It was an incredible event filled with vibrant canvases and delicious bites, but the real masterpiece was the confidence and pride on students’ faces. 

On this episode of Raising Joy, we meet Dr. Jillian Peterson, founder of The Violence Project, a nonpartisan nonprofit that created the largest and most comprehensive database on the life histories of mass shooters. She is a forensic psychologist, professor of criminology and author of “The Violence Project – How to Stop a Mass Shooting Epidemic.”

Her work has helped school leaders, police departments and universities across the nation adopt realistic tools for violence prevention. Listen in to hear what Dr. Peterson learned about mass shooters in her research and what parents and caregivers can do to help prevent the next school shooting.

Raising Joy is part of Cook Children’s Health Care System’s Joy Campaign, a communications initiative aimed at preventing youth suicides. For more information about the Joy Campaign, visit cookchildrens.org/joy.

New episodes of the Raising Joy podcast will be available each Tuesday. It is currently available on all major streaming platforms including Apple, Spotify and Google Podcasts.

To get an excused absence due to illness, please:

1. Contact your school’s attendance office to communicate your child’s absence. 
2. Submit a parent note in writing within five school days of your child’s return to campus. The excuse note should include the following:

• Student Name
• Student ID Number
• A written statement giving the dates and reason for absence
• Parent/guardian signature
• Parent phone number

3. If your child is absent for multiple days, contact your school for the attendance petition process.

From Cook Children’s Medical Center: Symptoms to be aware of and action to take

Like many hospitals and children’s hospitals around the country, Cook Children's is experiencing a surge in patients diagnosed with RSV, flu and other respiratory illnesses. The increase impacts our ability to care for patients in a timely manner.

RSV is a common respiratory virus. Some children require hospitalization, but most do not.

It is NOT necessary for your child to take a strep throat, flu or RSV test before returning to school.

RSV and Other Illness Guidelines for Parents

Parents should NOT go to the Urgent Care or Emergency Department for only a flu or COVID test. See your pediatrician, who can test for flu, RSV, strep throat and COVID. Adults can also use at-home tests or tests at a pharmacy.

Call your pediatrician if:

• If your child is experiencing mild respiratory symptoms but is not having difficulty breathing and is well-hydrated.
• If you need to have your child tested for RSV, the flu or COVID-19.

Seek immediate medical care if:

• Persistent fever for more than two or three days. However, any temperature greater than 100.4 in an infant under two months of age is considered a medical emergency.
• You have concerns that your child is dehydrated.
• In dehydrated babies, parents will see fewer wet diapers or a lack of tears. Their flat spot on the head can also appear more sunken.
• Breathing faster than usual or can see the skin between the ribs being sucked in.
• If your child requires frequent use of their albuterol rescue inhaler or is having worsening asthma symptoms.

Prevention:

• Get the flu vaccine and stay up to date on the vaccine schedule from the Centers for Disease Control and Prevention.
• Get the COVID vaccine and approved boosters.
• Teach your children to cough or sneeze into their elbow.
• Use hand sanitizer.
• If sick, wear a mask in public and stay home.

If your child attends a different district, please call your campus to find out what your absentee policy is.

RELATED

• RSV Decreases While Flu Continues to Increase at Cook Children's (checkupnewsroom.com)
• Prepare Now for Flu Season with Vaccine Protection
• Get Immunized for a Healthy School Year (checkupnewsroom.com)
• Does My Kid Have Allergies, COVID, a Cold or the Flu? (checkupnewsroom.com)

“What’s school going to look like in the fall?” “Should I send my child or keep them at home?”

These are the questions that every parent is probably already asking as school districts roll out their plans for re-opening school in the context of continued COVID-19 cases in our communities. Many schools may present the option for all in person, all online or some blended method. And parents will have to consider what works best for their children.

There have been many stressful decisions in regards to COVID, but this might be the most anxiety inducing one for parents so far. School districts realize how stressful this is for parents and are taking steps to protect their students and your kids.

 “We understand that some of our families are anxious about the new school year so we are implementing strict new cleaning protocols for every campus. That means that schools will be cleaned multiple times during the daytime hours rather than in the evening as has been the practice for many years,” said FWISD Superintendent Kent P. Scribner. “We are also making a significant investment in both Personal Protective Equipment--for both adults and children—as well as cleaning supplies for campuses and other FWISD facilities. The good health and safety of our students and employees remains our top priority.”

