dr. nutter's list of suggested resources - by topic:
Abuse, crisis intervention & online safety
If you are a child/youth and need to talk to someone: call Kids Help Phone (ages 5-20): 1-800-668-6868 to speak with a counsellor 24/7 or 1-800-784-2433 or call the Helpline for Children at 310-1234 or the BC Crisis Line 310-6789 (do not add 250 area code) which is also available 24/7 and confidential: more
If you think a child or youth <19 years is being abused or neglected, you have a legal duty to report concerns: call MCFD-Ministry of Children and Family Development via their centralized child protection reporting system: 1-800-663-9122 any time day or night in BC. If you believe the situation is an emergency: call 911.
Kelowna Child Advocacy Centre (CAC) is a not-for-profit organization that supports the long-term well-being of children who have been impacted by abuse, trauma.
Parents/caregivers: teach your child self-regulation skills, build post traumatic growth/resilience
Tools to help keep children safe, more tips here, RCMP's My First Safety Book (ages 4-7)
Parents: start having basic safety discussions early: teach your child about consent, body autonomy & make sure anything your child (or you) post online you're comfortable sharing with the world; once it's online it's forever & don't post details ex. your child's school, home address or current location; online predators can easily use/track this info
FBI safe surfing, NetSmartz, Thorn, watch "Childhood 2.0" documentary here
Attention deficit hyperactivity disorder
ADHD is a neurodevelopmental condition that affects the brain's executive functions (including attention regulation, working memory, emotional control / self-regulation, planning, prioritizing, organization...). It is not a behavioral disorder.
ADHD myths, challenges & issues by age
What is executive functioning? Read about 7 key deficits, behavioral therapy & games
Boys are 3x more likely to be diagnosed with ADHD compared to girls. Girls are consistently under-identified and underdiagnosed; girls tend to have less externally disruptive behaviors & often internalize their struggles (anxiety, poor self-esteem, low mood).
Adolescents with untreated ADHD are more likely to smoke, drink, or use drugs & they tend to experiment with all three at younger ages and are at a significantly greater risk for developing a substance use disorder
ADHD is highly inheritable so when a child is diagnosed with ADHD both parents should also be screened. Left untreated, ADHD can cause lifelong impairments including increased risk of anxiety, depression, drug and alcohol misuse, chronic underachievement, engaging in risky and/or impulsive behaviors (unsafe driving leading to car accidents, risky sexual behaviors leading unplanned pregnancy, etc.).
Common comorbidities include:
- 9 in 10 people with Tourette’s (tic disorder) also have ADHD
- about 2/ 3 of people with ADHD have some features of autism; other studies indicate 30-50% of those diagnosed with autism also have co-occurring ADHD so they often co-occur.
- 50% have sleep problems (read about insomnia, Melatonin & info parents should know)
- nearly 1 in 2 people with ADHD have specific learning disabilities such as dyslexia, dyspraxia (diagnosed via psychoeducational assessment; current waitlists through the public school system are very long. Variety will fund private psychoeducational assessments - check eligibility criteria)
- Symptoms of ADHD & anxiety disorder overlap; both cause restlessness, difficulty falling sleep& it can be easy to mistake anxiety for the hyperarousal of ADHD, or misinterpret a child's worries and obsessions as inattention. It often takes time to tease apart ADHD and anxiety
Tools for PARENTS:
- BCCH offers a free online Rolling with ADHD course for parents
- Children with ADHD require different parenting strategies, positive reinforcement & empathy
- Challenging behaviors, emotional dysregulation, Oppositional Defiant Disorder & lying
- Strategies to deal with meltdowns, anger and some mindfulness activities to try at home
- Physical activity: regular exercise & time spent outside in nature can help children with ADHD recover from "attention fatigue" and recharge their focus - physical activity tips
Treatment should include behavior therapy (ie. parenting strategies, consistency, incentives) and long-acting stimulant medication is a first line treatment in children >age 6. For more info on medication see:
- CADDRA medication chart (last updated November 2022)
- BCCH factsheets on ADHD medications & managing common side effects
- Comprehensive medication guide including a helpful Q&A section
