Dangers of Leaving Kids in Hot Cars on Sweltering Summer Days

By Richard A. Saladino, MD, chief, Pediatric Emergency Medicine, Children’s Hospital of Pittsburgh of UPMC

Saladino_RichardWith the hot temperatures rising this summer, we want to make sure families know  about the dangers of leaving kids in hot cars, even for a minute.

Heatstroke is the leading cause of non-crash, vehicle-related deaths for children, according to Safe Kids Worldwide. On average, every 8 days a child dies from heatstroke in a vehicle.

Being left in a car is quite dangerous for small children and infants since they don’t have as effective an ability to regulate their temperature as adults. If the outside temperature is 90, temperatures in the car can increase from 80 degrees to 130 degrees in 10 to 15 minutes.

The high temperature that occurs in a closed car causes the body core temperature to climb rapidly.  Elevated core body temperature in this sort of setting may result in heat exhaustion or heat stroke, defined as a body temperature is 106 or greater, and including other symptoms, such as altered mental status, headache, nausea and vomiting.

However, heat-related dangers go beyond hot cars, because simply being outdoors on ahot_kid summer day without proper hydration or over long periods of time can cause a child to overheat and become ill. Kids are more vulnerable to dehydration, heat cramps, heat exhaustion and heat stroke because their bodies are less efficient at cooling than adults’ bodies are.

Here are some more tips to keep kids safe from heat-related illnesses:

  • Never, ever leave a child or infant in a car.
  • Be sure to keep kids hydrated with water, before, during and after activities, even if they say they are not thirsty.  Remember, the best hydration is “pre-hydration!”
  • Have children take frequent breaks to rest and cool down.
  • Have kids wear loose-fitting, lightweight clothing.
  • Become familiar with symptoms of heat-related illnesses, including cramps, nausea, vomiting, headache, fatigue and weakness.
  • If a child shows any sign of a heat stroke, remove them from the hot environment to a cool environment, and take him or her to an emergency room right away.

For more information, please visit www.chp.edu/CHP/besafe.

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Does my child have depression?

By Ana Radovic, MD, MSc, Assistant Professor of Pediatrics in the Division of Adolescent and Young Adult Medicine at Children’s Hospital of Pittsburgh of UPMC

RADOVIC_ANA_MD_ADL_20131113_ (1)It can be tough to decide whether you think your child has depression or does not. Why is that? Mental health symptoms happen on the inside – they don’t show up like a rash on the skin that everyone can see, even though some studies show how the brain does look different with depression.

When symptoms show up on the inside, the only way you can “see” them, is by the person explaining to you how they feel, or by what you see as their behavior. If they are also having trouble understanding how they feel and are worried about what you will think or that you will get upset if they say anything, they might not share that with you. That is one good reason why if you are the least bit worried, a good idea is to ask your doctor for help figuring it out.

If your doctor tells you that your child may be depressed, what does that really mean?

Maybe some of the “symptoms” they have could be from something else like:

  • trouble adjusting to a new situation at school or home
  • a bad break-up, a friend who let them down, or not making a sports team or other extracurricular activity
  • bullying at school
  • a medical problem like anemia (a low blood count), headaches, belly pain
  • not getting enough sleep from being overscheduled, overhomeworked, too much online time, or having to wake up too early
  • another mental health or physical problem like ADHD, anxiety, or anemia

Don’t some people even have thoughts of harming themselves, but in the end they don’t end up having depression?

It is true that depression can be difficult to diagnose, especially in adolescents and young people, whose moods seem to change every day. Young people have developing brains and because they keep changing, it is hard to know whether some of the symptoms they have are here to stay or not. That’s why health professionals might have to see your child for several visits before they can get a better idea of what is going on.

