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Tid★BiTs 2013 Calendar Children’s Hospital of Richmond at VCU A year of tips for your family

NEWS, KNOWLEDGE AND HEALTHY FUN

Featured in this calendar★ Articles from CHoR specialists★ Ideas for family fun★ Safety info from Virginia Poison Center★ Safety tips from Safe Kids Virginia★ Special event datesNote: The 2013 Tid★Bits Calendar lists dates for several special

events and educational programs organized by Children’s Hospital

of Richmond at VCU (CHoR) and partnering organizations

including Children’s Hospital Foundation (CHF). CHF is dedicated

to funding and advocating for pediatric initiatives that improve

the status of health care and the quality of life for children in our

region. The Foundation provides support for the programs and

initiatives of CHoR and the children it serves each year, as well as

other pediatric health care programs in the community. To learn

more about CHF, visit chfrichmond.org.

Connect with CHoRVisit Children’s Hospital of Richmond at VCU

(CHoR) online at www.chrichmond.org for our

Tid ★Bits family newsletter, publications and more!

chrichmond

@ChildrensRVA

youtube.com/user/VCUMedCtr

804-828-CHOR (2467)

New Children’s Pavilion under Construction on MCV CampusConstruction of a new Children’s Pavilion and parking deck on the

MCV campus began in 2012. The new pavilion will be the largest and

most advanced outpatient facility in the region dedicated to children.

It will bring the majority of CHoR’s outpatient pediatric services

(which are currently spread throughout the MCV campus) to one

location designed to meet the unique needs of pediatric patients.

The new pavilion will house:

procedure rooms

support space and a centralized clinical team hub. The building

accommodate additional clinic pods and operating rooms.

Construction will also include an attached parking deck with

over 600 parking spaces.

Like us on Facebook for Children’s Pavilion construction

updates and additional news: facebook.com/chrichmond

Parking Update - The underground parking deck for the

current CHoR Children’s Pavilion, located at 1001 E. Marshall

Street in Richmond, Va., is now closed due to construction of

the new facility. Valet parking drop off has been relocated to

Marshall Street, between 10th and 11th streets, in front of the

Children’s Pavilion. For parking information and updates about

the new Children’s Pavilion, visit go.vcu.edu/pavilion.

SPECIAL THANKSCalendar Contributors: Corri Miller-Hobbs, Registered Nurse, Safe Kids Virginia Program Coordinator; Evelyn Waring, Education Coordinator,

CHoR would also like to thank the patients and families who are featured in the 2013 Tid ★Bits Calendar.

New Children’s Pavilion, view from Broad Street

CHoR provides services at the two main campuses listed

below and several satellite and outpatient therapy centers:

MCV Campus Brook Road Campus

1001 E. Marshall Street 2924 Brook Road Richmond, VA 23219 Richmond, VA 23220

Children’s Hospital of Richmond at VCU

LOCATIONS

TID★BITS ADVISORY BOARD

Chris Gardner, Licensed Clinical Social Worker

Kendall Lee, Associate Director of Government Relations

Corri Miller-Hobbs, Registered Nurse and Safe Kids Virginia Program Coordinator

Shira Cantor, Public Relations Coordinator

Kristin Stemhagen, Editor

Children’s Hospital of Richmond at VCU Tid★Bits is published by Children's Hospital of Richmond at VCU (CHoR), 1001 E. Marshall Street, P.O. Box 980646, Richmond, VA 23298-0646, and issued in a printed newsletter format twice a year and a printed calendar annually. For more information on articles appearing in Children’s Hospital of Richmond at VCU Tid★Bits publications, contact the Public Relations office at (804) 828-7035.

Photography: Children’s Pavilion rendering courtesy of HKS Architects. All other photos taken by Doug Buerlein.

©2012 Children’s Hospital of Richmond at VCU, Richmond, Virginia. All rights reserved. Reproduction or redistribution in any form without the prior permission of Children’s Hospital of Richmond at VCU, Richmond, Virginia is expressly prohibited. This information is provided on an “as is” basis without warranty of any kind, either express or implied.

This material is provided for informational and educational purposes only; it does not contain specific medical advice. If you have specific health questions or problems, consult a health care professional for personal medical advice.

Children's Hospital of Richmond at VCU (CHoR), a children's hospital within the Virginia Commonwealth

University (VCU) Medical Center, offers the widest range of pediatric services in the region and is Central

Virginia's only full-service children's hospital. CHoR's continuum of care includes:

MEDICAL/SURGICAL SERVICES

Acute CareAdolescent Medicine Allergy, Asthma and Immunology AnesthesiologyBurn CareCardiologyCardiothoracic SurgeryChild ProtectionCritical Care MedicineDentistryDermatologyDevelopmental PediatricsEmergency MedicineEndocrinology and MetabolismFeeding Program Gastroenterology and NutritionGeneral Pediatrics Genetics Hematology and OncologyHospital Medicine Infectious Diseases International Adoption Medical ProgramLong -Term CareNeonatal Medicine NephrologyNeurologyNeurosurgeryOphthalmology

Orthopaedic SurgeryOtolaryngology (Ear, Nose and Throat)Palliative Care and Pain Management Pharmacology and Toxicology Physical Medicine and Rehabilitation Plastic Surgery Poison CenterProgressive CarePsychiatry/Behavioral HealthPulmonologyRadiologyRheumatologySurgery (General/Trauma)Transplant SurgeryUrologyWeight Management

