Millions of parents across the country face the tough decision of whether or not to place their children in daycare each year. As the number of families with both parents working outside the home has risen, the need for daycare services has increased dramatically. These families may not have relatives that live close by or are able to care for their children. Others families may have a parent that works from home but needs uninterrupted time to complete work. Many daycare centers offer full day versus half day or full week versus partial week options, priced accordingly. This allows each family to match the daycare’s services with their needs.

Daycare, however, is debated among parents, health care providers, and educational professionals. Some support daycare, saying it offers socialization and educational opportunities a child would not have staying at home with a parent or a relative. Others claim those who use daycare services are allowing others to raise their children and have abandoned their responsibilities as a parent. Like any controversial issue, there are arguments for both sides. Here’s a look at the pros and cons of sending your child to daycare.

Pros:
Independence- Children who separate from their parents early and have a positive experience at daycare learn to trust that Mom and Dad will leave but they always come back. In addition, these children become confident in their own skills and thus, more self-reliant.

Socialization- Even with siblings, you can’t match the opportunities for social interaction that a child has at daycare in the home. Your child will be placed in a class with children close in age and have opportunities to play and negotiate with peers each day. Nicole, of Northvale, New Jersey, says she toyed with the idea of keeping her one and 2-year-old home with an in-home caretaker because they had each other to play with. “Even though they are young, I see them argue. I made the right decision-it’s good for them to have time apart and play with other children at day care.”

Academic Advantage- Many daycares provide some form of instruction or exposure to academic concepts. Calendar concepts, time concepts, letters, and numbers are all explored during circle time each morning. Many daycares offer music classes and art projects, exposing your child to a variety of experiences. Your child will learn to follow a schedule and the structure will prepare her for school.

Cons
Increased Exposure to Illness- One parent, Lynn of Harrison, New Jersey, reports her children have come down with more illnesses since they started daycare this past September. Lynn works to provide health benefits for her family of five as well as to supply a second income and time off from her job does not bode well for her paycheck. “My job allots a certain number of sick days for staff and I’ve used all those days and more. Now my pay is being docked every time I call out because one of my kids is sick. I feel like I have to choose between my kids and my job; of course I’m going to choose my kids.” She still worries about her job security because of her absences from work. Lynn also cites seeing other children come in to daycare despite being sick. “Not all parents call out from work and stay home with their kids like I do.”  This leads to the spread and recurrence of illnesses in young children and staff.

Less Quality Time with Parents- Naturally, if you are working during the day, you are going to miss quality time with your child. All parents know, time away from your children cannot be regained. Danielle of Park Ridge, New Jersey, says “There are days my daughter comes home with beautiful art projects and I wish I had been the one to sit and paint it with her.”

Exposure to Poor Behavior- We cannot shield our children forever, but it is certainly discouraging to see children pick up poor habits from peers at daycare. From as early as 18 months, your child may mimic others’ words and actions. If a child at daycare is not speaking nicely to peers and staff, or worse, exhibiting aggressive behaviors such as biting or hitting, your child may see this as a way to gain staff’s attention. Communicate with the staff immediately if you see behaviors in your child that you did not see before daycare. Remember to approach staff as a concerned parent without accusing other children, families, or staff.

Whether you are comfortable with your decision to utilize daycare services or you are still apprehensive, there are a few ways to ensure you choose the right daycare. The best way to choose a daycare is to ask friends for references. Happy children often equal happy parents. If many parents in your community are sending their children to the same daycare facility, put it at the top of your list. Visit each prospective daycare and ask about safety protocol. Ask if there is a nurse on staff and if staff are CPR-certified. Also, ask how children with behavioral difficulties are handled. Whether your child is having a hard time adjusting to the new routine or is witnessing other challenging behaviors, you want to make sure staff approaches these situations with care and concern.

Jennifer Cerbasi teaches at a public school for children on the autism spectrum in New Jersey. As a coordinator of Applied Behavioral Analysis programs in the home, she works with parents to create and implement behavioral plans for their children in an environment that fosters both academic and social growth. In addition to her work both in the classroom and at home, she is also a member of the National Association of Special Education Teachers and the Association for Supervision and Curriculum Development.

