges, it builds their problem-solving skills. I always encourage parents to refrain from telling their children what to do or from answering their questions so quickly. Instead, ask them questions such as “what do you think?” “what will you do now?” “what did you notice?” Asking children questions also builds their own confidence and strengthens their faith in themselves. Coaching. Taking the art of asking questions one step further, coaching adds two more elements that teach a child greater problem-solving skills: Telling a child what you see, and offering to help. Putting these three concepts together creates a powerful method for parenting that will build the child’s coping skills. You are not always going to be at your children’s side to protect them, so you have to arm them with the ability to cope and survive. Telling your children what you see provides a perspective that they can compare to their own assessment. Asking them questions invites creativity and solutions. And finally, offering to help gives them the courage to take on things that they might feel are too big for them; whether it’s putting on a bandage, choosing a book report project, or finding solutions to teen problems. Living Out Loud. Similar to living by example, this concept takes teaching one step further and works best with younger children. By living out loud, you seek opportunities to set an example by narrating what you’re doing. For example, you are watching television and your child is playing in the same room. You want your child to learn that television is not what life is all about and that it should be limited, so as you turn it off you say out loud for anyone to hear: “That’s enough television for me today.” If your spouse does something for you that demonstrates respect, say out loud: “I love it when mommy gets me a glass of water.” If you’re serving the meal and your child is at the table and watching, you could say: “Everyone gets a small serving of pasta because they need to leave room for the vegetables.” Using this narration will teach many wonderful messages about respectful living, boundaries and limits. Accomplishments. One final method for teaching your children is through the examples of your actions and individual accomplishments that will speak to them for many years. It is more than living by example and the things you do on a regular basis. It is about what you create that influences others. I think of these things as “our works” that contribute to making the world a better place to live. Doing so teaches children important lessons about the power we each have to give back to the world, and inspires them to do the same.

October 31, 2016

ADD/ ADHD And Alternative Treatments

Over the past years there have been many debates and controversy discussions around what Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) is? Furthermore how it is diagnosed and what are all the options to treating the disorder? The definition of attention-deficit/hyperactivity disorder (ADHD) has been updated in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This revision is based on nearly two decades of research showing that ADHD, although a disorder that begins in childhood, can continue through adulthood for some people. Changes to the Disorder ADHD is characterized by a pattern of behaviour, present in multiple settings (e.g., school and home), that can result in performance issues in social, educational, or work settings. As in DSM-IV, symptoms will be divided into two categories of inattention and hyperactivity and impulsivity that include behaviours like failure to pay close attention to details, difficulty organizing tasks and activities, excessive talking, fidgeting, or an inability to remain seated in appropriate situations. Children must have at least six symptoms from either (or both) the inattention group of criteria and the hyperactivity and impulsivity criteria, while older adolescents and adults (over age 17 years) must present with five. Treatment options There are a number of treatment plans that are available to parents when making the appropriate decision when treating their child for ADD/ADHD. Nutritious meals, play, exercise, and learning better social skills are all part of a balanced treatment plan that can improve performance at school, improve your child’s relationships with others, and decrease stress and frustration. Pharmacological Treatment Stimulants such as Ritalin, Concerta and Adderall are often prescribed for attention deficit disorder. Such medications may help your child concentrate better or sit still, however there is a general debate as to whether or not medication is a ‘quick fix’ and what about the long term affects as well as immediate side effects of appetite suppression, insomnia and an overall change in the child’s personality? For some parents they have found medication to be the best result for their child, while others look for alternative treatments and see pharmacological treatment as the last resort. Homeopathy There are many other effective treatments that can help children as well as adults with ADD/ADHD to improve their ability to pay attention, control impulsive behaviour, and curb hyperactivity. According to Dr Raakhee Mistry who is a Homeopath, commented that Homoeopathy has often been used to assist with ADD and ADHD and has been effective. But unlike conventional medicine, there is no one particular homoeopathic medicine for these conditions. The ADD and ADHD symptoms for that particular child and factors that aggravate or ameliorate the symptoms, are taken into account when selecting the remedy for the child. Homoeopathic medicines do not numb or block symptoms, instead they work with the body to re-establish a state of equilibrium. When the patient is in this equilibrium state, the symptoms ease and the patient is able to function better. The aim of homoeopathic treatment is not to keep a patient dependent on medicine, but rather to bring the patient to the space where he/she can maintain this equilibrium state. Many homoeopaths also incorporate other modalities to their treatment such as supplements, herbs and probiotics. A child’s restlessness and ability to concentrate has also been linked to the state of the child’s gut Nutrition Good nutrition can help reduce ADD / ADHD symptoms. Studies show that what, and when, you eat makes a difference when it comes to managing ADD/ADHD. The following tips can be seen below By scheduling regular meals or snacks no more than three hours apart is a useful tip, which will help keep your child’s blood sugar level, minimizing irritability and supporting concentration and focus. Try to include a little protein and complex carbohydrates at each meal or snack. These foods will help your child feel more alert while decreasing hyperactivity. Check your child’s zinc, iron, and magnesium levels. Many children with ADD/ADHD are low in these important minerals. Boosting their levels may help control ADD/ADHD symptoms. Increasing iron may be particularly helpful. One study found that an iron supplement improved symptoms almost as much as taking stimulant medication. Add more omega-3 fatty acids to your child’s diet. Studies show that omega-3s improve hyperactivity, impulsivity, and concentration in kids (and adults) with ADD/ADHD. Omega-3s are found in salmon, tuna, sardines, and some fortified eggs and milk products. However, the easiest way to boost your child’s intake is through fish oil supplements Tips for supporting your child’s treatment In order to encourage positive change in all settings, children with ADD / ADHD need consistency. It is important that parents of children with ADD / ADHD learn how to apply behavioural therapy techniques at home. Children with ADD/ADHD are more likely to succeed in completing tasks when the tasks occur in predictable patterns and in predictable places, so that they know what to expect and what they are supposed to do. Follow a routine. It is important to set a time and a place for everything to help a child with ADD/ADHD understand and meet expectations. Establish simple and predictable rituals for meals, homework, play and bed. Use clocks and timers. Consider placing clocks throughout the house, with a big one in your child’s bedroom. Allow plenty of time for what your child needs to do, such as homework or getting ready in the morning. Simplify your child’s schedule. Avoiding idle time is a good idea, but a child with ADD/ADHD may become even more distracted and “wound up” if there are too many after-school activities. Create a quiet place. Make sure your child has a quiet, private space of his or her own. A porch or bedroom can work well too as long as it’s not the same place as the child goes for a time-out. Set an example for good organisation. Set up your home in an organised way. Make sure your child knows that everything has its place. Role model neatness

