Category Archives: Local resources

Who do you trust with your child? – Part 2

She was just a few months old, so she had only her cries and her body language to communicate her fear. It could easily have been dismissed with any number of excuses — maybe a precocious stage of separation anxiety. But her daddy knew it was something else.

“You could tell she didn’t want to be with her [caregiver],” he says now. “She clung to me. You could see the terror in her eyes. She was clawing and scraping, and I thought, that’s weird.”

But it didn’t make sense. The person who cared for his daughter while James Motz and his wife were at work was a family member. “She was good with her own kids,” James remembers, shaking his head as he still struggles to understand it all. “Her daughter, who is a little older than my daughter, was perfect — well-behaved, well-mannered, polite.”

But there was that one thing: The child had a hurt arm every once in awhile. James and his wife didn’t dwell on it. Kids grow up with bumps and bruises. It doesn’t always mean something sinister is going on.

Still, he couldn’t let go of a gnawing sense that something wasn’t right. “I told my wife I needed to put in cameras [at the caregiver's home],” he says. He had every right to do that. James, then a wildly successful 24-year-old business owner, had bought the house in which the caregiver and her family were living. It was just a few blocks away from his own west Valley home.

The decision was supposed to be a win-win, a way to provide safe and loving care for his daughter while James and his wife went back to work. He was trying to be a good guy, finding his own solution by helping some relatives who were down on their luck. He’d given them a place to live, given them both jobs.

But cameras? Basically spying on someone you have every reason to trust? James and his wife argued about it. How do you weigh vague suspicions about your daughter’s safety against the privacy rights of a family member you’ve entrusted with her care?

Before the decision could be made, before the plan could be implemented, Lily was in the hospital, a victim of Shaken Baby Syndrome. Her parents were faced with the prospect of raising a child who could have permanent brain damage.

April is National Child Abuse Prevention Month. Child advocates around the state are commemorating it by launching a new awareness campaign to help parents choose safe caregivers.

“Who Do You Trust With Your Child?” is a joint effort involving the Arizona Department of Economic Security, the Arizona Coordinated Prevention Campaign, ChildhelpSouthwest Human DevelopmentPhoenix Children’s Hospital and Prevent Child Abuse, among others.

A dedicated website at childhelp.org/mychild directs parents to resources. A hotline at 1-800-4-A-CHILD (1-800-422-4453) is operated by trained staff who can answer questions about safe caregivers.

James Motz with his daughter Lily (now 5), who made a full recovery from her injuries. Photo courtesy of the Motz family.

If you could talk with James Motz, if you could see how this experience haunts him still, you would realize how important it is to trust that primal, instinctual sense of danger we all have deep inside us. You wouldn’t hesitate to consult these resources if you had even the slightest sense that something was wrong in a childcare environment.

“I’d never had kids,” says James, who is now a stay-at-home dad to Lily and her younger brother. “I didn’t know if  I was just crazy and overprotective.”

His advice to other parents? “Trust your instincts, 100 percent. If something is off, it’s off.”


Who do you trust with your child? – Part 1

James Motz and his daughter Lillian (then 3) in a photo that ran in our April 2010 magazine. Photo by Daniel Friedman.

What do you think when you see this picture? A proud, loving father. A caring, protective father. A guy who would do anything to keep his precious daughter safe.

That’s what James Motz of Surprise thought he was doing when he went to extraordinary lengths — near superhuman lengths, some would say — to make sure his baby girl would be in safe hands once he and his wife returned to work following her birth.

They had looked at some child care centers as they considered their options.  They interviewed some nannies. Nothing felt right. Then some family members came to mind. The husband had lost his job; the couple had declared bankruptcy and were losing their home. Maybe, James thought, he could do something to help them that would also solve his own dilemma. Who better than family to love and care for his daughter?

He found his brother-in-law a job. He hired his sister-in-law to take care of then 3-month-old Lillian. He even bought a house for the couple. It was just down the street from his own. It was a spec home and it wasn’t cheap. But James was 24 and making $350,000 a year. To him, it was an investment well worth making.

Phoenix writer Mary L. Holden won an Arizona Press Club award for writing the story of what happened next — and what happens all to often in what should be a safe and trusting environment.

Before she was 5 months old, Lily was in the hospital, a victim of Shaken Baby Syndrome. Her dad’s confidence that he could protect her was shaken, too.

April is National Child Abuse Prevention Month. Child advocates around the state have chosen to commemorate it by launching a new awareness campaign to help parents choose safe caregivers.

“Who Do You Trust With Your Child?” is a joint effort involving the Arizona Department of Economic Security, the Arizona Coordinated Prevention Campaign, Childhelp, Southwest Human Development, Phoenix Children’s Hospital and Prevent Child Abuse, among others.

