Principal to give overview of drugs at High School

Photograph by Floome (http://2045tech.com/).

Photograph by Floome (http://2045tech.com/).

At this week’s Home and School Association meeting (April 10th, 2014), Dr Yannacone will speak on drugs: alcohol, nicotine, heroin, etc.  High School Library at 7 pm.

If you’re on the fence, here are some facts to get you to come:

Pennsylvania has the 3rd highest rate of heroin addicts in the country (behind CA and IL).  Delaware County alone as an estimate 8,000 users (source).

Philadelphia is the number 2 heroin-distribution center in the United States (source).

In 2012, 6.5% of surveyed 12th graders admit to using marijuana daily.  In 1973, THC content of marijuana was approximately 0.74% … through selective breeding it is 6.4% in 2003 (source); some cultivars now top out at 33% THC.  10 years ago, 14% of high school students who have driving licenses admitted to driving while high on marijuana (source).

11% of all the alcohol consumed each year in the United States is by people aged 12-20.  33% of all 8th graders have tried alcohol (source).

E-cig usage in middle school and high school doubled from 2011 to 2012 (10%).  Kids are allowed to buy e-cigs in Pennsylanvia.

 

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No drugs on Thursday

Apparently, presentation on Thursday will not include comments on drugs at the High School.

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Put scheduling into your Thursday schedule

scheduling-process-slide1In addition to drugs, Principal Yannacone will discuss the scheduling process for grades 8-11.   At the High School library,  7:00pm.

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Alcohol and other drugs at the High School

Photograph by Floome (http://2045tech.com/).

Photograph by Floome (http://2045tech.com/).

If you’re interested in these topics, please come to the next Home and School Association meeting on March 13th, 2014.  Principal Yannacone will talk about drugs (liquid, dry, smokable, injectable, etc.) and how we can work together to keep students safe … especially during the spring prom season. 7pm in the High School Library.  Please come!!

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Concussion guidelines

If you are a parent of a particular age, you probably grew up in a day when hits to the head and brief periods of unconsciousness were just part of being a kid. That’s changed, so that’s why I went to last week’s presentation on concussions organized by SRS by Swarthmore Recreation Association’s Linda McCullough. The presentation was by Dr Steve Stache, a sports medicine physician at the Rothman Institute (Jefferson Comprehensive Concussion Center. If you want some insight into how interested he is in student concussions, check out his publications list.

I went because I have kids who do dangerous sports, but took notes in case other parents might be interested (only 18 people showed up). First, some resources.

  • WSSD policies on concussion.
  • Policy on diagnosis and treatment of concussion is largely determined at the International Consensus Conferences on Concussion in Sports. Currently, school policies nationwide are influenced by the Zurich Guidelines, drawn up after the 2008 meeting. The most recent, New Zurich Guidelines (from 2012) will change recommend protocols yet again. After every new consensus document it takes a huge effort to get doctors, coaches, parents, and athletes re-educated. He apparently spends a good amount of time each day just dealing with misconceptions, especially among, um, parents. His presentation was toward that goal of re-education, and he is happy to make further presentations to any group who wants to learn more (contact Colette Glatts).
  • I located a PDF of the latest consensus statement (atsnj.org/documents/pdf/ZurichGuidelines2013.pdf) in case you are a coach, school nurse, school administrator, or parent of an athlete. Read it during half-time, or whenever you have a lull during your child’s sport. Some sections might make your head hurt, but it is full of good advice.
  • The other important resource is the Safety in Youth Sports Act, a Pennsylvania-specific law. Here’s a short summary. Again, coaches, school nurses, and school administrators should know this document well. Parents should probably read it, too.
  • CDC has good site on concussion. Here’s the page on symptoms. And this is the PDF for parents.

