WartsWWartsWartsEnglishDermatologySchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)SkinSkinConditions and diseasesCaregivers Adult (19+)NA2020-05-13T04:00:00Z6.4000000000000069.90000000000001185.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Learn about the types of skin warts, what causes warts, how to prevent warts and what common treatments are used.<br></p><h2>What are warts?</h2> <figure> <span class="asset-image-title">Common warts</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Warts_MED_ILL_EN.jpg" alt="A hand with warts on the fingers and a close-up of warts around the fingernail" /> <figcaption class="asset-image-caption">Common warts are usually found on the fingers, toes and knees. They make up about 70 per cent of warts.</figcaption> </figure> <p>Warts are common, harmless growths of skin that occur in roughly 10 per cent of all children. They are caused by a virus called <a href="/Article?contentid=25&language=English">human papillomavirus (HPV)</a>. Warts are caused by the rapid growth of skin as a result of the virus. They are not cancer. </p><p>Normally, warts are found on the top layer of skin (epidermis). They may look different depending on what area of the body they are on. They can often have small black or dark red spots in the center. These spots are very small clotted blood vessels. </p><p>Some warts can cause pain and bleeding, especially the plantar type on the bottom of the feet.</p><p>Warts are most common in people between the ages of five and 20 years.</p><p>Generally, your child's doctor can diagnose a wart by looking at it. Your child will not usually need special tests.</p><h2>Key points</h2> <ul> <li>Warts are common growths of skin. </li> <li>Warts are caused by a virus called human papilloma virus (HPV). They can spread. </li> <li>Warts often go away on their own. </li> <li>Wart treatment may or may not work. </li> </ul><h2>Treatment of warts</h2><h3>Option not to treat</h3><p>Viral warts will often go away on their own, but they can also persist for years. They are not dangerous. Depending on where they are located in the body, they may cause pain and discomfort, or people can be unhappy with how they look. How long it takes for warts to go away on their own varies and cannot be predicted.</p><h3>Option to treat</h3><p>There is no treatment to cure HPV, the cause of warts. Most treatments kill the cells that contain the virus. If treatments are started, the aim is to remove the wart without scarring. </p><p>Because some warts go away on their own, stronger treatments are often not used, except with plantar warts. Also, treatments can be painful and may not work well. People may need multiple treatments to remove the wart entirely.<br></p><p>There is no treatment that is considered "the best" at removing warts. Your doctor may choose different treatments depending on the age of your child, where the wart is located or what has been used so far.</p><h4>Treatments to use at home</h4><ul><li>Salicylic acid wart removal products can be purchased without a prescription at a pharmacy (there are many brands available). There are also prescription forms of salicylic acid. Apply the product once per day to the area of the wart. Usually, it is not applied to the face, genitals or normal skin unless directed by a doctor. The salicylic acid will make the wart turn into dead skin (the skin will look white). </li><li>Duct tape or other airtight tape may be used. This can be combined with other treatments, such as applying duct tape over the salicylic acid product. The use of duct tape alone for management of warts is not very effective.</li><li>Other medications such as podophyllotoxin, topical retinoids (such as tretinoin or tazarotene), cimetidine, imiquimod or sinecatechins might also be prescribed by your doctor. </li></ul><h4>Doctor's office treatments<br></h4><ul><li>Higher concentrations of salicylic acid can be applied to the wart by your doctor.</li><li>Liquid nitrogen, also called cryotherapy, is a common treatment for warts. The liquid nitrogen is very cold, and it freezes or burns the wart. After, the skin will likely blister and scab. When the scab comes off, the wart can come with it. This treatment is quick but can also be painful. For this reason, it is not often done in young children. Multiple treatments, or use of other treatments at the same time, are commonly necessary.</li><li>Other treatments applied in the doctor's office include <a href="/Article?contentid=86&language=English">bleomycin</a> injections, podophyllotoxin, candida injections and cantharone.</li></ul><h4>Not-so-common treatments<br></h4><ul><li>Electrosurgery with a carbon dioxide (CO2) laser requires a pain medicine called a local anaesthetic. </li><li>Photodynamic therapy involves two steps: applying a prescription cream and then exposing the wart to a specific type of light. This is used for warts resistant to other treatments.</li><li>Surgery is very rarely used, as it may increase the chances that the virus may spread in the skin. </li></ul><h2>When does a wart need to be seen by a doctor?</h2><p>See your child's doctor if:</p><ul><li>warts develop on the genital area or around the anus</li><li>plantar warts are painful or cause discomfort when walking</li><li>warts develop on the face</li><li>any warts are causing pain or distress</li></ul><p>For further information about warts, see the following resource from the Society for Pediatric Dermatology: "<a href="https://pedsderm.net/site/assets/files/1028/4_spd_warts_web_final.pdf">Warts (verruca vulgaris) and what to do about them"</a>.</p><h2>References</h2><p>Schmitt, B. <a href="https://patiented.solutions.aap.org/handout.aspx?gbosid=494586">Warts</a>. American Academy of Pediatrics, Pediatric Patient Education. Retrieved from <a href="https://patiented.solutions.aap.org/handout.aspx?gbosid=494586">https://patiented.solutions.aap.org/handout.aspx?gbosid=494586</a>.</p><p>Boull, C. and Groth, D. Update: Treatment of Cutaneous Viral Warts in Children. <em>Pediatric Dermatology</em> (2011). <em>28</em>(3), 213-217.</p>https://assets.aboutkidshealth.ca/AKHAssets/warts.jpg
Water safety and drowning preventionWWater safety and drowning preventionWater safety and drowning preventionEnglishPreventionChild (0-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+)NA2020-11-09T05:00:00Z7.0000000000000072.30000000000001552.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Learn how to keep children safe in or around water.</p><p>Timing is critical when it comes to saving your baby or your child from a near-drowning (submersion) episode. If enough oxygen is not being delivered to the brain, severe damage can occur within a few minutes. If your child's heart has stopped beating for more than eight to 10 minutes, their chances of surviving are greatly reduced.<br></p><div class="asset-video"> <iframe src="https://www.youtube.com/embed/CI1BvnNEQNY" frameborder="0"></iframe><br> <p>For more videos from SickKids experts in collaboration with Youngster, visit <a href="https://www.youtube.com/channel/UCoKMd2cYwegtZX19uHdNLQA">Youngster on YouTube</a>.</p></div><h2>Key points</h2><ul><li>Drowning can occur in as little as 20 seconds.</li><li>Most accidents happen when swimming, boating or bathing in the bathtub.</li><li>Always supervise children near any water and keep young children within arm's reach.</li><li>Do not put your life at risk trying to save your child. If you must enter the water to perform a rescue, bring a flotation device with you.</li><li>If your child is unconscious and not breathing, have someone call 911 and get an AED right away.</li><li>After a drowning episode, see a doctor if your child develops fever or difficulty breathing.</li></ul><h2>How can you tell if your baby or your child is drowning?<br></h2><p>Be sure to monitor your child at all times when they are in, or near, water. Watch for signs of drowning because a child in distress will be <strong>unable</strong> to yell for help.</p><h3>Signs of drowning</h3><ul><li>head tilted back with mouth open</li><li>floating face down</li><li>gasping for air</li></ul><h2>Rescue</h2><h3>Avoid putting yourself at risk trying to save your child</h3><p>You should not put your life in danger trying to rescue your baby or your child. If your only option is to enter the water, bring a flotation device with you. This can be a life-jacket or even a pool noodle. </p><h3>CPR</h3><p>CPR stands for cardiopulmonary resuscitation. CPR is an emergency procedure that involves a combination of chest compressions and rescue breaths (mouth-to-mouth resuscitation). <a href="/Article?contentid=1044&language=English">CPR given to a baby</a> younger than 12 months of age is different from <a href="/Article?contentid=1041&language=English">CPR given to an older child</a>.</p><p>Once you are safely out of the water and if your child is not responsive, not breathing or only gasping, call for help and begin CPR right away.</p><h2>Assess your child’s state</h2><h3>Checking for alertness and injuries </h3><p>Check to see if <strong>your baby</strong> is responsive by rubbing their back, flicking their feet and calling their name.</p><p>Check to see if <strong>your child</strong> is responsive by tapping them on the shoulder and asking loudly, "Are you OK?"</p><ul><li>If you get an answer or a physical response, quickly check to see if they have any injuries. If they need medical attention, have someone call 911 right away.</li><li>If you get no answer or physical response, shout for help, ask someone to call 911 and have them get an AED (automated external defibrillator) right away, if available, while you begin CPR. If you are alone, call 911 from a cell phone that you can put on speaker and begin CPR.</li></ul><h3>Check for breathing</h3><p>Check for normal breathing (no gasping) by watching your child's chest for any movement. If you are alone, make sure your child is breathing normally before you leave to call 911. Carry your baby with you to make the call.</p><h2>When to call a doctor</h2><p>Get medical attention right away if you see any of these signs in your baby or your child:</p><ul><li>persistent coughing</li><li>difficulty breathing</li><li>blue colour on skin and lips</li><li>loss of consciousness (fainting)</li><li>fever</li><li>being moody or very sleepy</li></ul>watersafetyhttps://assets.aboutkidshealth.ca/AKHAssets/water_safety_and_drowning_prevention.jpg
Weight gain after a blood and marrow transplantWWeight gain after a blood and marrow transplantWeight gain after a blood and marrow transplantEnglishHaematology;Immunology;OncologyChild (0-12 years);Teen (13-18 years)BodyImmune systemNATeen (13-18 years) Adult (19+)NA2010-03-19T04:00:00Z10.200000000000052.3000000000000520.000000000000Flat ContentHealth A-Z<p>Learn how to prevent and manage your child's weight gain, after a transplant.</p><p>Some children who have undergone an allogenic transplant may gain weight. This is particularly true for those who have taken the steroid, prednisone. Children are at most risk of gaining weight during their treatment and up to one year after finishing it.</p><h2>Key points</h2><ul><li>To prevent weight gain, encourage your child to eat healthy, exercise, and maintain a healthy lifestyle.</li><li>Long-term survivors of BMT are at risk for developing high blood pressure, high blood sugar levels, hyperlipidemia, heart disease and type 2 diabetes.</li><li>Children who have a BMT are at risk of becoming obese due to steroids used for treatment and a lack of physical activity.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/weight_gain_after_a_blood_and_marrow_transplant.jpg