Some behaviors can be signs of depression symptoms:

  • Feeling down most of the day.Maybe your child notices they are just feeling sad, empty, or down in the dumps. They might not even notice – but you might see they are tearful or irritable much of the time.
  • Not interested in things they used to like. Things they used to think were fun aren’t fun anymore. They don’t really do them and even if they don’t notice or say they don’t care, you notice the difference.
  • Changes in appetite or weight.They’re hungry all the time or they don’t feel like anything tastes good anymore.
  • Problems with sleep.They are tired and sleepy all day even when they get enough rest, or the opposite – they can’t fall asleep no matter how hard they try.
  • Tiredness or not having energy. 
  • They feel like everything is their fault.They feel like they’re no good at anything.
  • They have a tough time concentrating or making decisions.
  • They may have thoughts of suicide.

MOST important is that because of these symptoms, they are having trouble living the life they want to live. 

It might mean they are not achieving their goals, getting to school every day, getting to work, doing the fun activities they used to do, or being the kind of friend they want to be.

In the end, you know when your child is not being themselves. It’s normal for teensTTC_8191 to want to be independent and make their own decisions – sometimes this could lead to arguments. Being depressed is different – they should still be doing things they enjoy and think are fun. And how well they do in school or other activities shouldn’t be going downhill.

A health professional can help you and your child figure out if your child should get treatment for depression or if something else could be causing the symptoms. For example, having a low blood count can cause sleepiness, fatigue, and a tough time concentrating. Sometimes it can take many visits for you, your child, and your health professional to figure out the best way to help.

The most important thing is if you notice these symptoms in your child, something is wrong, and although it’s easier to say – maybe they will just go away – often they won’t. The good news is the sooner you do something about them, the better. The adolescent and young person brain is amazing – it is kind of like clay – moldable into many different things! Talking to a trusted health professional will be your next best step.

If your child does have depressive symptoms, there are two important reasons why getting treatment is a good idea to consider:

  • Seeing a therapist can help your child learn new skills which can help them a lot even if they don’t have depression. One of the major treatments that can help with sleep issues and anxiety and problems with pain or headaches is the same type of therapy which is recommended for depression: cognitive behavioral therapy.

For more information about diagnosing depression, see the American Academy of Child Adolescent Psychiatry Facts for Families handout.

If you have questions about depression, schedule an appointment with your primary care physician or visit us in the Division of Adolescent and Young Adult Medicine. To schedule an appointment, call 412-692-6677 or visit www.chp.edu/adolescent.

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Children’s Hospital: An Institution to Which I Owe 7,868 Days of My Life (And Counting)

By Luke Ziegler, Heart Institute patient and volunteer at Children’s Hospital of Pittsburgh of UPMC


Luke with Dr. Victor Morell, chief, Division of Pediatric Cardiothoracic Surgery, in 2007

At less than one day old, I was flying through the sky on the way to Children’s Hospital of Pittsburgh of UPMC. My walnut-sized heart contained a congenitally defective aortic valve that would require an immediate catheter-based procedure, open heart surgery at 13 years old, and would necessitate life-long monitoring and re-intervention.

While the memories of my biannual cardiology appointments during my youth are quickly fading, the pervading feeling I recall is one of incredible safety within the walls of the hospital – a testament to the caring nature of the staff of the entire facility. My most notable symptom while growing was a complete intolerance for physical activity – 20 or 30 minutes of running and playing would result in 2 days spread out on the couch recovering from the exhaustion. As such, I was barred from playing any competitive sports, one of the biggest bonding activities of children at my small school. My childhood was filled with just as much happiness as any “normal” child, but that didn’t make it any less of a life-changing relief when I first attended Dr. Bill Neches Heart Camp for Kids, a summer camp where I was finally able to find others who could relate to my medical struggles. The mentoring I received from several counselors there made me realize that any social issues I was encountering due to my condition would fade to nothing in time, and that life promised to hold even greater joys for those of us who have known true pain.

It was around this time that I received open heart surgery. Being forced to contemplate one’s own mortality at such a critical developmental age fundamentally changes the way an individual views the world. Through this self-evaluation spent during many sleepless nights preceding the date of the procedure and weeks spent in bed following it, I began to recognize the fact that I wouldn’t be alive should I have been born even 40 years prior; that every day I have lived is a gift given by doctors, nurses, and every other staff member who has sacrificed and traded their time for my life. It was then that I began awakening to my desire to pursue a career in medicine myself.


