Medical News MEDICAL UPDATE FOR REFERRING PROVIDERS January 2018 & the Department of Pediatrics of the University of School of Medicine

Current and former chairs of the Department of Pediatrics and current department heads gathered for a photo at the celebration of the department’s 50th anniversary. Department of Pediatrics Celebrates 50 Years The University of Connecticut School those honoring Milton Markowitz, MD, and of Medicine’s Department of Pediatrics Michael D. Bailie, MD, PhD, were awarded celebrated its 50th anniversary with a posthumously. festive event on Nov. 10 at Hartford’s Speakers at the event included emeritus Downtown Marriott. Connecticut Children’s faculty member Leon Chameides, MD, Medical Center is home to the school’s founding chair of Pediatric Cardiology Department of Pediatrics. at Connecticut Children’s and Hartford More than 200 people gathered for the , who was on the staff of the celebration, which focused on how the medical center for 30 years. Chameides’ department has impacted children’s health remarks were titled A Look Back on worldwide. All living department chairs the Global Impact of the Department of attended the event, including the first Pediatrics. Other speakers discussed how acting chair, Martha Lepow, MD, who is the department is affecting child health Adam Silverman, MD, director of Connecticut Children’s Center for Global Health, presents a plaque to Martha Lepow, MD, first 94 years old. Lepow and former Chairs now and prospects for continuing to do so acting director of the Department of Pediatrics. Robert Greenstein, MD; John Raye, MD; in the future. The event concluded with a and Paul H. Dworkin, MD, as well as slide presentation and remarks by Salazar; Shmerling, DHA, FACHE, president and current chair, Juan Salazar, MD, MPH, Bruce T. Liang, MD, FAAC, dean of the chief executive officer of Connecticut were honored with plaques. Two plaques, UConn School of Medicine; and James Children’s Medical Center.

Connecticut Children’s and Western Connecticut Health Network Launch Partnership A new partnership between Connecticut Connecticut Children’s will provide WCHN chose Connecticut Children’s from Children’s Medical Center and Western hospitalists, neonatologists and pediatric among several prestigious institutions that Connecticut Health Network—which physician assistants for pediatric inpatient responded to its request for proposals. comprises Danbury, Norwalk and New units, nurseries and neonatal intensive While the pediatric hospitalist component Milford —officially got underway care units at and began Jan. 1, neonatology coverage is on Jan. 1. Under the arrangement, . Continued on page 2.

