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MyCookChildren's Patient Portal

Hospitals can be complex to navigate, especially for the health care novice, but family friendly tech features integrated into every inpatient room at Cook Children’s Medical Center - Prosper keep children and families in control of their hospital experience and make their health care journey easier. 

While these rooms appear much like any hospital room, the technology that powers them puts everything the patient may need or want during their stay right at their fingertips, from access to their health information to conducting a telemedicine visit with a specialist to ordering food and selecting in-house entertainment. And it can all be viewed and operated from the patient or family’s own smart device through an easy-to-use app, or from the television in each patient room.

When designing patient rooms for the Prosper facility, which opened in January, Cook Children’s wanted to match the innovation that patients and families experience at every turn throughout the facility, from the life-size digital display in the front atrium to the operating rooms equipped with technology that allows real-time remote viewing and physician collaboration. The teams designing the rooms, particularly the technology behind them, conducted extensive research and asked patients and families for feedback on what tools would make their stay easier.

“The majority of ideas we heard centered around empowering patients and their families to have more control of their stay and experience, having clear and concise communication and a better understanding of who was a part of their child’s care team,” said Nicole Yowell, digital products manager for the inpatient experience and leader of Cook Children’s Virtual Health program.

All of these features and many more were built into an app for patients and families that puts control of their experience right in the palm of their own hands.

Complimentary Care

When families download the app during their hospital stay, they can view and interact with much of the behind-the-scenes workflow involved in their child’s care. If, for example, the patient is awaiting lab results, families can view those results in the app once they are posted in their child’s electronic medical record. They no longer have to rely solely on a nurse or other provider to update them, giving waiting families better access to their information.

“The goal is really to bring visibility, from a patient and family experience perspective to everything that the staff is doing,” said Danika Meyer, product owner for patient experience at Cook Children’s. “So when we think about our clinical strategies for informing patients along the way, a lot of that is dependent on interactions with our care team, which is a huge part of what we do. We didn’t necessarily want to take any of that away, but more so compliment it with the technology already available to us so that families aren’t kept waiting longer than necessary and our clinicians are better supported to focus on patient care.”

Features like an in-app TV remote, food service link and much more allow patients to access creature comforts when and how they want them for a customized, individualized experience.

“A lot of times in health care, if not all the time, everybody's thinking in terms of outcomes like an illness has been cured or a wound has been healed, and a lot of the softer side of things is overlooked,” said Lesley Wager, director of digital products at Cook Children’s. “But our outcomes are also about the experience and the journey, right? The stuff that parents and kids are going through is scary, and while a little bit of a delight feature that we add in any of these rooms or in our apps might not change the fact that their bone was mended. It does help the general overall outcome for their mental health and their emotional wellbeing. That's incredibly important to us.”

Room Service

In addition to the app, the communication portals in each patient room are fully digitized and populated with information in real-time.

Traditionally, in-room whiteboards are used to communicate information about the patient’s care team and daily schedule. They have to be updated manually by a nurse or patient care technician using a dry-erase marker. 

The new generation of whiteboards at Cook Children’s - Prosper are both digital and interactive. In addition to information on the patient’s care team, they display mobility and pain scores, educational assignments and completion, meal times, food offerings, room temperature control, interactive requests for assistance and hospital information sharing. 

Outside of each room, digital door signs use icons to communicate important patient alerts such as fall precautions and isolation procedures to the patient’s care team, family and visitors so they can take the appropriate safeguards before entering a room.

“The patient-centered room is the digital room of the future, allowing patients and families to interact seamlessly with technology through the digital whiteboard in the room for patient care information as well as the ability to watch TV, stream movies and play games,” said Gina Basham, Cook Children’s assistant vice president, Inpatient Clinical Apps. “In the future, we hope to expand these in-room technologies to include patient schedules and further interaction with MyChart beyond just the mobile app. Incorporating these features is in keeping with our commitment to do everything for the child.”

Collaborate and Communicate

Integration between multiple tech platforms, and collaboration among several health system departments and tech vendors, help make the app and other patient communication tools the seamless supporting players for the care and comfort of patients that they are. All of these innovations talk to and inform each other.

“We had to do a multi-level integration across multiple technologies so that when something happened in one, it triggered a workflow in another,” Yowell explained.

For example, when a nurse is assigned to a patient in the electronic medical record, that information also flows to the nurse call system as well as the in-room digital whiteboard and the patient’s TV. This eliminates the need for nurses to write on the whiteboard who they are at each shift change, so the patient is informed about who is caring for them before they even enter their room.

These tools help Cook Children’s communicate with and care for a tech-savvy generation in the way they prefer to consume information. But, should a patient not have access to a personal device or care not to use one, there are multiple ways to communicate and access the information and features offered in the app.

