Reading is fundamental. It affects all areas of a child’s success. And summertime is a great time to make reading a priority. Dr. Amy McCollum is a pediatrician at Midtown Pediatrics in Birmingham. She says it is important for parents to help encourage strong reading habits in their child and she says, that begins at birth. “I would really encourage parents from birth to start reading to their baby,” she says. “Holding your child and reading a book together is going to have these great associations of attachment and connection. Your voice, which is the most comforting voice, is going to be what they hear.”
As the child gets older, Dr. McCollum says parents should encourage their child to choose what books they want to read. And she adds, don’t worry if they stick with the same theme, or want to read the same book over and over; they’re still reading.
Make library visits a regular part of your summer. Dr. McCollum says, if you are able, choose one day a week that is a library day. “Talk to the librarian, let them suggest books the child might like,” she says. “Check out books on a regular basis and sign up for summer reading programs at the library.”
Again, Dr. McCollum says, as the child gets older, continue to let them choose the books they are interested in. “I think sticking with the topic of letting them choose what they’re interested in is important,” she says. “For instance, if your son only wants to read graphic novels instead of chapter books, that’s fine if that’s what he enjoys.”
As kids get older, encouraging good reading habits can be challenging, as video games and devices serve as constant distractions. Dr. McCollum knows this firsthand, “We just have to fight to fight. In my family 30 minutes of reading gets you 30 minutes of video game time,” she says.
And parents should ask themselves, am I modeling good reading habits to my child, or am I spending my free time on a device? By putting forth a little bit of effort and intentionality, any child can become a reader.
BIRMINGHAM (June 1, 2021) – Children’s of Alabama announced two promotions in its leadership today.
Andy Loehr was named Senior Vice President of Operations and Chief Nursing Officer (CNO) and Delicia Mason was promoted to the role of Vice President of Nursing Operations.
“I’ve had the opportunity to work closely with each of them and to see the impressive result of their strong leadership abilities. This was never more so than during the past year in response to Covid-19,” said Tom Shufflebarger, Children’s President and CEO. “I know Andy and Delicia will continue to make our organization even stronger in the future. It’s my pleasure to recognize them with increased responsibilities in these new roles.”
Loehr joined Children’s in 2014 as the Vice President of Nursing Operations and was promoted to the role of CNO in 2020. Prior to joining Children’s, he was a staff registered nurse, pediatric nurse practitioner and nursing director at Children’s Mercy Hospitals and Clinics in Kansas City, Mo. He began his career at Children’s Medical Center in Dallas as a staff registered nurse in hematology-oncology.
Loehr graduated from Truman State University in Kirksville, Mo., with a bachelor’s degree in nursing. He received a master’s degree in nursing and pediatric nurse practitioner certification from the University of Missouri-Kansas City. He received his Doctor in Nursing Practice from the University of Alabama at Birmingham (UAB) and completed a fellowship in nursing leadership with the American Organization of Nurse Executives.
Mason joined Children’s in 1998 as a staff nurse in PICU and has worked as a Charge Nurse, Unit Educator, Quality Outcomes Coordinator, and most recently as Division Director of Inpatient Nursing and the Emergency Department. She earned her bachelor’s degree in Nursing from Auburn University at Montgomery and a master’s degree in Nursing Health Systems Administration from UAB.
Since 1911, Children’s of Alabama has provided specialized medical care for ill and injured children, offering inpatient, outpatient and primary care throughout central Alabama. Children’s is a private, not-for-profit medical center that serves as the teaching hospital for the UAB pediatric medicine, surgery, psychiatry, research and residency programs. The medical staff consists of UAB faculty and Children’s full-time physicians as well as private practicing community physicians.
Anxiety disorders are one of the most common mental health issues of childhood and adolescence. Anxiety disorders cause extreme fear and worry, and changes in a child’s behavior, sleep, eating or mood. Parents should be cognizant of ways to help their child deal with stress and anxiety at a young age so it doesn’t worsen or compound into other mental health issues.
