Gerard Gioia, PhD, is the Division Chief of Neuropsychology and the director of the Safe Concussion Outcome, Recovery & Education (SCORE) Program at Children’s National. He treats people with brain injuries with dual areas of interest in disorders involving the executive functions and pediatric concussion/ mild traumatic brain injury (TBI). He shared in the Rise and Shine blog hat with all the current media attention given to concussions, it is hard not to be worried and question your child’s involvement in sports, especially contact sports. As a society, we want our children to be active, stay healthy and enjoy the positive benefits of team sports. While there is a risk in playing any sport, the benefits will likely far outweigh the risks if coached and played with concussion prevention in mind.

Once a child chooses the sport they want to play, parents must do their homework and ask the leagues and coaches questions about how they handle head safety.

Below are 10 questions I encourage parents to ask youth sports organizations to make sure they’re minimizing the risk of concussion in their players. Youth sports organizations should also prepare themselves to answer these questions.

  1. Does the league have a policy on how they handle concussions?
  2. Who is responsible for the sideline concussion recognition and response to suspected concussions during practice and games? Is there an assigned person?
  3. Does the league have access to healthcare professionals with knowledge and training in sport-related concussions?
  4. Are the coaches required to take a concussion education and training course?
  5. Are the coach’s tools (concussion signs and symptoms cards, clipboards, fact sheets, smartphone apps, etc.) readily available during practice and games to guide proper recognition and response of a suspected concussion? Children’s National has a free mobile application called “Concussion Recognition & Response” to assist coaches and parents in asking the right questions and doing the right thing if they suspect a concussion.
  6. Does the league provide and/or encourage concussion education for parents, and what is the policy for informing parents of suspected concussions?
  7. What is the policy regarding allowing a player to return to play? (Correct answer should be ONLY when a medical professional provides written clearance that the athlete is fully recovered.)
  8. Does the league teach coaches and players proper techniques, such as blocking and tackling in football, in ways that are “head safe,” by not putting the head in position to be struck?
  9. If it is a contact sport, are there limitations to the amount of contact? How often will your child practice live contact? Is that any different than past years?
  10. How amenable is the league, team, and/or coach to accepting feedback from parents about their child’s safety as it relates to head safety?

Asking these questions will provide the peace of mind of knowing your child is playing the sports they enjoy in the safest way possible to minimize risk of concussion.


Football Photo by Amina Filkins: https://www.pexels.com/photo/smiling-ethnic-boy-in-helmet-and-uniform-of-football-player-5559992/

Baseball photo from Pexels.

May is Mental Health Awareness Month

The Center for Disease Control and Prevention shared that supporting the mental health needs of children starts early in childhood and can have lifelong impacts on overall health and wellbeing. Parents, communities, schools, and healthcare providers all play a role in addressing the mental health needs of children, but often separately, with limited coordination and collaboration.

The Children’s Mental Health Champions aim to address the needs of children with or at risk for mental disorders by building the foundation for a stronger, more inclusive mental health system for children. The Champions share common program goals, but each has its own approach that best fits the population they serve.


Childhood is a critical period that shapes long-term health and well-being, and half of all lifelong mental disorders start by the age of 14 yearsexternal icon. To support lifelong mental health, it is important to prevent problems, identify concerns early, and provide effective treatment. Parents, communities, schools, and healthcare providers all play a role in addressing the mental health needs of children to reduce problem behaviors and support child development. Many families face barriers when trying to access evidence-based prevention and intervention programs.

Through a cooperative agreement, the Association of University Centers on Disabilities (AUCD)external icon and the Centers for Disease Control and Prevention (CDC), started the Children’s Mental Health Champions program. The pilot program expanded from 6 Champions in 2020–2021 to 12 champions in 2021–2022. The current 12 Champions work within 11 states and territories as liaisons to CDC’s children’s mental health work and positive parenting resources.
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How to help children and teens live healthier lives: 6 Proven Steps

Chad Alexander BSc, MEd, BEd is the founder of Fitness Minimalists. He asks with Healthy Lombard followers, ” What can parents and teachers do to help children and teenagers live healthier lives?

The Centre for Disease Control (2018) notes that 19-20% of children ages 2-19 years old are obese (Source: Childhood Obesity Facts).  Additionally, 72% of Americans 20 years and older are also considered either overweight or obese (NASM Essentials of Personal Fitness Training, 2022).  According to the World Health Organization (2018), obesity rates have almost tripled since 1975. Fortunately, obesity can often be prevented (Source: Obesity and Overweight).


