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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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
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:
SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY
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
6 -12 MonthsFine Motor Skills
hand to the other
small foods like Cheerios
Gross Motor Skills
explore with other (when on stomach)
and cruise around furniture
12 -18 MonthsFine Motor Skills
Gross Motor Skills
18 -24 MonthsFine 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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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
SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY
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.
SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY
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)
SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY
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.
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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
SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY
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,
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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
SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY
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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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
SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY
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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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
SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY
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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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
SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY
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.
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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
SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY
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
Children’s Hospital of Richmond at VCU
P.O. Box 980646 Richmond, VA 23298-0646
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