Beijingkids has been an essential family resource for Beijing international families since 2006. And just as kids grow up in the blink of an eye, Beijing has grown and changed almost beyond recognition in that time. In Throwback Thursday we jump in the time machine, traveling through our 14 year-strong blog archives to dig out the most entertaining, fascinating, and thought-provoking stories for your reading pleasure. Ready? Let’s go…

When kids seem to want to subsist on chicken fingers, French fries, and pizza alone, you have to wonder whether they’re getting all the vitamins they need. Vitamin deficiencies can cause serious health problems, but how worried should parents be about their children clinically lacking vitamins? Back in 2013, beijingkids spoke to Dr. Maher Eldadah, M.D., a pediatrician at Beijing United Family Hospital, and Dr. Basim Ansari, a family medicine practitioner at the then Puhua International Hospital in Shuangjing (Ed’s note: Beijing Puhua International Hospital is now located at 12 Tiantan Dongli, near the Temple of Heaven), for clarity on vitamins, what a lack of them can mean, and the best way to ensure optimal nutrition.

Do we need to be loading ourselves and our kids up with vitamin supplements?

Vitamin Deficiencies – Should You Worry?

The good news is, “it’s hard to imagine someone developing a vitamin deficiency unless they have very strange eating habits,” says Dr. Eldadah. “As long as your child is eating a regular, healthy diet, vitamin deficiencies are not common.” That goes for parents, too.

“Vitamin deficiencies are uncommon in general populations,” agrees Dr. Ansari. But women and children can become deficient in certain vitamins in certain cases, he continues, so tests to rule out a vitamin deficiency are sometimes recommended. Unfortunately, there is no single test to determine all vitamin deficiencies, so each one must be tested separately.

Vitamin D

Vitamin D has received a lot of attention recently, especially since some studies found low levels of vitamin D in hospitalized COVID-19 patients. Found in fortified dairy products like milk, cheese, and yogurt, as well as naturally in egg yolks and fatty fish like sardines and tuna, vitamin D is synthesized when the skin is exposed to the sun. Deficiencies in vitamin D arise especially when children are kept away from the sun or live in regions that get little sunlight, such as Scandinavia.

While using sunscreen is important, it’s good for kids to get a few minutes of unprotected sun exposure so that they can naturally synthesize vitamin D. While heavy pollution can make it seem like Beijing doesn’t see much sun, Dr. Eldadah thinks that families can still get plenty of rays through the pollution. Dr. Ansari recommends getting sunlight on days when there is less smog to avoid exposure to pollutants.

“Vitamin D is essential for absorbing calcium and phosphorus, which you need for healthy bone growth and development,” says Dr. Eldadah. “If you don’t get enough vitamin D, you don’t have enough calcium and phosphorous, so you don’t have enough calcium to build your bones.” This is why a vitamin D  deficiency can lead not only to soft and brittle bones but also in severe cases to rickets – though this is nowadays uncommon, reassures Dr. Ansari.

Vitamin D is found in dairy products like milk, yogurt, and cheese

Vitamin D deficiency can manifest itself in confusing ways, including late teething in young children, irritability, poor growth, and muscle cramps. It’s hard to diagnose a vitamin D deficiency based solely on symptoms unless there are, for example, obvious fractures. The only way to know for sure is to do a vitamin D blood test or an X-ray to check for abnormal bone growth.

Infants who are breastfed exclusively will need vitamin D supplements of about 400 international units (ius) per day, according to Dr. Eldadah, especially if the child is regularly bundled in layers of clothing or religiously kept out of the sun. However, supplements may not be necessary if the baby’s diet includes a fortified formula. If your child doesn’t drink fortified milk as they get older, consult your doctor about supplementing with vitamin D.

Vitamin A

As the old saying goes, eating carrots helps keeps your eyes healthy — and it’s true. Your retinas rely on vitamin A; without adequate levels, you may start experiencing vision problems like night blindness. However, vitamin A deficiencies are only common in impoverished nations where children regularly suffer from malnourishment. Nevertheless, your child should eat plenty of yellow and orange produce, such as carrots, yams, and squash, as well as eggs and cheese.

Yellow and orange fruits and vegetables are rich in vitamin A

Vitamins B6 and B12

The B vitamin complex is essential for nervous and musculoskeletal health, as well as the heart and skin. All eight B vitamins work together, so a deficiency in any of them can cause severe nerve damage. Your body only needs small amounts of vitamin B, says Dr. Eldadah. As long as your child is eating a balanced diet, vitamin B supplements are not necessary. The only exception is for vegetarians or vegans, who may want to consider taking vitamin B tablets. Dr. Ansari recommends 0.1 to 1.5 mg of vitamin B6 and 0.5 to 2.5mg of vitamin B12 per day. Vitamin B can be found in meats, fish, nuts, beans, eggs, and milk.

Too Much of a Good Thing

It is possible to get too many vitamins, and it’s more common than people think, says Dr. Eldadah. “If you take too many vitamins, you’ll reach vitamin toxicity,” he explains. “The body is a smart machine; if you give it too much of anything, it gets rid of it. If you take a multivitamin [with a recommended intake of]one or two tablets a day and you take four or five tablets every day for weeks, you’re probably overdosing.”

Symptoms of toxicity differ for each vitamin but may include weakness, irritability, fatigue, mood swings, hair loss, tingling sensations, numbness, and skin problems. These symptoms are vague, so diagnosing vitamin toxicity can be difficult and problems may continue to worsen. If you or your children take a daily multivitamin, stick with the recommended dosage. “A lot of people think they will be vitamin-deficient if they don’t take supplements, but you have to be very poor and have a diet [completely devoid of nutrition]to develop deficiencies,” says Dr. Eldadah.

Eating a healthy, balanced diet is the best way to get the vitamins we need

Taking Multivitamins Correctly

Children should only take multivitamins if they are extremely picky about food, cautions Dr. Eldadah. If parents are concerned about their child’s diet, then taking a multivitamin may not be a bad idea. Chewable or gummy multi-vitamins are child-friendly, but parents should keep these out of reach from kids, who may think the vitamins are candy. Eating too many can lead to acute vitamin toxicity, which can manifest in symptoms such as vomiting and diarrhea.

