Editor's note: This story was originally published on Nov. 4, 2021.

Results are in for the 2021 Community Health Needs Assessment parent survey conducted by Cook Children’s Center for Children’s Health and one thing is clear—the mental health of children is top-of-mind for parents, particularly during the pandemic.

Half of all children ages 6 to 17 living in Cook Children’s eight-county service area have a parent who is concerned that the pandemic will have a negative impact on both their child’s education and mental health, according to the survey. The impact of COVID-19 was also noted by parents and guardians as one of the top three barriers to children receiving necessary health services, along with a lack of insurance coverage and the scarcity of needed services available in the area they live.

These barriers played a role in 137,000 children not getting needed medical care, more than 180,000 kids being deprived of needed dental care, and 63,120 kids going without needed mental health care. When compared to the same demographics from the 2015 and 2018 parent surveys, all of these numbers represent an increase in children not getting the health care they need.

The survey revealed that parents need support, too. More than 30,000 children have a caregiver not coping “very well” or not “well at all” with the day-to-day demands of parenting, and 24% of children live with someone who has a mental illness, or is suicidal or depressed.

“Parents of teens score lower when it comes to coping well with the demands of parenting than those with kids ages 6 to 11,” said Blair Williams, community health analyst at the Center for Children’s Health. “So the question becomes what do we do for parents to help them grapple with those daily parenting demands and the really tough topics that they face with their teens that are relatively new to us adults and changing almost every day.”

These results, along with many other survey data points, were shared Tuesday at the Virtual Children’s Health Summit presented by the Center for Children’s Health. Nearly 300 community members representing a number of area schools, health agencies and community organizations attended the summit.

“We recognize and acknowledge that Cook Children's isn't the only one working to improve the health of children and families in our communities,” said Becki Hale, director of Child Health Evaluation within the Center for Children’s Health. “We have such strong community partnerships and these issues around children's health are so complex that it can't just be one entity. It has to be all of us working together. We're so grateful that we have such a strong community that comes together to support one another to help families.”

Every three years the Center for Children’s Health surveys parents and guardians within its service area, including Denton, Hood, Johnson, Parker, Tarrant and Wise counties. This year the Center added Grayson and Collin counties into the surveyed region in preparation of meeting the needs of children served by the new Cook Children’s-Prosper, slated to open in late 2022. It also increased the child age range from 0 to 14 to 0 to 17.

A total of 5,715 surveys were collected from a sample of households across the surveyed region at large, not just Cook Children’s patients. Surveys were also collected from parents of special underserved populations via partners within community shelters and other local aid agencies. The results are weighted to represent the actual population of children living in the service area. That means data percentages are translated into the actual number of children within the population the percentage represents.

“We use this data to see how we might need to adjust our current programs to best address the needs we already know exist within our community because of what we see within Cook Children’s Health Care System,” Hale said. “Mental health is a good example. Because of what we are seeing in our health system data around self-harm and suicide, we’re particularly looking a little closer at what the survey reveals about mental health knowing that there may be some opportunity to adjust our programming to address that issue, especially within the adolescent and teen population. It’s another piece of the puzzle to help us figure out how to best support families and children.”

Parents reported that 19% of children ages 6 to 17 have been told by a health care provider they have anxiety, and 10% have been told they have depression. That’s higher than the national numbers of 13% and 6% respectively. In addition, Cook Children’s has recorded a record number of suicide attempts by children within the last 12 months.

“The survey reinforces what we have seen over the past year with skyrocketing numbers within our mental and behavioral health services,” said Rick W. Merrill, President and CEO of Cook Children’s Health Care System. “In 2022, we’ll dive deep into mental health access and behavioral health services. We owe it to the hurting children in our community to continue to make this a top priority.”

In addition to addressing mental health, the Center for Children’s Health will work with its community partners to explore new and innovative approaches for increasing access to food, personal health care providers, insurance, oral health care, parent support networks, injury prevention education, and opportunities for physical activity.

“The information we shared at the summit was just the tip of the iceberg,” said Chris Pedigo, senior vice president of system planning, health analytics and the Center for Children’s Health. “We’ll continue to dig deep into these issues to understand how to join with our community partners to best address these needs.”