Luke participating in Drum Circle at Heart Camp

Over a decade was far too long to wait to begin repaying this “debt” to the medical system. I wanted to take the first available opportunity – the position of senior counselor at the same summer camp that made an impact on my life just a few years prior. As a student facing the stresses of following the path to being a physician, it is a fantastic experience to be able to be a kid again and experience the sheer joy of a week of canoeing, swimming, campfire songs, and all of the other activities that take place at Heart Camp. Most enjoyable, however, is the experience of mentoring. While I certainly have some lessons and tips to teach my campers about navigating life as an adolescent with a congenital heart defect, I believe I have also learned just as much from them – lessons on courage in the face of adversity, friendship, and never growing too old and serious to smile at everything life brings your way. Seeing the same group of children grow up, mature, and take on leadership positions of their own over the course of several summers have been incredibly rewarding. I think that is the real beauty of Heart Camp – one is never too young nor too old to learn from each other, or to lean on each other for support in the trials that inevitably come our way. It is a network of friends closer than I have ever seen or experienced anywhere else in life.


In 2015, Luke volunteering and posing for a photo with Ty, a Heart Institute patient at Children’s

After being in this position for several years, I became aware of the opportunity to volunteer at Children’s Hospital itself, more specifically volunteering within the Child Life Department. After applying and accepting a position, I was given the opportunity to work with children who were hospitalized and try to brighten their day through play, whether that be by painting, playing video games, or any other variety of activities. I began in “Austin’s Playroom” on the weekends, during which I would interact with children from all units in the hospital. However, I quickly found myself drawn and devoted to the cardiac units, where I now spend my time split between the Cardiac Intensive Care Unit (CICU) and 7A – the area for more stable cardiac patients.

What I really enjoy about my volunteering at the hospital is building a relationship with patients and the family of the patient over the course of several weeks (or in some cases months to years). To see a patient supported by a ventricular assist device wait for a heart transplant for months, finally receive a heart, and later transition out of the hospital, or to follow a patient from the CICU to the day of discharge is absolutely priceless. Being able to watch a patient smile while being confined to a hospital bed and infused with countless IVs is something that will keep me coming back as long as I live in Pittsburgh.

combined photo(1)

Top: Luke and Dr. Peter Wearden, surgical director, Pediatric Heart and Lung Transplantation, in 2007 following Luke’s surgery Bottom: Luke with Dr. Wearden presenting his cardiac bioengineering research at the American Society for Artificial Internal Organ research conference

But to bring this full circle, I return to those who make the hospital “tick.” Whether it be a chief of surgery, a housekeeper, a cook, an engineer, or a member of Child Life, every individual I have come into contact with at the hospital works and acts in a manner that makes one believe they are living their true life’s purpose. Through their lives I have been inspired and taught what living a compassionate life means firsthand. Without them, I would have no story to share with you.

If you are a former (or current) patient of Children’s Hospital, parent of a patient, or have in any way been affected by their life-saving work, I urge you to find some small way to give back regardless of what form that may take. While we’ve all been given gifts we could never hope to repay, I know we can achieve more than we think with our collective sustained efforts.

In closing, I would just like to take a moment to thank those individuals from Children’s who have touched my life in a special way – Dr. Donald Fischer, Dr. Bradley Keller, Dr. Linda Russo, Dr. Victor Morell, Dr. Peter Wearden, Dr. Jacqueline Kreutzer, Dr. Yoshida Masahiro, Dr. Vivek Allada, Beth Moneck, and Matt Brooks. It’s your inspiration that gets me up in the morning to get back at biochemistry and the MCAT.

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Happy & Healthy Eating: Here Come the Fabulous Foods of Summer

By: Ann Condon-Meyers, RD, LDN, Children’s Hospital of Pittsburgh of UPMC

ann condon meyersAfter the winter we just endured here in the tristate area, who isn’t celebrating the fact that summer is almost here?!  I’m thinking about frozen desserts, watermelon, and grilled everything. Summer provides a perfect opportunity to enjoy food favorites and make new summer memories. It’s a great time to enjoy the abundance of fresh fruits and vegetables from our local farms, farmer’s markets, and grocery stores. In my mind, summer may be the best season to introduce our children to the wonderful rainbow of healthy foods.

