Supporting Your Kids through Holiday Stress

Family at ChristmastimeThe holidays are a time of peace, love, joy, and family, but it’s also a time where schedules are irregular, routines are disrupted, meals are heavier, and sugar abounds.  For children of all ages, these changes can be difficult; if the child has depression, anxiety, an eating disorder, attention deficit disorder (ADHD) or other emotional or behavioral health challenges, the holidays can compound the issue.

Did you know?

  • Depression and anxiety: According to a 2019 study published in the Journal of Pediatrics, about 1.9 million children ages 3 to 17 years have been diagnosed with depression, and 4.4 million have been diagnosed with an anxiety disorder.
  • ADHD: Nearly 6.1 million kids ages 2 to 17 have been diagnosed with ADHD, according to a 2018 study in the Journal of Clinical Child & Adolescent Psychology.

If your child suffers with emotional or mental health issues, here’s some tips to help you child and your family decrease the stress and impact of the holidays:

  • Communicate plans: With each activity or outing, let the child know what will be happening ahead of time- who will be there, how long you will be staying, what food to expect, etc.  Knowing what will be happening will help decrease anxiety.
  • Share feelings: If you are feeling stressed, tired, or anxious, share your feelings with the child.  He or she will take comfort in knowing that even adults get nervous and stressed during the holidays.
  • Maintain a sleep schedule: Everyone in the family will benefit from a good night’s rest, especially children. According to the American Academy of Sleep Medicine, kids with mental health issues need adequate sleep; for teens, 8 to 10 hours per night is recommended.
  • Manage screen and device time: When adults are busy, it’s easy for children of all ages to occupy themselves with television, video games, and social media. However, too much “technology time” has proven to negatively impact sleep as well as contribute to depression.
  • Keep medication schedules: If a child takes medication, ensure he or she continues to take it at the same time each day.
  • Watch sugar intake: Help keep the child’s diet balanced with regular nutritious meals and limit sweets and sugar-filled drinks, especially before bedtime.

Most importantly, be aware of the child’s mood and listen to him or her.  The child or teen make need some downtime in between the hustle and bustle of the holidays.  Allow time in the family’s schedule for everyone to decompress, so each member of your family can enjoy the spirit of the holidays.

Article originally published by District Medical Group at

Dental Health in Children: Get the Facts

By Lyn Hughes, dental hygienist, DMG Children’s Rehabilitative Services

parent and doctor showing child how to brush teeth

Originally published at District Medical Group on October 21, 2020


October is Dental Hygiene Month, which is somewhat ironic as Halloween, the day of the year where children probably get more candy than ever, is also in October.  So, why not take this month to talk to your children about the importance of taking care of their teeth?

Getting your children into healthy dental habits now can save them time and pain and give them advantages throughout their lives.  According to the Centers for Disease and Control and Prevention (CDC), children who have poor oral health often miss more school and receive lower grades than children who don’t.

Did you know cavities are one of the most common childhood diseases in the United States?

When untreated, tooth decay can cause pain and infections which can lead to problems with eating, speaking, playing, and learning.

The CDC also shares these facts about cavities in children:

  • 20 percent of children ages 5-11 and 13 percent of adolescents have at least one untreated cavity.
  • Children ages 5-19 from low income households are more than twice as likely to have untreated tooth decay.
  • About one-third of cavities in baby teeth can be prevented by a fluoride varnish.
  • Dental sealants applied to the surfaces of back teeth can prevent 80 percent of cavities.

Beginning dental care when your child is a baby is a great first step towards optimal dental health.  Schedule your child’s first pediatric dental care appointment at the age of one to spot signs of early problems.  We’ll help you identify good at-home dental habits to engage your child in taking care of his or her pearly whites for a lifetime.

What Is Pediatric Physical Therapy ?

young child receiving physical therapy

Originally published at District Medical Group on October 21, 2020


Did you know October is National Physical Therapy Month?  Each year during October, the physical therapy team at DMG Children’s Rehabilitative Services (DMG CRS) supports the Spina Bifida Association of Arizona through their annual Walk-N-Roll® fundraiser.  The team is passionate about serving patients in and outside of the clinic.

What do pediatric physical therapists do?

Pediatric physical therapists provide services for children with developmental disabilities from birth to 21 years-old; in addition, the team provides support and education to the patient’s family.  At DMG CRS, our goal is to develop, restore and/or improve mobility to enhance quality of life for the child and his/her family.

Pediatric physical therapy benefits children and their families and/or caregivers by promoting activity and participation in everyday routines, increasing functional independence, improving strength and endurance, facilitating motor development and mobility, and easing the challenges of daily caregiving.

The team has also begun serving adults with disabilities who may benefit from the services specifically available through DMG CRS.

