My Child Has What?: Case Studies of Common Illnesses and Problems That Five- to Twelve-Year-Old Children Face

By Janet L. Stafford M.D. and Pablo Ruiz Arroyo

This collection of twelve case studies featuring common childhood illnesses and problems of children aged five to twelve is a must have for anyone who wants to help children.
Janet L. Stafford, M.D., highlights stories based on real clinic visits, including diagnosis, causes, and how various problems can be treated. She also shares follow-up assessments of children after treatment.
The illnesses and problems include everything from autism to obesity, headaches, asthma, seizures, attention deficit disorder, and recurrent abdominal pain.
She also highlights more sensitive topics, such as a five-year-old girl acting in a sexual manner with classmates and a seven-year-old boy whose short stature does not sit well with his family members, who are passionate about athletics.
Other case studies include a 10-year-old girl who is overwhelmed by her parents’ divorce and a nine-year-old boy who wets his bed but wants to go to camp.
The case presentations are geared for families, teachers, nurses, therapists, and anyone who wants to help children as they develop physically and neurologically.

• Language: English
• Publisher: Archway Publishing
• Release date: Nov 9, 2021
• ISBN: 9781665708098

Janet L. Stafford M.D.

Janet L. Stafford, M.D., is a retired board-certified pediatrician with more than thirty years of experience. She worked at Kaiser Permanente in San Francisco, diagnosing and treating problems in infants and children. She has taught medicine to Kaiser and UCSF medical students and residents. She was raised in Michigan and graduated from University of Michigan before working in Chicago as a medical and laboratory technician and returning to the U of M for a Master of Social Work.  She went on to graduate from University of California Davis Medical School and completed a three-year residency in pediatrics. She has been married fifty years and has four sons.

Book preview

Copyright © 2021 Janet L. Stafford, M.D..

All rights reserved. No part of this book may be used or reproduced by

any means, graphic, electronic, or mechanical, including photocopying,

recording, taping or by any information storage retrieval system

without the written permission of the author except in the case

of brief quotations embodied in critical articles and reviews.

This book is a work of non-fiction. Unless otherwise noted, the author

and the publisher make no explicit guarantees as to the accuracy of

the information contained in this book and in some cases, names of

people and places have been altered to protect their privacy.

Archway Publishing

1663 Liberty Drive

Bloomington, IN 47403

www.archwaypublishing.com

844-669-3957

Because of the dynamic nature of the Internet, any web addresses or

links contained in this book may have changed since publication and

may no longer be valid. The views expressed in this work are solely those

of the author and do not necessarily reflect the views of the publisher,

and the publisher hereby disclaims any responsibility for them.

Any people depicted in stock imagery provided by Getty Images are

models, and such images are being used for illustrative purposes only.

Certain stock imagery © Getty Images.

Illustrations by Pablo Ruiz Arroyo.

ISBN: 978-1-6657-0810-4 (sc)

ISBN: 978-1-6657-0808-1 (hc)

ISBN: 978-1-6657-0809-8 (e)

Library of Congress Control Number: 2021911610

Archway Publishing rev. date: 05/11/2022

CONTENTS

1   Fatima: A Ten-Year-Old Girl with Recurrent Headaches

2   Maya: An Eleven-Year-Old Girl with Weight Loss and Social Isolation

3   Aman: A Six-Year-Old Boy Who Spaces Out and Has School Problems

4   Adrian: A Seven-Year-Old Child with Wheezing and Disagreeing Divorced Parents

5   Jaime: An Eight-Year-Old Boy with School Behavior Problems and Possible ADD

6   Halley: A Twelve-Year-Old Girl with Tiredness and Obesity Issues

7   Tomas: An Eight-Year-Old with Learning Differences

8   Marcus: A Six-Year-Old with Recurrent Abdominal Pain and Social Isolation

9   Chloe: A Five-Year-Old Girl with Sexualized Behaviors

10  Dione: A Seven-Year-Old with Short Stature

11  Lucia: A Ten-Year-Old Whose Parents Are Having Intense Custody Issues

12   Carlos: A Nine-Year-Old Boy Who Frequently Wets the Bed

INTRODUCTION

I was a pediatrician for decades at Kaiser Permanente Medical Group in San Francisco. Our patient population was composed of families of diverse ethnic and socioeconomic status. After retiring in my late sixties, I realized that I had been privileged to interact with many wonderful and fascinating families. I had always appreciated that the years of five to twelve are unique. In our bookstores, the sections on children are bursting with infant, preschool, and adolescent rearing advice. However, information on the crucial years of five to twelve, previously called the latency years, is sorely thin.