INPATIENT UNITS

Acute Care Units Bone Marrow Transplant UnitEpilepsy Monitoring UnitEvans-Haynes Burn CenterNeonatal Intensive Care UnitPediatric Intensive Care UnitPediatric Progressive Care UnitTransitional Care Unit Virginia Treatment Center for Children/Behavioral Health

THERAPY SERVICES

Assistive TechnologyAudiology Early Intervention/Infant ServicesFeeding ProgramNutrition ServicesOccupational TherapyPhysical TherapyPsychologySpeech/Language Pathology

SUPPORT SERVICES

Art Therapy Care Connection for ChildrenChild LifeHospital EducationMedical-Legal PartnershipMusic Therapy Pastoral CareRecreation TherapySafe KidsSocial Work

Enjoy the Many Benefits of Family Time

At the table Developing family relationships provides the emotional support required by children of all ages to develop a healthy sense of their personal identity as well as how they are part of the family. When gathered around the family dinner table, children learn appropriate social skills such as using “please and thank you” and listening respectfully to others. Skills related to turn-taking in conversation and sharing one’s thoughts and opinions are also acquired at family meals. One fun way to gather for a family meal can be a picnic developed around a holiday theme with younger children making decorations such as place mats and older children preparing food items. Having children involved in the planning helps them feel connected, which in turn helps them learn to see themselves as part of a team.

Volunteering Participating in a volunteer program is a great opportunity for families to share values and contribute to the wider community. Interest in animals, for example, could be expanded to assisting at a local animal shelter. For families interested in ecology, there are websites that describe opportunities to assist in river or park clean-up projects. Another option might be visits to a nursing home or retirement community to read, write letters, or help older citizens make scrapbooks of their memories. Families can also volunteer to deliver meals to those in need or assist in collecting donations for a food bank. Spending time together helping others allows children to consider the needs of others and extends their sense of belonging to a wider support network.

Reading and sharing Spending time reading together and then sharing ideas and impressions with other family members allows children to learn to engage others in respectful conversation and resolve differences in opinion. When children learn positive interactions such as compromise and respect for different viewpoints, they can experience a smoother transition into school and community life.

by Dr. Elizabeth C. Shepherd, Licensed Clinical Psychologist

Explore the outdoors Exploring Virginia’s many parks and gardens allows families to learn together about their broader neighborhood. Try choosing a theme for outdoor exploration. For example, wildflowers or birds are topics that a variety of ages can explore for color, size and habitat. Back at home, the activity can be extended to include drawings, stories or creating a scrapbook of family outings. This allows all ages to make contributions. Younger children can make up stories about photographs, and older children can select photos they’ve taken and write stories about the animal, location or plant of interest. Younger children might be fascinated with waterfalls from Shenandoah National Park, for example, and create a story about playing in the pool at the foot of South River Fork Falls. Older children might be interested in eagles, hawks or owls and write a story about protecting their habitat.

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27 28 29 30 31 DECEMBER 2012 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

FEBRUARY 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

JANUARY 2013SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

Martin Luther King Jr. Day

New Year’s Day

MORE IDEAS FORFAMILY FUN

Look for more “Family Fun Ideas” throughout the 2013 Tid ★Bits Calendar! Recommendations for special activities that promote family bonding, playtime, child development and much more are featured on calendar days and with many of the articles in this year’s publication. These suggestions are provided by members of the Child Life Department at Children’s Hospital of Richmond at VCU. We hope their recommendations and ideas inspire fun for your family and for the children in your lives. Spending time together as a family offers so many benefits for all.

Look at family photos and share stories about

what’s happening in the photos.

Paint take-out containers. Try making

different winter scenes or animals.

Virginia Dance Festival – Dozens of dance troupes perform classical and modern dance styles. Benefits Children’s Hospital Foundation.

www.chfrichmond.org

Healthy Eating: Put Superfoods on the Menu!

The term “superfoods” refers to foods that are rich in vitamins, nutrients and antioxidants, and may have other health-benefiting properties, like omega-3’s or fiber. These foods are known for their role in preventing heart disease, cancer, high cholesterol and obesity. Encouraging children to eat superfoods can begin a lifetime of great eating habits and may help prevent a host of common health problems.

Recipe Ideas: Superfood CombosTry a quick and easy fruit salad with chopped fruit from the list above and

add a dollop of yogurt. Sprinkle walnuts and rolled oats on the top.

For an unusual dessert: puree ripe avocado with kiwi and freeze.

This superfood combo makes a creamy, delicious sorbet!

Top wild-caught salmon with orange zest, drizzle with olive oil, and

pomegranate seeds for a sweet and tart crunch!

by Jennifer Vaughan and Mary Henck, Registered Dietitian, Nutrition Department

SUPERFOODS Broccoli May slow tumor growth and prevent

cancer

Salmon (wild caught) Supports brain health and good

cholesterol levels

Apples, with skin Kiwi

helps regulate heart function) and folate/

folid acid

Spinach

support eye health

Avocados

May combat cancer and heart disease

Oats Known for lowering cholesterol, very rich

in vitamins and minerals

Tomatoes

Great for eye and heart health

Beans

heart-healthy magnesium and folate/folic

acid (which helps build healthy new red

blood cells and can also help prevent birth

defects)

Oranges

Good for heart health, may prevent cancer

and stroke

Turkey

and iron for energy

Pomegranates

reduce bad cholesterol

Walnuts

Blueberries Pumpkin Yogurt Supports stomach health and a healthy

immune system

When incorporating superfoods into your

family’s diet, use whole, unprocessed,

fresh versions. Blueberry-flavored cereal

and turkey deli slices don’t count!