DMG CRS physical therapists treat patients one-on-one in the physical therapy and rehabilitation clinic at DMG CRS as well as serve patients being treated at other DMG CRS clinics such as:

DMG CRS physical therapists also perform equipment evaluations, trialing each child in specialized equipment before ordering it to determine what works best. Types of equipment evaluations provided include:

  • Adaptive seating
  • Adaptive car seats
  • Forearm crutches
  • Gait trainers
  • Standers
  • Walkers
  • Wheelchairs

Additional Content

For more information on DMG CRS equipment evaluation services, watch this video.

For additional information on  the services offered by DMG CRS physical therapists, view this video.


Newborn Screenings: What You Need to Know

By Troy Nelson, MD, pediatrician and medical director, DMG Children’s Rehabilitative Services


Did you know September is Newborn Screening Awareness Month?  Newborn screening allows identification and treatment of a disease before symptoms even emerge.  A newborn may appear healthy, but still have a serious condition that cannot be seen.  If left untreated, these conditions can lead to slow growth, blindness and/or intellectual disability, and may be life threatening. Early detection and treatment can help prevent these serious problems, which is why newborn screening is critical.

Based on published research by Dr. Robert Guthrie in 1963, newborn screenings have evolved with newborns now being screened for more than 25 conditions within days of birth; screenings involve just a few drops of blood.  According to the National Institute of Health, newborn screening detects a treatable condition in about 1 in 300 babies born each year, a total of about 12,500 cases each year. In Arizona, approximately 100 babies annually are found to have a serious condition identified through newborn screening.

Providers in Arizona are required by law to order newborn screening tests for all newborns.  Arizona requires newborns to be screened twice to help ensure accuracy, as some conditions are easier to detect on a subsequent screen.  In addition, approximately 98 percent of all infants born in Arizona are screened for hearing loss prior to hospital discharge.  The first screening sample will be taken before the newborn leaves the hospital and the second will be taken between 5-10 days after birth, or at the first well-baby visit, whichever comes first. For those newborns born at home, the healthcare provider present at the birth will collect the first screen.

At DMG Children’s Rehabilitative Services (DMG CRS), we provide specialized treatment for newborns for which a condition was detected during screening.  Our goal is to provide most medical specialties and services in one location by physicians and staff that work exclusively with children.  With early detection, intervention, and treatment, we can partner with you and your family to enable your baby to thrive to the maximum of his or her abilities.

We’re Here for You…Safely

May 21, 2020

heart doctor

DMG Children’s Rehabilitative Services Families:

As you and your children are part of the DMG Children’s Rehabilitative (DMG CRS) family, we want to ensure you know we are always here for you. Throughout the COVID-19 pandemic, DMG CRS has remained open to support the health of our patients and their families.

We understand you may have concerns about leaving your home right now, especially if your child has a medical condition making him or her more vulnerable. We are employing safety measures recommended by the Centers for Disease Control and Prevention (CDC) to protect you and your family as well as our staff, including:

  • Safe screening practices for all patients and families prior to an in-person office visit
  • Availability of telehealth appointments, as appropriate, so you can meet with your child’s DMG CRSprovider safely from home
  • Enhanced office cleaning and personal protection procedures, with hand sanitizer readily availablethroughout the facility
  • Social distancing measures at check-in, checkout and in our waiting rooms, including rapidly movingpatients that are sick to a private room
  • Use of masks and face shields by all providers and staff while caring for our patients, as well as anyother employees in the clinic
  • Providing masks or cloth facial covering to patients and parents or accompanying adult entering theclinic without a cloth mask

Whether your child needs to visit DMG CRS for a preventive care visit- such as screenings, vaccines, or dental health- or management of a chronic or complex condition with DMG CRS medical specialists, we are here for you, providing a safe, clean environment.

To schedule an appointment or ask us questions, please call (602) 914-1520. If you have any concerns, do not hesitate to call us. You are part of the DMG CRS family, and we are here for you.

Troy Nelson, MD
Medical Director, DMG CRS


Message from DMG CRS About COVID-19

cover 19 notice

DMG CRS Recognizes National Physical Therapy Month

national physical therapy month

by Linda Thunn, PT, DPT, DMG CRS Physical Therapist

Pediatric physical therapists provide support and services for children (birth to 21 years of age) with developmental disabilities and their families. They aim to develop, restore and improve mobility to improve quality of life.

Pediatric physical therapy benefits children and their caregivers by promoting activity and participation in everyday routines, increasing functional independence, improving strength and endurance, facilitating motor development and mobility, and easing the challenges of daily caregiving.