Parents can teach their child coping skills to deal with stress and anxiety. Coping skills help children manage anxiety in a healthy way. Children can feel stress and anxiety for many different reasons, whether it is a parent’s divorce, controversial world news or a relative’s illness. Academic or social pressures can also increase stress. Some children are people pleasers, perfectionists or have type A personalities, which can contribute to anxiety. Parents should teach their child how to manage their time and responsibilities to prevent feelings of being stressed, overwhelmed or overcommitted. Parents should also be cautious when discussing serious issues when their pre-adolescent children are near because children will often pick up on their parents’ anxieties and start to worry themselves.
Dr. Natalie Krenz, clinical psychologist in the Children’s Behavioral Health unit, said parents can teach the following coping skills to their pre-adolescent children struggling with anxiety:
Use the “sniff the flowers” and “blow bubbles” technique
Teach child to relax by taking a deep breath in (like they are sniffing flowers) and taking a deep breath out (like they are blowing out bubbles)
Since this idea uses imaginary flowers and bubbles, children can use this technique anywhere
Use the “squeeze lemons” technique
Teach child to imagine they are squeezing the lemon juice from the lemon and then shaking the lemon juice out
This demonstrates the tensing and relaxation of the muscles
Parents should take steps to help their child deal with stress and anxiety at a very young age. Dr. Krenz said being a good role model by modeling healthy techniques to cope with anxiety is very effective. A parent may tell their child they had a stressful day, so they are going to take a break and do something relaxing – going on a walk, taking a bath, engaging in a hobby such as painting or reading, or partaking in deep breathing exercises.
Another important step parents can take to help children cope with anxiety and stress is to communicate to children that it’s okay to feel scared, worried or stressed. Parents should be sure to validate their child’s feelings first, then work together to come up with a solution to cope with stress in a healthy way.
Parents should not only model self-care for their children, but they should also encourage their child to partake in self-care on a regular basis. Important self-care methods for children include getting 10-11 hours of sleep per night for ages 5-10 and 8-10 hours of sleep for ages 10-17, having a balanced diet, and avoiding the use of electronics before bed.
Trauma of any form, including physical, sexual or emotional abuse, dangerous living situations, academic issues, personality tendencies or certain genetic components can cause anxiety in children.
Some children have learning disabilities, Attention-Deficit/Hyperactivity Disorder (ADHD) or a high-achieving personality, which can contribute to stress at school. A child’s personality type – more introverted or timid – could contribute to development of anxiety.
“Low Socioeconomic status (SES) children are also more at risk for developing anxiety,” Dr. Krenz said, “due to the tendency of low SES families living in neighborhoods that are not safe.” This could result in children being prone to experiencing an event that is traumatic for them, such as gun shots. Dr. Krenz said the likelihood for anxiety depends on what the child perceives as traumatic.
Genetic components can also contribute to anxiety. If a parent experienced anxiety at a young age, the child is more likely to have the genetic components for anxiety.
“A parent should seek professional help if their child is dealing with anxiety and stress that interferes with their functioning; the child can’t control anxious feelings and it worsens as time goes on,” Dr. Krenz said. If the child is not engaging in self-care or missing school, parents should consider these as telltale indications they should seek professional help for their child.
Parents should discuss options with their pediatrician. Dr. Krenz suggests looking into therapy before choosing the route of medication. It is also important to consider that anxiety often coexists with other mental health conditions, including depression. While anxiety is a pervasive issue among children and teenagers, parents should be encouraged that there are many effective coping skills and resources to help their child.
