Nearly 104,000 children in Allegheny County are covered by Medicaid, yet even though they are required to enroll in a managed care organization, a new study suggests a significant percentage of them did not see a dentist in 2009.

The online report by the Pennsylvania Medicaid Policy Center at the University of Pittsburgh Graduate School of Public Health found that Medical Assistance covered about 1 million, or 35.5 percent, of all Pennsylvania children last year. Only 42.8 percent of children enrolled in managed care had an annual visit to a dentist.

“Oral health is an important component of overall physical health and well-being,” the report says.

Find out more about this study.

McNeil Consumer Healthcare has voluntarily shut down the Fort Washington plant where it produces Children’s Tylenol and dozens of other recalled over-the-counter medications in response to an FDA report that said raw ingredients contaminated with bacteria had been used in some of the infants’ and children’s products.

The Food and Drug Administration said it had so far found no evidence of bacteria in any finished products it tested. At a news conference Tuesday afternoon, agency officials said they considered harm to children unlikely from the microorganisms or from previously identified problems with the McNeil medications, including inconsistencies in product potency and other contaminants.

“We think at this point that the risk to consumers is remote,” said Deborah M. Autor, director of the Office of Compliance in the FDA’s Center for Drug Evaluation and Research. However, Autor said the inspection found “numerous deficiencies in the ways in which McNeil products were manufactured.”

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Parents and investors may both be worried by this weekend’s recall of dozens of versions of Children’s Tylenol and several other infants’ and children’s medications made by Johnson & Johnson’s McNeil Consumer Healthcare division.

Three days after the recall late Friday, the stock market appeared to reflect little concern. Johnson & Johnson’s share price rose 1.6 percent – more even than Monday’s rise in the Dow Jones industrial average, of which J&J is one of 30 component companies.

But parents voiced fears to pediatricians and pharmacists, and asked questions about the affected products – two dozen formulations of Tylenol, known generically as acetaminophen, along with liquid formulations of Motrin (ibuprofen), Benadryl (diphenhydramine), and Zyrtec (cetirizine).

Find out more.

The first sign may be that your bright child is having trouble reading, or organizing school assignments, or concentrating on homework. Your child may be frustrated with school, and you may find yourself frustrated with what looks like a lack of effort. And a teacher may also notice that something is amiss.

If you suspect that your child has a learning disability, and you’ve ruled out distractions like bad chemistry with the teacher or a social issue, your best recourse is to have the child tested.

The cost of getting a thorough assessment by a trained professional can be steep, often as much as $5,000. But that financial burden is not necessarily yours to bear: under federal law your local school district is obligated to assess your child free of charge, even if he or she attends a private school. That said, if you go through the process with a school district, it might take a bit more effort than hiring a professional. Below, we discuss both options.

First, though, some context. By some estimates, about one in seven Americans has a learning disability, a neurological disorder that can make a basic task like reading, writing or organizing information more difficult than usual. Disabilities cannot be cured, but if identified early they can often be ameliorated. Parents, teachers and specialists can help children develop strategies for dealing with them.

Read more.

Autism affects about 1 in every 110 American children, a 57 percent increase over the last estimate in 2002, according to a report released yesterday by the U.S. Centers for Disease Control and Prevention.

The disturbing trend reflects greater awareness and diagnosis of “autism spectrum disorders,” but may also mean more children are being exposed to the still-mysterious causes, said Catherine Rice, lead author of the CDC report.

“These new numbers are concerning,” she said. “We’re struggling to find answers. We know complex genetic and environmental factors are involved, and we have much to learn about the causes.”

The CDC, Rice said, considers autism “to be a significant public health issue.”

Advocacy groups immediately called for more federal funding for research and services.

“We need meaningful action now that acknowledges the scope of the problem and allocates the resources necessary to take the fight against autism to a new level,” Bob Wright, cofounder of Autism Speaks, said in a statement.

A Pennsylvania law that went into effect this year calls for parents of autistic children to get up to $36,000 in annual health-insurance benefits.

But many families say the mandate isn’t yet working.

Autism includes a range of developmental disorders of varying severity, but the hallmarks are an inability to interact and communicate socially, and compulsive interests and behaviors.

Mental retardation, once thought to be an integral part of autism, was present in only 40 percent of the children identified as autistic in 2006.

Find out more at the Inquirer.

Babies are often given acetaminophen when they get their routine vaccinations. The drug, sold as Tylenol in the United States and called paracetamol in most countries, counters the common risk of fever and the much less common risk of fevers high enough to cause seizure.

But a new study, done in the Czech Republic and published last week in The Lancet, may have implications for children everywhere: the researchers found that the antifever drug makes some vaccines less potent. Fever is part of the immune response, and suppressing it, the authors said, appeared to impair the body’s ability to make antibodies.

They divided about 450 children into two groups, half of whom got acetaminophen with their shots. The group that was denied it had more fevers, but only 1 percent of the children went above 103 degrees. Yet the group that got acetaminophen had “significantly lower” levels of antibodies against pneumococcus, Hib, diphtheria, tetanus and whooping cough. After booster shots, weak protection persisted for tetanus and pneumococcus.