Some highlights from Dr Stache:

  • Concussions are like pregnancy — you have a concussion or you don’t.
  • Common protocol during games/practices is “when in doubt, take ‘em out.”
  • Many people (coaches, officials, school representatives, etc.) may remove a player for concussions … but coaches cannot return an athlete to play (or practices). That’s where doctors come in.
  • Concussion symptoms can manifest later, so even if a player seems fine (or claims to be fine), issues can reveal themselves at a later time. There’s no way to predict this, unfortunately, so it’s best to be cautious.
  • When observing a player who might be at risk (e.g., might have had earlier hit), sometimes a coach or trainer is tasked with visually following that player closely.
  • glasgow-coma-scaleConcussions are usually a mild form of brain trauma on the Glasgow Coma Scale. Can be caused by too-rapid rotation of the head in addition to standard jolt. Jolt can also be transmitted to brain via a hard hit to chest.
  • Second injury can be much more damaging to brain. First hit causes micro-trauma to axons, changes in brain physiology … brain is for some reason fragile because of such changes.
  • Parents should relay concerns to coaching staff but are asked not to run onto the field/ice screaming … that never helps. But parents are best judge of changes in behavior and cognitive behavior, so if you notice something off about your kid, it might be concussion related EVEN IF YOU OR COACH DIDN’T SEE THE CONCUSSION. Sorry about the all caps — that just seems very important given that teens can seem off all the time. Parents also can be good family historians/detectives, so if your kid comes back from sledding on a Snow Day seeming sluggish, you might ask about the broken sled …
  • Sometimes massive hits to the head don’t cause concussions. When parents see this, they typically freak out. So don’t automatically freak out.
  • If your kid gets a hit and is diagnosed with a concussion, don’t rush off to ER to demand a CT scan. Hospital will probably comply (they want your money, plus they don’t want to be sued) … but you’ll have subjected your kid to a radiation dose equivalent to 120 x-rays. The CT scan will not help diagnose a concussion or evaluate its severity. All it will do is increase the chance your kid will develop cancer.
  • If your kid has a concussion, don’t allow them to sleep all day. That slows recovery.
  • Mouth guards do not protect against concussions, even if the mouth guard claims that on the package. Might increase risk, in fact.
  • Head guards don’t seem to decrease concussions in soccer. [If they wore football-style helmets??]
  • There are apps for smartphones that help with diagnosing concussions. Search for “concussion” (of course).
  • Pre-season cognitive testing is extremely helpful. After a hit, coaches, trainers, and physicians can administer a variety of tests to measure cognitive ability and balance, but if your kid has preexisting issues with both, he or she might be needlessly tagged with concussion status. Baseline testing can eliminate these false diagnoses. Testing is not mandatory, but strongly recommended. Doctors can do this (costs money, I’m sure).
  • Once diagnosed, recovery usually involves abstinence from reading as well as from all electronic devices. Teens hate to be taken out of games, but really, really hate to be removed from their electronic world. Recovery usually involves balance therapy, cognitive therapy, and occasionally medications.
•••

Some further thoughts (of mine).

  1. Football helmets are now being sold with accelerometers (those devices in your phone that measure phone movements) — coaches can download data to iPads to view hits for players that might be under concussion watch. With football, coaches’ and trainers’ eyes are often on the ball, not on all the players colliding with one another every play, for hours. It might be the case that hard hits, multiple hits, or dangerous rotation movements are missed. The accelerometers clearly don’t protect from hits (duh), but they can give exposure data just like those radiation badges that some scientists wear in the laboratory. Regardless of whether WSSD adopts these helmets, researchers will probably use these helmets to gather information on whether and how different types of hits translate into concussions. We will need to wait a few years for these data.
  2. I am left wondering whether girls soccer should use a lighter ball. Concussion risk in girls soccer is higher than in boys games (like all injuries, apparently), fyi. Seems like resizing the ball would be good given the cognitive effects of heading. (Girls basketball, at NCAA level, at least, uses lighter ball.)
  3. Cheerleading is often left out of discussions on concussions, yet the sport/activity has the highest rate of concussions by far. Surprisingly, the risk is not for the girls at the top of the pyramids (the fliers), it’s for the lower level of girls.
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Error in BMI letter

If you received the “SHHS BMI letter” recently, please note that there is mistake in the bottom portion where the various Body Mass Index ranges are explained.  It should read (corrections in ALL CAPS):

BMI less than 5th percentile – underweight
BMI betweeen 85th and 95th percentiles – at risk for overweight OVERWEIGHT
BMI equal or greater than 95th percentile – overweight OBESE

The category names were changed six years ago (I think).