October 28, 2016

Travelling with your children

What’s the one job in the world, that doesn’t pay a cent, has no formal working hours and doesn’t offer you any time off? You may have guessed it, parenting! Despite what the critics might say, parenting is by far the most influential position you’ll ever find yourself in. The perks of watching your kids experience snow for the first time or to see how their eyes light up at the sight of a real medieval castle is priceless. With so many places to see and so little time, travel specialist, Pentravel’s CEO Sean Hough suggests ditching the map book and saving yourself hours of tedious research plotting your route through Europe by rather choosing a family coach guided holiday. Especially designed with kids in mind it could save you from whinge-worthy moments, like “are we there yet?” or “this is so boring!” Kids just want to have fun! For families who love to mingle, a coach tour is the ideal setting. With free Wi-Fi on board and anywhere from 20 to 25 other children for your kids to socialise with, its pure heaven. Although the tour is open to children between five and 18 years old, Hough suggests the ideal age is from ten to sixteen. Tour directors know how to stimulate young minds by offering dramatic and animated descriptions of sights. In the UK, expect visits to Harry Potter movie sets and overnighting in a real castle. Feel like a celebrity. If you were to rent your own car and travel through Europe, its most likely that poor old Dad will be the one driving around the block several times looking for parking before having the backbreaking job of offloading all the bags and carting them to the hotel. On a family coach guided holiday, you’re given the red carpet treatment and delivered to your hotel’s front door, while your luggage magically appears in your room. Absolute bliss. Experience a destination like a local. Blending in with your environment makes travelling far more relaxing and authentic. There is nothing worse than being harassed by a local haggler who triples the price just because he knows you’re a tourist. Tour directors are experts in local tourism and will show you the best places to eat real authentic Italian pizza that won’t cost you an arm and a leg, or where to find the prettiest spot to watch the sun setting over Paris to avoid big crowds. Stop counting your pennies. For budget conscious travellers there are no hidden costs when you choose a Guided Holiday. Before you leave South Africa, you and your family can decide on which additional tours or sights you want book. Border crossings, ferries, toll gates, gratuities and entrance fees are all taken care of before you leave home. Plus you are exempt from standing in line at a monument or museum and can walk right to the front of the queue. University of the World. It’s one thing learning about the Invasion of Normandy during the second World War from a text book and actually standing on the beach looking out across the English Channel with your kids while they rattle off details about the day the invasion unfolded. And then the enormity of a glacier in the Alps can’t be fully grasped by reading a text book or watching a video, however standing on it as it moans, creeks and cracks will be a moment that moves you forever. Show and tell will never be the same. When the kids go back to school, just imagine the show-and-tell moment, when they display selfies on the smartboard taken with a guard outside Buckingham Palace, or share stories about the day they spent at Gladiator School in Rome learning how to handle a sword and spar just like an ancient Roman gladiator. There are many ways to create lasting family memories but a family Guided holiday will change you and your kids’ lives forever. No longer will stories just be words on a page and is bound to change the way they learn and grow as young people. To see the world through their eyes is priceless but it will be them bugging you to book their next holiday even before you touch down. To find out more about the 2016/17 touring season contact Pentravel www.pentravel.co.za or follow on @pentravel. Bookings made before 27th September are based on 2016 rates minus 10%.