The Texas Education Agency released these guidelines for school reopening on July 7, 2020:

• Daily on campus learning will be available to all parents who choose that option for their children
• Parents may be asked to commit to remote instruction for a full grading period but will not have to commit until 2 weeks ahead
• Health and safety procedures should be in place for student and teacher safety

In normal times, making a decision about what your child will do for school in the middle of July would seem way too late, but this year it feels way too early.

Each parent will have to make their own decision but here are some things that it would help to consider:

Childcare and Other Resources

First and foremost, it’s important to consider that children attending school is an important part of allowing parents to work and function in society. Parent’s jobs help secure food, shelter and in many cases provide health care insurance that allow children to receive care when needed. Not all parents can work from home, stay productive and keep a job. In addition, many of our children receive their most nutritious and guaranteed meal during the school year through their school lunch. Schools provide many resources to our communities and children beyond education.

Medical

Healthy children, for the most part, are considered to be safe in the school environment. Children have been more or less spared from severe illness but, as with most illnesses, children with chronic medical conditions are at higher risk for severe illness. Parents of children with medical conditions may learn toward keeping their child in the online environment in order to protect them from exposure. In addition to the child, considerations must be made for other household members and extended family members with whom the child might have contact. If the child will have contact with family members who have weakened immune systems, they could bring the virus home despite not having significant symptoms.

School

Examining the policies and procedures of the school will be another important decision point for families. Is the school district taking the recommendations for safety seriously and attempting to implement them consistently? With kids involved, there will be a learning curve but districts should be considering policies in regards to social distancing, mask use and movement throughout schools at a minimum. The evidence suggests that most schools are taking the threat of COVID very seriously but each parent should make that assessment for themselves.

Educational

April and May taught us a lot about how capable our students were of learning in an online environment. While the school districts will be significantly more prepared for teaching online, there are certain kids for whom it was obvious that the online environment was not going to be the right choice for them. Children who receive services and support at school might have a more difficult time adjusting to life at home without that extra help. For others, they struggle to learn online and in-person teaching might be a better fit. In addition to the child’s learning needs, families must consider their ability to support their learner with their existing responsibilities. Teachers and school staff can help, but students at home will often require some, if not significant, guidance from someone in the home. This is especially true for younger students and those with special learning needs.

Social and Emotional Needs

Some kids have thrived in regards to their mental health with the online learning environment. Many children with anxiety in regards to school or formalized testing had significant improvement in their symptoms as they transitioned to at-home learning. Other students and families needed the structure and activity of school in order to maintain a sense of normalcy. The lack of contact with friends, teachers and other school staff affected them in very negative ways. Another consideration should be the child’s level of concern about COVID-19. Children with significant anxiety regarding the virus could anxiety, depression and other severe health and mental health issues.

Decisions regarding going back to school in the fall are complex. Each parent should consider how the effects of being at school or at home would affect their children and consider that as part of their decision.

For more information on this topic, read the recommendations of more than 50 Cook Children’s pediatricians, led by Medical Director of Infection Prevention, who worked to create guidelines for returning back to school. The AAP released similar guidelines that support opening of schools for in person instruction.

It’s likely the plans for each school will continue to change throughout the rest of the summer. Parents should consider the best option for their children and be prepared for disruptions to occur based on local case numbers.

For more on this topic:

• Cook Children's Physicians Create Guide to Help Kids Safely Return to School amid COVID-19 pandemic
• COVID-19 Planning Considerations: Guidance for School Re-entry (AAP)
• Young Athletes and COVID-19: 'When Can My Child Start Playing Sports Again?'
• TEA Issues Comprehensive Guidelines for a Safe Return to On-Campus Instruction for the 2020-21 School Year

As Texas enters Phase 3 of Governor Gregg Abbott’s plans reopen the state amid the COVID-19 pandemic, bars, restaurants, amusement parks and sports venues are working to welcome back patrons.

But for many parents, their biggest concern remains what to do during the upcoming school year.

Medical Director of Infection Prevention at Cook Children’s Marc Mazade, M.D, hears questions about how to reopen school again on a daily basis from his patient families as well as his own colleagues.

“Everyone kept asking me, ‘Are kids even going back to school?’ I don’t really know what the plan is. I certainly hope schools reopen in the fall, but we have some work to do,” Dr. Mazade said.

Seeing a need for more guidance, Dr. Mazade worked with more than 50 Cook Children’s physicians to create “Recommendations for the Practical, Fair and Safe Reopening of Public Schools K-12 in the State of Texas.”

