How to Keep Stress from Ruining the Holidays

by Linda M. Manning, RN, LPC-S, RPT-S
Registered Nurse
Licensed Professional Counselor-Supervisor
Registered Play Therapist-Supervisor

From Halloween through New Years our stress is heightened because of an increase in shopping, parties, baking, family get-togethers, etc. These holiday times can be very enjoyable, difficult or both! Too much stress damages our health, relationships and overall well being. One of the first things that comes to mind during the holidays is that expectations are often unrealistic. We often want to do more than is possible. We add on extra things to accomplish onto our already overwhelming schedules. And we want everything to be perfect! Without realizing it we often project these feelings and false expectations onto our children. This takes a toll on our relationships as the stress of the extra activities during the holidays makes us exhausted and emotional.

To begin with, it is helpful to be aware of what your expectations are and to keep those realistic. What is it you expect and want? Acknowledge your feelings. The holidays can elicit many feelings from the past and present. People often have a mix of feelings both positive and negative. It is common to feel excitement, anticipation and hopefulness as well as disappointment, guilt, loneliness and depression. Allow yourself to be aware of these feelings and find a way to express them that is helpful and does not hurt yourself or others. Acknowledging your child’s feelings by clearly stating what those feelings are in a normal tone helps your child feel understood and experience feelings as a normal part of the human experience. Focus on problem solving under stressful circumstances rather than reacting emotionally. How you express your feelings will influence your child’s acceptance and expression of feelings. Keep in mind that acknowledging feelings does not mean you have to act on them.

Reach out to others, even if it is just to ask for a hug or for help. Social support is something we all need. Be careful not to disclose emotional information to friends that are not able to understand or accept what you are experiencing. Revealing too much may put you at risk of feeling guilty or embarrassed later. Seek those who can really accept you and help you.

Be realistic about what is really important. Learn to say “no” when you cannot do something without adding more stress to your routine. Keep the healthy habits that you may have. Don’t abandon your exercise routine or the few minutes you have for yourself in the morning. Stick to a routine as much as possible especially if you have young children in your household. Stress is reduced when a predictable routine for sleeping and eating can be maintained.

Plan ahead and do what you can in a timely fashion to avoid last minute rushing as much as possible. Take a breather if you need to. Always ask, what is more important? And how will this affect my relationships with my spouse and my children in the long run? Take the time to stop and really be in the moment with your child and spouse. Being fully present emotionally brings a heightened sense of satisfaction. This means keeping our thoughts from being stuck in the past or racing towards the future. It means not dividing our attention into doing too much at once. Young children are present in the here and now and do not interpret why their parent seems distracted, tense or even angry. If the adult is just trying to do too many things at once, the child will see that as not being interested in them and therefore not caring. Attention and love are synonymous to children. Set aside at least 30 minutes to be present with your child without distractions or interruptions. Build lasting happy memories associated with the holidays.

With so much going on and so much expected it is easy to become overly stressed and tense during this time of year. I hope this information and these few suggestions are helpful for you to improve your most valued relationships and your feeling of contentment during this holiday season and throughout the year. Merry Christmas and Happy New Year to all!

"Why See a Pediatric Dentist?"

by Dr. Gordon Strole, Jr.

If you use a pediatrician for your child’s health care, doesn’t it make sense to use a pediatric dentist for your child’s dental health? Pediatric dentists are trained in dental problems that are specific to children and adolescents and keep themselves informed and updated in the most recent advances in dental procedures for kids.

Children are not miniature adults. They have their own needs and conditions that the pediatric dentist specializes in. In addition, pediatric dentists are experienced and knowledgeable in how to make children feel comfortable and gain their cooperation. The pediatric dentist studies child psychology in order to understand the normal emotional and psychological growth and development of children. The office design and staff trainings are all geared toward working with children. Part of this extensive training includes providing quality dental care for physically and mentally disabled individuals.

Growth and development from infancy to adolescence is rapid and extensive and the child’s dental needs undergo changes during each developmental stage. I recommend a child’s first visit to be no later than age 18 months or even earlier if dental problems are noticed. The child goes through various psycho-social, physical and dental changes that the pediatric dental team is prepared to manage. This means that emerging problems can be caught early and treatment less extensive than waiting until the damage is irreversible. The pediatric dentist takes advantage of the child’s growth.

