Category Archives: Health Tips

Q-and-A with Dr. Troy: How to talk to children about death

During the past 12 months, we’ve been rattled by the tragedies we’ve read and heard about in the news.

In July 2012, 12 people were killed and 58 others were injured in an attack in an Aurora, Colo., movie theater shooting.

Twenty children and six adult staff members were shot to death in December 2012 at Sandy Hook Elementary School in Newtown, Conn.

Closer to home, an insanity trial is underway for a man who admitted to murdering his three daughters this past summer. Last weekend, a woman and her two children were found dead in their home after authorities say she drowned them and then committed suicide.

As parents, we want to protect our children from these horrors. It’s hard to comprehend discussing the unthinkable – a mother or father taking the life of their child – with our own kids. Do we bring it up? How do we respond when they come to us looking for answers?

We spoke with Dr. Michael F. Troy, Ph.D., L.P., our medical director of behavioral health services, in an attempt to answer some of those questions:

How do I explain death to my child in an age-appropriate way?

Dr. Michael F. Troy

There are important differences between explaining the death of an important person in your child’s life and talking about a tragic death in the news. The former is likely to be a challenging, but near universal, role for a parent.  Eventually, all families will face the loss of a loved one requiring parents to share sad news with their child. While it is typical for parents to find these junctures difficult, this does not mean that they are unable to do so with skill and sensitivity.  Parents are used to explaining things to children in developmentally appropriate ways. Whether it’s why they have to have a shot at a doctor’s office or why they need to move to a new community, parents generally know – by instinct and knowledge – how to do this. Talking about death, while less common and inherently sad, is not an entirely different kind of task. Parents should think of it as being like other kinds of sad or disappointing news they might have to discuss with their child.  The specifics, for example, the closeness of the person who died, whether it was an expected loss, and the age of the child, will determine what is communicated.  But the general point, that parents actually do have experience in talking about difficult things and that they should rely on that experience, is most important.

Talking about deaths reported in the news is a different situation. While there are always exceptional circumstances, it is generally best to wait and see if your child raises the issue.  Whether they are aware of a news story is likely to depend on factors such as their age, how routinely they are exposed to the news, and how direct the event in the news is to their day-to-day lives.  If they don’t have knowledge of the story, raising the issue with them is unlikely to be a helpful. If they do raise the issue, it’s important to first find out what they have learned and what specific questions they have (there is no need to respond with answers to questions they don’t have). Additionally, it is important to keep your feelings and thoughts about the news story separate from the actual, specific concerns your child has. Your job as a parent is to help your child understand the event in a way that’s consistent with their developmental level, as well as to reassure and comfort them as necessary.

How do I explain why a parent killed his/her child?

You can’t really explain what you may not understand yourself. If you find the news of a parent killing her children and then herself perplexing and distressing, then it is OK to say that you are confused and upset by it. At the same time, you can also provide reassurance of your child’s safety and, if necessary, of your own ability to take care of them. If you feel you have some understanding of the event, for example, if it was the result of the mother’s severe mental illness, do your best to explain this briefly and in developmentally appropriate ways and with an emphasis on how rare such events are. You might also want to communicate empathy for those most affected by the loss.

Should I talk about the mental health of the parent? How do I do that?

You should talk about the mental health of the parent if your child asks about it, or if you feel that it’s important and appropriate for you to include in your response to the specific questions your child has asked. It’s unlikely that we would actually know the mental health status of a parent taking the violent and tragic actions reported in these recent cases, especially in the immediate aftermath of the tragedy when it is most likely to be in the news. Consequently, you might note that questions regarding mental health issues have been raised – and what this might mean – without suggesting that you know for certain what led to act of violence. It may also be important for you to note that while mental health issues are sometimes linked to violent acts, the vast majority of people with a mental health diagnosis are not violent.

At what age is it appropriate to approach my kids about this topic? Should I always wait for him/her to bring it up?

