The PediaMag Winter 2019-2020

YOUR HOME FOR QUALITY PEDIATRIC CARE • WINTER 2019/2020 Welcome to The PediaMag.............. 2 OFFICE INFORMATION New office in Edgewood.................. 3 AHN Pediatrics-Pediatric Alliance knows that we all live busy lives...... 3 NEW PROVIDERS New Physicians............................... 4 NURSING MOM CAFÉ A breastfeeding support group........ 5

Walking to Support the Juvenile Diabetes Research Foundation

AUTISM Updated Autism Guidelines.............. 6 ONEWALK PITTSBURGH Juvenile Diabetes Research Foundation OneWalk Pittsburgh....... 8 CLASSES AHN Pediatrics-Pediatric Alliance provides learning opportunities for new and expectant parents........ 9 DAISY AWARD Congratulations to Beth Herr........... 10 PATIENT PORTAL Helpful Tips for Patient Portal Users......................... 11 PARENTING Raising Teenagers........................... 12 HALLOWEEN Staff and providers at our offices got into the Halloween spirit............ 14 HOLIDAY DONATIONS Clearway Energy graciously donated seven bicycles and helmets to AHN Pediatrics – Pediatric Alliance Allegheny............. 15 HOLIDAY GIFTS Gifts for Children............................. 16 Publication Provided by:

Welcome

Welcome to The PediaMag Last Spring, Pediatric Alliance announced that we were joining Allegheny Health Network (AHN) to become AHN Pediatrics – Pediatric Alliance. This move has allowed us to expand our resources in order to stay abreast of the latest technology and advances in health care. While our pediatric offices have continued to provide exceptional pediatric care to our communities, this was the next step in our mission to provide high-quality, comprehensive primary care to infants, children, and adolescents. In the past months, some changes have been made, and one of our providers has moved. This is now allowing us to extend our pediatric care to new areas and communities. We have also formed new partnerships with companies and community outreach groups. We look forward to a long and happy relationship with you, our readers, families, and patients.

About Us: Pediatric Alliance was formed in 1996 when eight individual practices joined together to provide quality health care throughout Southwestern Pennsylvania. Over the years, Pediatric Alliance grew to be the largest physician-owned group pediatric practice in the area. In 2019, Pediatric Alliance joined with Allegheny Health Network to allow expansion of resources in order to stay abreast of the latest technology and advances in health care. Our board-certified pediatricians offer primary care to children and adolescents in 16 different office locations including two specialty care offices for allergy, asthma, and immunology and pediatric endocrinology.

We are proud to offer personalized, patient-centered care to patients from birth to 21 years of age. We strive to meet your family’s pediatric needs, provide convenient access to care, and build strong relationships with families to maximize your child’s health.

To learn more about AHN PediatricsPediatric Alliance, visit our website at www.ahnpediatrics.com.

AHN Pediatrics-Pediatric Alliance 1100 Washington Ave., Suite 219 Carnegie, PA 15106 pediatricalliance.com

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The PediaMag is published semiannually, copyright 2018. All rights reserved.

Publisher AHN PediatricsPediatric Alliance

Editor Rebecca Scalise

AHN Pediatrics-Pediatric Alliance • Winter 2019/2020 • www.ahnpediatrics.org

Art Director Brent Cashman

Office Information

New office in Edgewood We are excited to announce that we have expanded the pediatric services that we offer at our newly-renamed Edgewood office, previously called AHN Pediatrics Endocrinology, 1789 South Braddock Avenue, Suite 294, Pittsburgh, PA 15218.

In addition to the endocrinology services provided by Dr. Deborah Rotenstein and Dr. Jadranka Dr. Deborah Rotenstein Dr. Jadranka Popovic Dr. Bruce Hyde Popovic, we began offering primary care pediatrics on December 5th with the inclusion of primary care pediatrician Dr. Bruce Hyde.

Dr. Hyde has been a pediatrician for 37 years and has been part of AHN Pediatrics for many of those years.

