Answers to your most common telehealth questions

During these challenging times, CHOC Children’s is offering parents peace of mind when it comes to caring for their children’s health and well-being. All medical care for kids is essential, including well visits, immunizations and access to specialty care. That’s why we’ve kept our offices open with additional safety measures in place and why we are offering telehealth appointments when appropriate, giving you access to our experts from your home.

We understand that many parents and families are new to telehealth, so we’ve prepared this guide of frequently asked questions on telehealth, to give parents peace of mind and help them prepare for their child’s first telehealth appointment.

What is telehealth?

Telehealth appointments are virtual visits with a CHOC provider via a smartphone, tablet or computer. You and your child can take these appointments from home or anywhere with internet access that you feel comfortable. During the appointment, you will see and hear your usual physician or specialist and will be able to interact, ask questions and answer your provider’s questions.

Are all appointments eligible for telehealth?

Primary and specialty care physicians can safely and appropriately deliver care for many conditions via telehealth technology. Some types of visits require an in-person appointment. Your child’s provider will determine if a telehealth appointment is ideal for you.

Is CHOC’s telehealth technology safe and secure?

CHOC uses a special version of Zoom, a video conferencing software, with additional layers of security to ensure the protection of our patients and their personal health information. Our telehealth platform has always been and continues to be safe.

What happens once my telehealth appointment is scheduled?

Once approved for a telehealth appointment, you will receive an email with instructions, troubleshooting tips and a link to access your video appointment. Follow the instructions. First, you’ll see a virtual “waiting room” that will instruct you to wait for your child’s physician to admit you into the appointment. Do not exit this screen. Once admitted, you will be able to see and hear your child’s provider, and they will be able to see and hear you. Make sure your child is with you so the provider can properly assess them.

Watch this video on what to expect during your first telehealth appointment and get tips for a successful telehealth appointment.

Who needs to be present?

Please ensure the patient is present for every telehealth appointment so your provider can properly assess them.

Which doctor will we see during my child’s telehealth appointment?

You will see your regular primary care physician or specialist.

What will we talk about during a telehealth appointment?

You and your child can speak with your provider about anything you would bring up during an in-person appointment. Discuss symptoms, your care plan and any questions or concerns you may have. If needed, your physician can share lab results and X-rays with you as they would in person. Your physician may ask you to help by taking your child’s temperature or by showing them a child’s rash, for example.

How much does a telehealth visit cost?

Telehealth visits are billed the same way as in-person appointments. You may be billed your standard co-pay for a visit. Telehealth visits feature your primary care physician or specialist, so you can expect the same high-quality care you’d receive at any CHOC appointment.

Do I have to have a telehealth appointment?

While telehealth may seem awkward or uncomfortable, your physician may prefer to see you via a telehealth visit so that he or she can see you sooner than they would be able to in person. If you prefer an in-person appointment, ask your pediatrician’s office or the Patient Access Center (PAC) when you call for an appointment to see if your provider is OK with waiting until the first available in-person appointment.

Ger more information on telehealth

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How to help kids that are afraid of masks due to COVID-19

By Dr. Marni Nagel, pediatric psychologist at CHOC Children’s

It is normal for children to have fears. Some kids are afraid of the dark, some are afraid of monsters and others are afraid of masks. We are experiencing an unprecedented time, full of uncertainty, which can make previous fears even stronger or bring on new ones.

The Centers for Disease Control has recently recommended that  children over the age of 2 years and adults wear masks in all public spaces. Some children may incorporate mask wearing into their daily lives with ease, while others may find it odd, uncomfortable or even scary. If your child is having trouble wearing a mask, here are some tips on how to ease their fears:

Explain the why

  • Explain why you want your child to wear a mask using short, clear words, making sure that you use language that your child can easily understand. You might say, “Putting on this mask helps your body stay healthy. It also helps other people stay safe and healthy.”
  • If children want more information, answer their questions.

Get creative                                                                                                   

  • Show your child pictures or videos of other children wearing masks and having fun.
  • Be creative with your masks by having your child choose the color, pattern, design or fabric. Depending on the type of mask, you can even put stickers, sequins or gems/rhinestones on them to decorate. The more your child is involved in creating the mask, the better.
  • Children can draw pictures or write stories about characters wearing masks and having fun or doing important jobs.
  • Engaging in fun activities while wearing masks can help distract your child so that they might not even notice that they have a mask on after awhile. You can play games, color, read books, dance, or do any other activity that you like.
  • You can use masks during pretend play to be their favorite superhero or animal. Children may want to wear their masks more if it helps them to get into character. They can also put masks on their favorite stuffed animals and dolls, perhaps even having matching ones for themselves.