What causes epilepsy?WWhat causes epilepsy?What causes epilepsy?EnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemConditions and diseasesCaregivers Adult (19+) EducatorsNA2021-03-17T04:00:00Z10.800000000000047.80000000000001410.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Learn about the many different causes of epilepsy in children, which are classified into six categories: structural, genetic, infectious, metabolic, immune and unknown.</p><h2>Causes of epilepsy</h2><p>Once your child is diagnosed with epilepsy (seizure disorder), your child’s health-care team will try to find the cause of their epilepsy. This will help them determine the treatment options available for your child. The causes of epilepsy are classified into six categories. These are described below.</p><h2>Key points</h2><ul><li>There are many different causes of epilepsy in children.</li><li>Causes of epilepsy are categorized into six groups: structural, genetic, infectious, metabolic, immune and unknown.</li><li>Your child’s health-care team will try to find the cause of their epilepsy; however, in 60–70% of cases, no apparent cause can be identified.</li></ul><h2>Causes of epilepsy are divided into six groups</h2><h3>1. Structural</h3><p>This means that your child has epilepsy due to an abnormality in the brain structure. These abnormalities are seen on brain imaging, such as a CT scan or an MRI. Abnormal brain structure may be caused by: </p><ul><li><p> <strong>Injury or trauma</strong>: Head injury or trauma, at birth or later, may cause focal epilepsy. Older teenagers and young adults are more likely to have brain injuries that result in epilepsy because they are more active and more likely to be injured than younger children.</p><p>The more severe the injury, the higher the risk that a child will later develop epilepsy and the longer the child is at risk. Severe head trauma, where the child’s brain is bruised or the child is unconscious for more than 24 hours, increases the risk of epilepsy 17 times. Moderate trauma, where the child’s skull is fractured or the child is unconscious for more than half an hour, increases the risk three times. Ordinary bumps and bruises do not increase the risk of epilepsy.</p><p>Epilepsy does not always develop right away. The risk of developing epilepsy is highest for the first year after the injury. However, a child who has had a serious head injury may develop epilepsy years afterward.</p></li><li><p> <strong>Lack of oxygen to the brain</strong>: Lack of oxygen to the brain before, during or shortly after birth can damage the brain and result in seizures in the newborn period. This may result from various birth complications, including difficult or prolonged labour, <a href="/article?contentid=354&language=english">placental abruption</a> (when the placenta separates early from the uterus) or compression of the umbilical cord.</p><p>Lack of oxygen to the brain (for example, from an accident, drowning or heart attack) can also result in seizures in older children and adults.</p></li><li><p> <strong>Brain tumour</strong>: Brain tumours are the second most common type of cancer in children, after leukaemia, but they are still rare. Approximately 30 per cent to of people with brain tumours have seizures, but they may not develop chronic epilepsy. The type of tumour affects the risk of developing epilepsy. Some studies suggest that epilepsy is more common in people with low-grade tumours that have been present for a long time than in people with malignant tumours. Brain tumours are a fairly rare cause of epilepsy, especially in children and young adults.</p><p>The outlook for children with epilepsy caused by a brain tumour varies but is often good. With the right surgical procedure, most people become entirely seizure-free or have more than 80 per cent fewer seizures. The outcome may depend on how long a child has had epilepsy and the type of surgery they have. </p></li><li> <strong>Cerebrovascular problems</strong>: A cerebrovascular problem (a problem with the blood vessels in the brain), such as a tangle of blood vessels or a stroke, can also cause epilepsy. Cerebrovascular problems such as stroke are common causes of seizures in older patients, but can also be seen in children.</li><li> <strong>Congenital malformation</strong>: Before a baby is born, their brain is formed in a complicated process in which new brain cells travel to their intended location in a very specific pattern. Different types of congenital (present at birth) brain malformations can be caused by: </li><ul><li>abnormal proliferation (when too many or too few brain cells grow or when brain cells multiply abnormally)</li><li>o abnormal migration (when brain cells stop moving at the wrong time and end up in the wrong place)</li><li>abnormal organization (when all or part of the brain forms in the wrong shape)</li></ul><p>Almost any brain malformation can lead to seizures. Sometimes, these malformations can also lead to developmental disabilities. If a baby has very severe brain malformations, they may not survive.</p><li> <strong>Neurocutaneous syndromes</strong>: Neurocutaneous syndromes are congenital disorders that cause tumours to grow in the brain, spinal cord or peripheral nerves. They often cause skin lesions (abnormal growths or marks on the skin) and may also cause developmental disability.</li><ul><li>Tuberous sclerosis is a genetic disorder in which growths or ‘tubers’ develop in the brain and, sometimes, in the kidney and heart. Hypopigmented, or pale, areas shaped like ash leaves are found on the skin, and butterfly-shaped facial acne develops over time. Approximately 80 per cent of people with tuberous sclerosis develop epilepsy. The number of tubers and their location seem to play important roles in cognitive and developmental outcome as well as seizure outcome.</li><li>Sturge-Weber syndrome is also accompanied by a birthmark on the face and is connected with epilepsy in 70 per cent to 90 per cent of cases. Sturge-Weber syndrome may get worse with time but eventually stabilizes. Early treatment, particularly surgery, may improve seizure control and intellectual outcome.</li><li>Neurofibromatosis, a group of genetic disorders in which many soft tumours develop throughout the body and is often accompanied by skin changes. Epilepsy occurs in less than 14 per cent of cases.</li></ul><li> <strong>Mesial temporal sclerosis</strong>, also known as hippocampal sclerosis, is a condition in which parts of the brain in the inner part of the temporal lobe shrink and develop scar tissue. The causes are unclear. It is more common in older children and adults, but it has been seen in children as young as two years old.</li></ul><h3>2. Genetic</h3><p>A genetic cause may be due to genes passed on from the parent to the child. Other times, a new genetic mutation occurs in the child. There are certain genetic mutations that increase the risk of having seizures.</p><p>Even though the same genetic mutation may be identified in your child and others, the degree to which each child is affected can vary.</p><h3>3. Infection</h3><p>Infection of the brain is thought to cause up to 25 per cent of epilepsy cases in children and 3 per cent to 6 per cent of all cases of epilepsy. Many different infections can result in seizures either at the time of infection or afterward, including: </p><ul><li> <a href="/article?contentid=761&language=english">meningitis</a>, a bacterial or viral infection of the tissues covering the brain</li><li>encephalitis, an infection of the brain</li><li>opportunistic brain infections in children with a weakened immune system, for instance from HIV infection</li><li>infections elsewhere in the body that cause metabolic changes or a lack of oxygen to the brain</li><li>various parasitic infections of the CNS, including trichinosis, cerebral malaria, cysticercosis and toxoplasmosis (more common in developing countries but can be acquired anywhere)</li></ul><p>The level of risk depends on the specific infection. For instance, viral encephalitis and bacterial meningitis increase the risk of epilepsy ten times, but aseptic meningitis (when no bacterial cause is found) or viral meningitis does not appear to increase the risk.</p><h3>4. Metabolic disorder</h3><p> <a href="/article?contentid=938&language=english">Metabolic disorders</a> are problems with producing, absorbing, breaking down or storing specific substances in the body, including sugars, fats, proteins and vitamins. They usually happen when a child lacks a specific enzyme, often because of a genetic mutation.</p><h3>5. Immune</h3><p>The immune system protects our body from illness and attacks bacteria and viruses to prevent us from getting sick. However, sometimes the immune system becomes confused and these cells end up attacking our own cells. This abnormal activity can disrupt normal functioning of all our body parts. When it affects cells in the brain, it can result in epilepsy. </p><h3>6. Unknown</h3><p>In 60–70% of cases, no apparent cause can be identified.</p><p>Sometimes a child can have more than one cause for epilepsy. For example, in children with tuberous sclerosis, genes in the body make it more likely for the body to make benign (non-cancerous) tumours. These tumours can also grow in the brain; however, some are more likely to cause epilepsy than others. If this is the case, the child is considered to have both a structural cause (the tuber) as well as a genetic cause (the gene mutation) for their epilepsy.</p>
What causes juvenile idiopathic arthritis?WWhat causes juvenile idiopathic arthritis?What causes juvenile idiopathic arthritis?EnglishRheumatologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemNAAdult (19+)Joint or muscle pain;Pain2017-01-31T05:00:00Z7.2000000000000066.8000000000000477.000000000000Flat ContentHealth A-Z<p>Find out why arthritis can occur in young people. This page describes how joint inflammation happens, and how juvenile idiopathic arthritis can hurt your joints. It also outlines some of the symptoms of arthritis in young people.</p>It is important to remember that JIA is not contagious. It is also not known for certain what the exact cause is. In JIA, the immune system is not working normally. The immune system's job is to fight off germs and disease. However, in JIA, the immune system attacks healthy joints, causing inflammation.<p></p><h2>Key points</h2> <ul><li>The exact cause of JIA is not known.</li> <li>In JIA, the immune system attacks healthy joints causing inflammation.</li> <li>If the inflammation of JIA is not treated it can lead to permanent damage of the joint.</li> <li>A flare is when there is an overall increase in symptoms for a longer period of time, while a remission is when the symptoms go away.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/what_causes_juvenile_ideopathic_arthritis.jpg