There is no single trusted brand name for vitamins, says Dr. Ansari. Every country has different preferred brands, so make sure that the packaging contains dosage guidelines and a recommended daily allowance (RDA). Buy vitamins from trusted sources and brands such as Centrum (善存 in Chinese), which has an official store on Taobao. When buying on Taobao or Jingdong, especially imported brands, follow the general rule that if the price looks too good to be true, it probably is. Local pharmacies also sell multivitamins — ask for 多维生素片 duō wéishēngsù piàn. You can also order from international health store iherb.com (which ships to China) or ask your family doctor which brands or retailers they suggest.

KEEP READING: Wintertime Woes: Extreme Eczema

Images: Pexels, Pixabay, Unsplash

Spring may not officially begin until March 21, but the winter chill still lingers – meaning that staying indoors is often still the best option. Luckily, there’s a shopping center in town under one glass roof: Indigo Mall.

If you’re planning to spend a Saturday or Sunday at Indigo, the ideal place to sate that lingering winter appetite is at at Feast by EAST Beijing. EAST Beijing, the newest hotel operated by Swire (which also runs the modern-chic Opposite House), is insistently serene, minimalist but warm, and is directly attached to Indigo Mall. The motto of all food done at Feast is “simple things, done well,” and the weekend brunch lives up to that motto in two or three scrumptious courses. The sun-bathed restaurant has a pleasant view of the eastern Lido area, and the friendly staff and kid-friendly ambiance make for a pleasant, brunch.

To aid digestion, ramble through Indigo, which you can access through a door just past EAST’s front desk. Indigo doesn’t flow like a standard mall, with a block of escalators in a stack; instead, escalators are staggered throughout the meandering mall, giving
patrons time to savor window shopping.

While some stores are still in the process of opening, Indigo is already fortified with local toy and baby shop darlings on the third floor, like Kids Land, Baby Land, and The Fifth Avenue. It will also be rounded out by the forthcoming Counting Sheep – also on the third floor. Kitchen enthusiasts can rejoice in the newest Cuccina store (on B1/F), which has all the cooking gadgets a chef could wish for. Tech fiends will relish the large Lenovo store (3/F) as well as all-around electronics purveyor Sundan (B1/F). There’s a Toni & Guy salon (B/1) if the family needs a trim, and Sephora (1/F), Watsons (B1/F), and Herborist Spa (B1/F) to round out the health and beauty side of things. There are shops aplenty to fill the wardrobe of any family member, including popular chains H&M (1/F, 2/F) and Gap (1/F, 2/F), – which both feature children’s sections. Pick up more threads at Tommy Hilfiger (1/F), Vero Moda (2/F), and Crocs (B1/F).

Be sure to head to Page One (B1/F), the plush but affordable bookstore chain. The Indigo branch has a nook with a decent selection of English children’s books and young adult fiction. The rest of the store has a large collection of English language fiction, non-fiction, and more, as well as a breathtaking art and design books that make for great browsing.

When you’re shopped out, catch a flick at CGV Xingxing International Cinema on the fourth floor. Savor the Hollywood feel of the light bulb-studded ceiling as you ascend the escalator. Screens at the entrance will tell you exactly what’s playing and what languages the films are in (Chinese only or Chinese with English subtitles). Snack combos are reasonably-priced (RMB 25 for popcorn and one drink or RMB 35 for popcorn and two drinks).

In the lobby of the cinema is Cine Shop (4/F), and film buffs will love browsing the modest but intriguing selection of music, DVDs, books about movie stars, and movie-themed accessories. There’s also a Twosome Coffee (4/F) if you want to linger after a showing or enjoy a snack on their terrace that overlooks the mall’s atrium.

When tummies really start rumbling, there’s a wide selection of cuisines and restaurants. Blue Frog (1/F) and Hercules (1/F) make up Western favorites, while there’s Bibigo (1/F) for Korean, Toyo Jazz (2/F) for Japanese, and Xihe Yayuan (1/F) for Peking Duck. If no one can decide, there’s always the Food Republic (3/F) and its abundance of Chinese food court selections. Pick up some sweets for the way home at Godiva (1/F), across from Blue Frog. For steak fans, Flamme is now open from 11am-5pm. Stay tuned for more restaurants, including Element Fresh, Tous Les Jours, Muse, Middle 8, Honeymoon Desserts, and Cold Stone Creamery.

Find out how to get there here

This article first appeared on the March 2013 issue. Read it here

While starting a new school year isn’t thrilling to most kids, it can be even more difficult for students with learning disorders. Most local schools lack support for children with learning and attention difficulties, and support can be limited or too general at international schools. For insight into learning disorders, the diagnostic process, and how local programs can work with kids, we spoke to Eliott’s Corner, a center for occupational, speech, and physical therapy, and Side by Side, a center that provides support for special needs and learning difficulties.

What Are Learning Disorders?

According to Clinical Psychologists Dr. Jaqueline Wolf and Danielle Speybrouck from Eliott’s Corner, learning disorders are different from typical developmental difficulties in that specific learning disorders are experienced in reading, writing, and/or math. Learning disorders are present for at least six months and persistent, meaning that a child’s skills don’t progress or progress very slowly despite standard academic instruction and specific intervention. A child with a specific learning disorder also performs well below the skill level expected for their age group.

Common learning disorders include dyslexia, dyscalculia, and dysgraphia. Dyslexia is an alternative term for specific learning difficulties in reading. This includes trouble with phonological awareness, word decoding, spelling, word recognition, and sounding out a word. Dyscalculia is difficulty understanding and mastering math and numbers, while dysgraphia is difficulty with handwriting and written language.

Specific learning disorders often co-occur and overlap with Attention-Deficit/Hyperactivity Disorder (AD/HD). Anita Franklin is a special education and learning support specialist, as well as the owner and director of Side by Side Beijing; she holds Master’s degrees in both education and applied linguistics. An attention disorder like AD/HD means that “a child has difficulty concentrating, keeping still, keeping on task, multi-tasking, and attending to certain tasks.” While AD/HD is not classified as a learning disorder, it can affect learning because “sometimes children take too long to complete tasks, they are too fast and rush their work, distract others, or are distracted by others. They also may not follow directions, especially multi-step directions, well.”

