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Less Is More

August 2018

Fall sports are about to start and one of the common injuries we see are concussions. A concussion is any injury to the brain that disrupts normal brain function on a temporary or permanent basis. Concussions are typically caused by a blow or jolt to the head. Concussions can happen in any sport but more often occur in collision sports, such as football, rugby, or ice hockey. They also are common in contact sports that don’t require helmets, such as soccer, basketball, wrestling, and lacrosse.

Sports-relates concussions in youth athletes are underreported. Coaches, parents and teachers often fail to recognize the signs of concussions in young athletes. Coaches and athletic trainers should be trained in the identification of concussions, and refer any student athlete suspected of sustaining a concussion to a licensed physician.

Below are some facts regarding concussions according to the American Academy of Pediatrics (AAP):

After a concussion has been diagnosed, it is important for the athlete and parent/guardian to understand symptoms to look for.

Signs to be observed by the parent/guardian are:

Symptoms reported by the athlete:

When should you call for help? Call 911 if your athlete has a seizure, passes out or is confused or hard to wake up. Call your Dr. immediately if your athlete has new or worse vomiting, seems less alert, or has new weakness or numbness in any part of the body. Watch closely for changes in your athlete’s health and be sure to contact your doctor if your athlete does not get better as expected or has any new symptoms, such as headaches, trouble concentrating, or changes in mood.

Less Is More

SUN & BUGS – June 2018

June brings more sunny days and weather that takes people out doors. As parents, it is very important that we protect children from harmful UV rays and biting insects. Keep your family safe from the sun and bugs by following these tips!

Sun Prevention for Babies Under 6 Months:

Avoiding sun exposure and dressing infants in long pants, sleeves and brimmed hats is best. However when adequate clothing and shade are not available, parents can apply a minimal amount of sunscreen to small areas.

Sun Prevention Children Over 6 Months:

*Apply sunscreen at least 30 minutes before going outside and use sunscreen that is at least 15 SPF (Sun Protection Factor), even on cloudy days.

*Reapply sunscreen every two hours, or after swimming or sweating.

*Be sure to apply enough sunscreen – about one ounce per sitting.

*Wear sunglasses.

*Limit your sun exposure between 10am to 4pm when UV rays are strongest.

*Still, the first and best defense against sun is covering up.

A sunburn is skin damage from the sun’s ultraviolet (UV) rays. Most sunburns cause mild pain and redness but only affect the outer layer of skin. These are called first-degree burns. These sunburns are usually mild and can be treated at home. Skin that is red and painful and that swells up and blisters may mean that the deep skin layers and nerve endings have been damaged. These are second-degree burns. This type of sunburn is usually more painful and takes longer to heal.

How to Treat a Sunburn At Home:

*Use cool cloths on the sunburned areas.

*Take cool showers.

*Apply soothing lotions with aloe vera.

*A sunburn can cause a mild fever and headache. Lying down in a cool and quite room or increasing fluids may relieve the headache.

*Take anti-inflammatory medicines to reduce pain, swelling and fever. These includes ibuprofen (Advil, Motrin) and naproxen (Aleve).

*Use lotion to relieve the itching when skin peels. There is nothing you can do to stop skin from peeling after sunburn. It is part of the healing process.

When to Call the Dr.:

*There are signs of dehydration: sunken eyes, dry mouth, and passing only a little dark urine.

*There are signs of infection: increased pain, swelling, warmth or redness, red streaks leading from the area, pus draining from the area, swollen lymph nodes in the neck, armpits or groin, and/or a fever.

*Sunburn is not getting better.

Also, this time of year it is important to protect children from bug bites. Follow the following Bug Safety Tips to have a bite free summer.


*Avoid scented soaps, perfumes, or hair sprays.

*Avoid areas where insects nest or congregate, such as stagnant pools of water, uncovered foods and gardens where flowers are in bloom.

*Avoid dressing in bright colors or flowery prints.

*To remove a visible stinger from skin, gently scrape it off horizontally with a credit card or your fingernail.

*Use insect repellents containing DEET when needed to prevent insect-related. Ticks can transmit Lyme disease and mosquitos can transmit West Nile virus, Zitka virus, Chikungunya virus and other viruses.

*The concentration of DEET in products may range from less than 10% to over 30%. The benefits of DEET reach a peak at a concentration of 30%, the maximum concentration currently recommended for infants and children. DEET should not be used on children under 2 months of age.

