The Jane Justin School, under the Child Study Center at Cook Children's, is a private school that provides special education to children. This year, 86 students are enrolled.

Early Monday morning, students hugged their parents, took photos in front of the school and met their teachers. Friends reunited with hugs and talked about their summers.

“The friendships are strong here,” said Tracie Mann, Ph.D., Headmaster at Jane Justin School. “A lot of them do things after school together and get together over the summer. Everybody is really excited for the first day.”

“I'm ready to get back to lessons and play with my friends – and not go outside because it's way too hot," student Wyatt Merchant said. 

Students in the Purple Room class are between 7 to 9 years old. They gathered around to color a large “back to school” sheet together.

“We're such a small community of people and we're so welcoming and so warm,“ Dr. Mann said. “I think it makes it easier for children to come in every year and kind of make that transition.”

, a Twisted X Global Brands company, have joined together to create the Cook Children’s by Twisted X Collection. Twisted X will donate 100 percent of wholesale proceeds from every pair of shoes sold from this collection directly to Cook Children’s.  

“The partnership between Cook Children’s and Twisted X furthers our commitment to providing patients and families with a one-of-a-kind resource tailored around their health care needs to enhance the overall experience,” said Cook Children's Health Foundation Senior Vice President and Chief Development Officer Grant Harris. “We are constantly looking for new ways to provide compassionate care and we are proud to come together with Twisted X who shares this passion and embraces creativity as a therapeutic outlet.” 

From factory to retailer, the entire supply chain has come together in support of the collection to deliver the footwear at a reduced cost to maximize the donation. The collection includes four unique designs made by patients at Cook Children’s with the help of Twisted X Designer, Tuan Lee. Each pair is named after the artist and embodies their dream pair of footwear to achieve a perfect balance of style and comfort in the form of a slip-on kick.  

• The Alex: Alex is a 6-year-old with Ketotic Hypoglycemia. She loves math, enjoys riding her bike and uses her imagination to go on adventures as colorful as her bright shoe design.  
• The Rowan: Rowan is a 9-year-old with Sigmoid Sinus Vein Thrombosis. She loves riding horses and is a member of 4H, which is highlighted by the western vibes of her cactus green design.  
• The Brianna: Brianna is a 14-year-old with Epidermolysis Bullosa. She has painted several canvases displayed inside Cook Children’s Media Center and especially loves to paint butterflies, which are prominently featured in her sky-blue design.  
• The Isaac: Isaac is a 15-year-old with Spina Bifida. He enjoys art, video games and Marvel movies, using Iron Man as the inspiration behind his sleek silver design. 

"Twisted X is dedicated to making a positive impact on the community we serve, and Cook Children’s is a perfect partner for us,” said Twisted X CEO Prasad Reddy. “We know that little steps can make a big impact and our hope is to raise awareness within the western industry for the amazing care provided at Cook Children’s in order to give back to those who need it most. This collection is a true embodiment of comfort that gives back and brings so much joy to footwear design.”  

"I like my shoe and my favorite part about it is that it’s rainbow colored and I love rainbows. And I love this shoe the best because I painted it and I got to make it however I want,” said Alex. “Art helps me relax and calm down my nerves from the pain that I get from my skin condition. I usually paint butterflies because it represents my illness. It’s like butterfly skin because it’s fragile,” said Brianna.  

Cook Children’s and Twisted X will celebrate the collection with a launch event today at Cook Children’s Fort Worth Campus. The collection is now available online at twistedx.com/pages/cook-childrens and in-store at select retailers nationwide. To learn more about the collection and the shoe’s young designers, visit cookchildrens.org/twistedx.    

It’s hard to imagine how a stroke could be a blessing in disguise, but Joseph and Allison Turner believe it was for their son, Owen, when he was just 8 months old.

“The stroke caused all kinds of battles that we’re still battling today, eight years later, but it saved his life,” Turner said.

When Joseph noticed Owen wasn’t moving the right side of his body while playing with his baby on a Sunday morning in January 2014, he and Allison knew something was terribly wrong. In addition to the loss of movement, their otherwise happy and content baby was fussy and irritable. He was suddenly behaving differently than he had been just a few days earlier when Allison took Owen to his pediatrician to check out a few bumps that appeared on the top of his head. Initially thought to be cysts, the doctor scheduled Owen for a return visit the following Monday to have them rechecked. But the changes they saw in Owen that Sunday morning led them to rush to the nearest emergency room in Cleburne, Texas, just one day before their scheduled follow-up appointment with Owen’s pediatrician.

Things moved quickly at the ER. It was apparent to doctors there that Owen’s condition warranted a more specialized level of pediatric care than could be given at their hometown hospital, so doctors called a helicopter ambulance to transport Owen to Cook Children’s Medical Center. Joseph wanted to be at Cook Children’s as soon as the helicopter landed with his son, so he jumped in his truck to make the 30-minute drive to Fort Worth. Allison stayed behind with Owen to travel in the helicopter with him.

As they were waiting for the air transport doctors were simultaneously running a number of tests to try and determine the cause of his stroke and interrupt further damage as quickly as possible. A diagnosis came quickly, and it was beyond belief for Allison—acute myeloid leukemia (AML), a fast-growing blood cancer that worsens quickly if not treated.

“Absolutely not,” Allison said describing her initial reaction. “There must be something else. It can’t be. This is my perfectly healthy baby.”

But Owen was critically ill. Abnormal leukemia cells were quickly building up in his blood and crowding out normal cells, which Allison says thickened his blood and led to the stroke. The bumps that appeared days before turned out to be clusters of leukemia cells sitting on top of his head. Had the stroke not prompted the Turners to take Owen to the ER, doctors told the family he may not have lived to make it to his scheduled doctor’s appointment the next day.

Allison rode with Owen in the helicopter to Cook Children’s in shock. Their lives had just changed forever, but there was no time to dwell on their disbelief. At Cook Children’s, Owen was immediately admitted to the pediatric intensive care unit (PICU) and met by Kenneth Heym, M.D., a pediatric oncologist and medical director of Cook Children’s oncology program. Dr. Heym wasted no time treating Owen’s cancer. That very Sunday night, the Turner’s baby boy began his first round of chemotherapy.

For the next four months, Cook Children’s was the family’s home while Owen underwent chemotherapy treatment. They left twice, but only to stay a few days just down the road from the hospital at Ronald McDonald House Fort Worth. After completing the intense AML treatment protocol, Owen was discharged from Cook Children’s in May 2014 and returned home for the first time in months.

In a matter of days, Allison and Joseph went from knowing little to nothing about AML to becoming experts on the topic. They credit their relationships with other cancer families at Cook Children’s for learning the ropes. Allison recalls that Cook Children’s chaplains would often stop by for a visit with Owen, and she would sometimes take that opportunity to step out and visit with other moms on the unit.

“Talk to the other cancer families if you're on the cancer floor,” Allison said about the advice she gives to families facing a new cancer diagnosis. “Those people were our family. We still send Christmas cards every year to the families that were inpatient while we were inpatient. They were such a support system. They share in something that nobody else on the outside would ever understand. Meet, find and talk to other cancer moms and cancer families that are going through the same thing.”

Today, 9-year-old Owen is cancer free and loving life, despite having a few lingering issues as a result of the stroke, like weakness on the right side of his body for which he continues weekly therapy. The stroke also led to daily seizures. In 2018, Owen became the first patient at Cook Children’s to undergo a trailblazing endoscopic surgery that disconnects part of his brain to stop seizures.

Even with these challenges, Allison says her son is a happy, easy-going kid looking forward to a future full of possibilities. If Owen has anything to do with it, that future will include lots of golfing and fishing, scoring a few goals for his soccer team, and cheering on Dude Perfect as they attempt their epic stunts.

About AML

Acute myeloid leukemia (AML) is a fast-growing blood cancer that originates in the bone marrow where blood cells are made. It starts with the abnormal growth of cells that form white blood cells, red blood cells or platelets. The abnormal cells end up crowding out normal blood cells, which can lead to infection, anemia and a tendency to bleed easily.

Of the more than 10,000 children diagnosed with cancer each year, nearly one in three cases are a form of leukemia. There are two main types of acute leukemia, with AML being the least common one in children.

Symptoms may be hard to spot. In Owen Turner's case, his symptoms began with bumps on the top of his head and escalated quickly resulting in a stroke. 

Other symptoms may include:

●     Easily tires, is weak or dizzy

●     Pale or ashen skin

●     Shortness of breath, trouble breathing or an unexplained cough

●     A fever or infection that doesn't get better

●     Bleeds or bruises easily, the gums may bleed often when brushing the teeth, recurrent nosebleeds

●     Continual bone or joint pain

●     A swollen belly

●     Swollen lymph nodes on the sides of the neck, underarms or groin area

●     Headaches, seizures, vomiting

●    Non-itchy rashes caused by bleeding under the skin

Acute myeloid leukemia is aggressive. It can move into other parts of the body and, if left untreated, can lead to death within six months or less.

If your child experiences any of the above symptoms, it is wise to talk with your pediatrician about them.

As COVID-19 continues to inundate our society, there arises the question of when to start the countdown clock of quarantine. Let’s say mom gets sick with COVID-19 and stays at home as she is supposed to. Centers for Disease Control and Prevention (CDC) guidelines state children should avoid physical contact with the sick parent.

For children staying in the home of a sick parent, the CDC recommends:

• Both parent and child (over age 2) should wear a mask while in the same room

• Wash your hands frequently for at least 20 seconds

• Try to stay six feet apart, if safe to do so

• Increase ventilation by opening a window

• Disinfect high touch surfaces (phones, remote controls, counters, table tops, doorknobs, bathroom fixtures, toilets, tablets, bedside tables, light switches) often

• Avoid sharing personal household items (dishes, cups, eating utensils, bedding, towels)

• Watch closely for any symptoms of COVID-19

Now let’s say dad has COVID-19, and his symptoms started seven days after mom became sick. What do you do about children returning to day care or school?

The CDC states anyone who has had close contact with someone with COVID-19 should stay home for 14 days after their last exposure to that person. What is not exactly specified is what to do if the COVID-19 positive parent and asymptomatic children are in constant contact in their own home. I recommend a safe watch and wait approach, practicing the above recommendations and if the child is still asymptomatic at the completion of 14 days after the parent’s 10 day isolation ended (which is a total of 24 days after the parent became ill or had a positive test), then they can resume day care and school attendance. The 14-day countdown would begin at the end of the most recent family member’s 10 day isolation period (in our scenario that would be dad’s). And as COVID-19 can slowly trickle through the household, this can be a month-long lockdown.

With any sick symptoms in your child following an exposure of COVID-19, they should see his or her pediatrician and get tested. If your child does test positive for COVID-19, they can be around others 10 days after symptoms first appeared, as long as their COVID-19 symptoms are improving and they have not had fever in 24 hours without the use of fever-reducing medications.