FEBRUARY 2013

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JANUARY 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

BENEFITS OF OMEGA 3’s & FIBER

to heart health, brain health

and lowering cholesterol.

produced by the body which

is why it is important to

get them from foods. Fiber

is best known for helping

to promote regular bowel

function. Fiber has many

preventing certain cancers

and improving heart health.

BRUSH 2MIN2X February is Children’s Dental

Health Month. Starting today,

be sure to help children

brush their teeth at least

2Min2X – 2 minutes each

time, 2 times a day – for

healthier teeth, good breath,

fewer cavities and to avoid

keep in mind: Children ages

2 and older should always

parents should help or watch

over a child’s brushing until

they are at least 8.

For more “Tooth To-Dos”

healthy-mouths

Recommended by Dr. Tegwyn Brickhouse, Pediatric Dentistry

MARCH 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

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SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

Groundhog Day

Presidents’ Day

Ash Wednesday Valentine’s Day

Have a princess or superhero snack party. Serve a superfood or

two from the list above.

Play balloon tennis or volleyball for

active indoor fun.

Children’s Hospital Foundation19th Annual Bowl-A-Thon

Open to the publicwww.chfrichmond.org

Play it Safe: How to Prevent Overuse Injuries

The American Academy of Pediatrics recommends the following to reduce the risk of overuse injuries:

instructional league. They should not move on to

Children should play multiple sports until age 12 and two to

desired, is not recommended until age 16.

Children should take a day or two off per week from

sports participation to allow their bodies to recover.

Children should take two to three months off from

a particular sport each year. Cross-training (engaging

muscular development) can help prevent loss of skill or

conditioning.

The areas where bones grow in children are at more risk

of injury. Tenderness over a bone should be evaluated by

a medical professional, even if swelling or limitation in

motion is minimal.

Sports specialization and intensive training should always be

undertaken with caution. Well-rounded multi-sport athletes

have the greatest chance of enjoying physical activity and

While the benefits of sports are numerous – improved fitness, the development of physical skills, opportunities for fun and friendship, etc. – the nature of sports participation involves the risk of injury. Though the amount of contact involved in a sport can raise the risk, most injuries in young athletes are due to overuse.1 In many cases, however, overuse injuries can be prevented. Here’s what you need to know:

By Dr. Bill Shaw, Division of General Pediatrics, and Contributing Writer Ryan Lockwood, Physical Therapist

1

The ABC’s of overuse injuriesMore and more, children are focusing on one

a result of this early specialization, athletes

injuries previously found mainly in adults and

when children specialize too early, many do not

from practicing different sports.

Overtraining is when too much stress is put on

the body and not enough time is allowed for the

body to recover. Overtraining puts athletes at

higher risk of overuse injuries and is considered

a side effect of early specialization.

Overuse injuries are typically related to

overtraining. These are small injuries that do not

get enough time to heal and can worsen over

time if not treated. Overuse injuries often occur

over time from repetitive motion and stress on

in a bone caused by repeated stress (stress

fractures), small tears to a muscle (muscle

such as tendonitis and bursitis.

MARCH 2013

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APRIL 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

WARNING SIGNSOvertraining & burnout

Child complains of:

Child demonstrates:

Sports injury

Seek professional help for these warning signs:


Daylight Saving Time Begins

St. Patrick’s Day

PalmSunday

First Day of Spring

National Doctor’s DayGood FridayEaster

Make a robot or a fairy house out of

recycled materials.

Glue buttons onto an outline of a flower to

make a mosaic,31

Dancing with the Richmond Stars – Local celebrities pair with

professional dancers. Benefits Children’s Hospital Foundation.

www.chfrichmond.org

NATIONAL POISON PREVENTION WEEK: MARCH 17-23

Passover Begins

Guidelines for Development: Motor Milestones

Almost all formal psychological tests of children’s development come from the work of child psychologist and pediatrician Dr. Arnold Gesell. Dr. Gesell created developmental schedules, commonly referred to as “milestones,” based on what parents observed about the children in their lives. The theory behind these milestones is that children’s development follows a sequence and can be reasonably predicted along a time course. The chart below outlines motor skill milestones from birth to age 3. Keep in mind that children develop different skills at their own rate and these are guidelines only. A child’s primary care physician can provide information if you have questions about development. Also, the state of Virginia offers free developmental screenings for children under the age of 36 months. (See details below.)

Developmental Milestones Chart

Developmental ScreeningsAll infants and toddlers (ages 0-36 months) in Virginia are eligible to have their development checked at no cost to the family. If

recommended, additional testing – which may include screenings of speech, hearing and thinking, motor and social skills – can also be

arranged, again at no cost to families. For details, call Children’s Hospital of Richmond at VCU at (804) 228-5818.For information about developmental milestones, visit healthychildren.org.