Let’s start with beverages. As the temperature rises, so does our thirst, providing an opportunity to try some new hydration ideas. First, let’s dispel the myth that our children need sports drinks. Even on the hottest days of temperatures in the upper 80s, it is rare that a child needs a sports drink for rehydration. Water remains the best beverage to quench thirst and replace fluids lost in sweat. It is only in extreme conditions that children and teens need rehydration with water, sodium, and potassium. Think about serving sports drinks during football and band practices under the full sun with a temperature above 80 degrees or when the humidity is high. That is, when your kids are really sweating a lot!

Not sure how much your child is sweating? Here is a “body function lesson” that your child may not know regarding urine. If your urine is straw colored or darker (and not pale yellow), it’s time to rehydrate. It is reassuring to know that kids, given free access to water, will not dehydrate themselves. Check with your children’s coaches and camp counselors to make sure that everyone is allowed to get water at any time during a game or event held outside.

An alternative to sugared sports beverages is … milk! That’s right – cow’s milk has been proven in studies to be as effective as a sports drink for rehydrating athletes. Other milk beverages such as soy or rice milk can hydrate but don’t have as much sodium or potassium in them as cow’s milk. Are your kids begging to add flavor to their milk? Fruit can be the answer in the form of a fruit smoothie – milk, ice, and fruits in a blender can make a refreshing drink and will rehydrate well since a fruit smoothie will have ample (and naturally occurring) sodium and potassium in it.

Infusion waters are another good way to offer water to your kids and expose them to some healthy fruits at the same time. Fresh fruits with strong flavors work best such as pineapples, berries, mangos, oranges or lemons and limes, papaya, coconut, and kiwi. Put at least 1 cup of the cut-up fruit in the bottom of a 2-quart pitcher and add cold water. Store in the fridge overnight and you will wake up to delicious fruit-flavored water.

There are other flavors for fruit infusion waters as well for the discerning palate. TryMomDau_salad_148389481 using herbs such as rosemary sprigs or mint leaves. They provide a more subtle flavor but look so beautiful! Having a party or picnic?  Cut pineapple and orange slices in 1/2inch-thick wheels. Fill a glass container with ice 1/3 full and put the “wheels” flat up around the side of the glass.  Add more ice and do it again until the entire container is lined with the fruit.  Pour in water over the ice to completely fill up the container. This “pineapple – orange wheel” drink looks festive and makes the fruit easy for kids to eat once the water is all gone. Infusion waters last about two days before they get a little strong, but keeping them in the fridge helps with this.

Looking for some new snacks this summer? Start with a trip to your grocery store or farmer’s market and have your children pick out a new fruit or vegetable. Next, find a recipe that uses that “new” fruit or vegetable and make a snack or meal item out of it. Or, if your child is old enough, let him or her search for a new recipe on the Internet or check out a kid-friendly recipe book from your local library. Of course, if you have a budding chef in the family, maybe he or she would like to make up a new recipe. Cooking is a great way to practice reading and math skills in a fun way.

One of the best ways to foster a love of new foods is to allow your kids to have a choice of new and familiar foods. For example, have a pasta bar for dinner:

Grill or roast a variety of veggies with a drizzle of olive oil and salt. Vegetables such as zucchini, yellow squash, Brussels sprouts, and beets work well on the grill or roasted in the oven. Cut the cooked vegetables into bite size pieces and put in separate bowls. Prepare whole wheat pasta such as penne, angel hair, or potato gnocchi and present along with the veggie “toppings” and shredded mozzarella cheese or grated parmesan. Grilled chicken strips or shrimp as lean protein choices work well too. Other delicious ingredients include chopped basil leaves, tomato chunks, or pine nuts.

