The American Academy of Pediatrics (AAP) recommends starting children in swim lessons as young as 12 months old to reduce the risk of drowning. The AAP says always keep in mind that swim lessons are just one of several important layers of protection needed to help prevent drowning.

“You are never too old to learn how to swim,” said Jillian Mitchell, community health program coordinator at Cook Children’s Health Care System. “There are instructors who specialize in teaching adults or co-teach adults and children.”

The National Drowning Prevention Alliance (NDPA) provides parents with a printable questionnaire to help identify the right swim program for their children. They suggest some questions for the program you are looking at, including asking for information about the instructor’s experience, swim lesson curriculum, length and frequency of classes. 

“Choosing the swim instruction style is a personal choice, and it should be an informed one,” Mitchell said.

Before choosing a program, the AAP recommends keeping your child’s emotional maturity, physical and developmental abilities and limitations, and comfort level in the water in mind.

“It is important to consider what unique needs your child has in addition to visiting a school, asking questions about their curriculum or teaching philosophy,” Mitchell said.

Swimming lessons teach the basics of swimming and, for toddlers, it introduce them to get them comfortable with water, teaching them physical movements in the water like kicks and “ice cream scoops” with their hands. It also shows them how to get in and out of the water. Infant Swimming Resource (ISR) teaches infants and toddlers how to roll in the water in emergencies.

When should you sign up a child for swimming lessons?

The AAP says most children are ready for swim lessons by age 4. However, parents of younger children should look into classes that allow a parent or caregiver and child to be in the water together with an instructor, whether swimming lessons or ISR. The AAP explains that by age 4, children can usually learn basic water survival skills such as floating, treading water, and getting to an exit point.

What is Infant Swimming Resource (ISR)?

Parents may feel their child is ready to learn as young as 6 months old. ISR instructors are unique in that they work specifically with infants. ISR focuses on teaching children to roll onto their backs, float, and rest. It is designed to give children instinctive reactions to emergencies if they find themselves in the water unexpectedly. Children learn how to “float, swim, float” until they reach the edge and can exit safely or be pulled out of the pool by an adult.

Cook Children’s recommends asking questions and choosing an instructor/school that fits families’ budget, schedule, and child’s unique needs.

How do parents talk to their kids about the flooding in Central Texas?

First, allow the child to approach you and see what type of questions they have. Let them speak freely and stick to age-appropriate facts, while also validating their emotions or what they might be expressing.

You do not want to give them too much information or detail because they may become more overwhelmed, stressed, and anxious about the situation.

How do you make your child feel comfortable approaching you with their concerns and emotions?

We always want the child to approach us without us putting our perspective into the situation. I would try sitting at the table together, bringing out what they love best. For example, a 5-year-old might like to color, or a 12-year-old may enjoy crafting. Let them take part in the activity and ask them how they feel about the recent events.

 If they do bring it up, this is when you can put them at ease by talking through their feelings. You can tell them, "Okay. Let's do this activity together and as we're doing this activity, let's express how we are feeling."    

Let them guide the conversation. Listening and answering questions age appropriately while reassuring them.

Why is it important to have conversations with your children?

We must talk to them because not talking about it can cause trauma, distress, anxiety and even PTSD. Children might see the news and reflect on themselves, thinking, "It could happen to me."

Parents and caregivers should explain that you are there for them. If the child is going to camp and has concerns, families can come up with a plan to offer reassurance.

What should parents do if their child is worried, but they, too, are grappling with their own emotions?

If you are not ready to have the conversation, we can assist them or have the other parent/ caregiver step in.  It is always great to have someone who is calm and collected, rather than someone who is anxious, overwhelmed and distressed, because you will just pass on that anxiety to the child.

Cook Children’s wants to reassure parents and caregivers that you are not alone. If you are not ready to have the conversation, you can seek professional help.  Learn more about Cook Children's behavioral health services or to schedule an appointment for your child, contact 682-885-3917.

When should you seek out professional help?

 If your child is having symptoms:

• Loss of appetite
• Feelings of overwhelm
• Feelings of helplessness
• Jittery
• Difficulty concentrating
• They are not able to do their daily routine.

Learn more about Cook Children's resources online and behavioral health services.  Families can access mental health resources 24/7 through MHMR by calling 1-800-866-2465.

Summer has begun, which means more outdoor activities and finding ways to cool down. Cook Children's Health Care System experts share tips for parents on how to keep children safe and prepared for the heat, from cooling down at the pool to summer travel safety.