Telemedicine appointments with specialists can also be streamed on the TVs in patient rooms, giving patients access to specialists all across Cook Children’s Health Care System. When a middle-of-the-night consult is needed, these features allow physicians to conduct a telemedicine visit from their home. Eliminating the need for a physician to make a late-night trip to the hospital when it isn’t necessary gives patients quicker access to care and saves the physician time, energy and sleep for their next busy workday.

After Your Stay

Use of the app isn’t limited to the inpatient stay. After a patient gets home, access to the app remains available to inform and empower them in the next phase of their health journey. Parents can view their child’s discharge instructions, medication list, information about their care team and follow-up care, for example, and have this information at their fingertips to share with their child’s primary care physician, who may or may not be a Cook Children’s doctor.

When patients are empowered with tools and information that make their lives easier, they’re more engaged with their care and more confident in their health journey, all of which health tech experts say lead to better overall outcomes.

“At Cook Children's, we talk about creating moments of magic and this definitely brings some magic to the experience for the patient and their family,” Yowell said. “It really is based on improving outcomes for their physical health and mental and emotional wellbeing by providing them the information that they need to make educated decisions and really understand what's going on in their care, along with giving them some delight features that make their time with us more comfortable.”

With more kids at home and without a lot to do, it’s not surprising most of us have eased up on our screen-time restrictions during the current COVID-19 pandemic.

However, statistics show it’s now more important than ever to be aware of what our children are doing online.

Tragically, the National Center for Missing & Exploited Children (NCMEC) report a significant increase in online child sexual exploitation.

Specifically, CyberTipline reports a 106% increase of suspected child sexual exploitation in March 2020 (2,027,520 reports) as compared to March 2019 (983,734 reports).

The greater amount of time a child/teen is online, along with the amount of free time now available to them, increases the risk that individuals may attempt to coerce kids into providing sexually explicit images or videos.

Perpetrators attempt to make casual contact in hopes of gaining a child’s trust and developing an online sexual relationship. Often these criminals threaten the child/teen in some manner to maintain compliance.

Unfortunately, children/teens are often so embarrassed that they were naïve and enticed or coerced to engage in these behaviors that it prevents them from coming forward. So it is imperative that they understand this was not their fault, they are not in trouble and by reporting they are actually helping others.

It is critical to keep in mind that reporting suspected sexual exploitation could help minimize or stop further victimization. If you suspect or know someone is a victim of child sexual exploitation you can:

• Contact your local law enforcement agency.
• Contact your local FBI field office.
• File a report with the National Center for Missing & Exploited Children (NCMEC) at 1-800-843-5678 or online at www.cybertipline.org.

Diabetic alert dogs like Journey are specially trained to detect high or low levels of blood sugar for kids like Hannah. Journey was Hannah's constant companion for the past three years and news reports say they went "everywhere" together: school church and camp.

"(Hannah) is struggling, but hanging in there," Hannah's mom told ABC news. "She has an amazing support system."

As one of Cook Children's endocrinologists, this story hit me especially hard. I see some amazing kids every day who are coping bravely with diabetes.

The story also reminded me of time I met Kyle Cochran (@KyleCochranANW) who was kind enough to volunteer at Camp Aurora one summer. Cook Children’s diabetes staff strongly support this camp, and many of the children attending are patients at Cook Children’s.

Kyle has lived with diabetes for most of his life and has competed at a very elite level in American Ninja Warrior. He uses both his diabetes service dog, Leeloo, as well as Continuous Glucose Monitoring (CGM) technology to closely track his blood sugars during high intensity training and competitions.

I asked Kyle to share unique perspective.

Why did you decide to get a diabetes alert dog?

Kyle: I decided to get a service dog because during my training I tend to drop really rapidly. I needed to be warned of the drop much sooner to avoid missing training time to treat a low. Leeloo alerts me before I even get low so I can treat the low and never have to pause the workout.

How do you use both Leeloo and CGM together?

Kyle: I love using Leeloo alongside my CGM. She is great at catching highs and lows before they even happen and the CGM is great for letting me see the exact number I’m at.

What advice do you have for a person or family considering a diabetes alert dog?

KyleThe advice I would give to people is to realize the HUGE responsibility it is to have a service dog. It’s kind of like having a child since you bring him/her with you everywhere. You must remember basic things such as ensuring enough food and water, avoiding over-heating, and dog bathroom breaks.

You will be asked questions about them EVERYWHERE you go. Training never ends, You must have more patience than you’ve ever had. I suggest buying the book, "Training Your Diabetic Alert Dog” and read the whole thing before getting a dog.

How do diabetes dogs help?