AD/HD has specifications or subcategories, say Speybrouck and Dr. Wolf. These include Predominantly Inattentive Presentation, commonly known as Attention Deficit Disorder (ADD), which involves difficulty with sustaining attention, organization, task completion, avoidance of tedious activities, carelessness, forgetfulness, and high distractibility.

By contrast, Predominantly Hyperactive/Impulsive Presentation involves fidgeting, restlessness, high activity levels, chattiness, impulsivity, and poor behavioral inhibition. Finally, Predominantly Inattentive Presentation involves a child daydreaming in class and having difficulty focusing. This is often a more difficult presentation to diagnose, and tends to be diagnosed later than others as a result.

The most common specific learning disorder is in reading; about 80 percent of all learning disorders are reading-specific. The prevalence rate of learning disorders falls between five and 15 percent among all school-aged children, with a five percent prevalence of AD/HD. Specific learning disorders and AD/HD are more common in boys than in girls, but girls are more likely to present with Predominantly Inattentive Presentation and are thus often diagnosed at a later age.

Diagnosis

There are things that parents can look for if they suspect their child has a learning disorder and/or AD/HD. According to Speybrouck and Dr. Wolf, younger children with AD/HD demonstrate more obvious hyperactive behavior as early as age 2 or 3, but adolescents or adults are better able to inhibit such behavior. Teens and adults may also fidget instead of not being able to sit still, or have racing thoughts rather than restlessness.

For specific learning disorders, Speybrouck and Dr. Wolf point to precursors like language delays, difficulties rhyming or learning the alphabet by kindergarten, early difficulties learning to count or identify numbers, difficulties drawing, or difficulties with fine motor skills, such as fastening buttons or using eating utensils.

The diagnostic process usually begins with a teacher or a parent expressing concern about a child’s skill acquisition during the early elementary years. Parents can start the diagnostic process by contacting a child psychologist or educational psychologist who has experience with assessments. At Eliott’s Corner, the assessment process includes gathering the child’s early academic, social, emotional, and behavioral history; having a psychologist visit the child’s classroom to observe them and talk with their teacher; evaluating the child’s cognitive abilities in broad and specific subjects; completing emotional-behavioral evaluations for AD/HD assessments; and discussing results and recommendations with the psychologist.

Meeting a Child’s Needs

Once a child is diagnosed with a learning disorder and/or AD/HD, they will require extra support. “None of these disabilities have cures,” says Anita Franklin. “It’s important that my clients don’t come to rely on my assistance too much. The aim is always to increase independence and confidence within their abilities.”  Side by Side designs individual programs for children based on their specific difficulties and consults teachers, parents, and previous reports. The center also observes the child’s difficulties before placing them in a specific program.

When Franklin works with clients, she finds that chocolate sauce makes an excellent teaching tool. The children’s favorite is a multisensory activity for spelling. First, the student uses the chocolate sauce to spell a given word on a cookie tray, saying the letters out loud as they’re written down. Once the word is spelled correctly, the student uses both hands to smear the chocolate sauce all over the tray. They then use a finger, a pretzel stick, or a similar tool to write the word a second time, again while saying the letters out loud. Franklin may ask them to write the word big or small, in capital or lowercase letters, or even while blindfolded. Once the word is spelled correctly, the student can lick the sauce or bite off the pretzel as a reward; if the word is spelled incorrectly, the sauce is smeared out and the child starts over.

This activity is designed to engage all the senses. Children hear the letters as they’re called out, see them as they appear on the tray, smell the chocolate sauce, touch the chocolate or pretzel as they write the word, and taste the chocolate sauce at the end. “The more senses are integrated into a session, the more likely the lesson will be remembered,” says Franklin. “And if it’s fun, it’s even more likely.”

Philip Schiffers also works at Side by Side. He’s a social worker, music therapist, and special needs support worker with a degree in social work and music therapy. He uses music therapy to help children overcome attention-related difficulties. Music can help improve concentration and focus when a child is challenged to play a melody for a specific period of time without any mistakes. Once the child can manage this, they have to learn another melody and play it for an even longer duration.

A child with a learning difficulty will need adjustments in the classroom as well. According to Speybrouck and Dr. Wolf, a student will need increased organization and structure; strategies for organization, planning, and self-monitoring; decreased demands for speed for children with specific learning disorders; and access to learning support services. Side by Side can act as a valuable resource for children in schools with inadequate learning support. “Our aim is to help our clients work within the school system, so sometimes we deliberately add distractions to help the child develop strategies, and we like giving and getting feedback from students, parents, and schools,” says Franklin.

Constant communication between the school and the parents is key. Side by Side provides progress reports and is available to answer questions from both teachers and parents. Parents of children may also find that they need to tailor their approach. “It can be that parents need to improve their ability to give directions or let the child handle more tasks by [themselves],” says Schiffers. Franklin points out that parents of children with attention issues will need to be more patient. Speybrouck and Dr. Wolf also recommend that
parents break the cycle of negativity by praising their child for a job well done when appropriate, even if they demonstrate behavioral issues or academic problems.
Parents may themselves benefit from a consultation with a child psychologist or learning support specialist to find out more about stimulating a child’s at-home development, set up a strategy such as a reward system, and advocate for a supportive learning environment at school.

While medication is sometimes an option for children, Franklin says that “children are capable of learning strategies to work with their issues and these strategies can help them in a lot of areas where medication can’t.” Schiffers agrees: “[Whether] a child with ADD or AD/HD needs medication is not for us to decide. We believe that medication often gets prescribed too soon and shouldn’t be the first choice for parents who realize that their child has AD/HD.”

Currently, Eliott’s Corner offers learning disorder assessments and reading support, as well as the services of occupational therapists who work with children with dysgraphia. They also provide assessments for behavioral and emotional issues and coping strategies for managing AD/HD, but currently don’t offer any learning support services. Side by Side Beijing offers a wide range of special education classes, as well as music therapy; learning support for learning difficulties, AD/HD, and a number of other disorders; and community support, including workshops and training for schools and parents, and parenting and family support.

Resources

Eliott’s Corner 胡宝小屋
Mon-Fri 9am-6pm. Rm 1905, Bldg 2, Kandu International, 10 Dongsihuan Beilu, Chaoyang District (6461 6283, contact@oliviasplace.org) www.oliviasplace.org 朝阳区东四环北路10号瞰都国际2号楼1905

Side by Side
Mon-Fri 8am-6pm (after hours by appointment). Capital Paradise 3336, Houshayu, Shunyi District (8046 3858, info@sidebysidebeijing.com) www.sidebysidebeijing.com 顺义区后沙峪名都园3336号

photos by Lova and wwworks on Flickr

This article originally appeared on p44-47 of the beijingkids September 2013 issue.