As the 4^th of July approaches, we are sharing the latest drowning data from Cook Children’s Health Care System. As of January 1 to June 18, there were 20 drownings treated at Cook Children’s, two of which were fatal. Most of these patients have been in the 5-year-old and under age group.

So far in 2025, there has been a decrease with 18 drownings and two fatalities. Most drownings in 2025 have occurred in a swimming pool or spa, second highest were bathtub-related.

While most drowning encounters were not fatal, drowning injuries can result in severe effects, especially on a child’s brain development. Drownings can happen silently and quickly. A submerged person might not attract attention or appear to be in danger.

Cool Down: Water safety and drowning prevention

Drowning is the leading cause of unintentional injury and death for children ages 1 to 4 and the second leading cause for kids 5-14 in Texas.  Eighty-eight percent of drownings occur with at least one adult present. 

• Wear swimsuits with bright colors that are easily detectable in water.
• Designate an adult Water Watcher to ensure constant visual supervision of children in and around water.
• Implement 15-minute shifts for Water Watchers.
• No Distractions: The Water Watcher must have no distractions, including conversations, phones, reading, or consuming alcohol.
• Communication is key: Talk with all caregivers (family and friends) about your child’s swim ability or water competency skills.
• Never assume that adults will be watching, but rather verbally confirm it before leaving your child in their care.
• Barriers: Locks, alarms, and pool fences can help keep unsupervised young children from entering swimming pools.

Fun in the Sun: Boating Safety

The risk of drowning in open water triples at age 15. Setting safety expectations with the whole family ahead of time is paramount. Most drowning fatalities in natural water are not related to boating. Texas law requires that all children 13 and under wear a life jacket while on a boat. Cook Children's Health Care System supports over 60 Loaner Life Jacket Stations in North Texas lakes, rivers, and reservoirs. The goal is to make sure no child or adult drowns at a public lake because they did not have access to a life jacket.

• Make sure life jacket usage is mandatory, along with adult supervision.
• Toe In/Vest On Policy: If a toe is in the water, a life jacket goes on.
• Life Jackets: Must be U.S. Coast Guard-approved.
• When your life jacket is on, ensure that it is buckled on your child as directed.  Always. 
• Know water conditions before getting into open water. Water conditions in lakes and oceans can vary daily.  

Heat Safety

Spending too much time in the heat can lead to heat-related illnesses, including heat exhaustion and heatstroke.

• Stay hydrated: Water is best, but other fluids count if they do not include caffeine.
• Hot car danger: Make a habit of double-checking your backseat each time you get out of the car.
• Watch out for hot buckles on car seats, as these can cause burns on your child’s skin.
• Be aware of heat illness. Know the difference between heat exhaustion and heat stroke.

Sun’s Out, Fun’s On

When it comes to sunburn, prevention is key. 

• Use a zinc oxide-based sunscreen with a minimum SPF of 30.
• Cover skin with SPF clothing.
• Apply sunscreen generously and frequently, 15 minutes prior to sun exposure.
• Reapply sunscreen every two hours and after swimming.
• For infants: Keep them out of direct sunlight, especially during peak hours of 10 a.m. and 4 p.m. Keep their skin covered with lightweight pants, a lightweight, long-sleeved shirt, and a wide-brimmed hat. 
• Wear sunglasses: Look for sunglasses that protect your child’s eyes from at least 97% of the UV rays. 
• If you are worried about any burn, even if it seems minor, consult your child’s pediatrician.

Fireworks
Fireworks can cause severe injuries that are both harmful and painful to children. Children should never handle fireworks. Even seemingly harmless sparklers can heat up to more than 1,200 degrees, making them dangerous for young children.

• The safest way to enjoy fireworks is at a professional display.
• If setting off fireworks at home, adults should only set them off in a “kid-free” zone.
• Adults should not hold fireworks in their hands or keep any part of their body over them while lighting.
• Avoid accidental burns: keep children away from bonfires and grills.

Sophia Price, with Cook Children's Trauma and Injury Prevention says Cook Children's Medical Center in Fort Worth reported its first snakebites of the season in late April and early May, including its first copperhead bite in May. In 2024, the Cook Children's Health Care System treated 30 snakebites, with the first reported in March.