Newborn -3 MonthsFine Motor Skills

Gross Motor Skills

3 -6 MonthsFine Motor Skills

directions

Gross Motor Skills

position

abdomen when on stomach


hand to the other

small foods like Cheerios

Gross Motor Skills

explore with other (when on stomach)

and cruise around furniture


Gross Motor Skills


Gross Motor Skills

one hand held

2 -3 YearsFine Motor Skills

Gross Motor Skills

Information provided by Dr. Pasquale “Pat” Accardo, Chief, Child Developmental Clinic

Fine motor skills are generally associated with use of the hands and upper extremities. Fine motor activities include reaching, grasping

Gross motor skills involve muscles in the arms, legs and torso and relate to balance, strength,

body awareness and reaction speed. Gross motor activities include walking, running, throwing, lifting and kicking.

APRIL 2013

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28 29 30 MARCH 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

MAY 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

BUCKLE UP, PHONE DOWN

April is Distracted Driving Awareness Month

Did you know…

■ 8 out of 10 crashes in

Virginia relate to a distracted

driving incident.

■

Facebook or Twitter while

driving you increase your

times.

■ When you talk on a cell

phone, your brain activity

associated with driving

is reduced by almost 40

percent.

■

like driving the length of a

closed.

Be sure teen drivers are

aware of the risks of

we encourage all drivers

(parents too!) to visit

drivesmartva.org to sign

Drive Smart Virginia’s online

pledge to drive distraction

free. Together we can make

Virginia’s roadways safer for

everyone.

Statistics provided by Drive Smart Virginia


Earth Day

Hide an object. Draw a treasure map

for child to follow.

Have a reading picnic – indoors or out!

Connections 2013: Free resource fair for children and youth with special needs and their families. Features 60+ exhibitors and children’s entertainment. For details visit: www.careconnections.vcu.edu

Food Allergies 101: Symptoms & Serious Reactions

Food allergies affect more than 1-2 percent of the general population and around 6-8 percent of children. The number of cases is growing, with an increase of 18 percent in the last few years. Here’s some general information about how to recognize symptoms and serious reactions:

SymptomsThe term food allergy describes a repeated abnormal

response of the body’s immune system to a food.

The foods that cause the majority of food allergies

peanuts, tree nuts (almonds, cashews, walnuts,

etc.), sesame and corn. Symptoms related to food

allergies include the following:

Itching of the skin and mouth

Skin rash

Swelling of the face, mouth and lips

Dizziness

Throat closing

Trouble breathing

Wheezing

Fainting

Food allergy symptoms can range from mild to

severe and can be visible after eating or after

minutes but in some cases the appearance of

occur at any given time.

If you suspect a child has an allergy to a food,

immediately stop the child from eating that food.

Depending on the severity of the reaction, the child

should be checked by a primary care physician or in the

emergency room. Visits to an allergist can then help

to identify the food(s) that are causing the reaction.

Serious reactionsIn some cases, food allergies can be life-threatening

and if you are unable to judge the severity of the

reaction, the child should be taken to the nearest

emergency room for care. Symptoms of a severe

reaction include:

Coughing Trouble breathing

Voice change Wheezing

Throat closing Fainting

Timely intervention can save a life. If you suspect a

child is having a severe allergic reaction, here’s how

to provide immediate help:

■

ground with his or her legs elevated.

■ If the child has been prescribed an EpiPen® for

emergency treatment of allergic reactions, use

it as instructed.

■ Call 911 immediately.

■ If the child is able to swallow Benadryl®,

administer an age-appropriate dose.

by Dr. Santhosh Kumar, Division of Allergy & Immunology

MAY IS NATIONAL ASTHMA & ALLERGY AWARENESS MONTH

MAY 2013

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APRIL 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

JUNE 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

FOOD ALLERGIESWho is at risk?

by food allergies and food

allergies can develop at any

time in a person’s life. If both

parents have food allergies

and/or eczema, a child is

at a higher risk. Children

who have eczema, asthma

or nasal allergies are also

more likely to develop food

allergies.

Is there a cure?

Currently there is no cure

for food allergies. The

good news is that some

common food allergies −

such as allergies to milk,

eggs, wheat and soy − are

often outgrown. Certain

others, like nuts and

seafood, are not commonly

outgrown. Regular follow-

up appointments with an

allergist can help identify if a

child is outgrowing his or her

food allergies.

Click It Or Ticket

It Or Ticket” mobilization

up and always be sure

all passengers are safely

buckled. Seat belts save

lives.


Mother’s Day

Memorial Day

Cinco de Mayo National Bike to School Day

Leave a note for your child to find telling them something you

love about them.

Write a story as a family. Draw pictures

to illustrate each other’s sentences.

Family Fun: Handprint & Footprint Art Projects

When considering art projects to do with your children, handprint and footprint crafts should be at the top of the list! Most handprint and footprint crafts are easy to make at home. Using children’s own hands and feet to make a base for a design allows young artists to think outside the box in creating new projects. Here are a few ideas from Certified Child Life Specialist Emily DePetris:

Lobster Hand/FootprintMaterials:

Red paint

Paintbrush

Black crayon

Paper

Handprint Giraffe Materials:

Yellow paint

Brown paint

Paintbrush

Black crayon

Paper

Footprint TurkeyMaterials:

Brown paint

Crayons

Scrapbook paper or construction paper (for feathers)

Child-safe scissors*

Paper

Materials:Brown construction paper (for sticks)

Child-safe scissors*

Red, orange and yellow paint

Cotton balls

Kabob skewer*

Glue or tape

Paper

Handprint and footprint art projects can be used as a measurement for future growth, giving children the opportunity to see how much

they’ve grown since originally completing the craft. They’re also wonderful keepsakes to give loved ones or display around the house.

