WIXLIB

4newsinhealth.nih.gov/special-issuesyears old, the ones who had theparent working with them had lostmore weight and maintained moreweight loss than the ones treated bythemselves, and obviously more thanthe comparison groups.”Over time, most parents graduallybegan to regain their lost weight,the researchers found. But after 10years, more than 40% of the kidswho worked with their parents hadmaintained a weight reduction of atleast 20%. “The finding suggests thateven if the parents go back to theirold behaviors, many of the kids willnot,” says Epstein.While it’s never too late to startmaking healthy changes in yourfamily, research suggests that theearlier your kids learn healthybehaviors, the better.Wise ChoicesHelp Kids FormHealthy HabitsBe a role model. Eat healthy familymeals together. Walk or ride bikesinstead of watching TV or surfingthe Web.Make healthy choices easy. Putnutritious food where it’s easy tosee. Keep balls and other sportsgear handy.Focus on fun. Play in the park,or walk through the zoo or on anature trail. Cook a healthy mealtogether.Limit screen time. Don’t put a TVin your child’s bedroom. Avoidsnacks and meals in front ofthe TV.Check with caregivers or schools.Make sure they offer healthyfoods, active playtime, and limitedTV or video games.Change a little at a time.If you drink whole milk, switchto 2% milk for a while, then tryeven lower fat milks. If you driveeverywhere, try walking to anearby friend’s house, then latertry walking a little farther.Dr. Julie Lumeng, a pediatrician atthe University of Michigan, focusesher NIH-funded research on thefactors that affect eating behaviorsin young children—especiallypreschoolers and infants. That’s anideal time to start exposing yourchildren to a variety of healthyfoods, such as fruits and vegetables,so they develop a liking for them.Getting young ones to acceptfruits and vegetables can be achallenge, but some parents give uptoo quickly if a child rejects a newfood. Research suggests that themore times you offer a food, the morelikely a child will be to warm up to it.“Kids typically have to taste a newfood 9 to 15 times to begin to like it,”Lumeng says.If your child doesn’t like a newfood right away, stay positive andkeep trying over time. Encouragingkids to take just one bite of a newfood can help. But avoid creatingconflicts and stress over it. “Tryinga new food can be exciting and alsostressful in general,” Lumeng says.“Several studies show that kidsare more likely to try a new foodif they’re eating in a setting that’srelaxing and pleasant.”Children under the age of threetend to stop eating on their ownwhen they’re full. “But after agethree,” Lumeng says, “the more youput on their plate, the more they’lleat.” So make sure to give your kidschild-size portions.Take opportunities to teachyoung children about feelings offullness. “If your child asks foranother helping, instead of saying,‘No, honey, you’ve had enough,’ trysaying something like, ‘You mustreally be hungry tonight,’ to raisetheir awareness of their feelings,”Lumeng suggests. “Or when theystop eating, say, ‘Oh, you must feelfull now,’ to help teach about hungerand feeling satisfied.”Several studies show that parentscan effectively influence healthybehaviors by talking in a positiveway or avoiding certain situationsGetting young onesto accept fruits andvegetables can be achallenge, but someparents give up tooquickly if a child rejectsa new food.altogether. “Instead of telling yourchildren, ‘No, you can’t have anymore cookies,’ just keep cookiesout of the house altogether,” saysLumeng.When you bring unhealthy foodand sugary drinks into the house,“parents essentially become the foodpolice,” adds Epstein. “It’s easier tocreate an environment in the homewhere there’s limited access tounhealthy foods and lots of access tohealthy foods.”Experts recommend that mostkids get at least an hour of moderateto vigorous physical activity eachday. Parents can help by limiting TVand computer time to no more thanone or two hours per day.“Small changes in the homeenvironment can also have a hugeeffect on physical activity,” saysEpstein. You can make sportsequipment like balls and jumpropes more accessible by puttingthem next to the door. Walking fast,bicycling, jumping rope, and playingbasketball, soccer, or hopscotch areall good ways for kids to be active.When it comes to food andphysical activity, what you say anddo around your children can havea lasting effect. Work together as afamily to make healthy habits easyand fun.Web LinksFor more about healthy eating andphysical activity, go hape-your-familys-habits

