The Emergency Department at Cook Children’s sees eye and face injuries from projectiles (fireworks that launch or that have parts that explode off), hand and finger injuries from holding items while they explode and burns of every type, especially when children are running around barefoot.

U.S. Consumer Product Safety Commission (CPSC)’s annual death and injury report on fireworks incidents indicates that nearly half of these injuries occurred to children younger than 15 years of age. The culprits? Firecrackers, bottle rockets and sparklers – yes, sparklers.

Sparklers are considered by many to be the “safe” firework. But even an innocent looking sparkler can get as hot as the flame on some blow torches and can easily ignite clothing?

“Every firework has its dangers and there simply isn’t one that I would consider completely safe,” said Justin Smith, M.D., a pediatrician in Lewisville. “Parents would be safest to take their children to an event and watch fireworks. You will have a good time and can view from a distance.”

Remind your friends and neighbors, before they touch a flame to any fireworks, to make sure it’s legal to do so where they live.

Prevent the Tragedies

If fireworks can be used legally where you live and you do want to use them, here are a few guidelines CPSC recommends they follow:

1. Never allow young children to play with or ignite fireworks. Adults should always supervise fireworks activities.
2. Never try to re-light or pick up fireworks that fizzle and don’t go off.
3. Never point or throw fireworks at another person.
4. Keep a bucket of water or a garden hose handy in case of fire or other mishap. After fireworks fully complete their functioning, douse the spent device with plenty of water from a bucket or hose before discarding to prevent a fire.

More guidelines are at CPSC’s Fireworks Information Center. 

Get to know Justin Smith, M.D.

Justin Smith, M.D., is a pediatrician in Trophy Club  and the Medical Advisor for Digital Health for Cook Children's in Fort Worth, Texas. Dr. Smith is an experienced keynote speaker for a variety of topics including pediatric/parenting topics, healthcare social media and physician leadership. If you are interested in having Dr. Smith present to your conference or meeting, please contact him at thedocsmitty@cookchildrens.org.

He has an active community on both Facebook and Twitter as @TheDocSmitty and writes weekly for Cook Children's checkupnewsroom.com. He believes that strategic use of social media and technology by pediatricians to connect with families can deepen their relationship and provide a new level of convenience for both of their busy lifestyles. Dr. Smith’s innovative pediatric clinic, a pediatric clinic “designed by you,” open now. Click to learn more. To make an appointment, call 817-347-8100.

The American Academy of Pediatrics (AAP) released a statement recently encouraging pediatricians to talk with their families about the importance of daily, out-loud reading to your children (Literacy Promotion:  An Essential Component of Pediatric Primary Care Practice). Sometimes, when the AAP releases statements like this, that seem like common sense, I have to resist the urge to roll my eyes and tell myself, “Ok, thanks for stating the obvious.”

This one, while perhaps common sense, is very important. 

Why?

Despite the fact that I think most parents would agree with the importance of reading to your children, studies show that only about ½ of children are read to aloud every day.  In addition, reading to children sets the stage for their speech development which helps them do better in school. So what are the reasons for not reading to your child?

1. I don’t have time.

We aren’t asking that you read “War and Peace” every night with your 6 month old.  I’m hoping for about 5-10 minutes of reading (1-2 short books).  Ultimately, if you don’t have that much time then just read for the amount of time that you can, any amount is better than none.  Our kids really like to read during meal times as well, it tends to keep them eating and moving and keep their fighting about food to a minimum.  If you routinely watch TV during meals, it’s a much better alternative.

2. If they don’t understand, it doesn’t matter.

Reading to your children even before they are speaking is an important part of teaching them language.  Babies learn the sounds of language long before they know any words.  The number of words a child hears before they start kindergarten is a strong predictor of how well they will do in school. This is why it’s not only important to read to them, you should also spend time talking with them all throughout the day.

3. It is so boring.

This one I can really sympathize with. There are nights where I feel like I deserve an Oscar for my dramatic performances … but there are also nights where I drone on in monotone and doze off between pages. It is important to really engage your children as best you can, based upon their age. Have them help you count objects, letters or words on the page.  If it’s a book you’ve read 1000 times, read the wrong word and let them correct you (“Ohhhh … daaaadd, you’re so silly!”).  You can be selfish here.  Do whatever it takes to make it interesting for you, it will make it easier for you to do it and it’s likely that your child will enjoy it more as well.

4. They don’t even seem to enjoy it.

Let’s face it … sometimes they don’t even seem like they care. Your 12 month old is crying because he or she is tired but doesn’t want to go to bed. My 2 year old would rather chew on a book than have you read it.  My 5 year old would often rather be reading his own book than listening to me. But, I press on. Reading is not only beneficial for the language development, but studies show that it helps to develop more nurturing parent-child relationships.  Perhaps more importantly, is what it does for me. After a hard day at work, getting home to refereeing the boys fights for 2 hours, it’s nice to have some one-on-one time with each child to remember that I still like them.

5. No one ever told me it was important.

Well, you can’t use this one anymore can you?  Just in case you missed the message, it’s important.

Start by making a plan to read to your child every day for the next month.

Get a calendar out and mark off the days. 

I promise it will benefit your child for years to come.

What is autism?

Autism is a disorder where a person has difficulty with communicating and interacting with others. There are many forms of autism that can vary from mild to severe.

There are 3 major categories of symptoms in autism:

Social interaction-Children show difficulty interpreting other’s emotions or difficulty in making appropriate eye contact.

Communication-Speech is often delayed or non-existent. In addition there are limited other attempts to try and communicate with others (lack of hand signals, expressions, etc).

Limited interests-Children show very specific interests and lack of interest in other activities.

So, that is the definition…here’s my practical look at how the diagnosis of autism usually evolves.

Up to 12 months-There are very few suspicions of autism prior to the first year of life. Occasionally, a family will pick up on a lack of eye contact or limited verbalization but this is uncommon.

12-15 months-Families and doctors will begin to notice that a child is not progressing in their speech development appropriately. Speech therapy referrals can be made at this time to begin appropriate therapy and to monitor development more closely.

15-18 months-Speech development will continue to lag behind and the other abnormal behaviors will continue to become more obvious. Many diagnoses can be made during this time, especially in severe cases.

What do I look for in a diagnosis of autism?

The main symptoms I look for when consulting with a family about autism is a “lack of joint attention.” An example of joint attention is when a child is playing with a toy they enjoy, they will occasionally bring it over to you and engage you in play with them. Another example is when an adult points to a plane in the sky and the child looks in the direction of the point. When I have a family with a concern about autism, I present both of these examples to the family. If the child does show these behaviors, autism is very unlikely and parents can be reassured. If they do not, further investigation and a possible referral to a developmental pediatrician could be in order.