iCan Bike

Cook Children’s recently co-hosted a five-day camp, iCan Bike, with iCan Shine, an organization that offers a variety of programs to enrich and impact the lives of children with disabilities. Over a week, riders learn how to independently stabilize a bike with the help of volunteers as they gradually discover the skill and joy of riding a bike. The bike camps occur in the summer months, typically in June or July, and consist of 75 minute sessions per day with a maximum of eight riders per session. Parents, teachers and therapists describe the results as miraculous!

iCan Dance

iCan Dance is a program in Fort Worth, TX, that teaches people with disabilities to dance. The camp takes place over five days and encourages people to find joy through dancing. At the end of the week, the participants get to show off their new dance skills by performing in a big recital. The foundation of the iCan Dance program is patience, as it takes a patient understanding of each dancer to create an effective dancing program. The staff and volunteers at iCan Dance want to see people with disabilities believe in themselves and learn a new skill!

Whether your child is a beginner on training wheels or an expert on the stunt ramps, every bicyclist should consistently wear a helmet that fits snugly and buckles securely.

That’s according to the safety experts at Cook Children’s, where 81 patients were treated for traumatic injuries to the head or body from bike accidents in 2021. Another 93 patients were treated last year for traumatic injuries on scooters, skateboards, skates and hoverboards. Most reported they weren’t wearing a helmet.

National data show bicycle injuries tend to spike in June. The most at-risk population? Boys in the 10- to 24-year age group. More than any other sport or recreational activity, bicycling accounts for the highest number of visits to the emergency department for traumatic brain injuries, according to the U.S. Centers for Disease Control and Prevention.

Sharon Evans, trauma injury prevention coordinator at Cook Children’s, hears a variety of excuses from helmet resisters. Teens and children often don’t wear helmets because their parents don’t enforce the rule, she said. Or they think they’re invincible and won’t ever fall.   

“It goes back to ‘It won’t happen to me,’” she said. “For the most part, there are way more broken bones. But when they have a head injury, it’s bad.”

As director of Neurotrauma at Cook Children’s, Daniel Hansen, M.D. has seen skull fractures, severe concussions, brain bruising, and bleeding in and around the brain in bicycle riders who crashed without the protection of a helmet.

“These injuries very often involve kids going downhill and flipping over the handlebar and hitting their heads,” Dr. Hansen said. “We do have the unfortunate instance where we have some auto versus bicycle accidents, but it’s usually children getting out of control going down a hill that was a little bit bigger than their skill level.”

Dr. Hansen pointed out that helmets are designed to absorb the force of impact when a cyclist’s head hits the pavement or other hard surface. If the helmet breaks in a bad fall, he said, it worked as intended.  

Helmets should be replaced if they’re damaged or if they’ve been in an accident, which could cause the interior foam to shift.

Cook Children’s is spreading the message, “Falls are Brutal. Protect your Noodle,” to educate North Texans about the importance of wearing the right-sized helmet. A helmet that fits correctly will feel snug but not uncomfortable.  A few other key points:

• Helmets that passed federal safety standards in testing will say “U.S. Consumer Product Safety Commission certified” on the label.
• Helmets should be worn in a level position just above the eyebrows.
• If the helmet rocks backward and forward or side to side, adjust the straps. No more than two fingers should fit under the buckled chin strap.    
• Never ride without a helmet.

Dr. Hansen said his three children have been trained in the helmet habit.  

“Start your kids off early with the idea that it’s just part of what you do when you’re on a bike, and it’s not an option. It’s not an accessory. A helmet is part of the bike,” he said.

“Helmets might seem at times like an inconvenience, especially in the hot Texas summers. They might sometimes seem like an unnecessary expense,” he said. “But when you’re thinking about the value of a child’s life or the expense of a hospital admission or the inconvenience of recovering from a bad head injury, it’s really a very small price to pay to keep someone you love safe.” 

If a child takes a bad fall, Dr. Hansen said, parents should watch for signs of head trauma. The child might be inconsolable from pain; unable to move normally or to say what happened; lose consciousness or appear to have a seizure. Call 911 if you’re concerned.  

Most patients recover well from head injuries after bicycle accidents, he said. But lingering effects can include restrictions on sports activities, weakness, memory problems and speech difficulty. 

“We certainly see a couple of kids a year who are pretty devastated from their falls,” he said.

Evans hopes helmet use someday becomes as automatic and widespread as seatbelts. Cook Children’s has given away more than 250 free helmets to hospitalized patients and at community events in collaboration with the Fort Worth Fire Department and Fort Worth Firefighter Charities.

For more information, go to Bicycle Safety (cookchildrens.org)

Last year saw more kids coming to the Emergency Department for playground falls, sports injuries and pedestrian accidents with kids walking or riding their bike to school.