Other notable findings include:

• 55,570 children are living in households that “sometimes” or “often” can not afford enough to eat.
• 57% of children ages 3 to 5 have a caregiver who is coping “very well” with daily parenting demands, which is lower than the national percentage of 63%; and 51% of children ages 6 to 17 have a caregiver who is coping “very well” with daily parenting demands, also lower than the national percentage of 61%.
• 70% of children ages 3 to 5 are ready for school according to their caregiver, which is slightly lower than the national percentage of 75%.
• 8 in 10 children have “excellent” or “very good” health.
• 9 in 10 children had continuous insurance coverage for 12 consecutive months prior to completing the survey.

In February, the Center for Children’s Health will release part two of its Community Health Needs Assessment, which will include a report of the “why” behind many of the survey results learned from parent focus groups and community leader interviews. That information will be combined with the parent survey results as well as the results of a community leaders survey to complete the Community Health Needs Assessment, which will be released in spring 2022.

Sometimes the first step toward saving the world begins in your own backyard.

That’s the hope for Frances Wampler and Blair Williams, two staffers at the Center for Children’s Health led by Cook Children’s, who are part of a team exploring how communities might target youth suicide as a standalone issue.

There are several “ifs” to contend with, but the two women believe it’s worth exploring the steady climb of youth suicide cases in the nation and determine what’s happening on the local and state levels.

“We see it in the headlines, see it on social media—even clinicians are expressing concern over it,” said Williams, who is a community health analyst and member of the community health needs evaluation team at the Center. “So, we’re seeing this as a rising need.”

Wampler and William’s decision to pursue the issue resulted from a culmination of events. In September, Wampler’s nephew, 19, died by suicide, leaving her family reeling from his death. And years earlier, Williams suffered the loss of a close family friend, a 15-year-old who took her own life. Their shared experiences, along with other data—including the Center for Disease Control’s report marking suicide as the nation’s second-leading cause of death among ages 10 to 24 in 2018 and a reported increase of self-harm cases seen at Cook Children’s last year—propelled the two women to pitch the idea of collaborating on exploring whether area communities needed help with this complicated issue.

“I know how hard it was for me and my family to experience the things we did,” said Wampler, program coordinator at the Center who focuses on child abuse. “He was my nephew, but he felt like one of my bonus kids. I felt like I lost one of my children, and I would take that heartache away from any person I could. I don’t want that to be the end of his story. He was not the last decision he made in his life...he was so much more than that.”

“I just want to do something with that—and I don’t know­­—try to save the world,” she said.

While discussing Wampler’s nephew’s death, she and Williams made note of how often youth suicide overlaps with other issues, such as firearm and poison injuries, child abuse and neglect, Adverse Childhood Experiences (ACEs), mental health and so on.

“These are things that the Center already has programming around,” Wampler said. “I was like, ‘We have to do something.’”

The two decided to take it to Center leadership and were given the green light to pursue it and “do some digging on the data,” Williams said.

“They’ve been really supportive of this,” she said. “That, to me, is really powerful because our leaders heard our concerns and supported us in our efforts to keep every child safe from injury.”

Wampler and Williams’s preliminary research efforts could potentially support the 2021 Community Health Needs Assessment. The Community Health Needs Assessment is conducted by Cook Children’s every three years to assess children’s health needs and the board uses the information to develop implementation strategies for addressing these needs.

They’re not sure how COVID-19 may affect this issue, let alone community health needs across the board, but youth suicide was on the rise well before the virus hit, Williams said. In 2012, the number of suicide deaths surpassed the number of cancer and heart disease deaths - causing suicide to be the 2^nd leading cause of all deaths in Americans ages 1-44 every year since.

“Part of it is recognizing there are several community partners and agencies that are well-equipped to handle this,” Williams said. “Part of the assessment is not only looking at the data, but it’s also looking at what resources are in the community that can be used to help.”

As it stands, the Center is in the data collection phase of the 2021 Community Health Needs Assessment process. They’ll sift through all sorts of data, such as what local health departments are seeing, what the CDC says, what the national and statewide numbers on children’s health needs show, and what’s happening inside and outside Cook Children’s walls. They’re currently conducting focus groups, a parent survey, a community leader survey, and key informant interviews, among other things. When finished, the data will be synthesized and a report published as the 2021 Community Health Needs Assessment.

Wampler and Williams are proud that the question they raised about what the Center can do to support youth suicide prevention has been met with a team approach to investigate this important topic further. They acknowledge this task is a huge undertaking. But both are passionate about getting help to children and families who need it.