Even though many advances have been made in the practice of dentistry, prevention and early treatment are still the best defense against dental problems. Dental problems affect growth and development of the growing child in many ways. So just as you choose a pediatrician for your child’s medical care, be aware that the pediatric dentist is the best choice for your child’s dental care.

Child's Play and Toys

by Linda M. Manning, RN, LPC-S, RPT-S
Registered Nurse
Licensed Professional Counselor-Supervisor
Registered Play Therapist-Supervisor

Children use play as an expressive language. It is a means of expression of what they experience and what they are exploring. Play is a central activity of childhood and is universal and natural to all children. It occurs at all times and in all places. Play also facilitates both physical and psychological development. Play crosses all language and ethnic barriers. If play is a language, then toys are like words.

Toys symbolically express what a child is experiencing or thinking. They give the child a way to communicate more complex feelings and ideas than they may be able to do with words. Children are more comfortable with symbolic expression through play, stories and pretend games than they are with sitting down and “talking it out”. Adults are comfortable sitting down to discuss a situation or issue at length. Children are not. Plato said “You can discover more about a person in an hour of play than in a year of conversation.” This symbolic language can reveal what a child has experienced, the reactions and feelings to those experiences, what the child wishes, wants and needs and the child’s perception of self and others.

What kinds of toys are best for children? In the holiday season there are long lines and parents getting up very early in the morning to get THE toy that is all the rage. Children are influenced very easily by the commercials they watch. Up until the age of 8 years, children do not distinguish between commercials and entertainment programming. Advertisers know very well how to instill a desire to have a certain toy. They also know that parents want to please their children and see their joy on Christmas morning. Love and gift giving are interconnected in our minds. Too often; however, that perfect toy is abandoned after a short time and something else needs to take its place. But I digress. What types of toys are beneficial and useful to children in terms of development and symbolic expression through play?

Toys that the child can manipulate or use their own imagination with are toys that benefit growth and development the most. Electronic toys and games may be fun, but they do not afford the child any expression of their own imagination or creativity. Toys that require batteries and have an on-off switch will limit the child’s use of imagination, especially if the toy only does one thing when switched on. Toys that are spin-offs of movies or cartoons are also limiting for the child’s expression because the child will “play out” the movie or the role of that toy instead of imagining their own scenarios. This is not always the case; however, the tendency is to re-enact the character as it is in the movie or cartoon.

Toys can be classified into different categories, such as aggressive toys, nurturing toys, role-play or fantasy and mastery toys. Toys and spontaneous play are helpful for children to explore their environment, learn to problem solve, increase their creativity and flexibility and is a window to the child’s inner world. So there is purpose to child’s play and it’s also lots of fun!

Ruth Hartley, who co-authored The Fundamentals of Social Psychology with her husband, said, “To read the language of play is to read the hearts and minds of children.” Observing child’s play that is driven by the child, is like listening to them express their inner thoughts. Keep in mind that it is natural to play out many different types of themes and types of play that are developmentally normal. When choosing toys for your child, think about what your child can do with the toy, not what the toys does to entertain the child. Giving them a selection of toys that can be used to express a variety of emotions and experiences is useful. In addition, providing too many toys is overwhelming and not productive to the child’s development and well-being.

Communicating through Play

Holiday time is especially stressful with so much going on, high expectations and time is short. This is a great time of year to devote a little time to focus on the moment, play with your child and bring down the stress level. This article gives you some guidance and hints in how to play with your child that will build a stronger relationship.


“Communicating through Play”
by Linda M. Manning, RN, LPC-S, RPT-S
Registered Nurse
Licensed Professional Counselor-Supervisor
Registered Play Therapist-Supervisor


