Healthy Start | Winter 2005

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Vo l . 1 1 N o . 1

C o o k C h i l d r e n ’s H e a l t h C a r e S y s t e m

Spring 2005

Cook Children’s Physician Network

Making the Grade on School Tests

is the

When schools focus on standardized exams, remember it’s learning that counts

largest

non-profit pediatric physician

network in North Texas with

more than 200

physicians, including primary care physicians and

pediatric

subspecialists in more than

30 locations in Tarrant, Denton and Hood counties.

find a pediatrician

To

near you or for a referral,

please call our toll-free number,

800-934-COOK.

I

t might not be a cold or the flu, but it’s something parents of school-age children frequently treat. It’s the exam-day jitters. As schools pass out the TAKS and other standardized tests and push pupils to do well on them, it’s becoming even more common. But parents can do a lot to ease test anxiety, both in their children and themselves, by focusing on the learning and not the scoring. “The bottom line is not testing, but measuring competence and understanding,” says psychologist Ruth Peters, PhD. “Some kids truly don’t know the material, and in the lower grades, it can be a real gift to hold them back a year and let them mature. Others get decent grades but can’t perform under the pressure of a test. It’s a very anxietyproducing situation.” To ease tension, experts say you can: ■ Teach your child deep-breathing techniques. ■ Make sure your child gets enough sleep and eats a good breakfast. ■ Keep your own emotions in check. “When a child demonstrates knowledge on a daily basis in the classroom month after month, yet fails on a standardized test, that shows you something is wrong,” Dr. Peters says. The child could be distracted or confused by the directions. Some problems have a physical

root. The list includes memory flaws, language defects and learning disorders, which may affect 15 to 30 percent of pupils. “Disturbances of mood, such as adjustment reactions and depression, also can affect concentration and overall performance,” says Clive Daniels, MD, of Cook Children’s Physician Network. “If your child is not meeting his potential in school or is experiencing significant difficulties with testing, your pediatrician can help

pinpoint the problem and make a diagnosis. You and your pediatrician can then choose from a variety of available treatments to assist your child in achieving his or her maximum potential.” ❖ Clive Daniels, MD, is a pediatrician with Cook Children’s Physician Network. He practices at 980 North Walnut Creek in Mansfield.


Preparing Your Child for Surgery Being honest and clear to your child is very important

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s a parent, you don’t want your child to experience anything that is the least bit unpleasant. So when you find out your child needs to have a surgical procedure, telling her about it can be difficult and feel unnatural. However, as uncomfortable as it might be, experts still recommend that parents try to truthfully answer any questions their children might have in terms they can understand. “Children commonly ask if something is going to hurt. That can be a tough question for parents to answer, but it’s important to be honest,” says Betsy Hillyard, a child life specialist at Cook Children’s Medical Center. “When parents know there will be discomfort, they can share this with their children and help them plan how to cope with it and give suggestions, like squeezing

someone’s hand or telling jokes or looking at a distracting toy or book.” Although many parents may think that children fear pain or discomfort the most, this is not the case with many children. Rather, they fear the unknown. By preparing the child — reading a book about going to the hospital or taking a pre-surgery tour of the facility, for example — parents can do a great deal to reduce the anxiety their child may feel. When the big day does come, parents can also make the entire day easier by being as low-key as possible and keeping scheduled activities or distractions to a minimum. Children can pick up on any uneasiness that parents might display, so by working to be confident and as at-ease as possible, parents can do a great deal to help make the day go well for their child. ❖

Too Much Weight Can Spoil Kids’ Lives Each day can bring new challenges to health and self-image

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or obese kids, just getting through the day can be tough. While obese children face a number of possible health problems, including diabetes, insulin resistance, asthma, sleep disorders and cardiovascular and orthopedic problems, they also can be as much as six times more likely to have emotional and social problems. One research team recently had 106 youths ages 5 to 18 answer questions about physical, emotional, social and school issues. For instance, could they walk more than a block? Were they scared or angry? Were they being teased or having trouble with

Susan Hess, MD, is a cardiologist with Cook Children’s Heart Center.