If your child needs help with coping, anxiety or mental health issues, these resources are available at Children’s of Alabama :
Behavioral Health unit general number – 205-638-9193
Psychiatric Intake Response Center – 205-638-PIRC
CHIPS (Children’s Hospital Intervention & Prevention Services) Center – 205-638-2751
Amelia Center (for grieving children and teens) – 205-638-7481
Vaping is on the rise among American teens. A recent study by “The Truth Initiative” found that 27.5% of American high school students use vape products. Susan Walley is a pediatrician at Children’s of Alabama. She says it’s very important for parents to understand the dangers of vaping and to be able to recognize e-cigarettes. E-cigarettes are battery-powered smoking devices that have cartridges filled with a liquid that contains nicotine, chemicals and flavoring.
Walley says oftentimes teachers and parents do not even recognize the cartridges when they see them. “Juul is one of the most common e-cigarettes,” Walley says. “The device is very small and can be hidden in backpacks and pockets. It looks like a USB charger, so oftentimes when we show teachers and parents the products they say, I saw those but didn’t recognize them!” Walley adds that the nicotine in those small, liquid cartridges can be the equivalent of two packs of cigarettes.
Health experts are reporting serious lung damage in people who vape, including some deaths. Walley warns, “The facts are e-cigarettes are dangerous, particularly for youth. Thousands of people have been hospitalized with e-cigarette or vaping associated lung injury, also known as EVALI. These products have toxins in them that are very dangerous,” she adds.
In addition to the lung damage, nicotine is highly addictive and can slow brain development in kids and teens and affects areas like memory, concentration, self-control, and mood. It also increases the risk of other types of addiction. Many e-cigarette products appeal directly to young children through the use of fruit flavors, and even branding that can appear cartoon-like. Walley warns parents to be on the lookout beginning at an early age for signs of e-cigarette use. It is recommended that parents talk with their children and teens about the dangers of vaping. And if you believe your child has already started, look for programs to help them quit. It is important for parents to be engaged and tune into what their children are doing to help them stay safe.
Ten years ago, on April 27, 2011, Noah Stewart – then an 8-year-old living in Pleasant Grove – was one of more than 60 children treated in our Emergency Department as part of a widespread outbreak of tornadoes throughout Alabama.
Now 18, Noah is a freshman at Troy University and is a member of the Sound of the South marching band drumline. We caught up with Noah about his experience that day. Experts said one of the reasons he survived a tornado striking his home was because he was wearing a baseball helmet. At the time, that was a novel concept. Today it’s a standard part of severe weather preparation.
“The first thing I remember about April 27, 2011, is there being a tornado warning and my mom telling me to put on my baseball helmet,” he remembered. “At that point, I got a little worried, grabbed the stuffed animal my girlfriend had given me and went to our designated safe place, my parents’ walk-in closet. My dad got home from work and we, my parents, my sister Haley and I, all took shelter literally minutes before the tornado hit.
“I remember losing power, the whistle of the wind and then a very, very low rumble. It sounded like a train, getting louder and louder the closer it came. In an instant, the house exploded, and we were all sucked out by the tornado. The experience was like being swallowed by a huge wave in the ocean; I couldn’t tell up from down or right from left – I was lost. It was over as quickly as it began except that I was about 50 yards from where I was only seconds before, now laying in a field of debris against the twisted remains of a tree stump. My parents and sister landed in different locations, but they all crawled to me. There was an immediate calm after the storm, but we soon noticed everything we owned was gone. In that moment it didn’t matter because we all survived and so did our dogs, Jack and Cody. My mom and Haley were taken by ambulance directly to the hospital. I was placed on the remains of a broken door. My dad and I were carried in the back of a pickup truck to a triage location several blocks away. Dad and I were separated when he was transported by ambulance. Several hours later, I was sent to Children’s. I was wet, cold and alone without my family but the doctors, nurses and staff were amazing. They made me feel safe and comforted me as they stitched and bandaged my cuts and bruises.”
Noah was treated that night by Drs. Mark Baker and Michele Nichols and a host of other staff.