newsinhealth.nih.gov/special-issues5It’s a Kid’s JobPlaying Helps Kids Learn and GrowWhat would childhood be withouttime to play? Play, it turns out, isessential to growing up healthy.Research shows that active, creativeplay benefits just about every aspectof child development.Play can help lay afoundation for learning theskills we need for socialinteractions.“Play is behavior that looks asif it has no purpose,” says NIHpsychologist Dr. Stephen Suomi.“It looks like fun, but it actuallyprepares [kids] for a complexsocial world.” Evidence suggeststhat play can help boost brainfunction, increase fitness, improvecoordination, and teach cooperation.Suomi notes that all mammals—from mice to humans—engage insome sort of play. His researchfocuses on rhesus monkeys. Whilehe’s cautious about drawing parallelsbetween monkeys and people, hisstudies offer some general insightsinto the benefits of play.Active, vigorous social play duringdevelopment helps to sculpt themonkey brain. The brain growslarger. Connections between brainareas may strengthen. Play alsohelps monkey youngsters learn howto fit into their social group, whichmay range from 30 to 200 monkeysin 3 or 4 extended families.Both monkeys and humans livein highly complex social structures,Suomi says. “Through play, rhesusmonkeys learn to negotiate, to dealwith strangers, to lose gracefully,to stop before things get out ofhand, and to follow rules,” he says.These lessons prepare monkeyyoungsters for life after they leavetheir mothers.Play may have similar effects inthe human brain. Play can help laya foundation for learning the skillswe need for social interactions. Ifhuman youngsters lack playtime,says Dr. Roberta Golinkoff, an infantlanguage expert at the University ofDelaware, “social skills will likelysuffer. You will lack the ability toinhibit impulses, to switch taskseasily, and to play on your own.”Play helps young children mastertheir emotions and make their owndecisions. It also teaches flexibility,motivation, and confidence.Kids don’t need expensive toys toget a lot out of playtime. “Parentsare children’s most enriching plaything,” says Golinkoff. Playing andtalking to babies and children arevital for their language development.Golinkoff says that kids who talkwith their parents tend to acquire avocabulary that will later help themin school. Let kids guide the conversation. When you take over theconversation, you may shut it down.Unstructured, creative, physicalplay also lets children burn caloriesand develop all kinds of strengths,such as learning how the worldworks. In free play, children choosethe games, make the rules, learnto negotiate, and release stress.Free play often involves fantasy. Ifchildren, say, want to learn aboutbeing a fireman, they can imaginePlay helps young childrenmaster their emotionsand make their owndecisions. It also teachesflexibility, motivation, andconfidence.and act out what a fireman does. Andif something scary happens, freeplay can help defuse emotions byworking them out.“Sports are a kind of play,”Golinkoff says, “but it’s not the kids

6newsinhealth.nih.gov/special-issuescalling the shots.” It’s importantto engage in a variety of activities,including physical play, social play,and solitary play. “The key is thatin free play, kids are making theAs media screens drawkids indoors, hours ofsitting raise the riskfor obesity and relateddiseases.decisions,” says Golinkoff. You can’tlearn to make decisions if you’realways told what to do.Some experts fear that free playis becoming endangered. In the lasttwo decades, children have lost anaverage of eight hours of free play perweek. As media screens draw kidsindoors, hours of sitting raise therisk for obesity and related diseases.When it comes to video games andother media, parents should monitorcontent, especially violent content,and limit the amount of timechildren sit.There’s also been a nationaltrend toward eliminating schoolrecess. “Thousands of children havelost recess altogether,” says childdevelopment expert Dr. KathrynWise ChoicesPlay To Learnand GrowKids don’t need expensivetoys and games to engage inenriching play.Let children lead.Monitor screen time (computer,TV, video games). Encouragemore active play.Get involved with yourcommunity to make playtimeand play space available for allchildren.Hirsh-Pasek of Temple University.“Lack of recess has importantconsequences for young childrenwho concentrate better when theycome inside after a break from theschoolwork.”Many kids, especially those inlow-income areas, lack access tosafe places to play. This makestheir school recess time evenmore precious. In response tothese changes, some educatorsare now insisting that preschooland elementary school childrenhave regular periods of active, freeplay with other children. The typeof learning that happens duringplaytime is not always possible inthe classroom. School recess is alsoOlder children, including teens, alsoneed to play and daydream, whichhelps their problem-solving andcreative imagination. Adults, too,need their breaks, physical activity,and social interaction.Play can also be important formedical care. At the NIH ClinicalCenter in Bethesda, Maryland,Unstructured, creative,physical play letschildren burn caloriesand develops all kindsof strengths, such aslearning how the worldworks.