Tag Archives: Teenage Issues

Cyberbullying for Kids

By Ritu Chandra, MD

Bullying is unwanted, aggressive behavior among school aged children and includes  behaviors that focus on making someone else feel inadequate, or focus on belittling someone else and is done with the intention of bringing another person down. There are different kinds of bullying: physical, social, verbal, cyber.


Cyberbullying is bullying that takes place using electronic technology, including devices and equipment such as cell phones, computers, and tablets as well as communication including social media sites, text messages, chat, and websites.

Examples of cyberbullying include mean text messages or emails, rumors sent by email or posted on social networking sites, and embarrassing pictures, videos, websites, or fake profiles.

Why Cyberbullying is Different

-Cyberbullying can happen 24 hours a day, 7 days a week, and reach a kid even when he or she is alone. It can happen any time of the day or night and even during the summer vacation. It is hard to get away from the behavior.

-Cyberbullying messages and images can be posted anonymously and distributed quickly to a very wide audience.

-It can be difficult and sometimes impossible to trace the source.

-Completely deleting inappropriate or harassing messages, texts, and pictures is extremely difficult after they have been posted or sent.

Effects of Cyberbullying 

Kids who are cyberbullied are more likely to use alcohol and drugs, skip school, experience in-person bullying, be unwilling to attend school, receive poor grades, have lower self-esteem, and have more health problems.

Real Examples of Cyberbullying for Kids

  • A kid in Pennsylvania committed suicide because he was called a ‘freak’ and was told that no one liked him.Cyber bullying for kids
  • A kid jumped off a bridge because his homosexual sexual encounter video was posted online.
  • An OH girl sexted a nude photo of herself to her boyfriend. When they broke up, he posted this photo on social media sites and then the entire school started calling her names; she hung herself in her closet. This is called ‘Revenge Porn.’

Why children do not seek help?

-No language or framework, feel alone, fear of retaliation, think others may not believe them, parents or teachers may not know what to do

Prevent Cyberbullying for Kids

Parents and kids can prevent cyberbullying. Together, they can explore safe ways to use technology.

  • Talk with your kids about cyberbullying and other online issues regularly.
  • Be Aware of What Your Kids are Doing Online- know the sites your kids visit and their online activities, ask where they’re going, what they’re doing, and who they’re doing it with.
  • Tell your kids that as a responsible parent you may review their online communications if you think there is reason for concern.
  • Installing parental control filtering software or monitoring programs are one option for monitoring your child’s online behavior, but do not rely solely on these tools.Cyberb
  • Have a sense of what they do online and in texts.
  • Learn about the sites they like.
  • Try out the devices they use.
  • Ask for their passwords, but tell them you’ll only use them in case of emergency.
  • Ask to “friend” or “follow” your kids on social media sites or ask another trusted adult to do so.
  • Encourage your kids to tell you immediately if they, or someone they know, is being cyberbullied.
  • Explain that you will NOT take away their computers or cell phones if they confide in you about a problem they are having.


Establish Rules about Technology Use

  • Be clear about what sites they can visit and what they are permitted to do when they’re online. Show them how to be safe online.
  • Set a strong password.
  • Help them be smart about what they post or say. Tell them not to share anything that could hurt or embarrass themselves or others. Once something is posted, it is out of their control whether someone else will forward it.
  • Encourage kids to think about who they want to see the information and pictures they post online. Should complete strangers see it? Real friends only? Friends of friends? Think about how people who aren’t friends could use it.
  • Tell kids to keep their passwords safe and not share them with friends. Sharing passwords can compromise their control over their online identities and activities.


Steps to Take ImmediatelyCyberbullying for kids 1

  • ALWAYS TELL. The most important thing is that you tell someone about the bullying. “A problem shared is a problem halved.” If possible, this should be an adult that you trust.
  • Don’t respond to and don’t forward cyberbullying messages.
  • Keep evidence of cyberbullying. Record the dates, times, and descriptions of instances when cyberbullying has occurred. Save and print screenshots, emails, and text messages. Block the person who is cyberbullying.
  • Change the phone number or online ID of your child

Report Cyberbullying to Online Service Providers

-Cyberbullying often violates the terms of service established by social media sites and internet service providers and it should be reported so they can take action against users abusing the terms of service.

