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RSV and Other Respiratory Viruses

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From the Washington State Department of Health

Pediatric hospitals and clinics across Washington are in crisis as rising case rates of Respiratory Syncytial Virus (RSV), flu and COVID-19 cause overcrowding in the midst of staffing shortages. Flu hospitalizations are at the highest rates seen in 10 years for this time period and pediatric emergency departments are seeing a record number of RSV patients. To slow the spread of respiratory viruses, Washington State Department of Health (DOH) recommends that everyone 6 months and older be vaccinated for influenza and get a COVID-19 booster to lower the risk of respiratory virus transmission and serious illness. Find resources here

What is RSV?

Respiratory syncytial (sin-SISH-uhl) virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious, especially for infants and older adults. RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than 1 year of age in the United States. (Centers for Disease Control and Prevention)

Pediatrician Discusses RSV Cases American Academy of Pediatrics

RSV is spreading rapidly and much earlier than normal this year. That combined with flu season and the continued spread of COVID makes for a scary time for many parents of young children. Pediatrician and parent of young kids Dr. Parga-Belinkie offers reassurance and practical guidance for parents in this new video, including signs it’s time to #CallYourPediatrician to be seen.

Posts by Pediatrician Dr. Elise Herman

Teacher draws with little girl while wearing surgical face mask

Returning to School After an Illness

As kids head back to school and are together in classrooms again, parents know their child may pick up some illnesses. There are times when it is appropriate to keep sick children home, both for their own recovery as well as protecting fellow students and school staff.

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Father giving drink to small sick son lying in bed indoors at home.

Preventing Respiratory Syncytial Virus Infections

RSV typically starts in fall, peaks in winter, and causes cold symptoms including runny nose, cough, and fever in children and adults. Most kids have had RSV by age 2. Although usually mild, RSV can cause more serious problems like wheezing, pneumonia, and trouble breathing.

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Information / Flyers, Handouts and Printable

Seattle Children’s Hospital

American Academy of Pediatrics

Center for Disease Control

Local Resources

If you or someone you are taking care of are exhibiting symptoms that you feel require immediate medical attention, please call 9-1-1. If you or someone you are taking care of are experiencing symptoms but do not require emergent care, please contact your primary care provider.

Most health insurance companies offer a 24-HR Nurse Line to assess symptoms, provide support and guidance for non-emergency situations. Check the back of your insurance card for the phone number.

Respiratory Virus Season and Children

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Contributor Dr. Elise Herman

As cooler weather approaches, the “sick” season does, too. For kids, this usually means respiratory illnesses, ranging from cold to croup or pneumonia. While these sicknesses are usually mild, more severe cases are rapidly increasing, with more kids going to the ER and being hospitalized. The viruses responsible include Respiratory Syncytial Virus (RSV), rhinovirus, adenovirus, and enterovirus. To complicate things, influenza season typically starts in October, and with COVID-19 currently spiking in Europe, a surge is predicted to hit the US soon.

Children are walking in nature, fall leaves.

This earlier and more severe start to the respiratory season for kids is felt to be related to gathering again (without masks) in schools and social settings. Kids do not have much immunity from last year when the respiratory season was milder due to social distancing and other anti-COVID measures. Wildfire smoke exposure may also be a contributing factor.

Most kids who contract these viruses will get a simple cold (“upper respiratory infection”), nasal congestion, mild cough, and mild fatigue. A low-grade fever is common for the first three days of illness. Kids may be sick for 1-2 weeks but remain fairly active with good fluid intake though overall eating is often decreased.

Younger or premature infants and children with lung problems like asthma are at increased risk of more severe illnesses like pneumonia. General warning signs include the pale or dusky color of the lips or skin, and increased work of breathing—rapid breathing with the ribs showing on inspiration (“retractions”). Unusually noisy breathing, such as wheezing (high-pitched musical noise with breathing out) or stridor (crowing noise with breathing in), is concerning. An infant who cannot feed well from a breast or bottle is worrisome. Extreme lethargy or limb weakness at any age is very concerning.