A dedicated website at childhelp.org/mychild directs parents to resources. A hotline at 1-800-4-A-CHILD (1-800-422-4453) is operated by trained staff who can answer questions about safe caregivers and make referrals to specific resources.

“Unsafe caregivers are often someone we know,” says Mark Klym, MPA, program coordinator for the division of Children Youth and Families at DES.

Next: Why James suspected his daughter was being abused. 

Puss In Boots makes a surprise visit

One of our colleagues at Allied Integrated Marketing in Scottsdale emailed an unusual request.

“Can Puss In Boots stop by the RAK office?” she wrote.

Um, well…

“Sure!” I responded. And then my heart sank. We’re pretty boring at our office. We make phone calls and stare at computer screens. It can be pretty quiet for long stretches of time. What in the world could we do to welcome a furry feline who is starring in his own animated film?

And then I remembered our neighbors at Cortney’s Place. Maybe they would enjoy a visit from Puss In Boots!

We share a wall with Cortney’s Place, which  provides educational and enrichment opportunities for physically and mentally challenged individuals who have aged out of the public school system.

The staff at Cortney’s Place thought it was a great idea. “Our students have been wanting to go see the movie when it comes out!” I was told. But they decided to keep it a surprise until the moment Puss In Boots showed up.

I’ll let Dan Friedman’s wonderful photos tell the rest of the story. But before I go, I want to put in a plug.

Cortney’s Place is planning to expand so it can accommodate more than 50 students. The organization relies on donations to meet this growing need and there is a golf tournament and dinner on Monday, Nov. 7 to raise funds. Find registration information here.

Out and about: Visiting the Children’s Developmental Center

Open House at the Children's Developmental Center.

As anyone in my office (or my family) will tell you, I spend way too many hours with my eyes glued to my laptop screen. So I appreciate a good excuse to escape the virtual world and drop into the real one.

Last week I said “yes” to an invitation to attend an open house at the newly opened Children’s Developmental Center at Easter Seals Southwest Human Development in Phoenix. This place, despite its big name, is all about little people. Specifically about understanding little people and what makes them tick.

The center is staffed by a team of professionals — in medicine, psychology, physical therapy, speech therapy, occupational therapy and more — who combine their expertise to evaluate children for developmental delays or disabilities and collaborate to recommend interventions.

I stepped off the elevator to a spacious area with cheerful, lemon-colored walls above wooden pegboard paneling. A huge fish tank commanded attention in a waiting area at one end of the room, where pint-sized tables and chairs and a variety of toys welcomed young visitors.

I met people I have read about and admired for years, including Ginger Ward (founder of Southwest Human Development) and Daniel B. Kessler, M.D., a developmental and behavioral pediatrician with a long history at St. Joseph’s Hospital & Medical Center who was recently named medical director of the Children’s Developmental Center. I met Terrence Matteo, Ph.D., a licensed psychologist and director of the Children’s Developmental Center, and had a chance to thank him for an article he wrote for our October magazine on helping babies sleep.

A sign pointed visitors down the hallway to “The playrooms.” The center has four, each of which can be set up in specific ways to help the experts make assessments for issues that may be impeding a child’s physical, intellectual, emotional or social development.

The first playroom was set up to evaluate children for autism. “What do you look for?” I asked.

“We look at the level of development of their play,” Matteo told me. “Are they rigid in their play? Are they using items in a way not intended? Are they banging cars together [instead of "driving" them around the room]? Are they throwing the plates? Are they able to request toys? What’s their level of social communication?” Such sessions are videotaped from a small, dark room behind a one-way glass window so that the multi-disciplinarian team of professionals can work together to make an assessment, and offer recommendations to the parents.

Another playroom was set up for feeding evaluations. Children who are referred to the center for such observation may be exhibiting anything from difficulty swallowing to muscle-related speech impediments. This room also has a one-way mirror behind which several professionals observe parents and their children interact.

Lorenzo Castillo enjoys playing in the room set up as a kitchen. He visited the open house with his grandmother, Veronica Castillo of Phoenix.

The room is set up like a kitchen — with small tables and chairs, toy appliances and a variety of plastic foods scattered about on tabletops and counters. The experts watch to see what happens. Does the child show interest or apathy? Does the child play with the pretend food or avoid touching it? Does the parent engage in play, guiding it with inquisitive comments and gestures, or sit passively and watch? The smallest observations can help the professionals piece together the puzzle to help them understand why some children do not enjoy the process of eating and do not grow and thrive as they should.

Plastic food set out for a feeding assessment. "Children learn to eat through play," Matteo says.

Before they even get to this room, the family has undergone a home visit by one of the center’s professionals so that interactions can be observed in the context of comfortable surroundings.

“With babies and young children, everything is so intertwined — parent, child, society, environment,” Matteo says. “You don’t want to look at the child in isolation.”