By the way, the letter doesn’t say what Body Mass Index is, so if you’re curious on how it’s calculated, it’s kg/[(meters)(meters)] … or you can cheat and use a web form.

The BMI percentile-for-age is a way to compare your child’s BMI with a sample of kids from 1977 (when parents were kids!).  If you ever want to compute the BMI percentile-for-age yourself, this page will do the calculation for you.  By the way, the CDC provides nice graphs of these percentile data.  Here’s one for boys, with examples of 10 year-olds with different BMIs:

BMI for age and height for boys

Finally, this sentence (also from State-suggested verbiage) confuses many people:

“For example, some athletes and serious dancers may have a higher than expected BMI due to their increased muscle mass, which weighs more than fat mass”

It essentially means that a cup of muscle weighs more than a cup of fat — it’s why large bodybuilders have high BMIs but low amounts of fat.  High-for-age BMIs in children are not usually due to unusually high amounts of muscle (according to most sources), though it can happen.  (I have no idea what “serious dancers” might mean — ballerinas?)

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Sleepy plea from school nurse

http://newsfeed.time.com/2014/01/27/were-all-doomed-using-your-smartphone-before-bed-can-cause-cellphone-hangover/

[ image from newsfeed.time.com ]

At the Freshmen Orientation meeting Thursday night, principal Yannacone relayed a plea from the school nurse to parents: make sure your teens are getting enough sleep. So below are some thoughts on sleep, partly recycled from a post last year on the same topic . . .

You probably already know that if teens don’t get enough sleep they are likely to be even moodier than usual (it’s possible!), to be slower, less coordinated, and more injury prone during sports (and driving), to perform at a lower level on tests and other academic measures, and to overeat. There are no known upsides to a sleepy teen.

But you might not know the exact hours of sleep recommended (as determined by experiments on actual teens): 8 1/2 – 9 1/4 hours.  This surprises most parents, even those that think teens need more sleep than adults.

So if you have a teen who wakes up at 6:00 am, if you do the math that means that the lights should be turned off in his/her room no later than 9:15 pm.  Given that target, you should probably ensure that usage of electronics ends at 8:15 pm — that allows one hour for the obligatory, post-electronics snacking, the brushing of the teeth, and the reading of books (those paper things).  Principal Yannacone mentioned that some parents have an “electronics basket” into which all child cell phones, iPods, handheld games, etc.) go in the evening … and then that basket is taken into the parent’s bedroom (she mentioned you might want to lock your door).  Your child will undoubtedly claim, “I just use my smartphone as an alarm clock” and “everyone else’s parents allow cell phones in their kids’ rooms,”  so it’s best if you start an electronics policy at age 2, to head off those silly claims.  If for some reason you missed that opportunity (likely), you really should reassert that control now (you pay for your kids phone, right?); teens will not voluntarily do any of the above.

Children, on average, use electronic media for 7 (seven!!) hours every day (source: American Academy of Pediatrics; graph) — that’s 7 hours not doing something else, of course.  Kids used to play outside, play board games, read books, and, gasp, help out around the house.

As an FYI, the Obamas don’t allow their kids to watch television during school nights (the President probably has drones to enforce that rule).  That policy is easier to set up years earlier, before your child thinks ad libitum television and gaming is a basic human right, and gets harder the longer you delay.  If you’re on the fence: an experiment clearly showed that kids allowed to watch television or game during school nights do worse in school (article).  That study also showed that if you allow your kids to watch R rated movies, the boys’ school work suffered even more.  One option to consider is that weekday television could be documentaries only … your kids will throw a spectacular tantrum, but eventually they’ll grow tired of protests and might learn to like documentaries.

You should never, ever put televisions in your child’s bedroom.  Of course, many kids bypass that by asking their parents for the logins for services like Netflix, Tivo, etc. … which allows them to use computers as televisions.  Don’t give them those passwords.  The sneaky little Devils will also get the movies/series using (illegal) download services, so you should never just assume they are in their rooms “listening to music”.   Fun fact: 20% of infants have televisions in their rooms these days (source) … not surprising so many kids grow up addicted.

If you’d like to listen to a radio program (short) on teenagers’ sleep needs, here you go:  here you go.

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