Check out the PDF version online at Issuu.com

Wendy Chow hasn’t had a lot of success getting a haircut she likes at Beijing’s local salons. A stay-at-home mom of two kids (ages 2 and 4) and co-founder of Paddington Puddings and Pies, Wendy felt as though she had lost touch with what’s trendy. On a sultry, summer day, Chow arrived at TATA, a salon at the north gate of Gongti that has a broad range of stylists with an equally diverse range of talents. Wendy put herself in the capable hands of Senior Stylist Da Hua, Technician I (Ed’s note: The technician’s name is “I”), and Makeup Artist Da Long. After six years of unflattering haircuts in Beijing, she was ready for a style that was current and adventurous, but flattering and easy to maintain. Wendy had some highlights done about three months prior, but was looking to pair a bright pop of color with a shorter, updated do. She and the stylists toyed with adding a chunk of bright brown or bright pink, but finally decided on a deep yet bright swath of violet. Wendy “totally loved” her new style, even more so because maintenance was relatively simple. Though her husband was nervous her hair would turnout too short, “He loves it,” she says.

Makeup List
Pore minimizer: The Porefessional by Benefit
Foundation: Giorgio Armani Luminous Silk Foundation in 06 and 02
Eyeliner: Bobbi Brown Long-Wear Gel Eyeliner in Black Ink 1
Blush: MAC Pink Swoon Sheertone Blush and Shu Uemura M Pink 31
Lip color: Christian Dior 323 Soft Coral Lipliner Pencil and MAC Frost Lipstick in Fabby

Get the Look:

Da Hua cut Wendy’s hair into a graduated A-line bob, knowing it would flatter her face shape. He cut the back shorter than the front to give the top volume and added a few layers for texture.

I, the technician, first bleached a chunk of hair on the right side of Wendy’s head. Then he added a rich black base all over Wendy’s hair, and finally painted Manic Panic’s
Ultraviolet semi-permanent dye onto the bleached section.

Da Long started by prepping Wendy’s face with moisturizer and pore minimizer. He used two foundations. One was a few shades lighter than Wendy’s skin tone to highlight her T-zone and reduce undereye circles. He applied a foundation that matched her skin tone over the rest of her face and added concealer under her eyes. Da Long lined Wendy’s eyes with gel eyeliner, adding a wing on the end to lengthen the appearance of Wendy’s eyes. He applied natural eyeshadow colors, explaining that bright colors can age the face. After applying false eyelashes, he brushed on two shades of pink blush and finished by coloring Wendy’s lips with an orange-y red lip pencil and brushing a mauve-ish pink shade of lipstick on top.

photos: SUI

This article originally appeared on p18-19 of the beijingkids September 2013 issue.

Check out the PDF version online at Issuu.com
 

Ah, the pre-teen years – the time between being a kid and becoming a full-fledged teenager. Being a tween comes with a lot of confusing and embarrassing changes, which yield a host of frustrating – and frankly terrifying – changes for the parents. Tween puberty is more than just physical changes. They are neurological, social, and emotional – the descent into the dark years of parenting a teenager. One of the most frustrating aspects for parents is that it’s impossible to control tweens once they’ve started to assert their independence and identity.

The most important thing to remember is to never, ever stop trying to communicate. Though a tween can’t be controlled, boundaries and communication give parents a fighting chance. No matter how repugnant a tween’s behavior is, remember the words of Dr. Tad Pu, a child psychiatrist at Beijing United Family Hospital’s Psychological Health Center: “As soon as you cut off the lines of communication, you’re finished.”

What’s Happening?
Kids go through a lot of physical changes when they hit their tweens. Hormones and oil production increase, bodies grow and develop hair, and even brain structure changes. Up until a decade ago, the general belief was that an increase in hormone production was responsible for mood swings. However, neurologists noticed that the brain begins a massive reorganization around 11 or 12 years of age, around the same time that reproductive organs are busy becoming fertile. The prefrontal cortex, which is responsible for executive function, decisions, and reasoning, undergoes a reconstruction process characterized as “pruning and blossoming,” which trains neuron connections and weeds out those that are unnecessary.

While the prefrontal cortex is busy pruning itself (it usually doesn’t finish until ages of 22 to 24), the limbic system – which hosts functions like emotion, behavior, and motivation and is usually controlled by the prefrontal cortex – takes over. This makes kids emotional, moody, rude, and self-centered. While dealing with such behavior is not generally considered one of the highlights of parenthood, take comfort in the fact that these changes are both normal and temporary.

A child’s moodiness is no excuse to stop communicating. In addition to changes in their brains, tweens’ bodies also undergo massive change, including growth, breast development, and menstruation for girls, and facial hair and voice changes for boys. Tween boys and girls will both need to learn the importance of good hygiene when they enter puberty. In addition to acne, tweens develop body odor. Many parents will notice their tween’s very distinct scent, which the tween may not even realize they’re giving off. They’ll need to establish a new hygiene routine to counteract hormonal changes, and parents are key to helping form these good habits. 

Tweens should bathe or shower every day, and always after exercise. Tweens may be loath to do so, but parents should explain the importance of showering. Many parents of tweens and teens find it difficult to make sure their child showers every night. It may turn into a constant battle, but it’s usually a phase that they will outgrow. Establishing a routine and letting a child know that not showering is not an option can help, but parents may have to fight the battle for a long time. Kids may also have to start using deodorant, but may not realize the need for it. It’s up to the parent to breach the topic of deodorant usage tactfully and without judgment.

It’s absolutely necessary for parents to educate their kids about the changes they will go through before they undergo puberty. Topics like menstruation or nocturnal emissions (read: spontaneous ejaculation) can be fraught with embarrassment for both parent and child, but this makes talking about them all the more necessary.

The best way to cover puberty-related issues is to sit down with your child before they enter puberty to explain basic anatomy and sexual reproduction. The talks should occur frequently and with digestible amounts of information offered each time, instead of one formal sit-down in which all information is unloaded and never spoken of again. Kids need time to process and ask questions, and a formal one-off talk will make them tune out or feel embarrassed.