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From the Surgeon-in-Chief Connecticut Children’s and Western Connecticut Health Network Launch Partnership, continued from page 1. By Christine Finck, MD slated to begin July 1. Hospitalists and Connecticut Children’s also will bring I hope you enjoyed a neonatologists at both hospitals are family-centered care to the hospitals, peaceful and joyous employed by Connecticut Children’s notably through the practice of family- holiday season with Specialty Group and are members of centered rounding, where the entire family and friends. As the faculty of Connecticut Children’s care team rounds at the bedside with we kick off this new Divisions of Hospital Medicine and the patient’s family. year, I am excited Neonatology. Standardized best practices will to share the latest Anand Sekaran, MD, division head be brought to the bedside through updates related to of Hospital Medicine at Connecticut the more than 30 clinical pathways our continued growth Children’s, notes that the partnership Connecticut Children’s has developed. and our strategic Christine Finck, MD goes far beyond staffing; it will bring the development across Education and quality improvement will medical center’s distinguishing attributes the region. be emphasized, just as it is in Hartford. to Fairfield County. And a Connecticut Children’s Emergency We have officially launched Connecticut “We will bring all of our expertise, Medicine specialist, John Brancato, MD, Children’s new five-year (2018-2023) systems improvements and connectivity will provide support and advice at the strategic plan. A major focus of this plan is to highly specialized pediatric care in the two hospitals’ Emergency Departments. the establishment of new partnerships and region,” Sekaran says. Nursing leaders from Connecticut expanded ambulatory networks. We have James Moore, MD, PhD, division Children’s will provide simulation training begun to execute our growth strategies within head of Neonatology, says that the and advice on nursing best practices. Neonatology and Hospital Medicine, and are partnership will give the region access Sekaran says the partnership is proud to be closely aligned with the Western to all the expertise and consultants consistent with Connecticut Children’s Connecticut Health Network. This alignment available through Connecticut Children’s. stated mission of making Connecticut’s has enabled us to hire seven neonatologists, Moore adds: “This helps provide regional children the healthiest in the country. four full-time pediatric hospitalists, five care, so that when a baby needs a per diem hospitalists and 11 physician “This represents an expansion of our higher level of care, they can come to assistants between Danbury and Norwalk commitment to children in other parts of Hartford to obtain it and then return to hospitals. These opportunities, combined with the state in a very formal way,” their home hospital to recover close to innovative healthcare delivery models such as Sekaran says. home, which is the best form of family- telehealth, will strengthen our presence in the centered care.” “We look forward to partnering with region and ensure optimal delivery of quality community practitioners to provide the . Initiatives such as our brand of Connecticut Children’s will enhance most evidence-based, state-of-the- family-centered care; evidence-based clinical continuity of care through its service art care to patients in that area and pathways; and an emphasis on education and model, in which the same hospitalist or becoming embedded in the community quality improvement will be shared with our neonatologist guides evidence-based care as a partner with the practices that are partners. for the patient Monday through Friday. there,” says Moore. To effectively support this five-year plan, we are very thoughtfully reallocating our internal resources and adding key personnel Connecticut Children’s Specialty Group needed to ensure execution of our strategy. We are pleased to welcome Ryan Calhoun, Welcomes New President MHA, MBA, as our new director of network Glenn Focht, years’ experience as a physician and development. Ryan came to us this past fall MD, is the new healthcare clinician and administrator. from Colorado Children’s and brings his president of Most recently, he worked at Boston expertise in strategic planning, healthcare Connecticut Children’s Hospital, where he was the services and technology. In his few short Children’s chief medical officer for the Pediatric months with us, he has had the opportunity to Specialty Physicians’ Organization at Children’s. meet with many referring providers. He will be Group. He was While in Boston, he was instrumental in working alongside Glenn Focht, MD, our new named to the creating an integrated behavioral health president of Connecticut Children’s Specialty position this program and expanding the hospital’s Group, enthusiastically traversing the state past fall after primary care network. Glenn Focht, MD identifying opportunities for new partnerships an extensive and growth strategies. national search and officially joined A graduate of the University of the practice group on Dec. 4. Focht Pennsylvania Medical School, Focht I wish you the very best of health and serves as a member of the executive completed his residency at the happiness in this new year, and as always, management team and reports directly University of Massachusetts Medical I thank you for your continued dedication to CEO Jim Shmerling. Center. He holds a bachelor’s degree in to our shared mission of taking care of chemistry and liberal arts from Messiah Connecticut’s children. Focht brings to his position nearly 20 College in Grantham, Pennsylvania. 2

