Thursday, April 04, 2013
Limiting screen time for children

By Dr. Anthony Policastro
The American Academy of Pediatrics (AAP) has a long standing recommendation about screen time. The recommendation is that total screen time for the day should be no more than two hours in children. When the recommendation first came out, it was meant to address TV time, computer time and TV video game time. That recommendation was made in 1999. Smart phones and hand held gaming systems have changed our media world since then. In light of that the AAP updated their 1999 recommendations in October 2011. That update was aimed at children under 2 years of age. It reiterated the 1999 statement that children of that age should not have screen time at all. The question now facing parents is what do they do about the ever present hand held devices? Unfortunately, there is not an easy answer. For example, we can compare two parents and their children. In one case, the mother sits in front of the TV for three hours a day. During that time, her child plays with a hand held game. In the second case, the mother works with a child for three hours on the computer assisting with research for a school report. In both instances mother and child spend three hours of screen time. However, in the first case, there is no interaction. There is also no educational benefit. In the second case, there is ongoing interaction. There is educational benefit for both mother and child. It is clear which of the two situations is preferable. The problem is that time spent with these devices is not always that clear cut. I have long advocated going out to dinner as a family. It encourages conversation that would not normally occur in the home setting. There is none of that conversation if the children spend the entire time with their handheld devices. Parents need to understand that they have a role in preventing overuse of smart phones and hand held gaming systems. There are several pieces to this particularly challenging portion of parenting The first of those is the need to set up rules for their use. That might include when they can be used. That might include how they can be used. That might include how long they can be used. I recently visited my grandchildren. One of them wanted to play a race game with me on the smart phones. When I asked her about what the game entailed, she informed me that that object of the game was to win the race by killing the other racers. I promptly told her that I do not believe in games in which there is any kind of violence. That is true even if it is cartoon violence as was the case there. That was one of my rules. When we took the grandchildren to dinner, I informed them that there was no playing hand held games at the table while we were out. Those were my rules. Their parents might have different rules. However, the key is that there must be some rules to follow. If you do not do that up front, then you will have nothing to fall back on when you try to make a restriction. Another thing to do is to have them earn time. It should not be a situation where they can play with the devices as much time as they want. The earning of time can be tied to chores. It can be tied to school performance. It can be tied to other behavioral requirements, e.g. not fighting with siblings over the device. One of the things that I find interesting is that when I try to counsel parents about it, I get some strange responses. I sometimes get told that they try to limit time but cannot do so. That is an easy one. Take the device away from them. I sometimes get told that using the device is the only way to keep them entertained. That would suggest that the parent needs to be more creative in terms of addressing their child's needs. Occasionally, I will have a parent tell me that the child will have a tantrum if they do not get to play with the device. What that means is that the parents have trained the child to have a tantrum in order to get the device. They are getting what they ask for. We sometimes wonder why adolescents will text while they are driving. If we do not train them otherwise, that is what we should expect. Screen time is one more challenge that parents face when raising a child. It has become one of the more difficult challenges in today's world.

HealthFest returns on Saturday Peninsula Regional Medical Center and the Wicomico County Board of Education invite everyone to join them for HealthFest: An event for all ages, on Saturday, April 6. This year's event, a showcase of healthy exhibits and health screenings, is free and open to the public at James M. Bennett High School on College Avenue in Salisbury. HealthFest: An event for all ages will be held from 7:30 a.m. to 1:30 p.m. Over 25 free health screenings, available the day of the event and without pre-registration. The health screenings, performed by Peninsula Regional Medical Center healthcare specialists and other area healthcare providers, will be available to anyone looking to find out how healthy they actually are, and to learn what they can do to lead an even healthier and more productive lifestyle. Blood glucose and cholesterol screenings are included and require a 12 hour fast by participants. At various times during the event, HealthFest will also offer participants free child safety seat checks, a K9 demonstration, a fun walk, a rock climbing wall, fire engine and ambulance tours, a health corner for kids, and interactive demonstrations in cheer and dance, Zumba, chair aerobics, juggling and healthy cooking. The daVinci Surgical System Robot will be on exhibit, giving anyone interested a "hands on" opportunity to test drive the robot and see, first-hand, how the technology is used at PRMC during revolutionary cutting edge surgeries. Additionally, Mega Heart, the world's largest, inflatable walk-through heart exhibit, will be at HealthFest to provide everyone an interactive view of how the human heart functions. Nearly 50 additional exhibitors and vendors will also join HealthFest with valuable information on their services. For more information on HealthFest: An event for all ages, a map and a complete list of screenings and demonstrations, visit PRMC's website at or call 410-543-7139.