- Helpful tips re: how to teach your child to swallow pills
Tools for TEACHERS:
- BCCH offers a free online Rolling with ADHD course for teachers
- Examples of classroom accommodations, tools, behavioral strategies
- Tips to help students improve their attention & stay alert in class
Tips re: Sensory Processing Challenges
- Learn about sensory differences, fill out a Sensory Checklist
- Making sense of sensory behavior: a practical approach for parents
- Sensory behavior tracking tool, information on interoception & helpful strategies to try at home
- Consult an Occupational Therapist (find an OT / search by city)
Allergy
Food allergy prevention (last updated February 2022)
Allergy Check app is an assessment tool re: likelihood child has a food allergy
Anaphylaxis Emergency Action Plan (includes photos/instructions on how to use an Epipen)
Insect sting allergy: resources
Allergic rhinitis (hay fever)
anxiety
Anxiety Canada "MindShift" app (download here)
Create a My Anxiety Plan & try these Everyday Activities to Ease Anxiety and other calming tools
Psychoeducation, resources from Anxiety Canada & BC Children's
How to manage stress, coping strategies
Why is sleep so important? Track your child's sleep habits using this sleep diary
Physical activity: regular exercise & time outside in nature helps decrease anxiety: physical activity tips
BC Children's SSRI medication factsheet
Find a Psychologist in BC-search by city
A note about MINDFULLNESS:
Mindfulness is the art of being present & aware of what's happening right here & now in a non-judgmental way. There are many different ways to be mindful including meditation, breathing exercises, going for a walk in nature, etc. The best way to teach mindfulness is to practice it yourself and to talk about it with your child. Stress, worries or feelings of anxiety can get in the way of doing what you want/need to do and mindfulness can help a child be more aware of their feelings so they learn to act on them in socially appropriate ways (ie. stop & become more aware of the feelings of others , interact with empathy & respect).
Mindfulness 101 and relaxation exercises
Cognitive Behavioral Therapy: link between thoughts. feelings & behaviors, thinking traps
Smiling Mind app (download here) is a great resource for children struggling with anxiety; promotes mindfulness through breathing exercises, guided imaging and other practices to relax the body and mind (which helps reduce stress & anxiety). BCCH also offers a free Breathr app (download here)
COMMUNITY RESOURCES:
Kelowna Family Y: YMCA offers meditation classes, Teen Mindfulness Group: 7-week program: 13–18yo
Kids Help Phone (ages 5-20): 1-800-668-6868 to speak with a counsellor 24/7 or 1-800-784-2433
Child & Youth Mental Health: CYMH offers walk-in intake appointments for children of all ages (no referral needed however if <5yo parents must call ahead & book an appointment)
The Foundry Kelowna offers services for youth aged 12-24 and their caregivers (either by drop-in or you can also schedule virtual counselling appointments, find peer support, access primary care, groups & workshops). Download the Foundry's app & explore suggested apps/tools
Confident Parents, Thriving Kids telephone-based parent coaching (requires a referral)
Asthma
Asthma Canada & Sick Kids Asthma Hub
Guide for families/caregivers from BC Children's; handout (Child Health BC)
Asthma Action Plan with instructions on how to use an MDI/aerochamber
Smoking increases your kids (and your) risk of upper respiratory infections AND it also makes it harder to heal after infections when they (you) are sick. Even if you only smoke outside, the smoke particles remain in your clothing and exposure to second-hand smoke can trigger flares.
If you don't want to quit for yourself, quit for your kids! Check out BC's free QuitNow program.
autism
Autism is a social-communication difference ie. a different way of communicating/interacting; some (but not all) have language delays and/or repetitive language & behaviors.
Every child is different & every child with autism is different.
Autistic children often struggle to communicate how they're feeling in expected ways (ex. when stressed they can quickly go in "fight or flight" mode ie. get angry, shut down or hide/run away) and often struggle to recognize and/or understand their own feelings or other people’s intentions, feelings (ex. they may miss social cues, poor perspective-taking), have very specific or intense interests, highly sensitive & rigid (unpredictability, change/loss of routine, meeting new people/going to new places, transitions are difficult).
