Liebster Award

So happy to read through Kulish’s acceptance of my nomination of him for the Liebster Award! If you have not checked out his blog…please do so! See this post (https://theexplorerk.wordpress.com/2016/04/15/liebster-award/) and hop over to his site at theexplorerk.wordpress.com

Check out why I nominated him! If you love travel and photography…this blog is for you!

theexplorerk

libster

I had the honor of being nominated for the Liebster award by Nerissa Bauer http://www.letstalkkidshealth.org/tag/maternal-anxiety/
If you have not checked her blog you must go, she is a great writer and she loves to chat. So hope you visit her blog. Once again thanks for the nomination Nerissa. I have took too long to accept the award as I had to think too much and find 10 more nominees.Thanks Nerissa for this honor and nominating me.
Here are my answers to the 10 questions (5 Blogging/writing related and 5 random) Nerissa asked me:
1.How did you decide to start blogging?
I just heard from somewhere about wordpress, but I was not sure what it was so it was by chance I started this blog and then I loved to write and my real passion started .
2.Where do you draw your inspiration for your blog posts?
Mainly from travelling and…

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Meet and Greet Weekend @ Dream Big: 3/25/16

Its time for another meet and greet weekend!
One of the things I am learning about blogging is how supportive the blogging community is. Meet and greets are great way to find new bloggers to follow–even if you do not blog yourself. You can sign up to follow and get posts sent to your email too! This has been a great community to interact with as a new blogger myself…hope you will click on this link and go through the comments. Bloggers will leave their links to their blogs! Enjoy and happy reading!

Dream Big, Dream Often

Make Your Dreams Come True ad MY FIRST BOOK WILL BE AVAILABLE FOR SALE SOON!!!

It’s the Meet and Greet weekend at Dream Big!!

Ok so here are the rules:

  1. Leave a link to your page or post in the comments of this post.
  2. Reblog this post.  It helps you, it helps me, it helps everyone!  So hit the reblog button.
  3. Edit your reblog post and add tags.
  4. Feel free to leave your link multiple times!  It is okay to update your link for more exposure every day if you want.  It is up to you!

  5. Share this post on social media.  Many of my non-blogger friends love that I put the Meet n Greet on Facebook and Twitter because they find new blogs to follow.

Now that all the rules have been clearly explained get out there and Meet n Greet your butts off!

See ya on Monday!!

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Sunday Spotlight on Children’s Books: The Kissing Hand by Audrey Penn

 

ChildrenbookspotlightEver had a child who had separation anxiety? I love to share the story of “The Kissing Hand” by Audrey Penn.

Story summary: It’s hard to say goodbye to your mom or dad. Little ones who have a hard time separating may enjoy this short tale about Chester Raccoon who doesn’t want to go to night school. He is scared about leaving his mommy.

TheKissingHand

Mom shares a family secret with him that helps warm Chester’s heart…and gives him the courage to go to night school. He knows his mom will be home waiting for him after school.

I love the message of this story and the cute ritual you can do with your own child. Children love rituals–it helps them feel secure and helps serve as a signal for a routine. Read this story with your little one, adopt the ritual or use the story to create one of your own.

Suggested ages: 3-5 years

RELATED: How to Ease your Child’s Separation Anxiety

Using children’s books for easier (and fun!) information sharing

children reading books

Going to the doctor’s office you are likely to get handouts on important health topics. You might have noticed that these handouts are always full of information but is usually in very small font, with A LOT of words that sometime are hard to pronounce and challenging to read.  This can be a problem for families who have a harder time with reading.

There has been a lot of emphasis within medicine to help patients be active participants in their care. Half of the battle is making sure our communication with families is clear, concise and easy to understand. Not just with how we say things, but with the written material we hand out.

In some ways, it is more important to ensure that the pamphlets & handouts are easy to read and understand because  parents will refer to and share this information with other family and friends.

We have explored the use of children’s books to share parenting information.  Why? Because children’s books are written in simple and plain language, have colorful illustrations and can be easily understood.  The bonus? It is sure to be used by parents and children TOGETHER to learn and can be easily read and shared with others.  Even if one parent has a harder time with reading, you can usually follow the storyline through pictures and still grasp the ideas and concepts contained within.