The high blood sugars and especially low blood sugars are a major concern for people with diabetes and their family. Low blood sugars in particular can lead to loss of consciousness and seizures. Any assistance in avoiding extremes in blood sugar is important and helpful in improving quality of life and keeping blood sugars in target range.

It's believed that the keen sense of smell is the key in blood sugar detection. A research study showed s dogs could sense blood sugar levels in sweat samples.It's possible that diabetes alert dogs (DADs) sense changes in the appearance, heart rate, or breathing associated with changes in a person’s blood sugar.

Technology vs Dog

Continuous glucose monitoring (CGM) technology continues to improve and has the ability to identify low blood sugars correctly in 90 percent or more cases. Given the cost and commitment of a diabetes alert dog, a prime question to be answered is how diabetes alert dogs compare to CGM reliability.

There is surprisingly not much information regarding alert dog reliability. Most of the information is comes from small sample size research surveys or reports. There are wildly differing reports on dog sensitivity to detect hypoglycemia ranging between 22-100 percent in a compilation of reserch studies.

Final Thoughts

It will be interesting to see if a research study is done to compare head to head dog vs CGM. One of the prime concerns regarding diabetes alert dogs is the quality/consistency of training. In the meantime, I agree with Kyle’s viewpoint. I believe the decision to choose a diabetes alert dog is very personal and needs to be researched before making a huge, expensive commitment. 

Finally, I want to dedicate this post to the memory of Sam. My mountain dog buddy.

Get To Know Joel Steelman, M.D.

Dr. Joel Steelman is an endocrinologist at Cook Children's. He grew up a military brat, on the move every three to four years, to a new home, in a different state. Nevertheless, his family roots remained in Texas, where he finished high school and developed a love for writing, working on the school newspaper and yearbook. He attended Texas A&M University both for his undergraduate and medical degrees.

When Patti Wilson was pregnant with her daughter Melanie in 1980, health care and technology looked a whole lot different than it does today.

Routine sonograms did not exist and there was no way for expectant mothers to know whether anything was wrong with their baby until the child was born. Up until labor, Patti’s pregnancy had been text book and no one had any reason to suspect anything was wrong with Melanie.

However, on June 3, 1980, when Patti went into labor, everything changed.

Doctors began noticing Melanie’s heart would stop every time Patti had a contraction. They originally thought the umbilical cord was wrapped around Melanie’s neck, but after an emergency C-section was performed, Patti and her husband learned their newborn baby girl was facing a life-threatening diagnosis.

The day after Melanie was born; she was transferred to Cook Children’s, which was called Fort Worth Children’s at the time. The prognosis Melanie’s parents received was bleak.

At 5 days old, Melanie had her first heart catheterization. This first procedure allowed doctors to diagnose Melanie with a combination of congenital heart defects that included transposition of the great arteries, ventricular septal defect and pulmonary stenosis. She would need multiple procedures to fix the structural abnormalities in her heart but the catheterization temporarily fixed the problem to postpone surgery as long as possible.

Melanie was a year old when she had her first open heart surgery at Cook Children’s. The procedure was called the Rastelli procedure and the surgeon performing the surgery had practiced under Giancarlo Rastelli himself before coming to Cook Children’s. Throughout her life, Melanie had additional surgeries at 3, 10, 16 and 27 years old. She also underwent multiple heart catheterizations and procedures.

Over the years, Cook Children’s has become a home away from home and Cook Children’s cardiologist Richard Readinger,, M.D, , who has followed Melanie since she was 8 years old, feels more like a family member a doctor.

When asked about how her diagnosis affected her life as a child, Melanie said it was all she ever knew. She learned about her diagnosis as a child learns most things – by experiencing it as time goes on. At age 11, James “Hud” Allender, M.D., another Cook Children’s cardiologist, sat her down to explain that her mom may not always be with her if there is an emergency and she must know and understand her own diagnosis. It was at this point that Melanie remembers truly understanding what she had been coping with up until then.

Since her last procedure at age 27, Melanie has had no complications. Even though she’s an adult, she continues to be followed by cardiologists at Cook Children’s who are skilled in treating patients of all ages with congenital heart defects. With the continued advancements in pediatric cardiology, children with congenital heart defects are not only surviving, but growing up to become adults who lead rich, full lives. Cook Children’s Adult Congenital Heart Disease program is one of only a few formal programs nationwide to offer inpatient and outpatient care for patients from the moment they are born all the way into adulthood.

But the story doesn’t end there.

Due to Melanie’s diagnosis, she was told that pregnancy would likely be too risky. Her doctors were unsure if her heart would be strong enough to carry a baby to term.