Due to current COVID-19 restrictions, only one parent or caregiver can attend appointments with patients. So each Tuesday, Aiden and his mother, Lori, attend appointments at Cook Children's where he receives chemotherapy. During his treatments, Aiden's father, Chuck, waits patiently outside of the building until Aiden is taken into a room with a window.

Once Aiden can see outside, Chuck hosts a one-man, music-free dance party for Aiden (and anyone else who happens to see him). The two are usually on the phone, talking to each other at the time. Aiden will call out dance moves for Chuck to do, and he even does a little dancing himself. Chuck says he does it to lift Aiden's spirits.

"The restrictions during the pandemic made me feel helpless. And the only way I knew to cope was to somehow be there during his treatments," said Chuck. "When he was able to come to the window, it just came natural to me to wave and carry on, which turned into me dancing!  I love knowing that it makes him giggle and smile, and let’s him know that his struggle is my struggle. I would never want him to think that he is going through this without his dad."

"I think it’s tough to break up a close knit family of four in these days, only allowing one parent to be present during Aiden’s clinic treatments and equally hard to not have his big brother Camden by his side too!" said Lori. "The population of kids present are all immunocompromised, so it makes sense, just a tough pill to swallow! I absolutely love listening to his giggles & watching him belly laugh at Chuck’s fancy dance moves. He can be having a terrible day, which transfers towards us some times too, and it’s instantly better once he sees his dad shake his booty. Aiden’s smile is contagious and can light up a room, even behind his mask."

The Yielding family is hosting a blood drive on Saturday, Oct. 3 in Fort Worth, Texas. Click here to sign up.

“I know I’m stronger than I look and I have a family that loves me and is always here for me. My mom told me that God gives sickness to kids who are strong and can handle the fight. That’s why I’m not sad. God does what he does for a reason and I know I’m going to get better.”

Yesenia started her freshman year of high school last month. While she may not be a typical teenager, she doesn’t let cancer slow her down. She plays tennis and is planning for her future. She wants to become a pediatric nurse and help other young cancer patients get better.

Dora says the hardest part of their cancer journey was the initial diagnosis, but there has been some good to come out of it all.

“It was like a bucket of cold water had been poured on me, as if time froze and they said you’re stopping here. I didn’t have time to react,” said Dora. “We learned a lot about her illness and about how to be strong. It’s been difficult, but it has actually built our bond stronger.” 

About #erasekidcancer

Each September, Cook Children's shares stories and raises funds in honor Childhood Cancer Awareness Month. The money raised for #erasekidcancer supports life-saving research, treatments, technology and programs for patients and families at Cook Children's in Fort Worth, Texas. Please help us create hope for kids, families and caregivers who are fighting every day to #erasekidcancer.

“By the time she was 1, she had been in the hospital more than out. She had a feeding tube along with countless tests, blood draws, exams and procedures,” said Vicki.

Bel was 5 years old when her parents noticed a pea-sized growth on her nose. Vicki’s gut told her something was wrong, and she was right. Cancer would soon take the roof of Bel’s mouth and damage her vocal chords, leaving her only able to speak in a whisper. After several rounds of chemo, Bel's cancer was in remission. While her family was relieved by the good news, bad news was not far behind. They later learned that Bel has what’s known as a B-cell disorder, meaning the cancer could rear its ugly head again.

“We have our share of bad days, but for the most part Bel is a ray of sunshine for all of us. Her smile lights up the room and she dances her way into the hearts of so many,” said Vicki.

Bel is being monitored closely by her physicians at Cook Children's to make sure she remains cancer-free. For Vicki and the rest of Bel's family, it's hard not knowing what will happen next, but they are taking one day at a time.

"The future is scary, but Bel teaches all of us so much about living life to the fullest every day. Her faith, strength, hope, courage and love are contagious!"

About #erasekidcancer

Each September, Cook Children's shares stories and raises funds in honor Childhood Cancer Awareness Month. The money raised for #erasekidcancer supports life-saving research, treatments, technology and programs for patients and families at Cook Children's in Fort Worth, Texas. Please help us create hope for kids, families and caregivers who are fighting every day to #erasekidcancer.

He was just days away from his second birthday in August 2016 when his mom, Arielle, noticed something was wrong with his arm.

"I thought it was broken. We took him to the emergency room and I thought he was just going to need a cast and we would go home," said Arielle.

Instead, Arielle and her husband learned that Adam had neuroblastoma. The cancer was eating up the bone in his arm and had spread throughout his little body.

"The whole scan looked like someone took a highlighter to it, that's how much cancer there was," she said.

In the months that followed, Adam went through seven rounds of chemotherapy, 12 rounds of radiation, two bone marrow transplants and a surgery to remove a tumor that had developed near his left kidney.

Today, Adam has no evidence of cancer in his body. He's in his last phase of treatment and if all goes well, he could officially be deemed cancer-free by February.

"It's scary because he carries a gene that makes it possible for the cancer to come back anytime, but we try not to think about that," said Arielle.

Helping to ease that worry is a new member of the family. Arielle gave birth to a little girl earlier this month, making Adam a big brother for the first time.

"Her name is Maddison Paige," said Arielle. "She has made everything better and we are so happy she is finally here."

About #erasekidcancer

Each September, Cook Children's shares stories and raises funds in honor Childhood Cancer Awareness Month. The money raised for #erasekidcancer supports life-saving research, treatments, technology and programs for patients and families at Cook Children's in Fort Worth, Texas. Please help us create hope for kids, families and caregivers who are fighting every day to #erasekidcancer.

Dr. McGehee, seen here with his daughter Brigid, became a stepfather of two younger girls 15 years ago, after his own four children were nearly grown and out of the house. He feels like the commitment he keeps to his wife, Pam, is what makes him a better father of a strong family.

“I know, to some, it sounds like it defies common sense to say put the children second,” Dr. McGehee said. “But, I think you have to have a strong marriage and a strong bond between the husband and wife. From there, everything grows from the love in that relationship. If the marriage is solid, the kids will benefit.”

That strong relationship between spouses will also be needed, Dr. McGehee said, with the extra challenges that come from being a stepparent.

Children of divorce often have emotional issues, sometimes of abandonment and sometimes of anger against the new father. Dr. McGehee said the parents need to have a unified front in dealing with their kids.

“You have to eventually find that place where you trust the stepparent and their objectivity,” Dr. McGehee said. “The stepparent can look at things with fresh eyes and without some of the emotional entanglement that may be there with the biological parent and the children. Hopefully, the biological parent will find that objectivity helpful.”

And then there’s one more relationship that Dr. McGehee feels stepdad has to at least attempt to make – with the biological dad.

“We have something in common – the relationship with the kids,” Dr. McGehee said. “I would hope that we are both trying to love and nurture the child. You have to try to get along with each other, eventually you will have things like graduation and weddings to attend together. You may not ever be friends, but you should at least be colleagues in raising a child. All the parents involved should have the same goals for the child – making them a happy, healthy and successful person.”

Last year, 24 kids died in the U.S. and from 1998 to present, 676 children have died.

“What’s heartbreaking is that this is a serious public health issue that is totally preventable,” said Dana Walraven, Community Health Outreach manager at Cook Children’s and Safe Kids Tarrant County Coordinator. “Every mom and dad out there must realize it can happen to you. Texas leads the nation in child heat-related car deaths.”

Parents may mistakenly think they can safely leave a child in a vehicle for a “quick” errand, but that’s simply not true. Temperatures inside the car can be 20 or more degrees hotter than the temperature outside, rising to dangerous levels in minutes. Unfortunately, it only takes a few minutes for tragedy to occur.

Safe Kids Worldwide says that heatstroke is the leading cause of non-crash, vehicle-related deaths for children.

“Heat is much more dangerous to children than it is to adults,” Walraven said. “When left in a hot vehicle, a young child’s core body temperature may increase 3 to 5 times faster than that of an adult. This could cause permanent injury or death.”

Heatstroke, or hyperthermia, occurs when the body isn’t able to cool itself quickly enough and the body temperature rises to dangerous levels.

Safe Kids recommend the “ACT” method to prevent tragedy to your child or to a child you see left in a car:

• A: Avoid heatstroke-related injury and death by never leaving your child alone in a car, not even for a minute. And make sure to keep your car locked when you’re not in it so kids don’t get in on their own.
• C: Create reminders by putting something in the back of your car next to your child such as a briefcase, a purse or a cell phone that is needed at your final destination. This is especially important if you’re not following your normal routine.
• T: Take action. If you see a child alone in a car, call 911. Emergency personnel want you to call. They are trained to respond to these situations. One call could save a life.

It’s difficult to think that as parents, we could “forget” our children, but it happens each year with no exception to socioeconomic or education level. Often times, a change in routine, a distraction along the way, or the event a child falls quietly asleep, unseen, in the back seat, allows for a parent/caregiver to “forget” and leave a child in the car.

Here are some important tips to help prevent unintentional injury to your child:

1. Dial 911 if you see an unattended child in a car. Sometimes, people don’t want to get involved or just assume the parents are on the way out. But as you read earlier, it doesn’t take long for a child to die in a hot car. If you see a child or children alone in a car without an adult, call 911 immediately.
2. Never leave your child alone in a vehicle, even for 1 minute. Windows left slightly open will not affect rising temperatures in the car.
3. Set safe habits: leave a cell phone, purse, briefcase, etc. in the back seat before driving, forcing you to always check the back seat and see a child is/is not back there.
4. Program your cell phone and/or computer to remind you to drop off your child each day.
5. Have a plan with your daycare provider to contact you within a few minutes of being late or absent. Let your daycare know that you want them to call you if you are late or you have not called in saying your child will not be in that day.
6. Teach children not to play in any vehicle.
7. Lock all car doors, even at home.
8. If a child goes missing, always check the cars and trunks.

Learn more by clicking here. Also, visit noheatstroke.org for the latest on heatstroke deaths of children in vehicles.

For more information

Every year children are rushed to the emergency room to be treated for car related injuries, many don't even involve traffic or another car. Some injuries occur without the car ever leaving the driveway. Click here for some of the top dangers to be aware of and the key things you can do to help make your car safer for your kids.

That’s how I remembered this:

Blood, frogs, lice, flies, disease, boils, hail, locusts, darkness, death.

You might ask, why was I learning the order of the plagues? Obviously, for a bible quiz game we used to play in Sunday school. Because I’m ultra-competitive, even when it comes to Sunday school.

The recent weather in North Texas has many questioning if we are witnessing plagues or if the Apocalypse is upon us.

Fortunately, it looks like the worst of the drenching rain (and hopefully the flooding as well) are behind us. As the waters recede, the rising threat will be mosquitoes and mosquito borne illness.

What’s the big deal with standing water?