Give your child a sense of control and accomplishment

  • Have your child choose a couple of masks that they really like and then before wearing a mask, they can choose which one they want to wear that day. You can also then ask, “Which mask do you want to wear today?” instead of asking, “Do you want to put on your mask?” Don’t give children a choice where none exists, such as wearing a mask in the first place. Allowing a child to choose which mask they would like to wear gives your child some control which can help increase comfort.
  • To increase a child’s sense of control, they can also select a mask for you to wear when you leave the house together.
  • Make sure to praise your child when they do a great job wearing their mask. They will feel proud of themselves when you acknowledge their accomplishment.
  • Children can also earn a reward when they wear their masks when asked. Find a reward that your child would like and that is reasonable for you to provide, such as a special activity with you, bonus time playing their favorite game, or picking their favorite food for dinner. The closer in time that you can give the reward to the mask wearing, the better.

Practice makes perfect

  • Model for children how and when to wear masks by setting an example yourself.
  • Practicing wearing masks before you need to helps the mask not seem so strange or unusual. If they have trouble putting one on, have them start with a favorite toy or doll.

If you sense that your child is afraid, here are some additional ways you can help them feel more comfortable wearing a mask amid the COVID-19 pandemic.

  • Encourage your child to express their fears and let them know that everyone feels happy, sad, angry and worried sometimes — even parents.
  • Listen to what your child has to say and let them know that it is ok to feel that way.
  • Comfort your child by letting them know that you are here and ready to help. Often holding their hand or giving a hug is reassuring.
  • Help calm your child down by taking a deep breath and counting to three
  • Use positive self-statements. Teach your child to say, “I can do this. I am going to be OK.”
  • Start off small when practicing. Determine what your child is comfortable with, such as holding the mask in their hand or holding the mask to their face but not securing it in place and start there. Provide them with an enjoyable activity to do while practicing.
  • Give plenty of opportunities to practice.

This article was last updated on May 18, 2020.

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I’m a pediatrician. Here’s what I want you to know about vaccines.

By Dr. Katherine Williamson, a CHOC Children’s pediatrician

dr-katherine-williamson
Dr. Katherine Williamson, a CHOC Children’s pediatrician

Proper vaccination is important for all people, but especially infants and babies. When children follow the recommended immunization schedule outlined by the American Academy of Pediatrics (AAP), they are better protected against potentially life-threatening diseases.

During the COVID-19 pandemic, your CHOC pediatrician’s office is a safe, socially distant environment to keep your child and family safe while still delivering high quality preventive care.

As a pediatrician, I get a lot of questions about baby vaccination and vaccines for children. Here are the most common questions I get about vaccines – and why maintaining your child’s immunization schedule is more important than ever.

Are vaccines safe?

Vaccines are one of the most important things we can do to help protect our children’s health. Vaccines and proper handwashing, more so than all other interventions, have proven to be the most safe and effective ways to prevent disease.

What is the proper vaccine schedule?

The current immunization schedule outlined by the AAP and Centers for Disease Control & Prevention has been researched and proven to be the most effective and safest way for children to be vaccinated against potentially fatal diseases. It’s important to know that no alternative schedule has been shown to be as safe and effective.

Is it better to do multiple vaccines at one time or space them out?

The safest way to keep your child safe from vaccine-preventable diseases is to get all their vaccines on time. There is no advantage to spacing them out, and instead the longer you wait, you increase the risk of them catching one of the preventable diseases before you protect them.

The amount of antigen (protein) in each vaccine is so tiny that your immune system can process multiple vaccines at one time and build an antibody “army” to protect your child for each of those potentially fatal diseases. In fact, the amount of antigen (protein) in each vaccine is 100,000 times less than if your child has a common cold, so there’s no concern about overwhelming their immune system when they get their vaccines.

Can I delay my child’s vaccines during COVID-19?

Getting vaccinated on time is important because even though we have the threat of COVID-19 to contend with, all the diseases that we can prevent easily with vaccines are still a threat. These diseases — such as whooping cough and measles — are ready to emerge at any time that we don’t have the majority of our kids vaccinated.

When global travel begins to pick back up again, the risk for the emergence of vaccine-preventable diseases is going to be very high if we don’t keep our kids protected against these fatal diseases. While we are waiting for a COVID19 vaccine to stop the pandemic, it is up to us to keep our kids safe and prevent any future epidemics by using the tools we already have to prevent disease.