Play is a natural way for children to express what they think and feel. Children do not have to be taught how to play. It is an important part of their world. Play helps them learn about the world, themselves and others. It helps them practice new skills and improve their coordination. Child’s play is not goal driven. The outcome is not as important as the actual process of play for young children. Play goes hand in hand with growth and development and learning. In fact, non-goal driven, child’s play is essential to normal development.
In general, when parents engage in play with their children, they tend to teach, ask questions and lead the play activity. Adults usually have an end result in mind when playing. The parent wants to teach the child what the animals say, question to elicit what the child knows to meet the needs of the parent. Instructing is an important part of parenting yet we need to stop the teaching sometimes when playing in order to build a close relationship and have fun with our children.
Through normal growth and development children will begin to separate psychologically from the parent. We begin as dependent on everything from our parent and adults around us and gradually learn to be more self-sufficient and care for ourselves independently. But relationships are always important in happy, normal development. Inevitably, problems crop up in the parent-child relationship because the need to separate creates power struggles, misunderstandings and hurt feelings. How can play help with this all important relationship between the parent and the child?
Begin with understanding that play is an essential part of the child’s world and is enormously important in their expression of feelings and view of the world. The play I am referring to is not the electronic toy world or the video game universe. Play with ordinary toys and objects that can be manipulated by the child and his or her imagination are what children need to be expressive and creative in their play activities. The human child is born with the ability to develop all human emotions and potential. Keep in mind that children will express all kinds of emotions through play. Play is symbolic of what the child feels.
As often as you can, set aside a 30-minute play period for you and your child that will NOT be interrupted. Children need to know that they are important to you and can have your undivided attention. The following skills when practiced regularly will go a long way in helping you develop and maintain a healthy, close relationship with your child. It will also help your child develop self-control and self-regulation of feelings and become a more cooperative and happy child in general.
In the last newsletter article, I talked about how to show your child that you are listening by reflecting back to the child what he has said or is doing. This listening skill is very valuable while playing with your child. Instead of asking questions or teaching, describe what you see your child doing and repeat back what they say to you. Children under 7 years of age especially love this because they know you are getting what they are expressing and it empowers their sense of themselves. Allow your child to choose what toys he / she want to play with. Do not direct the play. You follow, let your child lead. Allowing your child to lead gives you a great opportunity to reinforce their ability to make decisions. “You decided to play with ….” is a great statement for a child to hear. You are validating her ability to make decisions and this goes along with growth and development. “You decided to feed the baby” is a much better statement than “Is the baby hungry?” or “What a good girl you are!”. These comments are subjective for the parent and not helpful to the child/parent relationship. If you consistently say “What a good girl (boy) you are!” the child learns to please YOU rather than learns about their own abilities. “You know how to take care of that baby” is a statement that recognizes and communicates your confidence in the child’s ability. The child will experience your praise through your tone of voice and acknowledgement of what he knows.
“You decided to color with those colors” will usually elicit the names of the colors from the child without asking “What color is that?” and it gives the child credit for making the decision. It opens communication because the child will usually feel comfortable telling you more. Asking “what color” will only get you the name of the color. Here’s how an exchange could go:
“You decided to color with that color.” (parent affirms the child’s ability to decide)
“Yea, that’s blue” (child – knows the name of the color and likes to show you)
“Oh, you know that name of that color.” (parent acknowledges the child’s knowledge)
“Yes, it’s my favorite color.” (child gives more information about himself)
“You really like that one.” (parent acknowledges and accepts child’s preferences)
“The water is blue and so is the sky.” (child feels comfortable and wants you to know what he knows)
“You know what things to color blue.” (parent gives child credit for knowing what he knows – young children especially do not usually hear comments like this)
“Uh-Huh. Sometimes I color flowers blue and sometimes I color
other things blue.” (child gives more information and feels comfortable expressing own likes and dislikes)
“You use blue for lots of things.” (parent is accepting – this is not a teaching moment – this is relationship building – you can teach lots of times)
In this exchange the parent is showing that she is listening, she gives credit to the child for knowing the name of the color and what to color with it AND recognizes the child’s likes. This exchange helps this parent and child feel closer.
If you only say to your child “What a pretty picture” you are only giving them YOUR subjective judgment. The only information children gather from this is that you only want pictures that you like so they will only try to please you. Not a bad thing to please their parent but it does limit your relationship if you child feels you are only accepting of certain things and you only love them if they can please you. The play activity becomes about the parent rather than the child. Use this play activity to learn about your child. Remember how you feel when someone really listens and accepts you. You feel cared about and connected that someone understands you.
There are a lot of opportunities in the daily activities with your child to teach them and they go to school where teaching is the focus. Take time to play with your child and build a close relationship where you communicate to your child that he or she is unique and valuable with abilities that you admire. Remember set aside a time you will not be interrupted; show you are paying attention by describing what the child is doing and restating what they say; allow the child to lead the play; do not teach or ask questions; acknowledge the child’s decisions and what he knows in your reflective comments. These skills will go a long way to build a communication style with your child that will nurture your relationship for life.
In the next article, I will discuss limit setting. Accepting your child, allowing him to lead in the play, and showing you are listening do not mean that you let your child get away with any behavior they feel like. Feelings are accepted because all humans have a range of emotions but behaviors are a different story and parents must impose limits and boundaries for children to grow up healthy.

