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Recognizing and Treating Anxiety

A Q&A With Dr. Kendra Read

Anxiety affects 30% of children and adolescents at some point in their lives. Of those, 8.3% are severely impaired by it.

Anxiety in children can be a part of normal development, but unhealthy levels of anxiety can lead to significant distress and impairment in school, social and home functioning.

Unfortunately, patients with anxiety disorders do not always receive the help they need. When they do receive treatment, it is often insufficient or not evidence based.

We spoke with Dr. Kendra Read, an attending psychologist within Seattle Children’s Psychiatry and Behavioral Medicine department, to find out how providers can identify childhood anxiety, which treatment options are most effective and what information they should provide to parents. Read on to learn more. Read full post »

Treating First-Time Traumatic Shoulder Dislocation

A Q&A With Dr. Michael Saper

Dr. Michael Saper

While some pediatric and adolescent patients with shoulder instability will improve with physical therapy, research has shown that patients with a traumatic first-time dislocation may benefit from early surgery.

We asked pediatric orthopedic surgeon and sports medicine specialist Dr. Michael Saper to describe how patients with a shoulder dislocation benefit from being treated at Seattle Children’s.

Should patients with a first-time traumatic shoulder dislocation have surgery?

Research has shown that in adolescent patients, having stabilizing surgery after a traumatic first-time dislocation is more cost-effective and leads to lower recurrence, higher function and less shoulder arthritis. Furthermore, repeated dislocations can make surgical stabilization more difficult, more invasive and less successful.

After a shoulder dislocation, patients and their families will benefit from a consultation with the Children’s surgical sports medicine team to discuss this option. However, surgical decision making is individualized to each patient, and not every patient is an appropriate candidate for arthroscopic surgery. Read full post »

Advice on Diagnosing Plagiocephaly

A Q&A With Dr. Michael Cunningham

Positional plagiocephaly, also known as deformational plagiocephaly or nonsynostotic plagiocephaly, is a condition in which an infant develops a flat spot on the back or side of their head.

While this condition is common and arguably harmless, it can be challenging to differentiate it from the more detrimental condition craniosynostosis.

Additionally, recent research has led to some misunderstanding regarding the correlation between plagiocephaly and developmental issues.

Provider News spoke with Dr. Michael Cunningham, medical director of Seattle Children’s Craniofacial Center to gather information for providers diagnosing plagiocephaly and counseling families on this condition.  Read full post »

How to Talk About Firearm Safety

A Q&A With Drs. Mark Del Beccaro and Fred Rivara

A child or teen is killed by a firearm every nine days in Washington, and firearms are the third leading cause of injury-related death in our state behind poisoning and falls – and ahead of motor vehicle crashes. In 2016, 3,155 children and teens in the United States died of firearm-related causes.

Most of these shootings occur in or around the home. One out of every three homes with children in the United States has a firearm. Many of these firearms are kept unlocked or loaded.

Children and teens are at the greatest risk of unintentional death, injury and suicide by firearm. Young children are naturally curious. They explore in drawers, cabinets and closets. Some older children and teens view firearms as signs of power. Others struggle with depression and thoughts of self-harm and live in households where firearms may be accessible.

Physicians may not always feel comfortable screening for the presence of firearms in the homes of caregivers or places where the child visits due to lack of training and perceived parent discomfort when discussing the subject.

A 2016 study found that fewer than 15% of physicians regularly ask caregivers screening questions about firearm safety. Yet, with national attention on recent school shootings, ongoing political dialogue and the opportunity to protect families with safe storage, pediatrician interest in discuss the subject with families may be changing. Read full post »

Talking to Teens About Intimacy

Seattle Children’s adolescent medicine specialist Dr. Yolanda Evans writes about important conversations parents should have with their teens about intimacy:

Parents often ask me for advice regarding sex and reproductive health. Many times this involves speaking with me separately from their teen and informing me they found a condom in a pocket or their teen has been in a long term relationship and they think they may be sexually active. Most parents are worried about pregnancy, some are concerned about sexually transmitted infections. For all, I also bring up some topics that aren’t always as obvious, but are just as important. In this post, we’ll discuss important conversations to have with teens about sex and relationships in addition preventing pregnancy and STD’s.

With the #metoo movement that is sweeping social media and the convictions of sexual assault by prominent men in Hollywood, the medical community, and other areas, people who have experienced sexual harassment and assault are beginning to have a voice. Unwanted sexual contact by anyone (regardless of gender) is criminal. Unfortunately, our culture is full of examples where (mainly) female bodies are objectified as sexual objects in movies, commercials, music lyrics, and music videos. The message this sends to youth (and adults) is that the body of whomever we’re attracted to is there for our pleasure. It also sends a message that those who experience harassment and/or assault are at fault or should keep quiet. This needs to change!