What causes seizures?WWhat causes seizures?What causes seizures?EnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemConditions and diseasesCaregivers Adult (19+) EducatorsNA2021-03-17T04:00:00Z9.8000000000000052.10000000000001919.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Learn about what causes seizures, the different types of seizures and what the concept of the seizure threshold means. </p><h2>What happens during a seizure?</h2><p>Electrical activity in the brain is carefully balanced. Neurons (brain cells) fire singly or in small groups to accomplish a task (excitation) and then stop firing (inhibition). A seizure happens if many neurons fire at once in uncontrolled bursts. This firing interferes with how the brain normally functions:</p><ul><li>Neuron excitation and inhibition become unbalanced; either there is too much excitation, or too little inhibition.</li><li>A small group of neurons begin to fire together.</li><li>Other neurons nearby or throughout the brain also start firing together because of abnormal connections between neurons or groups of neurons — this firing is called hyper-synchrony.</li><li>The neurons involved in the seizure send instructions to the parts of the body that they control which may result in movements, sounds or change in level of consciousness.</li></ul><h2>Key points</h2><ul><li>A provoked seizure has a direct cause such as a head injury, an infection or low blood sugar.</li><li>An unprovoked seizure does not have an immediate cause. A child must have two or more unprovoked seizures before epilepsy will be considered or have one seizure and an underlying condition with a high risk of more seizures.</li><li>A seizure threshold is a person's likelihood to have a seizure. The higher the threshold, the less likely it is that a seizure will happen.</li><li>Factors that raise a seizure threshold include getting enough sleep every night and taking anti-epileptic drugs according to instructions.</li></ul><h2>Causes of epilepsy</h2><p>There are many different causes of epilepsy. There are tests available to look for the cause. However, in 60–70% of cases, no apparent cause can be identified.</p><p>The cause of epilepsy can be classified into six categories: </p><ol><li>Structural: There is an abnormality in the brain tissue, including previous injury to the brain from trauma, car accident or stroke that makes the brain more likely to have seizures.</li><li>Genetic: Some types of epilepsy run in families. In these cases, it is passed on from parent to child. Other times, a child has a new change in genes (mutation) that has only occurred in them and there is no family history. There are some types of epilepsy that have been linked to specific genes.</li><li>Infectious diseases: Infections such as meningitis or encephalitis affect the brain and can cause seizures and epilepsy.</li><li>Metabolic disease: The brain cells use energy in a way that makes them more likely to create abnormal electrical activity.</li><li>Unknown: The cause of epilepsy is not yet known.</li><h2>Seizure threshold</h2><p>The seizure threshold is not a specific measurement. It is a way of thinking about the balance between excitation and inhibition in the brain cells or neurons.</p><p><em>Sarah’s seizures are well controlled on anti-epileptic drugs. She has an important test tomorrow. She stays up three hours later than usual to study, and then takes her medication when she goes to bed. The next day, she has a seizure at breakfast. </em></p><p>Under normal circumstances, Sarah would not have had a seizure because her medication and her regular sleep schedule keep her seizure threshold high. The combination of taking her medication late and losing three hours of sleep lowered her seizure threshold just enough to trigger a seizure.</p><p>Some factors can lower the seizure threshold of a person with epilepsy.</p><ul><li>Missing medication doses: This is the most common trigger.</li><li>Lack of sleep: Children with epilepsy are encouraged to maintain a regular sleep pattern and avoid late nights. If your child has a medical condition that causes sleep loss, such as sleep apnea, treatment should be sought for this condition to decrease the risk of breakthrough seizures.</li><li>Illness: Fever, vomiting and diarrhea can lower the seizure threshold. </li><li>Alcohol and drugs: Too much alcohol or certain drugs (e.g., cocaine, ecstasy) can trigger seizures. Over-the-counter or herbal medicines may also trigger seizures. Always check with your medical team when starting your child on a new medication or supplement to determine whether it will affect their seizures.</li><li>Hormones: For some women, changes in menstrual cycle can reduce seizure threshold. Their neurologist can propose changes to help with this trigger.</li><li>Stress: Stress and anxiety, common in adolescents, are reported as seizure triggers. Participating in support groups can decrease stress and anxiety.</li><li>Sensory input: Some children have triggers that include flashing lights, doing puzzles and soaking in hot water.</li></ul><p>While one of these things by itself might not be enough to cause a seizure, a combination of them may lower the seizure threshold enough to cause a seizure.</p><p>There are many things your child can do to help control seizures:</p><ul><li>Avoid triggers.</li><li>Get enough sleep every night.</li><li>Take prescribed medications regularly.</li><li>Keep a medication reminder chart or other alerts to help with remembering to take medications.</li></ul><p>Many children do not have seizure triggers. Try to keep precise records and include details of what occurred before the seizure to identify a pattern and trigger. One way to do this is by keeping a seizure diary or using a seizure diary application on your phone or another device. Identifying common triggers and avoiding them can improve your child’s quality of life, as well as your own. </p></ol><h2>Do seizures damage the brain?</h2><p>A great deal of epilepsy research in humans and animals has focused on the question of whether seizures cause brain damage. Because there are so many different factors, including the specific epilepsy syndrome, other health conditions, the age of the child, the age at which epilepsy began, the treatment regimen and the child’s particular characteristics, this is a difficult question to answer.</p><p>It is not clear whether single seizures can cause brain damage or if it is the cumulative effect of many seizures that cause damage.</p><p>We know that:</p><ul><li>While children who have multiple seizures over a long period of time are at risk for long-term effects, children who have only one or a few brief seizures in their lives do not usually have long-term consequences.</li><li>In animal studies, seizures lasting more than 30 minutes and frequent, recurrent seizures appear to cause some brain cell death and may affect learning and memory. We don’t yet know how these animal studies translate to children.</li><li>If the child’s epilepsy is caused by underlying abnormalities of the brain, this abnormality may also cause learning and behaviour problems.</li></ul><p>Most children with epilepsy do not have developmental disabilities. They have as wide of a range of cognitive abilities as other children, ranging from very intelligent to below average.<br></p><h2>Can my child die from a seizure?</h2><p>It is uncommon for a child to die from a seizure. However, people with epilepsy, particularly those who have other neurological disorders, do have a higher risk of death than people without epilepsy. The risks vary widely and depend on the individual child.</p><p>There is a higher risk of death if:</p><ul><li>The child has a significant underlying neurological disorder. For example, children with severe cerebral palsy may also have problems with swallowing. The difficulty swallowing makes it more likely for them to choke on food, fluids or secretions, and then develop pneumonia, an infection of the lungs. This can lead to complications with breathing that result in death.</li><li>The child has status epilepticus, defined as a seizure lasting longer than 30 minutes; however, status epilepticus is less likely to cause death in children than in adults.</li><li>The child is injured during a seizure, for instance through head injuries, drowning, burns or suffocation.</li></ul><p>In the absence of these factors, the risks to the child are very low. Most of the time, death is related to the underlying cause of the epilepsy. If a child is otherwise in good health, their risk of death is small. Talk to your child's doctor about their specific situation.</p><h2>SUDEP (Sudden Unexplained Death in Epilepsy)</h2><p>SUDEP is defined as death for no obvious reason in a person with epilepsy. These deaths occur most often suddenly at nighttime. SUDEP does not always involve a recent seizure. In some cases, there is no evidence that a recent seizure has occurred.</p><p>SUDEP affects one in 1,000 people with epilepsy each year. The rates of SUDEP are about the same in adults and children; however, rates are higher in adults and children with seizures that are not well controlled by medication. </p><p>The most well-proven risk factors for SUDEP is frequent seizures, especially a type of seizure called generalized tonic-clonic seizures. Having even a few of these types of seizures each year increases SUDEP risk. SUDEP is also more common in people who have a neurological problem of which epilepsy is one of the symptoms and those with difficulty following their anti-seizure medication regimen (such as skipping doses).</p><p>More information about SUDEP and support for families who have been affected is available from <a href="https://www.sudep.news/">SUDEP Aware</a> and the <a href="https://www.epilepsy.com/living-epilepsy/our-programs/about-sudep-institute">SUDEP Institute</a>.</p><h2>Resources</h2><p><a href="https://ontarioepilepsyguidelines.ca/">Ontario Epilepsy Guidelines</a> — Find recommendations to improve the quality and consistency of care for people living with epilepsy. These may be helpful in advocating for care for your child with epilepsy.</p>
What does scoliosis look like?WWhat does scoliosis look like?What does scoliosis look like?EnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)Vertebrae;SpineMuscular system;Skeletal systemConditions and diseasesAdult (19+)NA2020-09-08T04:00:00Z7.1000000000000072.8000000000000542.000000000000Flat ContentHealth A-Z<p>There are five different curve patterns in the spines of children with scoliosis. Learn about these, and other physical changes that can occur. </p><p>There are three parts to the spine: the cervical spine (neck), the thoracic spine (mid back), and the lumbar spine (lower back). Usually, the spine looks relatively straight when viewed from the front or back. In patients with scoliosis, the spine curves sideways, usually into the shape of an <em>S</em> or a <em>C</em>. An S-shaped curve is also called a double curve. A C-shaped curve is also called a single curve.</p><h2> Key points </h2><ul><li>The spine is made up of three major sections: the cervical spine (neck), the thoracic spine (mid back) and the lumbar spine (lower back).</li><li>Scoliosis is when the spine curves sideways, typically into an S-shape (a double curve) or a C-shape (single curve).</li><li>A curve in the spine can be accompanied by changes to the rib cage, shoulders and hips. As the curve in the spine increases, the spine and ribs twist, making the ribs more pronounced on the side of the curve (a "rib prominence.")</li></ul>
What happens if scoliosis is not treated?WWhat happens if scoliosis is not treated?What happens if scoliosis is not treated?EnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)Vertebrae;SpineMuscular system;Skeletal systemConditions and diseasesAdult (19+)NA2008-06-01T04:00:00Z8.7000000000000061.1000000000000355.000000000000Flat ContentHealth A-Z<p>Informed decision making is an important component of choosing whether to treat scoliosis. Learn about what can happen if scoliosis is not treated.</p><p> Without treatment, your teen's curve may increase. Their doctor and an orthopaedic surgeon can advise as to whether surgery is the best option.</p><h2> Key points </h2><ul><li>A young teen with a medium to large sized curve will probably see their curve increase without treatment.</li><li>Older teens with a small or medium curve will probably not see an increase.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/what_happens_if_scoliosis_is_not_treated.jpg
What is a blood and marrow transplant?WWhat is a blood and marrow transplant?What is a blood and marrow transplant?EnglishHaematology;Immunology;OncologyChild (0-12 years);Teen (13-18 years)BodyImmune systemProceduresAdult (19+)NA2010-02-12T05:00:00Z7.5000000000000066.10000000000001166.00000000000Flat ContentHealth A-Z<p>Learn what a blood and marrow transplant is, and where blood stem cells come from.</p><p>During a blood and marrow transplant (BMT), doctors replace your child’s bone marrow system with healthy blood stem cells. These stem cells are young, immature cells that grow into more specialized cells. The stem cells your child receives during the transplant will grow into mature blood cells. During the transplant, your child’s bone marrow absorbs the healthy stem cells. Once inside the bone marrow, the cells start to produce healthy blood cells. This process is called engraftment.</p><h2>Key points</h2><ul><li>Your child may need a BMT because they have too few blood stem cells, the blood cells do not work properly, or as part of cancer treatment.</li><li>Healthy blood stem cells can come from bone marrow, circulating (peripheral) blood, and cord blood.</li><li>Graft vs host disease is a common complication that can occur when a child receives a BMT.</li></ul>https://assets.aboutkidshealth.ca/akhassets/Graft_vs_Host_Disease_MED_ILL_EN.jpg