Allow your children to make their own “rainbow recipe” at the pasta bar. Resist the temptation to sing the praises of any one food – no pressure when offering healthy vegetables since they are all good choices! Instead, giving your child a plate or bowl to fill up at the pasta bar, you can make zucchini boats: cut zucchini length wise, hollow out, bake or grill al dente along with the other vegetables.

This idea of a “serve yourself” bar works well with lots of entrees such as tacos, roll-up wraps, salads and fruit plates. Giving your children a choice at meal times will help them feel in control of their food choices, respect their palates, and steer them toward healthy choices.

Remember too, that kids like moist foods that are easy to chew. After all, their jaws are not as strong as the jaw of an adult. Long, tedious, chewing sessions take the flavor and fun out of many foods for kids. Giving dip options with drier foods such as meats or raw vegetables may entice your kids to try a new food. Besides Ranch dressing or ketchup, try making a lemon or lime melted butter dip. Melt ½ stick of butter and add the juice of one half lemon or lime. How about peanut butter sauce? My kids love this with meats such as pork tenderloin or chicken breast.

Mix ¼ cup peanut butter (melt in microwave or on stove) with ¼ cup soy or canola oil and 1 – 2 T of soy sauce with a splash of hot sauce. Or allow your child to make his or her own ketchup or Ranch dressing.

Looking for a nutrition project that doesn’t require cooking? Have your child tell you about the “My Plate Model.”  If he or she hasn’t been exposed to this concept yet, you can get the information on the website ChooseMyPlate.gov. The healthy plate model has replaced the food guide pyramid. MyPlate is a great way for kids to understand why a slice of pizza or a burger and fries is not, by itself, a healthy meal.

Challenge your kids to plan snacks that are half fruits and/or vegetables and half protein and grains. Some examples of this would be fruit tacos with shredded cheese sprinkled on top, of pita bread stuffed with peanut butter and lots of apple slices or Naan bread with hummus and a pile of roasted red peppers on top.

Some families have even started using divided plates to help remind everyone that half of their plate should be fruit and vegetables. For more information about the divided plate, check out the website KidsHealth.org. If you are looking to buy these plates, shop around on the Internet. These plates cost anywhere from $8 to $26. Or make your own plates with a kit – there are websites that allow you to make a drawing.  You send the drawing to the company and they will adhere the design onto a melamine plate and mail back to you for $11.99 per plate.

Your challenge to meet the MyPlate model will be to adapt your cooking as well. Serve more fruits and vegetables and fewer protein foods and starches. Try adapting your recipes to include more vegetables. Most recipes can be adapted by doubling the amount of veggies while cutting the starch or protein in half. Pasta served with lots of vegetables such as peas or broccoli, meatloaf with extra diced celery, onions and carrots, macaroni and cheese with chopped tomatoes and peppers stirred in, casseroles with mixed vegetables added — these versions will please everyone and meet the MyPlate guidelines easily.

Once summer comes to an end, you and your children will have made some new food favorites along with healthy nutrition habits that will stay with you through the seasons.  For now however, let’s get ready to enjoy the fabulous foods of summer!

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Memorial Day Traveling – Tips to Stay Safe

By Chris Vitale, Injury Prevention Manager, Children’s Hospital of Pittsburgh of UPMC

VITALE_C_RN_CAMEO_CHP_20100803Memorial Day marks the unofficial opening of the summer travel season. There will be many more vehicles on the road and more people as families embark on vacations and road trips. Please keep these important safety tips in mind so everyone can have a safe and enjoyable holiday.

  • Seatbelts are to be buckled on everyone in the car, every time. We can’t control everything that happens on the road. Even though we may be safe drivers, we are always still at risk. Seatbelts double your chances of surviving a car crash.
  • Never drink and drive. Always have a plan for a designated driver – alcohol changes your judgement so have a set plan before you drink.
  • Make sure all children are secured safely in an approved child passenger restraint system that is designed for their weight, size, and age. Read your vehicle manual and the car seat manual, installing all seats according to those directions. Laws may vary from state to state so be sure you are aware of laws as you travel. For more information, visit nhtsa.gov.
  • Never leave a child or children alone in a car. Temperatures climb very quickly in the summer. Every year, children left unattended in cars can die from heatstroke.
  • Plan ahead with activities to keep children entertained and decrease the distraction to the driver.
  • Obey the rules of the road! Be sure your car is in travel condition prior to leaving – and, have a wonderful, safe trip!