For mild respiratory illnesses, the diagnosis is usually based on symptoms and examination alone. Checking respiratory rate, heart rate, and oxygen level are routine when the child is seen by a medical provider. Testing for viruses with a ‘respiratory panel’ can be done but is expensive and usually reserved for those more severely ill since there are few specific anti-viral treatments available. Specific testing for COVID-19 and RSV may be done, given that the implications of having these viruses are more significant regarding attending school, childcare, etc.

If your child has typical cold symptoms, it is essential to ensure they stay well-hydrated; solid food intake is less important. Offer infants extra breast milk or formula. Saltwater nose drops and nasal suction for infants can be helpful in terms of clearing mucous which interferes with breathing through the nose. Fever control with Tylenol (over age two months, though talk to a provider first) or Advil (over age six months) is primarily for comfort since fever, as part of the immune response, may help fight the virus.

No cold medications are recommended under the age of four years and should be used with caution for those 4-6 years old. These meds are usually not helpful and may have harmful side effects in younger kids. Honey (1/2 to 1 tsp by mouth) may help to cough but is safe only for those over one year of age.

To help prevent respiratory illnesses, keep up the frequent handwashing we have all gotten good at during the pandemic. In addition, kids should be reminded not to touch their faces and not to share food or drinks. Although not easy, masking (especially if your child will be in a large group) does help prevent illness. Lastly, it is vital to get your child vaccinated against those respiratory viruses for which we have safe, effective vaccines—COVID-19 and influenza.

Resource / HealthyChildren.org

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Dr. Elise Herman

headshot of Dr. Elise Herman
Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Curiosity in Children

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Contributor Dr. Elise Herman

There are characteristics we hope to see in our kids such as kindness, intelligence, and perseverance. We may not put ‘curiosity’ high on this list, but in fact it is crucial to a child’s success in learning and school—and maybe, even in life.

Research has shown that those who are curious tend to be happier, less anxious, and have a greater sense of well-being. In children, studies connect curiosity to higher academic performance, and in adults it is tied to greater achievement at work.  When people are highly curious about a subject, they are more engaged with it and more likely to remember what they have learned. General memory is also improved for information unrelated to the original area of interest. It seems curiosity primes the brain to absorb and retain new information better.

Being curious has been shown to improve one’s patience. Those who are very curious seem willing to do the work themselves to figure something out as opposed to needing an answer immediately. Curiosity can lead to increased creativity, more original ideas, and a willingness to ‘think outside the box’. It also translates into greater empathy and stronger interpersonal relationships.

So despite the sometimes endless “why?” questions from our kids that can be a bit much, curiosity is a very good thing. There are lots of ways we can encourage this important trait:

  • Express curiosity and wonder yourself, e.g., “I wonder why the moon looks so big tonight?”  Have a back-and-forth discussion about possible explanations. Together with your child find resources to get answers (and not just online) such as books, the library, and knowledgeable individuals.
  • Ask your child questions about things from the everyday to the more fantastical and encourage them to go deeper with their theories and ideas.
  • When your child asks you questions, avoid the “just because” response and research together if you don’t know the answer.  You do not need to know everything, and it is valuable to show your child that you are still learning, too.
  • Encourage your kids to be aware and mindful, to be thinking about what they experience, and to use their full senses to engage completely.
  • Limit “screens” including TV, smartphones, and social media which generally are passive entertainment, though quality programing such as nature shows can encourage curiosity. Watch educational programs (on PBS and National Geographic for example) together so you can have discussions about the content.
  • Explore new things such as ethnic food, museums, and new cultures either through travel or online resources. This promotes not just curiosity but an openness to people different than us.
  • Encourage books about subjects that inspire curiosity such as history-making individuals, exploration, and science fiction.
  • Help your child to follow their interests and learn more about what they are naturally intrigued by.
  • Embrace outdoor activities, especially in nature such as walking in a park, hiking, birdwatching, and camping. These immerse us in the natural world and foster curiosity and wonder.