“Recreation therapy services areseen as essential to the patients’recovery,” says Donna Gregory, chiefof recreational therapy. She andher team tailor activities for bothchildren and adults. Games canget patients moving, even for justminutes at a time, which improvestheir functioning.Medical play helps children copewith invasive procedures. A 2-yearold can be distracted with blowingbubbles; older kids can place theirteddy bear in the MRI machine orgive their doll a shot before theythemselves get an injection. It giveskids a sense of control and supportstheir understanding in an ageappropriate, meaningful way.Without play and recreation,people can become isolated anddepressed. “There’s therapeuticvalue in helping patients maintainwhat’s important to them,” saysGregory. “When you are physicallyand socially active, it gives lifemeaning.”important because of the growingnumber of obese children in theUnited States. Running aroundduring recess can help kids stayat a healthy weight.Play also may offer advantageswithin the classroom. In anNIH-funded study, Hirsh-Pasek,Golinkoff, and their colleaguesfound a link between preschoolers’math skills and their ability tocopy models of two- and threedimensional building-blockconstructions. Play with buildingblocks—and block play alongsideadults—can help build children’sspatial skills so they can get anearly start toward the later study ofscience, technology, engineering,or math.“In a way, a child is becoming ayoung scientist, checking out howthe world works,” says Hirsh-Pasek.”We never outgrow our need to play.”Older children, includingteens, also need to playand daydream, whichhelps their problemsolving and creativeimagination.Web LinksFor more about play,go to: kids-job

newsinhealth.nih.gov/special-issues7See, Hear, SpeakAre Kids’ Senses Ready for School?When setting off for kindergartenor first grade, a child may feel prepared with a backpack loaded withcrayons, pencils, and paper. But agood start in the classroom dependson more than just school supplies.Healthy hearing, vision, speech,and language are key to success atschool. If a child has problems inthese areas, the sooner they’re spotted, the better they can be treated.A good start in theclassroom depends onmore than just schoolsupplies. Healthy hearing,vision, speech, andlanguage are key tosuccess at school.Sometimes problems with senses,speech, or language fly under theradar. A child with a lazy eye or a little hearing loss might get along justfine at home or in daycare. But whenchildren get to school, minor difficulties may start to catch up withthem. They may have trouble focusing and flourishing in the classroom.NIH-funded scientists are searchingfor better ways to recognize andtreat these types of problems as earlyas possible.Nearly all newborns are screenedfor hearing loss before leaving thehospital. For newborns diagnosedwith hearing loss, interventionssuch as hearing aids or cochlearimplants should begin no later than6 months of age. When interventionsbegin early, children with hearingloss can develop language skills thathelp them communicate.Hearing problems can also arisein older kids. “Some children areborn with normal hearing and develop hearing loss later for variousreasons,” says Dr. Mary Pat Moeller,who studies childhood deafnessand language development at BoysTown National Research Hospitalin Nebraska. Head injuries, meningitis, and chronic fluid behind theeardrum from repeated bouts of earinfections are just a few conditions that can lead to laterhearing loss.“We rely on normal hearing to pick up concepts andlearn new words,” Moellersays. But a noisy classroom can be tough forkids who can’t hear well.