Unless you have specific reason to anticipate your child encountering discussion of these issues, it is generally better to wait and see if your child raises such concerns with you. Of course, the older children are, the more likely they are to both hear about and initiate questions about news of a tragic event. Similarly, the older your child is, the more reasonable it likely is to bring up the issue.

Are there things I can say or do to make my child feel safe and at ease?

First, it’s worth remembering that our goal as adults caring for children is to help them feel safe without needing frequent reassurance. If such reassurance is necessary, then the most important thing to emphasize is just how incredibly rare these types of events (school shootings, parents killing their children) are. They are extremely upsetting to hear about, and terribly tragic for the families affected, but also quite unlikely to happen. Because they are so rare and so dramatic, they tend to receive intense media coverage. But it also this pervasive media coverage that can make it seem as if these tragedies are more common than they really are. Consequently, it is almost always reasonable to reassure children that they are safe and that there are many adults in their lives looking out for their wellbeing. Some children will have specific concerns requiring specific reassurance. Younger children are likely to need you to talk about the ways in which their own home and school are safe places, while older children might need help understanding the rarity of these events through comparison to other types of risks.  For example, you might point out that while there are people struck by lightning every year, the odds of any given individual beings struck is exceedingly low.

My child has a fever. What should I do?

By Erin Dobie, CNP

Fever is one of the most common reasons parents seek medical attention for their child or infant. All kids get fevers at some point. Studies reveal parents are most worried about fevers due to the fear that they can cause brain damage or even death. But, there is no evidence to support these concerns.

As a nurse practitioner in the Emergency Department at Children’s Hospitals and Clinics of Minnesota, I frequently see kids with fevers. The questions from parents are usually the same. I wanted to answer some of those questions here.

What is a fever? Fever is defined as a body temperature greater than 100.4°F (38°C). It is part of the body’s natural defense mechanism and a normal body response to fight infection. Fevers help the body fight infections by stimulating the immune system. Fevers slow the growth and reproduction of the virus or bacteria. They also increase production of antibacterial substances in the immune system.

Should I treat a fever? Otherwise healthy children and infants (3 months and older), whose temperature is between 100.4 and 102°F (38.0-38.9°C), do not require any medication to reduce the fever unless the child is uncomfortable. Consider how your child is acting before treating with medication. Is he/she still playful? Drinking and urinating? These lower grade fevers help the body fight off illness. Fevers greater than 102°F do not always indicate a more serious illness. Does your child have other specific symptoms or complaints that are concerning or need medical attention? It’s important to remember to treat the child, not the fever.

When should I call my child’s health care clinician? You should call your child’s physician or nurse practitioner if your child is:

    • younger than 3 months old with a rectal temperature of 100.4°F or higher
    • crying and can’t be consoled or extremely irritable
    • somewhat difficult to wake up
    • refusing to drink fluids
    • experiencing painful urination
    • not vaccinated

If your gut tells you something wrong or if your child has a chronic condition, then you should also call.

When should I call 911? Pick up the phone if your child has:

    • trouble breathing
    • purple spots on skin
    • extreme difficulty waking up

Which medication should I use to treat my child with a fever? Acetaminophen (Tylenol) and Ibuprofen (Motrin or Advil) are two fever-reducing medications recommended for children and infants. Do not give Ibuprofen to infants younger than 6 months. Do not give Aspirin to children of any age. Be aware that many other over-the-counter medications often contain acetaminophen. Therefore, please read the labels carefully to reduce the risk of overdosing your child. Medication dosages are unique for children based on your child’s weight.  See Fever Dosage Charts for more information.

Remember, treating the fever with these medications doesn’t treat the illness causing the fever so when the medications wear off, the fever will most likely return until the body is done fighting off the illness.

A night in the ED with a child life specialist

A 3-year-old girl needs her bottom lip sutured. A 2-year-old sibling is bored to tears – literally – while she waits for her brother to be released so they can go home. A 7-year-old needs an IV start for blood draws and medicine.