Obesity-Reduction Initiative Launched Connecticut Children’s has launched Connecticut are obese—the 12th highest an initiative aimed at creating a rate in the country. In Hartford, 32 percent comprehensive system to reduce of 3- to 5-year-olds are overweight or childhood obesity in Hartford. The obese. program, Kohl’s Start Childhood Off Right, or SCOR, is supported by a $350,000 The SCOR initiative emphasizes engaging grant from Kohl’s. families in preventive efforts in the form of healthy nutrition and adequate physical SCOR focuses on children ages birth activity. It includes a public-awareness to 2. This is an age group where few campaign; education for pediatric interventions have been targeted providers on screening for risk factors previously, even though research shows and linking at-risk children to community- prevention efforts among infants and based resources; training home visitors to toddlers can have the most profound and provide obesity-prevention education to long-lasting effects. families; and re-establishing a childhood wellness collaborative to mobilize Connecticut has some of the highest rates community members and create a health- of child obesity in the nation, and the issue resource toolkit for families and providers. disproportionately affects low-income At the annual Gala, patient Erin Edgar spoke eloquently and minority children. More than 15 The SCOR initiative is overseen by about the importance of a new Infusion & Dialysis Center at Connecticut Children’s. Edgar receives regular infusions for percent of 2- to 4-year-olds enrolled in the Connecticut Children’s Office for rheumatoid arthritis. Special Supplemental Nutrition Program Community Child Health. for Women, Infants and Children in Gala Benefits New Care Coordination Forum Planned Infusion & Dialysis Connecticut Children’s 3rd Annual Care and state agencies. Providers from Center Coordination Forum will be held on Connecticut and surrounding states will Thursday, May 3, 2018, at the Sheraton discuss contemporary issues and critical The more than 800 guests who attended Hotel in Rocky Hill, Connecticut. The components of care coordination for our the 2017 Connecticut Children’s Medical theme for this year’s forum is It Starts most vulnerable children. Center Gala in November raised more with You: Redefining Your Role in than $1 million to support patient care Change through Story, Substance and For more information, see at Connecticut Children’s. Bid4Kids, a Strategy. The forum brings together care connecticutchildrens.org/community-child-health/ live appeal held during the event, raised coordinators, nurses, social workers and and click on Our Programs then Center more than $150,000 in just 10 minutes other professionals, as well as community for Care Coordination, then Care to benefit the Infusion & Dialysis Center Coordination Forum. being created at Connecticut Children’s. The center, which will be located on the fourth floor of the medical center, is Take in Grand Rounds Your Way scheduled to open in late 2018. It will be You can “attend” Tuesday morning Grand at connecticutchildrens.org. As a reminder, the state’s only hospital-based pediatric Rounds in the way that suits you best. Be faculty also give grand rounds at Bristol, Saint center of its kind. present in person on Tuesday mornings Mary’s, Middlesex, Day Kimball, and Danbury from 8 to 9 in Hartford Hospital’s Conklin Hospitals and MidState Medical Center. A PRESSING NEED Building Auditorium. Can’t make it? You can A new Infusion & Dialysis Center is also hear Grand Rounds lectures via live New in 2017-2018: Pediatric Grand necessary to meet the medical center’s streaming or podcast. For more information, Rounds participants have the potential to growing patient population. Connecticut see the For Medical Professionals page earn Maintenance of Certification Part 2 Children’s performs more than 3,400 credits in addition to AMA PRA Category 1. infusions annually, and the existing room, built in 1996, has inadequate space for patients and families. In addition, children Lunch & Learns Now Offer CMEs! needing outpatient dialysis services must Referring providers can now earn CME credit through travel long distances to adult centers for Connecticut Children’s popular Lunch & Learn talks. their lifesaving treatments. Specialists will visit your private practice to discuss The new, larger center will allow children topics of your choice. Talks are for physicians, APRNs to receive world-class care close to home and PAs. by providing infusions and outpatient To schedule a visit, contact Trish Masse at dialysis services conveniently, comfortably [email protected] and in privacy. or 860.837.6251. 3 CASE REVIEW A RARE INJU

Fourth-year medical student Sarah Grout prepared this issue’s case.

A 7-year-old boy presented to the The Hartford Hospital cardiovascular Connecticut Children’s Emergency surgery team established vascular access Department at 6 p.m. on a Friday night. through the femoral artery and placed He was an unrestrained passenger in an iliac artery stent across the injured a rollover motor vehicle crash. He was segment of the patient’s thoracic aorta. ejected from a car traveling at highway The patient’s small size precluded the use speeds and thrown 200 feet down an of a standard aortic endovascular graft. embankment. He was transported by An aortogram showed no further active ground to our center along with three extravasation of contrast at that time, other children from the same crash. A indicating good integrity of the graft. The screening chest X-ray on arrival showed patient tolerated the procedure well and widening of the mediastinum and left- was admitted to the PICU postoperatively

sided pleural effusion. CT angiogram of The team transports the patient through the tunnel to Hartford and discharged home on postoperative the chest showed a large left hemothorax, Hospital day nine without any significant bilateral pulmonary contusions and was performed. A 3 mm hole in the aorta complications. a thoracic aortic injury with pseudo- with active bleeding was identified and aneurysm just distal to the takeoff of controlled with a vascular clamp, which Traumatic aortic injury (TAI) secondary the left subclavian artery with active allowed anesthesia to continue aggressive to blunt chest trauma is uncommon in extravasation of contrast consistent with resuscitation and to initiate the massive children compared to adults, with an transection. transfusion protocol whereby packed incidence of less than 1% in pediatric red blood cells, fresh frozen plasma and patients sustaining blunt chest trauma. The patient experienced worsening platelets are administered at a ratio of The most common mechanism of TAI in respiratory distress and was intubated 1:1:1. Once the patient was stabilized children is motor vehicle crash. The most in the and hemodynamically, he was transported with common site of injury is the aortic isthmus taken to the operating room for chest an open chest through the tunnel from (90%) where the aorta is tethered by the tube placement. The chest tube put out the Connecticut Children’s operating room ligamentum arteriousum, the remnant of over a liter of blood. The patient then to the hybrid operating room at Hartford the ductus arteriosus. became acutely hypotensive, and an Hospital for endovascular graft placement. emergency posterolateral thoracotomy Over the last two decades, the gold

4 The patient, three weeks after his injury, with Brendan Campbell, MD, MPH, medical director of Connecticut Children’s Pediatric Trauma Program RY, AMAZING TEAMWORK, A LIFE SAVED

and adult vascular surgeons who can offer endovascular treatment options, are all critical components of care at pediatric trauma centers and allow patients like this to get the care they need, when they need it.