For more information on safety tips, please visit www.chp.edu/CHP/besafe.

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Bedtime Resistance or Refusal?

By Hiren Muzumdar, MD, FAASM, co-director of the Pediatric Sleep Evaluation Center, and Melissa Milbert, MS, NCC, LPC, Behavioral Health Therapist, Children’s Hospital of Pittsburgh of UPMC

bedtimeChildren over the age of 2 who sleep in a bed, rather than a crib, and refuse or resist bedtime can ignite much family distress. Resistance to or refusal of bedtime can manifest very differently across different ages of children. The child might go to sleep while watching television with a parent, or he or she sleeps in the parents’ bed. In a milder form of bedtime refusal, a child stays in his bedroom, but delays bedtime with ongoing questions, interminable requests, protests, crying, or temper tantrums. The child is often tired in the morning and has to be awakened when it is time to get up for the day.

If the child occasionally comes to the parents’ bed because he is frightened or not feeling well, he should be supported. However, if the child postpones bedtime or tries to share the parents’ bed every night, he might be testing his limits, and not actually be fearful. In contrast, if the child expresses worries during the daytime, reports frequent nightmares, or is fearful of bedtime on a nightly basis, additional help may be required.

How can a parent end bedtime refusal?

These are a few ideas that apply to children who are manipulative at bedtime, not fearful.

  • Start the night with a pleasant bedtime ritual.

Provide a bedtime routine that is pleasant and predictable. Most rituals before bed last about 30 minutes and may include taking a bath, brushing teeth, reading stories, talking about the day, saying prayers, and other relaxing interactions. Try to keep the same sequence every night because familiarity is comforting for kids. Both parents should try to take turns in creating this special experience. Never cancel this ritual because of misbehavior earlier in the day.

Before you give your last hug and kiss and leave your child’s bedroom, ask “Do you need anything else?” Then leave and don’t return. It’s very important that you are not with your child at the moment of falling asleep; otherwise he or she will need you to be present following normal awakenings in the night.

  • Establish a rule that your child can’t leave the bedroom at night.

Enforce the rule that once your child is placed in the bedroom, he or she cannot leave that room, except to go to the bathroom, until morning. Your child needs to learn to go to sleep in his or her own bed. Do not stay in the room until your child lies down or falls asleep. Establish a set bedtime and stick to it. Obviously, this change won’t be accomplished without some crying or screaming for a few nights.

  • Ignore verbal requests.

Ignore ongoing questions or demands from the bedroom, and do not engage in any conversation with your child. All requests should have been dealt with during your pre-bedtime ritual.

When should a parent seek additional help?

Behavioral training takes time, effort, and consistency, and help from a trained professional may be very useful. If may be time to seek additional help if:

  • You have tried to stop your child’s refusal for several weeks and he or she still does not fall asleep within 30 minutes.
  • Your child’s lack of sleep is causing behavior problems at home or at school.
  • Your child has fears about bedtime.
  • Your child has frequent nightmares.
  • Bedtime problems are making your child sleepy during the day.
  • Your child has a change in sleep patterns and another medical or psychiatric problem.

Who can help?

Additional help can include working with a medical professional with specialized training in sleep.  At the Pediatric Sleep Program at Children’s Hospital of Pittsburgh of UPMC, we have a specialized team to help with a variety of sleep problems and disorders.

Melissa Milbert, a licensed professional counselor, is a new addition to the sleep medicine team with experience treating a variety of sleep problems, including sleep resistance and sleep refusal.  Melissa will work with children, adolescents, and their families around problems with nighttime anxieties, nightmares, and problems initiating and maintaining sleep.

For more information on the Pediatric Sleep Program at Children’s or to make an appointment, visit www.chp.edu/sleep.