Standing water is the breeding ground for mosquitoes. There are four stages of life for mosquitoes. The adult flying stage is the only one that does not rely upon water for survival. The eggs, larva and pupal stages must live in standing water.

Any standing water - water in a bird bath, pond or standing water from improper drainage can be a place for mosquitoes to breed.

Why do mosquitoes bite?

Female mosquitoes bite because they need a source of protein before they can produce eggs. Otherwise, like males, they can feed on nectar or sap.

When females bite, their long mouthpart breaks through the skin and gets into the small blood vessels just underneath. They also inject a small amount of saliva into the wound to make entry easier and to keep the blood from clotting.

What harm do bites cause our children?

Local reaction - While not technically an allergy, some kids will have a large local reaction with swelling and redness at the site of mosquito bites. These can be itchy and cause distraction in school or lack of sleep when severe.

Local infection – It’s not uncommon to see local infection in kids who have scratched mosquito bites, leaving a gap in skin, which can lead to infection. If the swelling worsens after the first few days or if there is significant warmth from the site of the bites, you should see your pediatrician to see if antibiotics are necessary.

General infection - Because mosquitoes can carry diseases, bites from mosquitoes can transmit infection that can affect the entire body. Mosquito borne illnesses cause over one million deaths world wide, most commonly from malaria. Two other diseases that we have seen in Texas associated with mosquitos are West Nile Virus and Chikungunya.

Given the amount of rain and the season, mosquitoes will be inevitable this summer season. Read more here about the many different ways you can reduce your child’s risk of discomfort and serious illness: How to fight (and) win against mosquitoes.

Some estimate that children will have 8-12 upper respiratory infections (coughs and colds) per year. Because many of those will be clustered in the winter and viral respiratory infections can last 1-2 weeks, it’s possible your child might seem to be sick “all winter long.”

Anytime a child seems to be sick off and on for months at a time, people will search for answers. Anytime people search for answers, they will start to make connections where connections don’t really exist…

So, now it’s time for: Winter Weather Health Myths

Myth No. 1 - Feed a cold and starve a fever.

I don’t care if you decide to feed a cold. If a child is hungry and not vomiting, let them eat but starving a fever doesn’t make sense. Besides, the major thing is that you need to monitor a child’s drinking when they are sick more than their eating. Dehydration is frequently what causes a child with a cold or flu to get sicker and require medical attention. You should encourage (“force”) your child to drink small, frequent sips of whatever fluid they will drink. Pedialyte or Gatorade are good options but milk is fine too (yes, even with fever).

Myth No. 2 – It’s been too cold for my child to exercise.

Maybe, for like two weeks in late January, it’s too cold for your child to exercise OUTSIDE. Otherwise, buy you and your child a sweatshirt and go for a walk. During those two weeks, you can walk circles around the house together or just do some lunges or something. Even 10 minutes a day is better than zero.

Myth No. 3 – Going outside to the cold (wet head or not) will make your child sick.

Cold weather and getting cold doesn’t actually make you sick. Getting sick is the result of being exposed to an infection that makes you sick not by getting cold. We think that viruses tend to increase in activity during winter due to the fact that people are more likely to be crowded inside.

Myth No. 4 – Taking Vitamin C (or a multivitamin or Zinc or essential oils) will protect your child from colds and flu.

The supplement industry has become big business for both adults and children as people look for anything to prevent illness. Unfortunately, study after study show that they simply don’t work. Essential oils are one of the latest to promote the ability to “boost” the immune system but studies are still lacking to show benefit in children. For now, our best bets are simple things like washing hands, covering coughs and getting the flu vaccine (I know it’s not perfect but at least it’s something).

Myth No. 5 – If you don’t like the weather in Texas, wait 5 minutes.

While not technically a myth, because weather can change fast in Texas. Good evidence is the last week. But, we’re not alone. Most of the United States believes that the phrase “If you don’t like the weather in ____, wait 5 minutes” applies to their state. A Google search ranking for this phrase puts Texas at number 8 on the states where this phrase was searched for (behind Massachusetts, New York, Georgia, Pennsylvania, Maine, South Carolina and North Carolina).

Don’t buy into the winter weather myths. Here are some tips for preventing winter weather health issues:

• Help your child eat healthy and get good sleep.
• Get your child up and active in some way every day.
• Teach your child to wash their hand and cover their coughs.
• Get your child a flu shot (it’s still not too late).

At best, the mom is rolling her eyes and pulling her phone out to hand to her screaming child.

“Children under 2 years of age should have no screen time and after 2 years, we should limit screen time to 2 hours per day.”

There is the common summary statement that can be taken out of the AAP Policy Statement on Children, Adolescents and the Media.

Is this realistic?

Is this practical?

Is anyone listening to anything we say?

In May, a meeting of the best minds in the use of media in pediatrics set out to answer these questions as well as look at recent research on the use of screens in children and teenagers.

In order to get information about the meeting out quickly, AAP News released a summary of some of the thoughts that came out of the meeting.

If you read the headlines that were generated as a result of the statement, you might have heard:

“Pediatricians think all screen time is OK. Go for it!”

“Pediatricians finally admit that they were dead wrong and outdated when they said toddlers shouldn’t use screens.”

“Pediatric guidelines now changed to allow for more screen time, at earlier ages.”

Unfortunately, we don’t always get the time to fully explain our message and the media doesn’t always get it right.

Here are my takeaways from the statement that I hope better reflect the intent of the authors:

1. What you might have heard: “Pediatricians think all screen time is OK. Go for it!”

What it should have said: “We need to continue to be careful about the amount of time children are on screens. Guiding them toward quality apps and games that are more than just watching a video is important. Watching and playing alongside your children helps to enrich the experience for the family as a whole.”

2. What you might have heard: “Pediatricians finally admit that they were dead wrong and outdated when they said toddlers shouldn’t use screens.”

What it should have said: “The benefit of screen time for toddlers is an ongoing topic of research but it is clear that children continue to learn best from interacting with and talking to other humans. One of the major risk of screen time is the time take away from rich interaction with parents and other caregivers.”

3. What you might have heard: “Pediatric guidelines now changed to allow for more screen time, at earlier ages.”

What it should have said: “While this statement is not a new guideline, it does highlight the AAP commitment to following new research in regards to screen use and helping to relay that information to parents as soon as possible. As more information comes available, we will update our guidelines to reflect current studies in the context of practical media use for children.

Do continue to follow this debate because the guidelines are likely to change over time. (P.S. That’s what guidelines should do in a new and heavily researched field.)

Don’t go out and buy your 1 year old her own iPad.

What if you then found out that you had been lied to about that day care’s license?

In fact, they didn’t have a license at all.

Fortunately cases like this are rare.

But what about a more common case where your child is bitten once or a few times at day care? What if your child is the one who is biting?

I reviewed the Texas Department of Family and Protective Services Minimum Standards for Child-Care Centers. Here is what I found:

• Parents should be notified about minor injuries when the child is picked up from day care (biting is included in this category).
• Relevant ongoing education is required for employees (and specifically mentions biting).
• Decisions about child/caregiver ratio must take into account situations where there are tricky situations. For biting, it suggests that a caregiver be assigned with training in redirection or that an extra caregiver be assigned.
• Biting is specifically prohibited as a means of discipline for a child (day care workers cannot use the old “just bite them back” techniques for biting).

What can you do?

Three tips if your child is being bit:

1. If it’s a one-time thing, try your best to let it go. I know this is hard but biting does happen and can happen in the blink of an eye even in very closely supervised environments.
2. If you start to notice bites over time, mention your concerns and assess what the day care is doing to prevent the issue.
3. If the bites are severe or very frequent, I would feel very confident suggesting that your child’s day care follow the steps as outlined in the Child Care Guidelines. This might mean that the day care needs a specialized or extra caregiver for the “problem” room.

Three tips if your child is the biter:

1. Do not feel guilty. Sometimes the day care will make it seem like your parenting is the problem. The reality is that you cannot do anything at home to teach a toddler to not bite at day care. Discipline in the toddler age does not work that way.
2. Discuss your child’s triggers with the day care. Biting usually occurs in predictable situations for children. You might be able to help them prevent biting in the first place.
3. Learn what works to distract your child. Children need to be distracted when they are biting. It’s clear from studies that direct punishment does not work well with toddlers. Teach the day care what strategies they can use.

Hello everyone. My name is Luke Lange. What a beautiful day for a walk to help erase cancer. I am very honored to be with you today and to have the opportunity to tell you my story.

I like to think of myself as a pretty normal kid. I enjoy football, basketball and golf. I like to hang out with my friends and of course obeying my parents. When I was in third grade, something happened that changed my normal years into my most challenging.

My grandparents came into town for a Veteran's Day celebration at our school. My grandmother noticed my neck was swollen on one side. She is always giving my sister and me the "grandmother inspection" so I didn't think much of it. I didn't feel sick so I didn't think anything was wrong.

After a few months of antibitiocs, blood tests, scans and even a biopsy all of which came back fine, my doctor decided to remove the swollen lymph nodes so everyone would stop worrying. In fact he said, "Let's get this done so you guys can go and enjoy spring break."

Once the lymph nodes were removed, the results showed I had Hodgkin's lymphoma or in simple terms: cancer. Spring Break was replaced with surgery to put in a port and I started my first round of chemo. My third grade year was over. My family and I were now focused on getting me healthy.

Before this, I had never stayed in the hospital overnight. Now I would check in for days with a machine hooked up to me constantly to give me medicine. Sometimes when I would like getting out of the bed, I would walk the halls of the cancer floor. As I walked the halls with my family and friends I noticed that some kids just like me and sometimes younger didn't have family with them during treatment. Sometimes those kids would only have a nurse or a child life specilaist with them during chemo. I can't imagine how they felt.

Everyone I met and dealt with at Cook Children's made dealing with cancer the best that it can be. Yes, I had to do the treatment, get sick, follow the rules and when my counts get low, I was the one that had to go into isolation, but the team here at Cook Children's was with me every step of the way. I always felt safe because my parents and so many people were there to support me.

Having cancer is scary for everyone. My family and friends and the team here at Cook Children's prayed and supported me and our family. It takes so many people to fight this disease.

My parents tell me that having cancer was a chapter in my life. It will and has changed my life forever. One good thing that came from this experience is that I designed a shirt to help me and other cancer patients not feel so sick while they are doing treatment. I was given the opportunity to partner with Mark Cuban. How cool is that? But one of the most important things I learned is that we all have to help each other. Especially, those who need our help.

Today is the kick off to Childhood Cancer Awareness Month. Just by you being here, you've made a commitment to help kids like me. Thank you! In a few minutes, we will begin the walk. We are walking for the kids and their families on the floor who would love to join us, but can't. We are walking because we know that everyone can help make a difference.