“I wish I knew the names of each person that helped me that night,” he said. “Children’s befriended me and allowed me to be a part of several events like the Regions Classic and the dedication of the Benjamin Russell Hospital for Children. This gave me an opportunity to tell my story and about the importance of protecting your head by wearing a helmet during a storm. I had a reunion with the ER doctors, nurses and staff on the one-year anniversary of the tornado. I am unable to visit on this anniversary as I will be in Troy but my admiration and appreciation for the doctors, nurses and staff of Children’s is as strong today as it was on April 27, 2011.
“Thank you all so much for what you did for me that night and what you continue to do for the children of Alabama and throughout the world. Just as I told you on the one-year anniversary visit, you guys are my angels and I will always appreciate the care and support you gave me. You are truly heroes! Because of Dr. Bakers’ research on the use of helmets as protection during tornadoes, many lives have been saved and the use of helmets during emergency weather events is widely practiced and encouraged by life safety professionals throughout the United States.”
Is your family prepared for severe weather? The 2021 tornado season is off to a deadly start. Already this year, twisters are blamed for the deaths of more than 200 people in the US.
“Children are at risk during tornadoes because of their relatively large heads,” Dr. Baker said. “Noah’s helmet helped protect him after he was thrown high in the air. We also found two more children who were protected by infant carriers when the tornado hit their homes. Helmet use and getting in a safe place can make a big difference when violent weather strikes.”
Have your safe place planned as part of a disaster plan. During a tornado, the best bet is to lay low. The basement is the best tornado safety shelter if available; if not, have an alternate place to seek shelter quickly when necessary. If you’re outside when a tornado hits, seek cover in a safe building or in a ditch, using your hands to protect your head and neck. Families who live in a mobile home should talk to neighbors or the park owner about tornado safety options.
Have a portable radio (with new batteries) on hand as part of your tornado safety plan. In the event of an emergency, someone needs to listen and be aware of the two types of reports given when weather conditions are right for a tornado: A “tornado watch” means that a tornado is possible. A “tornado warning” means that a tornado has been sighted; people who are in its path should go to their tornado safety shelter immediately. A local or state map will help you visually follow the path of the tornado when listening to radio reports.
Have a helmet designated for each member of your family in your safe place. The most common injury related to tornados is head injury, and doctors believe helmets can prevent the majority of head trauma during severe weather. Baseball, bicycle and football helmets are all good examples of protective head gear and should have a well-fitted chin strap to keep the helmet secure.
Put together an emergency supplies kit. The emergency kit should include everything that might be needed during or in the aftermath of a tornado, especially if power is lost or water sources are affected. Bottled water, flashlights, batteries, prescription medicine, a first aid kit, and snacks or non-perishable food for the family are essential components of the supplies kit. Make sure the kit is easily accessible in the event it’s needed. Include notepad and pen in your kit if you are worried that your child might be anxious or frightened while executing your disaster plan. Having him or her write a journal entry on the experience of preparing for a tornado or inclement weather helps your child overcome feelings of helplessness and will also provide an interesting record of events for the future. Also, based on your child’s age, you may be able to assign him a task or two to help him or her feel more in charge of the situation. Something that doesn’t require much supervision is ideal; tasks such as testing all the flashlights and replacing batteries as needed, putting together snack bags for family members, or even occupying younger children while you are working on preparations. Giving your child some responsibility will make them feel more secure and help reduce their anxiety about the chaotic nature of the storm.
Moving lawn furniture and trash cans out of the storm’s path and removing dead limbs from trees in the yard can be a life-saving tornado safety precaution. Even small items can become dangerous when propelled by high winds. Make sure to move these items several hours before the storm arrives.
Set up a disaster plan with extended members of your family. Tornados typically strike during late afternoon and early evening, but they have been known to touch down in the middle of the night. Families should decide ahead of time which family members are responsible for calling the rest of the family to warn them and to provide them with updates as part of the tornado safety checklist.
