PC4DC/Forum In The News
June 20th, 2010 tyko
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The intrauterine device also protects against endometrial cancer.
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Choosing a Daycare Center – Part 2
February 1st, 2010 shendlLast month we talked about how to think about the needs of your child as you select a daycare center. This month we will look at other aspects of daycare that are important to pay attention to. 
1. What kind of training does the staff have: It is very helpful for the daycare workers to have a background in the theories of child development. With a sense of what is appropriate for a particular age group, you can receive information about your child that may be remarkable. It will help determine what activities the daycare center offers to your child and how to help them have appropriate relationships with the other children and staff. Make sure the staff is trained in first aid. Red Cross trainings are very effective.
2. Does the center offer you access to a satisfying relationship with them: Ascertain if the center is available to interact with you when you have questions or concerns. You know it can be frustrating when the staff is not available to address issues to do with the welfare of your child. Find a daycare center that allows parents to be involved with the children’ activities, when it is possible in your schedule. You can get the best sense of the appropriateness of the center when you can have an active role in it. Get a sense of how much turnover there is in the staff. It makes it difficult to have a satisfying relationship for you or your child.
3. What can you expect to receive in writing: The daycare center should be able to provide a written copy of their policies. Choose a center that knows how they operate in terms of discipline, illnesses of the children, food they provide, etc. The more they are organized and have documentation of their policies, the better able you are to assess the appropriateness for your child.
4. Is the daycare center a safe place for your child? Checking for safety is something that parents often do instinctively when they are with their children. However, it is sometimes overlooked when an establishment like a daycare center is being considered. It is thought that because it is their business to care for children, of course, it will be the model of safety. It is a good bet that this will be true, however, checking on a few things is a good idea.
• What kind of access do people who are not connected to the day care center have to where the children are?
• Are all dangerous substances completely out-of-reach?
• Should there be any problem, are the emergency numbers (ambulance, poison control) posted next to the telephone or saved into cell phones?
• If there is a playground, does it have a soft and/or impact absorbent surface underneath?
• Are the electric outlets fitted with safety covers?
• Are there appropriate smoke alarms and fire extinguishers?
• What are the policies for cleaning the facility, toys and hand washing?
5. Do they have a set schedule of activities? Most centers have a policy of providing an array of activities that encourage play (alone and in groups), rest time and meals. These activities promote socialization in children while also being cognizant of their developmental abilities.
6. Are the times appropriate to your needs? Make sure the daycare center is open as early and as late as you need it to be to fit your schedule. Find out what the additional fees are should you need extended care. Determine if there are fees for being late to pick up your child.
These considerations address the needs of you and your children both logistically and psychologically. When you are comfortable that your child is safe and being taken care of by competent people, it allows you to manage the rest of your life without distraction. Given the stressful lives many of you lead, it is best to put time and effort into the selection process rather than having to address problems as they might arise.
In order to accomplish these suggestions, consider doing the following:
• Start looking at daycare centers well before your child will be starting.
• Decide what is important to you and write them down to bring with you when you visit.
• Visit a number of centers to get a sense of their differences and which meet your requirements.
• Make sure you have access to a knowledgeable person to ask all the questions you have.
• Interview others that have had their children there.
• When you have narrowed down or decided on a center, bring your child for a visit.
Good luck,
Dr. Shendl Tuchman
Shendl Tuchman, Psy.D.
2 Crow Canyon Court, Suite 200, San Ramon, CA 94583
phone: 925.201.3435
3120 Telegraph Ave., Suite 9, Berkeley, CA 94705
phone: 510.595.5525
fax: 510.496.2712
dr.tuchman@earthlink.net
Mother of Nine Sues Massachusetts Hospital
January 6th, 2010 tykoBy SARAH NETTER
Jan. 5, 2010
A Massachusetts mother with nine children who had asked a hospital for post-delivery birth control was sterilized instead without her consent, according to a lawsuit against the Springfield hospital and several doctors and nurses.
Tessa Savicki, 35, claimed that doctors at Baystate Medical Center had agreed to insert an intrauterine device, or IUD, that she brought to the operating room, but instead performed a tubal ligation that effectively ended her chances of having more children.
“They’ve done something. They cannot correct this,” she told ABCNews.com. “You think you’re safe at the hospital. You’re not.”
Savicki’s attorney, Dr. Max Borten of Waltham, Mass., a licensed obstetrician-gynecologist who practiced for 30 years, said his client was devastated when she found out about the tubal ligation shortly after a December 2006 Cesarean section.
Awake with only spinal anesthesia, Saviciki “realized that when she was still on the table,” he said.
