How a car accident changed my life

By Jacob Werkmeister

My journey with CHOC started on Dec. 18, 2016, when my dad and I were hit by a car. The weeks following the accident were terrifying, and my 18-month rehabilitation process afterward was physically and mentally challenging. Now, I’m doing incredibly well and so is my dad.

My dad and I were in a movie theater parking lot in South Orange County. We’d just seen the latest Star Wars movie. We were standing next to our car when a driver careened off a nearby road at 100 miles per hour and hit us. I was immediately knocked unconscious and flew into a nearby body of water. I was completely submerged and almost drowned. I suffered a traumatic brain injury, broken shoulder and multiple facial fractures. My dad and I were not initially expected to survive. I was rushed to CHOC at Mission Hospital. I underwent multiple tests, scans and procedures, including one to drain leaking cerebral spinal fluid.

I don’t remember much of my time at CHOC Mission – I was comatose for most of my first week there. I finally woke up on Christmas Eve, and over the next 10 days I made significant progress – sitting up and even taking a few steps.

Jacob Werkmeister_after accident
Jacob after the car accident.

During this time, my dad was recovering at Mission Hospital. Thanks to the partnership between CHOC Mission and Mission Hospital, my mom was able to go back and forth between my room and my dad’s room without even having to leave the building.

CHOC doctors and nurses exemplify kindness and caring. One of the kindest things they did for us was allow my dad and I to see each other. Once we were both awake and extubated, they brought my dad up to my room. The simple act of allowing a father and son to see each other and hold each other’s hand was instrumental in our healing process.

Jeff and Jacob Werkmeister hold hands for first time since accident 12.21.16
Jacob and his dad hold hands for the first time after the accident.

Dr. Gary Goodman, medical director of the pediatric intensive care unit at CHOC Mission, was incredible. He kept my parents well-informed about my care and progress. Every single nurse who treated me went out of their way to also ensure that my mom felt cared for. She was included in every conversation about his care.

My mom has been a nurse for 25 years. She works with the American Hospital Association and helps hospitals implement strategies to improve outcomes for patients and make care as safe as possible. Because of her clinical eye, she noticed everything that happened with every shift. Even during the holidays or shift changes, she always said my care at CHOC Mission was impeccable. This shows the entire team’s commitment to excellence.

Despite being incredibly complicated trauma patients, with high-alert medications and surgeries, neither my dad nor I experienced any adverse events during our hospitalizations. We both received perfect care.

My dad and I went home after around two weeks. Next, I started 18 months of rehabilitation through CHOC. I worked with an occupational therapist and a physical therapist. I had to relearn how to walk, hold a pencil, do math, read and remember things.

I also worked with Dr. Sharief Taraman, medical director of neurology at CHOC, and Dr. Jonathan Romain, a CHOC neuropsychologist, as part of CHOC’s concussion program. Even though I wanted to speed up my recovery so I could try and get back to playing baseball, Dr. Taraman and Dr. Romain made sure I was safe.

Before the accident, I was a lifelong baseball player. After the accident, no one imagined I would play baseball again. Not only did I return to baseball a few months after the accident, but I recently signed a letter of intent to play baseball for Ohio Christian University.

Jacob Jacob Werkmeister_today
Jacob today, back to baseball.

This journey has taught me so much. I really shouldn’t be alive right now. Now, I don’t let the small things get to me. I know I can get through anything.

Our family could never repay our gratitude to CHOC. We are so thankful for everything CHOC has done for us.

A Parent’s Guide to Understanding the Teen Brain

The mind of a teenager can be at times mysterious and illusive. A pediatric neurologist, a pediatric neuropsychologist and a pediatrician who works with adolescents at CHOC offer advice for parents on how to better understand and connect with their teen.

Navigating adolescence with a still-developing brain

Adolescents’ brains are not yet fully developed during their current stage of life. Physical development can start as early as 8 years old, but the tail end of brain development doesn’t occur until closer to age 25. The more your child is exposed to new things, skills or experiences, the more connections their brain will develop.

“The brain is constantly developing through young adulthood. Just like we wouldn’t expect a baby to be able to speak or a toddler to be able to understand certain consequences, we have to have appropriate expectations for our adolescents,” says Dr. Sharief Taraman, a pediatric neurologist.

Dr. Sharief Taraman offers advice on the teen brain
Dr. Sharief Taraman, a pediatric neurologist at CHOC

This constant development can lead to experimentation and in turn, a healthy decision making process.

