The Children's Clinic News and Discussion

What to do with bored kids that is light on the pocket book

Fri, 08 Jul 2022 14:28:07 GMT

Summer activities that are easy on the wallet

Kids look forward to summer, but it does not take long to hear “I’m bored.” And unfortunately, if you go out, it doesn’t take long to feel the pain of how expensive activities are! Thankfully, there are many resources in Central Arkansas to keep your kids entertained without completely draining your
bank account.

My kids have always enjoyed crafts. There are several great resources for free kids crafts in Conway! Lowe’s in Conway is doing a free workshop where kids can build a treasure chest on July 16th. You can see more information about the event and register here: https://www.lowes.com/events/register/arrr-treasure-chest-kit-workshop . They are also offering a workshop to build a muscle car that kids can take home and play with. Registration for that opens July 11 th and the event is August 20 th . You can register here: https://www.lowes.com/events/register/build-a-muscle-car-with-your-mini-mechanic . These classes are usually offered throughout the year, so don’t worry if you aren’t able to make them all! They also offer many free adult classes – so check out their other events on their website!

Like Lowe’s, Home Depot also offers free workshops. They have dozens of videos and activities online that are free to you! Check out https://www.homedepot.com/c/alp/activities-for-kids-kids-crafts/qz47-42j4 to see which activities and workshops appeal to your family. Home Depot also hosts a kids workshop the first Saturday of each month from 9am-noon. You can preorder the kits to use in store or at home for less than $5! Check out the workshop schedule here: https://www.homedepot.com/c/kids?cm_sp=vanity-_-Kids-_-JUL20 .

Speaking of arts and crafts, the Michael’s store in Conway offers several free in-person or online classes! We have had a birthday party at Michael’s, and it was a fun afternoon with lots of crafts for the kids. This link takes you to view the schedule of the in-person classes at the Conway Michaels https://www.michaels.com/instoreevents . In person classes not your style? They also offer hundreds of free online classes and videos! These are for kids of all ages and adults. Of course, we recommend adult supervision with kids on the internet. Check out all the several types of classes and videos here: https://www.michaels.com/classes .

Do your kids have a sweet tooth? Check out Julie’s Sweet Shoppe every Wednesday where they have cookie kits for kids to decorate for FREE! Let your kids enjoy decorating a cookie and devouring it before you leave or take it home to decorate later. No purchase required, but when you smell the
heavenly goodness that is inside Julie’s, you may be tempted to grab another sweet treat for the road.

Central Arkansas has so many activities going on in local libraries – for FREE! Kids can get their very own library card to check out books or listen to them on the library’s free Libby app (must have active library card). The libraries also host a variety of events, movie days, story times, special guests,
and more. Check out this link to show all the activities going on at different Faulkner County libraries. https://fcl.libnet.info/events .

The heat may make it a challenge at times, but we have so many great hiking trails and state parks nearby that are free to visit. Wooly Hollow, Petit Jean, Cadron Settlement, Pinnacle, Mt. Nebo, and so many more areas in central Arkansas are beautiful to explore. Wooly Hollow also offers paddle
boats for a small charge - $8/hr for a 2-seater boat and $10/hr for a 4-seater boat. They also have a beach area and a snack bar you can visit to make a day out of the park. Beaverfork lake is another local wet spot to cool you and your kids off during the summer. Another option to cool your kids off on a sweltering day is to visit one of the splash pads in Conway or Greenbrier! These are free to enjoy. The splash pads in Conway are at Laurel Park at 2310 Robinson Avenue and the 5 th Avenue Park at 573 5 th Avenue. The Matthews Park in Greenbrier is a fantastic park with special needs accessible equipment, a skate park, walking trails, a pond, and a splash pad! Go check it out behind the Fat Burger in Greenbrier at 25 Ivy Street.

Conway Family Bowl also offers their “Kids bowl free” program during the summer. This starts at noon and goes until the evening. Kids can play up to two free bowling games every day! They offer discounted programs if adults want to play also. The only cost is shoe rental if you need it. Bowling is a
fun indoor (yet out of the house) activity to enjoy with family and friends. Check it out and register for free at https://www.kidsbowlfree.com/center.php?alley_id=5809 .