Do I really need a flu shot every year?

Yes. Now more than ever, it is important that everyone 6 months of age and older receive an influenza vaccine this fall. As many experts are expecting an increase of COVID-19 cases in the fall, an important step to protect our families is to make sure they are vaccinated for influenza in addition to their routine vaccines. While the influenza vaccine does not protect against COVID-19, it may help children if they are exposed to the new virus and may be at higher risk of developing pneumonia or other complications if their bodies are also fighting influenza.

Influenza causes a higher number of death and illness over any other disease annually in the U.S., and your best chance of preventing influenza is the flu vaccine. Symptoms of influenza include high fevers, chills, muscle aches, and respiratory symptoms that can lead to pneumonia and respiratory failure. Children under 2 years and adults over 60 years of age are at the highest risk of becoming seriously ill if they are exposed to influenza.

The CDC recommends an annual influenza vaccine for everyone 6 months of age and older. You should be vaccinated as soon as the influenza vaccine becomes available. Although flu season peaks between December and February, it can start as early as October and last through May.

What can I do to make my child more comfortable while receiving a vaccination?

Studies have shown that preparing your child for vaccinations should ideally include three components: explaining what will happen, how it will feel, and strategies for coping with any related stress or discomfort. Here’s more tips on how to make shots less stressful.

This article was updated on May 18, 2020.

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Is it OK to skip your child’s checkup if they’re healthy?

The first few years of your child’s life are a major factor in their lifelong growth and development, which is why we recommend all well checkups for your child even if they’re healthy. During the COVID-19 pandemic, your CHOC pediatrician’s office is a safe, socially distant environment to keep your child and family safe while still delivering high quality preventive care.

These checkups, also known as well child checks, are an opportunity to track your child’s development, make sure they’re getting the care they need to stay healthy, and for parents to get answers to any parenting questions.

Under the current stay at home orders, it may be tempting to skip something called a “well child check” if your child is feeling healthy. Here are six reasons why it’s not OK to skip your child’s checkup, even if they’re feeling healthy.

dr-katherine-williamson
Dr. Katherine Williamson, a CHOC Children’s pediatrician

#1 Developmental screening

At every well checkup your pediatrician will be making sure that your child is meeting her or his developmental milestones, whether they are 4 months, 4 years, or 14 years old. For babies and toddlers, these milestones come rapidly as children’s brains are learning many new skills every day, from crawling to walking, and from first words to conversations. It is important to make sure your child is acquiring these necessary skills for brain development every step of the way. For older kids and teens, these milestones become less apparent, but are just as important, and are often reflected in a child’s ability to handle academics, relationship, and emotions. Your pediatrician is here to help at every stage of your child’s development.

#2 Relationship building

It’s important for your child to develop a rapport with their pediatrician. We are positive role models for young kids and help lessen their fear of going to the doctor. When your child is a teenager, parents are often asked to leave the exam room so the pediatrician can speak to the teen in private. Your child will feel more comfortable asking personal questions about their body and puberty later in life if their pediatrician has been a constant figure and steady resource since childhood.

#3 Mental health check up

Well checks also serve as a mental and behavioral health check-in. Your pediatrician can help evaluate your child’s mental health and wellbeing over time.

During well child checks amid the pandemic, mental health has been a bigger part of conversations during appointments than ever before. This is a chance for pediatricians to check on how the whole family is coping with stress related to COVID-19. They can share advice for how to talk to kids about COVID-19 and help them cope with COVID-19 anxiety as well as how to teach teens the importance of stay at home orders.

You can also talk to your pediatrician about how your child is coping with social distancing, or a lack of playdates and time with friends. They can offer advice on how to make this a positive time for your family.

#4 Enforcing healthy habits

Well child checks are a great opportunity to reinforce healthy habits. Often, kids will listen to their pediatrician more than their parents. We can remind children about the importance of eating healthy, doing their homework, brushing their teeth, wearing helmets—and listening to their parents!

Do you ever struggle with the question, “How much screen time is too much?” or find yourself battling your children over screen time limits? Your pediatrician can be a resource for you in helping reinforce screen time limits with your child. We can help explain to your children why their bodies need less screen time and more play, and how too much screen time affects their body and brain.

With children spending more time at home than ever, your pediatrician can be a resource on activity ideas for kids during COVID-19.

#5 Getting answers to questions you didn’t know you had

During many appointments in my office, my conversation with parents takes a turn from why they originally came in to see me. They might have an appointment to get a rash checked out, but then I’ll notice a mole on the child I hadn’t seen before, and they’ll realize they too were wondering about that, but just forgot to ask.