But, some things are left to fate and Melanie began to have vivid dreams that she was feeding twin girls that she knew had to be her own. She would wake up absolutely bewildered because she knew it wasn’t a possibility. Fast forward a few weeks and Melanie and her husband found out the shocking news that she was pregnant.

Melanie immediately made an appointment with Dr. Readinger where he performed an EKG, echocardiogram and an exam and said, “It’s the strangest thing. Your heart appears to be in the best shape it’s ever been in. If you’re going to have a baby, now is the time.” The sonogram revealed that Melanie was actually pregnant with twins as her dreams suggested. Unfortunately the one baby’s heart never fully formed and at 8 weeks another sonogram revealed that the baby had been absorbed.

Having wanted to create a girl name from two men’s names, Melanie and her husband already had a plan when they found out 15 weeks into the pregnancy that they would have a baby girl. Rossleigh is named after her great grandfather, Ross, and her grandfather, David Lee.

Melanie’s pregnancy went smoothly physically, but it was incredibly draining emotionally. At the beginning, Melanie and her husband felt as if they were only receiving disheartening news. At week 18, the couple was informed that there was an issue with Rossleigh’s heart and the perinatologist could only see one kidney. Luckily, her second kidney would be detected on a later sonogram.

At week 22, a fetal echo was performed at Cook Children’s where cardiologists could diagnose Rossleigh’s heart defect while she was still inside Melanie. Fetal echocardiography didn’t exist when Melanie was born. A fetal echo allows doctors to see a baby’s heart while it’s still in the womb. Doctors can make the diagnosis and work with the surgical team to come up with a treatment plan even before birth. This technology gives the gift of time, both for the surgical team and for the family.

When the fetal echo was performed, Rossleigh was originally diagnosed with Truncus Arteriosus with a ventricular septal defect but at birth, that diagnosis would change.

Rossleigh Claire Dewey was born on Sept. 26, 2012 and was immediately transferred to the Neonatal Intensive Care Unit at Cook Children’s. An echocardiogram would show that her diagnosis was actually Tetralogy of Fallot and pulmonary atresia. Only five days after birth, Vincent Tam, M.D., Cook Children’s medical director of Cardiothoracic Surgery, operated on Rossleigh’s heart. She stayed in the hospital for 29 days, ironically, in the exact same surgery recovery room that Melanie had stayed in after her most recent surgery, and has had no procedures since. She could end up needing another procedure in her teenage years but right now, she is living life like any other 5 year old.

The bond between a mother and daughter is always special and unique, but Melanie and Rossleigh’s bond is even more unique because of their shared experiences.

These days, because both Melanie and Rossleigh are still being followed by Dr. Readinger, they have annual mother-daughter cardiology appointments. Melanie said that while one is getting their echo, the other will hang out in the waiting room and vice versa. A unique mother-daughter experience that most don’t have to share but they make the best out of a tough situation.

The Dewey family is forever grateful to Dr. Readinger and the care and compassion that he has shown both Melanie and Rossleigh throughout their medical journey. Melanie bragged on his ability to appropriately explain and literally sketch out the most complicated situations to both generations of heart patients.

Even though nearing retirement age, Dr. Readinger wanted to be the one to treat Rossleigh so that he could be involved in both of their care. He has made a great impact on their lives and the family is forever thankful.

As Melanie reflected back on everything she’s been through, she explained, “I have such a unique viewpoint going into this situation. I’ve been on both sides, as a patient who was scared to go into their own heart surgery, as well as the mom of a child with heart issues. Both are frightening in their own ways but I was able to gain the courage to push through these circumstances because of my faith and an amazing team of skilled doctors in nurses.”

As we look back over Cook Children’s 100 year history, Melanie’s story is proof of not only how many medical advancements have been made but how things are literally changing each and every day. If Melanie was born 10 years earlier, the Rastelli procedure wouldn’t have existed and she would have died as an infant. However, if she was born 10 years later, she would have been able to undergo a newer procedure, at the time, called the Nikaidoh procedure where they could easily switch the two sides of the heart. It’s likely she would have needed just the one surgery rather than five. Plus, she would have had the added benefit of the experience of Dr. Tam and Hisashi Nikaidoh, M.D, who created the procedure, and have the largest combined experience of aortic translocations in North America.

These advancements are even more apparent with Rossleigh’s journey thus far.

All of these medical advancements are not taken for granted at Cook Children’s and we know that we could not have made these strides without your help. Our generous donors and supportive community allow us to help Melanie and Rossleigh to live their lives to the fullest, despite their complications. As you join in our celebration of 100 years, remember who we are really celebrating – patients like Melanie and Rossleigh, and also, you. Thank you for being the 1 in our 100.