What is a good A1c reading?WWhat is a good A1c reading?What is a good A1c reading?EnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemTestsAdult (19+)NA2016-10-17T04:00:00Z8.1000000000000063.6000000000000285.000000000000Flat ContentHealth A-Z<p>Find out what a good A1c reading is and what it means for your child.</p><p>An A1c test measures the average glucose level over the previous three months. This section will tell you what a good A1c reading is.</p><h2>Key points</h2> <ul><li>A child should aim for an A1c level based on their age.</li> <li>Your child should have their A1c measured and recorded every three months.</li> <li>Children and teens using insulin pumps may be able to aim for lower blood glucose targets and achieve lower A1c levels.</li></ul>https://assets.aboutkidshealth.ca/akhassets/IMN_hemoglobin_A1c_targets_EN.png
What is asthma?WWhat is asthma?What is asthma?EnglishRespiratoryChild (0-12 years);Teen (13-18 years)LungsRespiratory systemConditions and diseasesAdult (19+)NA2009-01-29T05:00:00Z6.1000000000000069.7000000000000390.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Asthma is the most common chronic condition in children. Learn about what happens during an asthma attack and how bronchiole constriction affects breathing.</p><p>Asthma is a chronic lung condition. When properly managed, children with asthma can live perfectly normal lives.</p><h2> Key points </h2><ul><li>Asthma can be a lifelong condition, but good asthma control can allow your child to live a normal life.<br></li><li>Asthma symptoms are different in different children.</li><li>In certain conditions, a child with asthma's airways become narrower, making it harder to breathe.<br></li></ul><figure class="asset-c-100"> <span class="asset-anim-title">What happens during an asthma attack?</span> <div class="asset-animation asset-cv-animation"> <iframe src="https://www.aboutkidshealth.ca/Style%20Library/akh/animation/What%20happens%20during%20an%20asthma%20attach/WhatHappensDuringAsthmaAttack_CANVAS_EN%20.html"></iframe>  </div> <p class="sr-only">This click-through animation demonstrates what happens within the lungs during an asthma attack and how medications can help.</p> </figure> <p>Asthma is a condition that affects your child's lungs. The most common signs of problems with asthma include:</p><ul><li>feeling short of breath</li><li>tightness in the chest<br></li><li>coughing</li><li>wheezing</li></ul><p>These symptoms may be mild, moderate, or severe. Sometimes your child may feel well, and at other times your child may feel worse because of the asthma.</p><p>Asthma may affect your child's lungs for the rest of their life. But with good asthma control, your child can go on to live a perfectly normal life.</p><p>Asthma is the most common chronic (long-term) illness in children. About 10 per cent to 13 per cent of children have asthma.</p><h2>Asthma symptoms are not always the same</h2><p>Asthma symptoms are different in different children, even within the same family.</p><p>Your child may have different asthma symptoms triggered by different things.</p><p>Your child's symptoms may look or feel different from one episode to the next. They may change over time.</p>https://assets.aboutkidshealth.ca/akhassets/Asthma_MED_ILL_EN.jpg
What is autism spectrum disorder?WWhat is autism spectrum disorder?What is autism spectrum disorder?EnglishNeurologyChild (0-12 years)NANervous systemConditions and diseasesAdult (19+)NA2009-03-09T04:00:00Z8.2000000000000060.5000000000000989.000000000000Flat ContentHealth A-Z<p>General information about autism spectrum disorder, its possible causes, and how it is diagnosed. Also discusses related conditions such as pervasive developmental disorder and Asperger's syndrome.</p><br><p>Autism spectrum disorder affects your child's social behaviour, communication, and play behaviour and interests. This page explains general characteristics of ASD, how ASD is diagnosed, and common misconceptions about its causes. </p><h2> Key points </h2> <ul><li>Autism spectrum disorder (also called ASD) refers to a specific set of behavioural and developmental issues affecting your child's communication, social and play skills. </li> <li> Every child with ASD is unique and has their own combination of characteristics.</li> <li> A diagnosis of ASD is based on what a medical doctor or psychologist observes and learns about your child’s behaviour and development in the early years. </li> <li> ASD is not a mental illness. </li> <li> No one specific cause of ASD is known. </li> <li> There is no medical cure for the difference in the brain that cause ASD, but with the right treatment, some behaviours can be changed. </li></ul>https://assets.aboutkidshealth.ca/AKHAssets/what_is_autism_spectrum_disorder.jpg
What is diabetesWWhat is diabetesWhat is diabetesEnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemConditions and diseasesAdult (19+)NA2016-10-17T04:00:00Z8.3000000000000061.6000000000000851.000000000000Flat ContentHealth A-Z<p>Diabetes is a life-long condition. Learn what causes it and what role insulin plays in the body.</p><p>Diabetes is a life-long condition that occurs when the body is not able to use and store sugar for energy.</p><h2>Key points</h2> <ul><li>Diabetes occurs when the body is not able to use and store sugar for energy</li> <li>Insulin is made in the pancreas and helps the body use and store glucose for energy.</li> <li>In order for us to supply our bodies with energy, we must eat food.</li> <li>Carbohydrates are used for energy by the cells after they break down into sugar.</li></ul>https://assets.aboutkidshealth.ca/akhassets/IMD_pancreas_cells_EN.jpg
What is juvenile idiopathic arthritis?WWhat is juvenile idiopathic arthritis?What is juvenile idiopathic arthritis?EnglishRheumatologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemNAAdult (19+)Joint or muscle pain;Pain2017-01-31T05:00:00Z8.3000000000000058.5000000000000596.000000000000Flat ContentHealth A-Z<p>JIA can occur in young people, up to age 16. Discover the differences in arthritis between young people and adults, how common arthritis is in young people, and how it can affect the joints.</p><p>The word arthritis comes from the Greek words "arthron" meaning "joint," and "itis", meaning inflammation. Thus, arthritis is inflammation in the joints, the places where the bones come together. Many people think that arthritis is something only old people get. Children and teenagers get a type of arthritis called juvenile idiopathic arthritis (JIA). "Juvenile" means young (16 years of age or younger) and "idiopathic" means the cause is not known. JIA is also sometimes called juvenile rheumatoid arthritis (JRA).</p><h2>Key points</h2><ul><li>Arthritis is inflammation in the joints, the places where the bones come together.</li><li>JIA affects about 10,000 children and teens in Canada.</li><li>Symptoms of joint inflammation include redness, swelling, warmth, stiffness, and pain.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/what_is_jevenile_ideopathic_arthritis.jpg
What is the difference between IBD and IBS?WWhat is the difference between IBD and IBS?What is the difference between IBD and IBS?EnglishGastrointestinalPre-teen (9-12 years);Teen (13-18 years)Small Intestine;Large Intestine/ColonLarge intestine;Small intestineConditions and diseasesCaregivers Adult (19+)NA2011-01-24T05:00:00Z10.100000000000050.1000000000000829.000000000000Flat ContentHealth A-Z<p>Find out how inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are each diagnosed and treated.<br></p><figure> <span class="asset-image-title">Digestive system</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_digestive_system_V3_EN.jpg" alt="The salivary glands, esophagus, stomach, large and small intestines, anus, pancreas, gallbladder and liver" /> </figure> <p>When children have chronic troubles with their digestive system and parents start looking for answers, they often get confused between <a href="/Article?contentid=823&language=English">irritable bowel syndrome (IBS)</a> and <a href="/Article?contentid=821&language=English">inflammatory bowel disease (IBD)</a>. While many of the symptoms of these two conditions are similar, there’s actually a large difference between the two. These differences also include how each is diagnosed and treated.</p><h2>Key points</h2><ul><li>Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) have similar symptoms but are different conditions.</li><li>IBD causes inflammation. There are two types of IBD, ulcerative colitis (affects the colon) and Crohn's disease (affects any part of the digestive system).</li><li>IBS does not cause inflammation. With IBS, the digestive system appears normal but does not work properly.</li></ul><p>For more information, you can reach Specialty Food Shop Dietitians with your nutrition questions by calling 1-800-737-7976 (toll-free line) Monday to Friday or by sending an e-mail to <a href="mailto:sfs.admin@sickkids.ca">sfs.admin@sickkids.ca</a>. Or, visit the web site at <a target="_blank" href="https://www.specialtyfoodshop.ca/">www.specialtyfoodshop.ca</a>.</p>https://assets.aboutkidshealth.ca/akhassets/IMD_digestive_system_V3_EN.jpg
What to do in case of a seizureWWhat to do in case of a seizureWhat to do in case of a seizureEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemConditions and diseasesCaregivers Adult (19+) EducatorsNA2010-02-04T05:00:00Z7.7000000000000067.90000000000002208.00000000000Flat ContentHealth A-Z<p>Read about what to do in case of each type of seizure to ensure your child's safety and comfort.</p> <p>Some seizures only involve short periods of unresponsiveness and do not require specific interventions. Other types of seizures are more intense and so require specific interventions such as ensuring the child maintains a clear airway to allow air into the lungs. </p> <p>It is important for you, your family members, teachers, babysitters, and anyone else who looks after your child to know what to do when your child has a seizure. The most important things to do in response to any type of seizure are to remain calm and to keep your child safe. No matter what the seizure type, if your child seems to be having prolonged seizures, many seizures in a short period of time (clusters of seizures), or many more seizures than usual, seek medical attention.</p> <p>Here are some suggestions for how to help your child with different seizure types. You may find that some tips work better than others, or that your child needs one particular type of help during a seizure. You may already know or will come to know what works best for your child. Let other people know as well. </p><h2>Key points</h2> <ul><li>When your child has a seizure, remain calm, keep them safe and make them as comfortable as possible.</li> <li>Observe and take notes about your child's seizure, for instance when and how the seizure began, what your child's movements were like during and right after the seizure and how long the seizure lasted.</li> <li>Call 911 if your child's seizure lasts a long time (more than five minutes), if your child does not regain consciousness after a seizure or if your child seems confused for more than an hour after the seizure ends. </li> <li>Call your child's doctor if your child's seizures seem unusual or are happening more often than usual.</li> </ul>