We took a look at Trauma Department registry for the week of Aug. 21-28 when Fort Worth ISD began. It’s important to remember that these numbers are based on what the Trauma department saw and not reflective of every kid who went to the ED during this time frame.

Here’s a quick glance at we saw last year:

Falls

By far and away, the most injuries seen last year were falls with 29 occurring during the week and seen by both the ED and our Trauma department. Eight of the falls happened at an elementary school and one at a football field.

Sports Injuries

We saw six sports-related injuries reporting to Trauma during this time period, with four of those injuries on the football field. Injuries ranged from concussions to leg injuries.

Miscellaneous

No matter how hard we try, kids get hurt. The six injuries seen by Trauma that occurred during the week ran the gamut of categories that were all their own, including placing a finger in fan to running into a wall during gym glass.

Car wreck

We were fortunate last year, only one child was taken from the ED to Trauma after a car crash. Still though the early part of school can be a risky time as parents are rushing to get back on a school schedule. Remember to make sure everyone is buckled up and follow the slower speed limits during school hours.

Pedestrian/bicyle injuries

This one almost needs an asterisk. Maybe it’s because during the first week of school, not as many kids are walking yet. But during the first week, only one child was hit by a car and seen by Trauma. However, In September four kids were hit by a car riding a bike, including one at an elementary school, and seen by our Trauma department.

According to Safe Kids Worldwide, more children are hit by cars during September than any month of the year. Kids walking or riding their bikes, scooters or skateboards can be dangerous when not done correctly. The next few weeks, while everyone is getting adjusted to kids going back to school, can prove especially hazardous.

The experts at Cook Children’s remind parents that bike helmets should be worn at all times for kids riding a bike to school. Bike helmets should sit on the top of the head with the chinstrap fastened, holding the helmet in place if the child is to shake his or her head or fall.

Sharon Evans, Trauma/Injury Prevention Outreach Coordinator at Cook Children’s, said the ride or walk to school can be especially dangerous for children who simply aren’t ready to go alone.

“Most children don’t have the cognitive skills to crossing streets safely until at least the age of 10,” Evans said. “They haven’t yet developed the depth perception or the ability to maturely judge the speed of an object.”

Evans said there are several reasons why children 10 and younger shouldn’t ride bikes, scooters or skateboards to school:

• Easily distracted by friends and toys.
• Can’t determine the direction of sounds. Some children may be listening for sounds and may not realize that some newer model electric/hybrid vehicles may not make much of a sound at all. This can be especially dangerous if the children are wearing earbuds.
• Can’t judge the speed or distance of a moving vehicle.
• Don’t understand how long it takes for a vehicle to stop.
• Have too narrow a field of vision.

Even when kids reach 10, Evans encourages parents to accompany them to school whenever possible.

This morning I seriously had a discussion with my 6 year old about how many times he can wear shorts without washing.

Him: “They don't look dirty.”Me: “But you sweat and they smell.”Him: “Mom only my head sweats.”

Ya right!

Today clean shorts are on my child. I won the battle, but my chances of winning the war against a smelly boy unlikely.

 And that's OK. 

As parents we all have battles with our kids, but I can’t help but wonder which ones are really worth the fight.  Which ones are worth the effort to bend your child to your way of thinking?

Some are easy. No brainers.  When it comes to safety we can feel confident that making our child sit in a car seat, wear a bike helmet or learn street safety are worthy the battle.

But others can sometimes seem less clear.  How important is it to have them eat healthy or go to bed on time or take a bath.  It may depend upon the day, or whether we are tired or whether our child is merely protesting or an epic meltdown is in process.

There are a couple I believe are worth the effort. 

Healthy foods and no sugar containing drinks should be fought for.  You will not succeed every time, but I see parents who have made the choice to take a stand on this and their success can and should be duplicated.

Teaching your children to be respectful and kind to others in words and actions is also worth it.  This can take daily and sometimes hourly intervention to achieve (Siblings fighting anyone? At my house just having them walk upstairs together without pushing sometimes requires serious parental guidance).  

Remind yourself parenting is not a sprint, it is a long journey.  Your kids will not remember every lesson, every time.  But trust me, they are learning and the lessons that you make a priority will stick.

So, as you can see clean shorts is not on this list, but still I tell my boys, no teacher wants to have a smelly kid in class.  That has worked for me so far.

Happy mom adventures to all of you this summer.

Dr C

About the author

Vanessa Charette, M.D., has been a pediatrician at Cook Children's for 10 years and is located in Fort Worth. Dr. Charette embraces the many components that contribute to health nutrition, physical activity, emotional, psychological stresses and the environment. As your pediatrician she will spend time with you discussing nutrition, child development and take the time to address any concerns you have about your child's health.