Bringing an Anxious Child to the Dentist

by Linda M. Manning, RN, LPC-S, RPT-S
Registered Nurse
Licensed Professional Counselor-Supervisor
Registered Play Therapist-Supervisor


Fear is a gripping emotion and renders us unable to take action no matter what the age. If your child is generally anxious or just afraid of going to the dentist’s office, you can help the situation by acknowledging the fear and making it a normal part of human existence. Parents are often under the mistaken belief that acknowledging a child’ emotion will make it worse. Many times an empathic response will help the child regulate the feeling. Each human being is born with what is needed to grow and develop physically and psychologically to maturation. It is important to trust that your child will learn to self-regulate his emotions and will mature.
Begin by looking at your feelings about going to the dentist. Do you dislike it? Does it make you feel anxious? Is it routine for you and not anxiety producing so you don’t understand why your child reacts fearfully? You can transmit those feelings and attitudes to your child without being aware you are doing so. Just be aware of it. It’s not wrong or right – just what is.
Now, accept the fearful feelings your child has. Accepting them does NOT mean that you agree or that you are endorsing the anxiety. Just accept your child where she is with the knowledge that she is able to learn to regulate those feelings. This allows your child to own her own feelings and experience your trust that she can learn self-control. Think about how you feel when you have an emotional response to something and someone listens and accepts your feelings. You feel relieved that someone understands. This helps you think more clearly, emotions generally subside and you feel you are not alone.
Next, state that it is ok and normal to sometimes be afraid. Making a general statement that sometimes things are scary will normalize the reaction. Accepting a child’s fear is not going to work if you think you can manipulate them to not feel that way. Kids are very astute in reading sincerity in adults. They are great at sensing tense, uncomfortable feelings. They are not good at interpreting what the tension is about so usually think that it’s their fault. Again, acknowledge the fear in a calm, normal tone of voice and make a statement that says “sometimes it’s scary to go to the dentist”, “you wish you didn’t have to go to the dentist today” or “you don’t like going to the dentist”. Stating that you understand the child’s feelings does not mean that the child won’t have to go to the appointment. Accepting feelings does not change what has to be done.
Once the child knows that you understand, accept the child’s feeling and with your calm attitude you let the child know that you will be supportive and all is going to be fine. Accepting how the child feels will help the child be able to hear what you have to say. Isn’t it difficult for you to listen to someone else’s opinion when you are in the grip of emotion! Here’s how an exchange could go between a parent and anxious, uncooperative child:
“No! I don’t want to go! I want to stay to play with Susie!“ (child refusing – could be because having fun playing or could be because is afraid)
“You wish you didn’t have to go. You’re having fun here.” (parent responds by stating the child’s point of view – understands)
“I don’t want to go!”
“You’re so upset. You want me to know how much you don’t want to go.” The child may go on crying and saying doesn’t want to go. This is where the parent needs to stay calm. You will be in a battle if you think you can make the child feel differently.
The child may show more fear than objection. You need to go with what the child exhibits. Such as, the child begins to cry and look fearful, your response could be any of the following: “You don’t like going to the dentist”; “You’re worried about going to your appointment”; “Going to the dentist is scary for you”.
If you know your child is anxious and doesn’t like to go to the dentist, give yourself a few extra minutes to go through this exchange. Be patient but not too involved with trying to “fix” the child’s feelings. Too much focus on feelings can also make it all worse. Once you’ve acknowledged and accepted how the child feels, tell the child that you know she’s “afraid” or “scared” or “doesn’t want to go” but it’s time to go to the dentist’s office. It’s never a good idea to ask the child if he or she is ready to go. Why would you ask a “yes” or “no” question when the “no” is not an acceptable response? It is not the child who decides that he needs to go to the dentist, it is you. “I know you’d rather not go, but it’s time to leave now.”
By this point you may have a more cooperative child who knows that you understand and yet is relieved that you are taking charge or you could still have a combative child. Either way, this is where you take the child to the appointment regardless of the emotional response. Your actions at this point are more important than giving in to the child’s or your feelings. Parents have emotional responses to their children and can also have difficulty in controlling their reactions. You set the tone and you decide the actions. Whether your child is anxious or is in a power struggle with you, reflecting the child’s feelings and desires but following through with the actions to go to the appointment will set the stage for all future situations.
Here’s what you should never do, but exasperated parents do all the time. Do not offer to buy something for your child if he goes quietly to the appointment. Offering to buy toys, gum, happy meals, etc. will ONLY get you MORE of the SAME behavior! Parent’s mistakenly go for what is easier at the moment and suffer the results later by reinforcing behavior they really do not want. We teach our children how to manipulate us! Temper tantrums will fall away if they do not get rewarded. Behavior that is not reinforced does not get repeated. Anxious behavior can be just as manipulating as temper tantrums.
In summary, respond to your child’s emotions knowing that YOU cannot fix the fear or anxiety. You can understand and ACCEPT it as a normal human emotion (yes, even irrational fear is common). KNOW that your child CAN learn to self-regulate his or her feelings and will be OK. ACKNOWLEDGE your child’s feelings by stating what he is showing you. Accept the emotions but DO NOT CHANGE the outcome based on feelings. FOLLOW through calmly and confidently. You will transmit your confidence in the child’s ability to overcome his fears. He will learn that feelings can be handled and there are things we have to do even when we don’t feel like it.