Who are you going to call? The child life specialist.

Mindy Teele, child life specialist

On a recent weekday night in the Emergency Department, Mindy Teele, a certified child life specialist at Children’s Hospitals and Clinics of Minnesota, is in demand. A patient is about to have an IV start, so an RN asks Teele to explain the procedure ahead of time. In another exam room, a patient is waiting for results, so Teele brings toys. A few minutes later, she returns to the patient with the IV start to distract the patient during the procedure.

“Child life specialists focus on the psychosocial and developmental needs of children to minimize their fears, clarify misconceptions, build coping abilities and enhance understanding when kids are in the hospital,” said child life manager, Sheila Palm. “Being better prepared improves long-term adjustment to medical conditions, increases cooperation and reduces pain during procedures.”

Children’s deploys certified child life specialists throughout the hospital – to the medical-surgical, pre-surgery, critical care, and cancer and blood disorders units. Child life specialists work in home care and hospice, too. Children’s also has child life associates who help on some of the units and in the Sibling Play Area. Philanthropy helps support child life specialist services; their work is not reimbursable.

In the ED, Teele helps reduce the stress of what can be a traumatic visit by providing age-appropriate information, coping strategies and parent coaching, Palm said. Gaining cooperation from the patient and family can reduce the time of the procedure, need for sedation and need for an extended ED stay.

A 2008 Children’s study in the ED compared parental satisfaction with their child’s experience during a laceration repair in the presence and absence of child life services. Overall, there was greater satisfaction when a child life specialist was involved.

Patients experienced less anxiety when they left the ED when a child life specialist was involved in their care. Child life specialists received a significantly higher rating than other providers in their efforts to relieve anxiety. Children’s also received a rating of excellent from families more often when a child life specialist was present.

“I find the presence of child life services in our ER to be a tremendous asset. The care that they provide in alleviating the apprehension and pain of the sick and injured children we care for on a daily basis is wonderful. I appreciate working alongside such caring individuals and see their effect in many of the patients I come across during my shifts,” said Dr. Mark Schnellinger.

Teele has worked at Children’s for 13 years, 12 of which she’s spent in the ED. “I feel like my personality fits this environment,” she said. “I like the instant gratification.”

In the ED, time is not on Teele’s side. She often only has minutes to explain and prepare patients and families for a procedure. So she relies on analogies to explain them. Instead of calling herself a child life specialist, she tells patients she’s a teacher – a term kids can understand.

“Anyone can go into a room and tell a child what’s about to happen,” Teele said.

But, a child life specialist is able to assess the child and take him or her through the experience on their terms, she said. If a child needs a CT and loves princesses, Teele might develop a scenario from “Snow White.” If the child is obsessed with video games, Teele explains the procedure like it’s a video game with various levels for advancing.

On this recent weekday night, a little boy is minutes away from having a needle inserted into his hand for an IV and blood draws. Teele explains that the RN will use a J-tip, which helps minimize pain with needles, to make the area feel soft. An RN will then use “soap” to clean the skin. Using the same tools for the procedure, she shows him what everything is supposed to feel like. She shows him the “straw” and explains that, unlike a juice box straw, it will give him medicine to make him feel better.

Later in the evening, she’s called in to help during an IV start with another patient. The ED has run out of J-tips. Armed with a Disney book, Teele holds it up for him and together they identify the characters while the RN inserts the needle, draws blood and then gives the boy medication. Distraction works. The patient remains calm the entire time.

“I think I have a very rewarding job,” Mindy said.

You can make it possible so that every family at Children’s can benefit from the support of this and many other invaluable programs. Please make a donation today.

Sharing knowledge: National Women and Girls HIV/AIDS Awareness Day

Today is National Women and Girls HIV/AIDS Awareness Day. Women and girls now make up almost a quarter of people living with HIV in Minnesota, and over 70 percent of these are women and girls of color, according to the Minnesota Department of Health.  Women of color have been especially hard hit, accounting for the majority of new infections occurring among women in the United States.