How to have a safe, healthy home Improving public health at home can prevent health problems and improve quality of life. National Public Health Week, which is this week, encourages the prevention of disease and injury by following these steps to better health:

  • Eat five fruits and vegetables daily. Good nutrition can reduce the risk of diabetes, cancer and obesity. Visit
  • Be active for at least 30 minutes each day. Physical activity is essential for children's health and development and helps to prevent many health problems over the lifetime. See physical activity ideas at
  • Make your home tobacco-free to prevent cancer and respiratory problems. Help smokers and those who chew tobacco receive free help at:
  • Prevent falls by removing clutter and tripping hazards, and installing handrails. Falls are the leading cause of injury-related deaths among people ages 65 and older.
  • Prevent burns by cleaning ovens, stoves and microwaves to eliminate grease.
  • Clean out the medicine cabinet; gather expired or unused prescription and over-the-counter medicines. Bag the discards and drop them off on April 27, 2013 National Prescription Drugs Take Back Day, at statewide collection sites. Visit
  • Post the Poison Control Center's phone number on the refrigerator and on your cell phone. 1-800-222-1222 will automatically connect you to life-saving information.
  • Prevent deaths by replacing batteries in smoke detectors, and installing carbon monoxide detectors. In 2010, about two-thirds of U.S. home fire deaths happened in homes without working smoke detectors.
  • Hang dry cleaning in the garage for a day so chemicals can dissipate there instead of the house. Find other tips on improving indoor air quality at this link:
  • Test household paint for lead, especially if the home dates to 1978 or older. For instructions, visit
  • Create or replenish your Household Emergency Preparedness Kit. Your stockpile should include a three-day supply of water and food. For a list of suggested items, visit
For more ideas on how to improve health and safety at home, visit

Diabetes education program Nanticoke Memorial Hospital, Seaford, will hold a four-session diabetes educational program on April 10, 17, 24 and May 1, from 5 to 7 p.m., at the hospital. Registration for this class is required. The cost of the four-session program may be reimbursable by insurance. This four-session program includes weekly education sessions and individualized meal planning for diabetes self-management. The goal is to give you the self-management skills to control your diabetes.

Family members/significant others are welcome to attend the weekly sessions. Pre-registration is required. To register and to obtain additional information, contact Nanticoke Memorial Hospital's Diabetes Education department at 629-6611, ext. 2446.

Hospice Lunch Bunch lecture Delaware Hospice's Family Support Center will hold a Lunch Bunch Lecture from noon to 1:30 p.m. on Friday, April 5, at the Delaware Hospice Center in Milford. Dr. Judy Pierson, clinical psychologist, will discuss, "But Enough About You: Dealing with a Narcissist." Dr. Pierson will examine common characteristics and behavior to help identify narcissists (people who tend to focus on themselves) and offer suggestions for coping with these difficult relationships in your life. Register by Wednesday, April 3, by contacting Vicki Costa at 856-7717, ext. 1129, or Cost of lunch is $5 per person.

Family support workshop Delaware Hospice will hold a Family Support Workshop on "Living Your Best Life" on Friday, April 5, from 2 to 5 p.m., at the Delaware Hospice Center, Milford. The workshop is free and open to the public but reservations are required as space is limited. Dr. Judy Pierson, clinical psychologist, will focus on the keys to unlock our best life. Register by Wednesday, April 3, by contacting Vicki Costa at 856-7717, ext. 1129, or

Journaling workshop Delaware Hospice invites anyone coping with a loss to a "Write Your Heart Out" journaling workshop from 5 to 6:30 p.m., on Thursday, May 9, at the Delaware Hospice Millsboro office, 315 Old Landing Rd., Millsboro. The workshop will focus on examining your grief journey through this safe, non-judgmental and therapeutic activity of journaling. There is no charge to attend but registration is required as space is limited. To register, contact Midge DiNatale, bereavement counselor, by May 6, at or 302-416-0581.

Hospice offers grief workshop Delaware Hospice will offer a "Grief 101: Introduction to Grief" workshop for adults from 5 to 6:30 p.m. on Wednesday, April 24, at the Hospice Center in Milford. This workshop will provide up-to-date information about what to expect when grieving the loss of a loved one, why we grieve differently even though there are many similar experiences, common misunderstandings, and ways to support yourself and others who are grieving. The workshop is free and open to the public but registration is required as space is limited. To register or learn more, contact Chet Carbaugh, MDiv, at 302-353-8345 or

Grief support group offered Delaware Hospice will hold a six-week support group for widows, widowers, and life partners on Tuesdays, from 5:30 to 7 p.m., beginning April 9 through May 14, at the Delaware Hospice Center, 100 Patriots Way, Milford. Many people find that a group experience just for those who have lost a husband, wife or life partner is a very beneficial way to give and receive support. One way to know that you are normal with your grief is to be with others who share the same heartaches. There is no fee for this service which is provided as a community outreach by Delaware Hospice. Registration is requested by April 4, by contacting Midge DiNatale, bereavement counselor, at or 302-416-0581.