You have inspired our family to give back. Our family can do many things, but we do not have the knowledge and the expertise that each of you have to help "Erase Cancer." Our position on the team is to drive awareness and help raise much needed funds so you guys can stay focused on the task at hand.

To kick off the month and this walk, we would like to donate $5,000 to help ERASE CANCER!

But recently, a mom wrote in for help, looking for advice to help her with a heartbreaking problem. Her husband is dying and she wanted to know how to talk to her young children about what her family would be going through in the very near future. For the answers, we went to our experts.

“It’s important to explain to children that a parent is sick, and it’s a type of sickness in which he or she will get sicker, not better,” Joy Crabtree, Psy.D., a licensed psychologist at Cook Children’s Urgent Care and Specialties in Southlake, Texas. “The dying parent should be involved as much as that person is able in terms of planning and engaging in special activities with the kids (together and separately) during periods that he or she is well enough to do so.”

Crabtree suggests lots of pictures be taken and the parent write special letters to each child to be opened later at specific ages or milestones. In the future, after the parent passes, there will be periods of grief that pop up and perhaps a sense of sadness or a feeling from the kids that they were robbed the opportunity to share proud moments or special occasions with both mom and dad.

“If that comes up, the kids can be encouraged to write those thoughts down, either randomly or in letter format,” Crabtree said. “They can simply keep an ongoing journal of what they wish they could tell the parent who died or even write it on a note and tie it to a balloon and set it free. They might keep a box of drawings or notes that they make for mom or dad.”

Crabtree suggest the children go into therapy and the dying parent join as well if possible to address and get support/guidance for questions/behaviors that are coming up for the kids. “There is certainly no guidebook or specific right or wrong way to handle the process,” Crabtree said. “It will be tough no matter what, but with open communication, sharing memories, and the understanding that all questions and thoughts are welcome, they can work through it together.”

Lisa Elliott, Ph.D., a licensed psychologist and clinic manager of Behavioral Health for Cook Children’s in Denton, said she has seen a family go through this first-hand. She said the young father did an “incredible job of leaving a legacy” for his 2 year old by writing a book for her and lots of letters for her at critical points in her life, such as starting kindergarten, middle school, high school, graduation, turning 13 and 16, getting married and becoming a mom. The parents also bought charms for their daughter to be given to her on those critical dates.

Lena Zettler, MA, LPA, director of Psychology at Cook Children’s, said finding the right words to describe what’s happening will be crucial to helping the child through such a difficult time and the way the message is delivered will depend on the age of the child.

• Very young children will not understand the abstract concept of death, and saying that “daddy is passing on” may be more confusing.

• Children should know that their parent will not be asleep, and some concrete things like “death happens when our heart stops beating."

• Kids will usually ask questions that they are ready to hear the answers to, so listen to what they are actually asking about and answer that. Most times they need more concrete answers than we expect.

• When answering, give kids some time to process … say a few sentences, and then wait until the child is ready to hear more.

“We often use a lot of words and kids under 10 may not be able to process more than a few sentences at a time,” Zettler said. “Make sure all the kids get the same info, but it may mean talking separately to the children if their age ranges are broad (example, a 3 year old and a 10 year old). Include both parents in the conversations if both parents able physically.”

Zettler says if you don’t know the answer to a question, it’s OK to say you don’t know (for instance, “How long can daddy play ball with me?”). Also, kids of all ages need the same information over and over again, so be prepared to have many conversations. They may ask you a serious question and after a brief, but accurate answer from the parent, they may go right back to playing and acting normally. That is OK … they are taking in the amount of information they can process at that time.

“Celebrate mom or dad’s life NOW while that person is still here; talk about what is happening,” Zettler said. “Don’t forget that kids need to play. That doesn’t change when something like this happens. In fact, playing is the best way that kids have to learn new coping skills.”

Remember to provide support for the children and notify caring adults at the children’s schools. There may be additional support that teachers, nurses and counselors can provide.

Read age appropriate books on grief/terminal illness together (parent and child, or as a family). Books on death may not seem relevant while the parent is “just sick,” but books on death/loss may be more helpful after the death. Zettler says examples of books on terminal illness and coping with that for kids are: “Beyond the Rainbow” and “Help me Say Goodbye.”

Zettler says some children may struggle academically early on. Some kids, however, may seem less disrupted and more able to keep up their school work. That doesn’t mean they aren’t grieving, or that their academics may not suffer later. If they are getting behind academically, and they have not had school problems, before, don’t panic. They will catch up. If they have had problems before in school, definitely reach out to school personnel and consider getting the help of a psychologist or therapist.

“Kids will be afraid, unhappy and may act out more than usual,” Zettler said. “Don’t see this as abnormal or behavior ‘problems.’ You can still enforce rules especially if kids get aggressive but be patient with each other. Try to help them find words to express their feelings. Tell them that it is OK to have feelings. Reassure kids with words, with your presence, and with other comforting things like maybe a stuffed animal. It is OK if they “regress” during this time and do things they stopped doing when they were younger. If they really struggle with this or with difficult behavior, see a psychologist or therapist who has experience with pediatric grief or loss.”

Resources

“Preparing Your Children For Goodbye: A Guidebook for Dying Parents” by Lori Hedderman.

http://www.centerforloss.com/wp-content/uploads/2014/10/A-Childs-Grief.pdf

http://www.cancer.org/treatment/childrenandcancer/helpingchildrenwhenafamilymemberhascancer/dealingwithaparentsterminalillness/dealing-with-a-parents-terminal-illiness-toc

About our sources

Cook Children's Behavioral Health services provides a broad range of care that focuses on children from ages three years through 17, and their families. We also have some limited services available for children age 2. 

As part of family-centered care all of our professionals are qualified both through education and experience to work with children who have behavioral and emotional challenges. Our psychiatrists are board certified in child and adolescent psychiatry and our psychologists and therapists are all licensed independently in Texas.

To access any of our services, please contact our Intake Department. To expedite your call, please have your child’s date of birth and insurance information ready.

"If it can accelerate your body, it can injure you," said Corwin Warmink, M.D., medical director of the Emergency Department at Cook Children's. "Vehicular accidents, including boats, ATVs, cars, scooters and bikes are all too common on holiday weekends during the summer."

Another danger Dr. Warmink is concerned about this weekend: broken bones. No one wants to spend Labor Day weekend in the hospital. But Dr. Warmink says many families do, thanks to trampolines and monkey bars.

One of the scariest threats we see all too often is drowning. And yes, it can happen to you. In August alone, 14 children were admitted to Cook Children's Medical Center for drowning-related injuries. Two of those children died.

"We've seen many cases where children took their life preservers off and jumped back into the water," said Magdalena Santillan, Trauma Injury Prevention specialist at Cook Children’s. "Often, parents are getting ready to leave the pool and don't realize their kids have jumped back in."

One of the best ways to protect your child around the pool or lake is to become a Water Watcher. This means adults take turns supervising the water with undistracted attention. You can find more information about the program here, including 5 seldom used tips that could save a child's life.

And Labor Day may mark the unofficial end of summer, but that does not mean an end to the heat. According to Dr. Warmink, heat-related illness also tops the list of Labor Day dangers. "Heat exhaustion, heat stroke, hot cars and sunburns are among the common injuries we see over the Labor Day weekend," said Dr. Warmink. "Parents should make sure their kids drink plenty of water and wear sunscreen, and of course, never leave a child alone in a car."

With your help, we can cut the number of Emergency Department admissions this holiday weekend and ensure a safe celebration for everyone.

Richard Roberts, M.D., a neurosurgeon at Cook Children’s, wonders what it’s worth for your child to play sports with a reputation for head trauma.

“I think the fact that when the NFL players sued the league initially and won, the judge said the settlement (more than $700 million) wasn’t big enough,” Dr. Roberts said. “That says a lot about this growing issue more so than anything else.”

The issue discussed in the NFL cases has been CTE (chronic traumatic encephalopathy), a progressive, degenerative brain disease that has been found in some athletes with repetitive brain trauma.

Research is currently being done to study just how playing contact sports such as football mainly, but also soccer, can cause damage to an athlete’s head. But is it worth it for parents to wait for the results of this work.

“Amateur sports are different than professional sports because no one is feeding their family with the activity that they are doing,” Dr. Roberts said. We need to look beyond the short term and really understand what could happen in the long term. That potential for long term problems should be the primary thought, not the secondary thought.

“What is the actual incidence? We don’t know. But if it was your kid, how much would you be willing to risk? Even if it was 1 in 10, would you roll the dice on your own kid?”

Dr. Roberts has previously worked at Children’s Hospital in Philadelphia and Charity Hospital in New Orleans. While he saw concussions at the other hospitals, he’s never seen parents argue with him about concussions as he has seen at Cook Children’s.

“Part of what I’ve seen which is different here than other places is that I do get push back from parents who I think underestimate the severity of some of these injuries,” Dr. Roberts said. “Some of it is that they want their kids to play and I think some of it is the short term nature of some concussions.”

Children get concussions and they do well relatively quick, so opposed to having a broken arm which is in a cast or needing surgery and having stitches for three weeks, kids hurt their heads, they are knocked unconscious for five minutes, but then feel essentially better soon after. This apparent sign of improvement makes it difficult for some parents to grasp that their child may have a fairly significant brain injury.

“The more we understand concussions and the more we see people who have hurt their heads for various reasons, soldiers, professional athletes, anyone who has suffered a head injury, I think that we are seeing that in adulthood they are starting to have more cognitive issues,” Dr. Roberts said. “Now the science is not perfect yet. We can’t say to a football player you had three concussions and that’s why you have dementia. We can’t say to the soldier you were exposed to be a bomb blast and that’s why you have dementia because it could be multifactorial. It could be that you have the right genes to make you this way later on. But the percentage seems higher in people who have had traumatic brain injuries.”

Dr. Roberts says parents should be concerned after head injury one. He knows you have to let kids live their lives and be kids, but the brain wasn’t made to get beat up like happens sometimes in sports.

It’s not known for sure that after one concussion, people are more likely to get more, but Dr. Roberts’ suspicion is that it is likely the case.

And when does he have a serious heart-to-heart with the parents and the athlete?

“After two. We discuss no longer participating in the activities which could cause further injury because the likelihood of you having a head injury in your lifetime is still pretty high,” Dr. Robert said. “You are going to hit your head on a tree branch or you are going to fall off your bicycle or someone is going to run into you. You are going to be stepping out of the car and slip or walking across ice and fall down. My opinion after behavior has shown us that you are going to get injuries in a particular sport, you should probably not be playing in that sport because you are not able to protect your head.”

Dr. Roberts has seen strong reactions from both the parents and the kids after being told he or she should quit playing their respective sport. And it’s not just football as most people expect. It’s with the gymnast who has fallen off the bars and knocked herself out or the soccer player who has headed the ball and gotten knocked unconscious.