schoolwork? Their results found that obese youths fared worse on all fronts. “I can tell you that what these obese children go through is nothing less than tragic,” says Charles Kuntzleman, EdD, a University of Michigan physical education professor. “On one occasion a few years ago, I watched a physical education student who weighed nearly 300 pounds struggle to complete a single lap around the gym. When the child returned to the bleachers, the teacher asked him how many laps he’d done — and his answer was: ‘Ten thousand!’ I know how that boy felt. For a child who’s struggling with obesity, a brief jog across the gym floor can feel like 10,000 laps.” The roots of the childhood weight crisis are complex. Some experts blame fast food and too much TV. Others point to a lack of exercise and physical activity. 2

“According to the American Academy of Pediatrics, children should not spend more than two hours a day watching television,” says Susan Hess, MD, a cardiologist with Cook Children’s Heart Center. “To help emphasize the


[ health bits ] You Can Get Help With Dental Care

When your child needs an outpatient surgical procedure, Cook Children’s has two surgery centers designed to help children and their families feel comfortable during a potentially stressful time.

Cook Children’s Medical Center 801 Seventh Ave. in Fort Worth

Cook Children’s Surgery Center 6316 Precinct Line Road in Hurst To schedule your child at either center, ask your physician for a referral. For more information on pre-surgery tours and other ways to prepare your child for a surgery, call 682-885-4053.

importance of physical activity, parents should encourage children to play outside whenever possible and to enjoy lifelong physical activities — as opposed to just team sports.” ❖

Kids miss more than 51 million hours of school a year due to dental illness, says the Academy of General Dentistry (AGD). Yet nearly half of tooth decay isn’t treated in low-income children. “Dental diseases grow progressively worse without treatment,” says AGD spokesman Mark Ritz, DDS. Your child’s health could suffer — and the cost of fixing the problem will only get worse. “However, most oral health problems can be prevented,” says Dr. Ritz. Routine dental exams and oral health education can help. You can get help if you can’t afford dental care for your child, You can get help if you can’t afford dental care for your child. To see if your child is eligible for Medicaid, call 1-877-8377. In Tarrant County, options for dental care based on a sliding scale are listed in the Children’s Dental Resources brochure produced by the Children’s Oral Health Coalition, a network of dentists and local organizations working to help children get dental care in the Fort Worth area. For a copy of this brochure, call Cook Children’s Advocacy Department at 682-885-4162.

Sibling Rivalry Can Pay Off Children who grow up with siblings get along better with kindergarten classmates than only children, an Ohio State University study shows. Researchers asked teachers to rate more than 20,000 children. “Children without siblings were consistently rated as having poorer social skills,” says study coauthor Douglas Downey, Ph.D. “Siblings fight with each other, they have conflicts, but they also figure out how to resolve those conflicts. That probably helps them deal with other children when they go to school.” The study appeared in the Journal of Marriage and Family.

Fish Aids an Unborn Child’s Brain

The Cook Children’s Heart Center team of nationally known cardiologists, cardiothoracic surgeons and clinicians is trained to care for disorders and defects found in the hearts of infants and children. The Heart Center provides care and diagnostic tests at locations across Texas and in the Metroplex at Arlington, Hurst, Southlake, southwest Fort Worth and at the campus of Cook Children’s Medical Center south of downtown Fort Worth. For more information or to schedule an appointment, call 682-885-2140.

Eating fish while pregnant may aid the growth of your child’s nervous system, a study shows. “Our research adds to the literature suggesting that fish contains nutrients that may enhance early brain development,” says coauthor Julie Daniels of the University of North Carolina at Chapel Hill. Two or three servings a week (about 12 ounces) seems to do the trick, she says. But women should avoid large predatory fish that may be tainted by mercury or other pollutants. Shark, swordfish, king mackerel and tilefish head that list. The study in the journal Epidemiology looked at 7,421 English children. It compared moms’ fish consumption while pregnant with their children’s early language and communication skills.

Active Kids Are Less Depressed Middle-school students who become more physically active show fewer signs of depression, researchers say. In a study of 4,594 Minnesota students, more physical activity at the start of seventh grade was tied to less depression. And among students who increased activity over the two-year study, symptoms of depression fell, says coauthor Rod K. Dishman, PhD, of the University of Georgia. The research appeared in the journal Psychosomatic Medicine. Depression tends to rise in early adolescence, Dr. Dishman warns. That means parents and educators should keep children as active as possible.