Tell Me Again Why My Child Has A Cavity!?

It's disturbing to hear that your child has developed a cavity when you know he or she brushes morning and night. And flosses once a day! How can that be possible? You've always been told that brushing and flossing prevents cavities. It does, however, unfortunately there is more to it than that.

Besides the usual cavity causing villians: diet, poor brushing and oral hygiene practices, there are other factors involved in the occurrence of the dreaded cavity. First of all, let's look at the tooth itself. What is the quality of the enamel? How thick is it? Are there deep pits and fissures in the shape and surface of the tooth? How much fluoride is the tooth exposed to? Many bottled waters do not contain fluoride. Then there is the saliva. What is the mineral content of the saliva? How effective is the buffering capacity of the saliva against cavity producing bacteria? Is the saliva supersaturated with calcium and phosphorus? Is the principle buffer, bicarbonate, present in sufficient quantities and functioning in a healthy manner? Other factors that can reduce the body's resistance to cavity development are medication, disease, dehydration, radiation and age. Still other factors involved are racial ethnicity, socioeconomic status, behavioral education, general health and stress. Then there are those pesky genetic markers that predispose an individual to cavities. There is a significant association between markers on genes for ameloginin and tuftelin, which are the proteins found in developing enamel in teeth and are involved in the strength of the tooth development.

Phew! As you can see, many of these factors neither you, the dental team, nor the child have direct control over. What you and your child do have control over is how often and how well your child flosses and brushes and how often you make it to your dental checkup. Yet, as we have just seen, even with regular flossing and brushing there are many variables involved in developing cavities. The chance of getting a cavity is greatly reduced with good oral hygiene, a healthy diet, drinking lots of water, plenty of rest, exercise and regular visits to the pediatric dentist. Those factors are under your control. Regular visits to the pediatric dentist are very important, but nothing replaces a focused and concerted effort to clean your child's teeth - front, back and in between!

Now that you know some of what contributes to cavities, consider all that you do not have control over. Brushing and flossing are important components of daily oral hygiene and if only it were that simple! Unfortunately, what you do have control over doesn't give you a guarantee that your child will never develop a cavity. Your pediatric dental team is here to help you catch those cavities early if they develop and help your child stay healthy.

Posted by Linda M. Manning, MEd, RN, LPC-S, RPT-S
October 15, 2009

Early Dental Care for Children

Fort Worth Texas Dentist Gordon Strole Jr. encourages parents to schedule their childs first dental appointment around the child's first birthday. Dr. Strole Jr. explains important information about teething, primary teeth, good diet and healthy teeth, infant tooth eruption and preventing baby bottle tooth decay at www.stroledds.com/early.asp.