“On the one hand, adolescents are more apt to experiment and make poor choices because their brains are still developing, but they are also more able than adults to learn from their mistakes and alter their perspectives,” says Dr. Jonathan Romain, a pediatric neuropsychologist. “I see adolescence as a period of great potential for growth and development.”

Dr. Jonathan Romain comments on the teen brain
Dr. Jonathan Romain, a pediatric neuropsychologist at CHOC

A parent’s role in teen brain development

The consequences of teens’ actions can help them link impulsive thinking with facts. This helps the brain make these connections and wires the brain to make this link more often. Parents play a crucial role in helping teens talk through consequences and decision making.

“Part of a parents’ role during this time in their child’s life is understanding that adolescents are practicing new reasoning skills they haven’t used before,” says Dr. Alexandra Roche, a pediatrician who works with adolescents. “Having abstract thinking is one new reasoning skill they need to practice. When they are trying to make a decision, it’s helpful for parents to let them explore various consequences.”

Dr. Alexandra Roche comments on the teen brain
Dr. Alexandra Roche, a pediatrician who works with adolescents at CHOC

The primary part of the brain developing during this time is the frontal lobe. As this area develops, teens are better equipped for abstract thinking and executive functioning, such as planning their day and making decisions. The frontal lobe is also involved with connections and how we socialize with people as well.

“They’re learning that if A happens, then B or C is going to happen after that. Parents get frustrated at how adolescents handle peer relationships and how extreme their feelings can be, but these may happen because those connections are being formulated. Talking through consequences helps good connections to form,” says Dr. Taraman. “Decision making takes practice. If you want to play guitar, you take lessons and practice, and it makes you better. If you only take one guitar lesson, you’re not going to learn how to play. Decision making is the same thing; it takes practice and it is never too early to start teaching our kids how to make good decisions.”

How to teach decision-making skills to your teen in an interactive way

Remember that you are a role model for your teen’s behavior. When it’s time to make a big decision, show them how to make a matrix, weigh the criteria of what is important to you and them, and teach the decision making process in an interactive way.

Modeling reasoning behavior with your teen will affect how they explore and understand downstream consequences, says Dr. Roche.

“If they approach you and want permission to do something, have them do research via respectable sources and find out what’s appropriate for their age. Involve them in the decision making process. That’s how you can give them good tools instead of just deciding things for them,” says Dr. Taraman.

Talking to your kids is essential in the digital age. It’s common for teens to want to be on their smartphone around-the-clock, but that can spur an extreme fear of missing out. Figuring out how to turn off both the devices and the need to be constantly plugged in is important.

“Try setting technology-free zones or times in your home, such as the dinner table. Take turns going around the table and sharing the highlight of your day. It can spark conversations about other things that happened during your day and how you dealt with them. Teens can learn by example,” says Taraman.

Your teen’s friends also play a crucial role in their development, but peer pressure is not always a bad thing.

“Peer pressure can be positive in many cases, like trying a new sport or joining a new club at school. Experimentation is the way adolescents learn how to interact with their environment and peers,” says Dr. Roche. “Kids should be curious and try different activities.”  Helping them plan ahead for unexpected events, such as being offered drugs or alcohol, can help your teen make the right choice when it counts.

How to calm an overly emotional teen

When teens are overly emotional and fixating on a problem they feel is the end of the world, there are several things parents can do to calm them down so they can start talking through their emotions.

“It’s very common for teens to be very dramatic. Whatever is happening in their world can seem like it’s the most important thing that has ever happened to them,” says Dr. Roche. “Help them identify the emotion they are feeling, and what is making them angry or excited, for example. Identifying the root cause of the emotion and then connecting that back to how that affects their decision making is important.”

Dr. Romain encourages parents to give their teen some space but remind them that you are available to listen.

“Not every problem needs a solution. Sometimes they just need someone to listen to them in a safe space. Encouraging journaling can also be a productive way of getting thoughts and feelings out,” he says.

Listen first and then expand on their statement.

“If they express hurt or disappointment, try to get them to more openly explain why something hurt their feelings,” says Dr. Roche. “Did they misinterpret a conversation?”

Allowing them to solve their own problems teaches independence and prepares them for adulthood.

“If you fix all their problems for them as a teen, then when they go off to college they won’t know how to deal with problems. We don’t just give them a driver’s license and tell them to hit the road. First they drive under supervision of a parent or guardian, and then they gradually gain more independence and responsibility,” says Dr. Taraman.