The doctors involved work in a variety of primary care offices as well as specialty clinics including Infectious Diseases, Emergency Services, Cardiology, ENT, Neurosciences and more. Dr. Mazade expects this to be a long-term plan, with elements in it that allow for looser restrictions based on current Centers for Disease Control and Prevention (CDC) guidelines for community transmission. He sent these recommendations to the governor and hopes to provide it to schools for the upcoming year.

Dr. Mazade admits to being cautious as kids return to the classroom, but he also believes a common-sense, careful approach will allow children the best opportunity to remain safe.

Students from kindergartners to high school seniors tend to tolerate infection better than adults, especially elderly people. Cook Children’s prescreening of asymptomatic children preparing for a medical procedure identified around 1% of children of all ages shedding the virus locally at the time of this writing.

“In order to put children safely to sleep, we have been testing children who are preparing for surgery for COVID-19 infection," Dr. Mazade said. "As feared, some children who have no symptoms are testing positive for COVID-19. That shows us that children with no symptoms have COVID-19 in our community and infection can spread unknowingly from person to person. We are urging everyone to continue to take precautions to keep everyone safe.”

The physicians worked on the document with the health and safety of students, teachers and their families at the top of mind, but they also thought about a common-sense approach to help bring a return of normalcy to kids’ lives.

“We want children to wear masks, but we also understand that’s going to be difficult for little kids,” Dr. Mazade said. “They may not understand why they are wearing masks, and it may cause problems for them emotionally. In those cases, we are asking for teachers and other adults around these children to take the proper precaution to protect younger children.”

It’s important to everyone involved in creating this document that kids are able to be kids. For instance, under the guidelines, athletes will return to the playing field, but that may mean playing in front of only family where everyone can be properly spaced out for safety.

“As we begin to look at these issues that students may face, we begin to focus on more than the spread of the virus,” Dr. Mazade said. “One of the concerns that came up was making sure we were screening kids for new problems such as starvation and hunger. We don’t know who all are dealing with these issues right now. The kid next door may not get enough to eat any longer. We want to think about screening for depression, too. We added those things to the document because it’s important to be proactive because the stresses are new, different, and so widespread.”

“My daughter plays select soccer and can’t afford to take any time off for her injury without the risk of losing her starting position on the team.”

Statements like this are commonplace in my world as a sports physical therapist. And while I genuinely believe that parents and coaches have their minds in the right place when it comes to wanting their child to be the best, the idea that this means you must specialize in your sport early in life is not supported.

Early sport specialization is defined as choosing to play only one sport, often without any breaks during the calendar year, while the body is still changing and growing.

As we are in the thick of another year of the NCAA college football national championship and bowl games, let’s revisit last year’s undisputed national champions as an example of one sport vs. multiple sport athletes. In early 2015, a social media post went viral detailing Urban Meyer’s recruiting record during his time as head football coach at Ohio State. Of his total of 47 recruits, 42 were multisport athletes in high school. Only 5 of his recruits played football alone.

Did you know?:

• Three-time Super Bowl champion, NFL Hall of Famer and Dallas Cowboys Ring of Honor inductee Troy Aikman played shortstop and pitched on his high school baseball team. He was drafted by the New York Mets out of high school and came close to choosing baseball over attending the University of Oklahoma, and later UCLA, to play football.
• Two-time women’s soccer Olympic gold medalist and 2012 FIFA World Player of the Year Abby Wambach credits her success as a soccer player to playing basketball in her youth.
• Eight-time NBA All Star and two-time NBA MVP Steve Nash did not start playing basketball until he was 12 or 13 and instead thanks his soccer background for his success in basketball.
• Six-time MLB All-Star Joe Mauer of the Minnesota Twins played football, basketball, and baseball in high school and was named USA Today High School Player of the Year in multiple sports.

An athlete like Tiger Woods, who started playing golf before the age of 2, is an extremely rare occurrence. It is by no means the norm and should not be expected.

In theory, specializing makes sense. After all, practice makes perfect, right? Wrong! In reality, research has shown the following:

Early specialization leads to overuse injuries.

More and more orthopedic experts are speaking out to shine light on the world of pediatric sports injuries. They have become increasingly alarmed by the skyrocketing rates of injuries in kids and some go so far as to describe it as an epidemic. Each year, roughly 3.5 million children, 14 years of age and younger seek medical treatment for sports injuries.