Many parents across the country are looking to support their child’s educational experience in any way they can. Often times, this means hiring a tutor to work one-on-one with your child. There are many reasons for seeking educational support outside the regular school day. Your child may be having a difficult time in one subject area or he could be struggling in all subject areas across the board. Your child may learn best from a specialized means of instruction, such as Applied Behavioral Analysis (ABA) therapy. Many parents hire tutors to maintain their child’s academic skills over the summer, or to have a leg up on the upcoming school year. These tips can be used to choose a tutor for a child with any academic or social needs.

Click here to watch a video on ABA therapy.

• Ask your child’s principal to recommend someone on staff. This ensures that the person has a valid state teaching certification and classroom experience. The principal also has a good feel for his or her staff’s personalities and may recommend someone who he or she thinks is a good match for your child.
• Check the potential tutor’s credentials. Ask for a resume, even if you know he/she is a classroom teacher. You should look to see if he/she has spent a long time at one school, which signifies he/she has developed good working relationships with staff and students.
• Ask for references. Anyone who is confident in his/her skills and has had positive relationships with other families will be more than happy to have you speak with past clients.
• Set up an interview, even if you only have one candidate. You want someone who is articulate and communicates well. He or she will be helping your child with a subject that is challenging — so you want him or her to communicate effectively. There are many bright people with great credentials who have difficulty explaining their area of expertise.
• Once you’ve chosen someone, have them work in a common space in your home. Listen to how he or she works with your child. Listen to his/her tone — see if he or she gets frustrated when your child has a difficult time. Staying close-by gives you an opportunity to observe without being intrusive.

Tutors can be expensive. Check with local colleges to see if they offer free or low-cost tutoring given by students in the education program. Many education programs require students to practice the instructional strategies taught in class. This type of tutoring is beneficial because education students are typically very eager to apply these strategies correctly and gain hands-on experience. Professors may observe the tutoring sessions and give the education student feedback on how to improve their work with your child. It’s like having two tutors for the price of one!

Before your child begins working with his new tutor, ask his classroom teacher for specific topics the tutor should cover. Teachers are often grateful to have support reviewing topics at home because of the time constraints in school.

Once the tutoring has begun, check in with the tutor after each session. Ask specific questions, like “What did she have the most trouble with?” or “Is there something I can review with her during the week?” This gives the tutor an opportunity to discuss your child’s progress and feel like a part of her educational team.

Give the tutor and your child time to establish a relationship. Keep in mind, this person may be new to your child and it may take time for him to feel comfortable. By the third or fourth session, they should be settling into a routine and working well together. Also remember, this person is working on subjects that are challenging for your child. Your child may not jump for joy when it’s tutoring time, but he should sit down willingly.

Finding someone to work with your child at home may feel challenging, but using these tips will speed up the process and ensure you find a good match for your child’s needs.

Jennifer Cerbasi teaches at a public school for children on the autism spectrum in New Jersey. As a coordinator of Applied Behavioral Analysis programs in the home, she works with parents to create and implement behavioral plans for their children in an environment that fosters both academic and social growth. In addition to her work both in the classroom and at home, she is also a member of the National Association of Special Education Teachers and the Association for Supervision and Curriculum Development.

Dawn Drexel, the mother of missing teen Brittanee Drexel, told WHEC News 10 in Rochester, N.Y. that she believes her daughter may have been kidnapped or may not be alive.

Brittanee, 17, has been missing since April 25 when she went to Myrtle Beach, S.C., for spring break.

Brittanee’s mother is no longer a stranger to the darkest possible chapter in a parent’s life story: the feared or actual loss of a child.

I have worked with several parents who have survived their own children. I have struggled with them against tides of grief that seem never to recede, but simply to become more expected, so they lose the power to sweep these bereaved mothers and fathers off their feet.

Losing a child lays bare the miraculous connections that can hold families together through thick and thin. No matter how contentious the relationships mothers and fathers may have with their children, the bond between them can’t be reproduced or entirely obliterated. At the ages of 50 and 60 (and older), my patients still want to make sense of the way they related to their parents in childhood, young adulthood and beyond. They are still sons and daughters, even if they have lost their parents.