One of my studies published in 2012 tested whether children’s books by author, Stacey Kaye (ParentSmart KidHappy series) could be used in pediatric clinics as a way to share positive parenting information to families. Parents and children LOVED these books! Parents learned different ways of handling common situations through the illustrations and story. Children asked their parents to read it over and over. See the Press Release for a summary of our findings. The full article is published in the Journal of Developmental & Behavioral Pediatrics.

Starting this Sunday I will be sharing a book review of some of my favorite children’s books I use or recommend to families.  There are so many wonderful books out there and more titles come out all the time.

Share your favorites for each pediatric or parenting issue when I post reviews so we can chat about your favorite children’s’ books!

Waging war on poverty: pediatricians are going to bat

Almost half of US households with children live at or  below the federal poverty level–incomes below the $23,500 for a family of 4. This means that a large proportion of our children are growing up in homes that are struggling to provide basic necessities.

Poverty has many negative effects on children, including an increased risk of chronic diseases like asthma, obesity and diabetes;  more injuries and poorer social-emotional health. Children in poverty usually enter kindergarten behind  on various developmental domains when compared to same age peers not living in poverty. 

Today the American Academy of Pediatrics (AAP) released a policy statement urging pediatricians to screen for poverty and help connect families to community resources and agencies to secure housing, food and childcare.  Pediatricians routinely screen child development, behavior and other issues known to affect child health. So why not make sure families are not struggling with basic resources to ensure each child has a bed to sleep in, access to nutritious and healthy foods and high quality childcare.  While this may be daunting, pediatricians are up to the task because it is the right thing to do.

RELATED: Doctors should screen for poverty during child wellness visits, American Academy of Pediatrics recommends

The US leads the pack with the highest level of child poverty in the developed world. This is unacceptable. We owe it to our children to do what we can to ensure every child gets a strong start.

So the next time you go to the pediatrician’s office, do not be surprised if your child’s doctor asks whether you are struggling to make ends meet at the end of each month. It will soon become part of the status quo.

Battling the myths of ADHD & Taking One Day At a Time

Today’s column by Valerie Strauss “If you can pay attention, you do not have ADHD”–and 9 other misconceptions about the disorder” was a great read.  Ms. Strauss highlights the Top 10 Myths of ADHD by Dr. Ned Hallowell, a child and adult psychiatrist. This list is a good for families of newly diagnosed children or in situations where parents are concerned about the possibility of ADHD and have yet to get confirmation.

I have been in the position of talking to parents, to grandparents, to schools about what ADHD is and what it is not. There are a lot of myths and misconceptions about the diagnosis and treatment options.

Let’s get that out of the way now. “Treatment” does not necessarily imply medication.  However, I know many parents cannot stop thoughts of: “if this is ADHD, then it must mean they will want to medicate my child…” First, as a behavioral pediatrician, I want to say that having the diagnosis of ADHD does not automatically mean your child will need to be on medication. In fact, the first line “treatment” for ADHD is parent training and education.

RELATED: Treatment & Target Outcomes for Children with ADHD (from healthychildren.org)

Yes, sometimes medications are used in the treatment but educational supports, behavioral therapy and parent training or also part of the plan. These components can be started at any time, may be combined with other treatments. Sometimes treatments are dropped and added on again at later times.

These decisions are made with the family and the team (for example: doctors, teachers, therapists)–and always with the goal of asking, “What else is needed to ensure that the child is learning and doing what he/she needs to be doing every day and doing it as well as can be?”

If you are a parent with a child with ADHD or a parent who is worried that your child may have ADHD, make sure you come prepared to ask questions at each and every appointment. It can be challenging and hard to remember who is doing what since much of the time behavioral conditions require many team players. Your child’s doctor wants you to feel comfortable with every decision that has to be made along the way. They are happy to have you ask questions, no matter how many times or different iterations.

Another thing to remember is that at the time when the diagnosis is uncertain or is new, it can feel like you are all alone and overwhelming. The first step is to take a breath and write down any and all questions. Organize all paperwork and relevant schoolwork in a binder/folder and keep them together. It helps keep things handy when you have to meet yet another new team player. It also ensures that everyone is on the same page. There is nothing more stressful than not knowing which team member to call when things go awry or after a particularly challenging day. See my post “A new handout for ADHD” that I developed and use with families that can help explain some concepts I think is important to think about when a child is newly diagnosed.