*The concentration of DEET varies significantly from product, so read the label of any product you purchase. For more information on DEET:

*When outside in the evenings or other times when there are a lot of mosquitos present, cover up with long sleeved shirts, pants and socks to prevent bites.

Less Is More

May 2018

As the weather improves and your children start to spend more time outdoors, teach them the safety basics of their bicycles, skateboards and hoverboards.


Bicycle Myths and Facts

Myth: My child doesn’t need to wear a helmet on short rides around the neighborhood.

Fact: Your child needs to wear a helmet on every bike ride, no matter how short or how close to home.

Myth: A football helmet will work just as well as a bicycle helmet.

Fact: Only a bicycle helmet is made specifically to protect the head from any fall that may occur while biking.

Myth: I need to buy a bicycle for my child to grow into.

Fact: Oversized bikes are especially dangerous. Your child does not have the skills and coordination needed to handle a bigger bike and may lose control.

Myth: It’s safer for my child to ride facing traffic.

Fact: Your child should always ride on the right, with traffic. Riding against traffic confuses or surprises drivers.

Myth: Bike reflectors and a reflective vest will make it safe for my child to ride at night.

Fact: It’s never safe for your child to ride a bike at night. Night riding requires special skills and special equipment.

Myth: I don’t need to teach my child all of this bicycle safety stuff. I was never injured as a child. Biking is just meant to be fun.

Fact: Riding a bike is fun – if it’s done safely. Unfortunately, most people don’t realize hundreds of thousands of children are seriously injured each year in bicycle falls.


Skateboard Safety

The use of skateboards by children has increased significantly in recent years. Not only do these young skateboarders have a high center of gravity, but they do poorly at breaking their falls.

As a result, there has been a rise in the number of skateboard-related injuries, including those to the arms, legs, head, and neck. In one study of five- to nine-year-olds who received medical treatment, only one third of skateboard injuries were classified as minor; the remaining two thirds were labeled moderate or severe.
If your child rides a skateboard, she should wear a helmet and protective padding and wrist guards to minimize the chances of injury. Also, she should never ride the skateboard in or near traffic. Homemade ramps have proven particularly dangerous for youngsters.

Hoverboard Safety Tips

  1. Wear a helmet and when you are just starting out you should wear elbow pads, knee pads, and wrist guards. 2. Calibrate your hoverboard. 3. Stand Correctly: Stand in the middle, not too much toe or heel with the widest stance possible. 4. Step back to disembark. 5. Look ahead: Maintain a straight posture and look straight ahead, not down.

Less Is More: April 2018

April is Autism Awareness Month. Here are some facts about Autism.

What is Autism?

Autism Facts & Stats

Safety is a major concern for most parents of children with Autism Spectrum Disorder or ASD . Here are safety facts:


Source: Interactive Autism Network Research Report: Elopement and Wandering (2011)
Source: National Autism Association, Lethal Outcomes in ASD Wandering (2012)


Source: United States Government Accountability Office, Selected Cases of Death and Abuse at Public and Private Schools and Treatment Center (2009)


Source: Issues in Comprehensive Pediatric Nursing (2009)

Sexual Abuse

Less Is More: March 2018

Asthma & Allergen Triggers

March is a good month for parents to revisit their children’s allergy and asthmatic needs. Spring often brings outdoor allergens that can trigger allergy and asthma symptoms. Treatment can be more difficult in children because triggers can change throughout childhood. Most triggers can be broken down into two categories: outdoor allergens like pollens and mold spores and indoor allergens like animal dander, house dust mites, cockroaches, mold, tobacco smoke, and strong odors or sprays.

How to avoid outdoor triggers:

How to avoid indoor triggers: 


All asthma attacks can’t be avoided, but being aware of your child’s triggers and trying to manage their environment to avoid these triggers are important to dodging attacks. Remember that your child’s airways or breathing tubes are sensitive and the sides of the airways in the lungs can become inflamed, sore, thick and swollen when introduced to allergens. This makes it harder for your child to breathe. The goal of treating asthma is keeping your child’s symptoms under control long term avoiding doctor appointments, the hospital and missed days of school.

In addition to avoidance, allergies can be treated by quick relief medications like antihistamines. Antihistamines (diphenhydramine, loratadine, and cetirizine) treat symptoms associated with allergies to decrease nasal congestion, itchy/watery eyes, and sneezing. Nasal steroids (Flonase and Nasonex) can be used daily during allergy season to prevent allergy symptoms.