Jay Pearson, P.A., a physician assistant with Cook Children’s Trauma Services, offers crucial advice for parents on keeping children safe from snakebites. Price recommends avoiding walking in tall grass and wearing protective boots. She also warns that at night, snakes may rest on warm surfaces like driveways or sidewalks. Price emphasizes that individuals should never attempt to touch or handle a snake, even if it appears dead.

North Texas is home to three species of pit vipers:

• Copperheads
• Cottonmouths (also known as water moccasins)
• Rattlesnakes

A snakebite can cause localized pain and swelling that may spread as venom progresses. Other symptoms can include nausea, vomiting, and an increased heart rate. In severe cases, patients may experience difficulty breathing, low blood pressure, or bleeding disorders.

If a snake bites a child, seek immediate medical attention at the closest emergency department.

What to do if bitten by a snake:

• Do not try to capture, photograph, or kill the snake.
• Do not apply ice, tourniquets, or attempt to suck out venom.
• Immobilize the affected limb and keep it at heart level if possible.

How snakebites are treated at Cook Children's:

Once at the hospital, patients with moderate to severe envenomation may receive antivenom, which is readily available at Cook Children’s Medical Center.

Patients are closely monitored for symptom progression and may require hospital admission for observation and supportive care. 

Breaking Barriers Through Movement

iCan Shine's mission is to provide quality learning opportunities in recreational activities for individuals with disabilities. Through their specialized programs—iCan Bike, iCan Dance, and iCan Swim—participants are empowered to challenge themselves to learn these activities in supportive, encouraging environments. This summer, Cook Children’s will host iCan Bike and iCan Dance in Fort Worth.

Research shows that over 80% of people with Autism and 90% of people with Down syndrome never learn to ride a two-wheel bicycle during their lifetime, yet approximately 80% of iCan Bike participants learn to ride a conventional two-wheel bicycle independently by the end of the five-day program.

Similarly, the iCan Dance program teaches participants complete dance routines that they perform for friends and family on the final day of camp—instilling confidence, joy, and a love for movement.

A Legacy of Success

Lexi Woolsey, 21, will be attending her fifth year at iCan Dance camp this summer. When asked what she loves most about the program, Lexi said, "Getting to spend time with friends, meet new people and learn dances."

Her mother, Kim Woolsey, has been a consistent champion of the program. "I'm impressed with the instructors,” she said. “These kids learn multiple dances in such a short amount of time.”

For many participants and their families, these camps offer more than just the opportunity to learn a new skill—they provide a sense of accomplishment and independence.

"She lights up. Dance is good therapy for her," Kim Woolsey said about Lexi.

Joselyn Arnold, 21, who has been friends with Lexi since they were three years old, has attended both iCan Bike and iCan Dance. Though she’s had great experiences at both, she particularly loves attending iCan Dance with Lexi. She shared her enthusiasm for the program by exclaiming, "I want to marry it!"

Both young women have found the camps to be places where they can express themselves, grow in confidence, and build their friendship.

"Every year that we go, I've seen progress in Joselyn," Brandy Arnold said. "The first year we went, I bawled like a baby because it was so cool to see various kids with disabilities being engaged in something that they love."

A Program for Everyone

The iCan Shine programs are designed to accommodate participants with a wide range of abilities and needs.

"It's for all levels of disabilities," Brandy Arnold emphasized. "It's for everyone, and that's what I think is so inspiring… they leave smiling and feeling confident about themselves."

When asked what she would say to encourage someone to join the iCan Dance Camp, Lexi Woolsey offered this advice: "I would tell them how much fun it is, you get to meet new friends, and don't worry. It's all about having fun."

Parents, who typically wait in a separate room throughout the duration of classes, also find reassurance in these programs’ structure. "We can hear how much fun they're having, so you know they're all well protected,” said Kim Woolsey. “I have absolutely no worries when I am there with her.”

Two Exciting Camps Coming to Fort Worth

This summer, Cook Children's will co-host the following iCan Shine camps in Fort Worth:

●     iCan Bike: June 2-6, 2025 at GameOn Sports Complex

●     iCan Dance: June 23-27, 2025 at Southwest Christian School

Both camps run for five consecutive days, with participants attending 75-minute sessions each day. The camps are designed for individuals ages eight and up, with each session accommodating a small group of participants to ensure everyone receives personalized attention.

Learn More and Register

For more information about the iCan Shine programs, visit their website at https://icanshine.org/.