Recognizing that this is becoming more of a trend is an important step, Williams said.

“There are so many great resources in our community, so many great partners. We have a wonderful health care system, a great employer who recognizes this issue. So, what can we do with these great assets and protective factors to keep kids safe from all types of harm, including harming themselves?”

Regardless of their findings and the various factors that come into play, Wampler and Williams believe ramping up awareness surrounding self-harm and suicide is key to preventing it among young people. But awareness doesn’t equate applying stereotypes, they said.

Even if children do “check off those boxes” for suicide risk factors, it doesn’t mean they’ll try suicide, Williams said. She encouraged all families to have a mental health plan to address any crisis that may arise.

“There are people who have multiple adversities and risk factors who lead very successful, healthy lives, and probably go on to help many other people, too,” she said. “It’s just recognizing that it needs more awareness. It can happen to anyone and to be prepared. If you’re in crisis, it’s going to be harder to seek out help. So, have that help lined up for you.”

Wampler agreed.

Normalizing conversations about thoughts of suicide, even if it’s uncomfortable for families, she said, also might help with prevention. Her nephew had supportive friends and family, played football in high school and had joined the military, she said, adding the family “had no idea he was feeling that way.” No one saw his suicide coming.

“I don’t think it’s talked about enough,” she said. “I don’t know how hard that would be to say, ‘I want to hurt myself.’ But you don’t have to suffer in silence. You can tell somebody that you’re struggling and get help.”

There may not be a simple answer to preventing youth self-harm and suicide, Wampler and Williams said. What leads to it and how to prevent it is often muddied by a multitude of factors, some controllable and others not.

But one aspect of it is clear to both women.

“For me,” Williams said, “if we can save one child, well, that is (saving) the world.”

“Yes. That’s right,” Wampler quickly agreed. “That one child is somebody’s whole world.”

Coming off one of the busiest winters in its history, with record high inpatient volumes, Cook Children’s employees, medical staff and leadership looked forward to returning to the business at hand in early 2020.

Much of that business centered on keeping up with the recent population growth in the Dallas-Fort Worth Metroplex. A focus on development in the area meant building new facilities in Prosper and Walsh Ranch in west Fort Worth, as well as expanding Cook Children’s Medical Center campus with a new specialty center and parking garage.

“We were very busy but very positive about the future of Cook Children’s,” said Rick Merrill, president and CEO of Cook Children’s.

Then everything changed. A new version of the coronavirus, SARS-CoV-2 which causes COVID-19 disease, enveloped the nation.

“It certainly changed a lot about what we did and how we thought about moving forward as an organization,” Merrill said.

Suzanne Whitworth, M.D., medical director of Infectious Diseases at Cook Children’s, remembers first hearing about COVID-19 when it ravaged through China. Then the virus turned up in Italy.

Dr. Whitworth told her parents in late January or early February that a time would soon come when she would tell them they could not leave the house. She also worried about her own daughter’s wedding, scheduled for March 14, 2020.

Three days before the wedding, the best man told everyone of his exposure to COVID-19. Around that time, health departments recommended quarantining exposed individuals. Two days before the wedding, guests were alerted about a scaled-back ceremony.

“We had this small wedding on March 14,” Dr. Whitworth said. “And, so for me, that was the personal event that I went, ‘Oh, here we go.’ I was going to be off for a few days after the wedding. But the day after the wedding, they opened the Command Center, which was March 15th. I think that was the point, I realized, ‘No vacation.’ No, I have to get back to work. I have to get back and see what I can do to help.”

With the increased threat of COVID-19 and the demand on staff and supplies required to battle the virus, leadership declared the event an internal disaster. They also activated the Command Center, which is a central hub that manages any type of disaster experienced by the organization. The Command Center kept current with patient volume, staffing, questions from employees, supplies and logistics. Any decisions made based on COVID-19 at Cook Children’s now went through the Command Center.

“I think that’s really what this organization does so well. We decided early on to set up the Command Center staffed by first-class people. They were able to effectively deal with the day-to-day issues, including so many questions and concerns from our 8,000 employees. They were able to coordinate our efforts in a way that has allowed us to get through the COVID crisis, probably as good, if not better, than most other health care organizations in the country,” Merrill said.