A Wide Variety of Services

Not only do our physical therapists provide one-on-one treatment for our young patients in the therapy clinic, they also work in the following areas at DMG CRS:

• Amputee clinic
• Cystic fibrosis clinic
• Orthopedic clinic
• Myelomeningocele planning clinic: pediatric, transition and adult
• Rheumatology clinic
• Spasticity planning and follow-up clinic

Equipment Evaluations

Our physical therapists also perform equipment evaluations, trialing each child in specialized equipment before ordering it to determine what works best for them. Types of equipment evaluations that DMG CRS provides include the following:

• Adaptive seating
• Adaptive car seats (takes place offsite)
• Forearm crutches
• Gait trainers
• Standers
• Walkers
• Wheelchairs (takes place offsite)

DMG CRS is thankful for our talented and compassionate physical therapists and are happy to take this time to recognize their hard work during National Physical Therapy Month. Thank you for all you do!

Did you know?

DMG CRS now allows patients to ”opt in” for services past the age of 21, and we currently have several physical therapists qualified to treat individuals over the age of 21. Adult patients with disabilities will be evaluated to determine if DMG CRS is the best fit for their individual needs. Call (602) 470-1520 to schedule an appointment.

Linda ThunnAbout Linda

Linda Thunn has her doctorate degree in physical therapy and has worked for the CRS program for eight years. Her mission is to provide solution orientated physical therapy through comprehensive care for children through young adulthood with chronic illness and disabilities.


3 Basic Wellness Tips for Every Family with Special Needs Children

arizona sports programs

by Linda Thunn, PT, DPT, DMG CRS Physical Therapist

Life with a special needs child or adult can be a complex, scary, and amazing journey full of ups and downs, triumphs and disappointments that affect the whole family. A good thing to remember is to think about the long-term outcome of a goal rather than just the immediate outcome. You may want your child to walk or talk, but that may not be possible. Therefore consider what can be done to support them in their effort to be the most independent and to find joy in their life.

Caring for a child with or without special needs is a marathon, not a sprint. You won’t always do the right thing, but with good intentions you will be on the right path. Below are three basic tips to improve wellness for the whole family.


1. Breathe

We know we need to eat right and exercise, but when you have a special needs child, you may not have the time to do the “right” things for yourself. Incorporating easy wellness activities into your daily life could make all the difference. The act of deep breathing with intention can decrease your cortisol levels thereby decreasing stress levels. Deep breathing for a few breathes, 3 to 5 times a day, takes practice to become a habit and to be effective.

Try it right now! Sit down in a chair with your feet flat on the floor. Slowly breathe in through your nose, counting to five (using your fingers to count will slow your breath). Hold your breath for two seconds, and exhale through your mouth to the count of five. The goal is to have your midsection expand during the inhale breath and soften during the exhale breath with your shoulders remaining still. Repeat this exercise three times. As you continue this practice you can add repeated positive thoughts while you breathe. And as you improve, you will be able to incorporate this in your walking, standing and exercising.


2. Play

Please take your therapists advice and include their information into typical activities of daily living. Whether you are working on sitting or walking with your child, you are promoting their independence. Ultimately all therapies are to promote progression to a less dependent adulthood. Please do not forget to play. Simple repetitive activities that are common during functional play builds pre-literacy, motor, and thinking skills. Whatever your age or skill level, everyone likes to participate if they are having fun. Arizona has a variety of resources for various skill levels, including adaptive parks and sports. Also family based physical activity increases the health and wellness of your family unit.


3. Community Resources

If you have access to the internet, search for community resources in your area by using terms such as “adaptive recreation” or “adapted technology,” and tailor the search to your child’s age based needs. Participate in the special programs that your child’s school offers, and if your child is going to the Special Olympics games, go with them or volunteer at an event. Another good resource are the support personnel in your child’s life, such as DMG CRS child life specialists, case workers, providers and therapists. For example, I have created the go-to document Arizona Community Sports and Programs for Children and Adults with Special Needs. That would be a great place to start improving wellness for your whole family.


Linda ThunnAbout Linda

Linda Thunn has her doctorate degree in physical therapy and has worked for the CRS program for eight years. Her mission is to provide solution orientated physical therapy through comprehensive care for children through young adulthood with chronic illness and disabilities.


DDD/ALTCS Plan Changes



By Philip Goritsas – CRS Director of Clinical Operations & Troy Nelson, MD – CRS Medical Director

Leer en español

May 16, 2019


Re: Change with Developmental Disabilities and the Arizona Long Term Care System (ALTCS).

Dear Parent or Legal Guardian,

DMG CRS here in Phoenix appreciates and values you as part of our family. You may have received a letter from the Department of Economic Security at the end of April that informed you about the DDD changes. We want to make this change easier for our patients.

DDD/ALTCS is changing on October 1, 2019. As a member of the CRS program, today you are insured by United Healthcare Community Plan. You will be assigned to a plan for October. All of our patients will now have a choice between two health plans:

  • Mercy Care
  • United Healthcare Community Plan

Remember – You can choose to keep the plan you are assigned to or you can choose another plan. You will have time between June 14th and July 15th, 2019 to change plans, during open enrollment. You will still have access to the same services at the DMG CRS Clinic. Both United Healthcare Community Plan and Mercy Care Plan contract with us to provide services.