How might parents and teachers support young people in living healthier, more active lives?

Over the years, I have been refining my approach to helping diverse groups of students create healthy habits that last. When teaching in a public school, in one semester, I worked with over 100 high school students where approximately 75% of the students reported consistently maintaining their healthy habits over a two-month period.

Let’s jump in and look at proven ways to help youth develop healthy, sustainable habits.

#1. What is the science of successfully starting habits?

#2. How to create a bulletproof habit plan

#3. Make it hard not to stick with your new habit!

#4. Invite your students or family to join you

#5. Emphasize starting as opposed to stopping

#6. Review, Revamp and Renew

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Bringing Your Child To The Emergency Room

Rise and Shine shared in its blog that going to the emergency department is a scary and overwhelming experience for both parents and children. We have outlined some things to consider before you go as well as what to expect once you are there to try to make your experience as smooth as possible for you and your child.

First, call your doctor

Unless your child is experiencing a life-threatening emergency, we encourage you to first call your doctor before taking them to the emergency department. Your doctor can help you decide if it is truly necessary for you to go to the emergency department, or if there are things that you can do at home to help your child. It is also helpful for your doctor to know what is going on so that they can check up on your child to see how they are doing.

How to prepare

  • Remain calm: Going to the emergency room can be very stressful, but if you remain calm, your child will be more likely to stay calm as well.
  • Tell your child what to expect: It is best to explain to your child what they can expect to happen before they get to the emergency room. Knowing what is about to happen can help to relieve their anxiety around the situation.
  • Bring a comfort object: If your child has a special, loved object, such as a stuffed animal, blanket, or toy, it can be helpful to bring this with you to help them feel more comfortable being in a new and scary place.
  • Consider snacks: You may be waiting in the emergency room for a long time with limited food available. If you know that your child likes to snack, consider bringing some with you. However, you must first confirm with your child’s provider that it is safe for your child to eat and drink before giving them any food.
  • Healthcare information to bring: Make sure you bring your child’s insurance card with you. It can be helpful to bring your pediatrician’s contact information and your child’s vaccination records as well, though this is not required.
  • Limit the number of people with you: Emergency departments often consist of small rooms with limited seating. If you can avoid it, try not to bring many people with you.

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Building awareness of autism

EE Health asks in its Healthy Driven log, “Are you noticing something unusual about how your child behaves, communicates or socializes?”

About 1 in 44 kids in the United States are likely to be diagnosed with autism, including those who previously would have received the diagnosis of Asperger syndrome, which, since 2013 has been classified under autism spectrum disorder (ASD) rather than as a separate condition.

Autistic children may present with skills, talents, and abilities that seem well-developed in some areas but may have challenges in other areas of life. This may make it difficult for parents, and even medical providers, to diagnose a child when navigating the constantly changing social landscape of childhood.

How can you tell if your child may be autistic? Some features of ASD in childhood include:

  • Difficulty with social interactions with same-age peers (and may relate better to adults than other kids)
  • Fixed interests/preoccupations (very strong focus on particular subjects or activities)
  • Repetitive routines, inflexibility, difficulty moving to new tasks until others are finished
  • Repetitive behaviors or mannerisms/gestures
  • Repetitive or unchanging speech patterns (may speak in a flat tone, loudly or repeating comments)
  • Demonstrating a formal style of speaking
  • Fleeting or indirect eye contact across many types of social interactions
  • Trouble reading the body language of others or following social cues
  • Sensitivity to the environment (light, noise, etc.)
  • In early childhood delays in motor skill development, awkward movements, clumsiness
  • Difficulty with give-and-take or taking turns in conversation
  • A literal interpretation of language (in some cases difficulty with sarcasm, humor, or related nuances in the communication)
  • Difficulty understanding others’ feelings, difficulty understanding the role of empathy

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Little boy looking at camera with smileRise and Shine shared that children who have difficulty with social communication and behavior are said to have an autism spectrum disorder (formerly known as a pervasive developmental disorder (PDD)). There may be large differences between individuals with these disorders, and symptoms and difficulties occur along a continuum or spectrum. The continuum may include a child with autism who does not find social interaction rewarding on one end, and another child who is very sociable on the other. Some children with ASD have an intellectual disability, while others have higher than average intelligence. ASD is found in children of all racial/ethnic groups and socioeconomic backgrounds. It occurs in both boys and girls, but is more common in boys.