Keep in mind that girls generally begin menstruation around the same age as their mothers, so parents can anticipate the change and arm themselves with information, tips, and pads or tampons. Boys will need talks from male figures about changes to the sexual reproductive system, especially around sensitive topics like wet dreams, which often result in feelings of shame and confusion. According to Dr. Pu, testosterone can increase in boys by up to 1,000 percent during puberty, leading to sexual urges and more dominant and territorial behavior.

Regardless of your child’s sex, emphasize that the changes their bodies are undergoing are both normal and temporary, and encourage them to continue asking questions. Talk openly about what’s happening to their bodies and remain judgment-free. Kids can sense if you are nervous or embarrassed; they take cues on how to feel about their bodies from parents.
Consistent dialogue is also important for their mental health. Dr. Pu points out that only 10 to 20 percent of teens report being happy most of the time. Have plenty of empathy for your child, make an effort to understand what they’re feeling, and guide them through tough times. A major factor in keeping the lines of communication open is establishing a routine in which the family converses, whether it’s at dinner every night or a designated time in the evening.

Wading In Deeper
All the physical changes that tweens go through have a significant impact on their behavior and psychological state. Dr. Pu points out that “before [tweens hit puberty], everyone their age was physically the same. But when puberty hits, there are big differences and they are more aware of their bodies.” If a child grows faster or slower, gets facial hair earlier or later, develops smaller or larger breasts, these can seem like dramatic differences that make the tween feel overly sensitive and self-conscious.

When it comes to deeper topics like sexuality and desire, it’s murkier territory. Each family has its own values. Naomi Taylor, a counselor and parent effectiveness training (PET) teacher, recommends that parents take cues from their tween about what they feel comfortable talking about. Taylor also suggests being aware of what you feel comfortable discussing and use books to support the conversation if needed. “Do not underestimate the power of playground talk,” she cautions. “These conversations will definitely take place in school among peers.” If a tween doesn’t learn from a parent, they’ll learn it from their peers – and peer information can be utterly false or completely at odds with the family’s values.

When it comes to going out with friends (and potentially being exposed to situations involving drugs, sex, or negative peer influences), parents may need to step in right away. Parents must accept that kids lie, says Dr. Pu. There’s no need to call them out on every falsehood; parents need to assess whether the lie is of great consequence.

Before the behaviors surface, topics like drug use or sexual behaviors need to come up in regular communication. “You do not want to turn sensitive topics into taboo subjects, otherwise you run the risk of your child not feeling able to share their concerns with you,” says Taylor. Dr. Pu suggests using third party examples to make a point, such as reaching out to a family acquaintance who has dealt with drug use or bringing up a scene in a movie. “As parents, we often fear the worst may happen,” says Taylor. “If you can be honest [about what]specifically concerns you, you may find yourself surprised when your tween talks openly.”

If a tween asks if a parent has ever tried drugs, Dr. Pu advocates parental honesty and suggests using your experience as a learning tool. Taylor prefers a more cautious approach. “Parents should consider whether they would like their child knowing certain details of their past,” she suggests. It’s also important to account for what a tween can handle emotionally. “Some tweens may feel overwhelmed by too much information too soon, while others may feel comfortable knowing that their parents were not always sensible.”

Combining insecurity with the media’s definitions of beauty ideals can prove a rough combination for tweens who are just starting to establish their identities and looking to become sexually attractive. According to Dr. Pu, 50 percent of girls and 25 percent of boys engage in disordered eating behaviors like fasting, skipping meals, using diet pills, inducing vomiting after eating, or using laxatives. Monitoring your child’s behavior again comes down to communication. Because kids start taking advice from their peers during the tween years, they need to hear from their parents what a healthy body needs and what a healthy body image is.

As their bodies change, tweens will also experiment with clothing and will have to learn what is appropriate. Dr. Pu suggests being a role model by enforcing a dress code at home or when the kids are with their family. It will be more difficult (or nearly impossible) to stop kids from wearing what parents consider to be  inappropriate clothing when they’re out of the house, but continuing to set boundaries and model appropriate dress will lay the foundation for how your tween dresses.

When there is a clash of values, Taylor recommends discussing concerns directly. If a tween wears something that the parent deems inappropriate, the parent should voice their concerns, including their feelings on the situation and the potential impact on the tween.
Taylor recommends staring the conversations with: “I am worried that wearing such a short skirt may attract attention that will place you in a difficult situation.”

Parents should keep talking, even though “most of the time the teens won’t listen. Parents have to get the message out, keep the channels open, and avoid being too harsh or pushing their teen out,” suggests Dr. Pu. Though it may be that tweens won’t always listen, keep talking to catch them when they are.

For Parents
Dealing with the typically unpleasant behavior of teens and tweens will test every parent’s patience. Dr. Pu offers some tips to dealing with a teen’s mood swings, anger, or all-around bad attitude. To remain effective, parents must strive to maintain thoughtful control by seeking a balance point between being permissive and authoritarian. He suggests that parents maintain high warmth: not cold or disengaged, but not too enmeshed. Remain empathetic and care about the tween’s feelings. Finally, maintain communication and encourage exchanges that are calm and respectful.

Taylor agrees that communication is the key to a successful relationship with your tween. “Talk openly, do not blame, and do not pass judgment,” she says. “If your child is behaving in an unacceptable way, then you can almost guarantee that they have a need that is not being met. Your job is to help them find out what this need is without assuming you already know what it is.”

When a tween acts out, parents should avoid engaging in similarly rash behavior. Dr. Pu recommends the CALM strategy: Cool down, Assess your options, Listen with empathy, and Make a plan. As the adult with the fully-developed brain, it’s up to the parent to be in control of their emotions. Once both sides have calmed down, step in with some suggestions, but listen closely and work together to form a plan. It’s not always easy, but training yourself not to react to crazy emotions and continuing to listen are the best ways to maintain effective communication.

Resources

Dr. Pu recommends these books:

• Getting to Calm: Cool-Headed Strategies of Parenting Tweens and Teens by Laura Kastner and Jennifer Wyatt
• Yes, Your Teen is Crazy – Loving Your Kid without Losing Your Mind by Michael Bradley
• The Whole Brain Child by Daniel Siegel

Taylor recommends:

• Let’s Talk About Sex by Robie H. Harris and Michael Emberly
• National Institute on Drug Abuse (teens.drugabuse.gov)

Illustration by Sun Zheng

This article originally appeared on p57-59 of the beijingkids August 2013 issue.