References: 1. Anderson SA et al. “Traumatic aortic injuries in the pediatric population.” J Ped Surg. 2008;43(6):1077-1081. 2. Eddy AC et al. “The epidemiology of traumatic rupture of the thoracic aorta in children: a 13-year review.” J Trauma. Fig 1. A: Axial CT showing aortic pseudoaneurysm and Fig 2. Intraoperative aortogram after 1990;20:989-991. hemothorax. B: Coronal CT showing contrast extravasation and endovascular graft placement. hemothorax. 3. Fox N et al. “Evaluation and management of blunt traumatic aortic injury: a practice standard for the treatment of thoracic The successful treatment of an injury of management guideline from the Eastern aortic injury has transitioned from a this magnitude requires the resources of Association for the Surgery of Trauma.” J traditional, open surgical approach to an a Level 1 Pediatric . The Trauma Nurse. 2015;22(2):99-110. endovascular one. Recommendations prompt response from pediatric surgeons 4. Pabon-Ramos WM, Williams DM, Strouse for the treatment of TAI in adults are well who have had numerous simulations of PJ. “Radiologic evaluation of blunt thoracic established. However, there are no studies clinical scenarios much like this is critical, aortic injury in pediatric patients.” Am J for outcomes or published guidelines along with immediate OR availability. Roentgenol. 2010;194(5):1197-203. regarding the management of TAI in The highly specialized team, including children due to the low frequency of this pediatric radiologists who provide real- Sarah Grout is a fourth-year medical injury. Management of this case was time evaluation of imaging, pediatric student at the University of Connecticut consistent with the standard of care for anesthesiologists who are able to expertly School of Medicine applying for a adult patients with TAI. resuscitate patients during procedures, residency position in general surgery.

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Trauma Program Earns Reverification Faculty Awards Connecticut Children’s prepared to care for all injured children. and Appointments Connecticut Children’s has been reverified more than 150 children with burn injuries as a Level I Pediatric Trauma Center by the received comprehensive inpatient and Tregony American College of Surgeons (ACS) and the outpatient burn care in Hartford, close to Simoneau, Connecticut Department of Public Health. This home. MD, was distinction makes Connecticut Children’s one granted the of only 29 freestanding children’s hospitals “Connecticut Children’s has the experience, Patterson nationwide and one of two in New England expertise and resources to care for the Trust Award, that are Level I Pediatric Trauma Centers. The most critically injured children,” says Brendan which reverification is for a three-year period ending Campbell, MD, MPH, medical director of provides in September 2020. Connecticut Children’s Pediatric Trauma $95,000 Program. over two Tregony Simoneau, MD To earn reverification, a hospital must years to demonstrate through an application and Those resources include pediatric surgeons, support her a rigorous site visit that it meets all of the neurosurgeons and orthopedic surgeons research on quality metrics specified in the ACS manual, who are immediately available day or night; childhood Resources for Optimal Care of the Injured 24-hour coverage by specialists in pediatric asthma. Patient. American College of Surgeons site emergency medicine, anesthesiology reviewers identified several strengths of the and intensive care; an on-site pediatric Physicians Pediatric Trauma Program at Connecticut rehabilitation program; a massive transfusion presented Children’s, including the trauma research protocol; and more. with this program, the expanded after-hours staffing year’s faculty Campbell notes that injury is the leading of the operating room, active participation awards were cause of death for American children and of advance practice providers in the trauma Felicia Wilion, MD Felicia says that the reverification “emphasizes our program and the availability of on-site Wilion, MD, goal of providing the highest-quality care rehabilitation services. of Children’s to injured children in Connecticut while Medical Connecticut Children’s first attained Level continuing to be a national leader in trauma Group, I pediatric trauma verification status in education and injury prevention research.” Bloomfield, 2008 in a collaborative effort with Hartford Community Hospital. Since the medical center became Physician an American College of Surgeons-verified of the Year; pediatric Level I trauma center, more than Michael 4,000 injured children have received the Bourque, Michael Bourque, MD highest-quality clinical care here, including MD, of 500 children who were admitted to the Pediatric Pediatric Intensive Care Unit. Additionally, General Surgery, Physician Connecticut Children’s Launches of the Year; and David New Partnership with Backus Sink, MD, of Connecticut Children’s will provide neonatal 24/7 consultative services, radiology Neonatology, intensive care services at William W. Backus telemedicine support and neonatal Quality & Hospital in Norwich, Connecticut, under transport. Safety award. David Sink, MD a new agreement that took effect last Backus, which has a growing maternity 39 Connecticut Children’s Specialty fall. Backus recently became an affiliate program, now has a Level I nursery, which Group faculty were named to Hartford of Hartford HealthCare, and Connecticut can care for babies down to a gestational Magazine’s “Top Docs” list. Children’s long has provided newborn and age of 35 weeks. Herson says discussions NICU services at all other HHC-affiliated are underway about increasing the level of hospitals. care to Level II, which would care for babies “This new partnership between Connecticut as young as gestational age of 32 weeks Children’s and Backus will ensure a and could provide advanced respiratory Transitions coordinated system of care for high-risk support for babies. Matthew Milewski, MD, has left the mothers and newborns requiring higher “Our partnership brings Backus into a Division of Orthopedics/Elite Sports levels of care,” says Connecticut Children’s regional system of care that ensures babies Medicine. neonatologist Vic Herson, MD. and mothers are at facilities appropriate to Colleen Jo, MD, has left the Division of Connecticut Children’s will provide staffing provide the level of care they need,” says Cardiology to pursue nonclinical interests. for delivery and newborn care, and the Herson. medical center’s neonatologists will provide 6 Welcome Aboard The newest additions to our medical staff!