What to do when your teen is not learning new health-care skillsWWhat to do when your teen is not learning new health-care skillsWhat to do when your teen is not learning new health-care skillsEnglishOtherTeen (13-18 years)NANAProceduresCaregivers Adult (19+)NA2021-03-03T05:00:00Z9.5000000000000063.8000000000000551.000000000000Flat ContentHealth A-Z<p>Learn some of the reasons why teens may stop doing self-care tasks and what you can do to help them. Also learn about some of the issues that teens with special needs have and how to help them learn new tasks.</p><p>There are many reasons that a teen may not be doing well learning or maintaining self-care tasks. Teens can feel unmotivated, find the tasks annoying and interfering, or they may be burned out or overwhelmed. There are also teens with special needs, such as developmental disabilty, that may need additional help and more time to learn new skills.</p><h2>Key points</h2><ul><li>If your teen has stopped doing a self-care task or is not doing it well then talk to your teen about it. If that does not help then talk to someone on your teen’s health-care team.</li><li>Teens with special needs, such as developmental disability, may need more time and help to learn new skills.</li></ul><p> Share these teen-specific articles with your child about what to expect when transitioning to adult care: <a href="https://teens.aboutkidshealth.ca/adolescenthealth?topic=adulthealthcare">Adolescent Health - Transition to Adult Care</a> and  <a href="https://teens.aboutkidshealth.ca/adolescenthealth?topic=chronicconditions">Adolescent Health - Managing Chronic Conditions</a></p><p></p>https://assets.aboutkidshealth.ca/AKHAssets/transplant_what_to_do_when_your_teen_is_not_learning_new_healthcare_skills.jpg
What to expect on the day of epilepsy surgeryWWhat to expect on the day of epilepsy surgeryWhat to expect on the day of epilepsy surgeryEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemProceduresCaregivers Adult (19+) EducatorsNA2010-02-04T05:00:00Z7.2000000000000068.50000000000001256.00000000000Flat ContentHealth A-Z<p>Read about what a child will experience in the hours leading up to their epilepsy surgery.</p><p>Your child's healthcare team will meet with you and your child in the days or weeks before surgery to discuss the preparations that will be needed before you come to the hospital. </p><h2>Key points</h2> <ul><li>On the day of surgery, your child will have their hair washed and will have some of it shaved in the operation room.</li> <li>Your child will receive a general anaesthetic to make them sleep during the surgery. Follow the pre-anaesthetic eating and drinks instructions from the healthcare team.</li> <li>After surgery, your child will receive pain relieving medications in the recovery room and will be monitored by a nurse.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/what_to_expect_on_the_day_of_epilepsy_surgery.jpg
What your newborn baby looks likeWWhat your newborn baby looks likeWhat your newborn baby looks likeEnglishNeonatologyNewborn (0-28 days)NANANAAdult (19+)NA2009-10-18T04:00:00Z7.6000000000000069.90000000000001784.00000000000Flat ContentHealth A-Z<p>Learn about what your newborn baby looks like at birth, including detailed descriptions of their head, face, eyes, skin, arms, legs, genitals and urine.</p><p>When your baby is born, they may not look exactly as you expected. If you have not spent much time around newborn babies up until this point, you may be downright surprised at their appearance. However, after a few days your baby will begin to look more like what you expected a baby to look like.</p><h2>Key points</h2> <ul><li>Babies who were born vaginally may have an elongated head or "cone head" due to pressure on the skull to fit through the birth canal; babies born by C-section will have a rounder head.<br></li> <li>You may notice changes in your baby's skin, limbs, genitals, stool and urine over the next few weeks.</li> <li>Most newborn babies do not take in much nourishment in the first three to four days of life and may experience some weight loss.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/what_your_newborn_baby_looks_like.jpg
Wheat allergyWWheat allergyWheat allergyEnglishAllergyChild (0-12 years);Teen (13-18 years)BodyImmune systemConditions and diseasesCaregivers Adult (19+)NA2021-03-08T05:00:00Z8.9000000000000059.20000000000001061.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Find out how to help your child manage a wheat allergy.</p><h2>What is a wheat allergy?</h2><p>A wheat allergy occurs when the body reacts to one or more of the proteins found in wheat.</p><p>A wheat allergy is very different from a condition known as <a href="/Article?contentid=816&language=English">celiac disease</a>. With celiac disease, a person cannot tolerate gluten, a different protein found in wheat and other grains.</p><h2>How serious is a wheat allergy?</h2><p>Wheat allergy reactions are different for each child, but they usually happen soon after your child consumes wheat. Inhaling wheat flour can also trigger a reaction in some children.</p><p>A wheat allergy carries the risk of <a href="/Article?contentid=781&language=English">anaphylaxis</a>, a severe and life-threatening allergic reaction.</p><h2>Key points</h2><ul><li>A child with a wheat allergy will usually outgrow it as they get older. The protein responsible for a wheat allergy is different from that responsible for a gluten intolerance. </li><li>Other names for wheat include bulgur, farina, spelt, couscous, semolina and graham flour. Food products that contain wheat include baked goods, canned soups, salad dressings, cereals, pastas, seasonings and soy sauce.</li><li>Your child can get the nutrients in wheat from other foods such as vegetables, fruit, rice, peas, beans, milk, cheese and meat. Safe wheat-free grain alternatives include quinoa, millet, oats, barley and corn. </li><li>To prevent an allergic reaction, always read food product labels, avoid foods if you are not sure of the ingredients and avoid using utensils or containers that might have come in contact with wheat.</li><li>If your child's diet is limited because of a wheat allergy, a registered dietitian can offer advice on getting a balanced diet.</li></ul><h2>Possible sources of wheat</h2> <p>Wheat is used in a range of packaged foods. Below is a list of some of the many food products that contain wheat.</p> <table class="akh-table"> <tbody> <tr> <td>Baked goods and baking mixes (cakes, cookies, donuts, muffins)</td> <td>Baking powder, flour, icing sugar</td> </tr> <tr> <td>Battered or fried foods</td> <td>Bread, cereals, crackers, pastas</td> </tr> <tr> <td>Canned soups (“thickened” soups)</td> <td>​Coffee substitutes</td> </tr> <tr> <td>Gelatinized or modified starch</td> <td>Ice cream</td> </tr> <tr> <td>Meat, fish and poultry binders and fillers (found mainly in deli meats and hot dogs)</td> <td>Natural flavouring (from malt or wheat)</td> </tr> <tr> <td>Pie fillings</td> <td>Prepared ketchup, mustard</td> </tr> <tr> <td>Salad dressings, sauces, gravy</td> <td>Seasonings, spices</td> </tr> <tr> <td>Snack foods (candy, chocolate bars)</td> <td>Soy sauce</td> </tr> </tbody> </table><h2>What do I do if my child has a wheat allergy?</h2><p>Your child should see an allergist (a doctor who specializes in diagnosing and treating allergies) who can discuss the wheat allergy with you in more detail. Children who have a wheat allergy should avoid all products that may contain wheat.</p><p>Your child’s doctor may also prescribe a medication called an <a href="https://www.aboutkidshealth.ca/article?contentid=130&language=English">epinephrine auto-injector</a>, which can be used to treat allergic reactions, in case your child accidentally eats a food containing wheat.</p><h2>Reducing the risk of cross-contamination</h2><p>Cross-contamination occurs when one substance unintentionally comes in contact with another substance, for example a potential allergen. If the substances mix together, one substance taints the other substance, making it unsafe to eat.</p><p>Food allergens can contaminate other foods when, for example, the same containers, utensils or frying pans hold a range of foods.</p><p>Bulk food containers pose a high risk of cross-contamination because they are often used for different products.</p><p>Be sure to avoid using utensils or containers that may have come in contact with allergy-causing foods and ask about possible cross-contamination when eating out.</p><h2>How can my child get the right mix of nutrients if they must avoid wheat?</h2><p>The main nutrients in wheat include fibre, <a href="https://www.aboutkidshealth.ca/Article?contentid=1444&language=English">protein</a>, B vitamins, <a href="https://www.aboutkidshealth.ca/Article?contentid=1449&language=English">folate</a>, <a href="https://www.aboutkidshealth.ca/Article?contentid=1450&language=English">iron</a>, <a href="https://www.aboutkidshealth.ca/Article?contentid=1451&language=English">magnesium</a> and <a href="https://www.aboutkidshealth.ca/Article?contentid=1452&language=English">zinc</a>. Your child can still get these nutrients even if they must avoid wheat.</p><h3>Nutrients in wheat that are found in other foods</h3><table class="akh-table"><thead><tr><th>Nutrient</th><th>Where to find it</th></tr></thead><tbody><tr><td>Fibre</td><td>Vegetables, fruit</td></tr><tr><td>Protein</td><td>Meat, fish, poultry, eggs, cheese, milk, beans, soy</td></tr><tr><td>B vitamins</td><td>Rice, milk, cheese, beef</td></tr><tr><td>Folate</td><td>Leafy green vegetables, beans (navy, pinto, kidney, garbanzo), lentils</td></tr><tr><td>Iron</td><td>Spinach, tomato puree, edamame (soy beans), lima beans, snow peas, instant oatmeal, cereal</td></tr><tr><td>Magnesium</td><td>Peas, pumpkin, squash or sesame seeds</td></tr><tr><td>Zinc</td><td>Meat, fish, poultry, vegetables</td></tr></tbody></table><h2>Wheat-free bread and cereal alternatives</h2><p>A wheat allergy does not mean that your child must avoid all cereals, breads, pastas or baked goods. Safe, wheat-free alternatives include products made from rice, corn, potato, sorghum, oats, barley, amaranth, buckwheat, tapioca, millet, arrowroot, soy, lentils, peas, beans and quinoa. Foods labelled “gluten free” are also safe to eat since all gluten-free foods are also free of wheat. Always read the nutrition label to make sure ingredients have not changed.</p><h2>When to go to the emergency room</h2><p>If your child is having a severe allergic reaction to wheat, call 911 or go to your nearest emergency department immediately. If your child’s doctor prescribed them an epinephrine autoinjector, administer this medication to your child right away. See <a href="https://www.aboutkidshealth.ca/Article?contentid=781&language=English">Anaphylaxis: How to recognize and respond to a severe allergic reaction</a> for more information.</p><h2>​Further information</h2><p>Health Canada. <a href="https://www.canada.ca/en/health-canada/services/food-nutrition/reports-publications/food-safety/wheat-priority-food-allergen.html" target="_blank">Wheat & Triticale - Priority food allergens</a></p>https://assets.aboutkidshealth.ca/AKHAssets/wheat_allergy.jpg
When babies feel painWWhen babies feel painWhen babies feel painEnglishNeonatologyNewborn (0-28 days)BodyNANAAdult (19+)Pain2010-10-18T04:00:00Z9.0000000000000061.8000000000000816.000000000000Flat ContentHealth A-Z<p>Pain is experienced by people of all ages, including babies. Learn about what causes pain and how to help alleviate pain in newborn babies.</p><p>Just like adults and older children, babies can feel pain. In addition to being able to feel pain, babies also have the right to pain relief. Every reasonable effort should be made to keep babies pain free. </p><h2>Key points</h2> <ul><li>Pain results when we are exposed to situations that are likely to lead to injury or tissue damage.</li> <li>Acute pain is short-term and chronic pain is long-term, lasting at least three months without interruption.</li> <li>Babies may experience pain because they are sick or injured in some way or from painful procedures, both diagnostic and therapeutic.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/when_babies_feel_pain.jpg