There are two ways to treat asthma when it comes to allergens: Quick Relief medication and Long Term Control medications. When your child’s asthma is triggered, a medication that can open the child’s airways is the best response. Quick relief drugs are called Adrenergic Bronchodilators. These medications relax the tightened muscles around the airways and are usually administered by inhalation. Inhalation can be administered through an aerosol inhaler (sometimes with a spacer) or through a nebulizer. Long term control can be achieved through preventative medications to reduce the reaction to asthma triggers. Medications used to prevent asthma attacks include steroids and leukotriene modifiers (LTMs).

According to the Centers of Disease Control and Prevention there were 13.8 million asthma-related missed school days in 2013 and this number is statistically rising each year. For parents, it is important to recognize and avoid your child’s triggers, use long term control medications and follow up with Children’s Medical Group when your child’s management plan is not working. Educate your child on how to manage their asthma when age appropriate. Teaching them to avoid triggers, to tell an adult when they have symptoms, and knowing where their medications are and how to properly administer them is very important. Keep your child’s school up to date with your child’s prognosis and provide them with any medication needed to manage symptoms.

Less Is More: February 2018

For some children, the change in season brings with it a shift in mood. Is it a passing phase, or something more serious? Here’s what you need to know about depression, SAD, and your child.

Seasonal Affective Disorder (SAD) — often referred to as “winter depression” — is a subtype of depression that follows a seasonal pattern. The most common form of SAD occurs in winter, although some people do experience symptoms during spring and summer.

People with SAD may crave comfort foods, including simple carbs such as pasta, breads, and sugar. With excess unhealthy calories and a lack of fresh fruits, vegetables, and whole grains, fatigue often sets in. They may become depressed and irritable. Eventually, they are no longer able to maintain their regular lifestyle. They may withdraw socially and no longer enjoy things that used to be fun. It’s as if a person’s batteries have just run down. For parents, SAD can obviously have a sharp impact on the ability to be an effective parent.

Children and adolescents can also suffer these symptoms. They may experience feelings of low self-worth and hopelessness. Children with depression struggle to concentrate on their schoolwork. Their grades may drop, worsening feelings of low self-esteem. Symptoms that last more than two weeks are cause for concern.

Researchers have not pinpointed what causes SAD. There is some evidence pointing to a disruption of a person’s “circadian rhythm” — the body’s natural cycle of sleeping and waking. As the days shorten, the decreasing amount of light can throw off the body’s natural clock, triggering depression. Sunlight also plays a role in the brain’s production of melatonin and serotonin. During winter, your body produces more melatonin (which encourages sleep) and less serotonin (which fights depression). Researchers do not know why some people are more susceptible to SAD than others.

Several effective treatments can help child sufferers of SAD. Simply bringing more sunlight into your life can treat mild cases. Spend time outdoors everyday, even on cloudy days. Open window shades in your home. Exercise regularly and eat a healthy diet, one low in simple carbohydrates and high in vegetables, fruit, and whole grains.

Parents of children with depression should participate in their child’s treatment and recovery. Learn about the disorder and share what you learn with your child. Make sure your child completes his treatment everyday, no matter what form your doctor prescribes.

Plan low-key quality time together. Your child won’t have the energy for an arcade, but reading a book or playing a family board game can be fun. Encourage your child to get exercise and spend time outdoors. Plan daily walks together. Fix healthy meals for your family, and establish a set bedtime to ensure he gets enough sleep and the same amount of sleep every night.

Your fatigued child will probably need help with his homework. Take time to work through schoolwork together, and communicate your child’s situation to his teachers. Be patient with your child and reassure him that these issues will get better.

Whether noticing symptoms of SAD in yourself or depression in your child, take it seriously. Treating this disorder early and diligently can turn the dark days of winter into a pleasant time of togetherness for your family. Parents can contact our office and talk to one our Care Managers for further assistance.

Source: &

Less Is More: January 2018

Whether winter brings severe storms, light dustings or just cold temperatures, the American Academy of Pediatrics (AAP) has some valuable tips on how to keep your children safe and warm.