Boys are diagnosed 4x more often than girls. Girls are often diagnosed years later compared to boys (if they are ever diagnosed) as girls tend to present with more subtle features & often mask their social challenges & internalize more (main presenting complaint is often anxiety), they may experience social 'burnout' , fatigue and more sensory processing challenges.
Early screening, diagnosis and timely intervention helps improve the development & future outcomes in children with ASD. Early intervention can help autistic children learn how to manage feelings, self-regulate, respond/cope in stressful situations & social skills training can improve social communication skills (an important part of childhood development and future lifelong relationships, job success ex. team work, etc.).
GPs and specialists can refer children for a public ASD assessment (IHCAN); parents can also choose to pay for a private assessment with a qualified professional (often a Child Psychologist with extra training).
ACT-Autism Community Training provides info about the assessment process, treatment & support in BC. Variety can help families cover the cost of a private autism assessment (check eligibility criteria).
Autism BC has lots of helpful resources including the "waiting for assessment" workshop, how to prepare before an assessment, next steps after a diagnosis & how to build a support team: see RASP provider list
General information: see Kelty Mental Health's resources & Sick Kids Autism Hub
Evidence-based treatments, webinars: Social Thinking, courses & complementary approaches
How to help prepare your child so they know what to expect before a medical visit, procedure, or hospital admission - try Boston Children's visual stories, Carol Gray's social stories, etc.
Behavioral Challenges:
Tracking and understanding behavior template
Managing anxiety, irritability, challenging behaviors, anger
PDA (Pathological Demand Avoidance): suggested approach
Autism Speaks toolkits (use NJ as the state, zip code 08540) ex. challenging behaviors
Regular exercise & time outside in nature helps regulate children: see physical activity tips
Sleep challenges: specific issues, tips, Melatonin factsheet
BCCH factsheet on medications sometimes used to treat irritability/aggression
Sensory Processing Challenges:
Learn about sensory differences; Sensory Checklist
Making sense of sensory behavior: a practical approach for parents
Helpful sensory behavior tracking tool
Information on interoception & strategies
Find an Occupational Therapist (search by city)
MINDFULLNESS:
Mindfulness is the art of being present & aware of what's happening right here & now in a non-judgmental way. There are many different ways to be mindful including meditation, breathing exercises, going for a walk in nature, etc. The best way to teach mindfulness is to practice it yourself and to talk about it with your child. Stress, worries or feelings of anxiety can get in the way of doing what you want/need to do and mindfulness can help a child be more aware of their feelings so they learn to act on them in socially appropriate ways (ie. stop & become more aware of the feelings of others , interact with empathy & respect).
Mindfulness 101 and relaxation exercises
Cognitive Behavioral Therapy: link between thoughts. feelings & behaviors, common thinking traps
breastfeeding support
Kelly Mom website
Dr. Jack Newman Breastfeeding Centre
Which medications are safe during breastfeeding?
cancer
Children's Oncology Group has reliable information to help guide families starting from the initial diagnosis through to treatment and follow-up care and tips for coping with cancer
cardiology (heart issues)
BCCH resources: congenital heart disease
What are benign or innocent murmurs?