Celebrating Cook Children's Centennial

Cook Children's is turning 100 and will be celebrating all year! Don't miss out on the fun throughout 2018. Enjoy unique stories, parades, special guests, and community events across Fort Worth. We hope that you can share in some our celebrations because you're the 1 in our 100!

Celebrate with us

1.Technology

2.Newborns

So, you might not be surprised to hear that a new tool for evaluating jaundice using a smartphone definitely activated my nerd alert.

Jaundice is a high level of bilirubin in the blood. Yellow skin is a reliable sign, but diagnosis is made with a blood test to measure the bilirubin level.

BiliCam is a smartphone enabled app which helps to measure a baby’s level of jaundice (bilirubin) by taking a picture alongside a calibration card which is then uploaded and analyzed.

The good news is that those measurements were found to be close to those drawn from the blood and, most importantly, were accurate in measuring infants with bilirubin levels over 17 (which is near the level at which treatment would be necessary). Currently, children who are on the border requiring phototherapy might require frequent visits to the doctor for blood draws to assess their jaundice levels. A non-painful option that could be done by the parent at home would be amazing.

BiliCam is just one of a number of rapidly expanding uses of technology in parenting a newborn. Starting with BiliCam, here are 4 technological advances in newborn care and my review:

1.BiliCam

I love the idea and I really think it could be useful. But I found a couple of problems right now. I can’t figure out how to implement it in practice. As far as I can tell, it's not commercially available at this time. Another problem is that it requires parents to have a card. I suppose I could keep them at my office for those babies who I’m sending home that I know will need a screen but, otherwise, if they need to be screened, they’ll have to come and pick up a card (which kind of defeats the purpose).

Overall Rating: B-

2.Respiratory and other vital sign enabled-monitors

We’ve written about these before, but I feel like a new one comes out every month. Every time I publish this story, there are people who comment about how much they loved theirs. But there are also people who echo my concern that they caused tremendous anxiety. Because of this and because there is no proof that they prevent bad things from happening to your child…

Overall Rating: C-

3.Baby tracking apps

Do we really need to know every time your baby poops, pees or feeds? Probably not. But I have found them to be helpful when babies are having trouble gaining weight. I’ve also seen parents use them to help their baby find a more predictable feeding schedule. With very little risk and the benefit of giving my accountant parents something to do…

Overall Rating: B+

4.Your smartphone camera

While you may not find this particularly groundbreaking, I have found it to be one of the best technologies for newborns. Whether it’s taking a picture to track head shape changes or birthmarks or if it’s for connecting with me for a live telemedicine visit that allows parents to stay home with their newborn, a lot of information can be gathered based on the quality of photos that can be taken.

Overall Rating: A

What are some other technologies you used during the newborn period? What other technology would you like to hear more about in the near future?

I am against giving phones as gifts because a gift signifies ownership. It has been made clear in our household that when he does receive a smartphone, it will be a privilege, not a gift, and the phone will belong to me and his mother, on our plan, paid for by family funds. Before we go further, please understand that my wife has a Juris Doctorate and was a practicing attorney prior to having children. So, my kids are well versed in making sound arguments.

With this in mind, he did come at us with a well thought out argument. He expressed his understanding of certain rules we have shared with him from previous queries, listing would-be imposed limits and other restrictions. He eloquently delivered his argument with style and grace – and then my wife and I used even more eloquence to deny his request with mutual style and grace. Although we have shared our age restriction with him in the past, I suppose he didn’t see any harm in trying. Our agreed upon age for his first phone is 12.

Giving him a bit of credit for his argument, I decided to do a little more research from angles outside of my expertise. I found several articles on the subject. A new report from Influence Central’s 2016 Digital Trends Study titled, “Kids & Tech: The Evolution of Today’s Digital Natives”  found the average now for getting a first phone is 10.3 years old.

With what I do for a living, and as a parent, I found information from the report interesting:

• Twenty-seven percent of parents now use online programs to control and filter sites or platforms, compared to 23 percent four years earlier. Parents, I highly recommend doing this. Click here and see the helpful links to learn more on my thoughts on this topic.
• Not enough parents are using smartphones’ GPS to track down their kids, but parents are catching on – the number increased to 15 percent in 2016, compared to only 7 in 2012.
• Fifty percent of kids have social media accounts by age 12 and 11 percent got a social media account when they were younger than 10. If I’m not ready to let my son have a smartphone at 10, I’m sure not ready for him to dive into social media.

I understand it’s beneficial for some parents to allow access to a mobile phone at a younger age than others – if the phone is limited. In our situation, we really don’t need our boys to have phones. My wife homeschools our kids, we live out in the country and use two-way radios on property. We don’t drop them off at places such as malls or theme parks on their own. Sure, those days will come, but not just yet. Families will differ greatly. Both parents may work, the kids may ride the bus home after school, etc.