If tornado sirens are sounded, it usually indicates that a tornado warning has been issued by the National Weather Service and you need to get to your “safe place.” If you happen to be outside and the sirens go off, do not panic. Find a culvert pipe, a ditch, or a low-lying area. Lie flat, cover your head and get to safety as soon as the storm has passed. In the event of severe weather, the sirens will sound when there has been damage equal to that is similar to that of a small tornado. This damage may include downed trees, power lines and property damage.
For more information on this and other children’s health and safety issues, please visit childrensal.org.
One in four children experience some sort of neglect or abuse in their lives and one in seven have experienced abuse or neglect in the last year (American Academy of Pediatrics). In over 90% of abusive situations, a child is abused – sexually or physically – by someone they know. Abuse is often carried out by the child’s caregiver.
The current health and economic crisis induced by COVID-19 intensified several challenges for children. Loss of jobs and resources, health concerns, and isolation have led to high stress among families. Director of the Children’s Hospital Intervention and Prevention Services (CHIPS) Center, Debra Schneider, said, “Increased stress levels among parents is often a major predictor of physical abuse and neglect of children.” Stressed guardians may be more likely to respond to their child’s behavior in an aggressive way. The support systems that many at-risk parents rely on, such as extended family, childcare, schools, religious groups and other community organizations, were no longer available in many areas due to the stay-at-home orders. Child protection agencies also experienced strained resources with fewer workers available, making them unable to conduct home visits in areas with stay-at-home orders.
Schneider, said, “There has been more suspected physical abuse cases seen by the CHIPS Center in the last six months directly relating to the pandemic compared to before.” Kids are at home more under the supervision of their caregivers. Caregivers aren’t getting as much of a break because the kids are not in school.
Vulnerable situations and disasters such as the tornadoes that recently plagued central Alabama can also lead to misplaced and unsupervised children, which can then result in abusive situations.
Lack of understanding regarding child development can also lead to abuse. In instances of physical, sexual or emotional abuse, Schneider said the child is often left in the care of a family member or significant other. That person may not understand the process of child development and expects a child to do a task they cannot yet fulfill – such as walking, feeding themselves or being potty-trained. They may take out their anger on the child through a form of abuse if they cannot fulfill the task.
Signs to watch out for in victims of abuse and abusers:
There are many signs that may indicate a child is being abused. Children who are being abused might:
Have new onset fears
Have a vocabulary too advanced regarding sexual activity
Be withdrawn from friends and family
Experience a drop in their grades
Change in appearance (wearing clothes that don’t align with the weather)
Not want to go home
Start using drugs
Be sad or depressed
Have stories to explain injuries that don’t make sense or keep changing
Not want to be with the abuser
Act out at school
There are also signs to watch out for in abusers themselves. They usually walk the victim through a grooming process. Schneider said it is important to remember that the child is usually not abused 24/7. The relationship often consists of a more positive bond. The abuser knows what the child likes, is curious about and afraid of, and they use it to their advantage. Some sort of ‘relationship’ is formed, and a trust is established between them. That way, when harm enters the picture, the child is less likely to question their character and actions. Other signs include spending more time with the child than is appropriate, giving extraordinary gifts to the child more than what’s normal, using excuses to be alone with the child and implementing gaslighting techniques. Gaslighting is defined by the Centers for Disease Control and Prevention as “presenting false information to the victim with the intent of making them doubt their own memory and perception.”
Most kids think abuse comes from a stranger, but abusers are usually someone a child knows. Schneider suggests teaching kids “stranger danger;” however, build off that concept to make them aware that abusers can be someone they know.
Steps for parents to take to prevent or stop abuse:
Parents should be aware of abusive situations and know the signs to look out for in children when they are victims of abuse. The child who has endured abuse the longest typically has the longest healing process. The quicker an abusive situation is reported, the faster a child will be removed from the situation and be provided with medical care, therapy and counseling to heal.
If an adult suspects an abusive situation, they should report it immediately. Anyone can provide an anonymous report of abuse and NOT have to prove it.
