Sound Medicine -- April 13, 2002

Barbara Lewis and Dr. Pescovitz talk to IU physicians about:

Selective mutism in children
Early puberty in girls and boys
An interactive nutrition learning game
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Selective mutism in children

What would make children so silent that they fall behind in school, don't make friends and cannot interact with anyone outside a few chosen people? It's an anxiety-related condition called selective mutism and it's rare. Only about one percent of children suffer from it.

To shed light on the condition is Dr. Eric Scott, assistant clinical professor of psychology in the Department of Psychiatry at the Indiana University School of Medicine. Dr. Scott describes this subtle communication problem and how it differs from normal childhood shyness. He also explains behavioral and chemical therapies that reduce anxiety and he offers good advice for parents, teachers, and physicians who suspect a child may suffer from selective mutism.

Resources
Find information and support at the Selective Mutism Group, part of the Childhood Anxiety Network, Inc. Some material is for members only.
The American Speech-Language-Hearing Association site has an excellent description of selective mutism, including symptoms and treatments.

Early puberty in girls and boys

In the last few years, research studies have indicated that girls are reaching puberty at an earlier age. Discussing the subject is co-host Dr. Ora Pescovitz, a nationally recognized expert in the area of puberty. She is director of pediatric endocrinology and diabetology and executive dean for research affairs at the IUSM.

Dr. Pescovitz has doubts about these studies but also has concerns about substances in the environment that may trigger abnormal growth in girls and boys. Pescovitz discusses 100 years of data about puberty and the role nutrition plays in its onset. The normal range for girls entering puberty is between 8 and 13 years old, and she says that obesity or "overnutrition" may be a factor for girls developing in the lower range. Pescovitz differentiates between early-normal and "precocious" puberty, a condition which may occur in 2- to 5-year olds and which has pathological causes. Left untreated, precocious puberty can cause the fusion of bones and result in stunted growth.

Environmental toxins called "endocrine disrupters" may also affect human reproductive system functions and are currently under investigation by the EPA and other American health organizations.

Resources
American Academy of Pediatrics site offers a synopsis on the link between obesity and early puberty.
The Magic Foundation for Children's Growth has a good discussion of precocious puberty and its treatment.

Interactive nutrition learning game for teens

Know some kids hungry for knowledge about science? A Purdue University food science professor has found the right ingredients: computers and pizza. Bruce Watkins talks about his invention, the CD-ROM (and now Web) program called Pizza Explorer, an interactive learning tool that makes science visual. To enhance comprehension, a portion of the game tests to see if a child is a right-brained or left-brained learner. The game was created with high school students in mind, but middle school and home school kids will enjoy it too.

Resources
Play the Pizza Explorer at the Access Excellence Web site. The Access Excellence site has loads of resources for teachers and parents educating youngsters in science.
 
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Episiotomy during labor, does it do more harm than good?

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Health Quiz —
The "stent" is one of the most commonly used devices in medicine, but unless you have a particular health problem you may not know what it is. Is a stent:

a. a special splint for broken fingers,
b. a tube for easily injecting medicine into hospitalized patients, or
c. a device for treating heart attack patients.

What's the answer?


Medical Mystery —
How much sleep?
Sleep -- we all need it, and many of us wish we could get more of it. Although experts say teens need more sleep and senior citizens less, the traditional rule of thumb is that we all need eight hours of sleep per night.

Is that rule really accurate? And if we're not getting our allotted eight, is that a bad thing?

Find out!


Weekly Notebook — Yankee couch potatoes

A recent CDC report shows Americans don't exercise much. The study defines regular physical activity as light-to-moderate exercise 5 times per week or 20 minutes of vigorous exercise 3 times per week.

• 38% adults don't get any exercise at all.
• Only 3 out of 10 adults are physically active on a regular basis.
• Men are more likely than women to engage in at least some leisure-time physical activity.
• Adults who live in the suburbs are more likely to be physically active than adults in urban or rural areas.
• Nearly 8 in 10 adults with graduate level degrees engaged in at least some form of leisure-time physical activity, twice as many as those with less than a high school diploma.

Source: National Center for Health Statistics