October 24, 2016

Punishment And Your Children

Punishment is a tool designed to make a child “pay for what they did” and to feel bad about the way they acted. The belief is that the bad feeling will stick with them and motivate them to not repeat the behaviour or action. But punishment has side effects that can create more problems for the parent then they originally had. For example, making a child feel bad can backfire and motivate them to hide and lie about their mistakes. It can also damage the parent / child relationship. Think back to your own childhood and remember a time when you were punished. How did you feel? How did you feel about yourself at that moment? What did you want to do as a result of the punishment? How did you feel toward the punisher? I’ve asked these questions numerous times in my workshops and not once did any adult say they felt good about anything in that moment. We now know that making a child feel bad about what they did affects the way they think and feel about them self. You wouldn’t buy one jacket to fit all of your kids, and you wouldn’t take one prescription pill to fix every sickness you come down with, so why would you use one form of discipline for all behaviour situations. Each situation requires a different solution. It’s not easy being a parent today and knowing what response should be used with every challenging behaviour. And it’s hard for a parent to change habits when they don’t have the right skills to replace ineffective techniques with more effective ones. That’s why I believe that parents should commit to becoming a life-long student when it comes to raising children. There are many great books that offer successful strategies and lots of parenting classes and workshops offered in the community. Begin by looking up information on, or getting help with, consequences and using them to replace punishment. A consequence is much more respectful to the child and can have longer lasting positive effects on him or her and the behaviour. And a consequence does not always have to be about the child; it can be about the parent. For example, if the child uses words that are hurtful to the parent or the child hits the parent, the consequence could be that the parent makes a strong statement declaring a refusal to let anyone hurt them physically or verbally, and then leaving the area where the child is. This type of response demonstrates (and teaches the child) about keeping them self safe from being hurt. The consequence is the child losing access to the parent in that moment. For example, the parent could say, “I don’t let anyone hurt me,” and then quickly walk away. In this example, there was no need to do anything to the child, resulting in a higher level of learning on the part of the child. Having trouble believing this? Try it the next time your child acts out this way.

October 20, 2016

Drawing Attention to #GlobalHandwashingDay

Global statistics reveal that 1.7 million children do not reach their fifth birthday caused by diarrhoea and pneumonia. This is a staggering figure particularly when you consider how simple it is to prevent diarrhoea and pneumonia. Regularly washing hands with soap is easy, effective and affordable; goes a long way to preventing infections and in turn saves lives. Handwashing requires only a small amount of water and soap with huge benefits, and Dettol SA through #GlobalHandwashingDay are placing much focus on the benefits and simplicity of handwashing. It is especially important to wash hands at regular key times ie after using the toilet and before touching food. This has proved to dramatically reduce the risk of diarrhoea and pneumonia – both serious illnesses that can result in death. Handwashing with soap will also prevent the spread of the influenza and Ebola viruses. Sadly, whilst soap can be afforded by most households around the world, research has shown that some of the world’s poorest households do not have access to soap due to financial constraints. Interesting too is that some of these very poor households who do have access to soap will more commonly use it for laundry, dishwashing or bathing and forego handwashing. #GlobalHandwashingDay initiative, is to create awareness around handwashing – the simplicity and cost-effectiveness of handwashing and the absolute benefit in the prevention of the spread of diarrhoea and pneumonia. #GlobalHandwashingDay initiative also aims to foster and support a global and local culture of handwashing with soap, and to shine a spotlight on the state of handwashing around the world. “Make Handwashing a Habit!” is the theme for the 2016 #GlobalHandwashingDay. This theme emphasises the importance of handwashing as a ritual behaviour for long-term sustainability. Changing behaviours to bring about the habit of handwashing is currently a hot topic and this theme taps directly into the water, sanitation and hygiene sector in terms of what they know about how habits are formed. Parenting Hub supports this valuable initiative #GlobalHandwashingDay and invite you to share this information and get involved where you believe you can. Send us a photo of your children washing their hands and your stories of what you’re doing to work towards preventing these awful diseases – diarrhoea and pneumonia.

October 14, 2016

Do your children know what integrity is?

Our children are the ones who have to live in this world when we are gone. They are the ones who will have to reap the consequences of the actions we take today and the decisions we make for the country and world. And their decisions will be a direct result of what we are saying and teaching them at home. So if you want them to live a peaceful existence, grow them in that direction. Don’t allow your opinions to muddy the waters of their minds. My youngest is almost ten. He is still small and impressionable and hopefully the impression I leave on him dents him in a positive way. But he watches me, more than he listens to me, and I know that when I “quickly check a message” in the car, I am inadvertently telling him that once in a while it is OK to glance at your phone while driving. When I am on the phone, and I say “I’m on my way!” when I have only just left, I am inadvertently telling him that it’s ok to twist the truth a little sometimes. When I tell him I will pick him up early today and he must skip sport because of xyz, I am inadvertently telling him it’s ok to sometimes shirk your responsibilities. The other day I was in traffic and someone cut me off, purely because she wasn’t paying close enough attention, my son said “Why didn’t you call her an old goat mom! That’s what you usually say!” It’s humbling to be called out for things you do that are leaving an impression. An impression you don’t really want to leave. I remember when I was studying developmental psychology, there was a cartoon in my textbook of a mom standing watching her little girl playing, and the little girl was sitting on her floor with her doll across her lap, giving it a spanking with a speech bubble that said, “I told you not to interrupt me when I am busy!” I remember the impression that left on me. And yet, here I am, fumbling through motherhood, doing what I believe is right. Mostly. If you ask me what kind of adults I want my children to be, I will tell you they should be happy, fulfilled, caring, kind people with ambition and integrity, and live passionate lives. But do I live that and model it every day? Am I modelling the type of adult I want them to be? Or is it a case of ‘do as I say and not as I do’? Do we have integrity? What we do and how we act, has more impact on them that what we say. So watch that your actions echo your words. Because your children are watching exactly that.