Pediatricians are resources for parents just as much as we are caretakers of your children. We’re here to help you get answers to your questions on acne, headaches, academic concerns and anything in between.

#6 A fresh perspective on parenting

Pediatricians specialize in taking care of infants, children and teens – but they can be there for you as a parent, as well.

Right now, parents have been asked to take on more than ever – working from home, overseeing their child’s distance learning curriculum, keeping kids entertained and engaged around-the clock, and more – and they are understandably overwhelmed.

Having a fresh set of eyes on a family’s situation may help troubleshoot what they are trying to figure out. Many of my patients’ parents are struggling with a seemingly never-ending to-do list. Their child’s pediatrician is someone they trust and respect, and I validate that they are doing their best.

Parents should congratulate and forgive themselves. At the end of the day they may be hard on themselves and wish they had done more, and that feeling compounds by the end of the week or month. What parents are juggling right now is Herculean. I applaud each and every one of you.

This article was updated on May 18, 2020.

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Activity ideas for kids during COVID-19

With social distancing guidelines in effect, many schools closed and some childcare options unavailable, many children are spending more time at home than usual.

Here’s a roundup of what parents and caregivers can do to keep kids occupied during this time.

Online learning

    • The Orange County Department of Education has created a roundup of free resources to help students supplement other materials that are being provided by their teachers.
      • OCDE also has a complete list of school districts providing grab-and-go meals at campuses across Orange County. See the full list here.
    • Many educational companies are offering free subscriptions in light of school closures. Here’s a guide.
    • Scholastic offers day-by-day projects to keep kids reading, thinking and growing.
    • PBS SoCal | KCET, in partnership with the Los Angeles Unified School District and in collaboration with California PBS stations, are offering broadcast programming and accompanying digital resources that adhere to California’s state curriculum. Learn more here.
    • Budding scientists can access Nova Labs at PBS, for video, animation and games on scientific topics like predicting solar storms and constructing renewable energy systems.
    • NASA’s Teachable Moments, offers a range of activities and lessons for grades K-12.
    • NASA’s Kennedy Space Center Visitor Complex has educational and fun Facebook videos where kids can learn from astronauts and other educators. For activities, instructions are available as free downloads.
    • Make any room a classroom with BrainPop, where curious learners can take units in science, social studies, math, engineering and tech, and more
    • Tynker is offering free premium coding courses during school closures.
    • Khan Academy offers free daily schedules for kids and teens ages 4-18 to keep stability and routine during this time. The online learning non-profit also offers a free downloadable app called Khan Academy Kids,that contains thousands of activities and books for children ages 2-7.
    • FunBrain.com offers hundreds of free games, books comics and videos for Pre-K through eighth grade.
    • National Geographic Kids offers free online quizzes on topics ranging from animals to planets to sports and food.
    • Cool Math 4 Kids offers games and lessons to make math fun for kids.
    • Math Game Time offers a variety of games, videos and worksheets for Pre-K through seventh grade.
    • Inspired by Dr. Seuss, Seussville has activities, crafts, printables and recipes to engage your child in playful learning.
    • Online  games that include K-12 curriculum.
    • Skillshare is offering two-month free trials for online classes that include animation, creative writing, web design and more.
    • Amazon is offering free computer science courses online for various grade levels.

YouTube channels

  • Crash Course Kids — bi-weekly shows on grade school science, including Earth, habitats, space and more.
  • Science Channel – learn about outer space, new technology and more.
  • SciShow Kids – every Tuesday and Thursday, the hosts explain fun, complex science concepts; do experiments and interview experts.
  • National Geographic Kids – videos feature animals, science, pets and more.
  • Free School – exposure to famous art, classical music, children’s literature and natural science in an age-appropriate and kid-accessible way.
  • GEOgraphy Focus – explore geography, maps, flags, culture, languages and travel.
  • TheBrainScoop – explore the work and research of natural history museums.
  • Kids Learning Tube – educate kids through music and animation.
  • Geek Gurl Diaries – videos on programming, computer science, logic, electronics and more.
  • Mike Likes Science – science-inspired music videos.
  • Science Max – large-scale science experiments.
  • SoulPancake – in addition to the well-known Kid President shows, this channels offers content that explores and celebrates the ways humans seek connection.
  • Course Hero – study guides and videos for various subject matters.