Savicki’s children range in age from 3 to 21 and she is a grandmother of one with another grandchild on the way. She had her first child, a boy, at age 13 after being raped, she told ABC News.
Getting back on her feet after a rough start — two of her children are on welfare and she is unemployed — Savicki said she’s working toward her GED.
Her three youngest children are with her fiance, Angel Tirado, who she said was hoping for one more baby. Their youngest, Manuel, was recently diagnosed with autism.
“He was talking about trying for another boy,” she said.
She understands that she would not be able to adopt, given her financial situation.
Borten said the chances of Savicki being able to become pregnant again, even if an attempt to reverse the procedure was performed, would be slim.
“The issue here is a little broader and more involved than what people think,” Borten said, noting how sterilizations have been used throughout history to control populations deemed unsavory. “The issue is, who has the right to permanently sterilize a woman? Or a man?”
Savicki said she believes the doctors intentionally sterilized her without her consent. “I honestly think they thought I had enough,” she said.
Jane Albert, a spokeswoman for Baystate Health, declined to comment on the lawsuit or Savicki’s own medical care, citing federal privacy regulations.
But speaking in general terms, it is “absolutely not” normal procedure for a woman to carry her own IUD into the operating room, Albert said.
“It is not our practice for a patient, it is not our practice to insert an IUD into a woman who has just had a C-section,” Albert said.
Choosing A Childcare Center
December 31st, 2009 shendlHappy Holidays Everyone! 
Welcome to the new PC4DC Community Forum. I hope you all had a healthy and enjoyable holiday season. It is now the beginning of a new year and a new decade.
I thought the first series of writings for the PC4DC Community Forum should be about how to choose a day care center. There are a number of areas to think about that affect the well-being of your child and your ability to take best advantage of the facility. Because there are many options to consider I will be breaking it up into a series. Today, let’s look at what things to consider when determining how well a day care center matches your child.
What do you know about your child or want to think about as you go about choosing a day care center? As the foremost expert on your child, you are in the best position to determine in what type of environment he or she will thrive. For instance, would your Sally do best in a larger or smaller group of children? Is a larger daycare center preferable to an in home center with fewer children? For children who are from larger families, they may do well in a day care facility that has more individualized attention. For children in small families or where Johnny may be an only child, he may benefit from socializing with a larger number of children. These are just ideas and may not match the individual needs of your child.
If possible, it is generally a good idea to visit the daycare centers without your children first so you can have time to observe and ask questions. Once you have found one or two that you are interested in, it is generally a good idea to bring your child to the center to explore and interact with the teachers, environment and other children. Observe how comfortable or uncomfortable Linda seems. Keep in mind how easily she transitions from being in your care to being at the day care center. Many children have a difficult time moving from one emotional environment to another. It is not necessarily a sign of their comfort at the day care center. Making transitions is often difficult for children. Think about all the many ways you try to get your child to stop doing something, like watching TV or playing with toys to come to the table to eat or get ready for bed. Children have different temperaments and abilities to focus. Again, you know your child and are in the best position to evaluate what the most positive environment is for them–especially once you know what to look for and what questions to ask yourself.
The questions and answers change depending on the age of your child. If you have an infant, you are looking to see how your child experiences strangers and how much attention the staff gives to infants’ basic needs of feeding, changing, and human interaction. Does Johnny need time to go from one person to another? Is it easier for him to transition once you have left? How well does he transition back to you when you return? Does the staff interact with Johnny beyond caring for his feeding and diapering? If your child is a toddler, you are looking for this information as well as how your child seems to maneuver in the environment. Does Sally know how to occupy herself? Does she need individualized attention to be able to play on her own or with other children? Does she get overwhelmed by large numbers of people? If your Robbie is 3 or 4 years old, what do you notice about how he interacts with other children or takes direction? These questions are helpful in determining what type of day care would best meet the needs of your child.
Day care centers have different child to caregiver ratios. Generally, the fewer children each teacher needs to be involved with, the more attention each child will get. This is not necessarily the most important consideration, but the younger the child is the more you want to have a pair of eyes on him or her at all times. The American Academy of Pediatrics suggests the following child-staff ratios:
|
AGE |
CHILD-STAFF RATIO |
MAXIMUM GROUP SIZE |
|
Birth-12 months |
3:1 |
6 |
|
13-30 months |
4:1 |
8 |
|
31-35 months |
5:1 |
10 |
|
3-years-old |
7:1 |
14 |
|
4-5 years old |
8:1 |
16 |
|
6-8 years old |
10:1 |
20 |
|
9-12 years old |
12:1 |
24 |
I hope this has helped you to start thinking about one aspect of choosing an appropriate childcare facility for your son or daughter.
Happy New Year.
Dr. Shendl Tuchman