The key is to remember to reach out to your child’s doctor if you have ongoing questions. Yes, they can prescribe medications for ADHD, but they can and always will be there to coordinate care and make referrals. They are interested in talking through all treatment options and linking you to great community resources and organizations. This is what the “medical home” is all about.

RELATED: Your child’s medical home: What you need to know


 

Helpful Resources to Learn More:

  1. http://www.healthychildren.org
  2. http://www.understood. org
  3. http://www.chadd.org

Tips on How to Talk with Kids about Guns

After talking with a few parents & colleagues about my last post: “Kids and Guns: It’s about Child Safety” it became clear that a follow up post was needed.  While playdate cards help parents talk to other parents, what resources are there to help non-gun owning families talk to children about guns?

S0, how do you start the conversation with your child if you live in a gun-free home?  When should you bring it up?  Will talking make a child curious? Yes.

Children are curious about EVERYTHING.

RELATED: How I Talk to My Children About Guns

As parents, we talk to children about looking both ways before they cross the street. We talk to them about buckling up whenever in the car. We talk to them about not talking to strangers.

Talking to children about what to do if they ever find a gun or weapon in a friend’s home is just as important. Guns in US homes are common. Reasons vary for keeping guns & weapons:  work, recreation or personal protection.

It is important to help your child be prepared to know what to do.

RELATED: How to End Gun Violence in the US

LISTEN TO THIS: How guns can affect families forever–StoryCorp: Gone with a Gunshot, His Little Sister Remains, Eternally 8

This handout*summarizes some key things for parents to think about before and during talking with children about guns and other weapons. It gives some suggestions on how and when to start the conversation. It also gives parents a reminder to use a matter of fact tone.

Review this handout. Share with your partner, spouse, family, friend. Then talk to your children about guns/weapons. It can help keep yet another child safe from gun violence.

And remember, talk to other parents about guns/weapons in their homes before sending your child over to play.  They will not be offended.

RELATED: Blood on our Hands

*A special thank you to Dr. Mandy Harris and Rebecca Cisneros for talking through this important topic and providing suggestions for the handout!

Guns & Kids: It’s about Child Safety

One of the first issues I became passionate about was keeping kids safe from guns. Why? While I was a pediatric resident in San Diego, the school shootings at Santee, California occurred. This was just two years after the horrific events at Columbine. I saw kids coming to clinic, with non-specific complaints and in the end, not wanting to go to school. Parents had questions about how to best handle their kids’ (and their own) fears.

Why did this happen? How could it happen here? Should kids be allowed to stay home from school? What can we do from preventing this horrible thing from happening again?

This experience set me on the path towards advocating for children’s health within the context of public health. I saw just how this type of violence affects individual families but also its effects on the larger community. I started a project to simplify the screening for the presence of guns and other risks for childhood injury during clinic visits; passed out free gun locks to families who told me there were guns in the home; and distributed play date safety cards to families.

Over 75% of gun injuries and death are the result of children with easy access to guns that are improperly stored. When these types of events happen, it is usually at a friend’s house or their own. Now we see these headlines daily: a toddler who finds his mother’s handgun in her purse and accidentally shoots himself; school aged boys who come across a loaded gun during play and it accidentally discharges; a teenager with depression or is bullied who has easy access to a gun and commits suicide or decides to bring it to school as an act of revenge for perceived wrongdoings. The one thing that comes out of these events is that  they are brought to our attention.  The endless stories can cast no doubt that guns and kids are a public health epidemic. On the other hand, hearing these headlines daily can leave us feeling no longer shocked that these events happen. That somehow it is part of our daily fabric living in this country. Too many children’s lives lost, too many senseless events that could have been prevented. Too many families torn apart and affected by guns.

BUT DO NOT GET NUMB. Sometimes it can feel like there is nothing we can do as a society to change things because too many of these events happen EVERY DAY. However, we have a responsibility to do what we can for our own children, for those in our care, for those in our global community. No one is immune to these events.