October 13, 2016

Looking after your little one’s skin during summer

Summer is just around the corner, and the chance to “unwrap” your little one from their layers of clothing is very tempting. Their little arms and legs have been encased for the past few months having them resemble sumo-wrestlers every time they waddle around. “Summer is the time when little ones can explore without the constriction of too many clothes, and being busy and exploring is what every little child needs for their development. It’s their job to keep busy, and our job to protect them while they are – and this includes looking after their skin,” says Su-Marie Annandale brand manager for baby skincare range Krayons. Annandale provides four tips on how to look after your little one’s skin this summer: Don’t forget a high SPF sunscreen. Your little one has been protected for the past few months from the harsh rays of the sun and it is important that you are aware of how much time they are playing in the sun. Applying a sunscreen often throughout the day is imperative, and even if you think that there is little chance of them getting sunburned still apply the sunscreen. A sweaty baby is normal during summer. When it is hot our little ones are going to sweat, but this does not mean that they need to be bathed all the time. Too much bathing can dry out their skin especially when the bath temperature is too hot. Use skincare products that moisturise and do not dry out the skin. Use a mild soap such as the Krayons’ Creamy Baby Soap Bar enriched with moisturising aqueous cream or the Krayons’ Mild Baby Soap Bar infused with pure baby petroleum jelly to give extra care to baby’s skin when bathing your little one. Gently Pat them dry so as not to remove too much of the moisture and then finish off by massaging in Krayons’ Aqueous cream. Keep them hydrated. Your little one’s body is made up of 60% water and their skin is the largest organ they have, which needs water to be kept hydrated and healthy especially during summer.

October 10, 2016

Connect, Communicate and Care

In my practice I work with people experiencing suicidal thoughts almost every day. These individuals range on a continuum from low risk for suicide, to very high risk for suicide and the way I approach them differs greatly depending on their degree of risk. Some individuals are at low risk. They have thoughts of dying, but they have never considered how they would go about doing this and have no intention of following through with their suicidal thoughts. These individuals are not overwhelmed by hopelessness and despair and are able to find other means of solving their problems or dealing with their difficult emotions. Significantly, they are able to appreciate that life can get better and that whatever is causing the suicidal thoughts will pass. Importantly, these individuals are not abusing any substances and are not impulsive in their behaviour. They have stable and supportive relationships with significant others. A person in this situation does not require emergency intervention but it would be useful to help them gain professional help to assist them with the underlying feelings that are causing the suicidal thoughts. On the other side of the spectrum are individuals who are at high risk for suicide. These individuals have a very high degree of hopelessness and significant despair about their current circumstances and their future. They feel that life will always be emotionally painful and they long for the peace that death can offer. These individuals have thought in detail about how they will kill themselves and may even have researched various options. They might have started making preparations for their death such as writing letters to loved one’s and sorting out their affairs or giving away special belongings. These individuals may or may not have attempted suicide in the past. Also at high risk, are individuals who may not be as determined and organised as the above individual, but who are abusing substances and/or are impulsive in their behaviour. These individuals may attempt suicide ‘in the heat of the moment’. Especially concerning are individuals who feel socially isolated or whose relationships are characterised by a high degree of conflict. Unfortunately, people who are at high risk do not always tell anyone how they are feeling and they take action in private. Still, you might notice certain behaviour changes that could alert you to the fact that someone is suicidal. These include: Social withdrawal. An individual starts spending much time alone or isolated. In the case of teenagers, parents might notice that where their child was once spending time engaged in family life, their child is now isolating himself permanently in his room. To be clear, this alone does not suggest suicide, but can can be an indicator that there is a problem and it might be worth connecting and communicating with the individual in order to understand how they are feeling and why they are withdrawing. Giving away special belongings. Taken out of context, this might appear that the individual is being generous or sentimental and this very well might be the case. However, it is worth probing and finding out what is motivating this behaviour. Change in mood. A person who is suicidal is more often than not depressed. You may notice that an individual who used to be well put together and functional suddenly appears lethargic, sad, irritable or angry. They may loose interest in previously enjoyed activities and their performance in work or school might decline. They may appear slightly dishevelled and you may notice a change in their sleeping patterns….sleeping a lot more than usual or being unable to sleep. They may lose weight or alternatively gain weight. Expressions of hopelessness. Hopelessness is one of the strongest risk factors for suicide. Some people may be direct in their expression of hopelessness saying things such as ‘what is the point’. They may talk about death and dying. Or they may be more subtle. You might start noticing that they have stopped making plans for the future or that their attitude towards themselves has become very negative ‘I’m worthless’. Substance abuse. Substance abuse alone does not make an individual at risk for suicide. But, if they are experiencing thoughts of suicide or have an unstable mood, substance abuse can often lower an individuals inhibitions enough that they act on their emotions whilst in an inebriated state. If an individual is experiencing suicidal thoughts and using substances, they are at greater risk for suicide. Planning their suicide. Obviously if you find direct expressions of suicide you should take these very seriously. Letters, notes, evidence of research into suicide methods, stockpiling medication, accessing knives, rope, guns, or poison, should be taken very seriously and professional help should be sought immediately. What should you do if you have noticed these warning signs and are concerned that a loved one might be suicidal? As this year’s slogan suggests, connect, communicate and care. Do not be afraid to talk about your concerns directly to the person involved. I often hear loved one’s saying that they are scared to talk about it, in case they put idea’s into the individuals head or in case they are wrong and they cause offence. This is not the case at all. Talking about it can help the individual feel less isolated and more understood. This alone can make a significant difference but it can also enable you to assess the level of risk so that you can get the individual the help that they need. Questions to ask include: Do you have suicidal thoughts? Have you thought about how you would do it? Do you have access to the things required to carry out your plan? Have you decided on when and where you would do it? How hopeless do you feel about the future? If there are positive answers to these questions, the person is at high risk. Practically, it is important to remove any means of suicide – weapons, poison, medication, knives, rope to name a few.