Love going to the movies but don’t want to spend an arm and a leg? The Cinemark movie theater in Conway offers their Summer Movie Clubhouse. Each Wednesday they play a different family-friendly movie and tickets are only $1.50! You can also get discounts on snacks if you decide to grab
some at the theater. This runs until August 3 rd .

Conway has been called the “City of Colleges” and those colleges offer some amazing programs for our community. One of those programs is the UCA Planetarium. This is an amazing place to learn about astronomy from people who want to share their knowledge. They offer free shows every Friday and Saturday nights this summer with shows starting at 7. Doors open 15 minutes before the show starts. You will want to be there early to get a seat and no entrance is allowed once the shows begin. You can get more information about the shows and other events and maps at this link:
https://uca.edu/physics/planetarium/ .

There are so many options for fun activities in central Arkansas. Of course, there are more than this list includes, but these may be some options you did not know about. I hope you have collected some tips for fun (and inexpensive) things to do to entertain your family this summer! Stay safe and
enjoy making those memories with your kids!

Katelin Whiddon, NP

Keep your kids safe while enjoying some water fun!

Thu, 23 Jun 2022 11:59:52 GMT

Water Safety

Finding ways to cool off in the hot summer months is a necessity while living in the south. I don’t remember a time growing up that I didn’t spend my summer at the pool. Water activities in lakes are also very popular in our region of the country. Being that water is such a normal part of our summer lives, we all must do our best to practice water safety for our families.

Many families will spend time at the lake or ocean this summer. Swimming in open water is quite different than in a pool. Adults and children should always have someone swimming with them, especially in open water. Younger children should always be kept no more than an arms length away near and in the water. Rip currents in the ocean can be very dangerous and even deadly; so being educated and teaching older children is very important. If caught in a rip current, do not fight it, and swim parallel to the shore. Once you are no longer in the current, you can swim back to safety. Fighting the current will not help you to escape it, and you will tire and be less likely to swim when in safe water. Diving into open water is never safe as you do not know exactly what is under the water.

When boating, law requires that there be a life jacket for each person on the boat. Children 12 years of age and younger are required to wear life jackets securely at all times. Adults should wear theirs too to set a good example and to keep themselves safe if an accident were to occur. Having the appropriate-sized life jacket is also very important.

Probably the most common water source to encounter this summer (and the easiest to access with current gas prices) is swimming pools. Having a pool with small children around can be especially dangerous. While pools can be so much fun, you may need to make some adjustments to help with safety with children around. Keep doors to the outside locked. Door alarms can also be helpful to notify if a door opens. This may catch a child going near water in the backyard. You can also purchase numerous types of safety devices including fences around pools, surface wave alarms in pools, and retractable covers for swimming pools to be activated when not in use. Children should also wear life jackets or flotation swim suits in the pool until they are able to swim on their own.

We had our oldest child in swimming lessons at a young age to teach her the skills to be safe if she were to fall in the pool. Children may be ready for lessons at different ages based on their developmental level – talk to your child’s pediatrician to see if your children would benefit from these lessons. Children, at any age, should never be left alone in or near the pool. A child can drown in as little as ½ inch of water, so even leaving children alone in bathtubs or “kiddie pools” is highly dangerous. Also, inspect surroundings for standing water in buckets or other containers and ditches. Kids under 2-3 years old are "top-heavy", meaning more of their body weight is in their head. If they go head-first into a container of water, they may not be able to get themselves out. Being trained in CPR is a fantastic qualification when caring for children – in water and out.

The water can be so much fun, but also very dangerous. Drowning accidents in the water are a mistake that we cannot reverse. Prepare and educate yourself and your children to ensure the optimal safety for your family and friends.

Katelin Whiddon, NP

How to protect your kids from the sun

Wed, 01 Jun 2022 17:15:20 GMT

Sunscreen Smarts

Skin is the body’s biggest organ and we have to do whatever we can to protect it! The sun is incredibly hard on our skin and using sun protection will help keep us looking better and potentially living longer!