Allowing a young child to have full use of a smartphone can lead to trouble. I am a little leery about 12 years old, so I would definitely not recommend it for a child under that age without heavy restrictions. Free apps that can be easily downloaded can allow the child to meet total strangers online. A child that young simply doesn’t have the maturity level to deal with the types of situations they are likely to encounter.

If you do find yourself in a situation where your younger child having a cell phone would bring peace of mind and make your life easier, go basic. Get the cheapest, most basic phone offered, do not allow data usage, and limit the phones ability to call other phone numbers. Once you have the phone, you can log onto your providers website (Sprint, AT&T, T-Mobile, etc.) and set restrictions on the phone. And, yes, you can limit the phone’s ability to only be able to call you and your spouse’s numbers, grandparents, neighbors, etc.

For my wife and I, we have the luxury of waiting until we are reasonably sure he is mature enough to handle the responsibility. But, if we did have a need for him to have a phone now, it would be very limited.

Rest assured, once that day comes, I will be monitoring his activity closely.

Related links

• To Spy Or Not To Spy?
• Want to protect your kids from online predators? Be a snoop.
• 7 dangerous Apps that parents need to know
• 7 things that make an App dangerous
• Uncovering the risks of cell phones

It took that long to outrage a country from what was seen and heard by members of Sigma Alpha Epsilon fraternity at the University of Oklahoma chanting a racial epithet on a bus.

While the video shows that we haven’t progressed as far as most of us would like as a society, it also proves once again that our children need to learn the life-changing consequences of going viral.

Jody S. Hawkins, Information Systems Security Officer at Cook Children’s, gives a presentation to children called, “The Virtual World.” He explains the permanence of everything we post to the Internet.

“Like a face tattoo, the things your child posts to the Internet in public forums could be discoverable by potential college recruiters, employers or those out to paint your child’s character in a negative way,” Hawkins said. “What does your child aspire to be when he or she grows up? Are the things your children are doing on the Internet today going to have a negative impact on that career choice?”

Considering the speed of today’s technology, it’s important for kids to understand that everything they do is permanent, even if it’s been deleted. Thanks to screen shots, a careless text message can be frozen in time and put on social networking sites, forever subject to public scrutiny.

Hawkins recommends parents talk with their kids and express the need for self-control when they interact with others, even when they aren’t speaking face-to-face. Explain the importance of cooling off before sending that angry text message, commenting on a blog or posting an aggressive Facebook status. And if someone is doing something inappropriate, walk away or don’t participate. Everyone has a recording device in their hands these days.

A study from the University of Massachusetts’ Center for Market Research found that 21 percent of college admissions offices research their applicants via social media sites. An offensive blog post could overrule a stellar SAT score and change a university’s admission invitation.

“Kids don’t think about the harms they could be causing themselves,” Hawkins said. “They tend to have this, ‘Look ma, no hands’ mentality while we watch them and freak out. But those split second decisions can have forever consequences.”

About the source

Jody S. Hawkins, Information Systems Security Officer, has been in technology for medical facilities since early 2000 and has been practicing for more than 20 years with his start in the United States Air Force. He is a part of Cook Children's Experts on Call Speakers Bureau. Hawkins specializes in privacy and technology safety and is a regular speaker at the National HIT/HIPAA Conference. He has been quoted and published in several national publications, including Health Information Management Magazine.

Hawkins' can speak on a variety of security topics facing our children & parents today, including:

• Social media
• Cyber bullying
• Sexting
• Safety online (Parents & Child)
• General home networking security
• Virtual Child (Parents)
• Internet Safety (Parents & Child)

I love to watch them play and have fun, but I’m not watching them every single second. I’m usually reading something on my laptop and I glance up here and there to see what they’re up to. More often than not, they’re pausing to get the rules straight before they conquer that which would destroy us all. However, I have found myself jumping from my seat and running to the back patio door to tell them to stop! Why? Because I notice them doing something with their sticks that has a high potential to hurt one or both of them.

In and of itself a stick is not dangerous. A stick is a stick. You can poke in the mud with it, you can use it to imagine slaying dragons, or you could run with it out in front of you (the tip only inches above the ground, bobbing with every stride) and potentially impale yourself with said stick. Or, you could witness your 4-year-old swinging his stick wildly as the 8 year old, backing up to prevent being struck, stumbles over a toy wheelbarrow while the 4-year-old continues his assault. That’s what got my attention.

So, let’s talk about sticks … I mean apps. It’s the same conversation. Sticks come in all shapes and sizes. Some may be too big for my 4-year-old to handle; however, being a bit older, my 8-year-old may not have a problem with a slightly larger stick. Comparing this to apps on the tablets, my 4-year old does not understand some of the games my 8-year-old might play; but, he loves Reading Eggs®! But, since my 8-year-old is reading chapter books, Reading Eggs® (which helped him at one time) is now a “boring baby game.” For one, the stick is too small. For the other, the stick is just right.