The period is not latent! Children in this age range are transitioning from the fantasy-filled period of acquiring language, fine motor skills, and social nuances of the preschooler to the age of reason period, when the grade-schooler around age eight understands fact versus fiction and learns the subtle aspects of honing skills and social and family interactions. I felt that I wanted to share my experiences and my input to educate families, teachers, nurses, and therapists to better understand common problems.

If this crucial period is complicated by chronic or frequent illnesses, learning differences, family turmoil, feelings of being different from peers and the child is not protected and nurtured by a caring adult in his or her life, the child may be affected physically or psychologically. Children in the age range of five to twelve are often able to mask reactions to the above complications. They do not have the breaking away beginning independence of the adolescent. The child of divorce may feel he or she has contributed to the separation and just withdraw. The child with chronic illness may either hide his or her feelings or deny the impact of the changes in the child’s body and lifestyle. The child with learning differences may become the class clown to create diversion. Children may become so obsessed with thinness that they become isolated from social contacts and may have chronic body dysmorphism or confusion about their bodies that may last a lifetime. The chronic bed wetter may forgo sleepovers or camp and thus lose the social maturity of these experiences. The period is not latent but dynamic and active!

I recall so many families over my decades as a pediatrician and so many experiences with our own four sons and their friends. I have imagined this book as a guide for those whose lives are affected by children of this magical age. Frequently I encountered persons involved with children to be clueless about many of the common medical issues for this age range. I have aimed to gear the material for families, teachers, nurses, and therapists so that they may understand common illnesses and situations that may have crucial effects on the development of grade-school-age children. I hope that in sharing my knowledge, I have an effect on a child at this special time in his or her life.

CHAPTER 1

50646.png

Fatima: A Ten-Year-Old Girl

with Recurrent Headaches

50666.png1Fatimaheadache.jpg

Fatima

FATIMA is a ten-year-old girl whose father calls me with a concern regarding her headaches. She recently told her father that her head pounds, and she feels like throwing up. She says she cannot go to school the next day. Similar episodes have occurred every few months for the last two years. Fatima’s general health is excellent other than the headaches. She spent the night before her last headache at her friend’s sleepover birthday party, and she recalls that she ate, several pieces of pizza with pepperoni, and, a lot of cake. The girls stayed up very late watching two movies on the computer monitor. Similar symptoms occurred on a prior sleepover and on several occasions over the last year. She feels like she cannot have any fun or go anywhere interesting because the activity might result in a headache.

I ask Fatima’s father if there were recent unusual activities, if this headache differs from the previous episodes, if they have noticed any unusual body movements or behavior differences, or if any close relatives have recurrent headaches. Based on the history of no other symptoms and that the headaches are common in the family, I tell him that I think that this headache is probably in the migraine category. I reassure the father that migraines are usually treatable. I advise giving over-the-counter medication and making a doctor’s appointment in the near future.

CLINIC VISIT

Fatima tells me she has taken ibuprofen and acetaminophen for the headache and has been able to fall asleep in a dark, quiet room. She is pain-free when she awakens in the morning. I ask more detailed questions about diet, sleep, medications, and health history, none of which is unusual. I give her a complete neurological exam. Although this exam is normal, Fatima’s father is worried as his cousin’s twelve-year-old daughter currently has a diagnosis of a brain tumor. He requests an X-ray or CT (computerized tomography) scan to be done as soon as possible.

Based on the above history and normal exam, I advise holding off on ordering an X-ray or CT scan. X-rays show skull bones but not bleeding or tumors in the brain. A CT scan shows many pictures of the interior brain, but it carries a significant risk of radiation. I also advise holding off on ordering an MRI (magnetic resonance imaging), which would probably require Fatima to have anesthesia to remain still during the test. I reassure the father that brain tumors are rare and that the symptoms of a tumor would be constant and increasing in severity.

I then discuss what the family should watch for when their daughter has another headache and what would necessitate imaging testing. I advise keeping a journal documenting diet, sleep, and anything unusual about the headache. I explain what triggers may be precipitating the headaches. I explain treatment options if over-the-counter medications are not effective. I tell him what changes to watch for and when to bring Fatima into the clinic.

HEADACHES IN CHILDREN

Headaches in grade-school-age children are fairly common. One percent of emergency room visits for grade-school-age children involve a headache.

Headaches may be categorized as follows:

50636.png A primary headache, which means the symptoms are coming from the brain. Diagnoses are neurologically based, such as migraine, tension,