Check out the PDF version online at Issuu.com

The world of immunizations has changed a lot since Edward Jenner invented the smallpox vaccine in 1796, but the need for those vaccines hasn’t. Arguably the single most important factor in decreasing human mortality, immunization has virtually eradicated several infectious diseases. Most children receive routine vaccinations from the time they’re born, but there are some outside the regular schedule that kids – and adults – living in Beijing should consider getting. beijingkids spoke to Dr. Thilan Fellay, a family physician and pediatrician at International SOS, and Dr. Pauline Tan Ngo, chief of pediatrics at Vista Medical Center, for advice on vaccines. As always, it’s important to speak to your doctor for personalized advice. Dr. Fellay stresses that vaccination schedules can be complicated. If you’re trying to plan which ones to get and when, consulting with your doctor is a must – especially if you want imported vaccines.

Rabies

“I really insist on the rabies vaccine,” says Dr. Fellay. Because doctors in the West do not routinely prescribe this vaccine, most do not mention it to patients who are leaving for China. According to the World Health Organization (WHO), China has the second highest number of reported rabies cases in the world. The good news is, it’s also the world’s largest administrator of rabies vaccines. Dr. Fellay insists on the vaccine not only because of the disease’s prevalence, but also because of the damage it causes. Without the pre-exposure vaccine, a person who contracts rabies through an animal bite immediately requires a series of time-sensitive injections, as well as a course of rabies immunoglobulin. If left untreated, rabies is fatal.

In China, dogs are the most frequent rabies transmitters. However, Dr. Tan Ngo notes that the likelihood of contracting rabies in Beijing is fairly low, as most cases present in rural areas in the south. However, rabies is present elsewhere in Asia, and other countries are not as vigilant about vaccinating their animals.

The most troublesome aspect of rabies is that there’s no way to tell that a person has contracted it until the onset of the virus, well past the point of treatment. If the animal is present, it can be tested for rabies within a few hours. While Dr. Fellay recommends the vaccine to parents and kids alike, she says that kids are more at risk of getting rabies since they are more likely to touch animals without thinking and may not report a scratch, lick, or bite.

The pre-exposure vaccine is a series of three shots administered over the course of one month. After an animal bite, get to the doctor within 24 hours regardless of prior vaccination. An immunized person will require two shots after exposure; an unvaccinated person requires four shots and a dose of rabies immunoglobulin. However, only locally-manufactured rabies immunoglobulin is available in China.

Among the international hospitals in Beijing, only Beijing United Family Hospital (BJU) carries the rabies vaccine. Patients can also visit Chinese disease control centers across Beijing. Ask your health provider for the address of the center closest to you.

Hepatitis A

Dr. Tan Ngo and Dr. Fellay both recommend the Hepatitis A (HAV) vaccine. HAV is transmitted via fecal-oral route – or, more bluntly, when fecal matter enters the mouth, usually via food handled by a carrier who did not wash their hands. “As with rabies, the Hepatitis A vaccine is one that doctors in the West [often]forget to advise,” says Dr. Fellay. “It is rarely fatal, but can cause severe illness in pregnant women.” She recommends that all travelers and expatriates in China consider vaccination, but especially women who are planning to get pregnant while in Beijing.

“HAV is generally mild,” explains Dr. Tan Ngo, especially in comparison to rabies. “It’s usually a few weeks of diarrhea and nausea, but it can lead to liver failure – which is why the vaccine is important.” Other symptoms include fever and jaundice, and can last from three weeks to six months in some cases.

The HAV vaccine is a series of two shots six to 18 months apart. In China, it is only available as a domestic vaccine. If you only feel comfortable with imported vaccines, get yourself or your child vaccinated when visiting home or another country. However, be sure to plan ahead to get the second dose within 18 months.

Meningitis

There are many types of meningitis, a severe bacterial disease, but there are only vaccines for four: A (typically found in Asia and Africa), C (found in Western countries), W, and Y (both typically found in Middle Eastern countries). In the US, there is a meningococcal vaccine that protects against all four strains; in other countries, this is not the case. In China, children are routinely vaccinated against meningitis from a young age, but these vaccines only protect against types A and C.

“The risk of contracting meningitis in China is rather low, as China has a high level of meningococcal immunization,” says Dr. Fellay. It’s still a good idea to get vaccinated, especially for teenagers heading off to university. In fact, many universities in the US require students be vaccinated before attending. “The disease is most prevalent in young people,” Dr. Tan Ngo explains. “I usually advise that a child get vaccinated if he hasn’t [already], as meningitis is debilitating.”

In China, the shot that prevents against both A and C may be available in limited quantities as an imported vaccine, but the type that protects against A, C, W, and Y, is not available. The number of shots and follow-up boosters depend on which type of vaccine you’re getting.

Japanese Encephalitis

Though there is generally a low risk of contracting Japanese encephalitis in Beijing, the disease is endemic to China. Both doctors agree it is worth considering. This mosquito-borne illness is an infection of the brain covering.
There is no treatment for the disease itself, only for its symptoms, which include high fever, disorientation, coma, and tremors.

“It’s a severe disease that can result in physical and mental disabilities,” says Dr. Fellay, though it is fatal in one in four cases. The vaccine is available as a local immunization. The American CDC recommends it for travelers who are planning to spend more than one month in an area with endemic Japanese encephalitis, especially if they will be traveling outside of urban centers. Additionally, those visiting forests, fields, or pastures during the summer tick season in China should consider vaccination against tick-borne encephalitis.

Parents: Get Your Updates

Dr. Fellay recommends that adults around the age of 30 get an update on their pertussis (or whooping cough) vaccine, especially if they are around infants. Dr. Tan Ngo concurs. She explains that the Td vaccine, which covers tetanus and diphtheria, used to be given as a routine immunization. Now, children are routinely inoculated with Tdap, which includes pertussis.

Pertussis is highly contagious and causes serious, occasionally life-threatening complications in infants younger than 1. In the US, the Advisory Committee on Immunization Practices now recommends that pregnant women receive the Tdap vaccine. If you’re planning to have a baby soon, talk to your doctor about whether you need a Tdap update.