And enjoy being a bit of a kid yourself as you marvel and explore the world we live in with your child!

more about The contributor

Dr. Elise Herman

headshot of Dr. Elise Herman
Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Parent Advice / Back to School

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Contributor Dr. Elise Herman

As summer winds down, parents and children are well aware of the approach of the new school year. Some kids are very excited about learning and seeing their teachers and friends again, while others have more reservations. COVID and recent school shootings complicate this often emotional transition. There are steps parents can take now to make this go more smoothly.

Sleep

If sleep schedules got lax over the summer, start now to get back on track. To make bedtime earlier, adjust the wake-up time, moving this up by 15 minutes a day. Kids ages 3-5 years need 10-13 hours total sleep daily, those ages 6-12 years should get 9-12 hours, and teens need 8-10 hours. Remember, no ’screens’ of any kind for at least one hour before bedtime. Reading to your child before bed (or kids reading on their own) aids in falling asleep and is an excellent habit to develop now.

Nutrition

Ensure your child gets up early enough to have a healthy (not sugary) breakfast, improving attention and mood. If your child is taking lunch to school, review what they would like to bring—plan on including fruits and veggies and avoiding processed foods. Water is much better than juice; if they drink milk, nix the chocolate milk, which has as much sugar as soda. Family dinners are a great way to connect during the school year and have been shown to improve nutrition and emotional health. Although it can be tricky to have family dinners with kids’ sports and activities, try to make this a priority.

School Prep

For younger kids, being able to go to school and play on the playground now is very reassuring. Some schools will allow a visit to the classroom and a brief meeting of the teacher as well. You and your child can look at their school online, where they can see photos of the building and the school staff. Review transportation plans and always spend 10 minutes of “getting ready” time on school mornings so your child can be on time with less stress.

School Supplies

Look at the list for your child’s school and classroom (schools often post this on their website) and buy supplies early. Have your child practice packing their backpack and designate a place at home where it goes at the end of the day. All papers and notebooks should come out of the backpack daily so homework gets done and other things don’t accumulate. Pack the backpack with completed homework and any needed items the night before to help mornings go smoothly.

School Safety

In view of recent events, your child may have questions or concerns about school safety. Reassure them that a school is a safe place and that you are comfortable having them there. Although there may be a spike in COVID this fall, we have good tools (vaccines, treatment, etc.) to help. As tragic as school shootings are, they are rare, and schools continue to work on security to help prevent such violence. We must display confidence in our child’s safety at school, even if we are concerned.

Back to school “nerves”: If your child feels a bit nervous about the return to school, let them know they are not alone. This is common, especially if they are going to a new school (as will be true of many kids in Ellensburg with the new attendance zones). Talk up the positives of learning new things, making new friends, and meeting their teacher. If you recall feeling the same way, share that with them and how your nervousness dissipated over time.

Going back to school in the fall is a big deal for you and your child; let them know you have confidence in their ability to rise to this challenge. Planning a fun post-school activity and a special family dinner after that first day will give them something to look forward to and be a terrific way to celebrate this transition.

Local School Districts

Below is a list of Kittitas County school districts and their Facebook pages. Schools often post supplies lists, drop-off/pick-up info, scheduling, and other important information for parents and students.

more about The contributor

Dr. Elise Herman

headshot of Dr. Elise Herman
Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Mindfulness for Children

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Contributor Dr. Elise Herman

We live in a busy and often stressful world. Mindfulness is a simple concept that can help parents and kids be calmer and enjoy life more. Mindfulness means being present, paying attention to what is happening, and accepting it non-judgmentally. This technique is helpful at all ages but learning this when young means children will carry it forward as they grow up. Kids’ brains are still developing, including the prefrontal cortex, which directs focus and control. Mindfulness targets this part of the brain, so it is an excellent opportunity to encourage these skills while the brain is actively growing. Research has shown that mindfulness helps decrease anxiety and improve attention in school-age children. As a result, many schools include mindfulness in their curriculum.

Like so many other things in parenting, modeling behavior is very influential. Practicing mindfulness also helps you parent more effectively. Slowing down, noticing the ‘little things’, making good eye contact, and eliminating distractions (e.g., phones) will help you be present for your child. Start this mindful practice early, beginning with feeding your newborn. Put your phone out of reach (or turn it off), so you won’t be tempted to be looking at it instead of your child.