  Report Cyberbullying to Law Enforcement

Cyberbullying for kids should be reported to law enforcement officials in cases of threats of violence, child pornography, sending sexually explicit messages or photos, talking and hate crimes.

Report Cyberbullying to Schools

Cyberbullying can create a disruptive/hostile environment at school and is often related to in-person bullying. The school can use the information to help inform prevention and response strategies.

Dr. Ritu Chandra is the founder of Preferred Medical Group. She is a board-certified pediatrician, and school related-problems, such as bullying is a special area of interest.

Eating Disorders/Body Image in Teens

By Michelle DeRamus, Ph.D.

The first time I remember being aware of my own body image was when I was in second grade. I was on the bus, and a girl a few years older than me asked with a smirk, “Do you think you’re fat? ‘Cause I don’t… I think you’re skinny as a rail.” I didn’t think I was fat, but I could tell by her sarcasm that she did. And so began the lifelong battle that so many of us face – developing and maintaining a positive body image.

So many things affect our body image, that is, the way we perceive their own bodies and how we think others perceive our bodies. It is influenced by our own personality, our life experiences with peers and family, and of course, what we are exposed to in the media. While most people have some difficulty with their body image at some point in their lives, girls and women tend to have a significantly greater struggle than boys and men, especially during the teenage years. The effects of a negative body image in teens can be devastating, leading to low self-esteem, unhealthy habits, depression, anxiety, and even eating disorders.

As we enter summer (and swimsuit season), following are some tips to help promote a more realistic and positive body image in your child or teenager.

  • Help your children have a realistic understanding of media images. As adults, most of us know that the models we see in the media have been airbrushed and “touched up” in a variety of ways. Several examples in recent years have given us the opportunity to see “before” and “after” pictures of models and actresses to help us understand that the final image we see is not reality. It is important for our teens to realize that the images they see in the media are not realistic. These images are also not attainable by approximately 95% of the population. Just because we see dozens of images of “beautiful people” each day does not mean that is the norm. However, if children and teens do not understand this concept, it can lead to expectations that most people look like those we see in the media, which creates unrealistic expectations for perfect bodies and creates poor body image in teens.body image in teens


  • Help your children develop a positive self-esteem. Everyone has strengths and weaknesses. It is important for children and teens to recognize their strengths across different aspects of life, whether it is sports, academics, personality and character traits, hobbies, other extracurricular activities, or social skills. Help your child identify and then strengthen their positive qualities. Guide them in understanding how these positive qualities can help them reach their goals and that success is not dependent on physical appearance.


  • Help your children develop good social skills. Much of our desire to look a certain way is driven by an underlying desire to fit in. Society, peers, and sometimes even family tell us that we will be more successful or better liked if we are a certain size or shape. However, the reality is that there are other ways to make friends and feel like you belong to a group. Children who know how to get along with others and have a positive peer group that supports and encourages them may be better able to keep their body image concerns in perspective.


  • Help your children learn how to focus on being healthy rather than focusing on looking a certain way, weighing a certain amount, or eating a certain number of calories. A focus on overall health can help children learn moderation in all things, both the excesses (e.g., desserts, sedentary activities) and the restrictions (e.g., limiting food intake). A focus on health also takes the emphasis off the image in the mirror and back onto how your child feels. Point out that your body is an amazing tool that can help you reach your goals, rather than something to be scrutinized and criticized.

Body Image 2 Mom and Teen

  • Help your children learn positive stress management techniques. Many unhealthy habits develop in response to stress. Teaching children and teens to manage stress appropriately with fun activities, social support, problem solving, exercise, and relaxation can prevent unhealthy habits from developing.