We must remain vigilant and continue to do what we can as responsible adults, providers, parents, and community members. We can join organized groups that advocate for action  at the federal level to pass sensible gun safety laws and ensuring access to comprehensive mental health services. There are things we can do each day by knowing what safety risks might be present in the places our children are allowed to play. We cannot assume that children will know the right thing to do when they stumble upon a gun.

Playdate safety cards are meant to help parents ask each other about potential safety hazards in the environment in which children play. It is hard to ask someone if they have guns in the home, and even more so of friends or acquaintances you have known for a while but may have never thought to ask. These playdates cards can help start the conversation.

While this is a small measure and will not “cure” this epidemic, it can be a step towards prevention of another event.

When parents arrange a playdate for their children, they usually share information about their children including any food allergies and any fears of pets. Parents exchange phone numbers or emails in the process.  This is the ideal time to ask whether there are guns in the home. It is up to the individual parent what to do with that information if the answer is yes. However, if you don’t ask, you won’t know–and I would argue it is always better to know.

The cards can be printed on cardstock.  You can stick it on the refrigerator with a magnet or in an address book once completed. You can trade them when you meet another parent. The crucial part is that it has statistics and a section with questions to ask the other parent. If you cannot bring yourself to ask spontaneously, having these cards can give you ideas for how to start the conversation. The first few times may feel awkward, but after that it becomes easier.

Download the playdate card file here.*

*A special thanks to Heather Hunt Dugdale, Esq. for working with me in those early days in San Diego on this tool. Another heartfelt thanks to one of my first mentors, Dr. Bronwen Anders, whose clinic I worked at during residency, who supported and helped me gain the confidence to move this cause forward.
Educate yourself about this issue & what you can do to help this cause.

More more information:

  1. American Academy of Pediatrics, HealthyChildren.org website has great parent friendly resources including: Gun Safety: Keeping Children Safe
  2. http://momsdemandaction.org
  3. http://everytown.org

 

Helping kids with ADHD talk about “My Today”

MyToday-EnglishWhen families face chronic diseases, it is especially important to encourage their active participation with the medical team. This is the hallmark of the “chronic care model,” which encourages medical providers and the patient/family to work together. Chronic diseases often require lifestyle and behavior change to maximize outcomes. This is especially true in pediatrics and behavioral conditions. Published clinical care guidelines for all pediatric behavioral/mental health conditions (such as ADHD) highlight parent training and behavioral interventions as “first line” treatments.

Part of what we do in the ADHD group visit model is to help pediatric providers empower parents and children with knowledge and skills that encourage active monitoring of symptoms and behaviors. It is important to involve children in their own self-care as soon as they are able to understand basic concepts of health and illness, can participate in some aspects of self-care and show self-awareness.

We developed an ADHD group visit curriculum for parents to begin to breakdown elements of ADHD chronic care over 5 sessions–knowledge about ADHD and developmental considerations and treatment options (behavioral considerations and positive parenting, educational supports, and medications).  We have a separate child curriculum that includes complementary topics, such as teaching children what ADHD is, along with specific skills to promote self-care and problem solving skills to use in home and school.

One of the things we noticed that happened organically after the group visits was that parents and children were eager to talk to each other about what they had learned or talked about in groups. This is because parents and children participate in group separately. Groups are run at the same time but in different rooms.

One of the tools that has come out of this work is a worksheet designed to help children monitor their feelings and how their bodies feel. This is especially important if a child is on medications for ADHD since potential side effects include headaches, stomachaches and decreased appetite. Helping children learn how to “tune in” to their bodies and thoughts and also how to talk with their parents about it is a important skill.

Together with our Patient Advisory Board and the team of health communication designers, we developed a way for children to track these feelings and thoughts. We printed these as memo pads and distributed them after session 2.

Children can be encouraged to complete these sheets for the first few days after starting or increasing medication as a way to “jump start” self-awareness and conversation. It can also be shared with the child’s doctor.

Click here to download “My Today” in English.

Click here to download “My Today” in Spanish.

*A special thanks to Dustin Lynch, Courtney Moore, Helen Senamatsu and Dr. Sarah Wiehe, as well as the families of our patient advisory board for their assistance in co-developing this tool.