Let’s face it - we all have sun damage. From our early childhood outside playing to sitting too long at the pool without applying and reapplying sunscreen, we are continually aging and damaging our skin. There are several ways to protect our skin when we are outdoors including sunscreen, protective clothing, eye wear, and more. And this should go without saying, but avoid tanning beds at all cost.

Millions of people around the country crave the tanned skin, but perhaps they would change their tanning method if they knew what the long-term effects of the sun could do to their skin. A “suntan” is actually damaged epidermis – the skin’s top layer. Long-term effects of sun exposure can lead to early wrinkling of the skin, cellular damage, age spots, and skin cancers –including melanoma, a very serious, aggressive, and potentially fatal cancer.

Protecting our children’s skin is incredibly important! The vast majority of wrinkles are from sun damage (tanning and sunburns) before the age of 18. Most moles are present before the age of 30, and those who are exposed to more sun in their childhood are more likely to have a greater number present. The American Academy of Dermatologists has an incredible website to teach the public about sun damage and skin cancer – visit www.listentoyourskin.org for more information and photos. Knowing the ABCDE ’s of melanoma can save a life (see below).

It is recommended that you use a sunscreen of at least 30 SPF. Using sunscreens higher than 30 SPF are still safe but may only give you a little more protection than SPF 30. Regardless of the SPF you are using, you should reapply EVERY 2 hours if you are dry and every hour if you are wet (after swimming or sweating). Using a daily moisturizer or make up with sunscreen will help to protect your face. Sun damage can even affect your lips – so be sure to snag a chap stick with SPF in it as well! Try to wear protective clothing when possible and try to utilize shade when you can to protect yourself from more of the harmful rays.

Children under 6 months of age should be kept out of direct sunlight whenever possible. Always try to keep children in the shade and in cool clothing that covers their skin – especially at very young ages. After 6 months of age, sunscreens are considered safe for children. The safest sunscreens are those containing zinc oxide and titanium dioxide because these do not penetrate the skin. These products are also less likely to cause skin irritation in children with sensitive skin. These formulations, however, are generally not waterproof, so reapply frequently with water activities and after sweating.

Did you know…your risk of developing melanoma DOUBLES if you have had more than 5 sunburns? Use protective clothing and sunscreens, try to limit direct, unprotected sun exposure whenever possible, and listen to your body. Do a monthly exam of moles and remember the ABCDE ’s of moles – look for A symmetry of the mole, irregular or poorly defined B orders, variations of C olor, large D iameter (anything bigger than a pencil eraser), and E levated or raised moles.

Also, if there is a family history of melanoma it is wise to discuss your personal risk factors with your healthcare provider.

Katelin Whiddon, NP

What you need to know about Developmental Disability and Arkansas Tax law

han0522@gmail.com (Chris Killingsworth) — Thu, 10 Mar 2022 19:25:49 GMT

Let's try and demystify AR1000RC5 "Certificate for Individuals with Developmental Disabilities"

Every tax season we (and I'm sure other clinics) receive a large number of AR1000RC5 tax forms from families. This form is titled "Certificate for Individuals with Developmental Disabilities". For some reason, this year we have had a larger number of these requests than usual.

Obviously I am not a tax expert nor do I have a law degree, so if you have questions about your particular situation please consult an expert!

The AR1000RC5 form is used by families to receive a $500 tax credit for individuals with developmental disabilities. It is submitted with your state income taxes. Part of this form is completed by the individual filing the income tax and the other part is completed by "a licensed physician, a licensed psychologist, or a licensed psychological examiner". This "medical professional", of course, can only complete this form based off of the medical documentation available to him or her.

The first step for the medical professional is marking the relevant diagnosis based off of the patient's medical history. There are only six options and additional boxes cannot be added. These options are:

Cerebral Palsy
Epilepsy
Autism
Down Syndrome
Spina Bifida
Intellectual Disability

There are two additional boxes that confirm the diagnosis was made before the age of 22 and that the patient is expected to be impacted "indefinitely" and that the condition will cause "substantial impairment" to the patient's ability to function without support services.

Every year we receive this form for patients with developmental delay (and no other supporting diagnosis). Often times the parents will assume that their child with developmental delay falls under the "Intellectual Disability" diagnosis category.