Children in an abusive situation need a trusted adult to confide in – whether that is a teacher, friend’s caregiver or guidance counselor. Schools encourage a child to tell three adults; two inside and one outside their family. That trusted adult can clearly communicate to the child, “I am here for you if anything is going on. I am not here to judge.” In some instances, the trusted adult’s child may be present for the conversation if it creates a comfortable atmosphere for the child experiencing abuse.
Adults who suspect abuse should approach the child gently. If the adult asks too many questions, the child may feel in trouble. Adults should never make promises to not tell anyone, since that is a key action to be taken when stopping abusive situations. Remind the child that abuse is NEVER their fault.
Since conversations about abuse can be very difficult to bring up, adults should consider this advice when approaching a suspected victim of abuse. Schneider suggests bringing up an incident from the news as a segue into a conversation about the abusive situation. In addition, having these conversations in the car creates a more relaxed, noninvasive environment.
The next step for adults would be to report to the local department of human resources or a child protective services agency. You can also contact the Childhelp National Child Abuse Hotline at 1-800-4-A-CHILD (1-800-422-4453). You don’t have to give your name. If the child is in immediate danger, call 911.
“Abuse is not the child’s whole story,” Schneider said. “There is hope when intervention occurs.”
BIRMINGHAM (April 15, 2021) – Mike Warren, president and chief executive officer of Children’s of Alabama, is retiring from the state’s only freestanding pediatric hospital, effective June 1, 2021.
Warren, who has served as CEO at Children’s since January 2008, will be succeeded by Tom Shufflebarger, currently serving as chief operating officer and senior executive vice president. The announcements were made by the hospital’s board of directors today.
“Together, we have accomplished a great deal over these past 13 years, the crown jewel of which is the Benjamin Russell Hospital for Children. That addition transformed our campus and allowed us to move transplant surgery and cardiovascular services to Children’s – truly making us a comprehensive pediatric medical facility. Along the way we greatly expanded many services, making tremendous progress in fulfilling our mission to the children and families of Alabama. With Tom set to take the helm, Children’s is positioned to achieve even greater things,” Warren said.
“Under Mike’s leadership, Children’s has thrived, and we are grateful for his service. We are confident in Tom’s ability to continue to carry out the mission of Children’s and guide the organization as a leader in pediatric healthcare here in the state, the region and beyond,” said Temple Tutwiler III, chairman, Children’s Board of Trustees.
Shufflebarger joined Children’s in 1992, having previously served as the budget director and director of physician recruitment and development for Brookwood Medical Center. At Children’s, Shufflebarger has managed the hospital’s daily operations and policy decisions. He also directs the operations and development of Children’s Physician Services, including Pediatric Practice Solutions (Children’s primary care practices), Hospital Ambulatory Care Services, and business relationships with Health Services Foundation and hospital-based physicians.
Shufflebarger is an honors graduate of Duke University where he earned both a Bachelor of Arts in economics and a Master of Business Administration. He is a Fellow of the American College of Healthcare Executives and has served as a Trustee of the Alabama Chapter of the American Hospital Association. He currently serves as chairman of the Child Health Patient Safety Organization, an affiliate of the Children’s Hospital Association. Active in numerous community organizations, he has served in volunteer leadership roles with the United Way of Central Alabama, American Red Cross, Magic Moments, the Lakeshore Foundation, Riverchase United Methodist Church and Hoover City Schools.
“I am honored to be named the next CEO of Children’s of Alabama,” Shufflebarger said. “It is a humbling experience to be part of the strong legacy of providing care for ill and injured children from throughout the region. As the past year has taught us, Children’s of Alabama stands ready to face the challenges of modern healthcare, while remaining firmly dedicated to providing the highest standards of care for our patients and their families.”
Under Warren’s leadership, Children’s of Alabama has grown both in size and standing.