Southern Delaware Kidney Walk The National Kidney Foundation of Maryland (NKF-MD) will hold its fifth annual Southern Delaware Kidney Walk, Sunday, April 14, at Cape Henlopen State Park in Lewes. Check-in and festivities begin at 9 a.m. at the Picnic Pavilion. The dog-friendly walk will kick off at 10 a.m. Participants can choose from a 3.2-mile trail or a shorter trail for strollers and wheelchairs. There is no registration fee, but Cape Henlopen State Park charges an entrance fee of $4 per vehicle registered in Delaware and $8 for vehicles registered outside the state of Delaware. For pre-registration, or information about sponsorship or volunteer opportunities, call 443-235-8407 or visit

Latina Health Forum is April 13 The Delaware Breast Cancer Coalition (DBCC) and the Arsht Cannon Fund present the 3rd Annual ÁVIDA! Latina Breast Health Forum on Saturday, April 13, at Grace United Methodist Church, 7 King St., Georgetown, from 9 a.m. to 2 p.m. This one-day conference is free and open to the public. ÁVIDA! is a bilingual (Spanish/English) educational event that focuses on breast cancer screening, treatment and survivorship. This year's event will feature free health screenings and information about breast health and healthy living. Lunch will be provided for all attendees, but space is limited so those interested are encouraged to register by calling toll-free, 1-888-672-9647. The State of Delaware's Women's Mobile Health Screening (WMHS) Van will be on-site to provide screening mammograms for women over 40 (with a prescription from a doctor). To schedule an appointment for a screening mammogram, call 1-888-672-9647. There will also be free screenings for blood pressure, cholesterol, glucose, bone density, skin cancer, clinical breast exams, HIV, and body mass index (BMI). In addition, the Food Bank of Delaware's Mobile Pantry will be on-site. To sign-up to receive food on the day of the event, call 1-888-672-9647 to pre-register. Quantities are limited and all food recipients must pre-qualify for benefits ahead of time. For more information, contact Patty Vivo-Aucoin in DBCC's Dover office at 302-672-6435.

NMH offers stroke support group Nanticoke Memorial Hospital's next Stroke Support Group meeting is Tuesday, April 16, at 1:30 p.m., at the Seaford Library. The support group is designed for individuals who have survived a stroke as well as their families and caregivers. The two-hour support group meetings will consist of guest speakers and breakaway sessions, in which caregivers and stroke survivors will meet in two groups to discuss concerns, provide support, and allow for networking. Refreshments will be provided. Pre-registration is not required for this free support group. For more information, call Nanticoke Memorial Hospital at 629-6611, ext. 8626.

Asthma Awareness Day is May 11 The American Lung Association in Delaware, Bayhealth Medical Center, and Nemours Health and Prevention Services will host a carnival-themed asthma awareness day, "Asthma Under the Big Top," on Saturday, May 11, from 10 a.m. to 1 p.m., in Pavilions I & II at Bayhealth Kent General Hospital in Dover. Snacks and beverages will be provided. Families, children and caregivers are encouraged to attend this free event. To register or for more information, contact Nicole Goldsboro at 302-737-6414, ext. 16 or

Community Health Promotion awards The Governor's Council on Health Promotion & Disease Prevention announces a call for submissions for Recognition of Community Health Promotion. The goal is to recognize the efforts of municipalities that are championing the health and well being of their local residents. Recipients will be communities that have demonstrated effective planning and implementation of best practice and/or creative and visionary programs to improve physical activity, nutrition/healthy eating, tobacco-free lifestyles, healthy environments; promote healthy lifestyles and integration of the needs of individuals with limited mobility and disabilities. All applicants must represent an incorporated municipality located within the State of Delaware and must focus on policy and practice changes related to improving the overall health of its respective community members. For more information and an application, contact Dr. Milton Delgado at or 302-444-9142. The deadline to submit an application is April 12. Upon submission, all applications will be reviewed by a subcommittee of the Governor's Council on Health Promotion & Disease Prevention.

Alzheimer's Caregiver Support Group Cadia Rehab Renaissance near Millsboro is hosting and facilitating an Alzheimer's Association Caregiver Support Group that meets the fourth Tuesday of each month at 6 p.m. All meetings are open to the public and interested parties are invited to attend. Alzheimer's disease is the sixth leading cause of death in the United States. One person out of eight who reaches the age of 65 will develop Alzheimer's, as will one person out of every two who reaches the age of 85.

2013 Walk MS dates The Delaware Chapter of the National Multiple Sclerosis Society has announced the 2013 Walk MS dates and is inviting all Delawareans to join the movement. Each year thousands of loved ones, friends, and neighbors throughout Delaware  from Wilmington's Riverfront to Sussex County's Baywood Greens  lace up and step out in solidarity, with hopes of creating a world free of MS. Last year, over a quarter million dollars was raised to help out the 1,550 Delawareans living with multiple sclerosis. The Twilight at Heritage Shores walk in Bridgeville will be held on May 31 and the walk at Baywood Greens will be held on June 7. To register, visit or call 302-655-5610.