You can promote mindfulness with your toddler by engaging in activities encouraging focus, such as looking at books, going on walks, and coloring. Just looking closely at grass or flowers (and maybe you’ll find a bug!) teaches patience and calm. Toddlers can also learn to take slow breaths when upset or frustrated. You can demonstrate this, too, and be an excellent example of handling difficult emotions.

Preschoolers can practice mindfulness and focus by being quiet for a short time and increasing this as their patience and ability to “be” increases. Some parents do this at bedtime, starting with kids having eyes closed, being quiet and calm for 15 seconds, then working up to several minutes or more. Your child may then be able to calm themselves more quickly at other times, such as when upset. Taking walks in nature and being attentive to clouds, leaves, birds, etc., encourages your child to be present and focused. Notice and discuss the five senses as you go about your day. What is your child aware of in terms of seeing, hearing, touching, tasting, and smelling? You can include mindfulness in eating– enjoying food slowly and being aware of taste and smell instead of just eating in a rush without truly paying attention.

Older kids can understand more about the concepts of mindfulness and master mindfulness techniques. By learning to observe something with curiosity and acceptance instead of having an immediate emotional reaction, your child will be better able to handle complex and stressful situations. By fully paying attention to the present, it is easier to let go of regrets about the past and worries about the future. A simple technique is focusing on the breath; counting each breath up to 10 (‘one breath’ equals breathing in and out) helps with this. Imagining each breath as a gentle wave can also be very calming. Mindful breathing is a form of meditating and can be done for just a minute or more throughout the day. This really does train the mind to focus and be more grounded.

There are lots of helpful online resources. “Smiling Mind” is an Australian website and free app with good info about kids and mindfulness, regulating emotions, and how to promote empathy and connectedness. Other apps have fees but can be very valuable including “Headspace for Kids” and “Calm.” Your child is always learning from you, so the more ‘present’ you are with your child (this means putting down phones), the more both of you can be mindful, calm, and enjoy life.

Resources

more about The contributor

Dr. Elise Herman

headshot of Dr. Elise Herman
Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Update: Talking to Your Child about Traumatic Events

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Note: This article was first published in 2017 after the Las Vegas mass shooting. Other than updating the location of recent mass shootings, little else was changed. A sad statement that these horrific tragedies continue.

Contributor Dr. Elise Herman

In the wake of the most recent mass shootings in Buffalo, New York and Uvalde, Texas, we all feel sad and stressed.  Parents also wonder if they should discuss traumatic events such as this with their children, what they should say and how to best reassure their child. Depending on the age of the child, how to do this will vary. 

Under age 2 years, kids do not understand exactly what is happening but often pick up on the emotions of the adults around them, and may cry more often, be fussy and be less social. Preschoolers may have some understanding that something bad happened and will look to their parents for reassurance and a sense of normalcy.  Kids in elementary school may develop fears depending on the trauma (especially a school shooting) and not want to go out to school or other activities. Regressive behavior and wanting more help from their parents are normal.

Preteens through teens, often very informed due to their exposure to media, may feel very worried and overwhelmed. They may minimize their feelings, withdraw, or not want to talk about the event. Their stress could come out in being more argumentative or they may have more physical complaints such as headaches.

Parents are crucial in helping their kids through a traumatic event such as a mass shooting. For the child old enough to express themselves who asks about the event, find out what they know or have heard. Keep your discussion age appropriate, and don’t volunteer additional details that may add to your child’s distress. For a preschool child, a simple explanation that a bad person hurt people but can’t hurt anyone anymore is enough. Of course, reassurance that they are safe is vital.

With their access to the news via their phone or computer, older kids may have more specific questions and worries.  They may have heard misinformation from their friends and social media. Give them your full attention and listen carefully. Address their concerns and correct misperceptions. Remind them of the plans in place to help prevent these events and plans that go into action if /when such events occur- and that as tragic as a mass shooting is, it is very rare.