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Anticipating a New Arrival Health and safety details to expect during your pregnancy

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o you want to know your unborn baby’s gender? Have you selected names? Where should you register? What’s the fastest way to the hospital? When you are expecting a child, there are a number of things to consider and some details regarding your newborn’s health and safety you may have never thought about. Thinking about these details ahead of time can make the days and weeks around your delivery a little easier.

Evaluating your needs Even before you become pregnant, it is important to review your lifestyle in preparation for the baby you will bring into the world. Your pregnancy will be a life-altering event. Evaluating your health, mental well-being and your relationships can be the first step in deciding how you’ll care for your child after delivery. Your health. Get a complete check-up and make sure you are up-to-date on immunizations. It can make a difference in the health of your child. For example, German measles is a fairly common illness that can be dangerous to an unborn child, but it can be prevented if you get

immunized for the illness before you’re pregnant. Also, it is never too early to start eating healthy and exercising in anticipation of your delivery. However, you’ll want to talk to your physician before beginning any program. Your mental well-being. Starting a family is an exciting part of your life, but it may also bring concerns about lifestyle, finances and other changes. You’ll want to think about the time necessary to recover from your pregnancy and how caring for a baby will take time and energy, possibly altering your lifestyle. Review your finances and your insurance plans to learn how having a baby may change your current financial status. Your relationships. The birth of your baby will be the start of a wonderful new relationship. You’ll have concerns about what kind of parent you will be. This is normal, but once your baby is here, you’ll find that some things just come naturally. You may wish to investigate a parenting class to learn more. After birth, you will 4

spend much of your free time with your baby and this may affect your other relationships. Friends and family should understand these demands and take them into account.

can call any of the Cook Children’s Physician Network pediatricians throughout the area to schedule a time for a new baby consultation. There are more than 30 Cook Children’s Physician Network offices in Tarrant, Denton and counties. To find a pediatrician near you, call 800-934-COOK (800-934-2665).

Childbirth education classes

Selecting a pediatrician After your baby arrives, there are a number of immunizations and checkups your baby will need. During your pregnancy, you should consider which pediatrician you want for your child. Although every pediatrician is a specialist in the health care of infants, children and adolescents and is committed to helping parents raise healthy children, personalities differ. By knowing whom you will use before delivery, you’ll have one less thing to think about on the day your baby arrives. You may have a pediatrician in mind who has been recommended by a family member or a friend. You also

It’s not too early to begin preparing for your delivery day. Many Cook Children’s Physician Network pediatricians work with area hospitals to conduct new baby classes. Check with your Lamaze coach, obstetrician or a hospital where you plan to deliver to find out when childbirth classes are scheduled. These classes offer an excellent time for parents to learn about their baby’s development and what to do during the birthing process, as well as to spend time together before the new baby arrives.

During these classes, you’ll learn breathing and relaxation techniques to be used during labor and delivery. Medications are also typically discussed. The use of


and weighs at least 20 pounds, the child can then move to a forward-facing child safety seat. Approximately 80 percent of all child car seats are inappropriately installed. To help parents make sure their child is secure, Cook Children’s Medical Center and Tarrant County SAFE KIDS offer routine child car seat checks by certified car seat technicians. Expectant parents may attend a car seat check so their seat is safely installed before their child arrives. Otherwise, after the child is born the parents should bring the baby to a car seat check to provide a good individualized fit for the car seat and the baby. For more information and to schedule your child car seat safety check, call 682-885-2634. ❖

Mother’s Journal

medications varies widely, depending on each mother’s needs. The coach’s role is extremely important during the birthing process. These classes also allow you to review the stages of labor to the benefit of both you and your coach.