“Children with undetectedhearing loss may look likethey have attention deficits.They may miss what they’vebeen told because they’re just nothearing clearly,” she says.Screening for hearing loss inschool-age kids is a familiar process. Children wear headphonesand raise their hands as they heara series of tones. Some 5% to 10% ofschool-age children don’t pass thesetests. Kids with hearing loss can befitted with hearing aids or benefitfrom cochlear implants or assistivedevices. For example, teachers canwear microphones that send theirvoices directly to the children’s ears.Even children with minimal hearingloss can benefit from this type oftechnology.Children learn language by listening to others and engaging in conversations. But kids with hearing losscan miss out on some of this experience. Moeller and her colleagues arestudying how children with hearingloss develop language. Results fromthis NIH-funded research point toseveral factors that can help. Theseinclude the quality and fit of hearingaids, how often kids get speech andlanguage training, and how oftenparents have conversations withtheir children.A different source of languageproblems is a disorder calledChildren learn languageby listening to othersand engaging inconversations. But kidswith hearing loss canmiss out on some of thisexperience.specific language impairment, ordevelopmental language disorder.This condition affects an estimated7% of children in kindergarten. Kidswith specific language impairmenthave trouble learning new wordsand engaging in conversation. Theymight produce grammaticallyincorrect sentences like “What hewant for dinner?” or they might havea small vocabulary.“Both of those are fundamentalto being able to communicate withthe teacher, to understanding whatthe teacher is saying to them, and toforming social relationships withtheir peers,” says Dr. Mabel Rice, anNIH-funded researcher who studies

8newsinhealth.nih.gov/special-issueschildhood language disorders at theUniversity of Kansas.For example, a child with specificlanguage impairment might not un-Vision problems arecommon in preschoolers,but kids don’t alwaystell others about theirsymptoms.derstand that “It’s time to put yourthings away now” means “Put yourthings away.” Children who don’tunderstand complicated sentencescan seem like they’re disobedient,Rice says. More complicated grammar is also good for making friends.Saying “I would like it if you’d comeplay with me” might attract moreplaymates than “Come over here.”Wise ChoicesSigns of Eye, Ear, orLanguage ProblemsTalk with a health care provider ifyour child:doesn’t respond consistently tosounds or to his or her name.asks for things to be repeated orsays “huh?” a lot.turns the volume up on the TVand other electronic devices.speaks unclearly.has trouble following spokendirections.leaves words out of sentenceswhen talking.uses tenses (past, present, andfuture) improperly.has trouble catching balls orseeing distant objects.has eyes that cross or pointoutward.avoids close work or holds booksunusually close when reading.complains of eye discomfort,headaches, or blurred vision.In the past, parents were sometimes blamed for a child’s languagedisability. They might have beenfaulted for not reading enough totheir children. But research suggeststhat specific language impairmenthas other roots. The disorder tendsto run in families, which hints thatgenes play a role. Rice led a study ofover 300 people, including childrenwith specific language impairmentand their families. The scientistsidentified a gene that’s also linked todyslexia and other learning disabilities. The finding might eventuallylead to better understanding andtreatment of these disorders.Kids don’t usually grow out ofspecific language impairment. Theirlanguage improves, but they cancontinue to struggle with subtletieseven after they enter the workforce.“It is very important to identify thesekids, particularly at school entry orbefore school entry,” Rice says. Manyschool districts screen children forspecific language impairment beforekindergarten. Language therapy canhelp children catch up.Poor vision can also cause troublein school, and the problems maygo unnoticed. Vision problems arecommon in preschoolers, but kidsdon’t always tell others about theirsymptoms. Children might eventhink it’s normal to see double orfor things to be blurry. But pooreyesight can cause headaches andhinder reading. Some children withvision problems might seem to haveattention difficulties, since eyestrainand headaches can make it hard tostay on task.The most common cause of visionimpairment in children is amblyopia, or lazy eye. It often arises if theeyes point in different directions, orif one eye produces a better imagethan the other. The brain starts toshut down signals from the weakereye. Treatment encourages use of theweaker eye, sometimes by putting apatch over the other eye. NIH-funded research has found that treatmentfor amblyopia is more effective ifbegun when a child is young.So

kinds of social activities are paired with foods. And kids learn a huge amount about eating and physical activity from watching and imitating their parents.” Epstein’s research shows how important parents can be. In NIH-funded work, his team assigned obese children, ages 8 to 12, t