The power of positive reinforcement

Remind teens that they are resilient and competent. They may have trouble remembering past times they have overcome obstacles.

“Positive reinforcement helps encourage certain behaviors you’d like your teen to model,” says Dr. Taraman. “If they want to go to their friend’s house after school and they ask if that’s ok, say “no problem, thank you for asking.” And if they instead tell you they are going, say “Don’t you need to ask permission first?”

Positive reinforcement will also help them develop strong self-esteem. As they develop their identity, encourage your child to reflect on successes as well as challenges.

“During adolescence kids are coming up with self-identify, personal morals and ethics. This all relates to self-esteem. Comparing yourself to others is common but it can also set unwieldy expectations. Identify their unique strengths (for instance music, but not math) and focus on encouraging them to pursue those,” says Dr. Roche.

When to seek help for your teen

Adolescents are prone to addictive behaviors. If they use certain chemicals such as drugs and alcohol, it can hard wire their brain in a certain way. If they are experiencing anxiety or depression and it is not acknowledged and treated, they are more likely to experience those into adulthood.

“It is important to keep an eye out for symptoms of depression and anxiety that extend beyond normal grief and loss. Check in with your child periodically and be aware of changes in behavior pattern. Persistent irritability, sadness, disrupted sleep, and lack of interest and isolation are some things to look out for that likely warrant a check-in with a counselor or psychologist,” says Dr. Romain.

A few days of emotional outbursts might just be a normal sign of adolescence, but if they are persistently practicing abnormal behavior, it may be a sign to seek additional help. Remind your child that you are there for them, says Dr. Taraman, but also empower your teenager to explore the resources available to them, with or without their parents’ help. Suicide hotlines (1-800-Suicide) or adolescent clinics can help them obtain resources without the help of their parents.

“Because adolescents have so many obvious physical changes, it’s easy to forget the cognitive changes going on in this phase. It’s the most exciting change for kids but can be very frustrating for parents,” says Dr. Roche. “Remember to enjoy the experience of watching your kid develop into an adult.”

Learn more about Adolescent Medicine

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Managing and Combating Test-Taking Anxiety in Children

By Dr. Jonathan E. Romain, pediatric neuropsychologist at CHOC

Many parents know the disappointment of seeing their bright child score poorly on an exam even after hours of studying. Teen showing symptoms of anxiety during test

“I knew the answers before the test!” and “My mind went blank when I saw the test!” are common refrains from these frustrated children.

These aren’t excuses. What these children are experiencing can likely be attributed to test anxiety, a real phenomenon that occurs when nervousness goes into overdrive, causing physical, behavioral and cognitive consequences that can impact test scores.

Fortunately for parents and children alike, test anxiety can be managed and even conquered.

When anxiety takes over

Anxiety at its best provides a bit of nervousness that keeps people sharp and making sound decisions at key moments.

However, the problem occurs when anxiety becomes more intense than what is necessary for the situation. Many people – more than 30 percent – have difficulty keeping anxiety at a manageable level. For these people, excess anxiety can lead to poor performance, low self-esteem, and school avoidance and social isolation.

Anxiety symptoms usually first develop during the school-age years, when tests are introduced and awareness that classroom performance is monitored increases. During these formative years, children need good coping skills and strategies to manage anxiety.

Symptoms of test anxiety

To best manage test-taking and classroom anxiety, first identify the symptoms:

  • Physical symptoms include increased heart rate, trembling or a shaky feeling, muscle tension, and feelings of lightheadedness.
  • Behavioral symptoms include irritability, restlessness, rapid speech and fatigue.
  • Cognitive or thought-related symptoms include difficulty focusing and concentrating, memory problems, poor problem solving, and persistent worrying.

Test anxiety can also self-perpetuate or reinforce itself. So, if a child had a bad experience on one test, it’s likely they will have similar feelings again. After several experiences, the child may feel that all tests are miserable and to be avoided.

Managing test anxiety

Parents, teachers and students should work together to control anxiety.

Parents should reward success and reinforce good effort, but know that too high expectations and unrealistic goals may have a negative effect. They should also ensure they control their own anxieties, as children can sense emotions and model learned behaviors.

Parents and schools should work together to identify test-taking anxiety as it occurs and ensure realistic expectations. Teachers can modify time constraints and put equal emphasis on homework, projects and classroom tests. Additionally, they can grade more for effort than output. Less emphasis on grades can diminish anxiety and improve grades.

