 Joining us is Dr. Ojoke Ajayi Akintade, Assistant Medical Director and Neurodevelopmental Pediatrician at Mount Washington Pediatric Hospital. Doctor, thank you so much for joining us. Thank you for having me. It is back to school season. Some parents rejoice. Some kids not so sure about it, but everybody wants their kid to get off on the right foot. What are the most important things for parents and grandparents and caregivers to focus on? That is true. So school readiness, other steps and ways parents, caregivers and pediatricians take to help children get back into the school mode. We know during the summertime, the routines that help children regulate themselves are put on hold. And that's rightly so because you want summertimes for children to be fun and carefree times. But when school is round the corner, we need to bring those routines back. We need to make sure our children are getting enough sleep because that's very important. They have enough food to eat, vaccinations, because we know those are proven ways of preventing diseases. So you do need to make appointments to your pediatricians. So the goal of school readiness is to make sure that that transition from home to school is smooth. And also that children are ready and eager to learn. So they're only getting their children healthy, physically active, but they also need to be socially and mentally ready to go back to school to learn. Well, let's take some of those topics one at a time. You talk about sleep and obviously, if you're gonna have to wake up early in the morning, you need to go to bed a little bit earlier. And it's tough to adjust. How much sleep do young people need? That's good. So I think we should first start saying sleep is good. Sleep is essential. And for our child, sleep is big deal because it affects a mental and physical well-being. As adults, we know how we feel energized and ready to start the day after a good night's sleep. For children, it's even more important because good sleep directly affects a child's ability to learn. A child, well, we know that younger children generally need more hours of sleep. So an infant and a newborn probably sleeps for at least 12 hours a day. A preschooler, we expect about 10 hours a day. A school-aged child, about nine. And even teenagers who notoriously tell us day in, day out, they don't need sleep. They do need at least eight hours of sleep every day. So sleep, I tell parents at my Washington pediatric hospital that a well-rested brain is a brain that's ready to learn, a brain that's ready to retain information because when we are asleep, not only do our bodies rest, but a brain also takes that rest that it's needed. You know, one of the things they talk about for adults in getting a good night's sleep is getting away from the computer or the phone or whatever screen you happen to be focused on. Like the idea that you can't put down the phone and expect to be fast asleep two minutes later. Does it work that way for kids? That is true. I remind parents that we have to be the role models for what we would expect our children to do. There are many studies out there that already tell us that excessive screen time is not good. It affects our child's ability to communicate. It affects our child's sleep too. So not only getting rid of the TVs, the computers, the game videos, out of the patient, out of the child's room, that's important. Because again, sleep is important for learning. So we need to, and whatever routines parents find works for the children, making sure you have sleep times and wake up times, the room is maybe dimly lit, no televisions, those work. How about music? I used to sneak a transistor radio a long, long time ago when the Orioles were really good and they are really good again. You know, I'd go to sleep listening to a ball game. Lullabies might be helpful, but I think what parents should do, and what I tell parents is to just keep the room distraction free, that works much better. You brought up vaccinations, so we'll get to the more serious health stuff. I wonder if the world of vaccinations, including childhood immunizations, has been affected by the politicization of the pandemic, the COVID vaccines. If things that we all took for granted that our kids are gonna have this series of shots, is there any evidence that parents are having second thoughts about it, that the percentage of kids who are getting the vaccines that they need is maybe changing? I don't think so. I think most parents realize that for the children to go to school, there are mandatory vaccines that are needed. And we do know vaccines have been around for quite some time and they're proven they're safe. I remember many of my parents at the Washington Pediatric Hospital that it's easy to forget how important vaccines are. If you've never seen the diseases that we're trying to prevent. Chickenpox, measles, mumps, rubella, hepatitis, pneumonia, meningitis, those are things that directly affect the child's well-being. And if not cut on time, even more serious harm can be done. How often do you see a child in the practice who is maybe behind on the vaccination schedule or is that something that the schools are on top of? Schools generally are on top of that. And pediatricians are trained to encourage parents to make sure that those vaccinations are current. Among the diseases that you've listed, are there any that are most important for kids to have? I think all of them, because you can't cherry pick out what diseases are. What you want is your child to be healthy. No, you don't want your child to have chickenpox, certainly not mumps or rubella. So I wouldn't say any of them is more important, but it's important that all those immunizations are obtained. Yeah, when we introduced you at the top of the show, we mentioned neurodevelopmental pediatrician. If I said that right, what conditions do you treat most often? So the neurodevelopmental pediatrician, the focus is to see from birth till age 21 how his child is developing. And when you look at a child's development, you can break it into two main streams, your language skills and your motor skills. So children, I see my practice at my Washington pediatric hospital have either a combination of deficits in their motor abilities or language abilities. So I see the whole spectrum. And within that spectrum, how important is it for somebody to recognize