In May 2009, the hospital broke ground on an expansion that would become the Benjamin Russell Hospital for Children. The 12-story building was designed to accommodate projected growth in patient volume, anticipated medical technology needs and the planned consolidation of pediatric services including cardiovascular surgery and comprehensive solid organ transplant care. The $400 million facility opened to patients in August 2012.
In 2010, six of the hospital’s programs were ranked for the first time among the nation’s best children’s hospitals by U.S. News & World Report. The most recent ranking released in June 2020 marked the 11th consecutive year that Children’s has been included.
The relationship between Children’s and the University of Alabama at Birmingham strengthened under Warren’s leadership as the two institutions worked together to offer world-class pediatric health services in an environment that fosters world-class research, excellence in medical education and access to leading-edge treatments for pediatric illnesses and injuries.
Warren has long been a leader in Birmingham’s business community, previously serving as chairman and chief executive officer of Energen Corporation and its two primary subsidiaries, Alagasco and Energen Resources. Prior to that, Warren practiced law with the Birmingham firm of Bradley, Arant, Rose & White. Warren served 22 years on the Children’s of Alabama board of trustees before he was named the hospital’s CEO. He has been in involved in many state and local efforts and served as chairman of the Business Council of Alabama, the United Way, Leadership Birmingham and Leadership Alabama. He has also been chairman of the Metropolitan Development Board, and the area American Heart Association. He has twice chaired the general campaign for the United Way and the United Negro College Fund. In 2004, Warren was inducted to the Alabama Academy of Honor.
Since 1911, Children’s of Alabama has provided specialized medical care for ill and injured children. Ranked among the best children’s hospitals in the nation by U.S. News & World Report, Children’s serves patients from every county in Alabama and nearly every state. With more than 3.5 million square feet, it is one of the largest pediatric medical facilities in the United States. Children’s offers inpatient and outpatient services at its Russell Campus on Birmingham’s historic Southside with additional specialty services provided at Children’s South, Children’s on 3rd and in Huntsville and Montgomery. Primary medical care is provided in more than a dozen communities across central Alabama. Children’s is the only health system in Alabama dedicated solely to the care and treatment of children. It is a private, not-for-profit medical center that serves as the teaching hospital for the University of Alabama at Birmingham (UAB) pediatric medicine, surgery, psychiatry, research and residency programs. The medical staff consists of UAB faculty and Children’s full-time physicians as well as private practicing community physicians.
Brain tumors are the most common solid tumor in children, and aggressive types like glioblastoma have an extremely low survival rate: as low as 10 percent five years after diagnosis. Even tumors successfully treated by surgery, radiation and/or chemotherapy have a high recurrence rate.
“This is the first study utilizing delivery of a viral immunotherapy directly into the tumor of children with brain tumors, and the results indicate the engineered herpes virus can be delivered safely into tumors located in all areas of the cerebrum in children,” said Gregory Friedman, M.D., professor in the Department of Pediatrics at UAB, research scientist at the UAB O’Neal Comprehensive Cancer Center, and director of developmental therapeutics for the Alabama Center for Childhood Cancer and Blood Disorders at UAB and Children’s of Alabama. “The key findings thus far are that the approach is safe and well tolerable, and the preliminary evidence of efficacy is promising.”
In the Phase 1 clinical trial of 12 patients between 7 and 18 years of age, the investigators employed a modified virus known as G207, derived from the herpes virus responsible for cold sores. The virus is genetically altered so that it infects only tumor cells. When injected into a malignant brain tumor via a catheter, the virus enters the tumor cells and replicates. This kills the cell and releases the virus’s progeny to hunt out other tumor cells. Additionally, the virus induces a strong immune response by the body’s immune system, which can attack the tumor. The trial tested G207 alone and then combined with a single low-dose of radiation designed to increase virus replication and spread throughout the tumor.