Of these, at least half can be attributed to overuse injuries. Repetitive activity leads to increased stresses on a growing child’s bones and muscles and can result in injuries such as Little League elbow, Little League shoulder, shin splints, Sever’s disease, Osgood-Schlatter disease, runner’s knee, jumper’s knee, or even stress fractures in areas like the back (spondylolysis or spondylolisthesis), hips, and feet.

So what’s the first line of prevention? Rest. Children should have at least two months off each year to recover from their specific sport. And if we’re talking about baseball, it’s recommended for those athletes to have three to four months of absolutely no throwing or overhead sports.

Early specialization interferes with healthy growth and development.

Playing a competitive sport is stressful, and just as the body must adapt to the changes and demands physically, handling the stresses around winning, losing, practice schedules, traveling, etc… in addition to regular schoolwork can be emotionally draining as well. Children may also struggle with identity and view themselves as solely an athlete. Playing a wide range of sports promotes diverse relationships and allows for a wide variety of experiences.

Early specialization increases the risk of burnout.

Playing only one sport, especially at a competitive or select level, can lead to burnout as a result of stress and physical and emotional demands. A history of injuries can also increase that anxiety. If a sport stops being fun or a child feels pressured to succeed, it can certainly lead to a desire to quit.

Early specialization reduces the chance that children will maintain an active lifestyle as an adult.

In 2013, researchers from The Ohio State University released a study that found that children who specialized in one sport early in life were more likely to be inactive as adults. Committing to a certain sport at too young of an age can lead to early burnout, quitting, and being reluctant to then rejoin physical activities as an adult. A history of injuries also contributes to an aversion towards exercise and a preference for a sedentary lifestyle.

Early specialization doesn’t guarantee future athletic success.

Consider these statistics from the NCAA regarding athletes during the 2013-2014 school year.

                              Estimated Probability of Playing in College

                           Estimated Probability of Playing Professionally

When you look at the numbers, the odds of playing a sport in college and especially professionally just aren’t in your favor.

So what does this mean for our kids?

• No, we shouldn’t put them in a bubble and shield them from sports. Athletic activity is extremely important.
• Children should learn the fundamentals of various sports and enjoy the experience.
• Sports should be fun at every age.
• Sports should create positive habits for later in life.
• Sports shouldn’t cause repetitive injury.

And if your child happens to be one of the lucky few who go on to play in college or even professionally, a history of playing multiple sports is clearly of great benefit.

About the author

Melissa Bro, PT, DPT, SCS, is a physical therapist for the Cook Children's SPORTS Rehab program. Our physicians, therapists, nurses and technologists work exclusively with kids and understand the unique needs of a growing athlete's bones, muscles, body and mind. As a part of Cook Children's integrated pediatric health care system, our patients have access to a multitude of pediatric specialty areas with board certified doctors, as well as laboratory services, nutritional consultations and sports medicine counseling.

According to a lawsuit filed by the American Civil Liberties Union (ACLU) on Monday, the deputy violated the rights of two children when he shackled the kids around their biceps in the fall of 2014. The boy and a 9-year-old girl had both been diagnosed with attention deficit hyperactivity disorder (ADHD). The lawsuit alleges that both children were being punished for behavior related to their disabilities.

ADHD is a common challenge in classrooms across the country. So what should parents and teachers do to prevent a child from becoming too unruly to handle? Lena Zettler, director of Psychology at Cook Children’s, suggests the following:

• Have a plan
• Have a team
• Have an advocate

“What are the steps that will be taken and who are the key people involved? These things should be understood before an emergency happens,” Zettler said. She says it’s important to remember that kids with ADHD most likely aren’t acting up for attention.

“Education is the first step for treatment for ADHD. It’s is a neuro-developmental disorder. It is not a disorder of bad parenting,” says Zettler.

Students with disabilities make up 12 percent of the student population nationally. According to the U.S. Department of Education, they account for 75 percent of the students who are physically restrained by adults in their schools. To prevent such drastic measures from being taken, parents who have a child with ADHD should have a conversation with their child’s teacher about the condition before the school year begins.

Together, parents and school officials need to put a team in place to assist in the child’s education and plan out what will happen when the child acts out.

Parents and school officials also need to designate an advocate, someone the child can turn to for help. The advocate could be an assistant teacher, a counselor or even a principal. By putting a team together and a plan in place, parents can help ensure ADHD children and their classmates get the most out of the school year.

“Taking these steps will not only benefit a child with ADHD, they will help the entire class,” says Zettler.