Dr. Tan Ngo recommends that prospective parents also ensure they are up-to-date on their rubella vaccine, which is given in conjunction with the MMR vaccine (the immunization for measles and mumps). Rubella is dangerous for pregnant women and can cause a host of birth defects. Prospective mothers and pregnant women should get their rubella antibody tested to see if they require a booster, continues Dr. Tan Ngo.

Imported Vaccines

In China, regulations over imported vaccines have become very strict. The list of available imported vaccines can change rapidly from day to day. Vaccine manufacturing practices have improved vastly in recent years, but talk to you doctor if you have any concerns about available vaccines. If you’re worried about domestic vaccines, the last thing you should do is try to sneak some back from your home country. Not only is this illegal, it’s also forbidden for doctors in Beijing to inject anyone with unofficially-imported vaccines.

The Anti-Vax Movement

The controversy surrounding vaccines is as old as vaccines themselves. Some believe that vaccines are not safe and can cause developmental delays or even autism. However, Dr. Tan Ngo points out that there is no study linking vaccines to autism, and that autism has no known single cause. A famous 1998 article by Dr. Andrew Wakefield linked the MMR vaccine to autism and bowel disease, but was later proven to be grossly falsified. Wakefield had been paid to find evidence against the vaccine and had a financial stake in his findings. His study was retracted and labeled an “elaborate fraud” by The British Medical Journal. A later study by the US Institute of Medicine found that “the MMR vaccine doesn’t cause autism, and the evidence is overwhelming that it doesn’t.”

Vaccines can cause adverse reactions. Usually, these reactions present as a low fever and soreness and swelling at the site of injection. Serious adverse reactions, however, like anaphylactic shock, are extremely rare. If you are worried, talk to your doctor and be sure to inform them if you or your child have ever had an adverse reaction to a vaccine.

Resources

International SOS 国际救援中心

Daily 9am-6pm. Suite 105, Wing 1, Kunsha Building, 16 Xinyuanli, Chaoyang District (Clinic 6462 9112, 24hr hotline 6462 9100, china.inquiries@internationalsoschina.com) www.internationalsos.com, www.clinicsinchina.com 朝阳区新源里16号琨莎中心座105室

Vista Medical Center 维世达诊所

Daily 24hrs. 3/F, Kerry Center, 1 Guanghua Lu, Chaoyang District (8529 6618, vista@vista-china.net) www.vistachina.net 朝阳区光华路1号嘉里中心3层

Center for Disease Control and Prevention (CDC)

www.cdc.gov

World Health Organization (WHO)

www.who.int

The History of Vaccines

www.historyofvaccines.org

The Institute of Medicine: Adverse Effects of Vaccines: Evidence and Causality

tinyurl.com/n3w6a9d

My Health Beijing – Vaccines Review: Few Major Side Effects – and No Autism

tinyurl.com/ka3ryv4

photo by Littleones Kids & Family Portrait Studio

This article originally appeared on p24-25 of the beijingkids August 2013 issue.

Check out the PDF version online at Issuu.com

Kyle and Emily Driggers

Children: Sydney (age 6), Stephen (age 4), and Aubrey (age 2)

Background: This family of five is originally from the US, though the two youngest were born in Beijing. Kyle originally came as a language student, but now teaches at a local university called Beijing Geely University (北京吉利大学). Emily is a stay-at-home mom.

Where do you live? We live in Changping, also known as Beijing’s “backyard garden” because it sits just to the south of the mountains that lead up to the Great Wall. It definitely feels like a slightly calmer, more natural, and slightly less polluted side of Beijing. We are able to find most of what we need by simply walking out the front door.

Have you ever lived in other neighborhoods in Beijing? We moved directly here from the US. We have friends who live in Haidian and Tiantongyuan, whom we visit often. It’s hard to compare since we haven’t lived there, but Changping seems far less congested. There are more green spaces and better access to grocery stores, shops, and restaurants. This does come at a cost though; both of those areas have foreign grocery stores, [Western] restaurants, and great expat communities.

How often do you go into the city? We go into the city at least once a week to attend church. If we are going for date night, we almost always find ourselves in Houhai taking a walk around the lake, [eating at]Hutong Pizza, and sitting outside at Starbucks afterwards.

Kyle’s favorite place to meet friends is at The Bridge in Wudaokou for breakfast; there’s a group of guys he sees there almost every Wednesday morning. Emily’s favorite place for a night out with the girls is at Element Fresh in Sanlitun. If we are with the kids, we like to keep it simple and go to Steak n Eggs or Pinnacle Plaza after going to Capital Community Church in Shunyi on Sundays.

How do you get around? Owning a car has been essential for us and helps us stay involved with our friends and churches (Beijing
International Christian Fellowship Zhongguancun and Capital Community Church). There are no Western grocery stores in Changping, so we make a run to Jenny Lou’s every few weeks.

Where do your kids go to school? Our daughter Sydney goes to a Chinese preschool called Beihai Changfang You’er Yuan (北海昌房幼儿园). [The curriculum] is in Chinese, so it was a bit of a transition when she started school at age 3.5, but she picked up the language quickly.

Her Chinese is great now. We would definitely recommend the school to anyone living in the area; the facilities are nice and the teachers care about developing creativity, joy, and a sense of community in the children. Sydney goes to school five days a week, and we either walk there in the summer or drive in in the winter. She will be starting first grade next year and we will either home school or send her to Hope International School in Shunyi.

What fun things are there to do in your neighborhood? We love living in a part of town where we can be hiking in the mountains in ten minutes, push the stroller to the grocery store, let the kids play in the park, and stop for dinner at our favorite jiaozi restaurant on the way back. There is also Changping Park (昌平公园), which is a great place to take the kids for a stroll. It’s always full of people selling
balloons and there are [inflatable]kid-sized hamster wheels on the small lake in the park.

Do you ever wish you lived downtown or in Shunyi? It would be nice to have a Starbucks nearby, but living [in those areas]also comes with a lot of hustle and bustle. There is a lot to be said for a part of town that is livable, natural, and a step off of the beaten path. For our family, [Changping] has been just what we were looking for.