Choosing an infant car seat Texas law requires that a child under 4 years of age and under 36 inches tall be restrained in a federally approved safety seat at all times when riding in a motor vehicle. However, when

infants are first born, they should ride in a rear-facing safety seat instead of the traditional forward-facing child safety seats. Sitting in a rearfacing seat better protects an infant’s neck and spinal cord from car crash forces. When the child is at least 1 year old 5

To help you during your pregnancy, Cook Children’s offers a “Mother’s Journal” for use in tracking important dates and helping keep your baby healthy. The journal can also act as a reminder for upcoming appointments and assist in documenting important information. To get your copy of the journal, call 682-885-4242.


Stuttering Is Normal — to a Point If it lingers, however, parents should seek professional help

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ctor James Earl Jones did it. So did author Lewis Carroll. And today about 3 million people in the United States do it, too. Stuttering. It frightens parents, embarrasses teenagers, and can frustrate young children who are just starting to talk. But Lisa Scott Trautman, PhD, of the Department of Communication Disorders at Florida State University, says parents shouldn’t worry about children who stutter when they’re learning to form words. “It’s common for young children to go through a period of speech disfluencies,” she says.

Helping your child beat stuttering while young reduces the chances of stuttering into adulthood. Here’s what the Stuttering Foundation says parents should do to help a child who stutters: ■ Listen patiently to what your child says, not how it is said. Respond to the message rather than to the stuttering. ■ Allow your child to complete thoughts without interruption. Maintain eye contact. ■ After your child speaks, reply slowly using some of the same words. ■ Wait before responding. This helps to slow things down and should help your child’s speech. ■ Spend at least five minutes each day talking with your child in a relaxed manner. ■ Find ways to show your child you value and enjoy your time together. “Encouraging talking and relaxed speech in a household can go a long way to helping a child who stutters,” says Lisa Ehl Lewis, MD, of Cook Children’s Physician Network. “If your child stutters for more than six months, is self-conscious or fearful of stuttering or has a strong family history of stuttering or speech delay, then professional evaluation may be warranted.” ❖

Rehabilitation Services

This can range from repeating words (but-but-but) or “uh” sounds (uh-uh-uharound) to stretching out initial sounds (MMMMMommy). The Stuttering Foundation of America says that if your child speaks like this for six months or more, however, or shows signs of tension or frustration when talking; you should find professional help.

Lisa Ehl Lewis, MD, is a pediatrician with Cook Children’s Physician Network. She practices in southwest Fort Worth at 6210 John Ryan Drive.

Cook Children’s Rehabilitation Services offers a variety of therapies to help children overcome or cope with disabilities and regain maximum function after injuries or illnesses at four Tarrant County locations: Arlington 3330 Matlock Road, Suite 124 Hurst 750 Mid-Cities Blvd. Fort Worth Child Study Center at 1300 W. Lancaster Cook Children’s Medical Center at 801 Seventh Ave. To obtain an appointment at any of our locations, ask your doctor to fax a prescription to 682-885-7590. For more information, please call 682-885-3898. 6

Find Safe, Fun Ways to Keep Young Kids Active Don’t let toddlers be couch potatoes

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n a world that hypes baby yoga and baby swimming classes, can baby football be far behind? Physical activity for the very young is vital — but avoid such extremes, experts say. “The norm now is for kids to be inactive, and your child is never too young to begin movement,” says Eric Small, MD, who chairs the American Academy of Pediatrics committee on sports medicine and fitness. “But on the other end of the spectrum we have parents enrolling kids 1, 2 and 3 years old in classes they are not ready for.


Kohl’s Cares for Kids® Items Help Cook Children’s Patients and Families Net profits from plush items and books fund various hospital projects

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he next time you purchase a storybook or a stuffed animal for your own child, you might be making a difference for many children and families at Cook Children’s Medical Center. At Fort Worth-area Kohl’s stores, the net profits of seasonal plush characters, books, music and other items available for $5 are donated to Cook Children’s through the Kohl’s Cares for Kids®

program. Over the past three years, the Kohl’s program has contributed more than $365,000 to Cook Children’s Medical Center. An example of projects that have been funded as a result include: ■ Save a Smile, a community collaboration created by the Children’s Oral Health Coalition of Tarrant County and Cook Children’s Medical Center to bring dental services and oral hygiene information to children of low-income families. Tooth decay is the most common infectious disease affecting children in the United States. The Kohl’s grant helps fund operational expenses and dental hygiene kits provided to children, including toothbrushes and oral hygiene information.