Story time

  • Here’s a list of podcasts — featuring stories, meditation, music and more — for ages 2 through 6.
  • Celebrities are taking to social media to read children’s books to little ones staying home during this time. The Los Angeles Times curated this roundup of these posts.
  • Audible, which has the world’s largest collection of audio books, is offering free stories — in six different languages —  for kids as long as schools are closed. Start listening here.
  • Here’s a list of authors doing read-alouds of their famous books, as well as books by their favorite authors.
  • Storyline Online, the SAG-AFTRA Foundation’s award-winning children’s literacy website, streams videos of celebrities reading aloud children’s books alongside creatively produced illustrations.

Music class

  • Carnegie Hall’s Music Explorer program offers a way to learn new musical genres and cultural traditions. Courses conclude in an interactive concert experience.
  • Chrome Music Lab lets kids learn music through a hands-on website.

Learn a new language

  • Learn a new language with Duolingo.
  • English52 allows users to strengthen English skills through video lessons and activities.
  • Fabulingua is an interactive app that teaches Spanish.

Virtual field trips

  • Google Arts & Culture has partnered with thousands of museums around the world to offer virtual tours from the comfort of your home. Here’s the complete list.
  • The San Diego Zoo offers 10 different webcams so animal lovers can keep up with a variety of their favorite creatures.
  • The Monterey Bay Aquarium also offers 10 different webcams for families to experience underwater life from anywhere.

Cook with your kids

  • CHOC nutrition experts have curated some of their favorite recipes and offer tips for how to get kids involved in the kitchen. “Children as young as 2 years old can help out in the kitchen. You can have your child wash fruits and vegetables or stir ingredients,” Shonda Brown, CHOC clinical dietitian, says. “Children are more open to trying new foods if they have opportunities to explore and learn about the food before they eat it.”

Opt outside

Kids can still benefit from nature while practicing proper social distancing. Even babies and toddlers can join a family nature walk. if you’re in a public space, keep them in a carrier or a stroller. If you’re in your backyard, they can explore more freely.

Children who spend more time outdoors have improved motor development and lower obesity rates. Playing outside promotes more curiosity, creativity, and critical thinking — especially essential with schools closed and extra-curricular activities canceled.

  • On a nature walk, collect twigs, leaves or rocks. Then, build a nature sculpture by sticking these items in play dough. Help your child notice the patterns created by different items.
  • Go on a family bike ride, while keeping a safe distance from others.
  • Nature scavenger hunts can be fun for the whole family. How many different kinds of plants, flowers, animals or birds can you see?
  • Playing soccer or catch is fine, but don’t share equipment with people outside your household.

Highlights@Home

The beloved classic kids’ magazine, Highlights, is posting twice-weekly online roundups of stories, puzzles, craft ideas and more to help children cope with being cooped up and help parents make the most of this time with their kids. Each installment has a different theme:

  • Celebrate reading — Reading can transport us somewhere else for a while, even when we’re stuck at home.
  • Pajama day — Showing your children affection with a hug, snuggling on the couch to watch a movie, or reading together in a cozy blanket tent are all ways you can be fully present with your child.
  • A never-ending pile of fun — Sequestering at home may actually provide you with the time to teach kids tasks like matching socks, folding clothes, and putting away clean laundry. Kids usually like to help, and when we make the chores fun, they’re often eager to pitch in.
  • We are (all) family — Whatever your family configuration, this week’s issue has ideas for strengthening your family bond.
  • Staying connected — Children are likely feeling the loss of connection with friends and extended family. This guide is full of ways you can help your kids feel more connected to people they love but can’t safely see right now.
  • Just keep dancing — What raises our spirits more or gives us a burst of energy like music and dance? These activities will help  your kids move their bodies, use their creativity, and improve their mood.
  • Shoot for the stars — Young or old, we’re all fascinated by space. What’s known is often mind-boggling, and what’s unknown leaves so much to the imagination.
  • Thank you teachers — Thanking teachers is not only a nice thing to do, but showing appreciation is a simple but important practice of gratitude.
  • Hooray for helpers — National Nurses Week presents an opportunity to expand your kids’ understanding of what it means to be heroic.
  • Let’s talk family — Someday, this quarantine will be a memory, and we hope your children will remember some of the family fun you’ve been enabling, and also the ways you are helping them focus on the things that really matter.
  • Cleaning up — A bundle of resources for making cleanup fun.
  • Celebrate the sun — Puzzles, stories, and activities related to growing gardens, having picnics, and taking nature hikes will remind your kids of some of the fun to be had in the sun. Sunny days together provide an opportunity to talk to your kids about optimism.

Other activities

This article was last updated on May 18, 2020.

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