But football still remains king in Texas – in popularity and in concussions.

So what can be done about it?

Dr. Roberts is not sure there’s a good answer to that question. Building better equipment helps, but then armoring players probably makes them feel invincible and they hit harder. If you take away the facemasks or hard shell football helmets, he expects you will return to the old days – less concussions, but more skull fractures and in the process, immediate deaths on the playing field.

For now, Dr. Roberts wants parents to monitor their kids closely and to take the recommendations from their doctor closely. If they say it’s time to stop – stop!

“All the steps that sports are taking to make it safer are positive,” he said. “I think that everybody involved has to think less about return to play and more about long term health.”

About the source

Richard Roberts, M.D., is a neurosurgeon at Cook Children's. When a child with a neurological disorder requires surgery, the experts at Cook Children's Medical Center offer comprehensive care and state-of-the-art technology. With the help of such state-of-the-art equipment as the revolutionary intraoperative MRI (iMRI), our neurosurgeons are able to determine effectiveness of surgical procedures for cranial and spinal nerve disorders and tailor the treatment to each child's unique needs.

If you don’t know her name, you more than likely have seen her photo because she has blown up the Internet with a photo of her breastfeeding her own son and the son of a friend.

For some it’s a beautiful expression of what’s perfectly natural. For others, it’s caused a range of emotion from “yuck” to outrage.

And for our lactation experts at Cook Children’s, well, they look at it as an opportunity to educate the public.

The lactation nurses at Cook Children’s have been busy working and had not seen the photo making the Internet rounds until called for this story. They realize that it makes many of us uncomfortable in the United States to see such a bold expression of a natural process. But they say it’s a common practice in many other countries around the world and accepted and sometimes expected culturally.

From a medical aspect, the lactation experts say milk sharing is becoming a more common practice but not without risks. There are numerous transmittable diseases that can be passed on through a mother's milk as well as many medications that will be passed on through milk too. As milk sharing is becoming more common there are even websites out there where people can share breastmilk with one another. Again, caution must be used when sharing breast milk.

To be perfectly safe, for those babies that have a medical need and prescription for breastmilk, they recommend a place like Mothers’ Milk Bank of North Texas, which allows moms to donate breastmilk. The mothers go through a screening process and is then the milk is pasteurized to make sure there’s no harmful bacteria.

The consultants hope that people don’t focus on the photo as much as they do the benefits of breastfeeding.

And for those of you wondering, “Aren’t those kids a little old to be breastfeeding?” Come on. We know a lot of you are. The World Health Organization recommends breastfeeding babies until at least 2 years of age.

The lactation nurses aren’t willing to weigh in as far as the emotional aspect of the picture or how it impacts them developmentally. Breastfeeding in a personal choice and one that we hope every mother will attempt. How long to feed your baby is personal and will be very different for each mother. At the end of the day, breastfeeding is supported by the World Health Organization, Center for Disease Control, the American Academy of Pediatrics just to name a few.

The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of a baby’s life, “followed by breastfeeding in combination with the introduction of complimentary foods until at least 12 months of age, and continuation of breastfeeding for as long as mutually desired by mother and baby.”

About the source

Because research shows that breast feeding helps improve babies' health and helps moms bond with their little ones, Cook Children's has full-time lactation specialists on staff to assist mothers with pumping and breastfeeding. We offer breast pumps in every room and have an on-site milk bank available for safety and storage. There are numerous resources available through lactation services for moms that are having difficulty with nursing/pumping. While other nurses are focusing on the baby's care, the lactation consultant can provide extra attention to mom.

School physical season is one of my favorite times of the year for many reasons:

• It’s really fun to see kids grow up and get big over time.
• I love watching my patients’ personalities mature.
• I love that the visits become progressively more about my relationship with the child in addition to my relationship with their parents.
• For the most part everyone is healthy and happy.
• For most children, the promise of a new school year and new beginnings is exciting.

I have a few things on my agenda for each back-to-school checkup.

I want to talk about diet, exercise and sleep. I want to talk about how school went last year and what the plans are for the upcoming year.

But checkups are more than just about what I want. In order for the checkup to be a success, it must meet the goals of the child and parent. Parents are all over the place when it comes to their expectations for physicals.

Here are just a few examples:

1.“Let me get out my list.”

Whether your weapon of choice is a spiral-bound notebook or long thumb-scrolling iPhone lists, you know who you are. And frankly, I love you. Having a guide that directs the visit through any questions and concerns that you have is beyond helpful. It keeps me from having to talk about stuff that’s not important to you and wasting both of our time. So, bring it on, Listers, and I promise not to roll my eyes.

2.“I’m just here to get my form signed.”

No worries. That may be all you need and that’s great. In the meantime I can provide a quick screen for height, weight, body mass index, high blood pressure, heart murmurs, risk for sudden cardiac death, hearing and vision (and much more). I can also screen for drug/alcohol abuse, depression, attention problems and other school issues. “Here’s your form, thanks for coming in.”

But seriously, even in those children who come in with no apparent concerns or complaints, we do pick up health problems that need to be addressed to maximize your child’s ability to function well in school or compete at their best in their chosen activity.

3.“I’m not worried, but __________ wanted me to ask about __________.”

This is a tricky one. I’m totally cool with it, but it can be hard to get at exactly what the concerns is if that person isn’t there to ask questions. My advice … if that person is close enough to be providing this type of advice, they could probably come to the appointment. If the concern is coming from the child’s teacher, a quick note explaining what is going on can be really helpful.

Just don’t leave it up to chance that we can figure out what the problem is, especially if you don’t quite understand why they are concerned. Get specific information about the concern or have them come along.

I’m sure there are many more ways that parents think about their children’s checkup, but these are some common ones I notice.

No matter what, regular checkups are an important part of helping you maintain your child’s health. Good health increases their ability to be present for and to participate fully at school and extracurricular activities.

Which category do you fall in? Is there a different one you think I should include?

Sports EKGs are free through the month of August at specific locations in Arlington and Fort Worth. Cook Children's offers a $25 Sports EKG (electrocardiogram) screening test at our Cardiology offices in Mansfield, Southlake and Denton. Adding a sports EKG to your child’s physical can help detect most heart conditions that may lead to sudden cardiac arrest. Click to learn more. 

For school physicals, visit your local Cook Children's pediatrician. Click to find one near you. 

But it’s the age when children began to look at pornography that may shock and concern you. Years ago, the accessibility to pornography was only on the home desktop computer that was monitored, but now, everyone in the house has a laptop, iPad and a smart phone. With children getting phones at a young age, they have access, away from the watchful eyes of their parents. So the temptation is now accessible.

Ernie Allen, former president and CEO of the International Center for Missing & Exploited Children, says the average age of U.S. children exposed to pornography is 12 years old and that one in three 10 year olds view porn.

Allen joined other health experts to speak in front of congressional staff members recently in Washington, D.C. to discuss children and Internet pornography, calling this issue a “public health crisis.”

Lisa Elliott, Ph.D., a licensed psychologist and clinic manager of Behavioral Health for Cook Children’s in Denton, agrees with this assessment.

Elliott and her colleagues see children 10, and even younger struggle, with porn addiction. She says porn is so accessible with the Internet that it’s easy for children to view it with little preventing them from seeing it. She says some studies claim that pornography releases the same chemicals in the brain as cocaine addiction, making it one of the hardest to overcome.

“Kids can’t handle what they are seeing,” Elliott said. “It sends such a horrible message about the value of people and what a loving relationship truly is. Their frontal lobe has not developed enough to comprehend what they are viewing and it sends confusing messages on intimacy and what love truly is. Kids then have a hard time distinguishing what is healthy vs. what is not.”

Things have come a long way since the days of a son hiding his dad’s discarded Playboy under the bed or watching a teen flick on one of the movie channels. The Internet allows for quick and easy access to a whole new world of porn, including violent and dangerous acts that can do harm to a person.

“Kids are going to be curious,” Elliott said. “It’s important for parents to talk to their children about what’s healthy and developmentally appropriate for kids their age. It’s uncomfortable for some, but it’s a good idea to sit down with your children and talk to them about sex and healthy relationships. Parents should watch for the signs of what crosses boundaries and educate their kids too on what is out there and how harmful it can be. With my own children, I keep that dialogue going at all times and I’m not afraid to ask them very direct questions.”

So what are the symptoms of a child addicted to porn? Elliott said parents should watch for:

1. Children may isolate themselves from their parents and spend a lot of time in their bedroom or bathroom.
2. Evidence of pornography on their hard drive or web browser.
3. Clearing their history on their phone, tablet or computer.
4. Appears tearful, sullen.
5. Sleep disturbance with either falling asleep, staying asleep or exhaustion.

Elliott says the combination of children becoming desensitized to porn and the accessibility of social media can make for a scary combination, leading to a lack of inhibition and self-control. Elliott said the casual attitude about porn can lead some children to lack the ability to recognize long-term consequences with texting and sexting, Snap Chat, Vine, Facebook, Kik and ChatRoulette.

“Porn exposure can lead to desensitization just like exposure to violence has,” Elliott said. “When our children are exposed to these negative elements they begin to see that behavior is acceptable and normal. Frequent exposure to viewing violence has been shown to normalize that for kids as well as increasing trends in bullying and behaving violently as a way to solve problems. The concern is that children will grow up believing that pornography is normal, routine and that way relationships are, not to mention teaching them to exploit others.”

In a presentation she gives to parents, Elliott gives these numbers:

• Up to 39 percent of teens admit to sexting.
• Fifty-one percent of teen girls feel pressure to take and send explicit photos.
• Twenty-two percent of teen girls and 20 percent of teen boys send nude or semi-nude photos of themselves.

Resources for you:

• How pornography harms children
• Pornography's Progressive Pattern of Addiction
• The impact of pornography on children & youth
• So your kid is looking at porn. Now what?

I think in “Inside Out,” Riley’s family is always trying to be positive and give Riley joyful memories throughout her childhood. As the family moves and life starts to unfold negatively, we see other emotions; fear, anger, sadness and disgust, start creeping up in.

We see Joy work harder to keep Riley’s emotions as joyful as possible. Joy is an important part of our memories that we like to revisit. As a child life specialist at Cook Children’s, I try to help normalize the day and make joyful memories with patients and families.

These memories will help children cope with other struggles that they overcome and find joy in their life. As adults, we have a hard time with this because we have so many experiences with sadness, fear, anger and disgust it’s hard for us not to project our feeling on children especially when they are in the hospital.

Children that come into the hospital may experience different emotions, but joy can be found through these emotions, even when as adults we may think there is no joy.

Sometimes kids find so much joy that they don’t want to leave Cook Children’s because it has become a fun and not so scary place. We need to remember to look for joy with all that may go on in a hospital setting.

We might not think children do a great job at a procedure because maybe they cried. However, they may have held still and been able to recover with playing by the end of procedure. This can create a joyful memory with having families at the bedside showing comfort.