The United States has made great strides in efforts to eliminate the spread of HIV from mother to child, and the number of children perinatally (around birth) infected with HIV in the United States has declined over 90 percent since the epidemic began. We’ve also seen a significant – 21 percent – decrease in new infections among women in recent years. But, the fight is not over.

As the largest provider of care to HIV-infected infants, children, and youth in Minnesota, Children’s Hospitals and Clinics of Minnesota provides medical care to about 75 to 80 children, adolescents and youth infected with HIV and their families annually. Children come to us from all over Minnesota and surrounding states (North and South Dakota, Iowa, Michigan, and others), and all over the world. Many of the children in our care have been adopted from countries in Asia, Africa, Eastern Europe, and the Caribbean.  Many more are first or second generation refugees and immigrants.

In addition to specialized medical care, families can access specialized support services, including education and family case management funded through the federal Ryan White CARE Act program and referrals to additional programs and services throughout the state.

With modern advances in HIV care, women and girls are living longer, healthier lives, and many men and women affected by and infected with HIV are choosing to start to add to their families.

Without medical intervention, about one in four children born to HIV-positive mothers will become infected, but by following current treatment and prevention guidelines, women can reduce their risk of transmission to 1 to 2 percent. Despite this success, however, the prevention of perinatal HIV infection remains complex and requires access to specialized, competent medical care and prevention support services.

Children’s houses the Minnesota Perinatal HIV Program, which exists to eliminate the transmission of HIV from mother to child in Minnesota and ensure men and women living with HIV can give birth to healthy babies, born free of HIV. Our specialized services are open to HIV-infected pregnant women and HIV-negative pregnant partners of HIV-infected men at-risk of acquiring HIV infection.

We provide nursing care coordination, case management, and education services to women, their partners, and their providers during pregnancy and up to six months following birth. In partnership with community providers, we also offer preconception counseling and guidance for couples wishing to conceive safely and prevent HIV transmission. During 2003 to 2012, the program provided services to more than 390 women, 75 percent of whom came from racial and ethnic minority populations and almost 40 percent were African-born.

Women and girls are EMPOWERED by knowledge and actions to change the course of HIV.

Prevention tips:

1. Get tested, know your status! HIV testing is recommended as a routine part of medical care.  Talk to your provider about testing.

2. Educate yourself about your risks! Learn how to prevent HIV infection and how to keep yourself safe.

3. Get connected, get support! If you are living with HIV, find out about the programs and services offered in your area to help you stay healthy and support you and your family in dealing with your disease.

Has the flu reached your home? Here’s the 411.

By Patsy Stinchfield

Patsy Stinchfield

Flu season arrived early this year and with more severity than in recent years. According to the U.S. Centers for Disease Control and Prevention (CDC), 48 states had reported influenza during the week of Jan. 6-12. There were nine influenza-related pediatric deaths during that week, bringing the total to 29.

We have seen a record number of influenza cases at Children’s Hospitals and Clinics of Minnesota. We’re seeing lab-confirmed influenza cases at rates higher than our highest week during H1N1. We’ve taken steps here to help prevent spreading the flu, including updating our visitor guidelines.

The No. 1 way to prevent the flu is to get vaccinated. And it’s not too late for that. We have more tips on preventing the flu here. In case the flu has reached your family, here are some helpful tips for taking care of your child.

What’s the difference between the cold and the flu and how can I tell?

Sometimes it’s hard to know whether a child has a cold or the flu because she may cough, have a runny nose, sore throat and fatigue with both. With the flu, a child tends to have a high fever. It comes on more suddenly with more severe fatigue and body aches.  Colds come on more gradually, and many kids may feel well enough to keep playing and going to school. Clinics use a rapid nose swab test to determine if someone has influenza.

What should I do if I suspect influenza?