The authors said their findings needed “further assessment” but suggested that antifever medication not be given routinely but only when needed.

In an editorial, researchers from the Centers for Disease Control and Prevention in the United States said that the Czech study offered “a compelling case” against routine dosing but that the issue required more study, especially since most of the children in both groups did develop enough antibodies to protect them against infection. The study was financed by GlaxoSmithKline, which makes vaccines.

Pediatric dental care, long a concern of children’s health advocates, is poised to get a major boost with each of the Democratic health reform proposals.

“The silver lining of all this heated debate, for children at least, is that in almost every conversation, in every version of a bill, there’s some provision for children’s oral health,” said Amir Moursi, chair of the department of pediatric dentistry at New York University’s College of Dentistry.

Yet in a surprising twist, some insurance industry experts worry that the legislation may create unintended consequences and disruptions for adult and family dental coverage.

While he calls the children’s benefit “an unbelievable mark of progress,” Jeff Album, the vice president for public and government affairs for Delta Dental insurance company, fears that adults and employers may drop their dental coverage because of the legislation’s treatment of dental plans and taxation of insurance benefits.

Find out more at Kaiser.

Reports the New York Times:

Children who have their tonsils removed are known to experience significant pain after surgery, but they might suffer unnecessarily because they get inadequate pain relief they need once they are sent home, a new study reports.

The study followed a group of 261 children, ages 2 to 12, who had their tonsils and adenoids removed at Yale-New Haven Children’s Hospital.

During the children’s first day at home after surgery, fully 86 percent of parents rated their child’s pain as significant. But even though the parents had been sent home with appropriate pain medicine, almost one-quarter of the children were given either none at all or just one dose the entire day. The study, financed by the National Institute of Child Health and Human Development, was published online on Sept. 7 by the journal Pediatrics.

Parents may have been reluctant to provide the medication, a combination of Tylenol and Tylenol with codeine, for any number of reasons, said Dr. Michelle A. Fortier, first author of the paper and a pediatric psychologist at the University of California, Irvine.

“Nurses responded well to the kids’ pain while they were in the hospital, but we know from other studies that parents hold some misconceptions and fears about pain medication,” Dr. Fortier said. “They may want to withhold it until the pain is very severe; they may want to stretch the time between doses so as not to use too much, and there is still some belief that they may be setting their child up for addiction if they use too much.”

Reports the Wall Street Journal:

Like all children, Perry Cunningham, age 4, wants friends. But until recently, he lacked the social skills to reach out to other kids.

When Perry tried to make a friend at his New Haven, Conn., preschool this year, he mimicked a move he had seen his 15-year-old brother make with his buddies—he gave another, much bigger child a playful shove. The big guy’s response: A punch in the face, leaving Perry with a bloody nose.

In many classrooms, Perry might simply have been regarded as a troublemaker. But Barbara Giangreco, a mental-health therapist who works in child-care centers and preschools, understood that he was just trying to be friendly, and worked with his mother and teacher on helping him use words to reach out to other kids. All the adults involved agree that Perry’s social skills have improved significantly. He is making friends, and while he still has conflicts with other kids sometimes, he knows how to apologize and make peace.

The idea of assigning mental-health workers to child-care centers and preschools is jarring; I was skeptical when I first heard the idea. Children so small shouldn’t need mental-health help, it seems, and having therapists or counselors working in classrooms seems to risk stigmatizing them with labels, or simply interfering with the innocence of childhood.

However, a growing body of research shows that the programs are benefiting entire classrooms of children by reducing behavior problems and supporting overburdened teachers. The specialists’ purpose isn’t to diagnose or treat mental illness in individual children. Instead, they provide targeted, expert help to teachers, and sometimes to parents, on ways to interact with children and reorganize classrooms that improve behavior and the emotional climate. In the process, many researchers believe, the specialists may be helping prevent bigger social problems in kids in the future, such as delinquency.

Find out more from the WSJ.

Reports Reuters:

Most US kids aren’t getting enough vitamin D, a report in Pediatrics shows, raising their risk of weak bones and, possibly, heart disease.

While the new findings shouldn’t spur parents to start mega-dosing their kids with the vitamin, most children could benefit from a little more sunshine, Dr. Michal L. Melamed of the Albert Einstein College of Medicine in the Bronx, New York, told Reuters Health. And giving children a multivitamin containing 400 international units (IUs) of vitamin D is a good idea too, she added, especially in the winter months.

A few small studies have suggested that vitamin D deficiency may be widespread among US children, Melamed and her team note in their report. To get a sense of how common the problem is nationwide, they looked at data on 6,275 children and young adults one to 21 years old from the 2001-2004 National Health and Nutritional Examination Survey.

Nine percent were classified as “deficient” in vitamin D, meaning the concentration of the nutrient in their blood was below 15 nanograms per milliliter (ng/mL), while 61% were vitamin D “insufficient,” with levels between 15 and 29 ng/mL.

Deficiency was more common in older children, girls, obese individuals, those who drank milk less than once a week and those who spent more than four hours a day in front of a TV, computer or video screen. Non-Hispanic black children and Mexican-Americans also were more likely than whites to be deficient in vitamin D.

Find out more at Reuters.