Heading up the Command Center were four incident commanders who rotated each week. They were available 24-7. They led daily meetings to keep up with COVID-19 demands, which included staff from the nursing units where COVID-19 patients stayed, supply chain, Infectious Diseases, Infection Control, Employee Health and more.

The incident commanders were:

• Debbie Boudreaux, Assistant Vice President of Nursing
• Stan Davis, Chief Operating Officer
• Nick Markham, Assistant Vice President of Facilities/Campus Services
• Jack Sosebee, Vice President of the Medical Center

“We define a disaster as something that is outside of your normal operations,” Davis said. “I mean we have ‘disasters’ every day that we can react to within our existing resources. We can handle those normal day-to-day types of disasters. But for anything that stretches the operations of the organization, we activate our Incident Command Center to bring a group of people together to analyze the activities occurring and put a response plan in place. The Command Center handles the communications, resources, staffing and mitigation activities that need to be addressed. We bring all of the experts who can help with the disaster together to discuss the situation. We get references from outside sources like the city of Fort Worth, or maybe the CDC or the health department. They help to inform what we know—and learn what we don’t know—so that we can best handle and manage the situation and bring normalcy back as soon as possible.”

Jack Sosebee, vice president of the Medical Center, said the main challenge throughout the pandemic became the unknown. Things frequently changed with new directions from the Centers for Disease Control or the state. As the pandemic numbers increased, the Command Center made difficult decisions. For instance, they changed the number of visitors allowed in the medical center from two caregivers to one. As the COVID-19 case numbers have decreased, they recently returned to two caregivers again.

“I think we’ve learned from this,” Sosebee said. “I think it’s something we can build on. Hopefully, we won’t ever have to do that again. But I think, looking back at it, the response from Cook Children’s was just outstanding. The response to COVID is our culture. You didn’t find people that refused to do things. Everybody stepped up to the plate and did what was needed. I think that this brought our organization closer together. I think if there’s anything positive out of all this, I think that’s one of the things.”

The response to COVID-19 did not come without a lot of hard work. Kaysey Pollan, director of Environmental Safety and Emergency Management, prepared Cook Children’s for events such as COVID-19 with disaster drills. Davis jokes that he will never complain about one of Pollan’s drills again and credits her preparation years before COVID-19 for laying the groundwork for the success the system has had throughout this crisis.

Pollan makes sure no one is duplicating efforts, and no one is overlooking anything. She gets people in the right place to respond to severe events such as COVID-19. As the events evolve, Pollan plays the role of liaison. She works with neighboring hospitals, critical people in the city, county and state to be informed and offer assistance as needed.

“Early on, it was just how quickly the situation was changing and evolving,” Pollan said. “We saw so much information that changed daily. It was challenging to keep our staff informed promptly. We saw so many changes with PPE and guidance from the CDC and mandates and regulations from a local level that we had to implement. It’s tough, you know? A year-long disaster response focused on the same event, doing the same thing every day. It becomes tedious. It becomes very wearing. I think more so recently; it’s been important for us to keep a pulse on our staff and make sure that they are engaged and as happy as they possibly can be through all of this.”

Of everything that occurred over the past year, perhaps nothing proved more uplifting than the arrival of vaccines to fight the COVID-19 virus. Almost 70% of employees received the vaccine first, followed by a couple more thousand patients 16 years old and older, and then employee family members.

“I don’t even know what day it was now, but we were all waiting outside for the truck to come with the vaccine,” Boudreaux said. “You would think it would come in like a Brink’s armor truck. We were all excited waiting, and the guy in the UPS truck pulled up and backed down the hospital's delivery area. I couldn’t believe it. They opened the back of the truck and pulled out the vaccine, and it was just like, ‘Oh, my gosh, it’s finally here!’ It was such a moment. I can’t describe it. It’s finally here.”

A year later, things are getting better. The COVID-19 patient and employee population have reached record lows. The Command Center no longer meets weekly, and the four incident commanders now share their duties with other leaders within the Cook Children’s system.

While things improve, the diligence to fight COVID-19 remains, and so does a tremendous amount of pride in how Cook Children’s handled this crisis.

“I would have to say I’m most proud of the organization, how we, as a whole, responded,” Markham said. “With each step of the planning that we’ve had, it’s just been amazing. We’re at a year, and it’s been a long year. It’s been trying, and it’s been hard. These people have worked and been away from their families and are putting in all this time and effort. Each time we get past a landmark, a period of accomplishment, something else comes up. It’s that group of people who rose to the occasion every time. It’s been awesome to see. It’s been amazing that we get to surround ourselves with this group of people every day and every day they rise to the occasion.”