He is a graduate of Temple University Medical School and completed his residency at Thomas Jefferson University Hospital and Children's Hospital of Pittsburgh. He also holds a Masters of Public Health.

Dr. Hyde's special interests include community health and preventative medicine. He is very excited to be providing pediatric care in the Edgewood community!

To schedule well child visits, vaccines, or sick visits with Dr. Hyde, please call 412-371-3000.

AHN Pediatrics-Pediatric Alliance knows that we all live busy lives.

And kids don’t get sick on a schedule.

For busy families and unexpected illnesses, AHN Pediatrics-Pediatric Alliance has Saturday hours and same-day sick visits available. Many of our offices also have extended evening hours at least once a week. We want you to know that we are always here for your children, no matter when you need us. Visit our website at www.ahnpediatrics.com for hours and contact information for your nearest AHN PediatricsPediatric Alliance office.

AHN Pediatrics-Pediatric Alliance • Winter 2019/2020 • www.ahnpediatrics.org

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New Providers

Meet our newest providers Bethany Ziss, MD • Bloomfield Education Medical School: Jefferson Medical College Residency: West Virginia University Children’s Hospital

Additional Information Bethany Ziss, MD, began her career as the attending physician in Developmental and Behavioral Pediatrics at Greenville Health System in South Carolina. During her time at Greenville Health System, she cared for children with developmental disabilities and presented at Grand Rounds on various developmental pediatric topics. Dr. Ziss has a strong background in disability advocacy, and throughout her career she has worked to bring a neuro-diversity and disability community perspective to her clinical care.

James Miller, MD • Allegheny Education Undergraduate: The University of Notre Dame Medical School: The Ohio State University College of Medicine Pediatric Training: Johns Hopkins University

Special Interests Dr. Miller has a special interest in working with families experiencing poverty and homelessness. He works extensively with the homeless and leads a street medicine team with the Center for Inclusion Health at AHN. Additional Information Dr. Miller originally hails from Reading, PA. He earned his medical degree at the Ohio State University where he was inducted as a member of the Gold Humanism Honor Society. He has worked with and helped create numerous organizations that cared for people experiencing poverty, homelessness, mental health disorders, and addictions. He is passionate about providing care that is sensitive to patients’ cultural preferences and supports them through many of life’s obstacles. Dr. Miller loves caring for children, and he believes that compassionate, supportive healthcare is essential to help children grow to their full potential. Dr. Miller currently makes his home in Plum Borough and is engaged. He and his fiancé, who is also a pediatrician, plan to be married in the summer of 2020.

Kayllie Wang, MD • Jefferson Hills Education Undergraduate: Penn State University, Schreyers Honors College Medical School: University of Pittsburgh

Additional Information Originally from Murrysville, PA, Dr. Wang now makes her home in Peters Township with her husband and son. In her spare time, she enjoys playing tennis and baking.

Mike Scarff, LPC, Behavioral Health Consultant • St Clair Office Education Undergraduate: Fairmont State University Master’s Degree: Chatham University

Additional Information Mike has worked for several years as a Crisis Manager and a Crisis Clinician Supervisor at UPMC Resolve Crisis Services. He has also been a Mobile Clinician and worked as a Clinical Supervisor at The Academy working with students and their families

Ashley Thrower, CRNP • Allergy, Asthma & Immunology Education Undergraduate: Bachelor Of Science, Nursing, West Virginia University Graduate: Master of Science, Nursing/Family Nurse Practitioner Program, West Virginia Wesleyan College

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Additional Information Originally from Saxonburg, Ashley Thrower currently makes her home in Valencia, PA. She earned her Bachelor of Science in Nursing at WVU, and her Masters Degree in the Family Nurse Practitioner Program at West Virginia Weslyan.

Prior to joining AHN Pediatrics – Pediatric Alliance, Ashley spent 10 years as a Critical Care nurse at West Virginia University Hospitals. In her free time, Ashley enjoys volleyball, camping, and kayaking.