Most children with problems in development have only one or two areas of disability. Children with ASD, however, have problems in multiple areas, particularly:

  • Social interaction
  • Communication
  • Flexibility
  • Imagination

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Oppositional Defiant Disorder Treatment Plan

Autism Parenting Magazine, is a leading magazine focused on delivering the latest news and interventions on the subject of autism.  They shared the following post with Healthy Lombard:

What Is Oppositional Defiant Disorder?

Oppositional defiant disorder (ODD) is a type of behavior disorder mostly seen in children. Children with ODD have consistent behavior patterns which include being argumentative and defiant towards parents and other figures of authority. This is a different condition from Pathological Demand Avoidance (PDA) where the drive to avoid demands is related to anxiety.

According to documentation from the DSM-5, the oppositional defiant disorder is “a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms from any of the following categories, and exhibited during interaction with at least one individual who is not a sibling.”

Most children have bouts of ODD from time to time, but it usually disappears on its own. However, ODD may be diagnosed when the behavior persists for months.  Children with ODD consistently show signs.

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Joanna CohenJoanna Cohen, MD, is an attending in the emergency department (ED) at Children’s National. Her primary research interest includes bedside ultrasonography in the ED. shared in the Rise and Shine Blog that children like to help their parents with outside activities during the spring and summer. It’s a great way for them to run around and get a little exercise. However, many outdoor tools and gardening materials are dangerous for children and could cause serious injuries if left unattended. Follow these gardening and landscape safety tips for kids to keep your little ones safe!

Backyard safety tips:

  • Observe the current landscape of your backyard:
    • Are there tools or dangerous gardening chemicals left lying around?
  • Make sure there are anchors and supports to hang tools and other objects to keep them from falling.
  • When leaving power tools or other equipment idle remove keys and unplug all tools.
  •  Lock sheds and other outdoor buildings to keep kids from going inside unattended.
  • Make sure small children are out of the way and supervised while you use ride-on lawnmowers and other machinery.

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Simple, Low-Sugar Easter Treats

Nicole Palmieri, who is currently studying Dietetics at the University of Dayton, shared with Healthy Lombard that…

With Easter around the corner, this holiday is typically associated with sugary treats such as Peeps, Cadbury Crème eggs, chocolate bunnies, and jellybeans. While it is tempting for kids to indulge in these desserts all day long, the Cleveland Clinic states that “too much [added] sugars can affect your child’s mood, hyperactivity levels…have a higher risk of insulin resistance, prediabetes, and Type 2 diabetes.” To add a healthy twist to Easter, here are a few ideas for less sugary treats!

Frozen Chocolate Banana Slices

Cut thick slices from bananas, dip in melted chocolate, and freeze for about 30 minutes before enjoying! This is still a sweet treat with chocolate, but you can control all the added sugars and cut back on it by implementing fruit! Bananas contain plenty of potassium, which is beneficial to regulating your child’s blood pressure and fluid balance.


Oatmeal Peanut Butter Bites

Simply combine ½ c. creamy peanut butter (or melt peanut butter in the microwave for 20 seconds), 1 c. old-fashioned rolled oats, and 2 T. honey in a bowl. Then, scoop out the mixture and form it into bite-sized balls. Lastly, place on a parchment-lined sheet in the fridge until they firm up, about 20-30 minutes before enjoying! This treat offers healthy fat, carbohydrate, and protein! The honey in these bites will sweeten it up, too!


Yogurt-Covered Strawberries & Pretzels

Either buy or make your own yogurt-dipped strawberries and pretzels! This dessert offers a healthier alternative to white chocolate-dipped fruit and pretzels for your kids, while still tasting delicious!

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Sick childLisa Hiers, MSN, APRN, NP-C, AE-C, is a board-certified nurse practitioner in the Allergy and Immunology Division at Children’s National Hospital. She shared in its Rise and Shine blog that there is some overlap between seasonal allergy symptoms and COVID-19, so sometimes it can be hard to tell the difference as we enter another pandemic spring, pollen counts are on the rise and the coronavirus continues to circulate in our communities. There is some overlap between seasonal allergy symptoms and COVID-19, so sometimes it can be hard to tell the difference! Here is a quick review of allergy symptoms versus COVID-19 symptoms.

Overlapping symptoms of allergies and COVID-19

The most common overlapping (meaning these can happen with allergies or COVID-19) symptoms of allergies and COVID-19 are:

  • Cough
  • Shortness of breath
  • Headache
  • Tiredness/fatigue
  • Sore throat
  • Runny or stuffy nose (this is less common in COVID-19)

Cough and shortness of breath happen less often with allergies unless the person has a history of asthma which can be triggered by pollen.

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