colic
PURPLE crying (a must read for all new parents)
concussion
Parent guide and a guide for adolescents
BC Centre for Ability program & more resources
Use the free "Concussion Ed" app to record symptoms, support recovery
CATT: Concussion Awareness Training Tool (for youth, coaches, parents/caregivers, teachers)
CONstipation & ENCOPRESIS
CHEO's constipation guidelines
Encopresis "The Poo in You" video-GI Kids
Restoralax (PEG3350) stool softener
Drink water and eat a high fibre diet
DEPRESSION
Depression & suicide prevention factsheet
Cognitive Behavioral Therapy: understanding the link between thoughts, feelings & behaviors
BCCH's Kelty Mental Health resources including how to manage stress, helpful coping strategies
What is mindfulness? See list of mindfulness resources (including books, websites, apps) and try out the Smiling Mind app (download here) - a great resource with exercises that promote mindfulness (breathing exercises, guided imaging and other practices to relax the body and mind to help reduce stress & anxiety)
Sleep is important for both mental and physical health: keep track with a sleep diary
BCCH antidepressant medication factsheets
Find a Psychologist-search by city
COMMUNITY RESOURCES:
Kids Help Phone (ages 5-20): 1-800-668-6868 to speak with a counsellor 24/7 or 1-800-784-2433
Child & Youth Mental Health: CYMH offers walk-in intake appointments for children of all ages (no referral needed however if <5yo parents must call ahead & book an appointment)
The Foundry Kelowna offers services for youth aged 12-24 and their caregivers (either by drop-in or you can also schedule virtual counselling appointments, find peer support, access primary care, groups & workshops). Download the Foundry's app & explore suggested apps/tools
DERMATOLOGY (skin issues)
DEVELOPMENTal delay
Milestones by age (2 months to age 5)
Download the CDC milestone tracker app here; adapted milestones for premature infants
Parents can still self-refer their children to Starbright for Speech, Occupational and/or Physical Therapy, Infant Development Program (to age 3), Supported Child Development, Clinical Counselling. The cut-off date for services is October 1st the year before child is eligible to enter Kindergarten (once a child starts school the services are provided through their school OR parents can choose to pay for private therapy).
The new Family Connection Centre (FCC) located in Kelowna will support children, youth & families. Services will be based on needs (rather than diagnosis) or involvement with a CYSN social worker; Arc Programs and subcontractors (Meridian Rehab, Boys & Girls Club, YMCA and the Kids Physio Group) will provide therapies, interventions, supports & services for children/youth (0 to age 19). More info to come.
DIABETES
BCCH tips: diabetes management
Sick Kids Hospital resources
ears, NOSE & THROAT (ENT)
Sick Kids ENT resources: ear infections, strep throat, croup, nosebleeds, etc.
eating disorders
Diagnoses of anorexia nervosa, bulimia nervosa, binge eating disorder and unspecified eating disorders have increased significantly worldwide. Many cases go undetected and untreated which is why it is important for families to be familiar with the signs and symptoms of these devastating disorders.
NEDA parent toolkit, NEDIC, BCCH's Kelty Eating Disorders
Parent cheat sheet (what to do and what not to do), meal coaching tips (for parents)
Information on body image & eating disorders
Peer support: Looking Glass and Jessie's Legacy
EMERGENCY medicine
Sick Kids information on coughs, fever, common injuries: sprains, strains & fractures
EPILEPSY & SEIZURES
What to do if your child has a seizure?
What is epilepsy?
Information on febrile seizures & what all parents need to know about fever
Fetal alcohol spectrum disorder (FASD)
FeVER
Fever is associated with common viral infections (like the flu) and helps the immune system fight disease. Fever-reducing medications (like Tylenol) are strictly for comfort (won't cure or shorten illness).
Learn about fever (38 degrees Celsius or higher) & how to measure your child's temperature: handout
Infants (<3months) with fever MUST get an assessment (even if it's the only symptom) to avoid missing a potentially serious bacterial infection like sepsis/meningitis which requires urgent treatment/antibiotics.
gastrointestinal (GI issues)
Keep track of pain: Abdominal Pain Journal
Watch these helpful videos (explains procedures such as colonoscopy, endoscopy & GI issues: EoE, GERD, IBD, cyclic vomiting, functional GI problems, Sick Kids hub: GI disorders, Celiac Hub
Cow's Milk Protein Allergy: CMPA diet for breastfeeding mothers (McMaster handout)
GERD/reflux: tips (NASPGHAN handout)
HEADACHES
Keep track: My Headache Diary
Download the "Migraine Trainer" app here
CHEO's migraine handout, BCCH migraine guideline & more info
National Headache Foundation resources (includes: abdominal migraine, cyclic vomiting)
LEARNING DISABILITies
Psychoeducational assessments are recommended if the following is suspected:
- Specific Learning Disability in reading (dyslexia), writing (dysgraphia) and/or math (dyscalculia)
- Intellectual Disability
- Giftedness
Psychoeducational assessments help identify areas of strength and need, suggest recommendations & accommodations in the classroom (and at home) and should be re-done every 3-4 years before important transitions (Middle School, High School). Current waitlists through the public school system are very long (2years+) so parents can also choose to pay for a private assessment with a qualified Child Psychologist.