Most cases of influenza are mild and can be managed at home with rest, plenty of fluids, and fever-reducing medicines.  Tender-loving care is good medicine, too. Most over-the-counter “cough and cold” medicines do not help a sick child get better faster and won’t have much effect on influenza. Sometimes, the flu can make a child very ill and a visit to the clinic or emergency room is necessary.

When should I take my child to the Emergency Department?

Take your child to be checked if there is difficulty breathing (fast, grunt-sounding, noisy breathing or small breaths), the color looks bad (pale or bluish), they aren’t drinking fluids often or urinating at least once every eight hours or just aren’t themselves and you’re worried.  Signs of dehydration are dry lips, sunken eyes, sleepiness or crankiness.  Children who seem like they’re getting better and then suddenly get worse should be taken to the Emergency Department immediately.  This could mean they have another infection in addition to the flu.

What are the best ways to get my child’s fever down when she has the flu?

Fever is one of the tools our immune system uses to kill germs.  However, children with high fever can feel quite miserable, get crabby, have trouble waking up and may drink less fluids causing dehydration. If you can’t keep the fever down with a fever-reducing medicine such as Tylenol or Ibuprofen, then the child should be taken to the clinic or Emergency Department.

Is there anything else I can do to help make my child more comfortable?

You can keep your child home from day care, school, sports or other activities and have them rest early in their illness and until they show signs of getting back to “their normal.” If your child doesn’t want to eat regular meals, don’t insist, but do make sure they drink small amounts of fluids every hour to prevent dehydration.

Is there anything I can do to help my child recover more quickly?

There is an anti-viral medicine called Tamiflu that can be given to children as young as 2 weeks of age. This is used if the child has moderate or severe influenza and works best if given in the first two days of illness.  Tamiflu usually cuts the severity and number of days of illness in half.

How long will my child be contagious?

Influenza is most contagious the day before symptoms present through about day five of illness. Your child should stay home from school during this time. After viral illnesses, kids can have lingering muscle or body aches and really do need time to rest and recover before rushing back to school. Depending on the severity of the flu, this may be a few days to a few weeks.  Most kids recover within a week. Most schools require that your child be fever-free (without the help of medicines) for two days before returning to school or day care. For more information, visit the CDC.

Patsy Stinchfield is a nurse practitioner and the director of the Infectious Disease Division at Children’s. Follow her on Twitter and watch her videos on Clear.MD.

 

Supporting kids after trauma

By Lizzi Kampf

As adults, we often face a variety of difficult emotions in the face of tragedy. The impact of a traumatic event can be substantial, whether it’s a natural disaster such as a hurricane or tornado, one that is man-made as we saw last week with the horrific mass shooting in Connecticut, or even one that is within a family, such as a car accident or the sudden death of a loved one. Our strong emotional reactions stem from an assault on our basic sense of safety and security. Children can experience these same emotions; however, their young brains aren’t yet fully developed and able to process them in the same way.

Many children express symptoms and feelings of helplessness and fear following a traumatic event. They may become unusually quiet, have problems sleeping, or be weary of separating from caregivers. They may react with agitation, or be unusually restless or aggressive. They may voice more worries or concerns about their own health, the health of others, and their general safety. Some children regress to behaviors they haven’t had since early childhood, such as sucking their thumb, wetting their bed, or baby talk. The good news is that children are naturally resilient and tend to return to whatever level of functioning they were at prior to the event.

Here are some things parents can do to support their children following a traumatic event:

  • Children live their lives through play. Utilize dolls, drawing, or role-playing games to help them express themselves and talk about what happened. Most kids want to talk about what they’ve experienced. Sometimes scary events need to be played out to be worked through. It helps them process what has occurred and use problem-solving skills.
  • Allow your children space to talk about their feelings. They may need to express their fears multiple times and be reassured of their safety frequently. Validate the feelings they are having and assure them that it is “normal” to feel the way they do.
  • Maintain as much structure and daily routine as possible. It can be difficult if your home is unlivable, you have to attend a funeral, or general daily life is disrupted. As much as possible, do the things your family enjoyed prior to the event, such as particular bedtime routines. Children also still need to have rules and discipline; this gives them a sense of order in the chaos.
  • Stay in check of your own reactions. It’s okay for children to witness parents having their own emotions, but they also need to hear an adult talk about how they manage those emotions. Model good self care for your child, making sure to take care of your own physical and mental health.