As they grow older, they will want to delve into apps that challenge their maturity level and hold their attention. In the tween years, they will become more and more enthralled with social apps. On into the teen years, connecting with friends will more than likely become far more important than playing Cut the Rope® or Where’s My Water?®. It’s during these transitional periods that we’ll want to glance up from the kitchen table to take a quick peek into the virtual backyard. Knowing how to do this is half the battle.

Any app – even ones designed specifically for the facilitation of risky behavior – can be used in a way that is benign. All children are different and most are going to push the boundaries at some point or another. It’s our job as parents to guide them. In order to guide them, we need to be able to “glance up” to see what they are doing. Are they using social media apps? Are they playing games? What apps do they have loaded on the device? Are they chatting with strangers? What information are they giving out? I could keep adding questions. First, let’s talk about the most dangerous app of all.

Depending on their temperament, maturity level, risk taking, decision making skills, and overall attitude, the most dangerous app could be between your child’s ears. On the flip-side, it could also be the best security app available. Apps are not dangerous. Impaling yourself with apps is dangerous. Teaching your child good decision making skills and helping them to keep their compass as north as possible is the number one best way to prevent harm, period. In order to do that, you have to be able to “glance up” to ensure the compass needle is not falling.

There are two ways to secure a mobile device. One way is preventative security. Net Nanny® is a great app for enforcing parental controls for younger children. It prevents the errant Youtube video from introducing your child to inappropriate content as they follow the rabbit hole after searching for Spiderman. As they get older (and a bit wiser), preventative security measures lose their potency and can lead to a false sense of security for the parent. That’s why I recommend monitoring software.

There are several monitoring software packages available and, as with apps in the app stores, they are a moving target. iSpyoo® for iOS and Android (and other mobile phones) has received an “outstanding” editor’s rating on CNET.com. The review (which can be found on the CNET.com site and a search for iSpyoo) is for Android specifically; however, iSpyoo’s website boasts that “iSpyoo works on all mobile phones and networks from around the world.” Whichever monitoring software you choose, ensure it (1) cannot be detected by your child and (2) can send periodic alerts to your email address. A quick scan of the activity could either set your mind at ease or raise red flags. However, in order for this to work, you must maintain ownership of the device.

As a security professional with over 20 years of experience, I am 100 percent against giving smartphones, tablets, and other devices as gifts unless the rules are laid out appropriately. My rule is that, until you are on your own, you are borrowing MY device. I am the administrator and you are my child. That phone is on MY data plan and, while I did name it as your phone on the carrier’s website, I still pay the bills and I can cancel at any time. If you lay these rules out from the beginning, you could potentially run into far fewer problems down the road.

The bottom line is, yes, there are apps on the markets that give us concern. Some apps can be used for setting up a rendezvous with a stranger in a dark alley. If I were to tell you about specific apps today, I would miss the ones that will be coming out next week, month, or year. In all of my research and expertise, I still have not figured out how to definitively foretell the future. I can predict with a high degree of certainty, however, that there will be more apps coming. Keeping track of what your child does on their phones, tablets or computers will always be the best way to protect them. Just remember to bring your own stick to the game.

About the author

Jody S. Hawkins, Information Systems Security Officer, has been in technology for medical facilities since early 2000 and has been practicing for more than 20 years with his start in the United States Air Force. He is a part of Cook Children's Experts on Call Speakers Bureau. Hawkins specializes in privacy and technology safety and is a regular speaker at the National HIT/HIPAA Conference. He has been quoted and published in several national publications, including Health Information Management Magazine.

Hawkins' can speak on a variety of security topics facing our children & parents today, including:

• Social media
• Cyber bullying
• Sexting
• Safety online (Parents & Child)
• General home networking security
• Virtual Child (Parents)
• Internet Safety (Parents & Child)

Oh, there she is, over there checking out Facebook.

Are you nervous every time her kid climbs up the ladder he might fall down and injure himself?

She’s still playing Candy Crush. Ok, let me rescue her kid from the top of the slide.

There’s new evidence to suggest that there may be some truth to your concern.

A recent study from Yale Economics professor Craig Paulson showed that, from 2005-2012, unintentional injuries in children aged 0-5 increased. He was able to correlate the increase in injuries with the expansion of 3G cellular networks across the country. Many of these injuries occurred during times of parental supervision (not day care or with other caregivers). There was no similar increase in injuries of children aged 6-10.