S’mores Handprints

*Always watch young children closely when they are using scissors/art supplies, painting, or working with sharp or small objects.

JUNE 2013

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MAY 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

JULY 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

SAFE TRAVELS Whether driving in your

neighborhood or to another

state, always follow these

recommendations to reduce

risks on the road:

■ Be sure car seats are

properly installed and all

passengers are adequately

restrained.

■ Toddlers should be in

rear-facing car seats until

age 2 or until they reach

weight for their car seat.*

■ Most children will need

to be in a belt-positioning

booster seat until they are

8 and 12 years old.*

■

should never ride in the

front seat.

■ Drivers should always be

well-rested and sober.

■

secured in the vehicle.

Information provided by Dr. Robin Foster, Director of Pediatric Emergency Services, and the Safe Kids Virginia Coalition

*Recommended by the American Academy of

Pediatrics (Policy issued April 2011)


Father’s Day

Flag Day

First Day of Summer

Color coffee filters with markers and

sprinkle with water for a special design.

Throw beach balls into laundry baskets set up

at different heights.

30

Teaching Children About Similarities & Differences

An important role for parents is to help their children better understand the complex world in which we live. One way parents can help do this is to teach their children how to identify similarities and differences. Parents can begin to teach this when a child is very young and can continue as the child ages, adjusting discussions to the child’s developmental level. The thoughts of young children tend to be concrete (centered on what they are seeing or experiencing) and it is not until about age 11 or 12 that abstract thought (the ability to consider ideas and relationships that are not tied to a specific object or event) typically begins to emerge. The following are ideas for teaching children about similarities and differences as their thought process develops.

Preschool through early elementaryWhen teaching preschoolers and young children to identify similarities and differences, it is a good idea to

neighborhood, point out that a dog and a cat are both animals, but one barks and the other purrs.

Middle to late elementaryBy middle childhood, children are better able to discuss similarities and differences that are not necessarily

differences between their mother and father’s elementary schools. Or, after reading a book about dinosaurs,

you could talk with your child about the similarities and differences between tyrannosaurs and stegosaurs.

Middle school and beyondIn late childhood or adolescence, children become more capable of abstract thought which allows them to

better understand that individuals have differing ideas and theories. They are also more capable of making

adolescent and discuss the similarities and differences among methods of government (communism,

socialism, democracy, etc.) or watch a movie and discuss the similarities and differences between the

characters’ personalities and intentions. They can also discuss the similarities and differences between the

training approaches of two coaches so that a decision can be made regarding which baseball team will be a

It is important to give children developmentally appropriate opportunities to make their own observations

and ideas regarding similarities and differences. They also need to learn the importance of considering the

will help them to more effectively participate in their community throughout life.

by Dr. Julie C. Neblett, Licensed Clinical Psychologist

JULY 2013

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28 29 30 31 JUNE 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

AUGUST 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

FAMILY FUN IDEA: OUTDOOR ART

inspiration for creative

activities for your family:

Tissue paper handprint trees

halfway down arm with

brown paint. Place painted

hand/arm on paper to make

a print for a tree trunk and

branches. Rip up colorful

tissue paper and roll into

loose balls. Glue the balls

around tree “branches.”

Tissue paper balls also

Tree/leaf rubbings

Hold paper on a tree trunk and

rub with brown crayon in a

tree trunk shape. Place leaves

under paper and rub with

crayons to make leaf outlines.

Cut out leaves and glue them

to the tree trunk print.

Apple prints

Cut an apple in half. (For the

classic “star,” cut horizontally.)

Paint apple halves and press

the painted side of apple onto

apple prints to blank stationery

or postcards to create a

special mailer for family and

friends. Note: It is safest if an

adult cuts the apple.

- Siri Bream, Certified Child Life Specialist


Independence Day

Ramadan Begins

Organize an obstacle course where players carry ping pong balls

in plastic spoons.

Start an annual “Do Something Nice for Someone Day.”

Anthem LemonAid weekend (July 19-21) – This Children’s Miracle Network Hospitals event raises funds for Children’s Hospital of Richmond

at VCU’s oncology clinic. For details: www.anthemlemonaid.com

Overview of ConditionsUrinary tract infections are often associated with burning on

urination or new wetting in children who were previously toilet-

trained. These infections are more common in girls and have

an increased risk at the time of toilet training. Current medical

opinion is that recurrent urinary tract infections (i.e., infections

that occur again and again) in females or any urinary tract

infections in males require a thorough evaluation by a primary

care physician, pediatric nephrologist or pediatric urologist. This

ultrasound. In some cases further studies looking at the bladder

Day and nighttime wetting also are common problems as children

go through the toilet training stage. Children who have never

been dry (i.e., who have day and nighttime wetting in their young

school-age years) are considered to have primary enuresis.

Children who have been dry and then begin leaking urine, during

the day or at night, are considered to have secondary enuresis.

prompt an evaluation by a primary care physician for causes of

this problem. Often simple things, such as decreasing caffeine

or water intake after 6 p.m., help with wetting issues. Persistent

nighttime wetting can run in families. To help address this issue,

the use of alarms or medication is sometimes also necessary

to help train bladders to not wet the bed at night. Persistent

evaluation by a primary care physician.

