Counseling on Early Childhood Concerns: Sleep Issues, Thumb-Sucking, Picky Eating, School Readiness, and Oral Health.

Family physicians are often a source of information and advice on early childhood concerns regarding sleep, thumb-sucking/pacifier use, picky eating, school readiness, and oral health. Evidence indicates that family variables are important in the genesis of sleep difficulties, and that traditional behavioral methods are not as effective as previously thought. Attention to family psychosocial well-being, especially maternal functioning, is important in addressing childhood sleep difficulties. Thumb-sucking and pacifier use may be associated with negative consequences if they persist, and referral is recommended after four years of age if appropriate behavioral interventions are ineffective. Picky eating is heavily influenced by environmental factors, and food neophobia is a normal stage of development. The main approaches to childhood eating problems include social modeling of normal eating behaviors, repeated exposures to new foods, and positive mealtime experiences. School readiness focuses on supporting the psychosocial variables that are associated with school success. Reading with the child enhances literacy skills. Quality early childhood education programs are also effective in enhancing school success. Delaying school entry is not beneficial and may be detrimental. School readiness includes the schools' role in supporting the learning needs of all children regardless of their abilities and skills. Oral health is increasingly recognized as an important contributor to overall health. Oral health should be incorporated into well-child visits beginning at the eruption of the first tooth.