Do you see yourself living here for a while? We love Changping and would love to live here for a long time. As our kids get older, however, we will probably move to Tiantongyuan or Shunyi if we want to send them to an international school.

photo courtesy of Kyle Driggers

Changping

Those in search of peace, quiet, and nature will find more of it in Changping than they wil in any other neighborhood. Located so far northwest of Beijing that the subway network stops at its southernmost border, Changping is known for its scenic spots, natural hot springs, and historical attractions like the Ming Tombs and Juyongguan section of the Great Wall.

Kwesi and Francinevia Abair

Children: Elysia (age 11), and Layla (age 10). Also part of the family is super canine companion Fufu.

Background: Hailing from the US, the Abairs have been living in Beijing for two years. Kwesi and Francinevia’s graduate law studies brought them to Beijing. Currently, Kwesi is working in the US and Francinevia teaches writing, literature, and journalism in Haidian.

Where do you live? In a part of Changping that is closer to the Ming Tombs than anything else.

Why did you choose to live there? We didn’t necessarily “choose” to live out here; the school that Francinevia was attending was in Changping. Given how crowded the morning commute could be (with constant fighting, stampeding, pushing, and pickpocketing), it really wasn’t feasible to live elsewhere.

Have you lived elsewhere in Beijing? We have never lived in any other neighborhood; the city is too large, crowded, and polluted. We certainly have experienced a reduced quality of life here compared to our time in Hangzhou.

How often do you go into the city? Two or three times a month to run errands, meet up with friends, or go sightseeing. We go to Wangjing to see friends, relax and go shopping in Sanlitun, and buy books and get our skates sharpened in Xidan. We go to Qinghe in Haidian to ice skate at least three times a week.

How do you get around? Express buses, the metro during [off-peak] times, and our amazing driver, Mr. Fu.

Where do your kids go to school? Elysia and Layla attend Beijing Foreign Languages School in Xi’erqi, Haidian District. It was an ordeal to find a school for the girls that didn’t cost a year of college tuition. [In a nutshell,] I found out about the school through word of mouth from a family friend, who is part of a karaoke singing group with an accountant at the university that the girls’ school is affiliated with.

How do your kids get to school? They live in dorms during the week, as the daily commute would crush their little souls.

What fun things are there to do in your neighborhood? There are lots of parks and areas in which to play, rollerblade, and walk the dog. We often head to Yanqing County, Miyun, Huairou, or Hebei to explore off the beaten track.

Do your kids like your neighborhood? They do. They enjoy a certain level of independence they didn’t back in the US. They love being able to roam around and make new friends while rollerblading or walking the dog. Our neighborhood is very laid-back.

Do many other expat families live nearby? No, not at all. There are a few families at the Defense College, but most of them are here for only a short time.

Do you ever wish you lived downtown or in Shunyi? Absolutely not! Downtown is too congested and the cost of a decent apartment is ridiculous. Shunyi has an “unfinished” feel, with rubble-filled lots next to schools that cost more than a year of college. It’s not our cup of tea.

Ultimately, how has living in your neighborhood affected your China experience? Our time spent in Changping was pleasant enough. The fact that not many people in the area speak English was major incentive for the girls to practice their Chinese.

Do you see yourself living here for a while? In China, yes. In Beijing, no. We are moving to Guangdong in August; it’s time for some sand and sun.

photo courtesy of Francinevia Abair

Michael Kruppe and Ai Li

Children: Gina (age 12) and Alina (age 5)

Background: The Kruppes have called Beijing home for two years, but spent the 10 years prior in Hong Kong, Guangzhou, and Shanghai. Michael is director of North Asia for HKI International, a stainless steel kitchen equipment supplier for restaurant chains like McDonald’s and KFC.

Where do you live? We live in Guoyuan in Tongzhou. It is a new and rapidly-developing area that is not so crowded; living costs are much lower than in downtown Beijing.

Have you lived elsewhere in Beijing? We lived in Liangma Qiao before. We love Tongzhou; people are friendlier and less-stressed than they are in Chaoyang.

How often do you go into the city? Michael goes every day to drop off and pick up Alina from the German Embassy Kindergarten in Liangma Qiao. Every two weeks, the whole family goes for brunch at the Kempinski Hotel. They have a very well-organized kids’ corner there.

We also regularly visit Solana, The Place, the Silk Market, and Le Cool ice rink in Guomao. The Grand Hyatt’s 63rd floor has the best view in Beijing on a clear day, so we go there for coffee. We also go to Chaoyang Park, where Michael plays soccer and tennis with Sexy FC, a local soccer team that plays in the first Beijing division.

How do you get around? We have a private driver who takes the family everywhere. We basically use the car 100 percent of the time.

Where do your kids go to school? Gina goes to Shuren Ribet and Alina attends the German Embassy Kindergarten. Shuren was recommended [to us as]the leading bilingual school in Tongzhou, and we are satisfied with her progress so far. For Alina, we decided to try the German School. The only problem is the terrible traffic. Sometimes, it takes 90 minutes to get to school one way. We leave at 6.30am to avoid traffic, but that sometimes means arriving at school too early. The driver takes Alina in the car, while Gina takes the school bus.

What fun things are there to do in your neighborhood? There are lots of really great restaurants and the girls enjoy playing in our compound’s park. Gina plays tennis with Michael sometimes. There is also the fantastic Moon River Resort Park just a 10-minute drive away, which has a beautiful park and boat rides.

Do your kids like your neighborhood? Yes, they like it a lot. They play with our neighbors, which was not the case in the other cities we’ve lived in. The girls love Wu Mart for its playground and the Weiduomei across from our compound, as it has the best mango and chocolate ice in Tongzhou.

Do many other expat families live nearby? No, we haven’t seen any other expat families here over the past two years. But it’s been easy for the children to make friends with kids in the neighborhood, as Tongzhou [residents]seem to be a bit more open and social than people in downtown Beijing.

Do you ever wish you lived downtown or in Shunyi?
The villa-style houses in Shunyi sound nice, but [the neighborhood]is so far away from any activities. We are happy in Tongzhou.

Ultimately, how has living in your neighborhood affected your China experience? Tongzhou has given us a true China feeling, which the family has enjoyed a lot (particularly Michael).

Do you see yourself living here for a while? Yes, we see ourselves staying here for at least the next 10 years.

photo by SUI