Amanda Begley, MD, FAAP Catherine Hansen, MD Hospital Medicine—Norwalk Hospital Neonatology—Norwalk Hospital and and Danbury Hospital Danbury Hospital • Pediatric hospitalist, Norwalk and Danbury hospitals • Onsite Neonatal Partners PC, staff neonatologist, • Residency in pediatrics, Yale New Haven Children’s Danbury, Norwalk and Charlotte Hungerford hospitals Hospital • Fellowship in neonatal/perinatal medicine, Babies • MD, SUNY Upstate Medical University Hospital, Columbia Presbyterian Medical Center • BS, molecular genetics, University of Rochester • Residency in pediatrics, Children’s Hospital National Medical Center • MD, University of Chicago Pritzker School of Medicine James Belisle, MD • BA, chemistry, Carleton College Neonatology—Norwalk Hospital and Danbury Hospital Beth Natt, MD, MPH, FHM • Onsite Neonatal Partners PC, attending neonatologist, Norwalk Hospital Hospital Medicine—Norwalk Hospital • Fellowship in neonatology, Columbia-Presbyterian and Danbury Hospital Medical Center • Medical director of Inpatient Pediatrics, Yale New Haven • Internship/Residency in pediatrics, Saint Christopher’s Children’s Hospital, Bridgeport campus Hospital for Children • MD, University of Connecticut School of Medicine • MD, College of Physicians & Surgeons of Columbia • MPH, University of Connecticut University • BS, biology, Bates College • BS, anatomy & physiology, Cornell University Bethany Peri, MD, PhD Alicia Briggs, MD, FAAP Endocrinology and Information Hospital Medicine—Norwalk Hospital Services and Danbury Hospital • Fellowship in pediatric endocrinology, Boston Children’s • Pediatric hospitalist, Norwalk and Danbury hospitals Hospital • Interim department chair, Department of Pediatrics, • Residency in pediatrics, Children’s Hospital of Norwalk Hospital Pittsburgh of University of Pittsburgh Medical Center • Internship and residency in pediatrics, University of • MD, Northwestern University Feinberg School of Nevada Medicine • MD, Ross University School of Medicine • PhD, tumor cell biology, Northwestern University • BS, biological sciences, University of California, Irvine Feinberg School of Medicine • BS, chemical engineering, Brown University Jonathan Gelber, MD, MS Sports Medicine Donald Sampson, MD • Fellowship in sports medicine, Cleveland Clinic Hospital Medicine—Norwalk Hospital Foundation • Residency in orthopedic surgery, Harbor-UCLA and Danbury Hospital • Pediatric hospitalist, Danbury Hospital Pediatric Hospital Department • MD, Mount Sinai School of Medicine • Residency in internal medicine and pediatrics, Medical • MS, biomedical engineering, Columbia University College of Virginia • BS, biology, University of Miami • MD, University of Colorado School of Medicinej • BA, chemistry, University of Miami • BS, biology, Pepperdine University