If you or your child is struggling following a tragedy and feel you need additional assistance, seek professional help through local crisis resources, a mental health counselor, or your doctor.

Lizzi Kampf is a Licensed Independent Clinical Social Worker who works primarily in the Emergency Department on the St. Paul campus of Children’s Hospitals and Clinics of Minnesota. She is also a volunteer with the Red Cross and recently returned from a deployment to New Jersey. As part of the Disaster Mental Health team, she worked to provide brief therapeutic services to individuals and families who had been affected by Superstorm Sandy. 

Navigating the holidays with food allergies

The holidays can be tough. You’re shuffling your family from school party to neighborhood shindig to a gathering with relatives. Throw food allergies into the mix, and what’s supposed to be one of the happiest times of the year can be stressful. Like really stressful.

We’re all too familiar with how exposures can be a matter of life or death for children with food allergies. We recently shared the story of Noelle Dilley (“Noelle’s story: The danger of one bite”) who suffered an allergic reaction after eating a cupcake that contained peanut butter. Sadly, she spent 31 days in our Pediatric Intensive Care Unit (PICU) but is doing great today and back to her happy, spirited self.

Because food is often a big part of holiday celebrations, we want to help you navigate them with ease. We want the child in your life to be able to experience this time of the year like every other kid in the safest way possible.

So we talked with Ellen Wade and Janie Cooperman, dietitians at Children’s Hospitals and Clinics of Minnesota, for tips. They emphasized that success is all about planning and offered these suggestions:

  1. If your relatives or neighbors are hosting the gathering, talk with them ahead of time about the menu and clearly communicate your child’s special health needs. Think about what will help your child be most safe. You may want to ask them to skip the bowl of mixed nuts or pass on the deviled eggs this year.
  2. Educate friends and family about cross-contamination. Even if a food item is removed, it leaves behind food proteins until washed with soap and water. Safe foods can get contaminated by touching other foods or residue from utensils, serving platters or even hands
  3. Bring safe alternatives for your child. Knowing the menu ahead of time will help you bring something similar so he or she doesn’t feel left out.
  4. Survey the scene upon arrival. Take a quick look for food allergens that may be present (even if you’ve already agreed on a plan with the host, someone else may have brought something). Some common offenders at other people’s homes may be food residue in play areas, dog food (may include food allergens such as eggs or milk) and bowls/platters of candy in open areas.
  5. Bring baby or disinfectant wipes to quickly wipe down surface areas your child may come in contact with, such as table tops or shared toys. Wipes are great whenever soap and water aren’t easily accessible. You can also use wipes to wash hands.
  6. Don’t forget your medicine kit! Even when you plan ahead, accidents can happen. Families with severe food allergies always need to have an epinephrine auto-injector (such as an Epi Pen, Jr) and an antihistamine such as Benadryl with them at all times.

We’ve collected a few recipes from the Food Allergy and Anaphylaxis Network you might want to use in your holiday meal.

Oatmeal Chocolate Chip Cookies

Milk, egg, peanut and tree nut free

Make your own granola bites

Milk, egg, wheat, peanut, and tree nut free

Parsley-potato stuffing

Milk, egg, wheat, peanut and tree nut free

Join us for more discussion about food allergies and the holidays during a Twitter chat on Wednesday, Dec. 12, from 3 p.m. to 4 p.m. We, along with Missy Berggren (@marketingmama), whose daughter has several food allergies, invite you to share your experiences and ask questions on Twitter. We’ll also have allergist Dr. Nancy Ott and Children’s dietitians on hand. Follow Children’s at @childrensmn and the hashtag #childrenschat.