October 5, 2016

How to handle a picky eater

Does your child turn their nose up at the sight of green vegetables? Or perhaps pick at their plate and only eat food smothered in tomato sauce? Well, don’t worry because fussy eating is very common and they will eventually pass through that phase. We used to dread dinnertime or in fact any mealtime when our children were toddlers. We would prepare healthy meals with care and include all the food groups and make the food look appealing. Most of these offerings were rejected or spilled on the table and the children would grumble that they weren’t hungry. It was difficult not to take this rejection of our culinary skills personally. What were we doing wrong, why were they such picky eaters? We decided to tackle this issue head on and did some research and came up with some of our own strategies. Be a good role model. It is quite simple. You cannot expect your children to eat healthy food if you don’t. Your child learns from watching and mimicking you. You may have to venture out of your own comfort zone of eating and try new foods yourself. Remember, you are being watched. Share it. Invite a friend or a cousin over who is the same age or slightly older whom you know likes to eat. Your child will catch on. Group feeding lets the other kids set the example. Include your kids in the prep work. Let them be involved in grocery shopping and food preparation. If they feel some ownership over the meal they may be more likely to eat it. Let them prepare and cook. Children are more likely to eat their own creations, so when appropriate let your child help prepare the food. Use cookie cutters to create edible designs out of foods like cheese, bread or cooked lasagne noodles. Give your” assistant” jobs like tearing lettuce, washing carrots or whisking eggs. Don’t rush meals. It is quite likely that your child is a slow eater and this is a good habit to encourage. Offer plenty of time to eat a meal. Praise them. Even if they just have small tastes of a new food congratulate your child. For a picky eater this little nibble is a great accomplishment. Ask them how it tasted and encourage them to have a bit more the next time. Respect tiny tummies. Keep food servings small. This less-is-more meal plan is not only more successful with picky eaters; it also has the added benefit of stabilising blood-sugar levels, which in turn minimizes mood swings. As most parents know, a hungry kid is generally not a happy kid. Minimise distractions. Make the mealtime table a relaxed and positive environment. Turn off the television during meals and don’t allow books or toys at the table. Stop the Snacks. Don’t allow snacks and juices for at least one hour before mealtime. If your children are hungry when they get to the table they may be more likely to eat what you put in front of them. Remember, when you serve snacks try and make it at the same time every day and keep them healthy! Don’t use sweet treat as rewards. This behaviour is unlikely to encourage your child to eat the food you want them to eat and can teach your child how to be manipulative with you. Eat with your child. This makes mealtimes more sociable and enjoyable. Ask them to give you a spoonful of their food and you can offer them some of yours. Show your enjoyment at what they have fed you. Try and have your meals at a regular time. Kids love that sense of routine. Be patient, it takes time to develop good eating habits. Above all have fun together and let children grow up believing that eating is a pleasurable experience.

October 5, 2016

How to improve your child’s fitness

Recent statistics show a rapid increase in overweight children – a reminder for parents to prioritise fit and healthy lifestyles. One of the contributing reasons is the excessive amount of time children spend in front of the television, and the unhealthy junk food consumed while watching TV. Since children are kept busy with homework and extracurricular activities during the school term; it’s a better idea for parents to consider ways in which fitness can be promoted during the school holidays – when kids often have no choice but to resort to technology for entertainment. Holiday camps are an excellent option. Fitness and outdoor activities are often a priority at holidays camps like Sugar Bay. Unlike boot camp, which implements a very direct and strict approach to fitness, Sugar Bay integrates fitness and promotes a healthy lifestyle in fun and creative ways through everyday activities at camp. Here are 6 ways which Sugar Bay holiday camp promotes a healthier lifestyle: Healthy Meals The kitchen staff and programmer take the utmost care in creating a daily menu that is on par with the recommended daily dietary requirements set up by the South African Department of Health. All meals are freshly prepared from local ingredients, and salads and fruit are available at every meal. Choose from a variety of outdoor activities There are no compulsory activities at Sugar Bay. Kids decide what they would like to do for the day, which is ideal since it ensures that they will enjoy the outdoor experience offered by any activity they choose. Sugar Bay offers over 100 activities, most of which are outdoors at the beach, in the ocean, lagoon, pool or on the fields. All activities promote mental and physical fitness. Some popular activities include: Surfing, paintball, rock wall climbing, bungee trampoline, dancing, kayaking, skateboarding, BMX, beach volleyball etc. Lagoon kayaking is a great example. Kayaking is an excellent all-round exercise that involves both cardiovascular and strength training. Campers first have to walk about a kilometer to the lagoon, and then participate in warm-up activities on the beach before they begin the activity itself. While kayaking, the kids play games which creates an enjoyable experience, without the competitiveness that is associated with sport. Limited junk purchases The tuckshop offers parents an option to specify how much their children can spend on snacks versus souvenirs. Since the children are served three healthy meals per day, this limit prevents children from purchasing too much junk food. The tuckshop also stocks a variety of healthy snacks, like dried fruit and nuts, to ensure that there are always healthier options available. Daily walks Everyday begins and ends with an invigorating exercise routine – walks along the canopy boardwalks. The cabins are a distance from the communal hall, which means that each walk to the cabin is a healthy dose of uphill exercise, and an energising opportunity to enjoy the fresh air and forest surroundings. Technology-free zone Camp is a technology-free zone. No one is sitting around with their cellphones, tablets or laptops. No one is missing these items either, because everyone is entertained by the company of friends and the endless options of fun activities. Camp shows kids alternative ways to enjoy themselves. Healthier, more active ways. It is for this reason then , that it’s important for kids to disconnect during the school holidays. Good rest Unlike boot camp, Sugar Bay ensures that campers get enough rest everyday. Bed times are allocated according to age groups, and everyone gets at least 8 hours a night. When there has been an exceptionally busy day, late-wake up times are scheduled. During the day, breaks are allocated between 30 minutes and two hours, so that kids can recharge between activities. Camp isn’t just a holiday away from home, it is the perfect opportunity to get your kids active, improve their physical fitness and encourage a healthier lifestyle while still having fun.