It may sound like a melee, but this is part of a unique program that launched last fall at the Jane Justin School at Cook Children’s Child Study Center. The program began as a R.A.D. self-defense course and has since evolved into a curriculum called ‘Hard Target.’ The 12-hour class teaches self-defense to students with developmental and learning disabilities in the Center’s Upper School.

On this morning, four female students are participating in a drill. The scenario includes being attacked at an ATM and sadly, because of their disabilities, it’s a situation they’re more likely to find themselves in than the average person.

“We know that individuals with developmental disabilities are three to five times more likely to become victims of bullying, assault and sexual assault,” said Joyce Elizabeth Mauk, M.D., CEO and medical director of the Child Study Center.

According to a recent investigative series by NPR called ‘Abused and Betrayed’, the rate of sexual assault among people with intellectual disabilities may be even higher. Reporter Joseph Shapiro said in his report that unpublished data from the U.S. Justice Department shows people with intellectual disabilities are sexually assaulted at seven times the rate of people without disabilities. His series calls the issue an “epidemic.”

The concern surrounding these statistics sparked an idea with the Child Study Center’s team. What if they taught students how to defend themselves, especially during the transitional years when students are preparing to go out into the world to seek employment and possibly even live on their own? Dr. Mauk and her team contacted Security Services at Cook Children’s, which already provided self-defense courses to employees. Together they developed a curriculum specifically tailored to the needs the school’s students, aged 13 to 22.

“The most important thing we want these students to learn is how to protect themselves,” said Brennan McCullars, ‘Hard Target’ instructor and security services trainer at Cook Children’s. “These are people who are much more vulnerable to predators than the majority of the population. They are often trusting of others. They don’t always know what behaviors are inappropriate, so we have to work on that.”

One of the girls in McCullars’ class is 18-year-old Elizabeth. She’s a soft-spoken junior at the Child Study Center’s school where she also interns as a teacher’s aide. She’s small in stature and supportive of her classmates, cheering them on as they move through the course. When it’s her turn to approach the “ATM” – a punching pad leaned against the wall – Elizabeth transforms. There’s no reservation in her voice as she belts out ‘’NO!” and blocks incoming hits. She throws eight punches before sprinting away from her “attacker.”

When asked what she thought of the course, Elizabeth said she feels more confident now.

“In self-defense class, they taught us how to use our voice and how to use our hands and our feet (against an attacker),” said Elizabeth. “It has eased my concerns because I know I can protect myself when my brothers and my support system are not around.”

For Elizabeth’s father, Lonnie Ramon, these new skills are just one more tool in her toolbox. He and his wife believe Elizabeth will be able to live and work independently. He says he feels better about her future knowing she’s had to think through what should be unthinkable situations.

“It’s a crazy world nowadays. You see too many weird and crazy things on TV. People take advantage of others and I’m afraid of that,” said Ramon. “But that’s part of this self-defense course. It’s helping her think about how to get herself out of situations, God forbid they ever arise.”

Along with the four females, a group of eight male students are also going through ‘Hard Target.’ All of the students who complete the class will have a chance to take a refresher course next school year.

“We are excited to offer this one-of-a-kind curriculum,” said Tracie Mann, Ph.D., LBA, the headmaster of the school. “The ‘Hard Target’ program demonstrates our unwavering commitment to preparing our students for the future, both academically and in life.”

Paul Thornton, M.D. is the medical director of Cook Children’s Hyperinsulinism Center, one of only two such centers in the U.S. and the only one in the southern portion of the country. He has dedicated his life to researching and treating congenital hyperinsulinsim (HI), and in turn has helped improve the quality of life for countless children.

Dr. Thornton’s work is so well respected he was recently named a Rare Disease Hero by Rare Disease Communications. The award recognizes five physicians each year for groundbreaking research and treatment in the rare disease community.

“Rare Disease Communications is proud to be honoring these real-life heroes,” said Chris Davis, president of Rare Disease Communications. “This is, indeed, a rare opportunity to applaud the silent victories that mean so much to patients and families.”