So Dawn Drexel, brave enough to speak to the media at an unspeakable moment, may wander tonight into Brittanee’s room. Maybe she’ll lie down on her daughter’s bed, maybe she’ll let herself smell her daughter’s pillow. She may think she hears Brittanee’s footsteps or voice or her car pulling into the driveway. That’s no surprise when we consider the sounds of togetherness that come to play like music in the backgrounds of our daily lives, sounds that we stop hearing after a while, maybe because we take them for granted, maybe because no parent’s heart could maintain its rhythm while bearing full witness to the unspeakable, unfathomable beauty of one’s own child. We don’t hear a tenth of what we could, if we thought the music might end.

For those of you reading these words  — the lucky parents out there with children still close enough to hug, I hope you’ll give it a try tonight. Sit for a few minutes and listen to the sounds of your children in the house: their footsteps, their fingers clicking keys on a computer, the opening and closing of their closet doors, their voices on the phone and their breathing as they sleep. Let yourself marvel at the fact that your life has spawned another life and that you have the continuing, rare and wonderful opportunity to shape not only your existence, but that of another human being. Let yourself smile at the thought of their favorite toys (if they’re still young enough), their favorite clothes, the posters on their walls, their best friends, the sports they’ve come to enjoy, the hopes and dreams they’ve embraced.

Stay silent a minute longer. Then close your eyes, think about Dawn Drexel and her missing daughter Brittanee and pray for them both.

I’m going to do that right now. My children are asleep, a few dozen feet away from me. I am a lucky man and I know it.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s website at livingthetruth.com.

As cases of swine flu are reported each day, the realization that your community could be affected begins to set in. While government officials make it clear there is no need for panic, it does not hurt to err on the side of caution and consider the possible repercussions of this illness hitting home. The solutions for dealing with school-based clusters of swine flu seem simple: Close the school for proper cleaning, make sure ill students are evaluated and treated, then, re-open the school.

Approximately 400 schools in the United States have closed due to outbreaks in their districts. As every parent and educator knows, any time spent away from the classroom is time lost. In the spirit of being prepared, here are some tips for continuing your child’s education at home should schools in your community close for any length of time.

• Keep a consistent schedule for your child. Have him wake up as if it were a typical school day and structure the day with a variety of activities. Have work sessions before and after lunch. Make sure bedtime remains consistent as well. Keeping a routine will make sliding back into a normal school week much easier.
• Read every day. Your child can read aloud to you or a sibling or she can read silently. Students who are not reading independently can have books read to them by family members. Students in grades K-3 should read for 20 minutes each day, students in grades 4-8 should read for 30 minutes, and high school students should read for 30-45 minutes. Consider other opportunities for reading, such as reading the local newspaper and having a family discussion on local and national events.
• Utilize the same online worksheet generators teacher use! Finding age-appropriate worksheets is only a click away. Type the content area keywords, such as third grade fractions worksheets, into any search engine and choose worksheets from the many options that pop up. Be aware that many websites are free, but some charge a small fee. There are plenty that are available free of charge so there is no need for you to spend your money on a service that could potentially only be needed for a few days.
• For a science activity, make a chart to monitor the weather each day. Your child can watch the news or search on-line to get the local forecast. Record daily temperature, humidity, precipitation, and pollen count. Your child can print out pictures of rain, sun, and clouds and glue them to each day’s report.
• Bring gym class to your backyard. Play a game of basketball, walk around the block or have family relay races. If you’re stuck with a rainy day, pop in a workout DVD. Make exercising a family affair and you could develop a new healthy habit!

Remember to speak to your child about proper hygiene. Health experts suggest covering your nose and mouth with a tissue when you sneeze or cough, washing your hands and using alcohol-based hand sanitizers. These are all good habits to continue regardless of the type of illness spreading around.

Talk to your children about the realities of the flu. Most people, if treated timely and appropriately, recover with no complications. Setting the tone for a calm reaction to a potentially scary situation will help your child understand how the swine flu is affecting people all over the world.

Many school administrators are being proactive in sending letters home and posting information on their Web sites. Since the school nurse and principal are likely inundated with questions and concerns, take an informal poll of the parents in your child’s class and submit a list of questions from the class. Acting as a spokesperson will help continue the flow of information between state officials, schools and parents.