Helpful resources from Sick Kids & videos
Learning Disability association of BC resources
NEPHROLOGY (kidney issues)
Info on kidney disease, CKD, cysts, single kidney, kidney stones & high blood pressure
NUTRITION & feeding
Feeding your child with love and good sense: tips from the Ellyn Satter Institute
Sick Kids Hospital nutrition hub & "Live 5-2-1-0" healthy lifestyle guideline
General tips on feeding your baby in the first year
How to improve your child's iron intake
Choose water for healthy hydration
Read the helpful Caring for Kids article "when your child is a picky eater"
How to calorie boost during the 1st year & in teens, children > 1 year
Obsessive-Compulsive Disorder (OCD)
What to do when unwanted thoughts, repetitive behaviors take over: NIMH
Tools for parents, Anxiety Canada OCD tips, International OCD Foundation
ophthalmology (eye ISSUEs)
Sick Kids website: eye conditions, first aid
Vision Therapy? (Canadian Ophthalmological Society)
PAIN: acute & chronic
Video that explains chronic pain
Coping; help your child get active again
Effective parenting for children with chronic pain for young children, older children and teens
Teens can download and use the free WebMAP Mobile self-management app (Seattle Children's)
MyCarePath is Pain BC’s free online tool to help youth aged 12-17 who live with chronic pain
positive PARENTING & emotional regulation tools
Self-care pyramid: parents/children - make sure everyone's basic needs are met first
Video: why we lose control of our emotions (for elementary-aged children)
Parenting tips: managing challenging behaviors using positive discipline and empathy
Child Psychologist Dr. Laura Markham: website & books - positive parenting tips
Mindfulness: list of helpful resources
Triple P & The Incredible Years programs
Consult a Counsellor, Psychologist or Occupational Therapist
Helpful tools for PARENTS:
- Free The Happy Child parenting app
- How to have more positive conversations with your kids
- Mind Masters: activities to improve your child's emotional regulation
- Zones of Regulation (often used in school)
PRESCRIPTION DRUG COSTS
Pharmacy Compass: compares medication costs at different pharmacies; although cost is not always the most important factor in choosing where to fill your prescriptions.
It is important to make sure that you choose a pharmacist that you trust and who helps you to understand your medications and how to take them most effectively.
RARE DISEASES, Genetic disorders
Living Without a Diagnosis: roadmap, navigation tools for families
Info on specific rare diseases, NORD's rare diseases database
SAFETY & INJURY PREVENTION
Parachute charity: injury prevention
Prevent unintentional cannabis poisoning
Safety tips: babyproof your home, information on car seats & helmets
Summer safety tips: playing in the sun or water, travelling or exploring nature (ex. burn prevention, poison ivy, insect/tick bites and wildfire smoke tips) and winter safety
SCREEN TIME, SafetY & cyberbullyinG
Numerous studies have found links between negative mental health effects in teens and an increase in social media use, including depression, anxiety and low self-esteem.
Technology is changing childhood. Screen use can become addictive; children to resist doing homework or other tasks to stay online. Playing outdoors, spending time with friends, reading books and hanging out with family is happening a lot less often to make room for hours of snap chatting & watching YouTube.
Screen time recommendations for young children & school-age children, teens
Up to 95% of youth ages 13–17 report using a social media platform, with >1/3 reporting they use social media “almost constantly.” In the U.S., nearly 40% of children ages 8–12 use social media. Video games, social media and smartphones simultaneously provide both connection & disconnection. Technology is an inescapable — and important — facet of everyday life.
Dr. Vivek Murthy (U.S. Surgeon General) recently issued a landmark advisory on the impact of social media stating “it can have a profound risk of harm to the mental health and well-being of children and adolescents; in early adolescence, when identities and sense of self-worth are forming, brain development is especially susceptible to social pressures, peer opinions and peer comparison. Children are particularly impacted by too much exposure to apps such as TikTok and Instagram."