  • Be an example. Children, and even teens, learn the most about how to “be” from their immediate family members. Even at a very young age, children notice when adults are critical of their own bodies in front of their children. If children see other family members modeling poor body image, they will grow to think that is the norm. One of the best ways to teach the above strategies to your children is to follow them yourself.

While almost everyone struggles with body image at some time, most people are able to ultimately keep appearance in perspective as only one part of who they are as a person and do not develop serious consequences as a result of their perception of ideal body image. However, for some individuals, body image becomes so distorted or such a priority, that significant problems develop, such as depression, anxiety, or eating disorders. Some warning signs of body image issues in teens that preclude a more serious condition include:

  • Changes in eating patterns (e.g., decreased intake, binging, vomiting after meals) Body Image 1
  • Preoccupation with weight, food, calories, exercise, etc.
  • Dramatic changes in weight
  • Frequent comments or anxiety about being “fat” or overweight
  • Development of rigid food or exercise rituals
  • Withdrawal from friends, family, or previously enjoyed activities

If you are concerned your child may be experiencing emotional problems or an eating disorder as a result of poor body image, it is important to get help right away. Early treatment leads to better outcomes. Talk to your child’s doctor about resources in your area.

Dr. DeRamus is a child psychologist with Preferred Medical Group’s Phenix City Children’s clinic. She specializes in Autism Spectrum Disorder (ASD) and provides diagnostic testing and therapy services for developmental delays, learning problems and ADHD. She also works with kids with anger, anxiety, depression, family problems and peer relationships.


E-cigarettes- all you wanted to know

By Ritu Chandra, M.D.

Electronic cigarette (e cigarette) use or ‘vaping’ is the new epidemic in tobacco use. Vaping products look like cigarettes and are typically disposable, such as e-hookahs, vape pens, and refillable tank-like or personal vaporizers. These devices heat a solution of nicotine and other additives that produce a vapor that is inhaled without combustion. The basic structure includes a chamber with juice of nicotine, a heater that heats and vaporizes the juice and a battery.

The use of e-cigarettes is growing exponentially. Use of e-cigarettes is highest among current cigarette smoking adults in the U.S. and has increased from 9.8% in 2010 to 21.2% in 2011 to 32% in 2012. The use is highest in the 18-24-year-old age group and in those with less education. The use by middle and high school students more than doubled from 2011 to 2012.e cigarettes

E-cigarettes have been on the market for approximately 10 years, and at this time, the manufacture of e-cigarettes is completely unregulated.  Proposed legislation calls for oversight from the FDA and/or Consumer Protection Safety Commission, but this has passed as yet. Also, no conclusive data exists on the long term effects of e-cigarette use.

As a pediatrician, I feel that e-cigarettes are a mixed blessing. We have worked for decades to decrease the burden of death and disease from tobacco. In the healthcare field, we have had the vision to build a generation that rejects tobacco. We have been doing a tremendous amount of work for decades, to get legislation passed for smoking bans, laws against advertising cigarettes to youth, laws against sale of tobacco to youth, clean air laws, etc. But, with the introduction of e-cigarettes we feel that all of that progress is being undone.

As with most things, pros and cons exist regarding e-cigarettes:

What I like about e-cigarettes:

  • Less adverse health effects than combustible cigarettes: the amount of nicotine is usually less than that in a cigarette, but the nicotine content is very variable.
  • The vapor is less harmful than cigarette smoke but not harmless because it does contain nicotine, Nitrosamines, heavy metals and propylene glycol and there is concern regarding exposing bystanders.
  • For those already using combustible tobacco or cigarettes and are unable or unwilling to stop, I support moving to the exclusive use of less harmful alternatives, such as e-cigarettes, with the goal of eventually stopping all tobacco use. Prudently regulated, e-cigarettes hold promise as a means to move current smokers towards smoking cessation and away from the devastating burdens of disease and death caused by combustible tobacco products such as cigarettes, cigars, or hookahs.
  • E-cigarettes may help smokers move towards decreasing their cigarette smoking or even help them with quitting. Several observational studies suggest that e-cigarettes can help adult smokers quit smoking.