Whether or not swine flu affects your community, consider this an opportunity to be prepared!

Jennifer Cerbasi teaches at a public school for children on the autism spectrum in New Jersey. As a coordinator of Applied Behavioral Analysis programs in the home, she works with parents to create and implement behavioral plans for their children in an environment that fosters both academic and social growth. In addition to her work both in the classroom and at home, she is also a member of the National Association of Special Education Teachers and the Association for Supervision and Curriculum Development.

I was very happy to learn Tuesday that the last of the Suleman octuplets is finally home  to be with his brothers and sisters. Jonah ― the last to be sent home ― was the smallest of the bunch, weighing just 1 pound 8 ounces when they were born nine weeks early.

Click here to see pictures of Jonah and his siblings.

But now, the real challenge begins. Let us not forget that these infants were premature and that this last baby stayed in the hospital for almost 12 weeks. There is a lot of data that has been published and analyzed looking at some of the hurdles that premature babies must overcome in their early years.

To me ― as a person who delivers babies for a living ― I also have three of my own ― I am aware of the significance of paying attention to the way kids grow and develop, and how important that attention is in preventing some of these children from failing to meet their full potential.

For parents of full-term infants, paying close attention to developmental milestones is sometimes an afterthought. But for parents of premature babies, keeping track of movement, visual, social and developmental milestones could make a world of difference in identifying problems and finding solutions to meet their needs.

Most premature babies meet their milestones and catch up by the age of 2. But depending on how early an infant is born, their development may lag anywhere from 6-8 weeks in development usually during the first year of life.

It’s important to use your child’s adjusted age when tracking his or her development. For example, if your baby is 21 weeks old, but was born five weeks early, his or her adjusted age is 16 weeks (or 4 months).

Now let’s take a look at some of the milestones the American Academy of Pediatrics says parents can look out for around 16 weeks…

Motor:
o Brings hands together, or to mouth
o Lifts head and pushes on arms when on tummy
o Reaches for objects
o Turns or makes crawling movement when on tummy

Language:
o Turns head to follow familiar voices
o Laughs and squeals
o Combines sounds more often (for example, “aaah-oooh”, “gaaa-gooo”)

Activities:
o Grasps more and reaches for objects
o Brings objects to mouth
o Increases activity when sees a toy

Social/Emotional:
o Is increasingly interactive and comfortable with parents and caregivers
o Shows interest in mirrors, smiles and is playful
o Is able to comfort himself

For more guidelines and milestones at different ages, click here.

Remember: Always watch for progress and do not be afraid to ask for help from doctors, teachers or other family members.

Again, I am pleased that all eight of the children have made it home safe ― I just hope that Nadya Suleman pays as much attention to their progress as she has to publicizing their births, because it should always be about the kids.

Spring signifies the beginning of a new baseball season, new gardens to plant, and longer days. For educators, parents, and students across the U.S., spring also signifies the time for standardized testing. The merits of these standardized tests are constantly debated, but like it or not, they are certainly happening this year and your child’s testing date is rapidly approaching. Because standardized tests can affect classroom placement for the following academic year, parents are usually as anxious about the process as the children taking them. Here are some tips for helping your child get ready for the standardized tests in any state.

• Leave your child a detailed to-do list of activities around the house. For example, Make your bed after you brush your teeth. When you are finished, underline this sentence. Following written directions are an important part of testing, and your child needs to attend to the order and specificity of directions, or his or her answer could be marked incorrect. Attending to written language will support them in all content areas being tested.
• Find ways to bring the curriculum to life! Show your child the way the skills he or she attains in the classroom can be applied in the real world.
• To bring math to life, include your child in the weekly grocery shopping and have him compare prices,   calculate savings, or find the average cost per item from the total bill. You can take notes on these items in the store and do the work at home where there are less distractions and you can guide your child through the mathematical process, if needed.
• To support reading skills, cut out an article of interest from your local paper and have your child read it. (Remember to read it first so you can help him answer questions he has trouble with!) After he has read the article, ask a series of comprehension, or “wh” questions such as “Who participated in that event?” “Where did the event take place?” or “What time was the event finished?”  The skill of recalling basic information from a reading entry is an essential building block for success in this area. In addition to the basic comprehension questions, ask your child to infer things from the article, such as “Why do you think that person enjoyed the event?” The skill of drawing a logical conclusion from the information  presented develops his abstract thinking skills, which comes into play frequently in the open-ended question portion of standardized tests.
• Remain an active participant in your child’s nightly homework, even as she gets older and gains more independence. Keeping abreast of the content area throughout the year makes it easier for you to remember the material come testing time, and also establishes a comfortable routine between you and your child. She will be more open to your assistance if you have been offering it all along.