In addition to the Rare Disease Hero award, Dr. Thornton was also recently honored at the 2016 sugar sHIndig at the Fort Worth Science & History Museum where he was given the Be My Sugar Medical Excellence Award by Congenital Hyperinsulinsim International (CHI).

“It’s an honor to be recognized by the leaders in the congenital hyperinsulinism community,” said Dr. Thornton. “As we continue to treat children from across the country and the world, we’re excited to share information about our program and the excellent team providing quality, family-centered care.”

When I returned, I checked on the children, but I only saw one. I thought, perhaps he climbed into a box, or was hiding…I called his name. No response.  I screamed his name. No response. My brother came outside.  “Boogie’s gone!” I screamed. That moment, I saw my brother, 36 at the time; tear off down the cul-de-sac with a speed I had not seen since he was the anchor on the record holding high school mile relay team. I continued to search for my son, by this time in tears and my heart pounding.

Bawling and nauseous, I felt each beat in my ears. My daughter thought it was a game and started to search as well. Someone has abducted my child! Where could he have gone in such a short time? How could someone whisk him away and be unnoticed? I was filled with anxiety and dread. Then, in the midst of my terror, I saw my son, standing in the back seat of the car, smiling, watching through the rear window, as the drama unfolded. Instant relief! I grabbed him from the car and hugged him tightly, relieved that my worst fear was not realized that day.

We comfort ourselves by saying “that would never happen in America”, yet the stark reality is that children routinely go missing in the United States. 

The 2015 stats show that there were 460,699 missing children entered into the National Crime Information Center, and 46,046 of those kids were from Texas. Of the kids in Texas, 2,769 children were from Tarrant County alone.

The National Center for Missing and Exploited Children (NCMEC) is the leading nonprofit organization that has been working for 30 years on issues related to missing and sexually exploited children. The abduction and murder of Adam Walsh (of Code Adam) in July of 1981 helped spur the formation of NCMEC. They provide valuable information on their website (www.missingkids.com) on what to do in the event of child abduction.

So as a parent, what can you do to ensure your child’s safety and even the safety of other children? The approach is common sense:

• Keep a current picture.
• When they are very young, just keep an eye on them at all times, in the store, in the mall and at the park. I have a friend who kept her son strapped into a stroller when they were out because he had a tendency to take off.  I used to think the kiddie leashes were cruel, but I get it now.
• As they age and gain more independence, parents need to create scenarios like “What would you do if we got separated in the store?” “What would you do if someone you don’t know wanted to show you a puppy?” “Give you a gift?” “Who is a trusted adult and why?” 
• In the tween and teen years, when they have access to the Internet and cell phones, rules need to be established for the use of technology.
• Sexting and cyberbullying need discussion, as well as what is and is not appropriate to share online. If they encounter anyone online who makes them uncomfortable, asks for or shows revealing photos, reports can be made to www.CyberTipline.com. Many teens are lured away from their homes by people that they meet online, in chat rooms and on social media sites.

NCMEC’s website www.Take25.org provides helpful, age appropriate information to parents about how to teach children about safety. There are also fun activities for children. In the event a child goes missing, call 911, and then call 1-800-THE-LOST.

She had her first heart surgery at Cook Children’s when she was 11 months old. Her second came at age 15 and left her with vivid memories of the place where she would one day work.

“It was magical. I still remember the atrium, the paint on the ceiling and all of the colors. I also remember the staff. The nurses and doctors were excellent and so friendly.”

Heart surgery isn’t something one would expect to have fond memories of, but Flores says her experience as a Cook Children’s patient helped guide her life in a direction she may never have imagined.

“Growing up, I always wanted to be like my pediatric cardiologist, Dr. Lai. Now, here I am, working alongside him.”

Not only is she working with the physician who cared for her as a child, but also with her current cardiologist, Scott Pilgrim, MD, Medical Director of the Adult Congenital Heart Defect Program at Cook Children’s. Flores may be the only Cook Children’s employee able to say she’s a lifelong patient, still being treated today, but it’s a title she carries well. She knows what the patients are going through, and uses her experience to reassure them and their families.

“Sometimes I tear up because I’m thinking wow, ‘Is this what my mom was like or is this what I was like?’” said Flores. “I know surgery is scary. I’ve been through it, so I’m there, scared with them and praying with them. It can be hard but also very rewarding. “

When it comes to the future, Flores doesn’t seem too concerned about change. She says she wants to continue what she’s already doing, helping patients understand what to expect and helping parents understand what their child is going through. Most of all, she wants everyone to know that having a heart defect doesn’t need to hold a person back.