When brain tumour treatment affects learningWWhen brain tumour treatment affects learningWhen brain tumour treatment affects learningEnglishNeurology;DevelopmentalChild (0-12 years);Teen (13-18 years)BrainNervous systemNAAdult (19+)NA2009-07-10T04:00:00Z8.4000000000000057.30000000000001232.00000000000Flat ContentHealth A-Z<p>Detailed information concerning the impact that treatment, tumours, and surgery may have on your child's ability to learn.</p><p>Some children treated with radiation therapy or with certain types of chemotherapy develop problems with learning. These are called neurocognitive late effects. They do not appear right away, but develop slowly and appear one to two years after treatment. </p> <p>If your child is at risk of developing these problems, you and your child’s teachers will need to work together to make sure your child has the extra help they need. In some cases, a neuropsychological assessment may be needed to help understand your child’s abilities and areas needing special education services. </p><h2>Key points</h2> <ul><li>Radiation or certain types of chemotherapy can cause learning problems in some children.</li> <li>Children may develop problems with reading, writing, math, speech, attention and memory.</li> <li>Early intervention is important to address any learning problems your child may experience.</li> <li>A neuropsychological assessment can help to provide recommendations for your child in the classroom.</li></ul>
When to worry about mathematicsWWhen to worry about mathematicsWhen to worry about mathematicsEnglishDevelopmentalToddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years)NANANAPrenatal Adult (19+)NA2009-10-31T04:00:00Z8.2000000000000052.7000000000000302.000000000000Flat ContentHealth A-Z<p>Math skills are divided into different categories. Within these categories, here are some specific signs that your child may be having difficulty. </p><p>Math skills are divided into different categories. Within these categories, there are some specific signs that your child may be having difficulty. </p><h2>Key points</h2> <ul><li>Math skills are divided into five categories: number sense and numeration; measurement; geometry and spatial sense; patterning and algebra; data management and probability.</li> <li>Within each category there are specific signs that your child may be having difficulty in that area.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/when_to_worry_about_mathematics_premature_babies.jpg
When to worry about reading problemsWWhen to worry about reading problemsWhen to worry about reading problemsEnglishDevelopmentalToddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years)NANANAPrenatal Adult (19+)NA2009-10-31T04:00:00Z10.000000000000065.4000000000000245.000000000000Flat ContentHealth A-Z<p>There are several signs you can look for to determine if your child is having trouble with reading. While all children develop at their own pace, if you suspect your child has a problem, the earlier it is resolved the better the outcome will be for their future learning.</p><p>There are several signs you can look for to determine if your child is having trouble with reading. While all children develop at their own pace, if you suspect your child has a problem, the earlier it is resolved the better the outcome will be for their future learning.</p><h2>Key points</h2> <ul><li>There are several signs to look for at each grade level that will indicate if a child is having problems with reading.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/when_to_worry_about_reading_problems.jpg
When to worry about speech and languageWWhen to worry about speech and languageWhen to worry about speech and languageEnglishDevelopmentalBaby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years)NANANAPrenatal Adult (19+)NA2009-10-31T04:00:00Z10.600000000000053.9000000000000437.000000000000Flat ContentHealth A-Z<p>There are a number of markers you can watch for to help make decisions about whether to seek a professional opinion about your child's language development. </p><p>While each individual child develops at a different rate, there are certain signs to look for that indicate their speech and language are not developing properly.</p><h2>Key points</h2> <ul><li>There are a number of signs you can watch for to help make decisions about whether to seek a professional opinion about your child's language development.</li> <li>In the classroom, language problems may become obvious if the child has trouble understanding instructions and new concepts.</li> <li>When problems with language are not attended to early, they can lead to negative effects on listening and reading comprehension in later grades.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/when_to_worry_about_speech_and_language_premature_babies.jpg
When to worry about visuomotor skillsWWhen to worry about visuomotor skillsWhen to worry about visuomotor skillsEnglishDevelopmentalPremature;Newborn (0-28 days);Baby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years)NANANAPrenatal Adult (19+)NA2009-10-31T04:00:00Z9.3000000000000057.0000000000000335.000000000000Flat ContentHealth A-Z<p>Learn to recognize problems with visuomotor skill development. Trouble controlling a pencil and trouble colouring within lines are a few good indications. </p><p>While each child is different and develops at their own pace, there are certain signs that your child's visuomotor skills are developing poorly. This could have a negative effect on your child's success in the classroom.</p><h2>Key points</h2> <ul><li>There are certain signs that your child's visuomotor skills are not developing properly such as poor pencil grip and poor scanning of visual material.</li> <li>Poor development of visuomotor skills will also impact your child's success in the classroom.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/when_to_worry_about_visuomotor_skills.jpg
Whole grainsWWhole grainsWhole grainsEnglishNutritionChild (0-12 years);Teen (13-18 years)NADigestive systemHealthy living and preventionCaregivers Adult (19+) Educators Hospital healthcare providers Community healthcare providers Remote populations First nationsNA2021-05-13T04:00:00Z6.5000000000000075.6000000000000458.000000000000Flat ContentHealth A-Z<p>Learn about the nutritional benefits of whole grains and how to include them in your daily meals and snacks.</p><h2>What are whole grains?</h2><p>Whole grains contain all three parts of a plant’s seed—the bran, the endosperm and the germ. When the germ and the bran are removed from the grain, the grain is considered “refined” (examples include white rice and white flour). These are not as nutritious as whole grains because some of the proteins, fibre and nutrients have been removed. Whole wheat foods are often partially refined, which means they may not be whole grain foods but are still healthy choices.</p><p>Examples of whole grains include:</p><ul><li>Whole grain brown rice</li><li>Whole grain wild rice</li><li>Whole grain pasta</li><li>Whole grain breads</li><li>Whole grain oatmeal</li><li>Quinoa</li><li>Barley</li><li>Buckwheat</li><li>Farro</li><li>Freekah</li><li>Amaranth</li></ul><h2>Key points</h2><ul><li>Whole grain products are a source of fibre, vitamins and minerals.</li><li>Whole grains can lower your risk of some diseases.</li><li>One quarter of each of your child’s meals or snacks should be whole grains.</li></ul>
Williams syndrome and congenital heart conditionsWWilliams syndrome and congenital heart conditionsWilliams syndrome and congenital heart conditionsEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemConditions and diseasesAdult (19+)NA2009-12-14T05:00:00Z10.600000000000042.1000000000000314.000000000000Flat ContentHealth A-Z<p>Most children with Williams syndrome have a heart or blood vessel problem.</p><p> Most children with Williams syndrome have a heart or blood vessel problem.</p><h2> Key points </h2> <ul><li>Williams syndrome is a rare, spontaneous condition in which chromosome 7 is missing genetic material.</li> <li>Most children with Williams syndrome have heart or blood vessel problems.</li> <li>Children with Williams syndrome have certain physical characteristics as well as physical and developmental problems, very outgoing personalities, and poor motor control. </li></ul>
Wilson diseaseWWilson diseaseWilson diseaseEnglishGeneticsChild (0-12 years);Teen (13-18 years)Brain;LiverLiver;BrainConditions and diseasesCaregivers Adult (19+)NA2013-06-12T04:00:00Z6.9000000000000066.20000000000001053.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Wilson disease is a genetic disorder that allows copper to build up in the body. Learn about how it is diagnosed and treated.</p><h2>What is Wilson disease?</h2> <p>Wilson disease is a genetic disorder that allows copper to build up in the body and cause damage.</p> <h3>Our body needs a small amount of copper</h3> <p>To work well, our body needs a small amount copper. Copper is a metallic element. It helps keep the immune system healthy, build strong bones and form red blood cells. We absorb copper from a variety of food such a nuts, seeds, oysters and liver. Normally, our bodies regularly dispose of copper to prevent it from accumulating in the body.</p> <h3>Too much copper damages the tissues</h3> <p>Some children are unable to get rid of copper. This inability is a disorder called Wilson disease. The excess copper is stored in the main organs, such as the liver, brain, kidneys and eyes. In the liver, extra copper causes damage and scarring. This causes the liver to stop working correctly.</p><h2>Key points</h2> <ul> <li>Wilson disease is a genetic disorder that allows copper to damage the liver.</li> <li>Children are born with Wilson disease.</li> <li>Doctors diagnose Wilson disease by taking blood tests, urine samples, liver biopsy and a genetic test.</li> <li>Treatment requires a life-long commitment to eating a low-copper diet and taking prescription medicines.</li> <li>After treatment starts, the health care team will book follow-up appointments to monitor your child.</li> </ul><h2>Signs and symptoms of Wilson disorder</h2><p>Symptoms are more likely in children 10 years and older. In Wilson disease, copper usually accumulates in the liver and brain. This is why symptoms are mainly liver disease and neurological problems.</p> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_wilson_disease_affected_organs_EN.jpg" alt="Upper body of a child with brain and liver identified" /> </figure> <h3>Symptoms of liver disease</h3><ul><li>tiredness</li><li>yellow skin (<a href="/Article?contentid=775&language=English">jaundice</a>) or yellow colour of the white of the eyes</li><li>enlargement of the abdomen</li><li>vomiting blood</li></ul><h3>Symptoms of neurological problems</h3><ul><li>confusion<br></li><li>emotional or behavioral changes such as depression, anxiety and psychosis</li><li>slow or decreased movement</li><li>slurred speech</li><li>tremors in the hands</li><li>clumsiness</li><li>worsening of academic performance</li></ul><h2>Wilson disease is a genetic disease</h2><p>A change or mutation in a gene causes Wilson disease. Children are born with it.</p><p>If a person has one copy of this gene they are a carrier of the disease. About one in 100 people carry this gene. A child needs to be born with two copies of the gene to develop the disease. If both parents carry the gene for Wilson disease, there is a 25% chance their child will have the disorder.</p> <figure class="asset-c-80"> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_wilson_disease_inheritance_EN.jpg" alt="Chromosome distribution from parents carrying Wilson disease" /> </figure> <h2>How common is Wilson disease?</h2><p>About one in 30,000 people have Wilson disease. It is most common in eastern Europeans, Sicilians and southern Italians. Wilson disease typically appears in people under 20 years old. In children, it is rarely diagnosed before the age of four years. Younger children rarely show any symptoms. Doctors suspect Wilson disease during routine blood tests.</p><h2>Diagnosis of Wilson disease</h2> <p>If your child experiences the symptoms listed above or there is a known family history, the doctor may suspect Wilson disease.</p> <h3>Blood tests</h3> <p>To help confirm the diagnosis, the doctor will take a sample of your child's blood. They will test for:</p> <ul> <li>The amount of copper in the blood.</li> <li>The presence of liver enzymes. High levels of these enzymes mean the liver cells are damaged.</li> <li>The amount of a liver protein called albumin. Albumin levels decrease in the blood when the liver is damaged.