Common Kidney Problems in Children

Urinary tract infections and bedwetting are common kidney problems in children. Below is general information about common kidney conditions, when to seek help, and how to minimize risks.

MEET MICHAEL, 9 monthsWhile some kidney problems relate to well-known issues like

contacted CHoR’s pediatric nephrology team when she was 20 weeks

pregnant and had learned Michael had kidney failure. Poor kidney

had regular dialysis (replaces kidney function) since birth and is one of

Decreasing risksCommon treatment for recurrent urinary

tract infections and wetting is to have

the child empty his or her bladder and

bowels (i.e., void) frequently. Children

hours throughout the day with complete

bladder emptying. This will help decrease

the risk of urinary tract infections, as well

as wetting.

School-year concernsThere is an increased risk of urinary tract

infections in the months after children

return to school. This increased risk

often relates to children spending more

time with their friends and also at the

same time feeling uncomfortable with

urinating in a public rest room. Children

need to be encouraged to maintain

voiding habits on a routine basis of

their bladder voiding and minimize the

risk of urinary tract infection, as well

as leakage.

Submitted by the Pediatric Nephrology Team at Children’s Hospital of Richmond at VCU (CHoR)

CHoR’s pediatric nephrology team provides comprehensive care for a full range of kidney and urinary tract disorders. The team is led by Dr. Timothy E. Bunchman and includes three additional physicians, a nurse practitioner, and a dietitian, nurse educator and social worker,

AUGUST 2013

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JULY 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

SEPTEMBER 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

SCREEN TIME POSTURE TIPSChildren spend lots of time

sitting when working or

playing on computers or

laptops. Proper posture can

help prevent back injuries

and stiff joints. Remind

children of the following

“screen time” posture tips:

■

surface) with ankles, knees

and hips each bent at a 90

degree angle. Head should

be lined up over the hips so

the spine makes its natural

“S” curve (no slouching

small pillow at the lower

back can help support the

spinal curve.

■ The monitor/screen

should be positioned at

eye level and the keyboard

positioned so elbows

hang at a 90 degree angle,

slightly in front of body

with forearms supported

on table.

■ Continued sitting in

one position can result in

shoulder and back pain so

spread out daily screen

time and also get up and

minutes.

- Lauren Champion, Occupational Therapist


Eid-al-Fitr

Make shopping fun with a scavenger hunt. Have your child find items on your list.

Try “Chore Olympics” with team dish washing, sock matching, stuffed toy “toss” into bins, etc.

Dairy Queen’s Miracle Treat Day to benefit Children's Miracle

Network Hospitals

Both overexertion and dehydration are concerns in warm

temperatures.

and heart rate associated with using large amounts of energy.

Dehydration occurs when the body does not have enough

Children are unique and they respond differently to

hotter temperatures. Infants, children and young athletes

are especially prone to heat stress which occurs when

the body is unable to cool itself enough to maintain a

healthy temperature. Infants and children have a higher

metabolic rate (the amount of energy used in a given time

period) which increases the rate of heat transfer from the

environment to their bodies. Their sweating mechanisms

automatically cool themselves.

Teens and child athletes often ignore the early signs

of heat-related illness. It is important to watch children

Organized sports like football, soccer and volleyball are not

the only fall activities that can lead to heat-related illnesses

and dehydration. Motocross, biking, cheerleading, PE classes,

hiking and other similar physical activities may pose concerns

activities stay well-rested, well-prepared and well-hydrated.

Keep Children Well-Hydrated in Warm Weather

Autumn means back to school and for many an increase in organized activities. Despite the promise of cooler days and evenings, September, October and November can still be very warm in Central Virginia. On warmer days, the combined effects of heat and humidity, commonly known as the heat index, can be very high. In warm weather and hot conditions, it is very important to monitor children’s activities, ensuring they have plenty of rest and fluids in between activities and that meals are not missed.

by Dr. Robin Foster, Director of Pediatric Emergency Services, & Susan Richards, Interim Nurse Manager, Pediatric Emergency Services

Children who are experiencing heat-related stress may complain of:

Headache

Nausea

Dizziness

In moderate cases you may get reports or see the child with:

Shaking chills

Elevated temperatures

Fast heart rate

In many instances rest, cool water, fresh

fruit and a light meal will restore health and

strength to your child.

In severe cases there can be:Confusion

Seizures

Combativeness

Children experiencing these symptoms

should be moved gently and safely to a cooler

environment and 911 should be called.

SEPTEMBER 2013

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29 30AUGUST 2013

S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

OCTOBER 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

WHAT IS HEAT-RELATED ILLNESS?Heat-related illness describes a wide range of problems that may include cramps, heat exhaustion, organ damage and heat stroke, which is a life-threatening emergency that can occur as a result of intense physical activity in hot temperatures.

SAFE PLAY: CONCUSSION PREVENTION TIPSWith organized sports and activities starting up again, Dr. Charles Dillard, Medical Director of the Concussion Clinic at CHoR, reminds children to ALWAYS play with sportsmanship, proper technique, and proper fitting, well-

maintained equipment, especially when participating in contact sports or high-speed recreational activities. For more on concussions (safety tips, symptoms, etc.), visit: www.cdc.gov/concussion


Labor Day

First Day of Autumn

Rosh Hashanah Begins

Yom Kippur

Play an active board game – have

players hop, spin, etc. before turns.