This is is a time-intensive, ideal, “best practices” approach to early childhood development assessment and intervention — and it’s not cheap. That’s where Development Director Laura Chasko comes in. It is her job it is to seek grants and donations to support this work.

The center works with families to avoid or minimize out-of-pocket expenses through qualification for primary and secondary insurance reimbursement and DDD, AzEIP, or school district eligibility. Any out-of-pocket expenses are reviewed under a sliding fee scale consideration.

“Our goal is to serve 300 families each year,” Laura told me. Right now, as they work to get the word out, there is not even a waiting list.

Learn more about the center’s approach and scope of services here. And if you are worried about your child’s development or behavior, contact the center at 602-468-3430 or email CDcenter@swhd.org.

Southwest Human Development is Arizona’s largest nonprofit child development agency, providing programs and support for more than 135,000 children ages birth to 5 and their families. In addition to the Children’s Developmental Center, the organization provides programs including the  A.D.A.P.T Shop, the Birth to Five Helpline (which offers free advice 24/7), the Good Fit Counseling Center and more.

Photos by Daniel Friedman

Understanding life with asthma

Darius Collins tries to blow on his pretend air tube while his parents watch.

Try this. Roll up a piece of paper. Stuff it with cotton balls. Wrap the roll in tightly wound rubber bands to hold the cotton in place.

Then put  your mouth up to one end and try to breathe. That’s what it feels like when a child is in the throes of an acute asthma attack.

Understanding what asthma is — what it does to the body and how to respond — can help children cope with a disease that is not curable, but is in most cases completely controllable. That’s why Cardon Children’s Medical Center provides free asthma education and support programs for families in the East Valley and beyond.

One such event was held last Saturday in a classroom overlooking Tempe’s Kiwanis Recreation Center indoor wave pool. I was there with RAK multimedia journalist Vicki Balint, who was producing a video about the asthma support group and education program.

Certified asthma educator Diana Braskett, RN, CPNP, AE-C, was stationed at the first table families encountered after signing in. She pulled out a diagram of the lungs, answered questions and showed children how to make a pretend air tube.

Diana Braskett demonstrates the air tube activity.

“The cotton balls simulate the effect of swelling,” she explained. “The rubber bands are muscles constricting.”

Having asthma can be tedious. Braskett knows; she has a mild case herself. “You get tired of taking medicine,” she says. “I can relate. It’s especially hard for the little ones. They don’t understand.”

But understanding is key to the ability to carry on, to stay healthy, to participate in the activities a child enjoys.

Children must become familiar with their own particular asthma “triggers,” which may include dust, allergies, seasonal changes, rain, humidity, cold, exercise, upper respiratory infections and more, Braskett told me.

They must learn modifications to avoid those triggers — sometimes something as simple as knowing to stay indoors when the weather (or pollution) is bad. And they must follow their doctor’s treatment plan to the letter.

Each child’s treatment plan is different, of course, so no one approach applies across the board. (Learn more about asthma on Cardon Children’s website.)

Asthma educator Kim Reiners talks to Keegan Palmer about a peak flow meter.

Surprisingly, exercise is usually encouraged. Swimming, especially, can be good for children with asthma (if they are not sensitive to chlorine) because it forces rhythmic breathing and helps them develop upper-body strength. Children for whom exercise can be an asthma trigger may be taught to use their “rescue meds” before they participate, Baskett says.

“Some parents are afraid to let their kids exercise when it can be the best thing for them,” adds Kim Reiners, R.N., CPNP, AE-C, who pioneered the asthma support group and education effort at Cardon Children’s. Her station at the event allowed kids the chance to blow hard into a peak flow meter to measure their speed of expiration, or ability to breathe out.

At another station, Paula White, R.N., CNP, AE-C, was leading a board game. While it didn’t have the most enticing name (“The Breathe Easy Asthma Education Interactive Tool,” by Merck), the kids seemed to enjoy the opportunity to drive little cars around a “city,” landing on destinations like hospitals and parks to learn specific facts about asthma.

Paula White shows Isaiah and Issac Salter how to playan asthma education board game as their mom watches.

Families that attended the program were issued free wristbands for a swim in the wave pool after the event. So at times it seemed the greatest challenge they faced that morning was finding the patience to wait until the pool opened.

A celebration at Phoenix Children’s Hospital

Randy Christensen, M.D., autographs a book.

As we approached the table where pediatrician and newly minted author Randy Christensen, M.D. was autographing copies of his book, we joked about being his “groupies.”

The book-signing event in the airy, natural light-filled lobby at the new patient tower at Phoenix Children’s Hospital was the second event in the past three weeks that multimedia journalist Vicki Louk Balint and I have attended in support of Christensen, his new book (Ask Me Why I Hurt: The Kids Nobody Wants and the Doctor Who Heals Them) and his work with the Crews’n Healthmobile, a collaborative effort between Phoenix Children’s Hospital and UMOM New Day Centers.

