2025 – PAGE 440 – PSYCHIATRY AND SOME SOCIAL ISSUES

NIGHT TERRORS

Night terrors usually occur during the first third of a child’s sleep, and they typically occur at about 90 minutes into a child’s sleep. This occurs in boys more than girls, and there is sometimes a family history of it. Children typically do not recall the event and may even be a little confused if they are woken during the episode. Children can actually walk during these episodes, and are thus at increased risk of injury. It occurs in stage 4 of the sleep cycle.

NIGHTMARES

Nightmares occur during the last third of a child’s sleep and occur during REM sleep. Children are easily woken and will recall the episode. Children do not walk during nightmares and remain immobilized in bed, so there is no risk of injury.

CHILD DISCIPLINE

The use of appropriate child discipline is considered EXTREMELY important. It provides children with emotional stability and structure.

PEARL: The AAP and the ABP frown on corporal punishment. Don’t pick it.

THUMB SUCKING

Most kids outgrow thumb sucking. Recommendation should be to provide positive reinforcement at times when the child is not sucking his/her thumb. Starting at age 5, a more aggressive approach is okay.

IMPACT OF MEDIA ON CHILDREN

Research suggests that watching too much TV increases aggressive behavior and influences children’s diets through advertising. TV also seems to obscure reality, as well as increase a sedentary lifestyle. Many children watch > 25 hours of TV per week. The most recent recommendations include:

• < 18 MONTHS: Avoid TV/screen time except for video chatting
• 18-24 MONTHS: < 1 hour of TV/screen time with adult supervision
• 2-5 YEARS OLD: Up to 1 hour of high-quality TV/screen time with adult supervision
• > 5 YEARS OLD: A customized plan may be needed based on the family’s schedule and what type of media is being used. Use apps for learning but don’t use media as a pacifier. Have tech free zones.