Sometimes going through these different periods of our life while growing up and experiencing many things good and bad allow our emotions to interact.

In “Inside Out,” we see that the character Joy realizes toward the end of the movie that you can mix your emotions and this can be considered normal. Joy realizes that you can cry tears of joy. So as a child life specialist we help families realize that tears in a difficult experience may help a child in the future to help to control his or her different emotions. The tears also allow us to look at our long-term memories and see how there might have been joy in that moment after all and change that core memory to be better than we thought.

This allows us to empower children with all these different emotions, especially joy, in their daily lives, in or out of the hospital. Joy is a great emotion which we all deserve to look for daily in our lives and others that live with us. What Joyful memory do you have?

Previous stories in our "Inside Out" series:

• Anger
• Disgust
• Sadness
• Fear

Heather Bayers is a Child Life specialist at Cook Children's. We know that a child’s illness or injury can impact a family physically, emotionally and financially. Fortunately, you don’t have to face these challenges alone. We provide a growing number of services for patients and families, all designed to help support, heal and encourage you through every step of your journey.

These moments can be quite amusing to watch because, let’s face it, we can all relate to having angry outbursts!

Anger is many times perceived as the ultimate negative emotion, however “Inside Out” gives us an interesting perspective that could teach us a few things. When Joy introduces us to Anger, she describes him as someone who “cares about what is fair.” If we really think about it, most of our anger is the result of feeling as if we have been wronged by someone or when a situation does not go as we feel it should.

Children and teens who are dealing with an illness, injury, and/or hospitalization have MANY reasons to feel as if they have been put into an unfair situation. They are missing out on events with friends and family, missing school, having to endure sometimes painful and scary procedures and experiencing so many things that they have so little control over.

The first step in helping kids cope with anger is to acknowledge why they feel angry and to let them know they have a right to feel angry about a difficult situation.

Big life changes and overwhelming situations can shake up our emotions and cause them to go into panic mode as they try to make sense of what is happening. This is what we see with Riley’s emotions when her family moves away. However, when Anger is able to fully take over Riley’s control board, she makes an impulsive and unsafe decision to run away in an effort to feel better and to fix what she sees as an unfair situation. She breaks her hockey stick, rolls her eyes, yells at her parents and is disrespectful. When children begin to show these negative behaviors (even when they are sick or hurt), they need clear reminders of what behaviors are not acceptable while validating the feeling behind them. Say to your child, “It is OK for you to feel angry. It is not OK for you to hurt yourself, hurt others or be disrespectful.”

But if we are going to remove the only way they know how to express anger, we must replace it with an acceptable and healthy outlet. Some simple activities may include punching a pillow, pounding play dough, breaking ice cubes outside, participating in sports or outdoor activities, taking deep breaths or tearing up paper. Providing these options prevents anger from being bottled up and eventually blowing up!

Is there a positive side to Anger?? Definitely. Anger is strong, determined, passionate and protective. Those are all things we want children to be. Children can learn to see things that are not fair and stand up for themselves and others. Anger can be an excellent motivator for change and reaching solutions. If we can teach a child to use their anger in a positive way, we can empower them to overcome difficult situations.

Related "Inside Out" topics:

• Disgust
• Sadness
• Fear

About the author

Angie Bradley is a Child Life specialist at Cook Children's. We know that a child’s illness or injury can impact a family physically, emotionally and financially. Fortunately, you don’t have to face these challenges alone. We provide a growing number of services for patients and families, all designed to help support, heal and encourage you through every step of your journey.

That was the overall message from Fort Worth, Texas Mayor Betsy Price and representatives from the city of Fort Worth, including Cook Children's, at a press conference to address city-wide support of drowning prevention measures.

Mayor Price said that the message of the day was that tragedy in the water only takes seconds and that drowning is a silent killer. "Children drown without a sound," she said.

The press conference called for awareness and a city-wide call-to-action to protect our children through education, prevention and response. Along with the Mayor and Cook Children's, representatives from the Fort Worth Drowning Prevention Coalition, the Fort Worth YMCA, the Fort Worth Firefighter Charities, the Fort Worth Fire Department and MedStar were all in attendance.

The event included a poignant speech from Denise Doherty, an RN and director of Emergency Services at Cook Children's. Doherty said her staff is "drained and heart broken" from the number of children and patients affected by this "very preventable tragedy."

In the past two months, Cook Children's has seen nearly a child a day for drownings. The month of July began with two drowning deaths and Cook Children's Trauma Department seeing 19 total drownings from July 1 to July 22, compared to 11 drownings and two fatalities last year for the entire month of July. June saw more than double the amount of non-fatal drownings from a year ago with 26. 

Parents have been urged to watch their kids. Now the message has a new sense of urgency - you must protect your children. 

"We've seen more than enough children die this year," Doherty said. "It has to stop. Can you imagine being a parent, sitting in the ED waiting room, praying that the life of someone you love so dearly is spared, especially since it was something that didn't have to happen? No parent wants to be saddled with that guilt. I think it's also appropriate for me to say that no one is immune, and yes, it can happen to you. Cook Children's has witnessed this in a very intimate way, even our own medical community has experienced this heartbreak."

Doherty added," Today, we're making a plea. It's not only time to watch your kids near the water, but it's time to protect them."

So what does it mean to truly protect your kids? Help us spread the word with these tips:

1. Get in the water. Be in arms reach of your child. Don't let your child out of your sight and be there to grab your children out of the water at any sign of trouble.

2. 100 percent adult supervision at all times. Be active in the pool with the children or watch like a lifeguard. Don't take your eyes off of your child. If you aren't in the water, be sure to watch your kids at all times. Don't spend time on your smartphone, talking to friends or walking away for even a moment. Do have a phone nearby in case of an emergency. But that's the only time anyone should be using one.

3. Watch them until they are safe and inside. Monitoring your kids includes accounting for everyone who had been in the water all the way to the house or apartment. Once you are inside, count again and make sure all the kids are safe and inside.

4. Be a water watcher. If you are at a party with a group of children, take 15-minute shifts watching the kids. Count heads above water and look for any that are motionless on the bottom of the pool. Give your undivided while you are the water watcher. Stay sober and be alert. You can't have a more important responsibility.

5. Life jackets. Not just any flotation device will do. Make sure your life jacket is U.S. Coast Guard approved. Check the tag to say so.

6. Swim lessons. Mom and dad, you need to know how to swim. If you don't know, take lessons with your child. Make sure your child knows how to swim too. If they are in the pool, they need to know how to get to safety. But this is only a layer of protection and doesn't take away from the fact that you need to be in arm's reach.

7. Know CPR. Local CPR lessons are given in your area. A quick Google search should help you find a class.

8. Use pool and child alarms to alert you if your child gets in the water without you.

9. Isolate your pool from the rest of your backyard with a permanent, four-sided fence with self-latching gates to prevent kids from accessing the pool area without an adult.

Previous articles on this topic:

• Drowning prevention - watch your kids
• Drownings double from a year ago 
• Be a water watcher. Adult supervisions saves lives.
• Is your baby ready for swim lessons?
• Drowning tragedy - 'I can't believe this happened to me.'
• Swimming with Type 1 diabetes
• Cook Children's drowning prevention page

For more information

Learn more about drowning prevention and water safety here. This page gives helpful information on keeping your kids safe during swim season, including proper fit for life jackets, pool safety videos and fences/alarms information.

She is especially protective of Riley when looking out for her well-being. She’s on vegetable alert. Remember the peas and broccoli pizza? Disgust also acts as Riley’s social situation monitor, helping her make new friends.

So what really is the value in our children's everyday lives of feeling disgusted? To feel disgust, means we are offended by something, or have an extreme dislike.

When was the last time you said, “That’s disgusting!”? Was someone acting in a way you felt was inappropriate, or was there food on your plate that you truly didn’t want to eat? We can see disgust acted out in kids all the time.

Food sometimes just has to look like it doesn’t taste good, for them to turn up their noses and say, “yuck, not eating that!” Think about all the times you’ve tried to get your child to take medicine that they refuse, or spit back out at you. Those may not seem like the most positive examples, but they’re probably the most realistic. But, if disgust is protective, then it may also keep your child from eating something they shouldn’t, such as bugs, plants or medicine that’s not theirs.

Disgust in the role of acceptable social behaviors has the potential to be very important. If we teach our children there are certain values that are important, and morals to follow, they have the potential to be offended (disgusted) when behaviors opposite to their values are displayed. It may keep them from getting involved in substance abuse, risk taking actions and becoming sexually active. If disgust helps them to live up to the expectations they know are important, then it plays a very positive role with the voices inside their heads.

Disgusted behaviors aren’t always the most positive if you look at sarcasm, being snarky and generally thinking they know everything. We may laugh when we see children react to situations with some level of egocentrism, except maybe when they are our children and we think they’re being rude. So, lesson learned, how children (and adults) display their disgust is important. Just like anger, it’s OK to feel disgusted, but there may be certain behaviors that are unacceptable, such as throwing peas, when we are expressing our disgust. Providing examples of what is acceptable behavior when disgusted, such as using words, not actions, is definitely a teachable moment.

Disgust, in all her green-ness in Inside Out adds a certain level of humor that is probably better understood by adults because it’s subtle and mature. But, don’t we all want to have a little bit of her humor in our heads every day? I know I do.

Related 'Inside Out' topics:

• Sadness
• Fear

About the author

Jill Koss is director of Family Support Services and Child Life at Cook Children's. We know that a child’s illness or injury can impact a family physically, emotionally and financially. Fortunately, you don’t have to face these challenges alone. We provide a growing number of services for patients and families, all designed to help support, heal and encourage you through every step of your journey.

“Stop Slouching!”

Why is my kid’s posture so poor?

THE PROBLEM

Do you get sick and tired of telling your child to sit up straight? Do you ever wonder why so many kids these days have slouched posture and often complain of back pain?

Let’s take a moment to think about a child’s typical day during the week.

1. They spend six hours a day at a desk in school. Most of this time is spent writing notes or typing with their hands in front of them and their head looking down.
2. When they are not in school, much time is spent playing video games, playing on their smartphones, surfing the Internet on the computer or texting. Again, arms are in front of them and head is down
3. They carry around a backpack that often weighs almost as much as they do and often times wear it low, resting on their low back or bottom. Backpacks should weigh no more than 10 percent of their body weight, be worn on both shoulders and fit snuggly to their back.

In April of 2012 – Archives of Pediatric and Adolescent Medicine published an article stating that only 51 percent of children went outside to walk or play per day with either parent.

Another national study found that the average American age 8-18 plays video games for greater than 13 hours per week. Studies also show that children today spend half as much time outdoors as their parents did when they were young. These kids prefer to stay inside to watch TV, surf the Internet, listen to music and even do their homework, rather than go play outside.