“I want patients to know that you can do anything you want to do. You can be a nurse, you can be a nurse practitioner, you can be a teacher or you can be the president!”

As for Flores, she’s perfectly happy being a nurse practitioner at Cook Children’s.

“I just want to continue working here forever. I fell in love with this place when I was a kid and am still in love with it now. “

In the morning, they begin with stretching, but by the middle of the afternoon they are running with real-life Olympians or breathing their way across the United States – all from the comfort of their own classroom. GoNoodle is a new interactive resource that allows children to not only increase their physical activity, but improve their academic performance.

Thanks to a sponsorship from Cook Children’s, 60,136 kids in Tarrant County enjoyed GoNoodle this past year. GoNoodle allows children the opportunity to participate in a fun, interactive “brain breaks,” while measuring the minutes of moderate to vigorous physical activity. The brain breaks include running, dancing, stretching and calming exercises. Kids play the games that include spelling, vocabulary and math with physical activity.

“Other programs seem to focus on one or the other – activity or academics; but GoNoodle was unique because it focused on both areas,” said Larry Tubb, senior vice president of the Center for Children’s Health. “We look at bringing GoNoodle as an extension of our Promise, to help the well-being of every child. That doesn’t always mean treating them to get better in a doctor’s office. It also means helping them get better in the classroom. By bringing this physical activity to schools, we are improving the health of these kids. That helps our children and our community.”

GoNoodle brain breaks give the children activities to help keep them focused during the day. They have breaks that help them stretch, release energy or reduce stress. Some of the breaks align with core subjects such as spelling, math, vocabulary, geography, math, reading and even nutrition.

Breaks include:

Airtime. Students “breathe” their way across the United States. They pick their state and begin breathing in and out. The simulation of blowing out blows a balloon on a screen across the country, giving fun facts along the way.

Run with us. Real-life Olympians, on a screen, coach children in track and field events such as the hammer throw, 200-meter sprint and javelin.

To The Maximo. Children perform stretching activities to get their body and mind going early in the morning.

The faculty at A.V.Cato elementary have seen the benefits of GoNoodle. Michelle Miles, the school’s counselor, said she saw the breathing exercises work during the State of Texas Assessment of Academic Readiness tests. The kids did their breathing exercises to calm them before the tests and give them the chance to perform their best.

“GoNoodle has been the greatest opportunity for ADHD students because you can just tell when those students become disengaged from a lesson and are just tired and antsy and unmotivated,” Miles said. “If you can just get them up in between transitions for a few seconds at a time and give them an opportunity to either get the wiggles out or start focusing on how they are going to move forward, it tends to help them just get the energy out; and have it be OK and accepted before they move on to the next lesson. This has been ideal for some of our younger kids who have all that extra energy bottled up.”

Amber Grier, an elementary teacher at A.V. Cato, said she recently saw the benefits of GoNoodle. She had been working with her students throughout the day on mixed fractions and adding fractions. One child in particular just didn’t seem to understand the lesson. She had exhausted her efforts for the day. Then they began to play one of the GoNoodle games and was pleasantly surprised to see the child get every answer correct.

“I had a huge smile on my face because I was so relieved to know that he had learned what we were doing,” she said. “But he wasn’t able to produce the answer quickly until he got moving and stopped worrying about making me happy. He was just playing the game and he was able to get all the answers. True learning is play.”

1. Have you ever fainted, passed out, or had a seizure suddenly and without warning, especially during exercise?
2.  Have you ever had exercise-induced chest pain or shortness of breath?
3. Are you related to anyone with sudden, unexplained, and unexpected death before the age of 50?
4. Are you related to anyone who has been diagnosed with a sudden death-predisposing heart condition like Hypertrophic Cardiomyopathy and Long QT syndrome?

Early detection could save your child’s life. Cook Children’s will offer free EKGs during the month of February. An EKG is non-invasive and takes less than five minutes. The EKG shows how fast the heart is beating, the heart’s rhythm and the timing of the heart’s electrical signals. Any child can get one with a referral from a primary care doctor. Just ask your child’s pediatrician to order a “sports EKG.” Results are sent back to your pediatrician.

For more information, please call the Heart Center office at Cook Children’s at 682-885-2140.