What I do not like about e-cigarettes:

  • Undermines the vision of a society that rejects tobacco
  • They are re-normalizing the image of smoking.
  • The sweetness and multiple flavorings (pina colada, pancake, maple syrup, etc) in e-cigarettes are very appealing to youth, and more youth are getting introduced to nicotine use.
  • For those wanting to quit smoking, the e-cigarettes promote continued nicotine use (i.e. another source that may contribute to tobacco usage and addiction).
  • The unrestricted advertising of e-cigarettes is targeted to appeal to youth and mislead the public.
  • E-cigarette users are undermining smoke free and clean air laws.
  • Manufacturing and safety standards are unregulated at this time, including: child-proof packaging of e-liquids and cartridges, accurate labeling of ingredients and nicotine content. Some e-cigarettes have actually accidentally caught on fire due to faulty batteries.
  • E-juice may contain marijuana and promote marijuana use because often the vapor does not have the smell of marijuana.
  • E-cigarettes are less expensive than cigarettes and hence more likely to appeal to youth. The average price is $10, and the tanks can be refilled relatively inexpensively.
  • E-cigarette users perceive that the second hand vapor is less offensive to non-smokers; therefore, new users are more likely to pick up e-cigarettes.
  • E-cigarette use might be a gateway into nicotine dependence and cigarette use.

As a pediatrician, I strongly advocate for having more stringent laws related to the manufacture, sale and use of e-cigarettes. I would support:

  • Enforcement of laws so that e-cigarettes do not target or appeal to youth- no candy flavorings
  • No sale to youth younger than 18 years of age
  •  Advertising materials and packaging do not provide misleading information to the public

 Current Laws and Regulation

  • As of May 2014, 34 states have prohibited the sale of e-cigarettes to minors.
  • As of  April 29, 2014, three states (North Dakota, New Jersey, and Utah) and 172 local governments have included e-cigarettes in their indoor air laws and smoking bans.
  • The U.S. Department of Transportation has proposed a ban on the use of e-cigarettes on planes, but that rule has not been finalized. Several airlines have prohibited smoking e-cigarettes on their aircraft on their own accord.

In conclusion, to vape or not to vape: try e-cigarettes it if you are a current smoker and you are trying to stop or cut down on smoking and do not feel that you can stop tobacco use altogether at this time. But, anyone who is not currently using tobacco products is cautioned about using vaping because it can lead to tobacco dependence and other long-term health consequences.




Having the sex education talk with your teen: A Pediatrician’s recommendation

By Shilpa Vernekar, M.D.

As a parent you have been by the side of your child, from the adorable infancy stage (and those not so adorable sleepless nights, trying in vain to rock the baby to sleep), through the “terrible two’s,” all the way up until puberty. You have been the one holding his/her hand and passing down small, golden nuggets of wisdom to help your child grow and excel. Then, the teen years start.  Having Talk with Teen 2

This is a turbulent phase for parents and children alike. Conflict is natural during this time, which we all know often comes with several big life changes for the child: the start of high school, the much-anticipated driver’s license (and subsequently terrifying driving lessons with Mom and Dad), perhaps the first serious romantic relationship for your child, and of course – the sex education talk.

As a parent, you may be wondering how to approach the topic regarding sex education and when to have the sex education talk. Those kids doubtlessly threw “the stork theory” away years ago along with Santa Claus and the tooth fairy. The teenage years, with high levels of hormones and emotions, are a time when kids may wish to explore the topic of sex, and curiosity is quite natural during this phase of life. However, they most likely do not wish to explore this topic with their…(gasp) parents!

Therefore, as a parent, one must think strategically about certain aspects of this conversation, such as when and where to have it.

When is the right time?