Vicki and Randy at a March luncheon where he was the featured speaker.

Groupies? Well, certainly admirers. Vicki, who interviewed Christensen for a story we published in January 2008, has followed his journey with great interest. She even read an advance copy of his book, which is a memoir about his work spearheading medical outreach to homeless teens, and wrote a review that will appear in our upcoming May magazine.

I am looking forward to reading my own copy, which I purchased at the PCH gift shop and which is inscribed, “Thanks so much for your support!” by “Dr. Randy.”

The event, which carried on throughout the day and early evening, was a true celebration. Many of Christensen’s coworkers and medical colleagues from around the community were there. Everyone was beaming. Some were wearing handmade bracelets mimicking the one adorning the book jacket. Teresa Boeger, a child life specialist and director at PCH (with responsibilities encompassing The Emily Center and the gift shop, too),  found a couple of extra bracelets, which she promptly gave to Vicki and me. With the “Ask Me Why I Hurt” message so relevant for the hospital’s young patients, I would expect to see a lot more of these around the hospital in the days and weeks to come. Vicki urged her to market them at the gift shop, with proceeds benefiting the Crews’n Healthmobile.

Michelle Ray, who sought medical help from the Crews'n Healthmobile while living at a UMOM New Day Center, came to offer her support. Michelle, now the mother of a 4-year-old, is studying to be a nurse. Christensen is her child's pediatrician.

Before we left, we took a quick tour of the new Crews’n Healthmobile, a big upgrade over the original vehicle (which Vicki wrote about visiting in her Health Matters blog).

When Vicki first interviewed Randy, he wasn’t necessarily thinking about writing a book. And yet he first talked to Vicki he told her about the young woman who wore a bracelet saying “Ask Me Why I Hurt.” As I listened to the interview again recently, I got chills. The larger purpose behind this man’s life, work — and now, his writing — is plainly clear.

Listen to Vicki’s 2008 podcast.

Randy and Amy Christensen. Amy is also a pediatrician.

The Crews'n Healthmobile and staff. Photo by Vicki Louk Balint.

With Randy at the PCH gift shop. Photo by Vicki Louk Balint.

Feeling fat

When she baked pies, my mother always saved a small piece of pie crust dough just for me. She’d put it into a small aluminum foil pan (the size of a single pot pie). She’d brush it with melted butter and sprinkle it with cinnamon sugar. She’d bake it with the regular pies, pulling it out a bit early so it didn’t burn.

Crisco and white flour. Butter, sugar and cinnamon. I can’t imagine eating something like that now; I’m much more health-conscious in middle age than I was as a child. But I thought about those warm slivers of buttery, cinnamon-y goodness this morning, as I toasted a two-day old bran muffin for breakfast. On a whim, I slathered some (zero grams trans fat) canola oil margarine on the warm pieces, then sprinkled some cinnamon sugar on top.

And I wondered when — and why — the joy of eating my childhood treat was ruined for me.

I wondered again this afternoon, when I listened to multimedia journalist Vicki Louk Balint’s podcast interview with Dena Cabrera, Psy.D., a psychologist at Remuda Ranch, which specializes in the treatment of eating disorders.

At some point in the lives of many girls and young women, food stops being a source of pleasure, comfort and joy. It becomes the enemy. It becomes the reason nothing else goes right in life. It contributes to self-loathing, insatiable perfectionism, anxiety and fear. And for some women, it stays that way, to one degree or another, for years. Even decades.

I was one of those young women. From the moment an elementary school classmate remarked that “you have big legs” I became self-conscious about my weight. Food became a source of shame and guilt. Enjoying it was something that I (as a person with “big legs”) was not entitled to experience.

When I got to high school, I refused to eat in public. I never ate lunch at school. I didn’t touch the food at parties. At home, I nibbled at meals. But when I was alone, I slammed down the food. It got worse when I went to college. One of my roommate would go for days without eating and then, when it became too much, she’d drag me out with her for fast-food binges. At one point in my young adult life I weighed 40 pounds more than I do now. (A self-fulfilled prophecy: my legs really were big.)

As the other stresses of adolescence waned and I found fulfillment in work and lasting relationships, my life — and my weight — stabilized. I was lucky to avoid the devastating effects of an eating disorder. But for more than 10 years, I definitely had disordered eating. So I recognized myself in many of the comments Cabrera made during her interview with Vicki.

I didn’t have a daughter, so I can only imagine how tricky it is to navigate food issues as the parent of a young girl. I’m just glad there is help, and hope, for those who find themselves in the throes of destructive eating habits.

Listen to Vicki’s interview. Hear Cabrera describe the “hostile environment” that awaits young women attempting to recover from eating disorders. Think about the message you are sending every time you say, “I feel fat.” And every once in awhile, eat something just for the sheer joy of it.