This trend is the opposite of the overwhelming decrease in unintentional childhood injuries since the 1970s.

While there could be other explanations of this trend, clearly distracted parenting is becoming more of a problem in today’s world.

Here are some things to think about:

1. You will underestimate how long you will be looking at your screen. Even if you look away for one task, that task will take longer than you think and you are likely to get sidetracked by something else.
2. Injuries in children often take mere seconds to develop. There may be no build up from independent play to dangerous predicament in the time it takes to read and respond to a text.

In any situation, you should be aware of how much time you are spending with your smartphone.

“When a child plays an electronic game and receives frequent intermittent rewards, their brains release dopamine – a neurotransmitter that is closely related to reward motivated behavior,” said Lisa Elliott, Ph.D., a licensed psychologist and manager of the Cook Children’s Behavioral Health Clinic in Denton. “In school or in other social situations, a child does not normally receive these rewards, making it more difficult for them to stay focused in a non-technology based situation.”

Elliott believes this is a factor contributing to the recent rise in ADHD. She said she is concerned about gadgets, especially video games, and what they could be doing to harm our children.  By allowing so much focus on technology and mobile devices, children aren’t learning to hold their attention without some type of reward.

Whatever the cause is, Elliott offers four simple ways to prevent the damage that gadgets could be causing your child:

1.Remove any screens from the bedroom.

2.Pay attention to the content your child is viewing, especially violence.

3.Set limits on screen time each day. The American Academy of Pediatrics recommends screens be kept out of kids' bedrooms and children should be limited to less than two hours per day of screen time. For children under 2 years of age, all screen media exposure is discouraged.

4.Create healthy playtime such as outdoors or being active.

These simple changes may make the difference in how your children perform this school year.And while your kids may be upset now, they'll thank you later.

About the source

Lisa Elliott is a licensed psychologist and clinic manager of Cook Children's Behavioral Health, located at 3201 Teasley Lane, Ste. 202, Denton, TX 76210. To make an appoinment with her, call 682-885-3917.

About the author

Caroline Gayler volunteers in the public relations department at Cook Children’s Health Care System. She is a senior at TCU majoring in Strategic Communications. 

I had this amazing, Mom of the Year type plan where our family would reduce our use of electronics to 1 hour a day and provide the kids an opportunity to EARN up to another hour of screen time per day by doing various chores around the house. Awesome plan right? Right.

I was trying to figure out how I was going to humorously chronicles all of our FAILS this first week of Operation UnPlug (thank you to my sweet friend DeeDee for the name). But I truly am a glass half full gal, so despite our family not being able to hit a home run with plan A, we had some big family wins. Even though we did not exactly follow the plan, we had a good week.

Some highlights from week 1

No one died. The kids swore they would die without constant electronic entertainment. They totally didn't.

We did use electronics a little less every day. Look, tracking kids' minutes (times three kids) proved to be a major pain from the word go. MAJOR.PAIN. It proved very quickly to be time consuming and complicated. But,having a general sense of how much time we are on and off electronics is admittedly helpful. We ditched the strict minute tracking and did a more informal tracking (That is us in a nutshell - informal). We were successful in making sure we were off more than we were on and that each day we were off even more than the day before.

We invented new family lingo. Our family now has our own terminology. Phrases like “going dark,” “screen free,” “fun break” and “screen amnesty” are all part of our daily conversation now. I am not sure what “Screen Amnesty” means in real life, but for us, it is unlimited screen time that is not earned and has no consequences. Fun Fact - “screen amnesty” was invented by my husband ... FOUR HOURS INTO THE FIRST DAY OF OPERATION UNPLUG! FOUR HOURS! Honestly, I thought about calling Cook Children’s and telling them they had the WRONG family after we started throwing around “screen amnesty” so early into this project.

We were so productive!!! I hate to even admit just how much cleaning we knocked out the first few days of this experiment. It was awesome. I had the kids work on their rooms, the cool thing was they would find toys they had not paid any attention to in quite some time. They would stop and play and I was OK with that. Take your time kids. All the time you need. And now that I am not consumed with crushing my old high school buddies that I haven’t seen in 20 years at Words With Friends, I do find myself spending a little more time on my own personal to-do list. Go figure.

The dog lost weight. Ok, I may be reaching here, but I am trying to focus on everything that went RIGHT this week. By unplugging, we did more cool things as a family like take the dog for long walks and she lost an eighth of a pound. Hey, a loss is a loss

Did we turn into The Waltons week 1? Oh good gravy, not even close. Did we become aware that things in our home need to change and we are in need of daily unplugging? Totally. We will keep working on it and we will keep you posted!

Previous media free stories:

• 'TV head' - Could you unplug?
• Going media free - part 1
• Breaking it to the crew - part 2