Kids of all ages benefit in these situations from parents being very available, whether it is for questions and conversation or just warm hugs and time together (take your lead from your child). Keeping the family routine including school, activities, and family meals is important.

It is healthy to express your emotions and encourage your child to do the same but process your own feelings before addressing the event with your child. Seeking help from a counselor, health care provider, or clergy member is appropriate for anyone feeling distraught and overwhelmed weeks later, or if you are worried about how your child is coping. 

We have ‘screens’ everywhere and younger children may think every photo or video is actually another tragedy happening. Children with Internet-connected devices should avoid overexposure to the event- the same goes for parents. Younger kids (some say under age 11) should not watch the news or news videos online at all because the visuals can be too overwhelming.

In the face of such incomprehensible tragedy, we can remember PBS’ Mr. Rogers recalling what his mom told him:

Look for the helpers. You will always find people who are helping.

Good advice for all of us. Highlight the bright spots—the first responders, the heroes, average people doing what they can, be it donating blood or giving money to help. Tweens and teens may want to get involved to help promote social change; the non-profit website DoSomething.org is a fine place to start. There is a lot of the good in the world, and we can be the good and an example to our children. Be extra kind, help your child do something nice for someone else, and make your corner of the world a reassuring place for your child. 

Resources:

more about The contributor

Dr. Elise Herman

headshot of Dr. Elise Herman
Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Kids & Allergies

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Contributor Dr. Elise Herman

Spring is here, the weather is improving and it’s great for kids to be outside, unless your child is itchy, congested, and miserable due to allergies. Seasonal allergies are rare under age 2 years but very common after that, affecting up to 40% of children. If your child struggles with allergies, there are strategies and treatments that can have them happily outside and relatively symptom-free this spring and summer.
Allergies are the immune system’s response to things such as pollens, grasses, dust, cat dander, and more. The immune system makes antibodies called Immunoglobulin E which then cause the release of histamines, chemicals in the body which cause allergy symptoms.

The typical culprits for seasonal allergies are flower and tree pollens (like cottonweed) which cause symptoms from spring through early summer. Grass pollen starts to cause problems in the spring and lasts the entire summer. Ragweed and mold spores (often found in hay) are typically problematic in late summer to fall.
Itchiness is the ‘hallmark’ of allergy and can involve the nose, eyes, and skin. Runny or stuffy nose, sneezing, throat clearing, and itchy pink, watery eyes are common. Children do not develop a fever with allergies. Kids can get raised pink itchy bumps called hives if their skin is exposed to something they are allergic to, like grass. Allergies can make asthma worse, causing wheezing, cough, and shortness of breath.

Allergies are often diagnosed by simply recognizing the symptoms and when they occur. Classic symptoms, which occur in spring and summer and worsen with outdoor exposure, do not need testing to make the diagnosis. Testing is indicated if allergy symptoms do not improve with typical treatments or if symptoms are severe or confusing. Skin testing is usually done in an allergist’s office with results in about 15 minutes. Allergy meds need to be stopped for at least 5 days before skin testing. Blood testing, which is best for kids who cannot stop their allergy meds or who have a skin condition like severe eczema which would make skin testing difficult, looks at the amount of Immunoglobulin E for certain allergens.

So how to help your itchy, allergic kiddo?

  • Rinsing off from head to toe and changing clothes helps, both when they are having lots of allergy symptoms and routinely before bed.
  • They should also wash their hands and face when they come in from playing outside to remove pollens.
  • Cool moist compresses to those itchy eyes provide relief, too.

There are multiple long-acting over-the-counter antihistamines which are safe and effective. Cetirizine (Zyrtec) is for kids 6 months and older, and Loratadine (Claritin) and Fexofenadine (Allegra) are approved for those 2 years and up. Loratadine and Fexofenadine are non-sedating; Cetirizine may cause mild sedation in a small percentage of people. Benadryl is not ideal since it only lasts 6 hours and typically is sedating.