How it affects the kids

The positions discussed above, which kids are in for a large majority of their day, place the muscles on the front of their chest into a shortened position. After a while, it is difficult to stretch those muscles back out to attain proper posture independently. Tight muscles on the front of their chest cause them to continue to sit with their shoulders rounded forward and thus the cycle continues. The muscles in the front of their neck also become tightened, pulling their head forward. A forward head can also cause the muscles at the base of the skull in the back of the head to become tense.

Unfortunately, the inactivity caused by the increased time spent indoors also contributes to a poor core. The core consists of the muscles around the center of your body that help your back stay up straight. Without an active core, it is very difficult to maintain good posture and fatigue will set in quickly. A weak core in combination with prolonged periods of inactivity will likely lead to a cycle that is difficult to break, causing poor posture.

What to do

Have a homework station set up for kids. Doing homework on the bed or floor often makes posture worse and increases the curvature of their back while they are sitting. Kids should sit in a chair where their feet can touch the floor and their hips and knees are at 90 degrees. The table height should be so that their forearms are able to rest comfortably while they are working so that their shoulders can relax.

They should be in the same sitting posture for the computer and the screen should be at eye-level to keep their head in a good position as well. There are shelves made to lift computer screens up to eye-level, however, a large dictionary will often do the trick, as well.

The American Heart Association’s recommendation for physical activity for children is at least 60 minutes of moderate-vigorous intensity aerobic activity at least every day. As a parent, try to encourage your child to be active for at least one hour a day, either at school or at home. If you cannot find the time for your child to perform 60 minutes of straight activity, try to perform at least 30 minutes of activity twice per day.

It is never normal for a child to experience back pain or consistent headaches. If your child is experiencing either of these symptoms and is not actively being treated by a healthcare provider, please discuss these concerns with their doctor. Physical therapy can assist with improving posture and core strength to eliminate back pain.

Related information

• Cook Children's Sports Performance Orthopedic Rehab Team Specialists (SPORTS)
• Dynamic stretching
• The basics of sports injury prevention for kids
• The essential backpack 

“Inside Out,” the new hit movie, helps us to understand, however, that sadness is just as important to our world and our perceptions, as joy and anger and all of the other emotions we encounter as human beings. We cannot pretend that sadness isn’t there. We cannot ignore it and hope it will go away. There is a reason for our sadness and if we don’t experience that feeling, it gets stuck inside where it grows and festers and can then prevent our other feelings from being realized.

We’ve heard the idea that we can’t know true joy without having known sorrow. The point in the movie where things change is when Riley’s parents stop and listen to her feelings. Riley tells her parents that she misses her old home and she wants to be with her old friends. Nobody is trying to change the way Riley feels. Nobody is trying, including Riley, to cover up her sadness with something else. Riley is allowing herself to feel the sadness and her parents are there with her, allowing her to feel. They are supporting her feelings and are listening to her.

As parents, we want our children to be happy. We want to protect them from pain. Unfortunately, that isn’t always possible. Once we understand that our children must go through pain and sadness, our job is to be there for them in those times.

We must allow those feelings to be experienced and we will likely experience the same feelings with them. Sometimes children (and adults too!) can’t put words to what they feel, but luckily words aren’t always necessary. As parents, we need to realize that at times silence is better. Don’t try to solve the pain. Don’t try to “make it better.”

As hard as it may be, let it happen.

As kids experience their feelings, they will begin to heal. Ask your child what they’re feeling and let them find their own way to tell you. They may not want to talk, so just be there. Hug them. Sit quietly with them and make sure they know you are willing to be by their side no matter what they are feeling. When they do talk about it, validate them. Tell them that it is okay to be sad, or angry, or confused. They need to know that whatever they are feeling is okay; it isn't wrong.

Here are a few examples of validating language that you can use:

“That sounds like it is really hard for you.”

“I can see that ___________ made you feel __________.” (Use their words for these blanks)

“I’m guessing you might have felt ______________ when _______________happened.” (When they aren’t providing you with answers of their own.)

Try to avoid these phrases/comments which invalidate someone:

“It’s not that big of a deal.”

“Don’t worry about it, you’re going to be fine!”

“You’ve got to be a big boy/girl, we’re not going to cry.”

Previous 'Inside Out' topics:

What 'Inside Out' teaches about fear

About the author

Shea Ingram is a music therapist at Cook Children's. At Cook Children's, music provides a creative intervention for children and young adults individually or in a small group format. It allows our young patients an outlet for the physical and emotional challenges they face in their lives.Music as an outlet and/or therapy aids communication and can be helpful to those who find it difficult to express themselves in words. Research supports music effectiveness in many areas such as: overall physical rehabilitation and facilitating movement, increasing people's motivation to become engaged in their treatment, providing emotional support for patients and their families, and providing an outlet for expression of feelings.

We can’t blame her, right? What parent doesn’t want joy to be the emotion that fills a child’s day, week, year and lifetime?

It’s the positive emotions, like joy, that we desire to be constantly filled with and to override the control center in our minds when any sign of the more ‘negative’ emotions, such as fear, sadness and anger start to rise.

Now, wanting to be a seemingly joyful, happy or content person is not at all a bad thing. Rather it’s that optimistic, glass half-full type of outlook on life that tends to attract others.

But what place do other negative emotions – like fear – have? Are they to simply be forever locked away in the subconscious realm of our minds? Could any expression of fear or anger or sadness, negative emotions that we so often seek to avoid, have a positive effect?

Fear is one of the emotions we hope our kids avoid. And when they inevitably do happen, we hope they overcome these emotions.

I believe that expressing our emotions, both positive and negative, can, in many cases create a more positive experience than suppressing or avoiding these more negative emotions such as fear.

Children who fear heights might not be the first in line to ride the rollercoaster. If someone fears snakes, they might bypass the reptile area at the zoo. When we fear something, we often try to avoid it. Sometimes, however, we inevitably are forced to come face-to-face with our fears. Or, we are placed in situations where we experience fears we didn’t know we had.

This happens all the time when children have to go to the hospital. For many children, going to see the doctor or coming to the hospital is a new experience. They often fear the unknown or their imaginations create a terrifying image of what is about to happen next. And when children have many hospital experiences and become ‘frequent flyers,’ they develop fears based on what they’ve experienced in the past.

Fears in this type of setting are almost inevitable. Our natural tendency as parents, adults or caregivers is to protect children from these fears by leaving out the scary details or distracting them so they won’t think about them.

However, many times these fears are still present and it is only a matter of time before they surface. So, rather than avoiding these fears to protect children from the hard or scary things, why not help children to process these fears and work through them?

Rather than telling children who might be scared that “there is nothing to be afraid of,” why not talk to children about what they are worried about? We can begin to work through these fears with them, developing strategies for facing fears that they might inevitably encounter, and empower them to overcome.

They may learn that just like in ‘Inside Out,’ fear is not so bad and sometimes needed.

About the author

Cristin D. Herbort is a Child Life Specialist at Cook Children's. Our Child Life specialists work with kids and families to make their visit to the medical center easier and more comfortable. Child Life staff members recognize that hospitalized children still need opportunities to just be kids. They help children and families cope with a hospital experience by providing emotional and developmental support, giving honest information geared to the child's level of understanding and providing fun activities. 

She is obviously looking for some sort of action on my part other than my smiling and nodding affirmatively. Since she’s my number one girl, I’ve learned the idiosyncrasies of her developing speech and know exactly how to handle this request. But to the layperson (or even Daddy or Grammy), I’m fairly certain I would need to come to the rescue with my toddler translator skills.

Mamas, I know you’ve been there. Your 3 year old launches into a monologue you find equal parts incomprehensible and adorable. Adorable, that is, until the tantrums and frantic attempts to understand and obey her demands kick in. In my practice, I have observed some masterful decoding mamas and some skillfully adaptive little ones navigating the waters of communication breakdown. Let’s talk a little bit about speech sound development and when to fret.

Articulation is the movement of the tongue, lips, soft palate and jaw to make speech sounds. It’s also the driving force behind your toddler’s incomprehensible speech. As parents, we are so excited when our little bundles of joy begin talking, but oftentimes, that excitement is quickly replaced with frustration when we realize we can’t understand a lick of what they’re saying.

An articulation disorder occurs when a child has difficulty forming speech sounds, most likely due to a structural or motor-based deficit. Most children tend to have some difficulty with certain speech sounds. Because creating sounds is challenging, he may substitute easy sounds for tough ones (think dumb for thumb), delete sounds (ha for hat), or distort problematic sounds (this is most often noted when children have a “slushy” quality). An articulation disorder occurs if these substitutions continue past the expected age.

Are all sounds created equal? In short, no. Children master sounds gradually. Most children can pronounce all of the speech sounds of English correctly by age 8. While each child’s speech sound acquisition is different, the following are age ranges in which most children master certain sounds:

• Introducing the “early birds”: Most wee ones will use m, n, y, b, w, d, p and h correctly between 18-30 months. That may explain why mama, dada and ball are frequently reported as first words.
• Not to be outdone, the middle of the road sounds includes: t, ng, k, g, f, v, ch and j. You may hear your little one utter these sound appropriately as early as 2 or as late as 6 years of age.
• Finally, the late bloomers include: sh, zh, r, s, z and th. This final pack of sounds contains the frequent offenders when it comes to articulation disorders. They are challenging for children to master and can wreak serious havoc on the clarity of their speech. We expect children to master these sounds between the ages of 3-8. (Based on Shriberg, 1993)

As children get older and learn new speech sounds, they gradually become easier to understand by a wider variety of listeners. Developing clear speech is a journey for our littles, albeit a frustrating one at times. And like all journeys, no two are equal. Some children are clear as a bell by their second birthday while others need a bit more time. As parents, we typically understand our babes before the rest of the world and therefore, are awarded the esteemed role of toddler translator. In many situations, one parent has a better handle on their child’s speech sound system than the other. But, as a general rule of thumb (or rule of “fum” if you happen to be a toddler):

• By 2 years of age children can be understood by familiar adults most of the time.

• By 3 years of age children can be understood by unfamiliar adults most of the time.

• By 4 years of age children can be understood by unfamiliar adults almost all of the time.

• By 5 years of age children can be understood by unfamiliar adults all of the time.

(Based on Flipsen Jr, 2006)

Although a continuum exists when it comes to speech sound development, there are a few red flags to be mindful of when chatting with your child.

It may be time to check in with your pediatrician regarding an evaluation with a speech language pathologist if your child:

• Uses only vowel sounds and a few consonants or shows limited babbling at 18 months.
• Seems to have a “slushy” (think mouth full of marbles) quality to his speech.
• Is difficult to understand and has a history of frequent ear infections.
• Leaves off the beginning or ending sounds of words (hatàha).
• Leaves off entire syllables of words (pa for purple).
• Is not understood by people outside his immediate family by age 3.
• Seems to be frustrated by his difficulty with speech or appears hesitant to interact or respond to peers or adults.