CarePagesSM, a program Cook Children’s

is developing, will provide assistance to families of hospitalized children who want to create Web pages to update friends and families. When complete, CarePages will be free, available in English and Spanish and managed by the Pastoral Care Department at Cook Children’s Medical Center. ■ Playrooms for hospitalized children and their families while being treated at Cook Children’s Medical Center in Fort Worth. Cook Children’s is one of 40 children’s hospitals across the country to benefit from the Kohl’s Cares for Kids® program. For more information about current products being sold through the Kohl’s Cares for Kids® program, go to Kohl’s Web site at www.kohls.com. ❖

something as simple as playing pattycake, for instance. ■ Toddlers need an hour or more each day in free play. That could mean riding, pushing, pulling and climbing safe objects, for instance. ■ Toddlers and preschoolers shouldn’t be inactive for more than an hour at a time except when sleeping. “Parents should remember that play helps a child investigate, develop imagination and explore the world,” says Aimee Vafaie, MD, a pediatrician with Cook Children’s Physician Network. “Toddlers love to play and will do it whenever they have the chance. Simply providing a safe and encouraging atmosphere for toddlers gives them the opportunity to do what they do best.” ❖ I just treated a preschooler for knee pain from being overstretched in a yoga class.” On the other hand, some busy parents keep kids immobile to aid child care. Some spend hours in car seats or strollers. Kids can suffer, because activity plays an important part in helping

them learn cognitive and motor skills. The experts recommend: ■ Toddlers should have at least 30 minutes of structured physical activity a day. Preschoolers need at least an hour. Activity doesn’t have to be complex or costly. It can include 7

Aimee Vafaie, MD, is a pediatrician with Cook Children’s Physician Network. She practices in Flower Mound at 3535 Fire Wheel Drive.


Cook Children’s Physician Network

largest non-profit pediatric physician network

is the 801 Seventh Avenue Fort Worth, TX 76104

in North Texas with

more than 200 physicians, including primary care physicians

pediatric subspecialists in more than 30 locations and

in Tarrant, Denton and Hood counties.

To

find a pediatrician near you

or for a referral, please call our toll-free number,

800-934-COOK.

Children’s Hospitals Provide Top Health Care to Kids

Y

ou’ve heard the saying countless times: Children are not small adults. Never is this more apparent than when it’s your child who’s sick. Children are unique, growing individuals who require special care. And nobody knows more about caring for kids than children’s hospitals. Whether your child needs to undergo a simple procedure or needs complex surgery, children’s hospitals are technologically advanced, kid-friendly facilities staffed by the top pediatric specialists in the country. The National Association of Children’s Hospitals and Related Institutions (NACHRI) supports children’s hospitals and their efforts to

NACHRI National Association of Children’s Hospitals and Related Institutions

ensure that all children receive the highest quality health care possible. Children’s hospitals devote 100 percent of their services to children. That’s why they are able to provide the majority of highly specialized care for kids hospitalized with complex and rare conditions — regardless of ability to pay. In fact, children’s hospitals provide 90 percent of all pediatric heart surgery and 94 percent of all pediatric transplants, and care for 84 percent of children in hospitals for advanced cancer. While most children’s hospitals are best known for serving children with these severe conditions, they also help all children grow up healthy through routine and preventive care, including vaccinations, nutritional counseling and injury prevention education. NACHRI helps its member hospitals continuously improve in all areas of children’s health care by providing data

and educational and networking opportunities that lead to new breakthroughs in pediatric health care. For more information about children’s hospitals and the services they provide, visit www.childrenshospitals.net or contact Cook Children’s at www.cookchildrens.org. ❖

Articles in this newsletter are written by professional journalists or physicians who strive to present reliable, up-to-date information. But no publication can replace the care and advice of medical professionals, and readers are cautioned to seek such help for personal problems. ©2005 Health Ink & Vitality Communications, 780 Township Line Road, Yardley, PA 19067, 267-685-2800. Some images in this publication may be provided by ©2005 PhotoDisc, Inc. Some illustrations in this publication may be provided by ©2005 The Staywell Company; all rights reserved.

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