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Strategies for Talking to Teens about Sexual Assault

By: Heather L. McCauley, ScD; Division of Adolescent and Young Adult Medicine, Assistant Professor of Pediatrics and Psychiatry

MCCAULEY_HEATHER_SCD_ADL_20140820_April is Sexual Assault Awareness and Prevention Month. And the bad news … adolescents and young adults are at highest risk for sexual assault, which includes rape, sexual coercion, and unwanted sexual experiences with and without physical contact. The recent national focus on sexual assault on college campuses is a welcome response. We know that one in five college women will experience sexual assault during this time. And sexual violence happens among younger teens, too. We need to create safe spaces for the young people in our lives to share their experiences.


What are some common myths about sexual assault?

Before we can have a conversation with our teens, it is important to understand common myths about sexual assault. We often think that sexual assault happens in a dark alley at the hands of a stranger. However, this is relatively rare. Adolescents and young adults are more likely to know the person who hurts them. They may even be dating this person. Many young people I work with think that that they are expected to have sex with someone if they are dating or going out with him or her. It is also common for young people to think that everyone else is having sex (even if that is not true), so when they are pressured to do something they do not want to do, they might not recognize this experience as sexual assault. Finally, many young people think that if they have been drinking or are wearing certain clothes, they are somehow responsible for being hurt. It is important to remind young people that it is never their fault and that there are safe adults who are there to help them.

How do I talk to my teen about sexual assault?

One strategy for talking to your teen about sexual violence is having a conversation with him or her about what a healthy relationship looks like. We can take this opportunity to emphasize that it is not normal for someone to make their child do something sexual he or she does not want to do and that affirmative consent is necessary when he or she is ready to have sex. That means, not just ‘No means no,’ but also that “Only ‘Yes!’ means yes.”

In these conversations, it is important for us to recognize the numerous pressures young people face from their peers every day regarding sex and substance use, for example, and listen to their concerns. You can also teach teens to be “upstanders,” which includes doing something or saying something to a trusted adult if they see someone hurting another friend.

What questions can I ask my teen if I am concerned?

Young people might feel scared to talk about what they experienced or they might think that what they experienced is a “normal” part of a dating relationship. In my research studies, I interview young women who have experienced some type of abuse. Many young women, though they experienced sexual assault, will not use those words to describe their experiences. So I changed the way I ask about their exposure to abuse. I might say, “Has anyone ever made you do something sexual you didn’t want to do?” or “Has anyone ever said something sexual to you or about you that made you feel uncomfortable?” This allows teens to talk about what they have experienced without having to label themselves. If someone discloses that he or she has been assaulted, you can say, “Thank you for sharing this with me. This is not your fault and you didn’t deserve this to happen to you.” In Pittsburgh, you can reach out to your health care provider in the Division of Adolescent and Young Adult Medicine for help with this conversation and connecting young people to important health care services. We can also help connect you to victim advocates in the community who are experts in working with survivors of sexual violence.

What is happening in Pittsburgh (and other resources) to prevent sexual assault?

Sexual violence is preventable. Preventing it requires us to challenge social norms that violence is acceptable, which gets easier the more we talk about it with teens. We need to stand up and speak out as a community that sexual violence is never acceptable. I work with Dr. Elizabeth Miller, who leads the Division of Adolescent and Young Adult Medicine at Children’s Hospital of Pittsburgh of UPMC, on prevention programs in our local middle and high schools and neighborhoods to reduce violence among our young people. Be on the lookout for us in your community. We invite you to become part of the conversation at http://southwestpasaysnomore.org/ — for information on prevention efforts in southwestern Pennsylvania.


  • Prevention Program: Coaching Boys into Men violence prevention program by Futures Without Violence (coachescorner.org)
  • Local resources: Pittsburgh Action Against Rape – 1-866-363-7273 and Center for Victims 1-866-644-2882
  • National resource: RAINN (Rape, Abuse, Incest, National Network) – 1-800-656-HOPE (1-800-656-4673)

For more information about the Division of Adolescent and Young Adult Medicine, call 412-692-6677 or visit www.chp.edu/adolescent.

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