Pick fun questions for family members to

answer during dinner.

SEPTEMBER IS CHILDHOOD CANCER AWARENESS MONTHAs part of this special awareness month, the ASK Childhood Cancer Foundation shares stories of local pediatric cancer patients in a traveling photo exhibit called Korageous Kids. ASK provides financial, spiritual, social and emotional support to the more than 500 pediatric oncology patients treated at Children’s Hospital of Richmond at VCU each year. For more about ASK’s programming and events, visit www.askweb.org.

InjuriesAccording to Safe Kids USA, children under the age of 7 are at greatest risk of injuries from fire or exposure to other

forms of heat. In fact, each year since 2001 more than 107,000 children have experienced injuries from burns. Young

children more frequently suffer from scald burns, caused by hot liquids or steam, while contact burns caused by

direct fire contact are more likely to occur among older children.

PreventionSafe Kids Virginia believes strongly that the vast majority of these injuries and additional deaths can be prevented.

Please consider the following recommendations as your opportunity to protect children from the possibility of injury

from burns.

Prevent Burns: Water, Cooking & Fire Safety Tips

All caregivers know that it’s a challenge to keep children from injury. They’re fast moving and before you know it, they’ve reached another milestone. These milestones present wonderful new experiences for children, but also exposure to new safety risks. Protecting children from fire and burn injuries should be a top priority, especially during bath and mealtimes.

by Corri Miller-Hobbs, Registered Nurse and Safe Kids Virginia Program Coordinator

The Safe Kids Virginia Coalition works to prevent accidental injuries to children age 14 and under. The coalition’s prevention efforts include education, advocacy, enforcement and engineering modifications on the local level and across Virginia. These program services are available with support from Children’s Hospital of Richmond at VCU and VCU Medical Center.

For additional safety information go to vcuhealth.org/virginiasafekids.

Set your water heater thermostat

at 120 degrees Fahrenheit.

Test bathwater with your wrist

or elbow before allowing a child

into it.

Install anti-scald devices on water

faucets and shower heads. These

devices turn off the water if it is

too hot. They can be purchased

at hardware or plumbing supply

stores.

Keep children away from cooking

appliances and never leave the

kitchen when you are cooking.

Cook with pots and pans on back

burners and turn handles away

from the front.

Keep hot foods and liquids away

from table and counter edges.

Remove tablecloths from tables

when children are around.

Never carry or hold children and

hot foods/liquids at the same

time.

Do not allow young children to

use the microwave.

Lock up matches and lighters.

Teach children never to touch

these and to tell an adult if they

come across these items or see

another child playing with them.

Ensure you have working smoke

alarms on every level of your

home. Change the batteries at

least every year and test the

batteries monthly.

Develop and practice a Home Fire

Escape Plan.

Be a good role model.

October is Fire Prevention Month

OCTOBER 2013

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27 28 29 30 31 SEPTEMBER 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

NOVEMBER 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

Columbus Day Eid-at-Adha

National Walk to School Day

BUS SAFETY WEEK: OCTOBER 21-25

injury when approaching or

leaving a school bus than

when riding the bus. Teach

children to:

■ Be very careful around

the “danger zone”: 10 feet

in front, behind and on both

sides of the bus.

■ Wait until the driver says

it’s safe to board.

■

you drop something while

getting on or off the bus.

■ Be careful of drawstrings

and straps that can get caught

in handrails and doors.

■

the front of the bus. Cross

only when the bus driver

lets you know it’s safe.

For additional bus safety

information, visit the

National Highway &

Transportation Safety

nhtsa.gov/School-Buses


Halloween

Trace a pumpkin-shaped outline, paint pumpkin seeds, and

glue them into outline.

Preparing a Child for Surgery or Medical Procedures

Preparing a child for an upcoming surgery or medical procedure is important at any age. Here are tips to help children feel more comfortable, safe and secure:

■ Talk with your child. Giving children time to learn, ask questions and gain a better understanding of an upcoming surgery or procedure may help to reduce their fear and anxiety around the unknown. If the child seems worried, see if they can tell you what's worrying them and provide reassurance.

■ Keep in mind that the age and personality of the child will help determine when you should start talking about the surgery/procedure and how in-depth you should discuss it. Typically, with a younger child, you want to give less advanced warning as a young child’s sense of time often isn’t fully developed so telling them they're going to have surgery in a month may not be helpful. When you feel the time is right, use medical play, books (recommendations below) and photos to start a discussion. Be aware of your child’s body language and make sure to stop the discussion if your child starts to seem scared or uneasy. With an older child, you can share more detail about what they will experience, but you don't necessarily have to describe the actual surgery or procedure in full detail. Use words they'll likely hear: "IV, anesthesia, operation, etc." and explain what the terms mean.

■ If possible, meet with a child life specialist* for a tour of where your child will check in and get ready as well as where they'll wake up and recover. Most child life specialists will provide photographs or medical equipment (gloves, saline flushes,

gauze, etc.) to give children another opportunity to explore what they’ll be experiencing and ask questions. This – as well as the time you spend talking with your child – can be an excellent time to correct any misconceptions a child might have based on previous experiences, overhearing other people's stories, or movie/TV versions of surgery. For instance, many children think that when they get an IV the needle stays in their arm and may reduce their movement and that anyone coming near their IV will stick them with a needle again.