Certainly these parents are not trying to commit tax fraud! I believe this is coming from a misunderstanding of the definition of Intellectual Disability (and perhaps a poor choice of words for the title of the form). According to the DSM-5 (the document that defines psychiatric disorders) Intellectual Disabilities are "neurodevelopmental disorders that begin in childhood and are characterized by intellectual difficulties as well as difficulties in conceptual, social, and practical areas of living" and involve deficits in intellectual functioning and adaptive functioning. To determine if deficits are present, a psychological examiner would need to perform specific tests to make a diagnosis of Intellectual Disability. This information would then need to be sent to the PCP's office.

These deficit tests are separate and different from the tests Speech, Physical, and Occupational therapists perform to determine if a child needs therapy in any of these domains.

Now, let's look at what Arkansas law states. If you go to https://www.arkleg.state.ar.us/ArkansasLaw/ , click on Arkansas Code (on the Right side of the screen) you will be forwarded to a lexis.com site listing (what I assume are) all of Arkansas' current codes and laws. To view the code that covers this tax form open 'Title 26 Taxation', then 'Subtitle 5. State Taxes', then 'Chapter 51 Income Taxes' and finally open 'Subchapter 5 - Tax Credits Generally'. The document you are looking for is '26-51-503' titled 'Support of a child with a developmental disability - Definitions'. After confirming that you are not a robot, you are presented with the relevant code backing this tax form. This is the direct link to this document:

26-51-503

This document lists out much of what is discussed above, but in a legal format. It, however, adds a provision for "other" conditions "related to an intellectual disability" requiring similar treatment or services (see Section c.1.A.ii). However, in c.1.C it stipulates that whatever condition the individual has must be expected to continue indefinitely. Almost all of our patients with developmental delay are expected to improve with therapy and, as such, would not qualify given their condition is not "indefinite". And, one could argue, that if the patient's condition is expected to continue indefinitely then that patient has an additional diagnosis separate from developmental delay.

Although Intellectual Disability is not defined here, it is defined elsewhere in the Arkansas Code (for example code 6-41-702):

5) “Intellectual disability” means a condition characterized by significant limitations in both intellectual functioning and in adaptive behavior:
(A) As defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, published by the American Psychiatric Association; and

(B) Diagnosed by a physician, psychologist, or other individual qualified by license or statute to diagnose; and

As we can see this Arkansas Code references the DSM-5 definition. Therefore, assuming I am interpreting this correctly, anyone claiming Intellectual Disability needs to have received specific tests, performed by a psychological professional, and meet specific requirements before this diagnosis can be made (at least from an Arkansas legal standpoint). And, again, these are tests that are different from the testing that, for example, a speech therapist would perform.

If your child meets the above criteria based off of Arkansas legal code and you have submitted the AR1000RC5 form (and any additional supporting documents) to your child's provider, we will complete and sign the form so you can submit it with your income taxes. Of course, if your child does not meet this strict criteria, we won't be able to sign this form as doing so is tax fraud.

I hope this helps to clarify this tax form and the underlying tax code and medical guidelines. As always, if you have any questions feel free to give us a call!

Chris Killingsworth, MD

Celebrating Thanksgiving during a pandemic

han0522@gmail.com (Chris Killingsworth) — Fri, 13 Nov 2020 19:12:43 GMT

We can still enjoy the "company" of our family and friends, despite COVID-19

Thanksgiving is less than 2 weeks away and all of us would like nothing better than to celebrate with our families without the need to worry about COVID-19. Unfortunately, over the last several weeks we have seen some record breaking case numbers both nationally and locally and our hospitals are getting closer to full capacity (remember, if you haven't received a flu vaccine, we strongly recommend you do so). For these reasons it is still important that we follow precautions to keep ourselves and our families safe.

So what can we do? The CDC and the AAP have released recommendations ( CDC recommendation s and HealthyChildren recommendations ) on how to celebrate Thanksgiving while also taking precautions and being safe. They recommend celebrating Thanksgiving with your household group only and "virtually" celebrating with friends and loved ones to limit potential COVID-19 exposure. Consider sharing recipes that your household and your loved ones can "share" together virtually!