AHN Pediatrics-Pediatric Alliance • Winter 2019/2020 • www.ahnpediatrics.org

Nursing Mom Café

Nursing Mom Café A Breastfeeding Support Group

AHN Pediatrics St. Clair 1580 McLaughlin Run Road Pine Bridge Commons Suite 208 Upper St. Clair, PA 15241

Every Thursday

except major holidays

11 a.m. – 12:30 p.m.

No registration needed Facilitated by a certified lactation consultant

Free and open to all mothers and babies

For more information, call AHN Pediatrics Nutrition and Lactation.

412-221-2121 ext. 116 Allegheny Health Network (AHN) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex in its health programs and services. In order to treat individuals in a nondiscriminatory manner, AHN provides free communication aids and language assistance services.

• Group support from other mothers • Share experiences and discuss concerns • Before-and-after feeding weight checks of infant What to bring: • Diaper bag with changing pad, diapers, and wipes • Change of clothing (just in case) • Breastfeeding pillow (optional)

10/19 Z HC409649

AHN Pediatrics-Pediatric Alliance • Winter 2019/2020 • www.ahnpediatrics.org

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Autism

Updated Autism Guidelines Written by Ned Ketyer, MD. Originally posted on The PediaBlog on January 13, 2020.

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After more than 12 years, the American Academy of Pediatrics has updated its guidelines and recommendations for the “Identification, Evaluation, and Management of Children with Autism Spectrum Disorder.” The new report begins with a simple definition of ASD, which now affects 1 in 59 children in the United States:

Autism spectrum disorder (ASD) is a category of neurodevelopmental disorders characterized by social and communication impairment and restricted or repetitive behaviors. ASD affects more than 5 million Americans, with an estimated prevalence of approximately 1.7% in children.

AHN Pediatrics-Pediatric Alliance • Winter 2019/2020 • www.ahnpediatrics.org

Children with ASD require a lifetime of close attention and support — a burden shared by parents, families, and communities that can be overwhelming for some and expensive for all:

The care needs of children with ASD are significant, affect parents and siblings as well, and require substantial community resources. Direct and indirect costs of caring for children and adults with ASD in the United States in 2015 were estimated to be $268 billion, more than the cost of stroke and hypertension combined. The lifetime cost of education, health, and other service needs for an individual with ASD ranges from $1.4 to $2.4 million dollars, depending on whether he or she has any co-occurring intellectual disabilities.

In addition to the two core symptoms (social and communication impairment and restrictive or repetitive behaviors), other conditions commonly accompany ASD. These comorbidities can affect daily living, challenge family functioning, and influence outcomes. They include: • intellectual disability (up to 40%) • anxiety and mood disorders (40-60%) • attention deficit/hyperactivity disorder (ADHD) • language disorders • behavioral disorders (especially self-injury and aggression) • sleep problems • feeding disorders • gastrointestinal symptoms (especially constipation and diarrhea) • seizures All of these issues must be screened constantly throughout a lifespan:

Food refusal on the basis of texture, color, presentation or taste may be associated with sensory differences, anxiety or perseverative rigidity. Most children with ASD do not have nutritional deficiencies, but a dietary history should be included during health supervision. Obesity is more common. Constipation is common and may be associated with behavioral symptoms.

Problems with sleep onset and maintenance are frequent in children with ASD and should be addressed with behavioral management strategies. Melatonin may be helpful with sleep onset.

Wandering is a major cause of morbidity and mortality and should be addressed through anticipatory guidance throughout the lifespan.

Because early detection of developmental delays and treatment result in the best outcomes, it is recommended that pediatricians and other health professionals who care for children refer kids for speech and language therapy, physical and occupational therapies, and behavioral therapy (including applied behavioral analysis) as soon as those deficits are apparent. The average age of ASD diagnosis is more than 3 years old, but many of these developmental difficulties typically reveal themselves well before 3. Pediatricians and families should not wait for a formal diagnosis of ASD before early intervention and comprehensive therapy begins.