■ Help your child pick out some favorite toys, books, movies, photos, pajamas, etc., to pack so he or she will have familiar items for the waiting room and to help their hospital room feel more like home.

■ The most important job you can do is to make sure your child feels loved and supported. Your child will pick up on your anxieties so take a moment to calm yourself before talking with your child. Taking the time to prepare can make a world of a difference for everyone involved and, most importantly, give your child confidence in knowing what to expect.

by Siri Bream, Certified Child Life Specialist

*The Child Life Department at Children’s Hospital of Richmond at VCU assists children and families as they cope with health care experiences. Child life specialists help prepare children and families by explaining procedures, operations and treatments; accompany children to procedures to provide support, relaxation and distraction; and provide a sense of normalcy in the hospital environment through play and special activities.

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OCTOBER 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

DECEMBER 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

RECOMMENDED READING

There are many wonderful books that will help explain the hospital, surgery and/or medical procedures to your child. Reading can help reinforce a sense of understanding and offer opportunities for your child to ask questions. Book recommendations from CHoR’s Child Life Department include:

Toddlers/preschoolers

A Visit to the Sesame Street Hospital by Deborah Hautzig

Franklin Goes to the Hospital by Sharon Jennings

School-age children

Let's Talk About Going to the Hospital by Marianne Johnston

Going to the Hospital by Anne Civardi

Teens

Coping with a Hospital Stay by Judy Monnig

The Patient's Guide to Anesthesia by A. J. Hill


Veterans Day

Thanksgiving

Hanukkah Begins

Daylight Saving Time Ends

Go on a nature walk and collect items for

an art project.

Groove to a new or favorite dance routine.

NOVEMBER IS DIABETES AWARENESS MONTHIndividuals can prevent or delay type 2 diabetes by eating healthy, well-balanced meals and exercising daily. Watching sugar intake helps too. Be aware that on labels, 4.2 grams of sugar = 1 teaspoon of sugar. For risk factors, symptoms and prevention tips, visit diabetes.org.

Popsicle Matching Game Popsicle sticks

Scrapbook paper

Child-safe scissors

Thick white paper/card stock

Glue

Cut two popsicle shapes out of each of the different scrapbook patterns. Cut an

equal number of the same-size popsicle shapes out of white paper.

Glue popsicle sticks to the blank side of the scrapbook paper. Be sure the sticks

are positioned in the same place so the “popsicles” look as similar as possible.

Glue the white popsicle shapes to the back side of the popsicles covering the

sticks. If pattern is see-thru from the back side, try card stock or darker color paper.

These can be used for a memory game, a Go Fish-style game, or as flash cards.

Paper Plate Snowman 2 different size paper plates

Construction paper (blue, black, orange, brown)

Child-safe scissors

Glue and tape

Tape plates together with smaller one on top.

Cut out shapes for the snowman (carrot-shaped nose;

circles for eyes, mouth and buttons; stick-shaped arms;

a hat and scarf; etc.) then glue them onto the plates.

Be creative! Try different colors/shapes for accessories, numbering buttons, or putting numbers in the snowman’s hand to count down to a holiday celebration. If all family members make snowmen, hang them together for a special family portrait.

Family Fun: Homemade Gifts & Decorations

This holiday season we encourage you to focus on things that can be made as a family! Making gifts and decorations not only brings everyone together; these projects also encourage development of children’s motor skills, self-esteem and awareness of others. Here are recommendations from Certified Child Life Specialist Emily DePetris:

Puzzle-Piece Snowflake Puzzle pieces

White paint

Glue and tape

Ribbon

Select puzzle pieces of

similar shape and size

and paint them white.

The number of pieces is

optional, depending on the

number of layers you want

the snowflake to have.

Once puzzle pieces have

dried, arrange them into

your desired snowflake

design. Then glue the

pieces together, starting

with a base (one piece)

and adding more to create

top layer(s). Note: The

snowflake may need to be

taped on the back to keep

the pieces together.

Once the glue is dry, glue

or tape a loop of ribbon to

the back. Allow time for

glue to dry before hanging

your snowflake.

DECEMBER 2013

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22 23 24 25 26 27 28

29 30 31 NOVEMBER 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

JANUARY 2014 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

ART PROJECT SAFETY TIPEncourage children to cut

out items on their own if

you feel they can do so

safely. Children are typically

able to cut simple shapes

watch children closely when

they are using scissors or

working with glue and other

art supplies.

FAMILY FUN IDEA:BOOK & CRAFTRead The MittenBrett, a story about several

animals crawling into a

mitten to stay warm. Draw

or cut out animal pictures

from a magazine and glue

them into a mitten outline.

- Siri Bream, Certified Child Life Specialist


Christmas Eve Christmas

New Year’s Eve

First Day of Winter

Kwanzaa Begins

Hanukkah Ends

Pick names out of a hat and thank the person

you pick for something they did this year.

NONPROFIT ORG.

U.S. POSTAGE PAID

RICHMOND, VA

PERMIT 1146


P.O. Box 980646 Richmond, VA 23298-0646

JANUARY 2014 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


MARCH 2014 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

APRIL 2014 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

MAY 2014 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

JUNE 2014 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

JULY 2014 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

AUGUST 2014 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

SEPTEMBER 2014 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

OCTOBER 2014 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

NOVEMBER 2014 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

DECEMBER 2014 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

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