CHOC recognized as one of nation’s best children’s hospitals

CHOC Children’s is one of only 50 pediatric facilities in the nation to earn recognition as a best children’s hospital by U.S. News & World Report. The following CHOC specialties are honored in the 2019-20 Best Children’s Hospitals rankings: diabetes/endocrinology, cancer, neonatology, neurology/neurosurgery, pulmonology and urology. Cancer ranked in the “top 20.”

“The national recognition for CHOC’s cancer program is well-deserved. There’s nowhere else I’d rather have gone through treatment than CHOC,” says 17-year-old Sydney Sigafus, CHOC patient and cancer survivor. “Everyone who works at CHOC cares about you as a person, not just a patient. I was included in every decision and conversation about my care.”

The Best Children’s Hospitals rankings were introduced by U.S. News in 2007 to help families of children with rare or life-threatening diseases find the best medical care available. Only the nation’s top 50 pediatric facilities are distinguished in 10 pediatric specialties, based on survival rates, nurse staffing, procedure and patient volumes, reputation and additional outcomes data. The availability of clinical resources, infection rates and compliance with best practices are also factored into the rankings.

“We understand how scary it can be for parents whose children are dealing with life-threatening illnesses or injuries. That’s why we are committed to the highest standards of care, safety and service,” says Dr. James Cappon, CHOC’s chief quality officer. “While we are proud of our accolades, including being named a best children’s hospital, we remain focused on preserving the magic of childhood for all kids, whether they are seriously ill or healthy, or somewhere in between.”

More information about the Best Children’s Hospitals rankings can be found here.

Can children outgrow autism?

A study recently published in the Journal of Child Neurology suggests that children may outgrow autism. We spoke to Dr. J. Thomas Megerian, pediatric neurologist and clinical director of the Thompson Autism Center at CHOC Children’s, about what parents should know about these findings.

What can providers tell parents about the study’s findings?

Many parents ask me, “Will my child outgrow autism?” and I always tell them that what we hope for is that with services and growth, the child will improve so much that after as little as a few years, they no longer meet the criteria for Autism Spectrum Disorder (ASD). Outgrowing the label may mean they have learned to compensate or overcome some challenges like socialization or repetitive movements. They may have little features left of ASD, and what symptoms they do have, may cease to interfere with their development or daily lives. When they have progressed to the point where they have outgrown the label, any remaining traits may be so small that only a parent would notice, but a new person who has just met the child wouldn’t pick up on anything.

However, I advise my patients’ parents that if and when their child outgrows the label of autism, they may still have other co-occurring issues like anxiety, attention deficit hyperactivity disorder (ADHD) or learning disabilities that require ongoing care.

So yes, indeed this study should give parents hope surrounding a child’s ability to outgrow the autism label, despite their other potential ongoing issues.

In some instances, schools may suggest a decrease in services because a child has improved and outgrown the label of autism. That same child may still be struggling with organization or learning certain subjects. Parents may be in a position to say that just because their child has outgrown the autism label doesn’t mean they do not have a need for additional support.

What does life look like for a child previously diagnosed with autism who is no longer on the spectrum?

Learning disabilities, obsessive compulsive disorder, and attention deficit disorder are common among children with ASD. Rates of other disorders are common among children with autism, including: gastrointestinal disorders, ear infections, seizures and anxiety. They may clear up later in life or become better managed, but they don’t necessarily go away at the same time as their autism label.

Residual symptoms of these co-occurring diagnoses may last into adulthood. For example, a child may outgrow their ASD label but still have anxiety that can be managed by cognitive behavioral therapy.

Why is early detection and early intervention of autism so important?

Early detection and intervention help many kids outgrow the autism label in the future due to improvements with socialization and repetitive behavior. It’s important for people to remember that just because they have lost the autism label doesn’t mean they don’t have other diagnoses or disorders that may require ongoing treatment.

There’s no question that early intervention makes a big difference in helping kids with the potential to outgrow their ASD diagnoses achieve that milestone even sooner. The trajectory has changed for many of those kids.

CHOC pediatrician talks adolescent sleep hygiene on SiriusXM’s “Doctor Radio” show

CHOC Children’s pediatrician Eric Ball, M.D., was a guest on SiriusXM’s Doctor Radio show to discuss sleep hygiene among adolescents—an often misunderstood topic.

Dr. Eric Ball, Pediatrics

“As a pediatrician, I have this conversation several times per day,” says Ball. “Many people don’t realize teens need more sleep than the average adult.”

Dr. Ball explained that adolescence is a tricky time in terms of sleep habit changes. Puberty transforms the average teen from a morning person to a night owl, and their sleep schedules need to reflect that.

Part of the issue, he says, is that schools have not yet adjusted to reflect this need; 43% of American high schools start before 8 a.m., he notes, but that ideally should be 8:30 a.m. or later. Dr. Ball has advocated for California state legislation that would mandate such a start time among high schools.

On the show, Dr. Ball also shared a few tips to help teens improve their sleep hygiene.

7 ways pediatricians can help parents manage their teen’s sleeping habits:

  1. Encourage parents to limit screen time after dark
    “I’m happy my kids are involved in their culture and keeping in touch with friends,” says Dr. Ball. “But bright light tells your brain it’s noon and not 10 p.m., so there’s no melatonin surge telling your brain it’s time for bed.” Blue light glasses may help, but it’s much safer and healthier to simply shut off the screens and focus on relaxation once the sun goes down.