Winter Sports and Activities

Ice Skating


Snow Skiing and Snowboarding


Sun Protection

Less Is More: December 2017

Tips for deSTRESSing your Holiday Season:

Tips for Eating Health this Holiday Season:

As parents, we have the unique role of guiding how our children eat. Since parents do the majority of the grocery shopping and cooking for the household, below are some tips for you when making decisions for your child’s diet.

Count calories, not just fat.

Despite the increased emphasis on fat content, the mathematics of weight loss and weight gain remains unchanged: Take in more energy than you expend, and the balance gets stored as body fat, regardless of whether the calories came primarily from fat, protein or carbohydrate.

The same guidelines that help adults cut back on calories will work for their children.

Monitor portion size. As the fat content of many foods has gone down, portion sizes have been growing steadily larger without anyone seeming to notice. Today’s “supersized” order of french-fries would have fed three hungry teens when you were a kid!

Eat slowly, eat less. Youngsters will feel more satiated if they eat at a leisurely pace, take smaller bites and chew their food thoroughly, and swallow one mouthful at a time. Warm foods, too, tend to be more filling than cold items.

Learn to read the nutrition facts labels. Direct your teenager’s attention to serving sizes, the number of servings per package, and the amount of calories per serving.

Add fiber to meals. Vegetables, fruits, grains and other fibrous foods are filling yet low in calories.

Drink ice water instead of soft drinks, which make up 8 percent of the average youngster’s daily caloric intake.

Snack healthfully. All teenagers snack to some degree; it is unrealistic to completely eliminate that aspect of their eating habits. However, keeping a supply of low-calorie snack food in the house will help in this area.

Scale back on fast foods. An adolescent can squander an entire day’s calories on a single fast-food meal.

Allow for occasional indulgences. For a teenager to decide that she’s never going to eat sweets or fatty foods again is unrealistic. Those foods can be permitted every so often, like for special occasions or eating out at a restaurant.

Less Is More: November 2017

Antibiotics fight bacteria, not viruses.

If your child has a sore throat, cough, or runny nose, you might expect the doctor to prescribe antibiotics. But most of the time, children don’t need antibiotics to treat a respiratory illness. In fact, antibiotics can do more harm than good. Here’s why: Antibiotics fight bacteria, not viruses. If your child has a bacterial infection, antibiotics may help. But if your child has a virus, antibiotics will not help your child feel better or keep others from getting sick. Antibiotics kill bacteria and cure infections caused by bacteria, such as strep throat. Viruses are completely unaffected by antibiotics. Remember, we have nursing staff available to answer questions as well as daily sick check appointments with providers.

Colds and flu are caused by viruses.

Chest colds, such as bronchitis, are also caused by viruses. Bronchitis is a cough with a lot of thick, sticky phlegm or mucus. Cigarette smoke and particles in the air can also cause bronchitis. But bacteria are rarely the cause.

Most sinus infections are also caused by viruses. The symptoms are a lot of mucus in the nose and post-nasal drip. Mucus that is colored does not necessarily mean your child has a bacterial infection.

Your child may need antibiotics if:

A bacterial form of pneumonia or whooping cough is diagnosed by your child’s doctor.

Symptoms of a sinus infection do not get better in 10 to 14 days, or they get better and then worse again.

Your child has a yellow-green nasal discharge and a fever of at least 102° F for several days in a row without any improvement in their symptoms.

Your child has strep throat, after using strict criteria to determine if testing is indicated and based on a positive rapid strep test or throat culture. Antibiotics should not be prescribed unless one of these tests shows the strep throat bacteria. Strep cannot be diagnosed just by looking at the throat.

Less Is More: October 2017

Flu is the short term for influenza. It is an illness caused by a respiratory virus. The infection can spread rapidly through communities as the virus is passed from person to person. When someone with the flu coughs or sneezes, the influenza virus gets into the air, and people nearby, including children, can inhale it. The virus also can be spread when your child touches a contaminated hard surface, such as a door handle, and then places his hand or fingers in his nose/mouth or rubs his eye.

The flu season usually starts in October and ends in May. When there is an outbreak or epidemic, usually during the winter months, the illness tends to be most pronounced in preschool or school-aged children. Adult caregivers are easily exposed and can contract the disease. The virus usually is transmitted in the first several days of the illness.

All influenza viruses cause a respiratory illness that can last a week or more. Flu symptoms include:

The Flu vaccine is for the respiratory influenza viruses, not the common stomach flu viruses that cause fever, vomiting and diarrhea.