</li> <li>How long it takes for the blood to clot</li> <li>The amount of a protein which transports copper in the blood, called ceruloplasmin. Its levels are lower in Wilson disease.</li> </ul> <p>The health care team will arrange for you to collect your child's urine over a 24-hour period. This will be explained in more detail when you are in clinic. They test the urine for copper levels.</p> <p>Excess copper in the eyes can cause dark rings to form around the iris. These are called Kayser-Fleischer rings. They are difficult to see without a special eye exam. Your child's doctor may do an eye exam to check for these rings. However, the absence of the Kayser-Fleischer rings does not rule out the disease.</p> <p>Your child's health care team may do other tests such as an <a href="/Article?contentid=1290&language=English">ultrasound</a> of the abdomen and a <a href="/Article?contentid=1272&language=English">CT scan</a> or <a href="/Article?contentid=1270&language=English">MRI</a> of the brain.</p> <h3>Liver biopsy</h3> <p>After finding signs that suggest Wilson disease, your child's doctor will take a sample of the liver. They check for specific changes in the liver. They also measure the amount of copper in the liver.</p> <h3>Genetic test for Wilson disease</h3> <p>The doctor may use a sample of your child's blood to run a genetic test for the Wilson disease gene. You will likely wait several weeks before finding out the results of the test.</p><h2>Treatment for Wilson disease</h2> <p>Wilson disease is a life-long disease. However, your child can lead a better quality of life and avoid serious complications by carefully following the treatment plan.</p> <p>The goal of treatment is to lower the amount of copper in the tissues. It requires a life-long commitment, which involves: </p><h3>Eating a low copper diet</h3> <p>Your child should try to avoid eating the following copper-rich foods:</p> <ul> <li>chocolate</li> <li>dried fruit</li> <li>mushrooms</li> <li>nuts</li> <li>liver</li> <li>shell fish</li> </ul> <h3>Taking prescribed medicines</h3> <ul> <li>Zinc tablets which helps block copper from being absorbed in your intestines</li> <li>Penicillamine or trientene. These medicines bind with copper in the body and then both are excreted in the urine.</li> </ul> <h3>Continual monitoring</h3> <p>Your child's health care team will book follow-up appointments to:</p> <ul> <li>Ensure they are consistently taking medicines. Do routine blood tests to check the levels of liver enzymes and copper. This happens every four to six months.</li> <li>Collect urine samples for 24 hours to check for copper levels. Your child's health care team will do this about one to two times a year.</li> </ul> <h3>Liver transplant</h3> <p>In more serious cases, your child may be considered for a liver transplant. If this is an option for your child, the doctor will discuss the procedure more clearly with you.</p> <h2>Communicate with your child's health care team</h2> <p>Wilson's disease is a life-long condition. It is important to maintain open communication with your child's health care team. <a href="/Article?contentid=1144&language=English">Talk openly with the doctor</a> if you have any questions or concerns about your child's treatment. Make sure you update the doctor with any new symptoms your child may experience. Remember the health care team is there to support you and your child.</p>https://assets.aboutkidshealth.ca/akhassets/IMD_wilson_disease_affected_organs_EN.jpg
Winter tipsWWinter tipsWinter tipsEnglishNAChild (0-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+)NA2018-01-19T05:00:00Z000Landing PageLearning Hub<p>Winter is a time of year when we participate in outdoor activities and then gather around a fire. Unfortunately, we may also experience seasonal illnesses. Keep the family healthy during the cold weather with our winter tips.</p><p>Winter is a time when we experience cold weather, snow and ice. It is a time of year when we look forward to participating in outdoor activities and then gathering around a warm fire. Unfortunately, we may also experience those annoying seasonal illnesses. Keep the whole family safe, healthy and happy during the cold weather season with our winter tips.</p>wintersafetyhttps://assets.aboutkidshealth.ca/AKHAssets/winter_safety_landing_page.jpghttps://assets.aboutkidshealth.ca/AKHAssets/winter_safety_landing_page.jpg
Wound careWWound careWound careEnglishDermatologyChild (0-12 years);Teen (13-18 years)SkinSkinNon-drug treatmentCaregivers Adult (19+)NA2019-02-28T05:00:00Z5.9000000000000080.30000000000001364.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn how to care for sutures and stitches and how to keep the wound clean and what you can do to prevent scarring. </p><div class="asset-video"> <iframe src="https://www.youtube.com/embed/l8FkHMdzqh8?rel=0" frameborder="0"></iframe>  </div><p>Some wounds need to be repaired by a health care provider in a hospital or clinic. This information will help you care for your child’s wound at home after it is repaired.<br></p><h2>Key points</h2><ul><li>Ask the health care provider who is managing your child's wound what to expect in terms of healing and scarring.</li><li>See a doctor if your child has signs of infection, including fever or pain, redness and swelling at the wound.</li><li>Most wounds that go through the upper layers of skin will heal with a mark or scar. This mark may be more noticeable in the weeks following the injury, but it should mature or diminish over many months.</li></ul><h2>When to see a doctor</h2><p>As your child’s wound heals, the edges will become slightly pink. This is normal.</p><p>Watch for any signs of infection. Take your child to their regular doctor or the nearest Emergency Department if any of the following happen:</p><ul><li>Your child’s wound becomes painful, red or swollen</li><li>There is a yellowish or greenish fluid coming from your child’s wound</li><li>Your child develops a <a href="/article?contentid=30&language=english">fever</a> in the next 72 hours</li><li>Your child’s wound opens up or starts bleeding</li></ul><h2>Caring for a wound with stitches (regular or dissolving) or staples</h2><p>Keep the wound covered, clean, and dry. Keep your child’s wound completely covered with a bandage for ____ days. After that, you may want to put a bandage on to protect the wound during activities, but leave it off and leave the wound open to the air when your child is resting or in quiet activity at home. Do not let your child play with or pull on the stitches. If the stitches are on an arm or leg, raising the arm or leg will keep your child more comfortable.</p><p>Depending on your doctor’s instructions, you may need to change the bandage one or two times a day. To change the bandage, you need to remove the soiled bandage and apply a fresh one. You may also need to need to put antibiotic ointment (a cream that kills germs to prevent infection, such as Polysporin) on the wound two times a day for seven days or more, depending on the wound and your doctor’s advice.</p><p>When squeezing the antibiotic cream out of the container, avoid contamination by making sure not to touch the opening of the tube with a dirty finger or by applying the tube directly to the wound. Instead, squeeze the cream directly onto a clean cotton swab or cotton ball and then use this to apply it to the wound.</p><h3>Washing the wound</h3><p>After ____ days, you can gently wash the wound with mild soap and water. Wash it only one or two times each day. Do not rub or soak the wound.</p><h3>Bathing</h3><p>Do not give your child a bath if the wound will go under water. It may be easier to have your child stand up in the bathtub or shower and use a damp towel to wash the non-wounded parts of the body. A shower is another bathing option while the wound is healing.</p><h3>Protecting the stitches or staples</h3><p>Your child should avoid contact sports and swimming until their wound has closed and their stitches or staples have been removed. This will give the wound the best chance to heal. Try to prevent your child from playing with sand, mud or paint near their wound as this could cause the wound to get dirty which could lead to infection.</p><h3>Removing stitches or staples</h3><p>If your child’s wound was treated with regular stitches or staples, your child’s doctor should remove these in ____ days. If your child’s wound was treated with dissolving stitches, they do not need to be removed. They will dissolve, or melt away, on their own after ___ days.</p><h2>Caring for a wound treated with glue</h2><p>The glue should peel or fall off between five to 14 days.</p><p>There is no need to cover the wound with a bandage, but some parents may put a bandage over the wound to prevent the child from picking at the glue. Avoid using a bandage that could remove the glue if the bandage comes off. Your child does not need to see the doctor after the glue has peeled or fallen off.</p><h3>Bathing</h3><p>You should try to keep the wound dry for at least five days. After that, it is fine to wash the wound but do not soak in water for a long time. Do not give your child a bath if the wound . will be under water. It may be easier to have your child stand up in the bathtub or shower and use a damp towel to wash the non-wounded parts of the body. A shower is another bathing option while the wound is healing. After the shower, the wound should be patted dry with a towel. Your child should not swim while the glue is still in place.<br></p><h3>Protecting the wound and glue</h3><p>Do not pick or scratch the wound or the glue. Pat the wound dry and do not rub it. Avoid wearing tight clothing that could rub against the wound. Do not apply any creams or ointments to the wound until the glue peels or falls off. Applying creams or ointments may make the glue come off too soon.</p><h2>Caring for your child’s wound treated with adhesive strips (Steri-strips)</h2><p>You can trim the edges of the strips as they naturally separate from the skin with time. If the strips remain in place after seven days, you can remove them at home by soaking them in water. Your child does not need to go back to see the doctor after the strips have peeled off.</p><h3>Bathing</h3><p>Keep the wound and adhesive strips dry for the first 24 hours. Then you can gently wash the wound with soap and water. Do not soak or rub the wound. Your child can have a shower after which the wound can be patted dry with a towel. Your child must not swim for seven days.</p><h2>Occlusive dressings</h2><p>Sometimes your health care provider may suggest using a special layered dressing called an occlusive or semi-occlusive dressing. This type of dressing keeps the healing area moist and helps to promote the growth of new skin cells. It consists of : </p><ul><li>a base or "contact" layer that will not stick to the wound (non-adherent)</li><li>an absorbent layer to absorb any fluid or blood</li><li>an outer layer to anchor the dressing and provide some pressure, if needed</li></ul><p>You can buy these layers at the drugstore. Some adhesive bandages provide all three layers in one.</p><p>To change a layered dressing, you should usually leave the contact layer in place. Change the absorbent and outer layer every day, or more often if the dressing becomes dirty or wet. When changing the contact layer, remove it carefully so as to not disrupt the healing skin.</p>woundcarehttps://assets.aboutkidshealth.ca/AKHAssets/wound_care.jpg