So what can you do to help him along?

Above all, it is important to always show your child you value WHAT he is saying regardless of HOW he is saying it. Always reinforce his attempts at striking up conversation with you! When you hear one of those adorable substitutions, help him to learn by repeating it correctly (If he says “tar” you can say “yes! A car!”) and moving on with the flow of conversation. Play face to face with him so he can watch the way your mouth moves to make sounds. Emphasize beginning and ending sounds in your own speech so he can hear them and begin to realize they are part of the word, too. If all else fails, ask him to SHOW you what he needs. And take comfort in the knowledge that this process is a gradual one.

Oh, and my daughter? She wanted to watch Frozen on the big T.V. and relax a little bit. Obviously.

1. Shriberg, L.D. (1993). Four new speech and prosody-voice measures for genetics research and other studies in developmental phonological disorders. Journal of Speech and Hearing Research, (36), 105-140.

2. Flipsen, P., Jr (2006). Measuring the speech intelligibility of conversational speech in children. Clinical Linguistics and Phonetics, (20) 4, 303-312.

3. http://www.asha.org/public/speech/disorders/SpeechSoundDisorders/

About the author

Amanda Fyfe is a speech-language pathologist at Cook Children's in Arlington and Mansfield. Speech/language pathologists focus on oral motor, speech, language and communication skills to enhance development, restore function and to prevent disability from pediatric conditions, illness or injury. Click here to find the closest Cook Children's Rehabilition Services near you.

What are the most common causes of a runny nose? How do you treat one? When should you call a pediatrician?

Doc Smitty is back with the latest My Kid Minute. Watch the video to find out all the answers.

From birth, your child is undergoing changes at a rapid pace and many factors may influence these changes, including your child’s genetic makeup, the environment in which you raise your child, nutrition, and medical care, to name a few. 

Though there are ranges in which kids attain developmental milestones, a delay in achieving certain skills does not necessarily mean that your child is ‘developmentally delayed.’ One should remember that "normal" is expressed in many different ways.

A child’s body systems can be categorized into motoric, sensory and cognitive components and can encompass a wide variety of changes, not to mention the defining personality and emotional changes that are occurring at the same time.

Typical development does occur in stages and can help you track your child’s progress, as listed below:

• Developmental milestones by age/dimension:
  • 3 months:
    • Physical development: Your baby is beginning to explore his/her environment and will start to push up on his/her arms and lift the head up against gravity for a short period of time.
    • Speech development: As you feed your baby, you will notice he/she will refine his/her ability to suck and swallow, will coo to the sound of your voice and smile, and turn his/her head in response to sound.
    • Play development: When playing with your baby, you will notice he/she will be able to follow toys with his/her eyes and reach for them. Your baby will also be able to position his/her head in the middle during interaction with people/environment.
  • 6 months:
    • Physical development: As your baby gets stronger, he/she will be able sit up with the use of his/her hands, will be able to explore his/her environment with rolling from back to stomach. When you hold your baby, notice that your baby can tolerate supported standing with full weight through his/her legs.
    • Speech development: What an exciting time for progress with your baby’s communication! Your baby will now start to babble in order to get your attention. Make sure to keep cereals and pureed foods handy, as your baby is now ready to eat these items.
    • Play development: ‘Tummy’ time is important during this stage of development and you will notice your baby reaching for objects when placed on his/her stomach, and will be able to hold onto his/her feet during play when placed on his/her back.
  • 9 months:
    • Physical development: Your baby is getting stronger during this age and should be able to sit up and reach for toys without a loss of balance, can transition from the floor to sitting, and can crawl using opposite hand/knee movement.
    • Speech development: During this time, your baby will be able to visually recognize familiar people and toys when named; and will now begin eating mashed table foods.
    • Play development: At this time, your baby will use both of his/her hands to play with toys, and will start mimicking others.
  • 12 months:
    • Physical development: During this time of rapid growth, your baby’s leg strength will truly begin to progress with pull-to-stand movements and walking alongside furniture with two-handed support. Your baby may begin to stand independently and take a few steps!
    • Speech development: Get ready to hear ‘mama’ and ‘dada’ frequently as your baby now will be able to call you by name and will be able to follow 1-step instructions!
    • Play development: With play, your baby will be able to use a pincer grasp to hold onto tiny objects/toys, and be able to grab and release toys/objects; at this time, your baby will also be able to start feeding himself using his/her finger.

Though the above characteristics of movement, speech, and play development are TYPICALLY observed in normal developing babies, do not be alarmed if milestones are not met right on time. Some kids develop at a more rapid rate while others may take more time.

There are some red flags to watch for and may indicate a possible need to make an appointment with your baby’s pediatrician, and potentially be referred to a developmental therapist (physical, speech, or occupational). These include (not inclusive of all signs):

• Stiff movements that are consistent throughout the first 3-6 months
• Decreased arm movement or asymmetrical arm movements that lasts through 9 months
• Rounded back
• Difficulty with or inconsistent visual tracking or lack of turning towards auditory stimuli
• Difficulty putting full weight through legs or needed hand support during sitting at 12 months
• Frequent toe-walking at 12 months onwards

Remember, each child is unique and though it is crucially important to monitor your child’s development, it is also important to allow your child to develop at his/her own pace and realize that ‘normal’ can be defined differently for each child.

[Source: Developmental milestones handouts (Cook Children’s), Pathways Awareness Foundation 2006, endorsed by the American Academy of Pediatrics, revised 09/10]

About the author

Radhika Trivedi, PT, MSPT, DPT, is a physical therapist at Cook Children's. Physical therapy focuses on large motor and functional skills to enhance development restore function and prevent disability from pediatric conditions, illness or injury. Cook Children's offers Rehabilitation Services in Fort Worth, Hurst and Mansfield.

Now she prays for Tre’s caregivers to make her son all better.

Tre, who is 9 years old, has been seen by the Rehabilitation Services team at Cook Children’s since his parents adopted him as an infant. Most of those issues centered on his articulation skills. Tre’s history with Rehabilitation Services started with audiology and other physician specialists; speech therapy services began at 7 years old working on articulation skills. 

Then about 15 months ago, Sara Adams, Tre’s speech pathologist, received a call from Jennifer to say her work with him would have to go on hold indefinitely.

Tre was involved in a horrible boating accident. He sustained a head injury and was in a coma at another hospital. But the miracle for the Faulkner family occurred and within two weeks, Tre was up and walking.

After his accident, Tre returned to therapy at Cook Children's Urgent Care and Pediatric Specialties – Mansfield and worked with Occupational Therapy, Physical Therapy and Speech Therapy to regain skills that were lost after his brain injury.

A year later, much of Tre’s care takes place at the Cook Children’s Rehabilitation Services at Mansfield. The focus is on Tre’s short-term memory loss and his severe ADHD, as a result of the injury.

“God has blessed us so much,” Jennifer said. “The Mansfield community has been with us since the beginning, I’m so thankful. I’m also thankful for the amazing care Tre has received since his injury. At Mansfield, Tre has really been helped in many ways, through his physical, occupational and speech therapy. They have helped him so much with his memory and his balance. It’s truly been miraculous.”

The rehab at Mansfield is working for Tre. Academically, Tre’s test scores are in the average range for a child his age. His mom says he’s learning and making strides every day.

And Tre’s doing very well physically. He recently received his gold belt in karate. Makes sense for a kid who has proven time and time again how tough he is.

“The progress Tre has made since his accident is truly remarkable,” Adams said. “Tre still has some struggles with his attention and memory that impact him every day. However, he continues to improve and learn how to work through these struggles. Tre’s sense of humor, determination, and supportive family are his greatest strengths. Tre is such a funny kid! He loves to tell jokes and riddles. One of his favorite jokes is: ‘Why don’t ducks tell jokes when they are flying? … They might quack up!’”

To see how far Tre’s come since his injury it’s hard not to smile at the miracle that’s occurred and the occasional duck joke.

For more information

At Cook Children's, we provide more than 60 pediatric medical and specialty clinic offices throughout Texas. Thanks to our skilled group of clinicians who support the leading-edge technology found among our specialty services, Cook Children's is the destination when it comes to taking care of your children.

Cook Children's Urgent Care and Pediatric Specialties - Mansfield is located at:

801 Matlock Road

Mansfield, TX - 76063

To make an appointment, call 817-347-8400.

Specialty services at Mansfield inlcude:

• Endocrinology and diabetes
• Gastroenterology and nutrition
• Nephrology and dialysis
• Neurosciences
• Orthopedics
• Pediatric surgery (inpatient/outpatient)
• Psychiatry and psychology
• Rehabilitation
• Urgent care

Time for school, which means shopping for school supplies, meet the teacher night and contracting parasites. Many diseases increase in frequency when you gather school aged children back together again for the start of the year (common colds and strep throat are great examples). Today, I am going to talk about three parasites that tend to cause outbreaks in school classrooms.

Head lice

Head lice are common; some consider their acquisition a rite of passage for elementary school. They are parasitic insects that live on the scalp and cause itching. They are not dangerous but very annoying and can be identified by finding their characteristic eggs (called nits). Less commonly, a caregiver can find live lice moving on the scalp. Treatment most often involves using medicated shampoo. A few tips on treatment:

1. There are many great over the counter shampoos. Follow the written directions closely as too much could be harmful and too little will not be effective. Contact your pediatrician if things are not improving.
2. Many doctors recommend clearing the nits off the scalp with a fine-tooth comb.
3. Many shampoos require a repeat dose in one week.

Scabies

Scabies are less common than head lice. but equally annoying and also not dangerous. The mites that cause scabies burrow down just under the top layer of skin and cause severe itching and a fine red rash. It is common to find the rash on the wrist and between fingers and toes. Diagnosis requires a visit to the doctor who generally makes the diagnosis based on the story and the characteristic rash. Treatment involves applying a cream to the skin to kill the mite.A few tips on treatment:

Apply the cream to all skin from the neck to the toes, not just the area with the rash.Leave the cream on for 8-12 hours (overnight works great).Wash all sheets and towels the next morning on the hottest cycle of your washing machine.Repeat the treatment in 1 week.

Cooties

Cooties are the most common parasite in the elementary age child. All children at one point or another have been exposed to and contracted cooties. Cooties are contracted by close contact with another child of the same age, but opposite gender. Diagnosis is sometimes difficult, but it is pretty safe to assume that all children ages 4-10 are infected at all times. There is no treatment for cooties although it is thought that passing them on to another child does provide some temporary relief.

Thankfully, there is a vaccination for cooties which your child's friend can provide by tracing a circle on your child’s arm and reciting, “Circle, circle, dot, dot…now you have the cootie shot."