G207 is the product of more than 30 years of research. James Markert, M.D., MPH, chair of the UAB Department of Neurosurgery, was part of the team at Massachusetts General Hospital in the early 1990’s that first developed the concept of using oncolytic herpes viruses. He worked on the parent virus for G207 and conducted the first clinical study of G207 at UAB. Today the use of viral therapies is under investigation for nearly every type of cancer.
A second-generation virus, called M032, has been developed by Markert and collaborators Yancey Gillespie, Ph.D., professor of neurosurgery, and Richard Whitley, M.D., Distinguished Professor of pediatric infectious disease, and is in clinical trials at UAB in adults with glioblastoma. UAB investigator Renee Chambers, DVM, M.D., is using M032 in a study of brain tumors in dogs, which can develop tumors very similar to those in humans.
In the current trial, 11 of the 12 patients demonstrated a treatment response. The overall survival rate was more than double the typical survival rate for children with high-grade glioma. Some 36 percent of the patients thus far have survived longer than 18 months, surpassing the medial overall survival for newly diagnosed patients with high-grade glioma.
Friedman’s team reports that G207 alone or in combination with radiation therapy was well tolerated, with no serious adverse side effects attributed to the treatment.
“There are still more studies needed; but thus far, viral immunotherapy with several different viruses, including herpes virus, has shown promise in treating high-grade brain tumors in both adults and children,” Friedman said. “We also have an ongoing clinical trial to test the safety of G207 when delivered into the cerebellum, an area of the brain that has not been tested before in adults or children but is the most common location for pediatric tumors to arise.”
Friedman says the next steps are to determine the ideal timing to treat patients and what therapies can be used with viral immunotherapy to maximize the anti-tumor immune response. Based on the encouraging Phase 1 trial results, he and his team are working with the Pediatric Brain Tumor Consortium to develop a multi-institutional Phase 2 trial of G207 for progressive pediatric high-grade glioma, which they hope to initiate later this year.
The study was supported by the United States Food and Drug Administration Orphan Products Clinical Trials Grants Program, Cannonball Kids’ Cancer Foundation, the Rally Foundation for Childhood Cancer Research, Hyundai Hope on Wheels, St. Baldrick’s Foundation, and the Kaul Pediatric Research Institute. G207 was provided by Treovir, LLC.
Friedman is supported, in part, by contracts between UAB and Eli Lilly and Co. and Pfizer. Markert and Whitley have financial interests in Treovir, LLC, which provided G207 for the trial.
Your home should be a safe place for your family, but there are actually many hidden dangers. Our homes are filled with poisonous substances. Knowing the dangers and how to prevent them can keep kids safe. Ann Slattery is the director of the Alabama Poison Information Center at Children’s of Alabama. She says parents and grandparents should do their part to “Prepare, Prevent, and Protect” kids against accidental poisoning.
PREPARE Prepare now for the possible event of poisoning. Slattery recommends saving the toll free number for the Alabama Poison Information Center in your phone to keep it close at hand at all times. The number is 1-800-222-1222. Also, she recommends every home have a carbon monoxide detector, and that adults should prepare a list of all medications. “For adults we say have a list of your everyday medications available in case you have to call the poison center,” she said.
PREVENT Act now to prevent the risk of poisoning. Store all cleaning products up and out of reach of children. Slattery also recommends storing prescription medicine in lock boxes. “Make sure you have child resistant closures on your medications,” she said. “Remember there is no such thing as child proof.” Slattery advises to remember this risk when visitors are in the home. You never know what guests may have in their bags, so store purses and suitcases out of reach or behind locked doors and away from children.
PROTECT In the unfortunate event that an exposure does occur, call the Alabama Poison Information Center immediately at 1-800-222-1222. Slattery advises that if the individual is unconscious, having trouble breathing or experiencing a seizure to instead call 911 immediately.
By taking the proper precautions now, you can help keep children safe from the risk of poisoning. But if an accident does happen, be prepared to act quickly in the event of an emergency.