Don’t be afraid to ask your child’s teacher for a packet of review work or have him or her suggest materials to use at home. Becoming familiar with the content and layout of the test will help you feel more in touch with your child’s testing experience. Your child’s teacher most likely has a clear picture on areas your child may be struggling with or could use extra support in. You are maximizing your child’s study time by communicating with his teacher.

Make sure your child is well-rested and eats a well-balanced diet throughout the year. This is especially important the week of testing. Your child’s biological needs must be met as a pre-requisite for optimal focus and energy. Translation: Children cannot do their best if they are tired and hungry! Make sure your child has a protein-packed breakfast, such as eggs and whole-wheat toast. Stay away from sugary cereals and breakfast bars, as the sugar will wear off around the start of testing and your child will experience a “sugar crash,” leaving her jittery and/or lethargic.

Stay calm! Your child will undoubtedly pick up on your anxiety and stress related to the test. Reassure your child that no matter what ― you are proud of his or her hard work!

You and your spouse may be raising your child, but clearly it takes a village to educate her. Educators, administrators, and parents must work together to ensure each child has the greatest success possible in their standardized testing experience.

Jennifer Cerbasi teaches at a public school for children on the autism spectrum in New Jersey. As a coordinator of Applied Behavioral Analysis programs in the home, she works with parents to create and implement behavioral plans for their children in an environment that fosters both academic and social growth. In addition to her work both in the classroom and at home, she is also a member of the National Association of Special Education Teachers and the Association for Supervision and Curriculum Development.

Today I read a story about a woman at the center of a controversial legal battle in Italy.

Eluana Englaro had been in a vegetative state since she was in a car accident 17 years ago. The media was calling Englaro “the Terri Schiavo of Italy,” because her case was similar to woman here in the United States. (Schiavo’s husband as legal guardian, wanted his wife’s feeding tube removed, but Schiavo’s parents fought their son-in-law for years to keep the tube in place).

Englaro’s father fought the Italian courts to remove his daughter’s feeding tube, which kept his daughter alive, saying it was not his daughter’s wish to be kept alive “artificially.”

This case sparked heated debate between parts of the Italian government and the Catholic Church, who likened the removal of the feeding tube to euthanasia, which is illegal in Italy. And the legal battle that ensued brought to light the ethical issues surrounding euthanasia and the right-to-die, as well as the legality of living wills.

This case sparked heated debate between parts of the Italian government and the Catholic Church who likened the removal of the feeding tube to euthanasia, which is illegal in Italy. And the legal battle that ensued brought to light the ethical issues surrounding euthanasia and the right-to-die, as well as the legality of living wills.

Unfortunately, the woman died before any of these legal issues were resolved, and I’m sure this is a controversial debate that will rage on among contending parties for years to come.

But one of the most interesting aspects of this story has nothing to do with lawmakers and government officials at the center of the debate. Rather, it’s the way the people in the region have taken matters into their own hands, and the ever-expanding role technology is beginning to play in the public’s interpretation of the law.

Over the weekend, some Italian citizens began creating living wills on YouTube, documenting their personal wishes with regard to “do not resuscitate” (DNR) orders, designation of health care proxies and any other modifications they feel are important, in the event they are rendered incapacitated. But the irony lies in the fact that in Italy, there is no legislation on end-of-life issues and no recognition of living wills as legal documentation of a person’s wishes.

Here in the U.S., it’s quite the opposite. As physicians, a standard question that we must ask all patients upon admission to the hospital is whether or not they have a living will. If they do, we request to see a copy of it so that it can described in detail in the patient’s chart.

But I have to tell you, in the last few years since this law was mandated, I can literally count on one hand, the number of patients that have answered yes to that question. For many of us, it’s human nature to try not to think about what could go wrong, so we often don’t take the time to plan for it.