The day that your mind starts to think about providing sex education advice, that is the right time. You know your child more than the school teacher or his/her friends. So if you are wondering if this is the right time, then yes it is. Let it not be delayed beyond 13 years of age.

What is the right location?

A place where the chances of you both being uninterrupted is best. Also, a place that the teenager sees as familiar is desirable. For example, you could begin this conversation in the teenager’s room. If a straight eye-to-eye conversation makes you uncomfortable, you can do an activity together, such as cleaning the room. You can help to arrange things in their proper places until the ice has been broken and the conversation has started.

How do I start the topic?

Try to assess how much your child already knows. As much as you feel your teen might be clueless this area, the chances are that he/she already has information through school, friends, books, TV, or the Internet. Teenagers know way more than we think they know.

So, the best way is to hit right on the topic.

Talking with your teen about sex   Having Talk with Teen

What are the important aspects to be covered?

  • First, gather the information that your teen already has. Listen to him/her and then attempt to correct the information.
  • Secondly, explain what could be the possible consequences of having sex, including: emotional involvement, pregnancy and sexually transmitted infections (STI), and impact on school life and higher education.
  • Research has shown that having a baby in the teenage years permanently impairs the career opportunities for both the teenage mom and dad. Pregnancy and birth is a serious life-altering change that cannot be reversed. Hence casual sex should not be taken lightly.
  • Thirdly, make sure your teen is also aware about inappropriate touching, which can slowly evolve into sex. It is important for the teen to know that he/she should not be forced into having sex under any pressure.
  • Let them know how substances like alcohol and/or drugs can affect thinking and impair judgment. Discuss the very real possibility that using these substances could lead to sexual activity that the teenager is not ready for and could even potentially lead them to become a victim of sexual abuse.
  • Peer pressure, curiosity, and the desire to be loved are some of the reasons why teenagers have their first sexual experience before they are ready for it. Emphasize that you do not wish for this to happen to them because they may have regrets later if they participate in sexual activity that they are not ready for.
  • All of this conversation may not happen in one day.
  • Be patient. Just like you needed time to teach your child, his/her A,B,C alphabets, similarly you will need time to guide your child about sex. Gain his/her confidence, and emphasize that you will always be there to answer all of their questions and help them through this phase.
  • If you have any personal, family, religious or cultural beliefs, pass on this information as well to your child.
  • If you feel comfortable, you may share your positive/negative experiences about sex to your teen, which could help in the teen’s decision-making process.
  • Lastly, make sure your teen is aware about common birth control options. You can always visit his/her pediatrician to help you explain these options in detail.

Some common birth control methods:

  • Abstinence – Avoid sex. It is ideal but not always practical.
  • Withdrawal method- It has a high failure rate and does not protect against STI.
  • Barrier methods (Male and female condoms) – Effective if used the right way. Offers protection against STI, but not highly reliable to prevent pregnancy.
  • Hormonal methods- Birth control pills, Depo shot, patch, ring, implant and intrauterine device. These methods are more effective in preventing pregnancy, but they do not offer protection against STI.
  • Others- Basal body temperature method, cervical mucus changes and calendar method to predict ovulation. These techniques are unreliable in preventing pregnancy or predicting ovulation for a teenager who has irregular menses or fails to keep track of their menstrual cycles.

More detailed discussion on each of these methods can be easily provided by your teen’s pediatrician.

At the end of the conversation, feel good about helping your teen make the correct choices. Studies have shown that when parents have a positive approach towards sex and are willing to guide their teenagers through it, unwanted outcomes of sex are avoided and the teenager is more capable of making the right choice. When it comes to the birds and the bees, knowledge is power.


  1. Don’t wait too late to have “the talk.” If you feel this may be the right time, it most likely is.
  2. Open the conversation in a casual, light way. You could even be working on an activity together with your teenager, such as helping him/her clean their room.
  3. Remember to explain to your teenager that sex is not something to be rushed into prematurely due to peer pressure, curiosity or a desire to be loved.

This blog was first published on http://www.muscogeemoms.com

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