If an oral medication is not adequate treatment, there are other options including nasal sprays such as Flonase and Astelin, and eye drops such as Zaditor and Pataday. Young kids may resist these at first but become more accepting as they get older. If allergies are severe, allergy immunotherapy (injections) may be recommended by the allergist. For kids 5 and above with severe grass or ragweed allergies, the allergist might prescribe immunotherapy pills that are placed under the tongue daily.

Every kid deserves to be able to get outside this spring and summer! Discuss your child’s allergies with their health care provider for more information.

more about The contributor

Dr. Elise Herman

headshot of Dr. Elise Herman
Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Nature & Children

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photo courtesy of KEEN

Contributor: Dr. Elise Herman

Many of us recall childhoods filled with lots of outdoor time, whether it was playing in the backyard, going to parks, building forts, or just running around. Our kids, however, are having very different childhoods, with most spending less than 30 minutes a day outside and up to 7 hours daily in front of some type of technology. The negative physical and emotional effects of this shift are far-reaching and concerning. Rising obesity rates and more mental health issues are huge problems in kids and too much time inside and on electronics are felt to contribute. Research shows that simple outdoor time in nature (recommended to be at least 60 minutes a day) can help reverse these trends.

The benefits for children of getting outside in nature are well documented:

  • Increased physical activity, decreased snacking, and therefore decreased obesity
  • Increased imagination, creativity, and focus
  • Improved distance vision (kids without much outdoor exposure are more likely to have nearsightedness)
  • Increased Vitamin D levels (important in bone and immune system health)
  • Decreased stress, depression, and anxiety
  • Better behavior with less anger and aggression
  • Boost in confidence and self-reliance
  • Improved sleep

So what does outside nature time look like? It could be exploring the backyard or park, hiking, gardening, riding bikes, or just sitting under a tree daydreaming. Unstructured time, without a specific plan, encourages a child to get creative and be independent.

There are some terrific opportunities in our community for kids to get outside this summer. We have wonderful city parks and lots of hiking trails, including the Palouse to Cascades Trail (formerly called the John Wayne Trail) which is easily accessible and great for all ages.

We are fortunate to have nature/outdoor camps as well. Lazy F Camp and Retreat Center in the nearby Manastash Canyon offers day, overnight, and family camps. Kittitas Environmental Education Network (KEEN) provides nature-based education for all ages year round and will once again hold the “Windy City Park Rangers” day camp program in local parks this summer for kids in kindergarten through 8th grade (more information coming mid-April). KEEN also has the Pond to Pines nature-centered summer camp for children in pre-K through 10th grade which is based at Helen McCabe Park. KEEN has been awarded substantial grants and is able to provide 80 full scholarships for kids from families in need.

KEEN
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So get your kiddo out regularly in nature now and make summer plans for more of the same. Enjoy the benefits of turning your child into a nature-loving, active, outdoor enthusiast!

More summer camp info at:

more about The contributor

Dr. Elise Herman

headshot of Dr. Elise Herman
Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Reach Out and Read

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Contributor: Dr. Elise Herman

The pandemic has affected so many things for our children, including their education. Despite incredible efforts by devoted teachers and school staff, progress in reading has suffered significantly, with many more students at risk of not learning to read than prior to the pandemic. Kids who do not learn to read in elementary school are at greater risk of dropping out, earning less, and getting in trouble with the law.

A valuable community resource for helping children become good readers may surprise you—it’s your child’s healthcare clinic. The national literacy program for children, Reach Out and Read, has been at Community Health of Central Washington for about 10 years and started at Kittitas Valley Healthcare pediatric and family medicine clinics this month. Reach Out and Read (ROR) was founded in 1989 by a group of pediatricians and educators. It promotes reading by giving out free books at every well child visit from age 6 months through 5 years, and is the only children’s literacy program endorsed by the American Academy of Pediatrics.

The books chosen are age appropriate and culturally sensitive to be ideal for each child. At the well child check, the provider shows the book to the child, perhaps modeling for the parents how to engage with their child through reading, while encouraging the child to handle and explore the book. This is typically an extremely positive part of the visit for all!