Additional Operating Room Opening in Farmington This winter, Connecticut Children’s will procedures done locally and allowing arthroscopic surgeries, endoscopies, open an additional operating room at providers to treat patients in the most colonoscopies and surgical repair of its Ambulatory Surgery Center, or ASC, appropriate setting. The increased orthopedic fractures. The specialties in Farmington. This will be the third capacity at the center also will open OR that operate at the center are operating room at the center, which is time at the main campus in Hartford for Otolaryngology, Urology, General located at 505 Farmington Avenue. complex and urgent cases. Surgery, Ophthalmology, Dental, Orthopedics, Sports Medicine and The new OR will increase the time Procedures typically performed at Gastroenterology. available for surgical procedures, the ASC include tonsillectomies, ear allowing area families to have tubes, circumcisions, hernia repairs,

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Medical News is also available online Medical News connecticutchildrens.org MEDICAL UPDATE FOR REFERRING PROVIDERS Editorial Board Inside Glance... Department of Pediatrics Celebrates 50 Years...... 1 Lunch & Learns Now Offer CMEs!...... 3 Kelli Allen-Dunn Connecticut Children’s and Western Connecticut CASE REVIEW...... 4 Annamarie Beaulieu, MPH Writer Health Network Launch Partnership...... 1 Faculty Awards and Appointments...... 6 Noreen S. Kirk From the Surgeon-in-Chief...... 2 Jill Bernstein, MD Trauma Program Earns Reverification...... 6 Connecticut Children’s Specialty Group Monica Buchanan Connecticut Children’s Launches Medical Editor Designer Welcomes New President...... 2 John Brancato, MD Edmond Jalinskas New Partnership with Backus...... 6 Ryan Calhoun Obesity-Reduction Initiative Launched...... 3 Transitions...... 6 Brendan Campbell, MD, MPH Care Coordination Forum Planned...... 3 Managing Editor Photographer Welcome Aboard...... 7 Take in Grand Rounds Your Way...... 3 Dennis Crean, RN Christine Finck, MD Erin Blinn-Curran Additional Operating Room Opening in Farmington....7 Gala Benefits New Infusion & Dialysis Center...... 3

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Continuing Medical Ask the Specialist Education Programs This column features questions referring day of high-quality programming. Screens should All programs are held at the Pond House Café, providers have asked specialists at Lunch & be avoided during meals and for one hour before 1555 Asylum Ave., West Hartford, Connecticut, and Learn presentations. Robert D. Keder, MD, of bedtime. Problem-solve with parents to find begin at 5:30 pm with registration and buffet dinner. Connecticut Children’s Developmental-Behavioral alternatives to media use to calm upset children. Pediatrics Division, prepared this issue’s column. Q. What about older children and teens? Pediatric Evening Lecture Series Q. What advice can I give to families about Promote development of a family media use plan. media use? Parents should co-view and keep up with media their Feb. 22, 2018 The Center for Bladder The American Academy of Pediatrics published children consume. Promote that children/teens get and Kidney Disorders policy statements in November 2016 on the potential the recommended one hour of daily physical activity April 5, 2018 Sleep Disorders benefits and challenges associated with media use and eight to 12 hours of sleep (depending on age). by young and school-age children. The guidelines Bedrooms should be media-free, and older children acknowledge that a one-size-fits-all approach is not should not be allowed to sleep with mobile devices in Andrulonis Child Mental Health the most effective way to help children and families, their bedrooms. Teens should be discouraged from Evening Lecture Series and they recommend the development of a family multitasking homework with entertainment media. March 1, 2018 Adolescent Mental Health: media use plan for children of all ages. Encourage ongoing discussions of digital citizenship A Primer for Primary Care and internet safety with school-age and teenage Q. What should families with young Practitioners children to reduce bullying and maintain privacy. children know? Providers should continue to educate parents Q. What resources are there for families? May 18, 2018 Half-Day Andrulonis about early brain development and the importance Families can make their own plan at www. Mental Health Symposium: of hands-on, unstructured and social play to build HealthyChildren.org/MediaUsePlan. Commonsense Opioids language, cognitive and social-emotional skills. Media (www.commonsensemedia.org) is an Children younger than 18 months, screen media excellent resource for understanding the quality To register or obtain more other than video chatting should be discouraged. For and content of almost every show, app and game information, contact childaren 18 to 24 months, high-quality programming viewed/played by children today. For young children, Diane Mouradjian at 860.837.6264 or should be used only with an adult. Preschool-age PBS Kids and Sesame Workshop offer high-quality [email protected]. children should be limited to one hour or less per educational apps, programs and games. 17-783 New 12/17 17-783