October 4, 2016

Spring allergies and breathing difficulties

While families are gearing up for spring after a cold winter, planning picnics and hikes with children, others are dreading the allergy season and the medical difficulties it brings along with it. Lets focus on the two most common respiratory related conditions children suffer from and are most prevalent in the winter and early spring seasons, asthma and croup. While both affect your child’s breathing and the symptoms may seem similar, the conditions are very different and often the methods treatment too. Lets start with croup. Croup is classified as an upper respiratory condition, which means, unlike asthma, the constriction of the airways happens higher up, in the trachea (windpipe) and larynx (voice box). It most commonly affects children aging from six months to three years however younger babies may develop it as well as children into their early teens, it is less common though. A virus called parainfluenza causes it. Despite the name it is not what we know as flu but can cause result in a runny nose, fever and cough. While this is the most common cause, allergies are also a trigger. Although croup is often a rapid onset, parents who are aware that their child suffers from croup can help prevent it by steering the child clear of known allergies such as dust, pollen, certain food additives such as Tartrazine as well as monitoring colds the child may develop. It is identified by a barking cough, horse voice and stridor (grating breathing sounds). If croup is caught early or a mild case is experienced, simply encouraging the child to inhale steam over a basin or in a shower may well ease the constriction. In more aggressive cases, a trip to the emergency room may be necessary for oxygen therapy and a course of corticosteroids such as prednisone. Do not play the “waiting game” as croup tends to worsen as the temperature drops at night. Remember to try keeping the child calm. They will be distressed and panic as well as crying often worsens the symptoms. Asthma on the other hand is a lower respiratory condition and affects the bronchioles (small tubes delivering air through the lungs). Asthma is considered a lifetime condition, especially is it develops in adulthood however children are known to “grow out of it”, however it may return later in life due to lifestyle changes or menopause. It is common for children to suffer from asthma if there is a history of it in the family however there are many other causes including pre-birth risks and environmental influences. Triggers are causes for attacks to take place and range from a cold, chest infection, environmental aspects such as change in season to allergies, emotional stress, open fires, mold and exercise and is identified by wheezing, coughing, difficulty in breathing and a tight chest Sadly asthma kills up to 45% of suffers before they reach hospital which is why, when symptoms develop and are considered “out of control” (an inhaler or nebulizer does not ease symptoms considerably), it is important that we take the child to hospital or call an ambulance timeously. Should your child have been diagnosed with asthma, it is imperative that we carry an inhaler on us at all times. For young children, a spacer (plastic adaptor) should be placed on the front of the inhaler to hold the burst of medication, as it is more difficult for them to synchronize their breath with the inhaler. Be careful not to confuse the two different types of inhalers. One is used when an attack is experienced; inhalers such as Asthavent or Ventolin are rapid acting and ease the constriction for almost instant relief and can be bought over the counter. The other is a steroid based inhaler such as Budeflam and is used for long-term treatment. This will not provide the relief the child needs in the case of an attack. Nebulizers are often used during an attack and provide similar relief as inhalers. The nebulizer is a machine, which reduces the same drugs you find in inhalers from a liquid form to a mist, which the child then inhales. Studies have shown that children under the age of five, using an inhaler with the correct spacer often benefit more than using a nebulizer. The inhaler administers a lower dosage of medication, however in a far shorter space of time, the nebulizers, which take up to 15 minutes to administer the metered dosage also has a loss rate of over 90% which means the child only inhales less than 10% of the medication versus the 10-40% when using an inhaler. This is not to say nebulizers are not recommended. They are great when dealing with a child who either refuses or is too young to inhale spay from an inhaler. Be aware that a rapid heart rate is also associated with the nebulizer and far less often with the inhaler. While the use of steam like in croup for treatment has never really been clinically proven to be effective, it may help some sufferers, but also worsen others so be careful if choosing to use this method. If you suspect the environment the child is in may be causing the attack, remove them from the environment as quickly as possible. Try and keep them calm and “coach” their breathing, crying may also exacerbate the symptoms. Always be prepared for known respiratory conditions. Both the conditions we have discussed, if not preventable, are treatable if the correct action is taken timeously. Don’t ever think you are being dramatic by calling an ambulance or taking a child to hospital if you are concerned. They are your children and quick, decisive actions and training will save their lives.