So when I look at these people taking matters into their own hands, making a short video clip detailing what they would want done in a worst-case scenario, I’m curious about how these videos will be interpreted by the law in future ethical debates, and at the end of the day, if their wishes will be honored.

Join the discussion on my Facebook page.

Today, millions of people across the country are making a date with history. To the millions of Americans looking for change, the inauguration of President Barack Obama marks a new beginning, bringing forth a universal feeling of patriotism, hope, and excitement. On this day, students are wearing T-shirts with Obama pictures to school, vendors are flooding the city streets, selling everything from flags to buttons, and millions of people are glued to their television sets, the Internet and radio stations — all to be a part of this monumental event in our nation’s history.

This morning, here at Hackensack University Medical Center, I met a couple who I think will remember this day for the rest of their lives — not only because of its distinguished place in American history — but because of its place in their hearts, as the birthday of their new baby girl. After the delivery, I asked the proud parents why they scheduled the birth (a C-section) for this day and they told me that — as African Americans — they wanted to give their child a gift she would remember for the rest of her life — a gift that would honor and empower her as a symbol of the hope and change that became reality when the first African American man became the new leader of the free world.

I am sure that of all the things that President Obama has received congratulating him on his well-deserved victory, nothing will match the gift of a life that represents a generational change and a belief that hope will continue to keep America strong and prosperous.

Sometimes, making a mistake teaches an invaluable lesson.  And so it is with the loophole in Nebraska’s “safe haven” law, a statute that allows parents to drop off children at hospital emergency rooms if they are unable to care for them.  The trouble is, Nebraska lawmakers neglected to define “child.”  So far, 34 children, some of them as old as 17, have been dropped off, including two teenagers just last Thursday. 

A special legislative session is underway in Nebraska to fix the law.  While different bills have been offered, the legislature will probably end up defining a “child” as one year of age or under.

Fixing the safe haven law, however, won’t fix the problem that the mistake in Nebraska has uncovered.  Many parents there—and across the nation—feel utterly unable to parent effectively and are looking for a way out.

It would be easy to demonize parents who bring a 5 or 13 or 17-year-old son or daughter to the hospital and say goodbye, but I don’t presume that all or most of these parents are unfeeling monsters looking to shirk responsibility and lay it at the doorstep of government.  And even for the percentage of parents who are that disordered in their characters, I wouldn’t want their children to remain in their custody, anyhow.

The real problem isn’t the Nebraska loophole, it’s the lack of available guidance and services for parents who are dealing with children and adolescents more prone than ever to use alcohol and illicit drugs, fall victim to psychiatric disorders like Attention Deficit Disorder and Bipolar Disorder and even succumb to joining gangs (which are now invading the suburbs, not just confined to urban centers).   The story of a Florida man driving all the way to Nebraska to drop off his 11-year-old boy is a story of desperation, not depravity.

I’ve always believed that we end up paying exponentially, in the long run, for underestimating how many American families are in crisis, without parents who can properly direct, discipline and nurture their kids.  Now, we have a little window, thanks to Nebraska, on the intensity of the trouble in some families, though still no insight into the real number of such families.

What is called for is a system of graduated aid to families in psychological distress.  This has to begin with case finding—perhaps through the schools—and continue through a spectrum of services, including parenting courses, child counseling and medication clinics, respite services and, yes, beefed up options for good foster care and adoption.

Here’s something to think about:  I recently referred a Massachusetts girl to a local child psychiatrist for help with symptoms that were overwhelming her parents and her school system.  Until she used my name to move up on the waiting list, she was given an appointment four months down the road.  And that’s Massachusetts, comparatively rich in medical resources.  According to Time magazine, Nebraska has a grand total of six child psychiatrists in the entire state.

So many in Congress are all about bailing out the auto industry and the banking industry and the mortgage industry and maybe a few cities along the way, moves that will ultimately weaken the marrow of our economy, upon which rests the hope for renewed ideas and approaches to real economic growth.  Some of their energy would be better spent bailing out emotionally overwhelmed American families, upon whose children’s shoulders rests the future.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s website at livingthetruth.com or e-mail him at info@keithablow.com.