Bios

Dr. Nancy Ott is a board-certified allergy, asthma and immunology specialist. She earned her medical degree at the University of Minnesota in 1984. She’s among Children’s professional staff and she’s been practicing with Southdale Pediatric Associates, Ltd., since 1991.

Missy Berggren is a parent to a 5-year-old girl with severe food allergies to eggs, milk, peanuts, tree nuts and shellfish, and a 7-year-old son with no known food allergies. Her daughter’s diagnosis at 12 months old led Missy to learn about food allergies, and she now serves on the Board of Directors for the Food Allergy Support Group of Minnesota to help support other families and raise awareness of life-threatening food allergies. She shares her experiences with food allergies in helpful articles on her parenting blog Marketing Mama and is a trusted ally and advocate for parents of children with food allergies. Missy has 15-plus years of experience in marketing and communications in the health care arena and is currently the brand manager at Allina Health.

Ellen Wade is a registered dietitian and has worked at Children’s for 11 years. She’s encountered many cases of food allergies and has helped guide families in navigating allergies while still enjoying a healthy diet.

Janie Cooperman is a registered dietitian and certified diabetes educator. She currently works in Children’s outpatient diabetes clinics and inpatient eating disorders program.

 

Ramsey County kids ‘lost’ in the medical system are found at Children’s

A child is left with a family friend, and the parents are nowhere to be found.

A teacher notices bruising over several weeks and worries the student is being abused.

The police are called, and the child is taken to the Emergency Department at Children’s Hospitals and Clinics of Minnesota before being placed in short-term foster care.

Through the Ramsey County Shelter Program, kids who are victims of abuse, neglect or abandonment in the county are taken to Children’s in St. Paul and given a full medical screening, new clothes thanks to the Children’s Foundation and a meal. Once they get the care they need, they’re placed in short-term foster care.

“We can get these kids healthier so they have a better childhood and a healthier, long-term life,” said Dr. Kellee Street, the medical director of the program.

There have been more than 12,300 patient visits since the program’s start in 1993, said Jean Henry, program coordinator. Children’s sees an average of one to two at-risk kids per day. As of mid-November, there had been 368 visits this year.

It’s critical for police officers to know they can take kids to a safe place to be evaluated, said St. Paul police Chief Tom Smith.

“This does make a huge difference here (in the community),” Smith said.

A recent lead gift from the Peter J. King Family Foundation has helped transform the St. Paul Emergency Department, and those physical changes help it continue to be a safe space for youth in the program. The updates also improve care and dramatically cut down on patient and family wait times. (Pioneer Press story here)

Street believes the county program is one of a few, if not the only, in the United States where kids to be placed in short-term foster care are first screened by medical staff.  In other counties and beyond Minnesota, children typically aren’t screened for up to 48 to 72 hours, she said.

Often, they lack current vaccinations, have poor dental health or have increased lead levels due to exposure where they live, Street said. Elevated lead levels can result in long-term developmental problems.

Children’s staff contact the child’s provider – if there is one – or inform the county if follow-up care is needed, Street said. In some cases, the child is admitted into the hospital.

“There are things we pick up that most people would never have found,” she said. “These are kids that are lost in the medical system.”

The 411 on teen sexting

By Amy Moeller

Amy is a therapist who has worked with children and adolescents for 25 years. She works in the Adolescent Health Department at Children’s Hospitals and Clinics of Minnesota and treats teenagers experiencing depression, anxiety, social struggles and chemical dependency. In addition, Amy co-founded The Family Enhancement Center in south Minneapolis 17 years ago. She works at the center part time with children and families who have been affected by physical abuse, sexual abuse and neglect. Amy is married and the mother of three children. 