After the first few days of these symptoms, a sore throat, stuffy nose, and continuing cough become most evident. The flu can last a week or even longer. A child with a common cold usually has a lower fever, a runny nose, and only a small amount of coughing. Children with the flu—or adults, for that matter—usually feel much sicker, achier, and more miserable.

Healthy people, especially children, get over the flu in about a week or two, without any lingering problems. However, you might suspect a complication if your child says that his ear hurts or that he feels pressure in his face and head or if his cough and fever persist beyond 2 weeks. Talk with your child’s doctor if your child has ear pain, a cough that won’t go away, or a fever that won’t go away.

The American Academy of Pediatrics recommends that an influenza vaccine be given annually to all children starting at six months of age. Children 6 month through 8 years old may need two doses of the vaccine given at least four weeks apart. Children 9 years of age and older only need one dose.

Flu vaccines are especially important for children at high risk for complications from the flu such as those with a chronic disease such as asthma, heart disease, and decreased immune system function due to a primary condition or from medications such as steroids, renal disease, or diabetes mellitus.

All eligible children may receive the inactivated flu shot. All adults should receive the flu vaccine yearly; this is especially important for adults who live in the same household as someone who has a high risk for flu complications or who care for children under the age of five.

Less Is More: September 2017

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SuperStars – Strengths for kids $39.99 Behavioral Intervention
Talk Around It $1.99 Communication
Talking Train $79.99 $79.99 Social Skills
Talking Train $79.99 $79.99 Communication
Talkingtiles Free Social Skills
TalkTablet – Symbol Based AAC/Speech $49.99 Communication
Tantrum Tracker $0.99 Behavioral Intervention
TapSpeak Button Free Communication
Teach Me Time $1.99 Functional Skills
Tellagami $19.99 Social Skills
Tellagami $19.99 Communication
The iModeling Boundaries App Free Social Skills
The Planner Guide Free Free Social Skills
The Planner Guide Free Free Functional Skills
The Tree I See – Interactive Storybook $3.99 Social Skills
The Zones of Regulation $5.99/$12.99 $5.99/$12.99 Social Skills
The Zones of Regulation $5.99/$12.99 $5.99/$12.99 Behavioral Intervention
The-NO-App Free Functional Skills
This for That: Visual Schedules Free Free Behavioral Intervention
This for That: Visual Schedules Free Free Functional Skills
Tim(mer) Stock -Simple Timer Free Functional Skills
Time For Bed Little Ted $2.99 Functional Skills
TOBY Autism Therapy $25.99 Social Skills
TOBY Autism Therapy $25.99 Behavioral Intervention
Token Economy $9.99 Behavioral Intervention
Touch & Say Free Social Skills
Touch-Animals Free Free Communication
Touch-Animals Free Free Functional Skills
TouchChat $4.99 Communication
Touch-Colors Free Free Communication
Name Apple Droid Category
Touch-Colors Free Free Functional Skills
Touch-Emotions Free Free Communication
Touch-Emotions Free Free Functional Skills
Touch-Emotions Free Free Social Skills
Touch-Numbers $1.99 $1.99 Functional Skills
Touch-Shapes $1.99 $1.99 Communication
Touch-Shapes $1.99 $1.99 Functional Skills
Touch-Words $1.99 Communication
Touch-Words $1.99 $1.99 Functional Skills
Training Faces $2.99 $2.99 Social Skills
uChoose $5.99 Social Skills
VAST Autism 1 $12.99 Communication
VAST Pre-Speech Oral Motor $59.99 $59.99 Communication
VizZle Player Free Free Behavioral Intervention
Voice4u $0.99 Communication
VolaFriends Free Social Skills
VolaFriends Free Behavioral Intervention
Volume Sanity $1.99 $1.99 Behavioral Intervention
Wait4it $1.99 Communication
Wait4It $1.99 Behavioral Intervention
Wait4It $1.99 Functional Skills
We Learn He, She and They $1.99 Functional Skills
We Learn: He, She and They $1.99 $1.99 Communication
Words with Ibbleobble $1.99 Social Skills
Working4 $0.99 $0.99 Behavioral Intervention
Working4 $0.99 $0.99 Communication
Working4 $0.99 $0.99 Functional Skills
ZacZoo $0.99 $0.99 Behavioral Intervention
Zody’s World: The Clock Catastrophe $7.99 Social Skills