Wait Until 8th pledge empowers parents to delay giving their child a smartphone until at least 8th grade.
Keep your family connected in a digital world
Support healthy screen & videogame use
FBI safe online surfing, NetSmartz, Thorn, safety tips, watch the Childhood 2.0 documentary here
SleeP
Safe sleep tips for babies (CPS-Caring for Kids)
"Precious Little Sleep" guide for newborns up to preschool aged children
Dr. Craig Canapari website & Decode Insomnia (for teens)
Why is sleep important? Keep track of your child's sleep habits with this sleep diary
What are night terrors and parasomnias?
Use the Smiling Mind app (download here) for free mindfulness tools to help you fall asleep
BC Children's factsheet on Melatonin
Speech & language delay
See "Developmental Milestones" section above for speech & language milestones
Speech exercises to help your child now
Consider working with a Speech Language Pathologist (find a SLP / search by city)
TEEN & PRETEEN HEALTH
The transition between youth and adulthood can be overwhelming as young adults face new experiences, challenges and pressures. Read this parent guide on raising teens & red flags
Read: Sick Kids Hospital Adolescent Health learning hub for preteens & teens
Mental health resources & information on self-harm (for parents)
Information on vaping and marijuana (for parents)
Open Mind BC for physicians, parents, teachers & youth to learn more about support services
Sick Kids Hospital sexual health & puberty Hub
Sexual & reproductive health: information on contraception, sexual orientation, gender identity, etc. Resources (for kids and their parents - by age)
Contraception resources from the Society of Obstetricians & Gynecologists of Canada website; choosing the right birth control can be overwhelming. The "It’s a Plan" tool can help; discuss your options/see your GP
COMMUNITY RESOURCES:
Kids Help Phone (up to age 20): 1-800-668-6868 to speak with a counsellor 24/7 or 1-800-784-2433
Child & Youth Mental Health: CYMH offers free walk-in intake appointments. The Foundry Kelowna also offers services for youth aged 12-24 and their caregivers (either by drop-in or you can also schedule virtual counselling appointments, find peer support, access primary care, groups & workshops). Download the app.
TODDLER HEALTH
Sick Kids Hospital toddler learning hub for parents
Challenging behaviors and positive discipline; "Zero to Three" resources
Caring for Kids handout "when your child is a picky eater"
Toilet training tips
TOrticollis & plagiocephaly
Info on torticollis & plagiocephaly
Consider working with a Pediatric Physiotherapist (find a PT / search by city)
TOURETTE SYNDROME & TICS
BCCH's Kelty Mental health resources
Tic Helper course (for elementary-aged children)
transgender cARE
Rainbow Health Ontario's parent guide
Peer support: The Foundry and Transcare BC
traUMA
Effects of childhood trauma on the brain - watch this YouTube video (UK Trauma Council)
Caregivers can help by teaching self-regulation skills & encouraging post traumatic growth/resilience
urologY & bladder issues
Foreskin care & issues like phimosis
Sick Kids Urology Hub: bedwetting, toilet training, urinary tract infections, inguinal hernia, undescended testicle and hypospadias
VACCINES, bloodwork & Needle phobia
Vaccines teach the immune system how to recognize and fight off specific disease-causing germs. Vaccines can save your child's life. In BC, children and teens are offered free vaccines that protect against 15 diseases. Find out what vaccines your child should receive and at what age: BC's vaccine schedule. You can download the free CANimmunize app = an immunization record that helps parents keep track / access vaccine records
**If you choose not to immunize it's important that parents understand the risks**
Specific questions about certain vaccines? Read CHOP's vaccine education center
7 important reasons to immunize your child
Strategies to help your child, ease the pain associated with needles/bloodwork (tips by age)
CARD toolkit, specific tips: needle phobia
Please note: the content and resources on this website are intended for the use of Dr. Nutter's patients and should not be considered medical advice or replace comprehensive medical care. If your child has any medical or developmental issues - contact your doctor.