Pediatricians depend on experience of what is “typical” paired with credible screening tools to detect developmental delays in their infant and toddler patients. The most widely used screening tool for ASD utilized by pediatric health providers is the Modified Checklist for Autism in Toddlers (M-CHAT) which can be used as early as 16 months of age and repeated periodically during the next two years. (Pediatricians use other developmental screening tools and observations to detect motor and language deficits even sooner.) Children who do not pass the screening test or who score “at risk” for a diagnosis should be immediately referred to early intervention services (under 3 years old) or school services to initiate evidence-based therapies. Again, it’s important to remember: Early detection of developmental delays that leads to early intervention and therapy results in the best outcomes.

And we shouldn’t forget that children with autism eventually grow up to be adults with autism. Families will need to lean on pediatricians for support as life’s transitions proceed:

Families should be supported to work on transitions to post-secondary education, work and adult health providers. Pediatricians should begin discussing transition needs in middle adolescence and have a process in their practices.

Researchers have determined that the cascade of neurobiological changes leading to the signs and symptoms of autism usually begins before birth. 30-40% of individuals with autism have genetic markers on their chromosomes, and studies are now underway showing ways in which environmental and immunologic factors interact to express (or “turn on”) these genes clinically. For families and pediatricians alike, that knowledge will be welcome news.

AHN Pediatrics-Pediatric Alliance • Winter 2019/2020 • www.ahnpediatrics.org

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OneWalk Pittsburgh

Juvenile Diabetes Research Foundation OneWalk Pittsburgh On Saturday, September 21, AHN Pediatrics-Pediatric Alliance staff and their families gathered on Flagstaff Hill in Schenley Park for the Juvenile Diabetes Research Foundations OneWalk Pittsburgh. Allegheny Health Network is proud once again to be a Platinum Presenting Partner for the 2019 JDRF One Walk. The Walk is always a great day and a great opportunity to support the community.

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AHN Pediatrics-Pediatric Alliance • Winter 2019/2020 • www.ahnpediatrics.org

Classes

AHN Pediatric-Pediatric Alliance offers classes to new parents and expectant moms and dads. Parents can meet the pediatrician, tour the office, learn basic information about the care of their newborn, and even learn what to expect while mom and baby are in the hospital.

We also offer classes in breastfeeding for expectant moms and new moms who are trying to make breastfeeding work. In fact, we have certified lactation consultants at many of our locations. These professionals are waiting to help you.

New & Expectant Parent Classes Increase your knowledge and confidence as you prepare for the birth of your baby. Receive helpful tips to calm a baby, ease fussiness, and much more!

Advanced registration is required for these complimentary classes. Make sure to register early to reserve your space. classes.pediatricalliance.com Z 6/19 HC406401

AHN PediatricsPediatric Alliance provides learning opportunities for new and expectant parents.

AHN Pediatrics-Pediatric Alliance • Winter 2019/2020 • www.ahnpediatrics.org

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Daisy Award

Congratulations to Beth Herr

Congratulations to Beth Herr, RN from our Seven Fields office for being awarded the Daisy Award for Extraordinary Nurses! The Daisy Award is a national award created to honor the super-human work nurses do for patients and families every day. Beth was nominated by a first time mom for her kindness and encouragement in helping a brand new mom deal with her struggles with feeding. This mom really appreciated Beth’s reassurance (and hugs).

We are so proud to have Beth as part of our outstanding team of nurses and medical assistants. Congratulations, Beth, for being honored for being the exceptional nurse we always knew you were.

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AHN Pediatrics-Pediatric Alliance • Winter 2019/2020 • www.ahnpediatrics.org

Patient Portal

Helpful Tips for Patient Portal Users Patient Portal gives patients a secure way to connect with our office and access their medical information at home and on the road.

— Please ensure your email address is current in our system.

Patient Portal Tips under the Patient Tools section of our website. www.pediatricalliance.com/patient-portal/

• How to Renew Medications • How to Request an Appointment • How to Send Messages via Patient Portal • What to do if you forget your Username/Password In addition to these helpful tip sheets, you can also email or call our portal line if you need assistance. portal@pediatricalliance.com or (412) 278-5102

Your Home for Quality Pediatric Care AHN Pediatrics-Pediatric Alliance • Winter 2019/2020 • www.ahnpediatrics.org

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Parenting

Raising Teenagers Written by Ned Ketyer, MD. Originally posted on The PediaBlog on January 23, 2020.