Wrist fractureWWrist fractureWrist fractureEnglishOrthopaedics/MusculoskeletalChild (0-12 years);Teen (13-18 years)WristBonesNon-drug treatmentCaregivers Adult (19+)NA2009-11-10T05:00:00Z5.5000000000000081.3000000000000603.000000000000Health (A-Z) - ProcedureHealth A-Z<p>A wrist fracture requires a full cast or a half cast. Read about broken wrists, treatment, follow up appointments and recovery which can take up to a year. </p><figure> <span class="asset-image-title">Fractured wrist</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Fracture_wrist_MED_ILL_EN.jpg" alt="Wrist with fractured radius" /> <figcaption class="asset-image-caption">The radius, ulna and wrist bones (carpal bones) meet at the wrist joint. Any of these bones can be broken in a wrist fracture.</figcaption> </figure> <h2>A broken or fractured wrist</h2><p>Your child has a broken or fractured wrist. A fractured wrist might also be called a cracked wrist.<br></p><h2>Key points</h2> <ul> <li>Your child needs a half or full cast to heal a fractured or broken wrist. </li> <li>A half cast can be removed at home after about three weeks. </li> <li>A full cast will likely not be removed for at least six weeks. </li> <li>You child will need to avoid high-impact activities after the cast is removed. </li> <li>Your child's wrist may need a year to fully recover strength and movement.</li> </ul><h2>Your child will need a cast</h2> <p>For the bone to heal, your child will need a <a href="/Article?contentid=1178&language=English">cast</a> and possibly a sling. What type of cast your child will need depends on how serious the break or fracture was. </p> <p>Minor fractures usually only need a half cast. A more serious fracture or a break will probably need a full cast.</p> <h3>Half cast</h3> <p>A half cast will stay on for three to four weeks. About one week after the cast is put on, your child will need to have a follow-up appointment with the fracture clinic at the hospital. At the clinic, staff will make sure your child's wrist is healing properly. If your child has a half cast, you may also be shown how to remove the cast at home. </p> <p>Depending on the size of the fracture, it may take six months to a year before your child's wrist can fully straighten, bend and twist. However, most children do not need physiotherapy. </p> <h3>Full cast</h3> <p>If your child has a full cast, it will have to stay on for four to six weeks or perhaps longer. Your child will have follow-up appointments at one week, two weeks, and four to six weeks after the cast was put on. </p> <h2>Follow-up clinic information</h2> <p>Write down the dates and times of your follow-up appointments here:</p> <p>Write down the number of the fracture clinic here:</p> <p>Write down the name of the doctor or nurse at the fracture clinic here:</p>wristfracturehttps://assets.aboutkidshealth.ca/AKHAssets/wrist_fracture.jpg
Writing and printing resourcesWWriting and printing resourcesWriting and printing resourcesEnglishDevelopmentalPreschooler (2-4 years);School age child (5-8 years)NANASupport, services and resourcesCaregivers Adult (19+)NA2009-10-31T04:00:00Z10.200000000000042.9000000000000196.000000000000Flat ContentHealth A-Z<p>Learn about resources that are available for parents to help their children improve their writing and printing skills.</p><p>There are many resources available for parents to help their children improve their writing and printing skills. Here are just a few.<br></p><h2>Key points<br></h2><ul><li>​Use books, workbooks and other resources to help your child learn writing and printing skills.​<br></li></ul>https://assets.aboutkidshealth.ca/AKHAssets/writing_printing_resources.jpg
Writing disabilities: OverviewWWriting disabilities: OverviewWriting disabilities: OverviewEnglishDevelopmentalPreschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)NANAHealthy living and preventionAdult (19+) CaregiversNA2020-03-03T05:00:00Z11.000000000000042.90000000000001450.00000000000Health (A-Z) - ConditionsHealth A-Z<p>A writing disability is when a child of age-appropriate intellectual abilities has significant challenges with writing. Learn about writing disabilities, their symptoms, and how they are diagnosed and treated.</p><h2>What is a writing disability?</h2><p>A writing disability is a specific type of <a href="/Article?contentid=653&language=English">learning disability</a>. Children with writing disabilities have age-appropriate intellectual abilities, but experience challenges with writing. These difficulties affect how they perform in school, and their achievement falls well below what is expected for children of their age, grade and intellectual ability.</p><p>Writing disabilities may include problems with:</p><ul><li>Composition: generating, organizing, and/or elaborating on ideas</li><li>Spelling</li><li>Punctuation</li><li>Grammar</li><li>Handwriting</li></ul><h2>Key points</h2><ul><li>Writing disabilities are learning disabilities that can include problems with composition, spelling, punctuation, grammar, and handwriting.</li><li>Children who are diagnosed with a writing disability often show early signs of speech and language difficulties and/or may have weakness with attention and working memory.</li><li>Writing disabilities are often linked with reading disabilities, and are diagnosed with a psychoeducational assessment.</li></ul><h2>Early signs of writing problems</h2><p>Children who are diagnosed with a writing disability may show early signs of speech and language difficulties, such as:</p><ul><li>Few spoken words by two years of age</li><li>Indistinct, garbled speech after three years of age</li><li>Speaking in phrases or sentences later than normal</li><li>Difficulty learning the alphabet and the sounds of the letters</li><li>Difficulty expressing themselves in words after three years of age</li><li>Using immature forms of grammar longer than expected (e.g., “I goed to the park”)</li><li>Mixing up word order in sentences</li></ul><p>However, not all children with these signs develop a writing disability.</p><h3>Are letter reversals cause for concern?</h3><div class="asset-video"> <iframe src="https://www.youtube.com/embed/zpM0Hypd9ww" frameborder="0"></iframe><br></div><p>For more videos from SickKids experts in collaboration with Youngster, visit <a href="https://www.youtube.com/channel/UCoKMd2cYwegtZX19uHdNLQA">Youngster on YouTube</a>.</p><h2>Writing difficulties</h2><p>Signs that your child may be having difficulties with writing include:</p><ul><li>Illegible printing or cursive writing (despite appropriate time and attention given to the task)</li><li>Writing inconsistencies: mixtures of upper and lower case, or irregular sizes, shapes or slant of letters</li><li>Unfinished words or letters, or omitted words</li><li>Inconsistent spacing between words and letters</li><li>Unusual wrist, body or paper positions when writing</li><li>The act of printing or writing is slow or laboured</li><li>Poor spatial planning on paper</li><li>Complains of a sore or tired hand</li><li>Difficulty thinking and writing at the same time (taking notes, creative writing)</li></ul><p>For a list of typical writing milestones achieved by children at different grade levels, see <a href="/Article?contentid=651&language=English">Reading and writing milestones</a>.</p><h2>Diagnosis of a writing disability</h2><p>If your child’s writing abilities are substantially below the expected level for their age, intellectual abilities and education, they may be diagnosed with a writing disability.</p><p>If you suspect your child might have a writing disability, it is important to share your concerns with your child’s teachers. They will be able to observe your child’s learning, and identify available resources and strategies to help improve your child’s writing skills. If the resources and strategies provided by the school do not help improve your child’s learning, your child might benefit from a formal psychoeducational assessment.</p><p>A psychoeducational assessment can identify your child’s strengths and learning challenges, and diagnose learning, developmental or attention-related disorders, as well as giftedness. The assessment will get to the root cause of your child’s academic issues, and identify a plan for solving them.</p><h2>Treatment</h2><p>Writing disabilities can be treated with two main approaches—accommodations and interventions.</p><p>The earlier a child with a writing disability receives an evidence-based writing intervention over a reasonable period of time, the more likely they are to catch up with their peers.</p><h3>Accommodations</h3><p>Accommodations are changes made in the classroom to help students work around their weaknesses. Accommodations can help some children succeed without direct intervention. Accommodations for a writing disability might include:</p><ul><li>Extra time for written work</li><li>Offering a scribe to support writing</li><li>Providing handouts of board work</li><li>Providing sentence stems or partially completed notes that the child fills in as they follow along</li><li>Providing checklists of grammar, punctuation, and organization</li><li>Providing rubrics with examples of written assignments</li><li>Allowing the use of audio devices so the child can record information</li><li>Providing the child with teacher prepared notes and having the child highlight as they are discussed in class</li></ul><h3>Interventions</h3><p>Interventions help students address their areas of need so that they can overcome them. Interventions teach children <strong>how</strong> to learn, and allows them to succeed as independent learners. Interventions for a writing disability might include:</p><ul><li>Providing explicit instruction on a variety of note-taking formats (e.g., jot notes, webbing of ideas, drawings) so that the child can determine which one works best for them</li><li>Teaching shorthand techniques (i.e., symbols and abbreviations)</li><li>Cognitive Strategy Instruction and direct instruction—targeted, well-organized instructional techniques teaching written expression</li><li>Voice-to-text software programs</li><li>Graphic organization software to help with generating ideas</li><li>Support in spelling and grammar</li><li>Occupational therapy assessment to assess grip and make recommendations</li><ul><li><a href="https://www.lwtears.com/hwt">Handwriting Without Tears</a> is one resource to support hand-motor functioning</li></ul></ul><h2>Association with other learning difficulties</h2><h3>Sequencing problems</h3><p>Children with weak sequencing skills may start their writing in the middle of a story, and they may not make meaningful connections among their ideas when writing. Sequencing issues may be related to weaknesses in working memory.</p><h3>Working memory and attention problems</h3><p>Writing requires generating and converting ideas into words and sentences and then writing those words on paper with accurate spelling, grammar, capitalization, and punctuation. All of these tasks put a large burden on working memory. Working memory is a “mental workspace” where information is stored and used for a few seconds. Working memory involves both storing and manipulating the information to reach a goal. Children with attention disorders often have working memory problems.</p><p>Children who have a problem with working memory or attention problems may need to be taught to work on one aspect of writing at a time. In general, children with a working memory problem need to learn strategies to keep on track as they perform complicated tasks. If a child continues to use a strategy, it will eventually become automatic, and the whole process becomes easier.</p>https://assets.aboutkidshealth.ca/AKHAssets/Writing_disabilities-Overview.jpg
Writing milestonesWWriting milestonesWriting milestonesEnglishDevelopmentalPreschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years)NANAHealthy living and preventionAdult (19+) CaregiversNA2020-04-29T04:00:00Z12.500000000000051.7000000000000824.000000000000Flat ContentHealth A-Z<p>Learn about the development of writing skills at different stages.</p><p>Once children start speaking, they move on to develop reading skills and later writing skills. This page describes the typical writing achievements for a child at different grade levels from kindergarten to Grade 3.</p><p>The "milestones" below are a general guide.</p><h2>Key points</h2><ul><li>Your child goes through a series of steps, or "milestones" as they develop their writing skills.</li><li>Not all children learn at the same pace.</li><li>You can help your child develop their basic skills for writing using a variety of activities.</li></ul>https://assets.aboutkidshealth.ca/AKHAssets/Writing_milestones.jpg

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