To register for camp, visit:

• iCan Bike Fort Worth: https://icanshine.org/ican-bike-fort-worth-tx/
• iCan Dance Fort Worth: https://icanshine.org/ican-dance-fort-worth-tx/

Camps for Kids are specialized camps that offer unforgettable experiences – from reeling in a fish to conquering the ropes course. They also go beyond traditional fun as they provide opportunities for campers to build supportive, lasting relationships with others who share similar life experiences.

Each weeklong camp and weekend retreat focuses on a different diagnosis or patient population. The goal is to create a sense of normalcy by providing experiences that help campers learn skills and gain independence. Click here to view a list of summer and weekend camps opportunities provided for eligible patients.  

Camp staff and medical staff work together to operate the camps, which creates a safe environment where kids can simply be themselves and share the magic of camp.

Kimberly Henry, a respiratory therapist at Cook Children's, has volunteered at camps for 18 years. 

Henry says these camps are an opportunity for education and learning more about what's necessary for daily care and health. Campers learn and grow alongside other children like themselves.

“I love the time spent with the campers making sure they are having a great time and learning how to take ownership,” Henry said. “To me, it’s rewarding to turn a child’s thoughts from ‘I can’t do that because I have muscular dystrophy or asthma’ to, ‘I can do that and I have muscular dystrophy or asthma.’”

Liz Barriteau, respiratory patient family asthma and trach educator at Cook Children’s, encourages volunteers to get involved with Camps for Kids. She says the most rewarding aspect of volunteering at Camps for Kids is “seeing the children being set free.”

“My advice is that if you like working with children, just do it!” Barriteau said. “It is very rewarding, and it is for a great cause. Camps need counselors, male and female, in order for camps to function well and safely. Without counselors, there is no Camps for Kids.”

If you’d like to volunteer at a camp this summer, please reach out to that camp’s coordinator listed here.

To donate:
Camps for Kids is a donor-funded program ensuring that all campers’ fees are provided. Each camp is targeted to provide memorable experiences to campers with a similar diagnosis. If you’d like to donate and provide these deserving children an experience that will impact them for the rest of their lives, click here.

As Cook Children’s pediatricians, we are getting the forms daily. And the questions that come along with it.

“Can my kids go to summer camp this year?”

“Are we putting ourselves at risk by letting them go?”

While CLEARING your child for summer camp may be straight-forward for us, deciding whether or not they should attend camp this year can be a much more difficult question for families.

“Over time we will know more about the amount of disease in each community and the risk of being in a group setting at camp. At a minimum, camps have to maintain social distancing, wipe surfaces, enforce hand washing frequently, etcetera - and no high-risk children should attend,“ says Suzanne Whitworth, M.D., medical director of Infectious Diseases at Cook Children’s.

Some camps nationwide are choosing to hold smaller sessions, with fewer kids. Many are imposing daily temperature checks. Some are even requiring a camper be tested for the virus before starting. The American Camp Association has recently put out a lengthy guide for camps to help them comply with CDC recommendations.

Obviously, there’s no easy answer here. But here are some things to think about in making your decision (developed in part by the thoughtful physicians at Cook Children's Southwest Harris Parkway office):

1. How healthy is your child? Do they have any chronic health conditions that would put them at an increased risk of significant illness from coronavirus, such as diabetes, asthma or immune deficiency?

2. How healthy are your other household members? Is there anyone who your child has frequent contact with who is elderly or at increased risk of severe illness from coronavirus?

3. How important is this camp to your child? If it is something they feel ambivalent about, it is probably not worth the exposure. If they have been looking forward to it since last year, it may deserve a serious family discussion.

4. What safety measures is the camp taking? Is there a screening process? Are there attempts at some degree of distancing? What happens if someone gets sick during camp? It is very possible, if someone gets sick at the camp, everyone will be sent home. It’s for this reason if you do send your child, it’s best that your family plan to be available for an unexpected pick-up.

5. If your child gets sick at camp, it could potentially mean the child or family would need to be on home quarantine for two weeks. What impact would this have on your household?

As for my family? My kids are young, 4 and 6. We had plans to attend four daytime camps in Fort Worth, for 1-2 weeks each. We canceled those plans. My kids aren’t emotionally tied to the idea of camp, and while they’ll be a little disappointed, we will find other ways to get outdoors, plan some fun projects, and interact with other kids virtually (if you haven’t tried a Zoom dinner date with another chicken-nugget-eating family once a awhile…try it!).

Stay Safe,

Dr. Diane