that there's a need for medical intervention or at least diagnosis early? And to allow for early intervention. What I've found over the years is that actually, parents are pretty on top of things. And I remind colleagues that when a parent comes and says, hey, my a-jokey here is not doing what I want her to do. You should take that seriously and get them to either be evaluated by the pediatrician or hopefully somebody like me. Because we do know that the earlier you put the services and the therapies in place, the better the outcome for the child. How much is the therapy side of it changing over the years? And in terms of how you approach different developmental issues? I think it depends on the diagnosis. We are lucky that I'm at Washington pediatric hospital. We just opened a multimillion dollar, I would say ability center because we realize that even for children who have ongoing rehab needs, they do not have to be cooped up in the hospital so you can come from home to get those occupational therapies to work on your arms, physical therapies. And that's working well. How much do the kids you treat worry back to school time about fitting in? I mean, every child I think has some, especially if it's a new school, a new you've gone from elementary to middle or whatever it is, it can be a little bit daunting. It can be. I often tell parents to that when you talk about disabilities in a child, we all have our own disabilities. Some, of course, are more obvious than others. And I think if you start from that perspective, saying, all right, we know you have your struggling, we language skills, but gee, we are very good at getting things done, cutting with scissors. So we need to find, as parents, as caregivers, as pediatricians, a child strength and work on that. What works in terms of giving advice to a young person? Maybe it's a young kid who was really concerned about making a couple of friends at a new school. Maybe it's a teenager who's being bullied or it's something serious going on. We sort of think that young people don't really want to hear any advice. I mean, how do you present something so it's not me telling, adult telling kid, do this, do it my way, which, you know, I've heard they tune out. Yeah, I think coming to their level, and that's a good point to me, that you do not want to lecture them because otherwise they just, they stop talking to you. Letting them realize to that is okay for them to have, you know, they're not excited to go to school, unhappy or unsure if they'll be able to make friends. If you do remind them that they're one of many other children who are having similar emotions, it becomes real. So they don't feel like they are special in any way because there are other kids who are having the same issues they have to deal with. And nobody believes that as a kid. You always, you see other kids in the class and think everybody's got it all together. It's hard to perceive that they've got the same issues or that you as a kid have the same issues that everybody else has. Well, then you hope you have teachers too, adults who are there to engage with the children and have positive student-teacher interactions because that is important. Yeah, you mentioned the parents tend to be fairly well attuned to when there's a neurodevelopmental deficit in a child. When it comes to something going on in a child's classroom, maybe it's an older child, maybe it's a bullying situation, how often do they miss that? How often do kids succeed in keeping that away from parents and how can parents be better listeners? Maybe. Let's go back to school readiness. So we talked about why it's important that a child is healthy mentally and socially prepared to go back to school. The school also has to be ready for the child. And one of the things schools can do is to promote parents engagement to make sure that the children know about the rules for the teachers themselves to be good role models for the children. So it's not only getting the child ready but also getting the school ready to take that child back to school so that that transition is smooth, successful. Because after all what we want is the children to learn to succeed and be, yeah. Helpful to be in touch with the teacher. I mean, especially if you have a concern. It is most important, it is most important. I am very partial to teachers because my parents were deceased, a teacher. So I have a very soft spot for them. We ask our teachers to take care and provide, obviously, hopefully, the best instruction. But we as parents must also participate and be part of that equation to bring the best out of our children. Before we go, I mentioned before the show that I had found an op-ed that you wrote. And I know that you treat patients of all backgrounds but a lot of kids who are on Medicaid. And there are concerns about accessibility of care. And it can mean financial, it can mean location, time, the parents having the resources. What do you see in practice? So those are real challenges for our population. But we are lucky, I'm at Washington Pediatric Hospital, a small hospital, smaller than the big ones. But we have a lot of resources too. So we have social workers to help reach out and identify those issues that might be impacting the child's well-being. That has been, I mean, one of the things we do, and we do very well. Yeah. You know, the other thing that during the pandemic, you heard from experts a million times, saying that kids are resilient. Is that true? Did kids do better than we adults did during the pandemic? It is true. It really is true. One of the things I've enjoyed working so long at my Washington Pediatric Hospital is, I'm always amazed at how well the children do. So you admit them to the hospital and they have a host of diagnoses and things quote wrong. By the end of the day, when you say bye to them and you see the smile, like you follow them up in outpatient, you pretty impressed with how far they have come. I think children luckily don't have all the garbage we adults carry around and that's to their benefit. A more innocent time, Dr. Ajayi Akintade, your friends call you Dr. A. Yes, I do. At Mount Washington Pediatric Hospital, Dr. we appreciate your time. Thank you so much. The pleasure is mine. Thank you. Your health segments are a co-production of Maryland Public Television and the University of Maryland Medical System.