As if we as parents don’t have enough to worry about, sexting has become yet one more concern for us with our already technologically savvy teenagers. Although teens are typically savvier than their parents, they also lack a basic understanding of the consequences of sending and receiving explicit text and photo messages via phone or computer.

Sexting is defined as “the practice of electronically sending sexually explicit images or messages from one person to another.” Sexting comes from the combination of the two words“sex” and “text messaging” and includes the sending of provocative messages or visual images to and from cell phones and computers.

Our teens often don’t realize the dire consequences of sexting and its ability to live in cyber space virtually forever. This phenomenon is poorly studied to this date; however, this is beginning to change with more data now available about sexting and just how common it is.

Depending on the study or the survey, somewhere between 20 and 60 percent of teens are sexting. As the trend continues, parents, teachers and lawmakers struggle with how to react to a phenomenon that ultimately puts kids at risk.

In a study reported in the September 2012 issue of The Archives of Pediatrics and Adolescent Medicine, researchers questioned a948 high school students in southeast Texas. The students were between the ages of 14 and 19 from seven public high schools. The following are amongst the most notable findings of the study:

  • 27.6 percent of teens reported having texted or emailed a naked picture of themselves.
  • Male and female teens send sexts with nearly the same frequency. Girls are asked more often to send a sext (65 percent) while boys more often ask for someone to send them a sext (46 percent).
  • Sexting is more common among older teens. They reported being less bothered by the requests to send a sext.
  • Of the females who had sexted before, 77 percent also reported having sex compared to 42 percent of the non-sexters.
  • In addition to being sexually active, girls who had sexted were significantly more likely to have also engaged in risky behaviors, such as drinking and using drugs before sex and having more then one sex partner.
  • Among the boys who had sent a sext, 82 percent were sexually active compared with 45 percent who had never sexted. Among males, sexting was not associated with more risky sexual behaviors.

In a nationally representative survey of 12- to 19-year-olds, the PEW Research Center conducted a series of focus groups with teens. Among their findings were that there tend to be three main scenarios for sexting:

  1. Exchange of images solely between two romantic partners.
  2. Exchange between partners that are shared with others outside the relationship.
  3. Exchanges between people who are not yet in a relationship, but where at least one person hopes to be.

Although the number of teens sending and receiving sexts is lower in this study, the study covered only images (not written messages) of sexually suggestive, nude or partially nude texts and videos. Again, there was no difference between girls and boys sending sexts.

Attitudes toward sexting vary among teens. Some feel it’s a major issue, and others think it’s not a big deal. Some view it as a safer alternative to sexual activity. Others see it as potentially damaging and illegal.

Legal consequences

Illegal it is. Many states are now creating legislation to address sexting after cases of sexting have led teenagers to be prosecuted for child pornography and forced to register as a sex offender. Several teens across the country are being faced with child pornography charges after sending or receiving sexually provocative pictures of themselves or other teens. Several cases have arisen that bring charges ranging from a misdemeanor to a felony.

Social and emotional consequences

As stated above, our teens need to understand that anything can be copied, sent, posted and seen by large audiences. It does not matter the intention, or that they trusted a person not to share the photo or message. Once it is in cyberspace, it is there forever. When revealing photos are made public, the subject almost always feels humiliated. There is ridicule and the embarrassment sometimes endless. There have been some high profile cases like Jesse Logan, a Cincinnati teen who committed suicide after a nude photo she sent to her boyfriend was circulated widely around her school resulting in harassment from her classmates.

Advice for parents

  • Don’t wait for an incident to happen, talk to your teen now. Communication is key – come right out and ask them if they have been sexting.
  • Remind them that once the image is sent, it can never be retrieved. They will lose control of it.
  • Talk about the pressures to send revealing photos. Be honest about the risks.
  • Teach your child to delete anything that comes to them immediately. If they do send it on, they are breaking the law.
  • Do not see sexting as an isolated event, but as a new expression fueled by today’s technology and the social and sexual experimentation that has always been a part of adolescence.