Does what you think about your children change the way they turn out? How about the way children’s teachers think about them? Could you be unknowingly setting your children up for failure by the way that you think and talk about them? It is difficult to find studies that directly address this question, but there is some interesting, related research.

In 1968, Robert Rosenthal and Lenore Jacobson set out to show that teachers' expectations of students could change how they performed. The thing I love about this study is how it was designed and carried out so beautifully. 

First, they went into a school and performed IQ testing on all the students. They called the test, "The Harvard Test of Inflicted Acquisition." The brilliant thing is that they told ("lied to") the teachers that the test not only assessed IQ, but could also predict which students were ready to make rapid, above average gains over the next year, regardless of their current performance (they called these students “spurters").

The teachers were then told which students were designated as spurters (these students were randomly selected and had nothing to do with their test scores). Thus, the only real difference between the spurters and their classmates was their teacher believed that certain kids were ready to make rapid intellectual gains over the next year.

So, what happened?

The average increase in IQ for the “spurters” was 12 points while the average increase for everyone else was 8 points. In addition, about half of the spurter in first and second grades had an increase of over 20 points. Even more striking were the teachers’ subjective assessments where the spurters showed significantly higher reading grades, scores for intellectual curiosity, behavior and likelihood of future success!

There are lots of possible explanations for these results, but the most commonly held (and likely) belief is that the teachers’ ideas that the child was a spurter changed the way they interacted with and taught that student. Perhaps they were a little more patient when they didn’t understand because they knew they were on the cusp of a big breakthrough. Or, maybe they challenged the student a little more thinking that they should be able to do more. Can you think of any other ways their behavior might have been changed?

This effect of self-fulfilling prophecy whereby the teacher’s positive expectations of the students actually improved their outcomes has come to be called the Pygmalion effect. Pygmalion was a character of Ovid who sculpted a statue of a woman that was so realistic that he fell in love with it (this is ridiculously simplified and changed to a rated G version, you can read the full version on the Wikipedia page if you like). The alternative to the Pygmalion effect is the golem effect whereby negative expectations of others can actually lower their chance of success.

The study isn’t perfect and with studies like this, you can’t make the data fit any situation. However, I do think that there are some pearls of wisdom we can take and apply to our own kids.

1) Avoid the golem effect - I commonly hear parents saying statements like, “He’s soooo bad” about their kids. They usually say them in a joking manner and most are careful not to say them in front of their kids, but not always. And, according to the golem effect, it doesn’t really matter. Continually thinking and speaking about your child in a negative way could change the way that you interact with them and even what you expect from them in a harmful way.

2) Strive for the Pygmalion effect –Speak well of your children and their abilities in front of them and when they aren’t around. Hearing your positive words will not only have a positive impact on them, but can also change your parenting ability with them in a good way. Challenge your kids with something a little harder than you think they can do. Of course you don’t want to make it so hard that it’s overwhelming. That just leads to frustration for everyone. But don’t let them stay at the same level for weeks and weeks without pushing them to do more.

3) Convince others that your child is a spurter - Believe it or not, teachers pass along messages about their students through the years.  This is especially true in the younger ages when warning other teachers about potential problem students ... Not all teachers do this (sorry to my great teacher friends out there). Imagine what this does to these students when a teacher has a negative expectation of a student to begin the year. 

So, what do we do about this? Think about these two scenarios…

A) Child who struggles with math (or any other subject): Spend some time over the summer working with your child in their trouble spots. Get them some tutoring or work with them and get them up to or a little above grade level. Then, have a conversation with their new teacher that goes something like this: “Billy has really struggled with math in the past but we’ve been working on it all summer. He has really come a long way.  We did x, y and z and his tutor says that he has really been progressing very quickly especially over the past few weeks.  We are convinced that this is the year he will really get math and it might even become one of his best subjects.”

B) Child who struggles with behavior and being in trouble: Pick 1 or 2 problem behaviors that your child has developed. Some examples might be: impulse control, talking out of turn, talking back or any other number of things. Work hard to improve those specific behaviors. Don’t try to fix everything all at once … it probably won’t work. If you need to, enlist some help from a private counselor or the school counselor, figure out a few simple strategies that help the child out.  Then have this discussion with his teacher: “We all know that Billy has struggled with (x) in the past.  But, we’ve been working hard on it and have come up with a few things that really help him to control (x).  He has shown such great progress and we really feel that this is a breakthrough year for him.”

So, help your child become a “spurter” and help them improve by having positive expectations for them.

About the author

Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.