Finally, children can manage their anxiety by identifying symptoms and practicing progressive relaxation and other deep breathing techniques to calm down. They should also be encouraged to talk to parents and teachers when feel overwhelmed.

They can also try journaling: A recent study at the universities of Colorado and Chicago suggested that writing about anxiety before taking a test reduced anxiety’s impact on performance. The idea is that by writing about the anxiety, test takers let go of symptoms and can concentrate better on the task.

Anxiety has a protective factor in dangerous or life-threatening situations, and a reasonable dose of nervousness can help one perform at their peak. But it is essential to know the symptoms of anxiety and to keep them in check so they do not take over. Learning to manage anxiety in the school-age years is the first step to an anxiety-free adulthood.

Dr. Romain is a board-certified clinical neuropsychologist at CHOC. Dr. Romain completed his pre-doctoral internship at Franciscan Hospital for Children in Boston and a two-year American Psychological Association accredited fellowship in pediatric neuropsychology at Medical College of Wisconsin. Learn more about Dr. Romain.

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Learning Disabilities and Your Child

Many children have learning disorders that affect everything from their reading comprehension to their math abilities. Learning disabilities affect the brain’s ability to receive, process, analyze, or retain information.

If your child has a learning disability, he’s certainly not alone; roughly 5 percent of children in public schools are receiving special education services for a learning disability, says Dr. Jonathan Romain, a CHOC Clinical Neuropsychologist.

Many dyslexic children also have another learning disability or neurological disorder, often Attention Deficit Hyperactivity Disorder (ADHD), says Dr. Romain, adding that ADHD and dyslexia should be treated separately when diagnosed. Medication and behavioral support and counseling, as well as helping your child to stay organized and have an organized environment, will help, he says.

Here are some tips from Dr. Romain on more ways parents can help their child with a learning disorder:

  • Get your child to read and read often! This can be challenging for parents of kids with ADHD, says Dr. Romain. “With ADHD, you don’t like to do the things that you don’t want to do, so this impacts the motivation, follow-through and determination to become a better reader. Parents should provide positive reinforcement. If Jimmy doesn’t want to read, have him practice reading for 10 minutes and then do something fun afterward. You want to tie positive outcomes with reading.” The goal is to get children with a reading disability and /or ADHD to be proficient enough at reading so they will find books or magazines they like and read them on their own.
  • Children may have a learning disability in relation to numbers or math. Parents should be aware if their child is having trouble in math and seek an evaluation for a learning disability in first or second.
  • Make sure your child has adequate exposure to the material (reading or math) before having him evaluated. First or second graders from low-income areas will often benefit first from more exposure to the material if they are having trouble. They can be evaluated more extensively if they are not making progress.
  • Watch out for your daughter! In the classroom, boys are identified as having a reading disability up to three times as frequently as girls, but in research studies, it’s evident that dyslexia is only modestly more common in boys. The conclusion is that girls tend to be underdiagnosed in the schools and this is also the case for other school-based struggles, including ADHD.
  • Public schools can evaluate a child to see if he or she needs special education support or accommodations if the problem impacts learning; a clinical evaluation will look for an underlying disorder, developmental delays, mood issues and other medical issues. Concerned parents can ask their school district or pediatrician as a starting point, and seek an outpatient evaluation or a second opinion if they want. If you seek a private evaluation for your child outside of the school district (possibly at your cost, since medical insurance may not deem this as a medically necessary), make sure it’s from a developmental psychologist or neuropsychologist familiar with educational development.

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Drs. Sharief Taraman, Jonathan Romain Discuss Concussions

Even minor concussions can cause lingering symptoms, two CHOC Children’s specialists tell “American Health Journal.”

Concussions can cause physical effects like headache and nausea, as well as emotional symptoms such as irritability and easy frustration, say Dr. Sharief Taraman, a pediatric neurologist, and Dr. Jonathan Romain, a neuropsychologist.

Learn more about concussions, including prevention, in “American Health Journal,” a television program that airs on PBS and other national network affiliates that reach more than 40 million households.

Each 30-minute episode features six segments with a diverse range of medical specialists discussing a full spectrum of health topics. For more information, visit

Sharief Taraman, M.D., attended medical school at Wayne State University School of Medicine and went on to complete residency training in pediatrics and pediatric neurology at the Children’s Hospital of Michigan. Jonathan Romain, Ph.D., completed his pre-doctoral internship at Franciscan Hospital for Children in Boston and a two-year APA accredited fellowship in pediatric neuropsychology at Medical College of Wisconsin.

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