Read more on Seattle Children’s blog Teenology 101. Read full post »

Bike Safety Tips From Seattle Children’s

Dr. Cora Breuner, a pediatrician and adolescent medicine specialist at Seattle Children’s, separates facts from fiction when it comes to bike safety, and shares tips from the dynamic perspective of a provider, educator and parent.

Read more on Seattle Children’s blog On the Pulse.

Read full post »

Caring for Traumatized Children

A Q&A with Dr. Ben Danielson, Mark Fadool and Dr. Nat Jungblut

The majority of children will experience a potentially traumatic event during childhood, but only some of them will develop clinically significant distress.

Identifying and supporting children who have been negatively affected by trauma is crucial to their emotional and physical health.

Primary care providers have a unique opportunity to recognize families experiencing post-traumatic stress and offer them support. We’ve brought together three experts to help: Dr. Ben Danielson, senior medical director of the Odessa Brown Children’s Clinic (OBCC); Mark Fadool, clinical director of Mental Health Services at OBCC; and Dr. Nat Jungbluth, a clinical psychologist working on a Washington state-funded pilot program to offer behavioral health services to youth and families in the Tri-Cities.

How does trauma affect a child’s health?

Dr. Danielson: The CDC-Kaiser Permanente Adverse Childhood Experiences Study, published in 1998, recognized a direct correlation between 10 stressful experiences – termed Adverse Childhood Experiences (ACEs) – and health outcomes. These experiences include: physical, verbal or sexual abuse; substance abuse by family members; parent separation or divorce; witnessing domestic violence; depression in a family; and a family member in prison, among others.

The study demonstrated that the more ACEs a person experiences during childhood, the more severe and the more frequent illnesses they are likely to suffer as a child and into adulthood.
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I Was Not Ready to Die: How Seattle Children’s Immunotherapy Saved My Life

Seattle Children’s doctors and researchers are leading efforts to better treat cancer in children, adolescents and young adults by boosting the immune system with T-cell immunotherapy. Patients who cannot be cured with standard therapies are benefiting from clinical trials developed at the Ben Towne Center for Childhood Cancer Research, and supported by the Strong Against Cancer initiative. 

One of these patients is Aaron. When he feared he might be out of treatment options, Aaron found hope at Seattle Children’s. 

Read Aaron’s story on Seattle Children’s blog On The Pulse.
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Born With a Hole in His Heart, Hybrid Procedure Helps Rowen Thrive

When Chelsie McKinney and her husband welcomed baby Rowen into the world in November 2017, they thought he was “absolutely perfect.”

“He was a big, strong and beautiful boy,” McKinney said. “We counted his fingers and toes like all parents do, and he seemed perfectly healthy. We were so excited to bring him home.”

However, before Rowen was discharged from the hospital, doctors noticed he had a heart murmur. An echocardiogram indicated he had a hole in the wall between the lower two chambers of his heart, which is called a ventricular septal defect (VSD).

Read more of Rowan’s story on Seattle Children’s blog On The Pulse.

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Seattle Children’s Launches New Celiac Disease Program

A Q&A with Dr. Dale Lee

Seattle Children’s recently launched a new Celiac Disease Program within its Gastroenterology Division. This program gives patients access to physicians and registered dietitians specially trained and experienced in working with pediatric patients with celiac disease.

Dr. Dale Lee, director of the Celiac Disease Program, addresses questions related to celiac disease, the new program and services it offers.

Thank you to Dr. Wendy Sue Swanson, a pediatrician at The Everett Clinic in Mill Creek, a member of Seattle Children’s medical staff and executive director of Digital Health, and author of the Seattle Mama Doc blog, for submitting these questions.

There is certainly public interest in gluten-free diets. Help us put in context those who seem to feel healthier and happier off gluten, and those who must be off gluten.

Gluten is commonplace in our modern diet and individuals can have a variety of conditions related to gluten.

  • Celiac disease is an immune-mediated hypersensitivity to gluten that results in intestinal inflammation/damage that can occur in certain genetically susceptible individuals.
  • Wheat allergy is different than celiac disease, but is also immune-mediated and can result in a variety of symptoms including rash, abdominal pain, vomiting or breathing difficulties.
  • Non-celiac gluten sensitivity (also referred to as “gluten intolerance”) does not involve an immunological response, but the symptoms can be similar to celiac disease, such as abdominal pain, vomiting or diarrhea.

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