  2. Suggest parents develop a “digital curfew”
    It is much easier to limit screen time if parents replace that time with something fun. Suggest family meditation or a starting a membership to a meditation app that teens can use on their own, if they prefer. If parents have a young child prone to waking up during the night, encourage them to try guided imagery to teach their child to put themselves back to sleep.




  3. Help parents start a sleep diary
    Sleepfoundation.org has a sleep diary function parents can easily introduce to their kids. It is a quick and simple way to keep track of sleeping habits, see where problems arise and work alongside their child to improve those habits.

  4. Have parents to work backwards to find the best bedtime
    Parents can start by figuring out what time their teen needs to wake up to get to school on time. Work backwards from there to find an appropriate bedtime. Then, keep working backwards to see how to fit in after-school necessities like homework, sports, social time and family time. The key is making bedtime the priority.

  5. Make sure parents focus on weekend sleep hygiene, too
    Sleeping in a little on weekends is fine, says Dr. Ball, but teens should avoid sleeping hours into the day. Helping adolescents develop more consistent sleep hygiene throughout the week and weekend is critical.

  6. Tell parents to avoid melatonin unless necessary
    Sometimes kids with autism spectrum disorder or who have attention deficit hyperactivity disorder require the aid of melatonin, but in other cases, says Dr. Ball, it’s best for doctors to use it as a last resort. “If teens have poor sleep hygiene, there’s not enough melatonin in the world to fix that,” he says. “It becomes a crutch, and then you’re treating the symptoms—not the cause.”

  7. Urge parents to prioritize sleep
    Adolescents in competitive schools or programs tend to prioritize just about everything other than sleep, but no amount of studying will prepare a kid to perform their best the way good sleep will. Remind busy and high-achieving kids that sleep is not a luxury but a necessity, and that an extra half hour of studying likely won’t make the difference that eight hours of sleep will.

CHOC ENT study finds kids more often exposed to loud noises, infrequently use hearing protection

A new study co-authored by a CHOC Children’s otolaryngologist finds that nearly a quarter of U.S. children are at increased risk for hearing loss due to exposure to loud sounds and infrequent hearing protection use.

Dr. Jay Bhatt and his co-authors examined the incidence and gender differences in pediatric recreational and firearms noise exposure in the United States. The study, published in the May 2019 issue of the otolaryngology journal “Laryngoscope,” is the largest evaluation of loud noise exposure patterns and the use of hearing protection in children to date. 

Drawing on data gathered by the National Health Interview Series (NHIS), the study makes several key findings:

  • The most common source of recreational noise was personal music players, now used by up to 90% of school children
  • One in five children have been exposed to firearm noise, with boys significantly more likely to have exposure than girls.
  • Only 16% of children always used hearing protection in the last 12 months during explosive sound exposures, and girls were less likely to use protection than boys.
  • Up to 96% of parents perceived their children to be at no to minimal risk of hearing loss from excessive noise.
  • The prevalence of pediatric loud noise exposure is the likely cause of the noise-induced hearing loss noted in one in five adults ages 20 to 29.

The gender disparities found by the study underscore the importance of hearing protection education to not just boys, who are more frequently exposed to loud noises, but also girls, who are less frequently exposed but less likely to wear hearing protection, the authors write.

Further, public health initiatives could identify children and families at risk for loud noise exposure and provide appropriate counseling to prevent hearing related consequences as adults.

Learn more about otolaryngology at CHOC Children’s.

In the Spotlight: Chenue Abongwa, M.D.

Chenue Abongwa, M.D., joined CHOC Children’s in October 2018 as a pediatric neuro-oncologist at the Hyundai Cancer Institute. After finishing medical school at the Universite de Yaounde in Cameroon, he completed his pediatrics residency at Brookdale University Hospital in New York, his pediatric hematology/oncology fellowship at University of Iowa Hospitals and his neuro-oncology fellowship at Children’s Hospital of Los Angeles. We chatted with him about his time at CHOC so far.

Dr. Chenue Abongwa, Pediatric Neuro-Oncology

What drew you to medicine? Pediatrics specifically?

I was drawn to medicine earlier in my childhood. My mother worked as a nurse, and I often accompanied her when she did house calls to visit children and was very impressed by her dedication and desire to help sick children. I wanted to be like her when I grew up.

What about CHOC stuck out to you?

I initially heard about CHOC in 2013 when I was a fellow in pediatric hematology/oncology and came across a well-written web guideline on febrile neutropenia. This prompted me to seek information about the institution and about the team. I was very impressed by the institutional vision, dynamism, patient-centeredness and search for excellence. I applied without hesitation when the opportunity came.

Are you or do you plan to be involved with any special projects or groups at CHOC?

I am currently involved in several divisional clinical projects based on COG (Children’s Oncology Group) and will be joining some committees.

Can you share some of your goals at CHOC?

My goals are to initially build a strong clinical base by working in the neuro-oncology team in the short term. I hope in the long term to be actively involved in quality improvement, research and teaching.

What do you want your patients and their families to know about CHOC? 

The diagnosis of cancer in a child is a very difficult and traumatic experience to children and their families. Being part of their lives in these extremely difficult periods and advocating for these families is a great privilege. Our team here at CHOC, with its focus on patient-centered care, is the right place for these families to be during this time.

What do you like to do outside of CHOC?

I love traveling, watching football and playing chess.