For some of us, celebrating virtually will be difficult to follow, especially with such an eventful and unprecedented year! If you do meet with friends and family (remember, meeting virtually is best), consider following some precautions to minimize everyone's risk. These can include celebrating outdoors (weather permitting), celebrating with a small group of people who have all followed CDC recommendations, requiring that everyone wear masks when not eating/drinking, limiting the time spent together, and only meeting in large, well ventilated rooms.

Although the CDC has the following statement:

"Currently, there is no evidence to suggest that handling food or eating is associated with directly spreading COVID-19."

They still recommend limiting the number of people preparing food for a gathering and limiting the number of non-food preparers who come into the kitchen. To limit multiple people touching serving utensils and dishes, consider having a designated person for "serving" food to others (vs passing food around the table). Another reasonable option is to have each family group bring their own food and beverage.

If you are hosting a gathering make sure to have extra masks and an area for mask storage while eating. Have hand sanitizer placed around the house and encourage your guests to wash their hands frequently.

2020 will certainly go down as an historically unusual year! And with a few reasonable precautions, we can all still give thanks for all of the blessings we do have, including our families, friends, and our wonderful community!

The Children's Clinic of Conway and Greenbrier

Changes to ADHD medication refills

han0522@gmail.com (Chris Killingsworth) — Fri, 13 Nov 2020 18:16:10 GMT

A new Arkansas Act will change how we handle ADD/ADHD prescriptions

Effective January 1st, 2021 the State of Arkansas is tightening the rules behind "Scheduled" medications (for example, stimulants), including a new requirement that ALL stimulant medication prescriptions be sent electronically . The Children's Clinic has offered this option through our patient portal for some time, but now it will be required.

Although this change will help reduce abuse of such medications, it does introduce additional steps to process and complete your child's refill. On a positive note, it means you will not have to drive to the clinic to pick up your child's prescription!

Requesting a refill electronically requires registration with our patient portal . Many of our patients are already using our patient portal for refills. If you are one of these families, great, no change is needed, simply continue to request your child's stimulant refill as you have already. If you are not signed up for the patient portal, please contact The Children's Clinic to request a unique PIN code. This PIN code will allow you to create an account with our patient portal and add your child to your account.

Remember we require 7 days notice to send a stimulant refill - this allows us time to properly review your child's chart and to complete the electronic submission process. This will be more important after January 1st as this new electronic refill requirement adds additional steps for our providers in completing your child's refill.

Thank you for your cooperation as we all adjust to the additional safety measures introduced by the State of Arkansas!

The Children's Clinic of Conway and Greenbrier

(501) 327-6000 for Conway

(501) 679-6796 for Greenbrier

Making sense of COVID-19 quarantine guidelines

han0522@gmail.com (Chris Killingsworth) — Mon, 26 Oct 2020 19:23:12 GMT

There are so many different COVID-19 related quarantine guidelines it's easy to get confused! Here we review some common scenarios and questions we have had from our families and community leaders.

The importance of the Flu Vaccine in 2020

han0522@gmail.com (Chris Killingsworth) — Mon, 26 Oct 2020 19:23:10 GMT

Despite all of the social distancing, mask wearing, and extra hand washing, it is still very important to get the yearly flu vaccine - read below to find out why!

The Children's Clinic News and Discussion

What to do with bored kids that is light on the pocket book

Summer activities that are easy on the wallet

Keep your kids safe while enjoying some water fun!

Water Safety ﻿

How to protect your kids from the sun

Sunscreen Smarts

What you need to know about Developmental Disability and Arkansas Tax law

Let's try and demystify AR1000RC5 "Certificate for Individuals with Developmental Disabilities"

Celebrating Thanksgiving during a pandemic

We can still enjoy the "company" of our family and friends, despite COVID-19

Changes to ADHD medication refills

A new Arkansas Act will change how we handle ADD/ADHD prescriptions

Making sense of COVID-19 quarantine guidelines

There are so many different COVID-19 related quarantine guidelines it's easy to get confused! Here we review some common scenarios and questions we have had from our families and community leaders.

The importance of the Flu Vaccine in 2020

Despite all of the social distancing, mask wearing, and extra hand washing, it is still very important to get the yearly flu vaccine - read below to find out why!

Water Safety