Here is what will stay the same:

  • You will still be able to be a patient at DMG CRS
  • You will still have the same range of AHCCCS covered services at DMG CRS as you have now

Here is what will be different:

  • You will have a choice between two health plans, instead of just one
  • We will be adding new specialties and providers to expand services for our patients
  • If you get services outside of our building, like surgery or primary care, please check with your insurance anddoctor’s office

DMG-CRS will continue to be open to treat patients as we have in the past. The plan you choose will not impact your ability to receive care at DMG CRS.

We are here to answer your questions. That is why we have created several ways for you to get more information about this transition:

  • Speak to any DMG CRS staff member at your next appointment
  • Call the DMG Transition Hotline: (602) 914-1555
  • For questions about the new health plans you can contact the DDD Customer Service Unit directly at:
    1-844-770-9500 ext 7 or by visiting on the internet

Troy Nelson, MD
CRS Medical Director


3 Tips for Interacting with Someone on the Spectrum


An insider’s guide on making friends and merging worlds

by Tre’Shawn Rizo, Administrative Assistant at DMG CRS

In the ninth grade I was fortunate enough to meet my best friend Daniel in biology class. At the time I didn’t know he was, as he likes to put it, “different.” It was later in the day that he let me and a few others know about his autism. But that didn’t matter to me. From the moment I first noticed Daniel, I knew he was a guy I wanted to get to know. You see, earlier that day in biology our teacher used the expression “pull yourself up by your own bootstraps.” I didn’t think anything of it, but Daniel quickly raised his hand and said, “Hey Mr. McWilliams, that’s physically impossible to do. So I’m confused by your statement.” Watching my teacher get red in the face and fumble over how to respond was priceless. During lunch that day I decided to find Daniel and sit next to him. And after an awkward introduction and eleven years I’m quite pleased to still call him my best friend.

Over these past eleven years of having an autistic best friend, and in honor of Autism Awareness Month, I want to share my top three tips for interacting with someone who has autism. But first, let’s start with some definitions just so we are all on the same page.

Autism: A neurological disorder characterized by repetitive behavior, difficulties communicating, and problems establishing and maintaining relationships.

Autism Awareness: A movement about spreading awareness and acceptance of people on the autism spectrum.

Neurotypical: A person who doesn’t display atypical thought patterns or behaviors.

Stimming: Self-soothing, repetitive body movements which autistic people do in response to over-stimulation or emotional stress. Common ‘stims’ are rocking back-and-forth motions, hand flapping, and arm and leg rubbing.

Now that that’s out of the way, we as neurotypicals have a way of being weird or awkward when it comes to interacting with someone who falls outside the norm. However, they are people just like we are. The only difference is they think differently. So here are three tips that will help you develop friendships with people on the spectrum.

Tip 1: Be Kind.

It should go without saying, and this applies no matter who you are talking with, but be kind and respectful. A little kindness and respect can go a long way. People with autism are often bullied, teased or talked down to. Do not assume their mental capacity is based off their condition. The two do not always go hand in hand. So do not talk down to or baby them.

Tip 2: Be Patient.

When talking, people with autism may experience an eruption of emotions and misunderstandings. Because of that, when processing social cues, they might miss something and accidentally say something that may be taken as stupid, mean, or offensive. This tends to hinder the formation and maintenance of lasting relationships. But this can be avoided by helping to bridge the gap of misunderstandings. Keep in mind that without the physical emotional cues to guide their responses like neurotypicals do, they are left with just the words. This sometimes can make an awkward experience.

To get a sense of what this is like, try closing your eyes the next time somebody is talking to you. It’ll give you an idea of how much they are missing out on. It is said that over half of all communication is nonverbal. If you’re the neurotypical in the conversation, it’s your job to make sure you are clear in your meaning. If you feel offended by what they may have said, instead of showing your offense through your facial expressions, kindly verbalize that they have offended you. You will get an apology a lot faster than making a face at them that they may not pick up on or understand.

Tip 3: Pay Attention.

Pay attention to their body movements for signs of stimming. This happens when they are experiencing an excess of emotion or sensory stimuli. It isn’t always bad, and it isn’t always good. It just is. Many people with autism have free floating anxiety even when they are happy, and stimming helps keep that under control. If you see that they are moving around more than usual, ask if they need anything. Most of the time they will tell you what they need, and the tiniest gestures go the furthest.

I know that these tips won’t make the stigma surrounding people on the spectrum go away in a day, but it’s a start. Kindness, patience and paying attention are a good start to making new friends and merging these worlds together.