October 3, 2016

How to Avert a Parent’s Nightmare

Close your eyes and imagine for a moment that your child is now 16 years old. It’s a week night and he or she is stressing over a test at school the next day. They tell you that some friends are coming by to pick them up to go to the library to study for this exam. You trust that your teen is being truthful and you watch the car drive away, headed to the town library. But what happens next is a parent’s nightmare. Somewhere between your house and the library, your child’s friends discuss going to a party they heard about on social media that has no adult chaperones. Your teen objects to the idea but in that moment influenced by peer pressure, the group decides to go find that party and your teenager goes along for the ride. Your teen may be thinking that there is still a possibility that the library will be their real and final destination that night. Later that evening, the young party-goers begin pairing off and disappearing in rooms and dark corners of the house. Your teen is on their best behavior and ignores the fact that the crowd is thinning out. Suddenly, another teenager begins flirting with yours and the situation gets very uncomfortable. They are able to fend off the advances and moves to another room of the house, only to be approached by someone else. Reacting quickly, your child exits the house, sits down on the front steps, and begins to wonder what to do next. They think about going and finding the friend who drove the car, but quickly realize how awkward that could be. Then, your child calls you from their cell phone without hesitation. They admit to you not being at the library, apologize sincerely, and provide you with the address to come pick them up. Their last words were, “Please come quickly.” I bet I’d have trouble finding any parent who wouldn’t want this to be the outcome for a similar situation involving their teenager. So, in order for your (future) teen to feel comfortable taking this action in a similar situation, what would be required to exist in your relationship with your child? If you said trust, you’re right. In that trust, your teen would have to feel safe calling and being with you, not feeling fearful of repercussions to admitting they made a mistake, and feeling comfortable calling you for help. Now come back to the present moment. Want to know what you can begin doing now on a daily basis to ensure that your relationship with your children will be built on trust? Here are six things you can begin doing immediately. Listen More and Lecture Less. Announce an “open door policy” in your family that your children (and teens) can talk to you anytime, about anything, and without judgment, ridicule, or punishment. Remain Calm if You Catch Them in a Lie. Lying is normal for most children and a natural means of protection from parents who get angry and punitive in reaction to mistakes, poor judgment or misbehavior. Commit to NOT Yelling. No human, child or adult, enjoys being yelled at. It kills the spirit, fosters fear, and provokes fight or flight; your child or teen will yell back or ‘run away.’ Quell Your Anger. Understand your own emotions and do all you can to manage them. If you’re easily brought to anger, seek out professional counseling. Develop the habit of taking a timeout to cool down before speaking or taking action in the face of your child’s behavior. Apologize When You Make a Mistake. Tell your family that you are working on learning to be a calmer parent (and spouse). When you make a mistake and yell, spank or punish, take ownership for what you said or did and apologize for it. Provide a ‘make up’ to the recipient of your words or actions and acknowledge the fact that you’re a “work in progress.” Use Consequences Instead of Punishment. Punishment in response to a child or teen’s behavior is designed to make them feel bad for what they did. What makes consequences more powerful is that they are respectful to the child, they are reasonable, and they are related to the behavior in question. Consequences are also implemented void of anger and retribution, a feeling of ‘getting even’ with the child or teenager. Now I’m sure some of you reading this may be saying to yourselves, “I remember lying to my parents too, and going to the library was an excuse I gave. It’s no big deal.” I too remember going to parties in which there was no adult supervision. Our parents probably left us unattended more than parents do today, but the world seemed safer then. Let me caution you that things have changed and so have the risks. Thanks to the media, a more bold entertainment industry, the Internet, and more plentiful, harmful substances, our children, teenagers, and young adults are exposed to far more pressures and messages than we were, that promiscuous behavior, drug use and recreational sex are OK. A relationship between a parent and a child that is built on trust is one in which the child feels comfortable and safe to call the parent, even when they’ve done something wrong. What are YOU going to begin doing today to cultivate a relationship with your child based on trust?

September 29, 2016

Respect

A while back I was doing research & developing a workshop for an NGO on conflict. Amongst other things, it deals with certain areas that create conflict such as people’s different levels of motivation & value structures and is written with Life Coaching ethos in mind. The purpose is to give everyone attending the course a clear understanding that everyone around us has a distinctly different reality from our own and that it is as equally valid as our own. And so while I was working through the workbook as well as the required power point presentation it dawned on me that it is really is all about one a little word – Respect. As a whole human beings do not respect each other. While we understand & acknowledge the concept, in reality, life has become so intense and stressful that most of us are thankful when we make it through yet another day. Never mind your impact on the lives of others. So what if we started to change this? The big question of course is how, because this lack of respect has become an intrinsic part of our culture. What if we started with our children? We as parents, while providing security & guidance to our children should be fostering the principle of respect. How? By treating our children with respect. By allowing them to develop into who they are. By not belittling their efforts or enforcing our reality onto them. If more children grew up understanding who they were and being allowed to develop the skills true to themselves, can you just imagine what a difference it could make to the rate our children are diagnosed with various stress related illnesses. A bit dramatic you may think, however, a fundamental lack of respect eats away at the core of your being and feeling has to come out somewhere. Do you allow your child the freedom to close their bedroom door when they need their space? Do you respect their space by knocking on the door before going into their room? Do you give them the opportunity to express their feelings and ideas, no matter how young they are? Do you guide or do you dictate? As parents we are responsible for teaching our children respect & tolerance of different belief systems. We are doing them & our country, in fact the world the greatest disservice by teaching them that people with different values, culture, beliefs etc are wrong if they are different to ours. Why has human kind become so threatened by differences, instead of embracing them and seeing them as for what they are? Different. Not wrong or evil, just different. It of course doesn’t stop their. We need to put our words into practice & actively show respect for our extended family, yes that includes the mother-in-law, colleagues, people using the same road, people walking passed you. After all, our children learn by watching us. The age of do as I say, is long gone. Children today expect us to honour our word. Think about it. If we were all just a little bit more respectful in our day to day lives, what a difference it would make. Of course we are all going to have that bad day when all you want to do is rip heads off, there again, if you go back, acknowledge that you were wrong & say sorry, you have gone a long way to earn respect. You have modelled appropriate behaviour. What the other person chooses to do with that is in fact not your concern. They have their own reality to deal with.