The effects of reading together with kids early and consistently are impressive. This activity and the extra love and attention that go along with it help promote brain development, especially important in the first three years of life. Children who are read to tend to develop better recognition of letters and sounds, have a bigger vocabulary, and become better listeners. The connection between parent and child while reading is also reassuring and soothing.

Research has shown that kids who are part of Reach Out and Read show better language scores (both speaking and listening) and their language development continues to improve with ongoing involvement with the program. ROR parents are twice as likely to read to their kids at least 3 times a week, and report increased enjoyment with reading together.

Here are a few tips to best encourage reading in your home:
  • Read together daily, especially at bedtime
  • Encourage your child to hold the book and turn the pages
  • You don’t have to read the words exactly, especially to young children; you can just talk about the pictures
  • Encourage your child to point to things in the book and ask your child questions Simple books, with rhyming and repetition, are perfect for young kids
  • Bilingual books and books about people from different cultures build empathy and understanding of others
  • Be a good role model and regularly read yourself, ideally using traditional books as opposed to an electronic device
Early Literacy Resources in Spanish

more about The contributor

Dr. Elise Herman

Blog Posts
Provider Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

COVID-19 and Children- Infection and Vaccines

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Contributor: Dr. Elise Herman, KVH Pediatrics

Little girl with a dog toy is leaning on the window

Parents know too well what “pandemic fatigue” is. They are tired of it all- the masking, the distancing, the quarantining, the disruption of life, and the loss of a “normal childhood” for their kids. But this is a critical time in the COVID-19 pandemic as the Omicron variant surges; Omicron is certainly targeting the unvaccinated, and many of those are children.

The number of daily cases of COVID-19 in the US is over 900,000 as of January 7, 2022. 17% of these are children and most concerning is the huge jump in pediatric hospitalizations. There recently has been a 50% increase in COVID hospitalizations for kids under age 5, the biggest increase since the pandemic started. Over 82,000 kids have been hospitalized with COVID thus far, and there is now a new record for hospitalizations of kids under age 18 years- almost 800 daily. Some of these are as young as 2 months old.

Pediatric hospitals are feeling the strain, including Seattle Children’s Hospital, according to staff pediatric infectious disease specialist Dr. Danielle Zerr. Dr. Zerr noted in a recent New York Times article that the number of young children in Seattle Children’s Hospital with COVID is much higher than with previous Delta surges. Some of these very sick children have risk factors such as asthma or obesity, but many were previously healthy children without underlying problems.

Omicron seems to cause milder disease overall but can cause severe illness and is much more transmissible than the Delta variant. With so many more people getting infected, even if a smaller percentage get very sick, the total number of those who get severely ill will be very large. The unvaccinated are most at risk, and of course this includes kids under 5 years since they are not eligible for the vaccine yet. A parent’s best strategy to protect their child is straightforward: vaccinate if eligible, avoid crowded spaces (especially inside), continue masking and social distancing. Additionally, make sure all the older kids and adults in their family are vaccinated.

Those who are vaccinated can still get COVID, especially with the Omicron variant, but they are less likely to get a severe illness, and less likely to be hospitalized. If kids are fully vaccinated and exposed at school, they do not need to quarantine. Those who are vaccinated are less likely to transmit the virus, helping to keep their family healthy and their school open.

As of December 5, 2021, almost 4.8 million US kids ages 5-11 had received at least one COVID vaccine dose. There have been no cases of heart inflammation (myocarditis) in this age group which was noted to be a very rare side effect of the vaccine in young adult and adolescent males previously. It is important to remember that COVID infection itself is much more likely to cause heart problems in this age group than would the vaccine. We have had enough experience now to know the vaccine is safe and effective.

Can we imagine a time when there is ‘background’ COVID, like influenza, but not huge surges that overwhelm our healthcare systems, shutter schools and businesses, and disrupt our lives? That is the “learning to live with the virus” scenario that may be our future. To get there we need to have many more people vaccinated (including our children) to minimize the rise of new variants. Increased access to testing and better therapies to fight COVID infection will also be important. We all really do have the opportunity to help move us along towards that goal, and towards a better future for our children.

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Dr. Elise Herman

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Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.