A couple of years ago, Time published a special issue devoted to “The Science of Childhood.” Mandy Oaklander tackled the teenagers:

Parenting an adolescent into adulthood can be difficult, frustrating, and always unpredictable. But if you can make it through the moody teenage years, while avoiding some common parenting pitfalls, a compassionate, functioning human will be waiting for you on the other side. Here are five rules of the road.

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AHN Pediatrics-Pediatric Alliance • Winter 2019/2020 • www.ahnpediatrics.org

Based on science which indicates that teens sleep differently than adults, Oaklander advises parents to let them sleep in — especially on school days:

Starting school after 8:30 a.m. can help sleep-deprived American teens (two thirds of them, to be exact) get the 8 to 10 hours they need for optimal health, according to the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics and the American Academy of Sleep Medicine. The groups concur that later start times mean students will be more focused during the school day, more alert while driving, and less likely to be absent or late.

Talking to teens about sex should be a shared responsibility between mom and dad:

Teens spend nine hours a day using screens, according to a recent report from Common Sense Media, a nonprofit group focused on kids and technology. Turns out that’s the same amount of time as parents. The same survey revealed that 78% of parents said they were “good technology role models” for their kids. To rein in your teen’s use of cellphones, social media and texts, be aware of your own. Designate no-phone zones, such as the car, dinner table and bedroom.

Finally, as much as technology might tempt parents to spy on their teenagers, it’s really not a good idea:

A study in early 2017 found that kids were more likely to share information when their parents directly asked them questions, and more likely to withhold information when their parents snooped.

When parents talk to their teens about sex, kids are more likely to have sex later and use contraception. But very few parents do it effectively […] One of the problems is that mothers are far likelier than fathers to talk with their kids about sex, and that doesn’t appear to be the best way to reach sons.

While there may be some logic behind introducing teenagers to alcohol, practically every pediatrician in America would agree with Oaklander: don’t do it!

Many parents think it’s better to be their child’s alcohol sherpa than to let them discover drinking themselves. But scientists have found evidence for the opposite. Recent research finds that adolescents who were supplied alcohol by their parents were more likely to drink than those whose parents did not give them alcohol.

Because parents are not immune to the attraction of digital media, they shouldn’t underestimate the importance of setting a good digital example for their kids:

AHN Pediatrics-Pediatric Alliance • Winter 2019/2020 • www.ahnpediatrics.org

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Halloween

HALLOWEEN FUN Halloween 2019 was a rainy day, but the sun was shining bright in our offices as staff and providers at our offices got into the Halloween spirit.

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AHN Pediatrics-Pediatric Alliance • Winter 2019/2020 • www.ahnpediatrics.org

Holiday Donations

A Gift of Fun During the 2019 holiday season, Clearway Energy graciously donated seven bicycles and helmets to AHN Pediatrics – Pediatric Alliance Allegheny to give away to children aged 7-12 years. This was a wonderful opportunity for the kids, and the staff at our Allegheny office feels blessed to have been able to share in this experience with the children and families.

AHN Pediatrics-Pediatric Alliance • Winter 2019/2020 • www.ahnpediatrics.org

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Holiday Gifts

Gifts for Children Staff at our Administration Office conducted an employee toy drive for Toys for Tots. The toy drive was coordinated by Annie Amella in our Billing Department, and our gifts were collected by the volunteer firefighters at East Carnegie Volunteer Fire Department. (Also pictured: Tracey DeCola, AHN Pediatrics - Pediatric Alliance Billing Manager).

Staff, patients, and families also shared their giving spirit with Beverly’s Birthdays, a nonprofit organization which has, since 2012, provided birthday cheer for children experiencing homelessness and families in need. We collected new toys and clothing to support the mission of spreading birthday cheer 365 days a year.

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AHN Pediatrics-Pediatric Alliance • Winter 2019/2020 • www.ahnpediatrics.org