September 28, 2016

Hospital Plans

You know that sinking feeling when you go into hospital for a procedure believing you are covered? When it takes longer to recover from the shock of the bill than the actual surgery? Thousands of people who have health insurance are waking up to the fact that the term can be a classic contradiction. Far too many consumers are confused between the terms hospital plan and health insurance. This is not made any easier by the fact that health insurance is available in two forms – GAP Cover and hospital insurance. According to Dr Bobby Ramasia, Principal Officer of Bonitas Medical Fund, the National Treasury has been approached to make amendments to the Demarcation Act in terms of medical aid schemes and medical insurance. Currently, medical aid schemes and the hospital plans they offer are not considered as insurance because medical schemes are non-profit, strictly controlled and regulated by the Council for Medical Schemes and the Medical Schemes Act 131 of 1998. However, medical insurance policies are ‘for profit’ companies. The recommended changes to policy will also address when insurance is paid out – the industry is pushing for this to come into effect from day one as opposed to a waiting period of a few days. Medical Aid Hospital Plans A hospital plan provides you with basic, yet important medical cover. They differ from scheme to scheme but in essence this plan – regulated by the Council for Medical Schemes – includes cover for all your required in-hospital procedures and check-ups. So when you are admitted into hospital for a procedure or due to an accident or illness, your expenses are covered – within the limits set by your particular plan. You are required to cover almost all of the other day-to-day out of hospital costs (such as visits to the doctor, specialists and medicine). The law also requires that medication for 27 chronic conditions – known as Prescribed Minimum Benefits or PMBs – must be covered by all medical plans, including hospital plans. These include: Addison’s disease Asthma Bronchiectasis Cardiac failure Cardiomyopathy Chronic obstructive pulmonary disorder Chronic renal disease Coronary artery disease Crohn’s disease Diabetes insipidus Diabetes type 1 Diabetes type 2 Dysrhythmias Epilepsy Glaucoma Haemophilia Hyperlipidaemia Hypertension Hypothyroidism Multiple sclerosis Parkinson’s disease Rheumatoid arthritis Schizophrenia Systemic lupus erythematosus Ulcerative colitis Bipolar Mood Disorder However, at times there may be a shortfall between what the Plan pays and the actual tariffs charged by the hospital and specialists. You will be expected to make up the financial difference and this is where GAP Cover or a Hospital Insurance policy can help cover the shortfall. Health insurance The good cop GAP Cover as the name suggests, assists with additional insurance cover to help pay for the difference between specialist charges and the amount paid by the hospital plan. Again the amount of cover differs from policy to policy. Many consumers purchase GAP Cover in conjunction with a hospital plan to provide for additional cover, however it can only be used for specialist service costs and not general healthcare related costs. Bonitas says that the proposed amendments propose that GAP Cover includes any and all shortfall costs for health related services and products, ie, between the costs that medical schemes are obliged to cover and what is charged by the medical practitioner. GAP cover complements medical schemes – it has never been a problem as it covers the costs between medical scheme tariffs and benefit limits. It is legitimate and a good cover for shortfalls. The bad cop Hospital insurance is not a medical aid but rather provides you with cash benefits that are paid to you while you are in hospital due to illness, accidents or intensive care of convalescence. You are able to use the money however you please, to cover your medical expenses or daily household costs. In short, hospital insurance is: Governed by the Financial Services Act (Short-term Insurance Act) Does not cover Prescribed Minimum Benefits (PMBs) Can include Personal Accident risk cover such as disability and loss of limbs, inability to work, salary protection, death and/or funeral covers. Paid directly to the Insured Used in conjunction with Medical Aid Not tax deductible So why the bad cop? Firstly it is a set amount which might not cover your hospital or medical bills, leaving you financially short and, in many cases, it does not kick in until a waiting period of three to five days. You will be responsible for settling all your medical bills and although the thought of being paid R5 000 a day while you’re are in hospital sounds appealing, this usually falls way short of the actual costs charged by surgeons, anaesthetists and hospitals. Turning the bad cop good The new amendments propose introducing payment from day one rather than having a waiting period and, as with gap cover and hospital plans, hospital insurance will be far more regulated going forward to ensure the practical protection of a consumer’s medical needs. The best news though is that the guidelines are opening the door for collaboration between medical schemes and insurance providers to offer a broader product range. ‘We have seen a growth in health insurance products over the past few years,’ says Dr Ramasia. ‘This is mainly due to medical aid being prohibitive for low income earners. For those strapped for cash there are healthcare options though. We suggest you shop around for the best plan that covers your – and your family’s – healthcare needs and your pocket.’

September 22, 2016

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