Time-in strategies

Filling up your child's "attention tank"

time-in for good behaviorWe all know about time-out, but how many parents understand the concept of time-in?

For time-outs to be effective, they have to be balanced by time-in. The underlying goal of time-out is to discourage bad behavior by putting your child in a situation that is boring—an experience they’d prefer to avoid. The goal of time-in is to give your child the attention he or she craves when behaving well.

Children have what I like to call an attention tank. They crave the attention of their parents or caregivers. If we can fill their attention tank with attention when they are behaving well, they’ll be less likely to try to get attention through bad behavior.

Children develop high levels of self-esteem through brief verbal praise and warm physical contact with family members. Obviously, young infants require a lot of physical contact. As they grow older and their needs change, parents usually touch their child less. At that point, it’s important that we as parents and caregivers make a conscious effort to maintain that physical contact. Strive to catch your child being good at least 50 times each day. Acknowledge that good behavior with verbal praise and physical contact.

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Safe sleep for babies

An issue that hits close to home

In a recent two-week span, nine infants in Wayne County died due to unsafe sleeping conditions. Nationally, an estimated 4,500 infants die each year due to unsafe sleep environments. This is the leading cause of preventable death for infants. These tragedies are preventable and a strong reminder to brush up on safe sleeping practices.

Babies need their own safe sleep environment — alone on a firm sleep surface with a fitted sheet, on their backs with no crib bumpers, no stuffed toys, no plush blankets and no pillows. In order to cover your baby, you can use an appropriately-sized sleep sack (some have swaddling flaps for younger infants) or cover your baby with a thin blanket (as long as the blanket is under the baby’s armpits, tucked in the sides of the crib and the baby’s feet are at the end of the crib).

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How do eating disorders affect the way someone thinks?

Eating disorder specialists shine a light on misunderstood aspects of eating disorders

A new study estimates that approximately a half million teens struggle with eating disorders or disordered eating. These conditions, such as bulimia and anorexia, are serious emotional and physical problems that can have life-threatening consequences for females and males.

February 4-March 22 is National Eating Disorders Awareness Week.  The goal of this national initiative is for everyone to do just one thing to help raise awareness and provide accurate information about eating disorders.

What one thing are you going to do to make a difference?

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Five things parents should know about the flu

This year’s flu season has arrived earlier than normal. Do you know the important prevention and treatment information necessary to keep your child healthy? University of Michigan pediatrician Heather Burrows, MD, PhD, is here to answer a few questions about how to keep the flu bug at bay.

What signs and symptoms of the flu should parents be aware of?

Symptoms of influenza include a high fever, cough, often times a runny nose as well as body aches and fatigue. The difference between influenza and the common cold is usually the severity of the symptoms. Kids with influenza have higher fevers and are more fussy and tired.

When a child does have the flu, is there anything that can be done to stop it from escalating?

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Getting to know our patients

Looking beyond the symptoms to the spirit within

Editor’s Note:  After more than 20 years at the University of Michigan, Dr. David Rosen is no longer seeing patients in order to spend time with his family while addressing health concerns.  A lectureship has been established in his name. Contributions to the lectureship in Dr. Rosen’s name can be made online.

We invite Dr. Rosen’s friends, family and colleagues to post a note of support using the comments tool at the bottom of this post.  We will share all notes with Dr. Rosen and his family. 


As doctors we work to see and treat each patient as an individual.  Being “The Leaders and Best” requires not only medical knowledge but also a deep appreciation for the importance of building a trusting, caring relationship with each and every patient we are privileged to care for.

The best doctors know that providing ‘patient centered care’ is about providing care that respects and understands the patient’s spirit, taking into account each patient’s personal and emotional challenges in addition to their symptoms and medical needs.

There is no class you can take to learn this, nor any textbook available that can provide this insight, because every patient is unique.  If you’re lucky, you have the opportunity to see it in action – to learn how to shape each physician-patient interaction to build a caring, trusting relationship.  I have been that lucky, as have many of my colleagues here who have had the honor of working alongside Dr. David Rosen.

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7 tips for choosing gifts for children with special needs

If you are looking for the right present for a child with special needs this holiday season, consider these ideas from therapists at C.S. Mott Children’s Hospital.  Above all, keep in mind the particular personality, preferences and ability levels of the child you are shopping for. Your thoughtfulness will be appreciated by parents and caretakers—and if the gift doesn’t work out well, the receipt usually will!

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